Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia (Spain).

OBJECTIVES: Polypharmacy is one of the main management issues in public health policies because of its financial impact and the increasing number of people involved. The polymedicated population according to their demographic and therapeutic profile and the cost for the public healthcare system were characterised. DESIGN: Cross-sectional study. SETTING: Primary healthcare in Barcelona Health Region, Catalonia, Spain (5 105 551 inhabitants registered). PARTICIPANTS: All insured polymedicated patients. Polymedicated patients were those with a consumption of ≥16 drugs/month. MAIN OUTCOMES MEASURES: The study variables were related to age, gender and medication intake obtained from the 2008 census and records of prescriptions dispensed in pharmacies and charged to the public health system. RESULTS: There were 36 880 polymedicated patients (women: 64.2%; average age: 74.5±10.9 years). The total number of prescriptions billed in 2008 was 2 266 830 (2 272 920 total package units). The most polymedicated group (up to 40% of the total prescriptions) was patients between 75 and 84 years old. The average number of prescriptions billed monthly per patient was 32±2, with an average cost of 452.7±27.5. The total cost of those prescriptions corresponded to 2% of the drug expenditure in Catalonia. The groups N, C, A, R and M represented 71.4% of the total number of drug package units dispensed to polymedicated patients. Great variability was found between the medication profiles of men and women, and between age groups; greater discrepancies were found in paediatric patients (5-14 years) and the elderly (≥65 years). CONCLUSIONS: This study provides essential information to take steps towards rational drug use and a structured approach in the polymedicated population in primary healthcare.

Gestión de la actividad no presencial y autoevaluación de competencias = Management of student learning outside the classroom and the self-evaluation of competences

La asignatura troncal “Evaluación Psicológica” de los estudios de Psicología y delestudio de grado “Desarrollo humano en la sociedad de la información” de laUniversidad de Girona consta de 12 créditos según la Ley Orgánica de Universidades.Hasta el año académico 2004-05 el trabajo no presencial del alumno consistía en larealización de una evaluación psicológica que se entregaba por escrito a final de curso yde la cual el estudiante obtenía una calificación y revisión si se solicitaba. En el caminohacia el Espacio Europeo de Educación Superior, esta asignatura consta de 9 créditosque equivalen a un total de 255 horas de trabajo presencial y no presencial delestudiante. En los años académicos 2005-06 y 2006-07 se ha creado una guía de trabajopara la gestión de la actividad no presencial con el objetivo de alcanzar aprendizajes anivel de aplicación y solución de problemas/pensamiento crítico (Bloom, 1975)siguiendo las recomendaciones de la Agencia para la Calidad del Sistema Universitariode Cataluña (2005). La guía incorpora: los objetivos de aprendizaje, los criterios deevaluación, la descripción de las actividades, el cronograma semanal de trabajos paratodo el curso, la especificación de las tutorías programadas para la revisión de losdiversos pasos del proceso de evaluación psicológica y el uso del foro para elconocimiento, análisis y crítica constructiva de las evaluaciones realizadas por loscompañeros

Profile Following for Inspection of Underwater Structures

We present a seabed profile estimation and following method for close proximity inspection of 3D underwater structures using autonomous underwater vehicles (AUVs). The presented method is used to determine a path allowing the AUV to pass its sensors over all points of the target structure, which is known as coverage path planning. Our profile following method goes beyond traditional seabed following at a safe altitude and exploits hovering capabilities of recent AUV developments. A range sonar is used to incrementally construct a local probabilistic map representation of the environment and estimates of the local profile are obtained via linear regression. Two behavior-based controllers use these estimates to perform horizontal and vertical profile following. We build upon these tools to address coverage path planning for 3D underwater structures using a (potentially inaccurate) prior map and following cross-section profiles of the target structure. The feasibility of the proposed method is demonstrated using the GIRONA 500 AUV both in simulation using synthetic and real-world bathymetric data and in pool trials

A segmentation analysis and segments profile of budget air travelers

Many Spanish destinations are now considering low cost airlines (LCA) important for attracting tourists. However, there is little evidence on the characteristics travelers using low cost airlines and their flight preferences. Typical segmentation of air travelers are business versus leisure travelers and business versus tourist fares. The aim of this paper is to obtain a deeper understanding of the demand of LCA through a segmentation analysis, based on 808 foreign travelers who used Girona airport, that focuses on low cost travelers’ valuations of different flight attributes and trip related characteristics

The profile of general practitioners (GPs) who publish in selected family practice journals

Background: Providing support for research is one of the key issues in the ongoing attempts to improve Primary Care. However, when patient care takes up a significant part of a GP's time, conducting research is difficult. In this study we examine the working conditions and profile of GPs who publish in three leading medical journals and propose possible remedial policy actions. Findings: The authors of all articles published in 2006 and 2007 in three international Family Medicine journals - Annals of Family Medicine, Family Practice, and Journal of Family Practice - were contacted by E-mail. They were asked to complete a questionnaire investigating the following variables: availability of specific time for research, time devoted to research, number of patients attended, and university affiliation. Only GPs were included in the study. Three hundred and ten relevant articles published between 2006 and 2007 were identified and the authors contacted using a survey tool. 124 researchers responded to our questionnaire; 45% of respondents who were not GPs were excluded. On average GPs spent 2.52 days per week and 6.9 hours per day on patient care, seeing 45 patients per week. Seventy-five per cent of GPs had specific time assigned to research, on average 13 hours per week; 79% were affiliated to a university and 69% held teaching positions. Conclusions: Most GPs who publish original articles in leading journals have time specifically assigned to research as part of their normal working schedule. They see a relatively small number of patients. Improving the working conditions of family physicians who intend to investigate is likely to lead to better research results.

Forage preservation (grazing vs. hay) fed to ewes affects the fatty acid profile of milk and CPT1B gene expression in the sheep mammary gland

Background: Alterations in lipid metabolism occur when animals are exposed to different feeding systems. In the last few decades, the characterisation of genes involved in fat metabolism and technological advances have enabled the study of the effect of diet on the milk fatty acid (FA) profile in the mammary gland and aided in the elucidation of the mechanisms of the response to diet. The aim of this study was to evaluate the effect of different forage diets (grazing vs. hay) near the time of ewe parturition on the relationship between the fatty acid profile and gene expression in the mammary gland of the Churra Tensina sheep breed. Results: In this study, the forage type affected the C18:2 cis-9 trans-11 (CLA) and long-chain saturated fatty acid (LCFA) content, with higher percentages during grazing than during hay feeding. This may suggest that these FAs act as regulatory factors for the transcriptional control of the carnitine palmitoyltransferase 1B (CPT1B) gene, which was more highly expressed in the grazing group (GRE). The most highly expressed gene in the mammary gland at the fifth week of lactation is CAAT/ enhancer- binding protein beta (CEBPB), possibly due to its role in milk fat synthesis in the mammary gland. More stable housekeeping genes in the ovine mammary gland that would be appropriate for use in gene expression studies were ribosomal protein L19 (RPL19) and glyceraldehyde- 3- phosphate dehydrogenase (GAPDH). Conclusions: Small changes in diet, such as the forage preservation (grazing vs. hay), can affect the milk fatty acid profile and the expression of the CPT1B gene, which is associated with the oxidation of fatty acids. When compared to hay fed indoors, grazing fresh low mountain pastures stimulates the milk content of CLA and LCFA via mammary uptake. In this sense, LCFA in milk may be acting as a regulatory factor for transcriptional control of the CPT1B gene, which was more highly expressed in the grazing group.

La percepción de los estudiantes universitarios de Bellas Artes sobre sus dificultades de aprendizaje: el caso de las competencias de búsqueda y selección de información relevante

[spa]Identificar las dificultades halladas en el proceso de aprendizaje con la especial relación entre el esfuerzo y el logro experimentada por los estudiantes implica afrontar uno de los problemas fundamentales del aprendizaje. El presente artículo pretende abordar los aprendizajes vinculados a las competencias transversales de la búsqueda y selección de información desde el examen de la percepción de los estudiantes universitarios de arte en la realización de una carpeta de aprendizaje adaptada a la titulación y al perfil del estudiante. A partir de un enfoque cuantitativo, y mediante un estudio descriptivo transversal, se analizará la relación existente entre el esfuerzo realizado, los resultados de aprendizaje declarados y la relación entre ambas cuestiones -lo que a la postre define las dificultades- que manifiestan los estudiantes. [eng]This article aims to address the learning skills associated with the competence of searching and selecting information from the examination of the perceptions of art college students in the drawing up of a learning portfolio tailored to the degree and student profile. From a quantitative approach, and through a cross-sectional descriptive study, we will analyze the relationship between effort, stated learning outcomes and the relationship between these two issues what ultimately defines the difficulties which declare the students.

The effects of milk as a food matrix for polyphenols on the excretion profile of cocoa (-)-Epicatechin metabolites in healthy humans subjects

The effect of different food matrices on the metabolism and excretion of polyphenols is uncertain. The objective of the study was to evaluate the possible effect of milk on the excretion of (2)-epicatechin metabolites from cocoa powder after its ingestion with and without milk. Twenty-one volunteers received the following three test meals each in a randomised cross-over design with a 1-week interval between meals: (1) 250 ml whole milk as a control; (2) 40 g cocoa powder dissolved in 250 ml whole milk (CC-M); (3) 40 g cocoa powder dissolved in 250 ml water (CC-W). Urine was collected before consumption and during the 0-6, 6-12 and 12-24 h periods after consumption. (2)-Epicatechin metabolite excretion was measured using liquid chromatography-MS. One (2)-epicatechin glucuronide and three (2)-epicatechin sulfates were detected in urine excreted after the intake of the two cocoa beverages (CC-M and CC-W). The results show that milk does not significantly affect the total amount of metabolites excreted in urine. However, differences in metabolite excretion profiles were observed; there were changes in the glucuronide and sulfate excretion rates, and the sulfation position between the period of excretion and the matrix. The matrix in which polyphenols are consumed can affect their metabolism and excretion, and this may affect their biological activity. Thus, more studies are needed to evaluate the effect of these different metabolite profiles on the body.

Executive functions profile in extreme eating/weight conditions: from anorexia nervosa to obesity

Extreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC).

Gestión de la actividad no presencial y autoevaluación de competencias = Management of Student Learning Outside the Classroom and the Self-evaluation of Competences

Psychological Assessment is a core subject of Psychology studies, and of the university degree Human development, at the University of Girona and according to the University regulations, had 12 credits. Until the 2005-06 academic years, the student work conducted outside the classroom consisted of undertaking a psychological assessment that was written and handed in at the end of the course. From this the student obtained a qualification and a review if they applied for it In accordance with the European Credits for Higher Education, this subject was reduced to 9 credits, which is the equivalent of a total of 255 hours of in-class work and outside the classroom. In the 2006-07 academic year we created a guide to manage the student’s experiences outside the classroom, with the objective of encouraging the application of problem solving/critical thinking (Bloom, 1975), in line with the recommendations of the Catalonia Agency for University System Quality (2005). The guide includes: learning objectives, evaluation criterions, a description of activities, work week timetable for the whole course, programmed tutorials to review all steps of the psychological assessment process, and the use of a web-based virtual forum for the transfer of knowledge, analysis and constructive critiques of the assessment done by themselves and their colleagues

Striatal pre- and postsynaptic profile of adenosine A2A receptor antagonists

Striatal adenosine A2A receptors (A2ARs) are highly expressed in medium spiny neurons (MSNs) of the indirect efferent pathway, where they heteromerize with dopamine D2 receptors (D2Rs). A2ARs are also localized presynaptically in cortico-striatal glutamatergic terminals contacting MSNs of the direct efferent pathway, where they heteromerize with adenosine A1 receptors (A1Rs). It has been hypothesized that postsynaptic A2AR antagonists should be useful in Parkinson's disease, while presynaptic A2AR antagonists could be beneficial in dyskinetic disorders, such as Huntington's disease, obsessive-compulsive disorders and drug addiction. The aim or this work was to determine whether selective A2AR antagonists may be subdivided according to a preferential pre- versus postsynaptic mechanism of action. The potency at blocking the motor output and striatal glutamate release induced by cortical electrical stimulation and the potency at inducing locomotor activation were used as in vivo measures of pre- and postsynaptic activities, respectively. SCH-442416 and KW-6002 showed a significant preferential pre- and postsynaptic profile, respectively, while the other tested compounds (MSX-2, SCH-420814, ZM-241385 and SCH-58261) showed no clear preference. Radioligand-binding experiments were performed in cells expressing A2AR-D2R and A1R-A2AR heteromers to determine possible differences in the affinity of these compounds for different A2AR heteromers. Heteromerization played a key role in the presynaptic profile of SCH-442416, since it bound with much less affinity to A2AR when co-expressed with D2R than with A1R. KW-6002 showed the best relative affinity for A2AR co-expressed with D2R than co-expressed with A1R, which can at least partially explain the postsynaptic profile of this compound. Also, the in vitro pharmacological profile of MSX-2, SCH-420814, ZM-241385 and SCH-58261 was is in accordance with their mixed pre- and postsynaptic profile. On the basis of their preferential pre- versus postsynaptic actions, SCH-442416 and KW-6002 may be used as lead compounds to obtain more effective antidyskinetic and antiparkinsonian compounds, respectively.

University teacher competences in a virtual teaching/learning environment : analysis of a teacher training experience

This paper attempts to shed light on the competencies a teacher must have inorder to teach in online university environments. We will relate a teacher trainingexperience, which was designed taking into account the methodological criteriaestablished in line with previous theoretical principles. The main objective of ouranalysis is to identify the achievements and difficulties of a specific formativeexperience, with the ultimate goal of assessing the suitability of this conceptualmethodologicalframework for the design of formative proposals aiming to contribute tothe development of teacher competencies for virtual environments.

Assessment of research competences using e-portfolio

The challenges posed by the assessment of distance learning is a topic that requires, on the one hand, evolution with new trends and, on the other improving evaluative processes, to promote good practices. This demand becomes more imperative when we are dealing with a formativescenario based on distance assessment of competence-based learning.The Open University of Catalonia has begun to work with these formative tools, promoting new practices for online education. A very clear example of these educational practices is the assessment of research competences using the e-portfolio system. To meet this aim a profound and solid process has been developed over recent years, with the intention of making this tool an assessment alternative, and providing the opportunity to use it in a formative context. The objective is to study its strengths and limitations keeping in mind the final goal of offering the higher education community a validated assessment system.

Building a Social Education curriculum based on Professional Competences : the experience of University of Girona

This article describes the process of adapting Social Education studies to the European Higher Education Area undertaken by a team of the teaching staff at the University of Girona (Spain). The aim of the experience is to build a curriculum based on thecompetencies recognized as such by professionals in the field of social education in our region. The article specifies the development of the various phases, each involving the active participation of professionals and teaching staff from the universities. To conclude, main characteristics of the curriculum are highlighted

Competencias genéricas en la transición universitaria

The university should add to the scientific and technical education of the students, the development of the so-called generic competences. They are cognitive, social, emotional and ethical (initiative, effort for quality, responsibility, etc.) competences which have a transferable condition and they constitute the " knowing of how to be" in the professional education of the university student. A structured proposal of the generic competences that could be included in the educative university action is presented. There is a description of the design and application of a question paper made to the students of the last course of Business Studies and their teachers to know not only the perception that the students have about the possession of generic competences, but also the valuation of students and teachers about the different generic competences for the professional profile of qualified people as well as the contribution of universities to the development or improvement of such competences. The data is analysed and checked, conclusions are extracted and action strategies are suggested