ABSTRACT
PURPOSE: This study investigated the incidence of pneumococcal pneumonia requiring hospitalisation among middle-aged and older adults with and without specific underlying medical conditions, evaluating the influence of these conditions in the risk of developing pneumonia. METHODS: Population-based prospective cohort study included 2,025,730 individuals ≥ 50 years around Catalonia, Spain. The Catalonian information system for the development of research in primary care (SIDIAP) was used to establish baseline characteristics of the cohort (comorbidities and underlying medical conditions). Hospitalisations from pneumococcal pneumonia occurred among cohort members between 01/01/2015 and 31/12/2015 were collected from hospital discharge codes of 68 reference Catalonian hospitals. Cox regression was used to estimate the association between baseline conditions and the risk of developing pneumonia. RESULTS: Global incidence rate (IR) of hospitalised pneumococcal pneumonia was 82.8 cases per 100,000 persons-year. Maximum IRs (per 100,000 persons-year) emerged among persons with haematological neoplasia (837.4), immunodeficiency (709.2), HIV infection (474.7), severe renal disease (407.5) and chronic pulmonary disease (305.7). In the multivariable analyses, apart from increasing age, HIV infection (hazard ratio [HR] 6.78), haematological neoplasia (HR 6.30), prior all-cause pneumonia (HR 5.27), immunodeficiency (HR 4.57) and chronic pulmonary disease (HR 2.89) were the conditions most strongly associated with an increasing risk. Pneumococcal vaccination did not emerge associated with a reduced risk in our study population (nor PPsV23 neither PCV13). CONCLUSION: Old age, immunocompromising conditions and chronic pulmonary/respiratory disease are major risk factors for pneumococcal pneumonia in adults. Our data underline the need for better prevention strategies in these persons.
Subject(s)
Immunocompromised Host , Pneumonia, Pneumococcal/epidemiology , Streptococcus pneumoniae/isolation & purification , Female , Follow-Up Studies , Hospitalization/trends , Humans , Incidence , Male , Middle Aged , Pneumonia, Pneumococcal/microbiology , Prospective Studies , Risk Factors , Spain/epidemiologyABSTRACT
The achievement of high growth rates in YBa2Cu3O7 epitaxial high-temperature superconducting films has become strategic to enable high-throughput manufacturing of long length coated conductors for energy and large magnet applications. We report on a transient liquid assisted growth process capable of achieving ultrafast growth rates (100 nm s-1) and high critical current densities (5 MA cm-2 at 77 K). This is based on the kinetic preference of Ba-Cu-O to form transient liquids prior to crystalline thermodynamic equilibrium phases, and as such is a non-equilibrium approach. The transient liquid-assisted growth process is combined with chemical solution deposition, proposing a scalable method for superconducting tapes manufacturing. Additionally, using colloidal solutions, the growth process is extended towards fabrication of nanocomposite films for enhanced superconducting properties at high magnetic fields. Fast acquisition in situ synchrotron X-ray diffraction and high resolution scanning transmission electron microscopy (STEM) become crucial measurements in disentangling key aspects of the growth process.
Subject(s)
Calciphylaxis/diagnosis , Kidney Transplantation , Liver Transplantation , Female , Humans , Male , Middle AgedSubject(s)
Polysomnography/methods , Sleep Apnea Syndromes/diagnosis , Aged , Continuous Positive Airway Pressure , Facility Design and Construction , Female , Humans , Hypertension/complications , Male , Middle Aged , Monitoring, Physiologic/methods , Primary Health Care/methods , Sleep , Treatment OutcomeABSTRACT
INTRODUCTION: In this paper, a collective of Psychiatry Residents from Valencia surveys the degree of achievement and satisfaction with the Spanish programme. METHOD: Every resident received an enquiry and a letter with instructions to fill it. Colleagues who did not answer back, were contacted and sent a new enquiry. RESULTS: We received a total of 142 enquiries from 52 institutions (80% of the total). The results are distributed in supervision, theoretical training, research, rotatories, assistential pressure, staff-resident ratio, training out of the programme and satisfaction. CONCLUSIONS: This work show that the programme is not being carried out properly. There are still some deficiencies in many rotatories, even though they have been improved. In spite of it, the level of satisfaction with the residence is acceptable.
