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Insomnio: Abordaje terapéutico desde Atención Primaria
Get PDFObjective:To establish the therapeutic approach that has been performed in patients diagnosed with insomnia in the town of Almazora (Castellón)
Method
It is a descriptive, observational, longitudinal and retrospective study.
Subjects are adult patients over 18 belonging the Health Center Pio XII and the Center for Almazora Health, both in the town of Almazora. Patients were diagnosed with insomnia (ICD 780.52 and 307.4) and/or presented a NANDA diagnosis associated to this problem (Impaired sleep pattern: 00095, Sleep Deprivation: 00096 and/or disorder sleep pattern: 00198) and included in the Computerized Medical Record (Abucasis). A stratified sample by sex, age and quota (312 patients) was randomly selected out of the Almazora Abucasis database.
Results:
The prevalence of insomnia was 5.5 % (95% CI 5.2 to 5.8). Only10% (95% CI 5.40 to 13.93) of the patients had received some non-drug treatment.
Conclusions:
According to the data, underutilization of non-pharmacological measuresis evident. Moreover, a very high percentage of patients receiveddrug therapy on the first day of diagnosis without previous attempt of non-drug treatment. Nursing care plays a fundamental role in the therapeutic approach of primary insomnia, since the first line of treatment is thenon-pharmacological therapy. Results suggest that an increased nursing role in combination with medical care would promote professional development and subsequently would improve the treatment of patients presenting this disease.Objetivo: Conocer el abordaje terapéutico que se ha realizado en los pacientes diagnosticados de insomnio en la población de Almazora (Castellón)
Método:
Estudio descriptivo-observacional, longitudinal y retrospectivo.
Los sujetos son pacientes de 18 años y más pertenecientes al Centro de Salud Pio XII y al Centro de Salud Almazora, ambos de la localidad de Almazora,diagnosticados de insomnio (CIE 780.52 y 307.4) y/o que presentan un diagnóstico NANDA relacionado con este problema (Deterioro del patrón del sueño: 00095, Deprivación del sueño: 00096 y/o Trastorno del patrón del sueño: 00198) e incluidos en la Historia Clínica Informatizada (Abucasis). Tras tener el listado de todos los pacientes de Almazora que presentan estos diagnósticos en Abucasis, hemos extraído una muestra aleatoria estratificada según el sexo, edad y cupo:312 pacientes.
Resultados:La prevalencia de insomnio ha sido de 5,5% (IC 95%: 5,2-5,8).Únicamente el 10% (IC 95%: 5,40-13,93) habían recibido alguna intervención de tratamiento no farmacológico
Conclusiones:
Con los datos obtenidos se evidencia la infrautilización de las medidas no farmacológicas, así como un porcentaje muy elevado de pacientes que reciben tratamiento farmacológico el primer día del diagnóstico en ausencia de estas medidas. En el abordaje terapéutico del insomnio primario tiene un papel fundamental la enfermera ya que la primera línea de tratamiento son las intervenciones no farmacológicas. La implicación del personal de enfermería en el tratamiento del insomnio, junto con el médico favorecerá su crecimiento y desarrollo profesional, y con ello mejoraremos el tratamiento dado a los pacientes que se diagnostican con este problema
Cuidado tópico del cordón umbilical: Una revisión de la evidencia
Get PDFObjectives: To review the available evidence on the effectiveness of topical treatments (Chlorhexidine and Alcohol 70º) in newborns versus the dry core care to prevent infection of the umbilical cord.
Methods: A systematic review of randomized clinical trials published in the last 5 years (2011-2015) addressing the topical treatment of umbilical cord in healthy newborn of any gestational age in developed countries and non-hospital environments was performed. The research was conducted in Spanish and English.
Results: 118 records that are girded to 8 appointments after reading the title and abstract were found. Five of them were included in the study.
Conclusions: The available evidence shows no significant differences in onfalitis or signs of umbilical cord infection. Thus making the cure clean and dry cord does not pose a risk of increased onfalitis in the newborn. Antiseptics (chlorhexidine and alcohol 70º) increase the decay time of the cord.Objetivo: Evaluar la evidencia disponible sobre la efectividad de tratamientos tópicos (Clorhexidina y Alcohol de 70º) en los recién nacidos frente a la cura limpia y seca para prevenir la infección del cordón umbilical.
Método: Se realizó una revisión de la literatura de ensayos clínicos aleatorios publicados en los últimos 5 años (2011-2015) que abordan el tratamiento tópico del cordón umbilical en el recién nacido sano de cualquier edad gestacional, en países desarrollados y ambientes no hospitalarios. La búsqueda se realizó en español e inglés.
Resultados: Se encontraron 118 registros que se ciñeron a 8 citas tras la lectura del título y resumen. De ellos se incluyeron 5 en el estudio.
Conclusiones: La evidencia disponible no arroja diferencias significativas en cuanto a onfalitis o signos de infección del cordón umbilical se refiere. Por tanto, la realización de la cura limpia y seca del cordón umbilical no supone un riesgo de aumento de onfalitis en el recién nacido. Los antisépticos (clorhexidina y alcohol de 70º) aumentan el tiempo de caída del cordón
An extremely sensitive nested PCR-RFLP mitochondrial marker for detection and identification of salmonids in eDNA from water samples
Get PDFBackground. Salmonids are native from the North Hemisphere but have been
introduced for aquaculture and sport fishing in the South Hemisphere and inhabit
most rivers and lakes in temperate and cold regions worldwide. Five species are included
in the Global Invasive Species Database: rainbow trout Oncorhynchus mykiss, Atlantic
salmon Salmo salar, brown trout Salmo trutta, brook trout Salvelinus fontinalis, and
lake trout Salvelinus namaycush. In contrast, other salmonids are endangered in their
native settings.
Methods. Here we have developed a method to identify salmonid species directly from
water samples, focusing on the Iberian Peninsula as a case study. We have designed
nested Salmonidae-specific primers within the 16S rDNA region. From these primers
and a PCR-RFLP procedure the target species can be unequivocally identified from
DNA extracted from water samples.
Results. The method was validated in aquarium experiments and in the field with water
from watersheds with known salmonid populations. Finally, the method was applied
to obtain a global view of the Salmonidae community in Nalón River (north coast of
Spain).
Discussion. This new powerful, very sensitive (identifying the species down to 10 pg
DNA/ml water) and economical tool can be applied for monitoring the presence of
salmonids in a variety of situations, from checking upstream colonization after removal
of river barriers to monitoring potential escapes from fish farms
Sesiones clínicas de enfermería en Centros de Salud docentes acreditados para la formación de EIR: Análisis y reflexiones.
Get PDFIntroduction: The legislation on health professions and specialities reflects the duty and right to continuous learning. One way to receive such training sessions are given at health centers and they are also collected in the different training plans and legislation speciality. The importance of this method for learning and the recent creation of the specialty on Family and Community Nursing motivated an analysis sessions. They were teach at nursing schools accredited for this specialty in Asturias during years 2014-2015.
Objectives: To analyze sessions taught in accredited nursing schools and to detect problems for implementation and seek possible improvements and / or solutions.
Methodology: The study consists of two parts according to each of the objectives. A first part, with a retrospective study to analyze and classify the sessions. And a second part, using qualitative methodology according to a nominal group technique for detection of problems and improvement proposals.
Results: A total of 139 sessions were held. They were classified according to the subject (6 groups) and the professionals who taught (nurse / a: 53 sessions, Nurse Internal Resident (EIR): 78, or both: 6). At the nominal organized groups, the different ideas generated were prioritized. Limited number of sessions, absence of some issues, lack of time or training to teach them and to perform searching were highlighted. As future approach we suggest the following: organizational improvements, assign responsible for teaching in each center, and the collaboration between health centers for training literature search and communication.
Conclusion: The development and delivery of nursing sessions are collected as duty and right to health legislation. The drawbacks found in this study make necessary to continue a path with improvements that increase the scientific and technical quality. It is important that sessions are taught in schools as they improve the knowledge level of the group and increase the quality of health care, therefore, deemed necessary staff training to perform and allocate time to develop them. A good planning, recording and broadcasting of the sessions is needed to share knowledge and to avoid duplication.Introducción: La legislación sobre las profesiones y especialidades sanitarias recoge la obligación y el derecho a la formación continuada. Una forma de recibir dicha formación son las sesiones impartidas en los centros sanitarios, recogidas en los diferentes planes formativos y legislación de las especialidades. La importancia de este método de aprendizaje y la reciente creación de la especialidad de Enfermería Familiar y Comunitaria, impulsan la realización de un análisis de las sesiones clínicas de enfermería impartidas en los centros de salud de Atención Primaria docentes acreditados para esta especialidad Objetivo: Analizar las sesiones de enfermería impartidas en los centros de salud docentes acreditados para realizar la especialidad de Enfermería Familiar y Comunitaria en Asturias durante los años 2014 y 2015. Detectar problemas para su realización y buscar posibles mejoras y/o soluciones.
Metodología: El estudio consta de dos partes, una primera parte descriptiva para analizar y clasificar las sesiones, y una segunda utilizando metodología cualitativa mediante la técnica del grupo nominal, para detección de problemas y propuestas de mejora.
Resultados: Se impartieron un total de 139 sesiones. Éstas se clasificaron en función de la temática en seis grupos y de acuerdo con los profesionales que las impartieron de la siguiente manera: enfermero/a: 53 sesiones; Enfermero Interno Residente (EIR): 78; Ambos: 6. En los grupos nominales organizados, se destaca el escaso número de sesiones realizadas, la ausencia de algunas temáticas, la escasez de tiempo y de formación de los profesionales. Como propuestas de mejora, se sugiere una mayor organización, asignar un responsable de docencia en cada centro, compartir las sesiones entre los centros de salud y fomentar la formación en búsqueda bibliográfica y comunicación.
Conclusión: Las dificultades encontradas en la elaboración e impartición de las sesiones de enfermería y el escaso número de éstas, hacen necesario continuar una trayectoria con mejoras que aumenten la calidad científico-técnica. Las sesiones, en general son escasas y la calidad y organización de éstas mejorable. Por ello sería necesaria la formación del personal para poder realizarlas, así como asignar tiempo para poder elaborarlas e impartirlas. Se precisa una buena planificación, registro y difusión de las sesiones, para compartir conocimientos y evitar duplicidades
Guía ampliada para la recomendación de activos ("prescripción social") en el sistema sanitario
Get PDFGuía desarrollada en la que se justifica y explica el proceso de recomendación de activos y recursos de salud en la comunidad o municipio desde la consulta médica
Caterpillar seed predators mediate shifts in selection on flowering phenology in their host plant
Get PDFVariation in selection among populations and years has important implications for evolutionary trajectories of populations. Yet, the agents of selection causing this variation have rarely been identified. Selection on the time of reproduction within a season in plants might differ both among populations and among years, and selection can be mediated by both mutualists and antagonists. We investigated if differences in the direction of phenotypic selection on flowering phenology among 20 populations of Gentiana pneumonanthe during 2 yr were related to the presence of the butterfly seed predator Phengaris alcon, and if butterfly incidence was associated with the abundance of the butterfly's second host, Myrmica ants. In plant populations without the butterfly, phenotypic selection favored earlier flowering. In populations where the butterfly was present, caterpillars preferentially attacked early-flowering individuals, shifting the direction of selection to favoring later flowering. Butterfly incidence in plant populations increased with ant abundance. Our results demonstrate that antagonistic interactions can shift the direction of selection on flowering phenology, and suggest that such shifts might be associated with differences in the community context.Swedish Research Council
FICYT
Gobierno del Principado de Asturias
Marie Curie-Cofund Action