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Intervenciones innovadoras en la gestión farmacológica de los adultos mayores
No full textEsta tesis doctoral examina la gestión de la polifarmacia en adultos mayores, con un
enfoque en el ámbito ambulatorio y en personas que viven en la comunidad. A través
de una combinación de revisiones sistemáticas, estudios observacionales e innovaciones
educativas, aborda los retos clínicos y educativos que plantea la polifarmacia en esta
población. La investigación destaca el papel fundamental de los enfoques
multidisciplinares, incluyendo la valoración geriátrica integral (VGI), en la optimización
de los regímenes de medicación, la reducción de problemas relacionados con los
medicamentos y la mejora de los resultados en pacientes, como su estado funcional.
Estas estrategias se evalúan en entornos clínicos reales, ofreciendo información sobre
su viabilidad e impacto.
Además, la tesis explora estrategias educativas para abordar brechas críticas en la
formación sanitaria. El desarrollo y validación de Optipharm, una plataforma de
aprendizaje gamificado, ejemplifica cómo las herramientas innovadoras pueden
mejorar la preparación de los profesionales de la salud para gestionar la complejidad del
manejo farmacológico. En conjunto, estos estudios proporcionan un marco para
integrar intervenciones basadas en evidencia con recursos educativos avanzados,
mejorando la calidad de la atención a los adultos mayores y fomentando la colaboración
interdisciplinaria y la innovación en la educación sanitaria.This doctoral thesis examines polypharmacy management in older adults, with a focus
on outpatient settings and community-dwelling individuals. Through a combination of
systematic reviews, observational studies, and educational innovations, this study
addressed the clinical and educational challenges posed by polypharmacy in this
population. The research highlights the pivotal role of multidisciplinary approaches,
including comprehensive geriatric assessment (CGA), in optimizing medication
regimens, reducing medication-related problems, and improving patient outcomes such
as functional status. These approaches have been evaluated in real-world clinical
settings, offering insights into their feasibility and impact.
In addition, this thesis explores educational strategies to bridge critical gaps in
healthcare training. The development and validation of OPTIPHARM, a gamified elearning
platform, exemplify how innovative tools can enhance the preparation of
healthcare professionals to address complex medication management. Collectively,
these studies provide a framework for integrating evidence-based interventions and
cutting-edge educational resources to improve care quality for older adults while
fostering interdisciplinary collaboration and innovation in health education.This thesis was conducted within the context of the Optimage project ("Opter pour la
Prévention Transpyrénéenne de la Iatrogénie Médicamenteuse chez la personne
AGEe"), funded by INTERREG-POCTEFA.Programa de Doctorado en Ciencias de la Salud (RD 99/2011)Osasun Zientzietako Doktoretza Programa (ED 99/2011
Backtesting a long-short HML strategy in the IBEX 35 Energy Sector (2021 - 2025)
No full textEn este trabajo se propone analizar si es posible conseguir rendimientos positivos en contextos de alta inestabilidad utilizando una estrategia Long short basada en el factor de riesgo Book-to-Market del modelo Trifactorial de Fama y French ( 1993). Para realizar en análisis se construyó una cartera con ocho empresas del sector energético dentro del IBEX 35 de las cuales se realizaban decisiones semestrales desde enero de 2021 hasta junio de
2024. Cada seis meses se tomaban posiciones largas en las acciones con mayor exposición al riesgo HML y posiciones cortas en las acciones con menor exposición. Tras los cuatros años, la estrategia obtuvo una rentabilidad acumulada de 36.72% superando tanto en retomo absoluto como ajustado por riesgo a una inversión pasiva en los mismos activos.
Incluso en años desfavorables para el sector como 2022 y 2024, la estrategia fue capaz de generar retornos positivos al centrarse en diferencias relativas de valoración. Los resultados corroboran la eficacia de las estrategias activas basadas en factores de riesgo para seleccionar activos, especialmente en mercados turbulentos. El trabajo también incluye un análisis estadístico de significancia y un ajuste con el modelo de Fama y French para medir la ejecución de alfa, para lo que el trabajo concluye que gran parte de
la rentabilidad se explica por su exposición al factor valor.This paper aims to analyze whether it is possible to achieve positive retums in highly unstable contexts using a long-short strategy based on the book-to-market risk factor of Fama and French's (1993) three-factor model.
To carry out the analysis, a portfolio was constructed with eight companies from the energy sector within the IBEX 35, for which semi-annual decisions were made from January 2021 to June 2024. Every six months, long positions were taken in stocks with the highest exposure to HML risk and short positions in stocks with the lowest exposure.
After four years, the strategy achieved a cumulative performance of 36.72%,
outperforrning both the absolute retum and the risk-adjusted retum of a passive investment in the same assets. Even in unfavorable years for the sector, such as 2022 and 2024, the strategy was able to generate positive retums by focusing on relative valuation differences. The results corroborate the effectiveness of active strategies based on risk factors for selecting assets, especially in turbulent markets The paper also includes a statistical analysis using the Fama-French model showing that the overall performance of the portfolio was largely driven by its exposure to the value premium.Graduado o Graduada en Administración y Dirección de Empresas por la Universidad Pública de Navarra (Programa Internacional)Enpresen Administrazio eta Zuzendaritzan Graduatua Nafarroako Unibertsitate Publikoan (Nazioarteko Programa
Assessment of anticancer and antimicrobial potential of bioactive metabolites and optimization of culture conditions of pseudomonas aurantiaca PB-St2 for high yields
No full textThe following study aimed to characterize the biological potential of the purified compounds of Pseudomonas aurantiaca PB-St2. Optimization of temperature and incubation time of 32oC and 72 h yielded the highest crude extract weight and optical density of bacterial culture. HPLC analysis of the crude metabolite extract (purified using gravitational column chromatography) showed three fractions named as PC1, PC2, and PC3. HPLC-purified fractions were subjected to LC-MS/MS analysis and the data was compared using reference library. Fraction PC1 was identified as mupirocin, PC2 as phenazine-1-carboxylic acid (PCA), and PC3 as the mixture of three compounds including pyoluteorin, PCA and 2-hydroxyphenazine (2-OH-phz). Fungicidal potential of the purified compounds was assessed against phytopathogens including Fusarium equiseti, Fusarium incarnatum, Alternaria alternata, and Colletotrichum falcatum. Fraction PC3 showed the highest fungicidal activity of ~89%, whereas, the least antifungal activity (~27%) was noted for mupirocin. Antibacterial activity of the purified compounds against Gram-positive pathogen Bacillus cereus, and Gram-negative pathogens Pseudomonas aeruginosa, Salmonella enterica, and Klebsiella oxytoca was also assessed. Fraction PC3 demonstrated the highest antibacterial activity against B. cereus and P. aeruginosa showing 1.8 cm, and 0.9 cm zones of inhibition, respectively. Against K. oxytoca and S. enterica, the antibacterial activity of PB-St2 crude extract was slightly higher than the fraction PC3. The fraction PC3 also demonstrated the highest IC50 against HepG-2 and SF767 cancer cell lines at 25 μg and 20 μg concentrations, respectively. The multifaceted attributes of P. aurantiaca PB-St2 make it an ideal candidate for agricultural and pharmacological applications.Authors would like to acknowledge Alexander Von Humbolt (AvH) Foundation, Bonn-Bad Godesberg (Federal Republic of Germany) for providing equipment grant to Dr. Samina Mehnaz. Mahnoor Zameer was supported by a PhD fellowship by Higher Education Commission (HEC) of Pakistan
The effects of monetary incentives tied to corporate social responsibility for executives
No full textEste trabajo analiza si vincular la remuneración de los ejecutivos a objetivos de
Responsabilidad Social Corporativa (RSC) impacta en el desempeño corporativo en
dimensiones financieras, medioambientales y sociales. A partir de 4.404 observaciones
de empresas europeas entre 2014 y 2021, se evalúa si los incentivos ligados a la RSC
generan mejoras reales en sostenibilidad o si responden principalmente a fines
simbólicos. Mediante análisis descriptivo, pruebas ty modelos de regresión lineal
múltiple, se estudia la relación entre la contratación RSC y los desempeños de las
empresas en los tres ámbitos mencionados. Los resultados no muestran efectos
significativos sobre el rendimiento financiero, pero sí una relación clara y positiva con
las dimensiones ambientales y sociales. Esto sugiere que los incentivos basados en RSC
pueden ser herramientas eficaces de gobernanza para promover un comportamiento
empresarial sostenible.This paper examines whether linking executive compensation to Corporate Social
Responsibility (CSR) objectives affects corporate performance across financial,
environmental and social dimensions. Using a dataset of 4.404 observations from
European firms between 2014 and 2021, the study evaluates whether CSR-linked
incentives lead to measurable sustainability improvements or serve just as symbolic
commitments. Through descriptive analysis, t-tests and multiple linear regressions, the
research assesses the relationship between CSR contracting and firm performance in the
three dimensions mentioned. Results show no significant effect on financial performance,
but strong and positive associations with environmental and social dimensions. These
findings suggest that CSR-based incentives can serve as effective internal governance
tools to promote sustainable corporate behavior.Graduado o Graduada en Administración y Dirección de Empresas por la Universidad Pública de Navarra (Programa Internacional)Enpresen Administrazio eta Zuzendaritzan Graduatua Nafarroako Unibertsitate Publikoan (Nazioarteko Programa
Balance competitivo en el rugby europeo. Diferencias en cuanto al género
No full textEl balance competitivo es una de las cuestiones más importantes en la competición de
deportes de equipo, ya que garantiza la emoción e imprevisibilidad en las competiciones,
lo que incrementa el interés del público y asegura la sostenibilidad económica de las ligas.
Este Trabajo de Fin de Grado tiene como objetivo principal analizar el nivel de balance
competitivo en el rugby europeo, comparando ligas masculinas y femeninas de cinco
países: Inglaterra, Irlanda, Escocia, Francia y España. El estudio abarca un periodo de
diez temporadas (2014/2015 - 2023/2024), con el fin de evaluar la evolución del
equilibrio competitivo y determinar si existen diferencias significativas en función del
género. Además, se explora una tercera línea de investigación: la relación entre el tamaño
poblacional de la localidad de cada equipo y su rendimiento deportivo.
La metodología empleada combina distintos indicadores de análisis, como el índice de
Gini (para medir la desigualdad en la distribución de puntos), el índice de HerfindahlHirschman normalizado (HHI*), y medidas de dominancia basadas en el número de
equipos campeones y clasificados entre los tres primeros puestos. También se aplican los
coeficientes de correlación y determinación (R y R2) para explorar la influencia de
la población en el desempeño deportivo.Competitive balance is one of the most important issues in team sports competition, as it
guarantees excitement and unpredictability in competitions, which increases public
interest and ensures the economic sustainability of the leagues. The main objective of this
undergraduate dissertation is to analyze the level of competitive balance in European
rugby, comparing men's and women's leagues in five countries: England, Ireland,
Scotland, France and Spain. The study covers a period of ten seasons (2014/2015 -
2023/2024), in order to assess the evolution of competitive balance and determine
whether there are significant differences according to gender. In addition, a third line of
research is explored: the relationship between the population size of each team's locality
and its sporting performance.
The methodology employed combines different analysis indicators, such as the Gini index
(to measure inequality in the distribution of points), the normalized HerfindahlHirschman index (HHI*), and measures of dominance based on the number of champion
and top-three ranked teams. Correlation and determination coefficients (R and R2) are
also applied to explore the influence of population on sport performance.Graduado o Graduada en Administración y Dirección de Empresas por la Universidad Pública de NavarraEnpresen Administrazio eta Zuzendaritzan Graduatua Nafarroako Unibertsitate Publikoa
Tratamientos para la dermatitis atópica en adultos: una revisión sistemática
No full textIntroducción: la dermatitis atópica es un trastorno cutáneo inflamatorio crónico muy frecuente. El
tratamiento clásico está basado en la combinación de corticoides tópicos, inhibidores
de la calcineurina tópicos y, en menor medida, agentes inmunosupresores.
La dermatitis atópica se produce por la conjunción de diversos factores que
desencadenan la disfunción de la barrera cutánea y una desregulación inmunitaria,
que involucra principalmente la vía inflamatoria de las citocinas producidas por
linfocitos Th2.
En los últimos años se han desarrollado numerosos fármacos que actúan
directamente en distintos puntos de esa vía inflamatoria, ofreciendo un tratamiento
dirigido adaptado a la enfermedad. Las principales familias farmacológicas
desarrolladas comprenden los tratamientos biológicos, inhibidores de la JAK e
inhibidores de PD4.
Objetivo: revisar las opciones terapéuticas existentes para la dermatitis atópica en adultos,
evaluando su utilidad práctica y eficacia en el manejo de los síntomas.
Metodología: revisión narrativa sistemática en bases de datos PubMed y Scopus de artículos en
inglés publicados desde 2020 hasta la actualidad.
Resultados: se incluyeron 28 artículos, de los cuales se obtuvo información sobre la eficacia y
seguridad de los tratamientos clásicos y de las nuevas terapias, así como opciones no
farmacológicas.
Conclusiones: las nuevas terapias dirigidas para la dermatitis atópica han demostrado su eficacia y
seguridad en el tratamiento de la DA en adultos. Los corticoides e inhibidores de la
calcineurina están desplazándose hacia un papel secundario en el manejo de la de
DA, manteniendo su indicación en casos leves, en brotes y como posible
complemento a tratamientos dirigidos. Las cremas emolientes se mantienen como
uno de los pilares fundamentales en el manejo de la DA, pudiendo asociarse tanto a
los tratamientos dirigidos como a los clásicos.Sarrera: dermatitis atopikoa larruazaleko nahasmendu inflamatorio kroniko oso ohikoa da.
Tratamendu klasikoa kortikoide topikoen, kaltzineurinaren inhibitzaile topikoen eta,
neurri txikiagoan, agente immunosupresoreen konbinazioan oinarritzen da.
Dermatitis atopikoa larruazaleko hesiaren disfuntzioa eta desarautze immunitarioa
eragiten duten hainbat faktoreren batuketaren ondorioz sortzen da, eta desarautze
horrek, nagusiki, Th2 linfozitoek sortutako zitokinen hantura-bidea inplikatzen du.
Azken urteotan, hantura-bide horren hainbat puntutan zuzenean eragiten duten
farmako ugari garatu dira, eta gaixotasunari egokitutako tratamendua eskaintzen
dute. Garatutako familia farmakologiko nagusiek tratamendu biologikoak, JAKaren
inhibitzaileak eta PD4aren inhibitzaileak barne hartzen dituzte.
Helburua: helduen dermatitis atopikorako dauden aukera terapeutikoak berrikustea, eta haien
erabilgarritasun praktikoa eta sintomak maneiatzeko eraginkortasuna ebaluatzea.
Metodologia:
Ingelesezko artikuluen PubMed eta Scopus datu-baseen berrikuspen narratibo
sistematikoa 2020tik gaur egunera arte.
iii
Emaitzak: 28 artikulu sartu ziren, eta horietatik tratamendu klasikoen eta terapia berrien
eraginkortasunari eta segurtasunari buruzko informazioa lortu zen, baita aukera ezfarmakologikoak ere.
Ondorioak: dermatitis atopikorako terapia berriek erakutsi dute eraginkorrak eta seguruak direla
helduen DAren tratamenduan. Kaltzineurinaren kortikoideak eta inhibitzaileak
bigarren mailako funtzioa betetzen ari dira DAren erabileran, eta haien indikazioari
eusten diote kasu arinetan, agerraldietan eta zuzendutako tratamenduen osagarri
gisa. Krema emolienteak funtsezko oinarrietako bat dira DAren erabileran, eta
tratamendu gidatuekin nahiz klasikoekin lotu daitezke.Introduction: atopic dermatitis is a very common chronic inflammatory skin disorder. Traditional
treatment is based on a combination of topical corticosteroids, topical calcineurin
inhibitors, and, to a lesser extent, immunosuppressive agents.
Atopic dermatitis is caused by the combination of various factors, causing skin barrier
dysfunction and immune dysregulation, primarily involving the inflammatory
pathway of Th2 cytokine -producing lymphocytes.
In recent years, many have been developed that act directly on different points of
this inflammatory pathway, offering targeted treatment tailored to the disease. The
main pharmacological families developed include biologic treatments, JAK inhibitors,
and PD4 inhibitors.
Endpoint: review the existing therapeutic options for atopic dermatitis in adults, evaluating
their practical utility and efficacy in symptom management.
Methods: systematic narrative review of articles published in English from 2020 to the present
in PubMed and Scopus databases.
Results: twenty-eight articles were included, from which information was obtained on the
efficacy and safety of traditional and new therapies, as well as non-pharmacological
treatment options.
Conclusions: new targeted therapies for atopic dermatitis have demonstrated their efficacy and
safety in the treatment of AD in adults. Corticosteroids and calcineurin inhibitors have
taken a secondary role in the management of AD, maintaining their indication in mild
cases, flares, and as a possible complement to targeted treatments. Emollient creams
remain one of the fundamental pillars in the management of AD and can be combined
with both targeted and traditional treatments.Graduado o Graduada en Medicina por la Universidad Pública de NavarraMedikuntzan graduatua Nafarroako Unibertsitate Publikoa
A lab project for entomophagy education
No full textOpen Educational Resource (OER) used in the "Entomophagy" course, available in two complementary formats:
- HTML version ( compressed in .zip): download the .zip file, extract the files, and open the index.html directly in any web browser without the need to install additional programs. This format is suitable for quick reference and online or local use.
- eXeLearning Project ( .elp): enables content editing and customization using the eXeLearning software. Ideal for educators who wish to adapt the material to their specific teaching needs.This Open Educational Resource (OER) introduces students to the fundamentals of edible insect production and processing for human consumpltion through a series of hands-on laboratory sessions focused on Tenebrio molitor (mealworms)—one of the most widely farmed edible insects and the first authorized as food in the European Union. In response to the FAO’s call to integrate edible insects into formal education, this course combines sustainable food systems, entomology, and food science into an engaging, low-cost practical experience.
Over the course of eight weekly labs, students cultivate mealworms across all life stages—larvae, pupae, adults, and eggs—while collecting data on key biological parameters such as survival, fecundity, fertility, developmental rate, and feed conversion efficiency. These activities are complemented by a series of food processing exercises that emphasize microbiological safety, moisture content, sensory quality, and consumer acceptability. Students learn safe handling techniques, process insects into food ingredients, and explore their use in cereal-based snacks through controlled recipes and free-form culinary creations.
Each lab session is fully documented with background information, required materials, and detailed step-by-step protocols. Worksheets and evaluation tools support student learning and facilitate classroom implementation. No previous lab experience is required, and materials are selected for their affordability and accessibility.
By the end of the course, students gain not only technical skills in insect rearing and processing, but also a broader understanding of the role edible insects can play in sustainable food systems. This OER is ideal for programs in food science, agronomy, biology, or environmental studies seeking to explore the future of food
Eficacia de los biomarcadores sanguíneos en el diagnóstico y pronóstico del traumatismo craneoencefálico leve
No full textIntroducción: el traumatismo craneoencefálico leve (TCE leve) representa una de las
causas más frecuentes de visitas al Servicio de Urgencias y, aunque la mayoría de
casos no presenten lesiones cerebrales relevantes y evolucionen correctamente, un
pequeño porcentaje puede desarrollar complicaciones. En este contexto, surgen los
biomarcadores sanguíneos como herramienta prometedora, tanto diagnóstica como
pronóstica.
Objetivos: evaluar la eficacia de biomarcadores sanguíneos de lesión cerebral aguda
en pacientes con TCE leves.
Metodología: revisión bibliográfica sistematizada según los parámetros PRISMA, con
búsqueda en las bases de datos Pubmed y Scopus, incluyendo artículos publicados a
partir de 2020. Se analizaron biomarcadores como GFAP, UCH-L1, S100B o NFL,
evaluando su sensibilidad y especificidad.
Resultados: se incluyeron 14 artículos, en los que se analizó la eficacia diagnóstica y
pronóstica de los biomarcadores evaluados, destacando la elevada sensibilidad de
GFAP, UCH-L1 y S100B especialmente para detectar lesiones cerebrales, así como
NFL y tau para predecir una recuperación desfavorable.
Conclusiones: los biomarcadores han demostrado ser capaces de detectar lesiones
cerebrales agudas y predecir una evolución clínica desfavorable en pacientes con un
TCE leve, aumentando su eficacia con el uso combinado de estos. Sin embargo, son
necesarios estudios de investigación adicionales para su implementación clínica.Introduction: mild traumatic brain injury (mTBI) is one of the most common causes
of emergency department visits. Although most cases do not result in significant
brain damage and show favorable outcomes, a small percentage may develop
complications. In this context, blood-based biomarkers have emerged as a promising
tool for both diagnostic and prognostic purposes.
Objective: to evaluate the efficacy of blood biomarkers of acute brain injury in
patients with mild TBI.
Methodology: a systematic literature review was conducted according to PRISMA
guidelines. Searches were performed in Pubmed and Scopus databases, including
articles published from 2020 onwards. Biomarkers such as GFAP, UCH-L1, S100B and
NFL were analyzed in terms of sensitivity and specificity.
Results: 14 articles were included, analyzing the diagnostic and prognostic value of
the selected biomarkers. GFAP, UCH-L1 and S100B stood out for their high sensitivity
in detecting brain injuries, while NFL and tau showed utility in predicting poor
recovery.
Conclusion: blood biomarkers have proven effective in identifying acute brain injury
and predicting unfavorable clinical outcomes in patients with mild TBI, especially
when used in combination. However, further research is needed to support clinical
implementation.Graduado o Graduada en Medicina por la Universidad Pública de NavarraMedikuntzan graduatua Nafarroako Unibertsitate Publikoa
Leveraged buyouts in Spain: organic growth or industry consolidation?
No full textPrivate equity controlled firms are often utilized as platforms for the consolidation of industries. Using a sample of Spanish firms acquired in leveraged buyouts, we argue that add-on acquisitions are distorting conclusions presented in the literature. For instance, Boucly et al. (2011), Bernstein et al. (2019), Battistin et al. (2017) and others associate buyouts, and specifically leveraged buyouts, with growth. We present a simple but novel approach to isolate organic growth and observe that depreciation is greater than capital expenditures. While Bansraj et al. (2022) documents that in Europe, organic sales growth is negative, and acquisitions mask this decline, we focus on investment. Our results show that industry consolidation is also masking a decline in economically important investment. We also study outcomes, comparing the bankruptcy rate in our sample to a propensity score matched set of control firms. We find that leveraged buyouts in Spain are accelerating industry consolidation without visible operating performance improvements or long-term value creation
Suicidal behaviours in people seeking treatment for substance use disorder
No full textLittle is known about the specific characteristics of suicidal behaviour in people receiving treatment for substance use disorder (SUD). The aim of this study was to describe the number and types of suicide attempts and the methods used by 215 patients with SUD, according to sex. A face to face interview (Columbia Scale Severity Rate) was conducted. Lifetime suicidal ideation was reported by 48.8 % (n = 105) of the patients, and lifetime suicide attempts by 28.4 % (n = 61). Forty-five patients reported actual suicide attempts (20.9 %), and overdose was the most common method used (52.5 %; n = 32). Women had more aborted attempts than men did. Most of the participants who attempted suicide made only one attempt (n = 34; 55.7 %). The projection of these figures is alarming. These results justify the need to integrate suicide prevention interventions into addiction treatment programmes.This study was partially supported by a grant (code GN2023/29) from the Department de Health of the Government of Navarre