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To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.
This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).
Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.
TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
Averroes (1126–98) wrote a commentary, or be’ur in the only extant
Hebrew translation, on Plato's Republic that is the subject matter of
the present anthology. He insists there that his aim
is to present Plato's doctrines without provoking
polemics and that the dialectical arguments are not
necessary to the understanding of those
Just as he did in his epitome of, or short commentary
on, Aristotle's Metaphysics, Averroes neither follows
the strict order of the Greek original nor preserves
the original division of books. While he gives his
reasons for the rearrangement in the case of the
Metaphysics, he does
not give any for the Republic. Although Averroes's work
follows Plato's text in many passages, the
independent structure of the work fits better into
an epitome than into a middle commentary. As for the
Arabic translation he was reading, we know that it
preserved the division into ten books but probably
not the dialogue form, since Averroes never mentions
the names of the figures participating in the
dialogue. In the Republic, Socrates narrates in the first
person, but in his commentary, Averroes give no hint
of Socrates's peculiar role in that work; on the
contrary, he presents Socrates only once, referring
to him in the third person and mentioning that he
held the belief that death is preferable to life
without human dignity.
Averroes lived two generations after Muḥammad ibn
al-Ṣā̔igh Ibn Bājja (d. 1139; henceforth Ibn Bajja),
who did not write a specific commentary on the
Republic. But he did
compose a treatise, titled the Governance of the Solitary, in which he
deals with some of the political issues raised by
Plato. There, as in some other works that we will
discuss below, Ibn Bajja refers to the Republic and to the Phaedo. In this chapter the
attempt will be made to reconstruct the influence of
Plato's Republic on
Ibn Bajja through his own texts, and incidentally,
to learn about the text that Ibn Bajja was
Greek Philosophy in Arabic
Scholars have displayed a lively interest in the
reception of Greek philosophy by the Arabs for many
years, and a few studies of that reception in
connection with Plato should be mentioned.
Objectives: The aim of this study was to adapt and assess the value of a Multi-Criteria Decision Analysis (MCDA) framework (EVIDEM) for the evaluation of Orphan drugs in Catalonia (Catalan Health Service).
Methods: The standard evaluation and decision-making procedures of CatSalut were compared with the EVIDEM methodology and contents. The EVIDEM framework was adapted to the Catalan context, focusing on the evaluation of Orphan drugs (PASFTAC program), during a Workshop with sixteen PASFTAC members. The criteria weighting was done using two different techniques (nonhierarchical and hierarchical). Reliability was assessed by re-test.
Results: The EVIDEM framework and methodology was found useful and feasible for Orphan drugs evaluation and decision making in Catalonia. All the criteria considered for the development of the CatSalut Technical Reports and decision making were considered in the framework. Nevertheless, the framework could improve the reporting of some of these criteria (i.e., “unmet needs” or “nonmedical costs”). Some Contextual criteria were removed (i.e., “Mandate and scope of healthcare system”, “Environmental impact”) or adapted (“population priorities and access”) for CatSalut purposes. Independently of the weighting technique considered, the most important evaluation criteria identified for orphan drugs were: “disease severity”, “unmet needs” and “comparative effectiveness”, while the “size of the population” had the lowest relevance for decision making. Test–retest analysis showed weight consistency among techniques, supporting reliability overtime.
Conclusions: MCDA (EVIDEM framework) could be a useful tool to complement the current evaluation methods of CatSalut, contributing to standardization and pragmatism, providing a method to tackle ethical dilemmas and facilitating discussions related to decision making.
We have theorized that clots with stasis are longer. We therefore explored the relationship between thrombus imaging characteristics on noncontrast computed tomography (NCCT) and magnetic resonance imaging (MRI) with clot length and pial collaterals on baseline computed tomography angiography (CTA).
Prospective study of acute ischemic stroke patients (2005-2009) from Keimyung University. Patients with known stroke symptom onset time, baseline CTA, MRI, and with M1-Middle Cerebral Artery (MCA)±intracranial internal carotid artery (ICA) occlusions were included. Clot length and pial collaterals were measured on baseline CTA.
A total of 104 patients (mean age 65.1±12.28 years, 56.7% male, median baseline National Institutes of Health Stroke Scale 13) with intracranial ICA + MCA (n=50) or isolated M1-MCA (n=54) occlusions were included. Hyperdense sign on NCCT had a median clot length of 42.3 mm versus 29.5 mm when hyperdense negative (p=0.02). Clots showing blooming artifact on gradient recall echo MRI had a median length of 39.1 mm versus 24.5 mm without blooming (p=0.005). Patients with poor baseline collaterals on CTA had longer clots than those with intermediate/good collaterals (median clot length 49.4 mm vs 34.9 mm vs 20.5 mm respectively, p<0.001). In censored logistic regression modeling, clot length was an independent predictor of hyperdense sign (p=0.05) and of the presence of blooming artifact (p=0.006).
Clot length and baseline collateral status are independent predictors of clot hyperdensity on NCCT and blooming artifact on gradient recall echo. Longer clots are more likely to be hyperdense and to bloom more, probably because portions of these clots are freshly formed locally due to of stasis of blood around the original clot. This stasis could be because of poor collaterals and inefficient angio-architecture within the cerebral arterial tree.
To compare and evaluate the reliability of several indexes of adherence to the Mediterranean diet.
The ten indexes included in the analysis were: Mediterranean Diet Score (MDS), Mediterranean Score (MS), Dietary Score (DS), Mediterranean-Dietary Quality Index (Med-DQI), Mediterranean Dietary Pattern adherence index (MDP), Mediterranean Adequacy Index (MAI), Mediterranean Style Dietary Pattern Score (MSDPS), Mediterranean food pattern PREDIMED Study (MeDiet-PREDIMED), relative Mediterranean diet (rMED) and Cardioprotective Mediterranean diet index. Factor analysis using the correlations between indexes was applied. The correlation with factors and the reliability coefficient were calculated.
A total of 324 healthy undergraduates at the University of Barcelona, Spain, were surveyed.
The highest correlations were observed between MDP adherence index and MAI (0·82); MAI and MSDPS (0·80); and MDS and rMED (0·77). Factor analysis showed a hidden common factor that explained over 70 % of the variability (71·03 %). This factor is understood as ‘adherence to the Mediterranean diet’. The indexes that showed the highest correlation with this factor were Med-DQI (0·85), MDS (0·84), rMED (0·80) and MAI (0·80). These indexes showed acceptable performance in measuring the adherence to the Mediterranean diet. The components that correlated strongly with this factor were monounsaturated-to-saturated fatty acid ratio (MS ratio), fruit and vegetables. Furthermore, a second common factor was found explaining 18 % of the variability. This second factor is highly positive related to dairy products and lean meat, and negative related to MS ratio.
The indexes showed satisfactory performance in assessing adherence to the Mediterranean diet. However, in order to improve the reliability and concordance between the indexes, further studies are required to select the components, the number of components, and the scoring criteria of the indexes to improve their internal consistency.
If anyone still raises doubts about the function of philology and the need for critical editions, this book should definitely put those doubts to rest. It shows that no history of philosophy is possible without intensive philological work with the original texts.
The stages in the development of Averroes' philosophy can be better defined by the revisions Averroes himself made of his works than by the traditional order of his commentaries (short, middle, long); such revisions often take the form of glosses. In his initial stages Averroes' opinions are influenced by the interpretations of Alexander of Aphrodisias and Themistius as well as Avempace. In his final stages, he departs from them and moves closer to Aristotle's original thought. Averroes' reading of the beginning of Physics, Book VIII is an exception: there he agrees with Aristotle in the first stage and moves away from him in the final stage, because he came to believe that Aristotle's purpose in this part of the book was to prove the eternity of heavenly movement. The explanation for the different reading of the introduction to the short commentary can be found in the persecution Averroes and other philosophers suffered in 1197, after which Averroes no longer declared philosophy to be the way to attain human perfection, and he only wanted to illuminate Aristotle's philosophy.
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