Clinical audit of multidisciplinary care at a medium-sized hospital in Spain

Background. Multidisciplinary care is a key enabler in the provision of high quality care for cancer patients. Despite compelling evidence supporting their benefit to patients and for providers, multidisciplinary cancer conferences (MCC) are not universally occurring. Team composition of MCC reflects the multidisciplinary nature of the body. Lack of nursing input can have a negative impact on team decision making. The objective of this study was to evaluate multidisciplinary care and adherence to national recommendations at a medium-sized hospital through a clinical audit of cancer conferences and clinical records. Methods. A total of 77 multidisciplinary cancer conferences were visited and 496 electronic health records were reviewed. The regularity of meetings and multidisciplinary attendance were evaluated. Each electronic health record was checked to verify documented prospective discussion before any treatment was started. Results. Nine multidisciplinary teams meet on a weekly or biweekly basis at the hospital with an average number of ten people and six different specialties represented. Average duration of meetings was 46.8 min. Though most patients (64.5%) were discussed at some point at the relevant cancer conference, only 40% had a documented multidisciplinary team discussion prior to the first treatment. Pathological stage (pTNM) was documented in 53.6% of clinical records. Conclusions. Nursing representatives should be included as usual attendees at cancer conferences. Prospective discussion of all cancer cases should be encouraged. Use of checklists and systematic collection of key information, specifically cancer staging, could improve clinical documentation in the electronic clinical record

Genetic relationships within and among Iberian fescues (Festuca L.) based on PCR-amplified markers

The genus Festuca comprises approximately 450 species and is widely distributed around the world. The Iberian Penninsula, with more than 100 taxa colonizing very diverse habitats, is one of its main centers of diversification. This study was conducted to assess molecular genetic variation and genetic relatedness among 91 populations of 31 taxa of Iberian fescues, based on several molecular markers (random amplified polymorphic DNA, amplified fragment length polymorphisms, and trnL sequences). The analyses showed the paraphyletic origin of the broad-leaved (subgenus Festuca, sections Scariosae and Subbulbosae, and subgenus Schedonorus) and the fine-leaved fescues (subgenus Festuca, sections Aulaxyper, Eskia, and Festuca). Schedonorus showed a weak relationship with Lolium rigidum and appeared to be the most recent of the broad-leaved clade. Section Eskia was the most ancient and Festuca the most recent of the fine-leaved clade. Festuca and Aulaxyper were the most related sections, in concordance with their taxonomic affinities. All taxa grouped into their sections, except F. ampla and F. capillifolia (section Festuca), which appeared to be more closely related to Aulaxyper and to a new independent section, respectively. Most populations clustered at the species level, but some subspecies and varieties mixed their populations. This study demonstrated the value in combining different molecular markers to uncover hidden genetic relationships between populations of Festuca

Anchoring of proteins to lactic acid bacteria

The anchoring of proteins to the cell surface of lactic acid bacteria (LAB) using genetic techniques is an exciting and emerging research area that holds great promise for a wide variety of biotechnological applications. This paper reviews five different types of anchoring domains that have been explored for their efficiency in attaching hybrid proteins to the cell membrane or cell wall of LAB. The most exploited anchoring regions are those with the LPXTG box that bind the proteins in a covalent way to the cell wall. In recent years, two new modes of cell wall protein anchoring have been studied and these may provide new approaches in surface display. The important progress that is being made with cell surface display of chimaeric proteins in the areas of vaccine development and enzyme- or whole-cell immobilisation is highlighted.

Informal entrepreneurship in developing economies: the impacts of starting-up unregistered on firm performance

To advance understanding of the entrepreneurship process in developing economies, this paper evaluates whether registered enterprises that initially avoid the cost of registration, and focus their resources on overcoming other liabilities of newness, lay a stronger foundation for subsequent growth. Analyzing World Bank Enterprise Survey data across 127 countries, and controlling for other firm performance determinants, registered enterprises that started-up unregistered and spent longer operating unregistered are revealed to have significantly higher subsequent annual sales, employment and productivity growth rates compared with those that registered from the outset. The theoretical and policy implications are then discussed

Contemplative positive psychology: Introducing mindfulness into positive psychology

A pesar de que mindfulness está integrado en muchos manuales de psicología positiva como una técnica “positiva”, apenas se han desarrollado las implicaciones que tiene su uso ni se ha investigado la relación entre mindfulness y bienestar humano. Analizar las principales potencialidades de los dos ámbitos, las posibilidades de integración, así como las posibles contradicciones entre sus mensajes, es fundamental de cara a establecer puentes. Mindfulness es más que una técnica de meditación, lleva implícitos una serie de valores y condicionantes éticos que se adecuan en buena medida con los presupuestos que se proponen desde la psicología positiva, como el desarrollo de la amabilidad, la compasión, y las emociones positivas. El objetivo de este artículo es presentar por un lado aspectos comunes y similitudes, y por otro lado diferencias entre mindfulness y la psicología positiva. También se presentarán los principales estudios que han investigado el papel que tiene mindfulness y las prácticas contemplativas sobre el bienestar humano. Finalmente se discutirá y plantearán futuras líneas de investigación e intervención para acercar ambas propuestas. Although mindfulness is included in many positive psychology manuals as a “positive” technique, the implications of its use have scarcely been developed and the relationship between mindfulness and human well-being has barely been researched. Analyzing the main strengths of the two fields, the possibilities for their integration and the potential contradictions between their messages is essential in order to establish connections. Mindfulness is more than a meditation technique. It has implicit within it a set of values and ethical conditions that coincide to a great extent with the proposed assumptions from positive psychology, such as the development of kindness, compassion, and positive emotions. The aim of this paper is to present, on the one hand, the commonalities and similarities, and on the other, the differences between mindfulness and positive psychology. We also present the main studies that have investigated the role of mindfulness and contemplative practices on human well-being. Finally future research will be discussed and intervention suggested in order to bring the two proposals together

Brain Changes in Long-Term Zen Meditators Using Proton Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging: A Controlled Study

Introduction: This work aimed to determine whether 1H magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are correlated with years of meditation and psychological variables in long-term Zen meditators compared to healthy non-meditator controls. Materials and Methods: Design. Controlled, cross-sectional study. Sample. Meditators were recruited from a Zen Buddhist monastery. The control group was recruited from hospital staff. Meditators were administered questionnaires on anxiety, depression, cognitive impairment and mindfulness. 1H-MRS (1.5 T) of the brain was carried out by exploring four areas: both thalami, both hippocampi, the posterior superior parietal lobule (PSPL) and posterior cingulate gyrus. Predefined areas of the brain were measured for diffusivity (ADC) and fractional anisotropy (FA) by MR-DTI. Results: Myo-inositol (mI) was increased in the posterior cingulate gyrus and Glutamate (Glu), N-acetyl-aspartate (NAA) and N-acetyl-aspartate/Creatine (NAA/Cr) was reduced in the left thalamus in meditators. We found a significant positive correlation between mI in the posterior cingulate and years of meditation (r = 0.518; p = .019). We also found significant negative correlations between Glu (r =20.452; p = .045), NAA (r =20.617; p = .003) and NAA/Cr (r =20.448; P = .047) in the left thalamus and years of meditation. Meditators showed a lower Apparent Diffusion Coefficient (ADC) in the left posterior parietal white matter than did controls, and the ADC was negatively correlated with years of meditation (r =20.4850, p = .0066). Conclusions: The results are consistent with the view that mI, Glu and NAA are the most important altered metabolites. This study provides evidence of subtle abnormalities in neuronal function in regions of the white matter in meditators

Compassion-based meditation quality practice and its impact on the positive attitudes toward others

Objectives: The authors report on the initial development and validation of the Compassion Practice Quality Scale (CPQS), a measure to assess the quality of compassion-based meditation (CBM). It is conceptualized and operationalized via two factors measuring mental imagery and somatic perception/response. Methods: The total sample was composed of 205 university students who underwent a CBM and completed pre-test/post-test assessment of compassion and related constructs. Results from a series of preliminary psychometric analyses of the CPQS were examined, including factor analysis, internal consistency, and convergent/discriminant validity. Results: The data supported a 12-item and 10-item (without reference to gestures and self-instructions) CPQS of which imagery and somatic perception emerged as two significant reliable subscales, with Cronbach’s alpha values of.90 and.88 respectively. Practice quality factors assessed by the CPQS correlated in expected ways with fear of compassion, imagery variables, and self-criticism, as well as predicted compassion outcome (i.e., feeling positive attitudes toward others). Conclusions: Our findings contribute to identifying two key components of high-quality meditation in CBM (i.e., mental imagery and somatic perception/response) for use in pedagogical development and further research and to offer a reliable self-report measure to assess them for the first time. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature

Energy shortage failure prediction in photovoltaic standalone installations by using machine learning techniques

The use of energy storage systems in standalone photovoltaic installations is essential to supply energy demands, independently of solar generation. Accurate prediction of the battery state is critical for the safe, durable, and reliable operation of systems in this type of installations. In this study, an installation located in the area of Aragon (Spain) has been considered. Two methods, based on different types of Recurrent Neural Networks (RNN), are proposed to predict the battery voltage of the installation two days ahead. Specifically, the Nonlinear Auto Regressive with Exogenous Input (NARX) network and the Long Short-Term Memory (LSTM) network are studied and compared. The implemented algorithms process battery voltage, temperature and current waveforms; and rely on the selection of different future scenarios based on weather forecasting to estimate the future voltage of the battery. The proposed methodology is capable of predicting the voltage with a Root Mean Squared Error (RMSE) error of 1.2 V for batteries of 48 V, in critical situations where the installation is running out of energy. The study contributes to the ongoing research of developing preventive control systems that help reduce costs and improve the performance of remote energy storage systems based on renewable energies with a positive outcome

Relationship between meditative practice and self-reported mindfulness: The MINDSENS composite index

Mindfulness has been described as an inherent human capability that can be learned and trained, and its improvement has been associated with better health outcomes in both medicine and psychology. Although the role of practice is central to most mindfulness programs, practice-related improvements in mindfulness skills is not consistently reported and little is known about how the characteristics of meditative practice affect different components of mindfulness. The present study explores the role of practice parameters on self-reported mindfulness skills. A total of 670 voluntary participants with and without previous meditation experience (n = 384 and n = 286, respectively) responded to an internet-based survey on various aspects of their meditative practice (type of meditation, length of session, frequency, and lifetime practice). Participants also completed the Five Facets Mindfulness Questionnaire (FFMQ), and the Experiences Questionnaire (EQ). The group with meditation experience obtained significantly higher scores on all facets of FFMQ and EQ questionnaires compared to the group without experience. However different effect sizes were observed, with stronger effects for the Observing and Non-Reactivity facets of the FFMQ, moderate effects for Decentering in EQ, and a weak effect for Non-judging, Describing, and Acting with awareness on the FFMQ. Our results indicate that not all practice variables are equally relevant in terms of developing mindfulness skills. Frequency and lifetime practice - but not session length or meditation type - were associated with higher mindfulness skills. Given that these 6 mindfulness aspects show variable sensitivity to practice, we created a composite index (MINDSENS) consisting of those items from FFMQ and EQ that showed the strongest response to practice. The MINDSENS index was able to correctly discriminate daily meditators from non-meditators in 82.3% of cases. These findings may contribute to the understanding of the development of mindfulness skills and support trainers and researchers in improving mindfulness-oriented practices and programs

Multi-dimensionality and variability in folk classification of stingless bees (Apidae: Meliponini)

Background: Not long ago Eugene Hunn suggested using a combination of cognitive, linguistic, ecological and evolutionary theories in order to account for the dynamic character of ethnoecology in the study of folk classification systems. In this way he intended to question certain homogeneity in folk classifications models and deepen in the analysis and interpretation of variability in folk classifications. This paper studies how a rural culturally mixed population of the Atlantic Forest of Misiones (Argentina) classified honey-producing stingless bees according to the linguistic, cognitive and ecological dimensions of folk classification. We also analyze the socio-ecological meaning of binomialization in naming and the meaning of general local variability in the appointment of stingless bees. Methods: We used three different approaches: the classical approach developed by Brent Berlin which relies heavily on linguistic criteria, the approach developed by Eleonor Rosch which relies on psychological (cognitive) principles of categorization and finally we have captured the ecological dimension of folk classification in local narratives. For the second approximation, we developed ways of measuring the degree of prototypicality based on a total of 107 comparisons of the type "X is similar to Y" identified in personal narratives. Results: Various logical and grouping strategies coexist and were identified as: graded of lateral linkage, hierarchical and functional. Similarity judgments among folk taxa resulted in an implicit logic of classification graded according to taxa's prototypicality. While there is a high agreement on naming stingless bees with monomial names, a considerable number of underrepresented binomial names and lack of names were observed. Two possible explanations about reported local naming variability are presented. Conclusions: We support the multidimensionality of folk classification systems. This confirms the specificity of local classification systems but also reflects the use of grouping strategies and mechanisms commonly observed in other cultural groups, such as the use of similarity judgments between more or less prototypical organisms. Also we support the idea that alternative naming results from a process of fragmentation of knowledge or incomplete transmission of knowledge. These processes lean on the facts that culturally based knowledge, on the one hand, and biologic knowledge of nature on the other, can be acquired through different learning pathways.Fil: Zamudio, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Instituto Multidisciplinario de Biología Vegetal (p); ArgentinaFil: Hilgert, Norma Ines. Consejo Nacional de Investigaciones Cientiâ­ficas y Tecnicas. Centro Cientifico Tecnologico Nordeste. Instituto de Biologia Subtropical. Instituto de Biologia Subtropical - Nodo Puerto Iguazu; Argentin