Midwives and medicines

This leaflet was developed for midwives and describes midwives' role in administering and supplying medicines. It should be read in conjunction with the Nursing and Midwifery Council rules, standards and guidance. It is only available from the Local Supervising Authority Midwifery Officer at the PHA.

La reincidència en les penes alternatives a la presó a Catalunya

Són quatre els objectius d’aquesta recerca: (1) determinar la taxa de reincidència administrativa dels sotmesos a formes substitutives a la presó; (2) descriure les relacions significatives entre determinades variables individuals i d’historial delictiu i la seva reincidència; (3) comparar taxes de reincidència entre penats que compleixen treballs en benefici de la comunitat (TBC) i suspensions de condemna amb imposició de regles de conducta; (4) comparar les taxes de reincidència de persones amb mesures alternatives amb les de reincidència penitenciària. Per reincidència administrativa s’entén entrar a presó o complir una nova mesura penal alternativa per un nou delicte durant el període de seguiment. Per assolir els objectius, han estat estudiades 329 persones que, al llarg de l’any 2000, van finalitzar, com a mínim, un TBC o una obligació imposada en el marc de la suspensió de la pena. El seguiment ha estat conclòs els 30 de juny de 2005. Els resultats indiquen que: (1) la taxa de reincidència administrativa dels sotmesos a MPA és inferior a la taxa de reincidència penitenciària; (2) no hi ha diferències rellevants pel que fa a la reincidència administrativa entre els homes i les dones estudiades, tampoc entre estrangers i espanyols; (3) presenten una major taxa de reincidència els que tenen antecedents de qualsevol tipus, i encara una taxa major els que tenen antecedents penitenciaris.

L'Educació lliure: una mirada a les experiències educatives alternatives

Investigació educativa de caràcter qualitatiu que estudia l’educació lliure. La recerca es basa en quatre experiències educatives alternatives actuals que presenten diversos models pedagògics, en l’àmbit de l’Estat Espanyol: Paideia, educació llibertària; Ojo de agua, ambient educatiu; i l’àmbit de Catalunya: El Roure, escola viva i La Llavor, escola Waldorf, per tal de conèixer, analitzar i contrastar les seves pràctiques educatives, observant les seves possibilitats en el moment de crisi educativa actual

Creació d'un consorci de microorganismes per l'eliminació de fòsfor a partir de fonts de carboni alternatives

L'existència d’una font de carboni adequada per l’eliminació biològica de fòsfor, és un factor decisiu per l'eliminació de fòsfor de les aigües residuals urbanes. Per a les aigües residuals amb baix contingut d'àcids grassos volàtils és necessària l’addició d’alguna font de carboni externa. El metanol és la font de carboni més utilitzada en processos a EDAR (p.ex. desnitrificació), degut al seu baix cost. Malgrat això, varis estudis proven que per l’eliminació biològica de fòsfor, aquest, no és una bona alternativa. En aquest estudi es desenvolupa un consorci amb la biomassa de digestió anaeròbia i biomassa acumuladora de polifosfat (PAO). El propòsit del consorci és la degradació de metanol en AGV, per obtenir l'activitat EBPR. A més, aquest estudi mostra la viabilitat de substituir en el consorci el metanol per altres fonts de carboni.

Drug assessment by a Pharmacy and Therapeutics committee: from drug selection criteria to use in clinical practice.

BACKGROUND In Spain, hospital medicines are assessed and selected by local Pharmacy and Therapeutics committees (PTCs). Of all the drugs assessed, cancer drugs are particularly important because of their budgetary impact and the sometimes arguable added value with respect to existing alternatives. This study analyzed the PTC drug selection process and the main objective was to evaluate the degree of compliance of prescriptions for oncology drugs with their criteria for use. METHODS This was a retrospective observational study (May 2007 to April 2010) of PTC-assessed drugs. The variables measured to describe the committee's activity were number of drugs assessed per year and number of drugs included in any of these settings: without restrictions, with criteria for use, and not included in formulary. These drugs were also analyzed by therapeutic group. To assess the degree of compliance of prescriptions, a score was calculated to determine whether prescriptions for bevacizumab, cetuximab, trastuzumab, and bortezomib were issued in accordance with PTC drug use criteria. RESULTS The PTC received requests for inclusion of 40 drugs, of which 32 were included in the hospital formulary (80.0%). Criteria for use were established for 28 (87.5%) of the drugs included. In total, 293 patients were treated with the four cancer drugs in eight different therapeutic indications. The average prescription compliance scores were as follows: bevacizumab, 83% for metastatic colorectal cancer, 100% for metastatic breast cancer, and 82.3% for non-small-cell lung cancer; cetuximab, 62.0% for colorectal cancer and 50% for head and neck cancer; trastuzumab, 95.1% for early breast cancer and 82.4% for metastatic breast cancer; and bortezomib, 63.7% for multiple myeloma. CONCLUSION The degree of compliance with criteria for use of cancer drugs was reasonably high. PTC functions need to be changed so that they can carry out more innovative tasks, such as monitoring conditions for drug use.

Detection, Determination of Chemical Composition and Chemical Profiling of Counterfeit Medicines by Raman Spectroscopy.

Raman spectroscopy has become a widespread technique for the analysis ofpharmaceutical solid forms. The application proposed here is the investigationof counterfeit medicines. This serious global issue requires quick and accurateidentification methods to fight against this phenomenon. Thanks to its chemicalselectivity, rapidity of analysis and potential of generating repeatable spectralprofiles, Raman spectroscopy presents distinct advantages for the analysis ofcounterfeits. Combined with chemometric tools, the technique enablesthe detection, the determination of chemical composition and the profiling ofmedicine counterfeits.

Reconversió d'una explotació hortícola convencional a producció ecològica i viabilitat de diferents alternatives de venda, en una finca de 2 ha situada a Fornells de la Selva, comarca del Gironès

L’explotació actual disposa d’una superfície de 1,8 ha i està situada en elmunicipi de Fornells de la Selva a la comarca del Gironès. Les comunicacions per accedir-hi són bones, ja es troba prop de la ciutat de Girona i dels seus accessos. Dins la finca s’hi poden trobar dos hivernacles que en total tenen unasuperfície de 180 m2, i la resta de finca està dividia en dues parcel!les, en les quals es desenvolupa cultiu a l’exterior i que anualment s’alterna el lloc de cultiu. El canvi que es proposa i es descriu en el projecte, es base en reconvertir el sistema productiu actual per un sistema d’agricultura ecològica. També es valora el canvi en el sistema de venda on s’estudia la possibilitat de realitzar la venda directa al consumidor mitjançant una cistella ecològica. Per realitzar el canvi de sistema productiu s’han dissenyat unes rotacions decultius i un augment de variabilitat d’espècies cultivades donant major importància a les especies locals. Les rotacions plantejades es basen en les famílies botàniques de les espècies cultivades i en la seva exigència en les extraccions de nutrients del sòl i la seva necessitat d’adobat. El sistema de reg s’ha utilitzat el mateix que ja hi havia en la situació actual fent una modificació en les vàlvules d’entrada als sectors de reg, col•locant electrovàlvules programades per automatitzar el reg

Framingham risk score and alternatives for prediction of coronary heart disease in older adults.

BACKGROUND: Guidelines for the prevention of coronary heart disease (CHD) recommend use of Framingham-based risk scores that were developed in white middle-aged populations. It remains unclear whether and how CHD risk prediction might be improved among older adults. We aimed to compare the prognostic performance of the Framingham risk score (FRS), directly and after recalibration, with refit functions derived from the present cohort, as well as to assess the utility of adding other routinely available risk parameters to FRS.¦METHODS: Among 2193 black and white older adults (mean age, 73.5 years) without pre-existing cardiovascular disease from the Health ABC cohort, we examined adjudicated CHD events, defined as incident myocardial infarction, CHD death, and hospitalization for angina or coronary revascularization.¦RESULTS: During 8-year follow-up, 351 participants experienced CHD events. The FRS poorly discriminated between persons who experienced CHD events vs. not (C-index: 0.577 in women; 0.583 in men) and underestimated absolute risk prediction by 51% in women and 8% in men. Recalibration of the FRS improved absolute risk prediction, particulary for women. For both genders, refitting these functions substantially improved absolute risk prediction, with similar discrimination to the FRS. Results did not differ between whites and blacks. The addition of lifestyle variables, waist circumference and creatinine did not improve risk prediction beyond risk factors of the FRS.¦CONCLUSIONS: The FRS underestimates CHD risk in older adults, particularly in women, although traditional risk factors remain the best predictors of CHD. Re-estimated risk functions using these factors improve accurate estimation of absolute risk.

Alternatives per a la generació de cartografia temàtica en entorn web relativa a vigilància epidemiològica

El propósito de este proyecto es proporcionar una herramienta relacionada con los sistemas de información cartográfica (SIG) para lograr detectar posibles anomalías y alteraciones en los patrones de aparición y contagio de enfermedades en un ámbito poblacional.

Médecines complémentaires: vers un consensus "evidence-based" à l'hôpital universitaire. [Complementary and alternative medicines (CAM): towards an "evidence-based" consensus in the University hospital]

Après la votation fédérale demandant de prendre en compte les médecines complémentaires, un consensus a été recherché dans quatorze services et unités du Centre hospitalier universitaire vaudois (CHUV). Confrontés aux données de la littérature (Plus de 2000 publications en "Evidence-based complementary medicine" depuis 1998), les soignants étaient tous surpris par l'ampleur des résultats cliniques disponibles actuellement. Tous identifiaient un besoin en formation et en informations sur le sujet. Une prise de position officielle de l'institution était aussi souhaitée, instituant l'enseignement et la recherche sur les médecines complémentaires et assurant la production d'informations rigoureuses et pertinentes pour la clinique. [Abstract] While a popular vote supported a new article on complementary and alternative medicines (CAM) in the Swiss Constitution, this assessment in 14 wards of the University Hospital of Lausanne, Switzerland, attempted at answering the question: How can CAM use be better taken into account and patients informed with more rigor and respect for their choices? Confronted with a review of the literature (> 2000 publications in "Evidence-based cornplementary medicine" since 1998), respondents declared their ignorance of the clinical data presently available on CAM. All were in favour of more teaching and information on the subject, plus an official statement from the Hospital direction, ensuring production and diffusion of rigorous and cJinically significant information on CAM.

Review of Stability Berm Alternatives for Environmentally Senstitive Areas, 2005

Stability berms are commonly constructed where roadway embankments cross soft or unstable ground conditions. Under certain circumstances, the construction of stability berms cause unfavorable environmental impacts, either directly or indirectly, through their effect on wetlands, endangered species habitat, stream channelization, longer culvert lengths, larger right-of-way purchases, and construction access limits. Due to an ever more restrictive regulatory environment, these impacts are problematic. The result is the loss of valuable natural resources to the public, lengthy permitting review processes for the department of transportation and permitting agencies, and the additional expenditures of time and money for all parties. The purpose of this project was to review existing stability berm alternatives for potential use in environmentally sensitive areas. The project also evaluates how stabilization technologies are made feasible, desirable, and cost-effective for transportation projects and determines which alternatives afford practical solutions for avoiding and minimizing impacts to environmentally sensitive areas. An online survey of engineers at state departments of transportation was also conducted to assess the frequency and cost effectiveness of the various stabilization technologies. Geotechnical engineers that responded to the survey overwhelmingly use geosynthetic reinforcement as a suitable and cost-effective solution for stabilizing embankments and cut slopes. Alternatively, chemical stabilization and installation of lime/cement columns is rarely a remediation measure employed by state departments of transportation.

Alternatives to Guardianship and Conservatorship for Adults in Iowa, 2001

A Elder Affairs documents about Guardianship and conservatorship for adults.

Testing I(1) against I(d) alternatives in the presence of deteministic components

This paper discusses the role of deterministic components in the DGP and in the auxiliary regression model which underlies the implementation of the Fractional Dickey-Fuller (FDF) test for I(1) against I(d) processes with d ∈ [0, 1). This is an important test in many economic applications because I(d) processess with d & 1 are mean-reverting although, when 0.5 ≤ d & 1,, like I(1) processes, they are nonstationary. We show how simple is the implementation of the FDF in these situations, and argue that it has better properties than LM tests. A simple testing strategy entailing only asymptotically normally distributed tests is also proposed. Finally, an empirical application is provided where the FDF test allowing for deterministic components is used to test for long-memory in the per capita GDP of several OECD countries, an issue that has important consequences to discriminate between growth theories, and on which there is some controversy.