Interventions for promoting the use of advance directives for end-of-life decisions in adults (protocol)

To assess the effects of interventions for promoting the use of advance directives (ADs) about end-of-life decisions of adults

Disseny de les pautes per la redacció del protocol de gestió per les aus del PNAE

Aquest projecte té com a objectius: determinar les Directrius a seguir per la futura redacció d’un protocol de gestió de les zones inundables del PNAE, amb la finalitat de potenciar la presència d’aus; determinar les millors condicions d’hàbitat per les poblacions d’aus del PNAE i redactar unes línies de seguiment que permetin d'una banda avaluar si les pautes proposades tindran l’efecte desitjat i d'altra banda que permetin la redacció del protocol de gestió

Alternative PCR protocol using a single primer set for assessing DNA quality in several tissues from a large variety of mammalian species living in areas endemic for leishmaniasis

The aim of this work was to establish a modified pre-diagnostic polymerase chain reaction (PCR) protocol using a single primer set that enables successful amplification of a highly conserved mammalian sequence in order to determine overall sample DNA quality for multiple mammalian species that inhabit areas endemic for leishmaniasis. The gene encoding interphotoreceptor retinoid-binding protein (IRBP), but not other conserved genes, was efficiently amplified in DNA samples from tail skin, ear skin, bone marrow, liver and spleen from all of the species tested. In tissue samples that were PCR-positive for Leishmania, we found that DNA from 100%, 55% and 22% of the samples tested resulted in a positive PCR reaction for the IRBP, beta-actin and beta-globin genes, respectively. Nucleotide sequencing of an IRBP amplicon resolved any questions regarding the taxonomical classification of a rodent, which was previously based simply on the morphological features of the animal. Therefore, PCR amplification and analysis of the IRBP amplicon are suitable for pre-diagnostically assessing DNA quality and identifying mammalian species living in areas endemic to leishmaniasis and other diseases.

Pla d’actuació contra l’absentisme escolar a Palafrugell: Diagnosi de la realitat socioeducativa i protocol d’actuació contra l’absentisme escolar i la desescolarització

El treball té l’objectiu de dissenyar un protocol d’actuació que contempli aspectes sobre prevenció, detecció i intervenció contra l’absentisme escolar i la desescolarització al municipi. Per a això s’ha desenvolupat una diagnosi municipal d’anàlisi de la realitat sobre el tema, fent èmfasi en la intervenció socioeducativa que s’ha de realitzar per a tractar el fenomen des d’una perspectiva holística i global

An experimental protocol for the establishment of dogs with long-term cellular immune reactions to Leishmania antigens

Domestic dogs are considered to be the main reservoirs of zoonotic visceral leishmaniasis. In this work, we evaluated a protocol to induce Leishmania infantum/Leishmania chagasi-specific cellular and humoral immune responses in dogs, which consisted of two injections of Leishmania promastigote lysate followed by a subcutaneous inoculation of viable promastigotes. The primary objective was to establish a canine experimental model to provide positive controls for testing immune responses to Leishmania in laboratory conditions. After inoculation of viable promastigotes, specific proliferative responses of peripheral blood mononuclear cells (PBMCs) to either Leishmania lysate or recombinant proteins, the in vitro production of interferon-γ by antigen-stimulated PBMCs and a significant increase in circulating levels of anti-Leishmania antibodies were observed. The immunized dogs also displayed positive delayed-type hypersensitivity reactions to Leishmania crude antigens and to purified recombinant proteins. An important finding that supports the suitability of the dogs as positive controls is that they remained healthy for the entire observation period, i.e., more than seven years after infection. Following the Leishmania antigen lysate injections, the infection of dogs by the subcutaneous route appears to induce a sustained cellular immune response, leading to an asymptomatic infection. This provides a useful model for both the selection of immunogenic Leishmania antigens and for immunobiological studies on their possible immunoprotective activities.

Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.

BACKGROUND: Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost-effectiveness of enhanced recovery implementation. METHODS: The first 50 consecutive patients treated during implementation of an enhanced recovery programme were compared with 50 consecutive patients treated in the year before its introduction. The enhanced recovery protocol principally implemented preoperative counselling, reduced preoperative fasting, preoperative carbohydrate loading, avoidance of premedication, optimized fluid balance, standardized postoperative analgesia, use of a no-drain policy, as well as early nutrition and mobilization. Length of stay, readmissions and complications within 30 days were compared. A cost-minimization analysis was performed. RESULTS: Hospital stay was significantly shorter in the enhanced recovery group: median 7 (interquartile range 5-12) versus 10 (7-18) days (P = 0·003); two patients were readmitted in each group. The rate of severe complications was lower in the enhanced recovery group (12 versus 20 per cent), but there was no difference in overall morbidity. The mean saving per patient in the enhanced recovery group was euro1651. CONCLUSION: Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.

Plasmodium falciparum gametocyte carriage, sex ratios and asexual parasite rates in Nigerian children before and after a treatment protocol policy change instituting the use of artemisinin-based combination therapies

The effects of artemisinin-based combination therapies (ACTs) on transmission of Plasmodium falciparum were evaluated after a policy change instituting the use of ACTs in an endemic area. P. falciparum gametocyte carriage, sex ratios and inbreeding rates were examined in 2,585 children at presentation with acute falciparum malaria during a 10-year period from 2001-2010. Asexual parasite rates were also evaluated from 2003-2010 in 10,615 children before and after the policy change. Gametocyte carriage declined significantly from 12.4% in 2001 to 3.6% in 2010 (@@χ² for trend = 44.3, p < 0.0001), but sex ratios and inbreeding rates remained unchanged. Additionally, overall parasite rates remained unchanged before and after the policy change (47.2% vs. 45.4%), but these rates declined significantly from 2003-2010 (@@χ² for trend 35.4, p < 0.0001). Chloroquine (CQ) and artemether-lumefantrine (AL) were used as prototype drugs before and after the policy change, respectively. AL significantly shortened the duration of male gametocyte carriage in individual patients after treatment began compared with CQ (log rank statistic = 7.92, p = 0.005). ACTs reduced the rate of gametocyte carriage in children with acute falciparum infections at presentation and shortened the duration of male gametocyte carriage after treatment. However, parasite population sex ratios, inbreeding rates and overall parasite rate were unaffected.

Sistema de reserves hoteleres on-line, basat en el protocol de comunicació OTA

L’origen d’aquest projecte neix en la necessitat de crear un sistema de reserves hoteleres on-line integral i amb connectivitat amb altres sistemes de reserves. S'ha optat pel protocol de comunicació OTA(Open Travel Alliance), es tracta d'un protocol de comunicació XML ideat per empreses del sector turístic dels Estats Units per la necessitat comuna d’unes especificacions tècniques que permetessin la comunicació electrònica de la informació

Primary renal lymphoma: long-term results of two patients treated with a chemotherapy + rituximab protocol.

Primary renal lymphoma (PRL) is a rare disease of which the etiology and pathogenesis remain controversial, and there is currently no standard treatment for it. We present the results of a long-term followup of two patients who were diagnosed with PRL and treated with cyclophosphamide, adriamycin, vincristine, prednisolone and rituximab (CHOP + R) regimen. Both patients reached a complete response, and there is no evidence of recurrence after 4.5- and 5-year followup periods. Based on our experience and other recently published studies, we recommend the combination of CHOP + rituximab as the elective treatment for this disease. To our knowledge, this is the longest followup period with a complete response that has been reported with this modality of treatment.

Continuidad de cuidados de enfermería a través de un protocolo asistencial de transferencia

The creation and establishment within the healthcare team of the Primary Healthcare Centre of Baena of a Protocol and Procedures for healthcare that provides a communication tool for nurses enabled the healthcare team to develop a dynamic circuit and at the same time communication with nurses of the Critical Care and Emergency Team (DCCU) assigned to that centre. The created work environment for healthcare included Case Management Nurse, Primary Healthcare Nurse and Critical Care and Emergency Nurse. Thus, nursing assessment and actions for programmed and urgent healthcare, provided the first contact with DCCU nurses and reoriented them for the proposed healthcare plan for the patients, in addition to communicate with the rest of the healthcare team. This article presents the results of continuous nurse healthcare over nine months, applying this protocol.

Estudi dels mètodes d'estimació de la tipologia de la xarxa en un protocol UUP basat en xarxes socials

En aquest projecte es presenta un mecanisme per garantir la privacitat de les cerques que fan els usuaris als motors de cerca aprofitant el potencial de les xarxes socials.