Standard care practices and psychosocial interventions aimed at reducing parental distress following stillbirth: A systematic narrative review

Objective: To summarise and critically evaluate the evidence informing the provision of standard care practices and psychosocial interventions following stillbirth. Background: Stillbirth is increasingly recognised as a significant bereavement experience with the potential to cause substantial psychological distress for parents. Standard care practices and psychosocial interventions to support parents have undergone dramatic changes, with limited basis in evidence. Methods: A systematic narrative review was conducted of quantitative studies examining interventions designed to reduce psychological distress in parents following the loss of a stillborn baby. Results: Twenty-five studies met the inclusion criteria for the review. Substantial methodological weaknesses were identified among reviewed studies, including small and heterogeneous loss samples, weak study designs and lack of clarity in reported methods and outcomes. Inadequate replication of many findings substantially limits the generalisability of the evidence. Conclusion: Tentative evidence was found for the provision of mementoes of the baby and information regarding the cause of the loss, support group attendance, and cognitive behavioural interventions for parents identified with clinical levels of distress. Contradictory findings for the impact of contact with the baby prevent the formation of clear conclusions for this practice. Due to the methodological weaknesses prevalent in the research identified, the current evidence base is not considered sufficiently able to reliably inform care practices and intervention approaches. High-quality research evidence in this field is urgently required.

Sickness certification in primary care: a survey on views and practices among Swiss physicians.

QUESTIONS UNDER STUDY: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients. METHODS: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence. We piloted the questionnaire and disseminated it through the networks of the five Swiss academic institutes for primary care. RESULTS: We received 507 valid responses (response rate 50%). Only 43/507 GPs experienced sickness certification as problematic per se, yet 155/507 experienced problems in sickness certification at least once a week. The 507 GPs identified estimating a long-term prognosis about work capacity (64%), handling conflicts with patients (54%), and determining the reduction of work capacity (42%) as problematic. Over 75% would welcome special training opportunities, e.g., on sickness certifications during residency (93%), in insurance medicine (81%), and conflict management (80%). CONCLUSION: Sickness certification as such does not present a major problem to Swiss GPs, which contrasts with the experience in Scandinavian countries and in the UK. Swiss GPs did identify specific tasks of sickness certification as problematic. Training opportunities on sick-leave certification and insurance medicine in general were welcomed.

La formulación magistral: adquisición de compètencias mediante ABP y estrategias no presenciales

[cast] La formulación magistral, una de las actividades profesionales más representativas del farmacéutico, consiste en la elaboración, de acuerdo con una prescripción médica, de un medicamento personalizado, adaptado a un paciente concreto, en un compromiso profesional de solucionar un problema de salud específico. La amplia oferta de medicamentos industriales ha reducido considerablemente esta actividad, que a pesar de todo, debe considerarse una herramienta de futuro en sintonía con la tendencia personalizadora actual de la medicina y las necesidades del paciente. Los conocimientos y competencias requeridas para dicha actividad profesional se introducen actualmente en la carrera de Farmacia mediante una asignatura optativa. En el presente trabajo se presenta el planteamiento metodológico diseñado por el Grupo de Innovación Docente de Tecnología Farmacéutica (GIDTF) y el grupo e-Galenica, ambos de la Universidad de Barcelona, para esta asignatura. Dicha metodología esta basada en el Aprendizaje Basado en Problemas (ABP) incluyendo tutorías y prácticas de campo, apoyada en estrategias no presenciales como foro de debate, recursos on-line, cuestionarios y tareas de autoevaluación a través de la plataforma Moodle del Campus Virtual de la UB. Se evalúan asimismo los resultados académicos y las respuestas de los estudiantes a las encuestas realizadas en relación al sistema de impartición de la asignatura. [eng] The pharmaceutical compounding, one of the most representative professional activities of pharmacists, involves the preparation of an individualized medicine tailored to a specific patient in a professional commitment to solve a specific health problem, according to a prescription. The wide range of industrial medicine has significantly reduced this activity, which nevertheless should be considered a tool of the future in line with the current trend of personalizing medicine and patient needs. The knowledge and competences required for this professional activity are introduced to the students of Pharmacy through an optional subject. In this paper we present the ethodological approach developed for this subject by the Teaching Innovation Group of pharmaceutical Technology (GIDTF) and e-Galenica group, both from the University of Barcelona. This methodology is based on Problem-Based Learning (PBL) including tutorials and practices in other centres, supported by out of class strategies as discussion forum, online resources, self-assessment questionnaires and work through the platform Moodle of Virtual Campus UB. The academic performance and student responses to surveys in relation to the didactic methodology are also assessed.

Identification of new transformation products during enzymatic treatment of tetracycline and erythromycin antibiotics at laboratory scale by an on-line turbulent flow liquid-chromatography coupled to a high resolution mass spectrometer LTQ-Orbitrap

This work describes the formation of transformation products (TPs) by the enzymatic degradation at laboratory scale of two highly consumed antibiotics: tetracycline (Tc) and erythromycin (ERY). The analysis of the samples was carried out by a fast and simple method based on the novel configuration of the on-line turbulent flow system coupled to a hybrid linear ion trap – high resolution mass spectrometer. The method was optimized and validated for the complete analysis of ERY, Tc and their transformation products within 10 min without any other sample manipulation. Furthermore, the applicability of the on-line procedure was evaluated for 25 additional antibiotics, covering a wide range of chemical classes in different environmental waters with satisfactory quality parameters. Degradation rates obtained for Tc by laccase enzyme and ERY by EreB esterase enzyme without the presence of mediators were ∼78% and ∼50%, respectively. Concerning the identification of TPs, three suspected compounds for Tc and five of ERY have been proposed. In the case of Tc, the tentative molecular formulas with errors mass within 2 ppm have been based on the hypothesis of dehydroxylation, (bi)demethylation and oxidation of the rings A and C as major reactions. In contrast, the major TP detected for ERY has been identified as the “dehydration ERY-A”, with the same molecular formula of its parent compound. In addition, the evaluation of the antibiotic activity of the samples along the enzymatic treatments showed a decrease around 100% in both cases

English as a medium of instruction in teaching other languages: attitudes and practices

Internationalisation of HE and emergence of English as a global academic lingua franca used by people who share neither a common native tongue nor cultural and educational background have not only offered more opportunities but also raised challenges. According to recent European surveys, the percentage of pupils attaining the level of independent user in English varies from 14% to 82%, which evidences the potential and the complexity for English as a medium of instruction at tertiary level. This study aims to present the model of foreign language instruction at Vytautas Magnus University where one third of 30 languages are taught through English. It investigates the attitudes and practices of teachers in delivering their English-medium language courses by discussing the questions whether teaching other languages through English is psychologically, culturally and educationally preferable for teachers and students, whether it can limit the content taught and require a special methodology, how the teaching process changes with multiple languages used in the classroom and what level of English is necessary for teachers and students to ensure high quality of English-medium language teaching. The study is based on qualitative methodology with 12 language teachers participating as respondents. The results reveal areas in need of improvement.

Protocol de conservació ex situ del Centre Ictiològic del Parc Natural del Delta de l'Ebre

En aquest Treball de Fi de Grau es pretén establir un protocol per a la conservació ex situ de les espècies que hi ha en el Centre Ictiològic del Parc Natural del Delta de l’Ebre. Les espècies que es troben en el CI són espècies vulnerables o en perill: espinós, samaruc, fartet, rabosa, llopet de riu i tritó palmat. Els objectius d’aquest protocol són: que el CI tingui un protocol propi, aprendre com funciona tot el centre, totes les espècies, com alimentar-les, com manipular-les i com tractar-les durant tot el seu cicle de vida. Un altre objectiu és el de veure si a finals d’any s’obté una alta població de cada espècie, quines són reintroduïdes, les patologies sorgides i els valors dels paràmetres químics de les basses naturals exteriors. El protocol s’elabora a partir de les pràctiques realitzades durant l’estiu del 2013 i els coneixements adquirits, la bibliografia i les dades del CI. Gràcies a això s’ha elaborat el treball. S’ha tractat la conservació ex situ; la problemàtica que sofreixen les espècies; cadascuna d’aquestes espècies; com funciona el CI a nivell de centre i a nivell de personal; les tasques que hi ha diàriament, setmanalment i ocasionalment segons les necessitats de l’estoc; el maneig sanitari; les patologies i com tractar-les; i l’anàlisi genètic. Els resultats obtinguts d’aquest protocol són els resultats numèrics obtinguts de l’any 2013 que són: 1. El gran nombre de cries nascudes de samaruc i fartet, menys de raboseta de riu, poques d’espinós i tritó palmat, i menys de llopet que tot just comença ara en el CI. 2. El total d’uns 5700 individus reitnroduits (samaruc, raboseta de riu i espinós de Girona). 3. La patologia més sorgida és el punt blanc. 4. I els paràmetres químics (amoni, nitrits, nitrats i fòsfor) no són molt elevats. La conclusió final i més important a la que arribo en fer el protocol és la gran importància que té el CI per a conservar aquestes espècies que no es saben apreciar fins que comencen a desparèixer. La existència del CI és més aviat una mesura correctora de tots els impactes que han sofert els habitatges de les espècies tractades i de la introducció d’espècies exòtiques que són una amenaça per les autòctones.

Workgroup climates and employees' counterproductive work behaviors: A social-cognitive perspective

This research examines employees' anticipation of social and self-sanctions as a self-regulatory mechanism linking workgroup climates and counterproductive work behaviors (CWBs) and personality as a limit to these effects. A cross-level study with 158 employees from 26 workgroups demonstrated that in groups with a high compliance climate-a climate emphasizing the importance of complying with organizational rules-employees anticipate more social and self-sanctions, leading those low in conscientiousness and low in agreeableness to engage less frequently in CWBs. In contrast, a high relational climate-a climate emphasizing the importance of positive social relations over self-interest-indirectly unbridles the CWBs of these employees by alleviating the social and self-sanctions they anticipate for CWBs. Climates did not have indirect effects for employees high in agreeableness and high in conscientiousness. These findings elucidate why workgroup climates do not affect the CWBs of all members in the same way.

The composition of airborne and grain-dust fungal communities is shaped at regional scale by plant genotypes and farming practices

Chronic exposure to airborne fungi has been associated with different respiratory symptoms and pathologies in occupational populations, such as grain workers. However, the homogeneity in the fungal species composition of these bioaerosols on a large geographical scale and the different drivers that shape these fungal communities remain unclear. In this study, the diversity of fungi in grain dust and in the aerosols released during harvesting was determined across 96 sites at a geographical scale of 560 km(2) along an elevation gradient of 500 m by tag-encoded 454-pyrosequencing of the internal transcribed spacer (ITS) sequences. Associations between the structure of fungal communities in the grain dust and different abiotic (farming system, soil characteristics, geographic and climatic parameters) and biotic (wheat cultivar, previous crop culture) factors were explored. These analyses revealed a strong relationship between the airborne and grain dust fungal communities and showed the presence of allergenic and mycotoxigenic species in most samples, which highlights the potential contribution of these fungal species to work-related respiratory symptoms of grain workers. The farming system was the major driver of the alpha and beta phylogenetic diversity of fungal communities. In addition, elevation and soil CaCO3 concentrations shaped the alpha diversity whereas wheat cultivar, cropping history and the number of freezing days per year shaped the taxonomic beta diversity of these communities.

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.

Mentoring in the acquisition of professional skills through practices in companies by degree students

Abstract This work has had as objective to analyze the skills acquired through internships in business companies by students of the Faculty of Economics and Business at the University Pompeu Fabra. The internship is a basic item in order to obtain a hard connection between the University and social-economic world where University and Enterprises develop their activity. In this study we want to know about two aspects. The first one, we want to know the profit that is obtained from the Student as a consequence of internship and mentoring. Also, we want to study about the importance of mentoring as a principal element that establishes the relationship between the Student and the Company. Moreover, it has sought to analyze if certain factors such as the size of the company where the practices has been performed, the study rank level that was achieved or the fact of being a man or a woman, were among the determining factors at the time of acquiring the skills. The results presented here indicate that the size of the company that have been making the practices and the gender of the student are related to the acquisition of certain skills. There was not a statistically significant relationship related to the rank level have by the students in the practice. In the future we are going to study if the labor market Integration is easier if the Student has performed work placement. Keywords Skills; employability; internship; meatoring.

Same Performance Changes after Live High-Train Low in Normobaric vs. Hypobaric Hypoxia.

PURPOSE: We investigated the changes in physiological and performance parameters after a Live High-Train Low (LHTL) altitude camp in normobaric (NH) or hypobaric hypoxia (HH) to reproduce the actual training practices of endurance athletes using a crossover-designed study. METHODS: Well-trained triathletes (n = 16) were split into two groups and completed two 18-day LTHL camps during which they trained at 1100-1200 m and lived at 2250 m (P i O2 = 111.9 ± 0.6 vs. 111.6 ± 0.6 mmHg) under NH (hypoxic chamber; FiO2 18.05 ± 0.03%) or HH (real altitude; barometric pressure 580.2 ± 2.9 mmHg) conditions. The subjects completed the NH and HH camps with a 1-year washout period. Measurements and protocol were identical for both phases of the crossover study. Oxygen saturation (S p O2) was constantly recorded nightly. P i O2 and training loads were matched daily. Blood samples and VO2max were measured before (Pre-) and 1 day after (Post-1) LHTL. A 3-km running-test was performed near sea level before and 1, 7, and 21 days after training camps. RESULTS: Total hypoxic exposure was lower for NH than for HH during LHTL (230 vs. 310 h; P < 0.001). Nocturnal S p O2 was higher in NH than in HH (92.4 ± 1.2 vs. 91.3 ± 1.0%, P < 0.001). VO2max increased to the same extent for NH and HH (4.9 ± 5.6 vs. 3.2 ± 5.1%). No difference was found in hematological parameters. The 3-km run time was significantly faster in both conditions 21 days after LHTL (4.5 ± 5.0 vs. 6.2 ± 6.4% for NH and HH), and no difference between conditions was found at any time. CONCLUSION: Increases in VO2max and performance enhancement were similar between NH and HH conditions.

Student Journalism 2.0 : Testing Models for Participatory Learning in the Digital Age

Many educators and educational institutions have yet to integrate web-based practices into their classrooms and curricula. As a result, it can be difficult to prototype and evaluate approaches to transforming classrooms from static endpoints to dynamic, content-creating nodes in the online information ecosystem. But many scholastic journalism programs have already embraced the capabilities of the Internet for virtual collaboration, dissemination, and reader participation. Because of this, scholastic journalism can act as a test-bed for integrating web-based sharing and collaboration practices into classrooms. Student Journalism 2.0 was a research project to integrate open copyright licenses into two scholastic journalism programs, to document outcomes, and to identify recommendations and remaining challenges for similar integrations. Video and audio recordings of two participating high school journalism programs informed the research. In describing the steps of our integration process, we note some important legal, technical, and social challenges. Legal worries such as uncertainty over copyright ownership could lead districts and administrators to disallow open licensing of student work. Publication platforms among journalism classrooms are far from standardized, making any integration of new technologies and practices difficult to achieve at scale. And teachers and students face challenges re-conceptualizing the role their class work can play online.

Quality in work and aggregate productivity

We explore the relationship between quality in work and aggregate productivity in regions and sectors. Using recent Spanish aggregate data for the period 2001-2006, we find that quality in work may be an important factor to explain productivity levels in sectors and regions. We use two alternatives definitions of quality in work: one from survey data and the other from a social indicators approach. We also use two different measurements of labour productivity to test the robustness of our results. The estimates are run using a simultaneous equation model for our panel of data, and find important differences between high tech and low tech sectors: a positive relationship between quality in work and productivity in the former case, and a negative relationship in the latter. Consequently, on the one hand we see that quality in work is not only an objective per se, but may also be a production factor able to increase the wealth of regions; on the other hand, at the aggregate level, we may also find that high productivity levels coincide with lower quality in work conditions.

Drivers and Barriers of Collaboration in the Value Chain of Paperboard-Packed Consumer Goods

Value chain collaboration has been a prevailing topic for research, and there is a constantly growing interest in developing collaborative models for improved efficiency in logistics. One area of collaboration is demand information management, which enables improved visibility and decrease of inventories in the value chain. Outsourcing of non-core competencies has changed the nature of collaboration from intra-enterprise to cross-enterprise activity, and this together with increasing competition in the globalizing markets have created a need for methods and tools for collaborative work. The retailer part in the value chain of consumer packaged goods (CPG) has been studied relatively widely, proven models have been defined, and there exist several best practice collaboration cases. The information and communications technology has developed rapidly, offering efficient solutions and applications to exchange information between value chain partners. However, the majority of CPG industry still works with traditional business models and practices. This concerns especially companies operating in the upstream of the CPG value chain. Demand information for consumer packaged goods originates at retailers' counters, based on consumers' buying decisions. As this information does not get transferred along the value chain towards the upstream parties, each player needs to optimize their part, causing safety margins for inventories and speculation in purchasing decisions. The safety margins increase with each player, resulting in a phenomenon known as the bullwhip effect. The further the company is from the original demand information source, the more distorted the information is. This thesis concentrates on the upstream parts of the value chain of consumer packaged goods, and more precisely the packaging value chain. Packaging is becoming a part of the product with informative and interactive features, and therefore is not just a cost item needed to protect the product. The upstream part of the CPG value chain is distinctive, as the product changes after each involved party, and therefore the original demand information from the retailers cannot be utilized as such – even if it were transferred seamlessly. The objective of this thesis is to examine the main drivers for collaboration, and barriers causing the moderate adaptation level of collaborative models. Another objective is to define a collaborative demand information management model and test it in a pilot business situation in order to see if the barriers can be eliminated. The empirical part of this thesis contains three parts, all related to the research objective, but involving different target groups, viewpoints and research approaches. The study shows evidence that the main barriers for collaboration are very similar to the barriers in the lower part of the same value chain; lack of trust, lack of business case and lack of senior management commitment. Eliminating one of them – the lack of business case – is not enough to eliminate the two other barriers, as the operational model in this thesis shows. The uncertainty of the future, fear of losing an independent position in purchasing decision making and lack of commitment remain strong enough barriers to prevent the implementation of the proposed collaborative business model. The study proposes a new way of defining the value chain processes: it divides the contracting and planning process into two processes, one managing the commercial parts and the other managing the quantity and specification related issues. This model can reduce the resistance to collaboration, as the commercial part of the contracting process would remain the same as in the traditional model. The quantity/specification-related issues would be managed by the parties with the best capabilities and resources, as well as access to the original demand information. The parties in between would be involved in the planning process as well, as their impact for the next party upstream is significant. The study also highlights the future challenges for companies operating in the CPG value chain. The markets are becoming global, with toughening competition. Also, the technology development will most likely continue with a speed exceeding the adaptation capabilities of the industry. Value chains are also becoming increasingly dynamic, which means shorter and more agile business relationships, and at the same time the predictability of consumer demand is getting more difficult due to shorter product life cycles and trends. These changes will certainly have an effect on companies' operational models, but it is very difficult to estimate when and how the proven methods will gain wide enough adaptation to become standards.

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry.

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.