Visual and optical performance and quality of life after implantation of posterior chamber phakic intraocular lens

Purpose To evaluate visual, optical, and quality of life (QoL) outcomes and intercorrelations after bilateral implantation of posterior chamber phakic intraocular lenses. Methods Twenty eyes with high to moderate myopia of 10 patients that underwent PRL implantation (Phakic Refractive Lens, Carl Zeiss Meditec AG) were examined. Refraction, visual acuity, photopic and low mesopic contrast sensitivity (CS) with and without glare, ocular aberrations, as well as QoL outcomes (National Eye Institute Refractive Error Quality of Life Instrument-42, NEI RQL-42) were evaluated at 12 months postoperatively. Results Significant improvement in uncorrected (UDVA) and best-corrected distance (CDVA) visual acuities were found postoperatively (p < 0.01), with significant reduction in spherical equivalent (p < 0.01). Low mesopic CS without glare was significantly better than measurements with glare for 1.5, 3, and 6 cycles/degree (p < 0.01). No significant correlations between higher order root mean square (RMS) with CDVA (r = −0.26, p = 0.27) and CS (r ≤ 0.45, p ≥ 0.05) were found. Postoperative binocular photopic CS for 12 cycles/degree and 18 cycles/degree correlated significantly with several RQL-42 scales. Glare index correlated significantly with CS measures and scotopic pupil size (r = −0.551, p = 0.04), but not with higher order RMS (r = −0.02, p = 0.94). Postoperative higher order RMS, postoperative primary coma and postoperative spherical aberration was significant higher for 5-mm pupil diameter (p < 0.01) compared with controls. Conclusions Correction of moderate to high myopia by means of PRL implantation had a positive impact on CS and QoL. The aberrometric increase induced by the surgery does not seem to limit CS and QoL. However, perception of glare is still a relevant disturbance in some cases possibly related to the limitation of the optical zone of the PRL.

Smart Sentinel: Monitoring and Prevention System in the Smart Cities

Today, faced with the constant rise of the Smart cities around the world, there is an exponential increase of the use and deployment of information technologies in the cities. The intensive use of Information Technology (IT) in these ecosystems facilitates and improves the quality of life of citizens, but in these digital communities coexist individuals whose health is affected developing or increasing diseases such as electromagnetic hypersensitivity. In this paper we present a monitoring, detection and prevention system to help this group, through which it is reported the rates of electromagnetic radiation in certain areas, based on the information that the own Smart City gives us. This work provides a perfect platform for the generation of predictive models for detection of future states of risk for humans.

Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach

This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels. We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.

Paleogene-Aquitanian Tectonic Breakup in the Eastern External Betic Zone (Alicante, SE Spain)

Six Paleogene-Aquitanian successions have been reconstructed in the Alicante area (eastern External Betic Zone). The lithofacies association evidences “catastrophic” syn-sedimentary tectonic processes consisting of slumps, mega-olisthostromes, “pillow-beds” and turbiditic deposits. This kind of sedimentation is related to unconformity surfaces delimiting sequence and para-sequence cycles in the stratigraphic record. The data compiled have enabled the reconstruction of the Paleogene-Aquitanian paleogeographic and geodynamic evolution of this sector of the External Betics. During the Eocene the sedimentary basin is interpreted as a narrow trough affected by (growth) folding related to blind thrust faulting with a source area from the north-western margin, while the southeastern margin remained inactive. During the Oligocene-Aquitanian, the sourcing margin becames the southeastern margin of the basin affected by a catastrophic tectonic. The activity of the margins is identified from specific sediment source areas for the platform-slope-trough system and from tectofacies analysis. The southeastern South Iberian Margin is thought to be closer to the Internal Betic Zone, which was tectonically pushing towards the South Iberian Margin. This pushing could generate a lateral progressive elimination of subbetic paleogeographic domains in the eastern Betics. This geodynamic frame could explain the development of such “catastrophic” tectono-sedimentary processes during the Late Oligocene-Early Miocene.

Health-Sector Responses to Intimate Partner Violence Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

This study aims to analyze how middle-level health systems’ managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: “IPV is a complex issue that generates activism and/or resistance,” “The mandate to integrate a health sector response to IPV: a priority not always prioritized,” and “The Spanish health system: respectful with professionals’ autonomy and firmly biomedical.” The core category, “Developing diverse responses to IPV integration,” crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.