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Background: Healthcare professionals traditional education reflects constraints to face the complex needs of people with chronic diseases in primary care settings. Since more innovative and practical solutions are required, Virtual Community of Practices (vCoP) seem to better respond to learning updates, improving professional and organizational knowledge. However, little is known about the value created in vCoPs as social learning environments. The objective of this project was to explore the value creation process of a gamified vCoP ("e-mpodera vCoP") aimed at improving the knowledge and attitudes of primary healthcare professionals (PCPs) (nurses and general practitioners) to the empowerment of people with chronic conditions. Methods: A framework analysis assessed the value creation process using a mixed methods approach. The framework provided awareness about knowledge and usefulness in a learning community through five cycles: (1) immediate value, (2) potential value, (3) applied value, (4) realized value, and (5) reframing value. Quantitative data included vCoP analytics such as logins, contributions, points, badges, and performance metrics. Qualitative data consisted of PCPs' forum contributions from Madrid, Catalonia, and Canary Islands over 14 months. Results: A total of 185 PCPs had access to the e-mpodera vCoPs. The vCoP showed the dynamic participation of 146 PCPs, along 63 content activities posted, including a total of 3,571 contributions (including text, images, links to webpages, and other files). Regarding the value creation process, the e-mpodera vCoP seems to encompass a broad spectrum of value cycles, with indicators mostly related to cycle 1 (immediate value – activities and interactions) and cycle 2 (potential value – knowledge capital); and to a lesser extent for cycle 3 (applied value – changes in practice) and for cycle 4 (realized value – performance improvement). The presence of indicators related to cycle 5 (reframing value), was minimal, due to few individual redefinitions of success. Conclusion: To reach a wider range of value possibilities, a combination of learning objectives, competence framework, challenged-based gamified platform, and pathway model of skill development seems crucial. However, additional research is required to gain clearer insights into organizational values, professionals' lifelong educational needs in healthcare, and the long-term sustainability of performance improvement. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 02/05/2016. [ABSTRACT FROM AUTHOR]

Background: Syllis vittata is present from British Waters to the Mediterranean Sea, Morocco and the Canary Islands and recorded from the South African coast and Indian Ocean. Results and conclusion: In this paper, S. vittata is reported for the first time in the Dutch EEZ. [ABSTRACT FROM AUTHOR]

Background: The composition of the average diet for the Canary Islands' population has been the subject of concern for the region's authorities and nutrition specialists. In this study, the composition of the average diet in the Canary Islands is estimated.Method: The approach is based on secondary data on local production and external trade. The breakdown of the total volume of apparent food consumption into specific product categories marketed to the consumers is achieved by applying hypotheses about losses in the distribution process. The estimation of food intake is obtained by making assumptions about the rates of food wastage in the final stage of consumption. This consumption is expressed not only in terms of edible weight and the market value associated with different food groups according to their local or imported origin, but also in terms of their energy and nutrient content.Results: The results obtained suggest a high-calorie diet, close to three thousand kilocalories per person per day, with an average cost of around eight euros per person per day. Imported products, with a lower average cost per unit of energy, provide most of the carbohydrates and fats.Conclusion: This study provides a complementary approach to survey-based evidence and also offers the possibility of evaluating the contributions of local or imported food to the diet. [ABSTRACT FROM AUTHOR]

Background: The Culicoides obsoletus species complex (henceforth 'Obsoletus complex') is implicated in the transmission of several arboviruses that can cause severe disease in livestock, such as bluetongue, African horse sickness, epizootic hemorrhagic disease and Schmallenberg disease. Thus, this study aimed to increase our knowledge of the composition and genetic diversity of the Obsoletus complex by partial sequencing of the cytochrome c oxidase I (cox1) gene in poorly studied areas of Spain. Methods: A study of C. obsoletus populations was carried out using a single-tube multiplex polymerase chain reaction (PCR) assay that was designed to differentiate the Obsoletus complex sibling species Culicoides obsoletus and Culicoides scoticus, based on the partial amplification of the cox1 gene, as well as cox1 georeferenced sequences from Spain available at GenBank. We sampled 117 insects of the Obsoletus complex from six locations and used a total of 238 sequences of C. obsoletus (ss) individuals (sampled here, and from GenBank) from 14 sites in mainland Spain, the Balearic Islands and the Canary Islands for genetic diversity and phylogenetic analyses. Results: We identified 90 C. obsoletus (ss), 19 Culicoides scoticus and five Culicoides montanus midges from the six collection sites sampled, and found that the genetic diversity of C. obsoletus (ss) were higher in mainland Spain than in the Canary Islands. The multiplex PCR had limitations in terms of specificity, and no cryptic species within the Obsoletus complex were identified. Conclusions: Within the Obsoletus complex, C. obsoletus (ss) was the predominant species in the analyzed sites of mainland Spain. Information about the species composition of the Obsoletus complex could be of relevance for future epidemiological studies when specific aspects of the vector competence and capacity of each species have been identified. Our results indicate that the intraspecific divergence is higher in C. obsoletus (ss) northern populations, and demonstrate the isolation of C. obsoletus (ss) populations of the Canary Islands. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with significant potential morbidity and mortality. Substantial gaps have been documented between the development and dissemination of clinical practice guidelines (CPG) and their implementation in practice. The aim of this study is to assess the effectiveness and cost-effectiveness of a multi-component knowledge transfer intervention to implement a CPG for the management of SLE (CPG-SLE).Methods: The study is an open, multicentre, controlled trial with random allocation by clusters to intervention or control. Clusters are four public university hospitals of the Canary Islands Health Service where rheumatologists are invited to participate. Patients diagnosed with SLE at least one year prior to recruitment are selected. Rheumatologists in intervention group receive a short educational group programme to both update their knowledge about SLE management according to CPG-SLE recommendations and to acquire knowledge and training on use of the patient-centred approach, a decision support tool embedded in the electronic clinical record and a quarterly feedback report containing information on management of SLE patients. Primary endpoint is change in self-perceived disease activity. Secondary endpoints are adherence of professionals to CPG-SLE recommendations, health-related quality of life, patient perception of their participation in decision making, attitudes of professionals towards shared decision making, knowledge of professionals about SLE and use of healthcare resources. Calculated sample size is 412 patients. Data will be collected from questionnaires and clinical records. Length of follow-up will be 18 months. Multilevel mixed models with repeated time measurements will be used to analyze changes in outcomes over time. Cost-effectiveness, from both social and healthcare services perspectives, will be analyzed by measuring effectiveness in terms of quality-adjusted life years gained. Deterministic and probabilistic sensitivity analyses are planned.Discussion: Impact of CPGs in clinical practice could be improved by applying proven value interventions to implement them. The results of this ongoing trial are expected to generate important scientifically valid and reproducible information not only on clinical effectiveness but also on cost-effectiveness of a multi-component intervention for implementation of a CPG based on communication technologies for chronic patients in the hospital setting.Trial Registration: ClinicalTrial.gov NCT03537638 . Registered on 25 May 2018. [ABSTRACT FROM AUTHOR]

A conference paper on bioinformatics in phylogeography is presented. It describes the use of phylogeographic approach to describe and interpret relationships between the genealogy of populations or closely related species, estimated from DNA sequences. It also presents data on studies that focused on the phylogeography and population dynamics of beetles endemic to the Canary Islands.

Background Considered a biodiversity hotspot, the Canary Islands have been the key subjects of numerous evolutionary studies concerning a large variety of organisms. The genus Cheirolophus (Asteraceae) represents one of the largest plant radiations in the Canarian archipelago. In contrast, only a few species occur in the Mediterranean region, the putative ancestral area of the genus. Here, our main aim was to reconstruct the phylogenetic and biogeographic history of Cheirolophus with special focus on explaining the origin of the large Canarian radiation. Results We found significant incongruence in phylogenetic relationships between nuclear and plastid markers. Each dataset provided resolution at different levels in Cheirolophus: the nuclear markers resolved the backbone of the phylogeny while the plastid data provided better resolution within the Canarian clade. The origin of Cheirolophus was dated in the Mid-Late Miocene, followed by rapid diversification into the three main Mediterranean lineages and the Macaronesian clade. A decrease in diversification rates was inferred at the end of the Miocene, with a new increase in the Late Pliocene concurrent with the onset of the Mediterranean climate. Diversification within the Macaronesian clade started in the Early- Mid Pleistocene, with unusually high speciation rates giving rise to the extant insular diversity. Conclusions Climate-driven diversification likely explains the early evolutionary history of Cheirolophus in the Mediterranean region. It appears that the exceptionally high diversification rate in the Canarian clade was mainly driven by allopatric speciation (including intra- and interisland diversification). Several intrinsic (e.g. breeding system, polyploid origin, seed dispersal syndrome) and extrinsic factors (e.g. fragmented landscape, isolated habitats, climatic and geological changes) probably contributed to the progressive differentiation of populations resulting in numerous microendemisms. Finally, hybridization events and emerging ecological adaptation may have also reinforced the diversification process. [ABSTRACT FROM AUTHOR]

Background Complete mitochondrial DNA (mtDNA) genome analyses have greatly improved the phylogeny and phylogeography of human mtDNA. Human mitochondrial DNA haplogroup U6 has been considered as a molecular signal of a Paleolithic return to North Africa of modern humans from southwestern Asia. Results Using 230 complete sequences we have refined the U6 phylogeny, and improved the phylogeographic information by the analysis of 761 partial sequences. This approach provides chronological limits for its arrival to Africa, followed by its spreads there according to climatic fluctuations, and its secondary prehistoric and historic migrations out of Africa colonizing Europe, the Canary Islands and the American Continent. Conclusions The U6 expansions and contractions inside Africa faithfully reflect the climatic fluctuations that occurred in this Continent affecting also the Canary Islands. Mediterranean contacts drove these lineages to Europe, at least since the Neolithic. In turn, the European colonization brought different U6 lineages throughout the American Continent leaving the specific sign of the colonizers origin. [ABSTRACT FROM AUTHOR]

The article focuses on the study which detects that use of cocaine during the pregnancy is not beneficial for health of the mother. It also discusses the result which demonstrate that cocaine use by pregnant women in Canary Islands and suggested that data should be used for the purpose of preventive health and policy strategies.

• Context: The suitability of thinning to prevent forest growth decline as a result of global warming has not been tested extensively in Macaronesian Canary pine ( Pinus canariensis Sweet ex Spreng.). • Aims: This study aimed to answer the following questions: (1) are tree growth patterns modified by the aspect and thinning intensity? (2) Is sensitivity to climate modulated by thinning? (3) Do trees of different crown classes respond differentially to thinning intensity and climate? • Methods: We used tree-ring series from dominant, codominant, and overtopped trees to study the effects of thinning intensity on basal area increments (BAI) and climate sensitivity on windward (wet) and leeward (dry) slopes on Tenerife, Canary Islands. Three replicated blocks of control, light thinning, and heavy thinning stands were set on each slope in 1988, and cores were extracted in 2007. • Results: Heavy thinning induced growth release and increased BAI, mainly on dominant and codominant trees, whereas light thinning effects were negligible; their impacts were more intense on the windward side. Temperature sensitivity was hardly affected by thinning on leeward, where climate control was stronger. On windward, thinning enhanced the influence of summer temperatures. Upper crown classes were more sensitive overall, but overtopped trees responded better in summer. Thinning intensity and aspect greatly influence growth on Canary pine afforestations, but individual responses are highly dependent on crown classes. In addition, thinning may be less effective to modify growth conditions on leeward slopes, at least if not intense. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to describe the health-related quality of life of Canarian population using information from the Canary Island Health Survey and three observational studies developed in the Canary Islands. Methods: A descriptive analysis was carried out on a sample of 5.549 Canarian citizens using information from 2004 Canary Island Health Survey and three observational studies on Alzheimer's disease, Stroke and HIV. EQ-5 D was the generic tool used for revealing quality of life of people surveyed. Besides the rate of people reporting moderate or severe decrease in quality of life, TTO-index scores and visual analogue scale were used for assessing health related quality of life of people that suffer a specific diseases and general population. Results: Self-perceived health status of citizens that suffer chronic diseases of high prevalence, identifies by the Canary Island Health Survey and other diseases such Alzheimer's disease, Stroke and HIV, independently examined in observational studies, are worse than self-perceived health of general population. Depression/anxiety and pain/ discomfort were identified as the dimensions of the EQ-5 D with highest prevalence of problems. Alzheimer's disease and stroke were the illnesses with greater loss of quality of life. Conclusions: Health related quality of life should be integrated into a set of information along with expectancy of life, incidence and prevalence of chronic diseases for developing health policy and planning health care activities The combination of information on health related quality of life from population health surveys with data from observational studies enlarges the sources of relevant information for setting health priorities and assessing the impact of health policies. [ABSTRACT FROM AUTHOR]

Background: The objective was to determine the economic burden, as well as the impact on HRQOL for people with HIV/AIDS in Spain in 2003. Methods: A cross-sectional study of 572 people with HIV were recruited from outpatient clinics in the Canary Islands, Spain. Demographic, health resources utilization, indirect costs and quality of life data were collected through medical records and questionnaires filled out by people with HIV. HRQOL was measured with two generic questionnaires: SF-36 and EQ-5D. Results: In 2003 annual costs of caring for patients with asymptomatic HIV, symptomatic HIV and AIDS were €10,351, €14,489 and €15,750, respectively. The HRQOL with the EQ-5D was 0.78. SF-36 summary results for physical and mental health were 48.30 and 38.80, respectively. Conclusion: HIV/AIDS represent a high economic impact from society point of view. the structure of health care costs have changed due to these new drugs, increasing the weight of pharmaceutical treatment over total costs and decreasing the importance of inpatient care costs. In spite of the therapeutic improvements, labour losses/indirect costs still represent a high cost. Costs and HRQOL were strongly associated with severity. Although the latest drug developments have not yet been able to find the definitive cure, they have allowed an improvement in expectancy of life and in the HRQOL of the patients. [ABSTRACT FROM AUTHOR]

We tagged individuals of the sea urchin Diadema antillarum (Philippi) around the island of Gran Canaria (The Canary Islands) during winter 2001?2002 using a new technique, consisting of the insertion of a hook fastened to a fishing line into the aboral pole (periproctal membrane). This allowed individual identification of tagged sea urchins. The goals were: (1) to quantify nocturnal movements and the homing behaviour of this echinoid on shallow rocky bottoms, and (2) to assess short term spatial and temporal variability of these movements. Tagged sea urchins displayed clear homing behaviour. The mean distance travelled at night was 3.7±1.2 m (range 1.0?5.1 m). Mean speed of nocturnal movement was 33±26 cm h -1 (range 5?110 cm h -1). We observed greater movement at midnight than at the beginning and the end of the night. [ABSTRACT FROM AUTHOR]

Background: Polypharmacy with psychoactive drugs is an increasingly common and debatable contemporary practice in clinical psychiatry based more upon experience than evidence. The objective of this study was to evaluate the prevalence and conditioners of polypharmacy in psychiatric patients. Method: A cross-sectional survey was carried out using the Canary Islands Health Service Clinical Records Database. A representative sample (n = 2,647) of patients with mental disorders receiving psychotropic medication was studied. Results: The mean number of psychoactive drugs prescribed was 1.63 ± 0.93 (range 1-7). The rate of polypharmacy was 41.9%, with 27.8% of patients receiving two drugs, 9.1% receiving three, 3.2% receiving four, and 1.8% of the patients receiving five or more psychotropic drugs. Multiple regression analysis shows that variables sex and diagnosis have a predictive value with regard to the number of psychotropic drug used, being men and schizophrenic patients the most predisposed. Benzodiazepines were the more prevalent drugs in monotherapy, while anticonvulsants and antipsychotics were the more used in combination with other treatment. A questionable very high degree of same-class polypharmacy was evidenced, while multi-class, adjunctive and augmentation polypharmacy seem to be more appropriate. Conclusions: Almost half of the psychiatric patients are treated with several psychotropics. Polypharmacy is common and seems to be problematic, especially when same class of drugs are prescribed together. Some diagnoses, such as schizophrenia, are associated with an increase risk of Polypharmacy but there is a lack of evidence based indicators that allows for quality evaluation on this practice. [ABSTRACT FROM AUTHOR]

Background: Intra-specific and intra-individual polymorphism is frequently observed in nuclear markers of Ilex (Aquifoliaceae) and discrepancy between plastid and nuclear phylogenies is the rule in this genus. These observations suggest that inter-specific plastid or/and nuclear introgression played an important role in the process of evolution of Ilex. With the aim of a precise understanding of the evolution of this genus, two distantly related sympatric species collected in Tenerife (Canary Islands), I. perado and I. canariensis, were studied in detail. Introgression between these two species was previously never reported. One plastid marker (the atpB-rbcL spacer) and two nuclear markers, the ribosomal internal transcribed spacer (ITS) and the nuclear encoded plastid glutamine synthetase (nepGS) were analyzed for 13 and 27 individuals of I. perado and I. canariensis, respectively. Results: The plastid marker is intra-specifically constant and correlated with species identity. On the other hand, whereas the nuclear markers are conserved in I. perado, they are highly polymorphic in I. canariensis. The presence of pseudogenes and recombination in ITS sequences of I. canariensis explain this polymorphism. Ancestral sequence polymorphism with incomplete lineage sorting, or past or recent hybridization with an unknown species could explain this polymorphism, not resolved by concerted evolution. However, as already reported for many other plants, past or recent introgression of an alien genotype seem the most probable explanation for such a tremendous polymorphism. Conclusions: Data do not allow the determination with certitude of the putative species introgressing I. canariensis, but I. perado is suspected. The introgression would be unilateral, with I. perado as the male donor, and the paternal sequences would be rapidly converted in highly divergent and consequently unidentifiable pseudogenes. At least, this study allows the establishment of precautionary measures when nuclear markers are used in phylogenetic studies of genera having experienced introgression such as the genus Ilex. [ABSTRACT FROM AUTHOR]

The midwater scorpionfish Ectreposebastes imus (Scorpaeniformes: Setarchidae) is distributed in tropical and subtropical waters of the worldwide oceans, at depths of 150–800 m. It has previously been recorded from the Gulf of Guinea in the eastern Atlantic. The present work extends the northern limit for the distribution of E. imus in the Atlantic Ocean to the area of the Canary Islands. [ABSTRACT FROM AUTHOR]

Background: Brucella spp. isolation is increasingly reported in cetaceans, although associated pathologies, including lesions of the musculoskeletal and nervous systems, are less frequently described. Concerning the nervous system, Brucella sp. infection causing meningitis, meningoencephalitis or meningoencephalomyelitis have been extensively reported in striped dolphins (Stenella coeruleoalba), and less frequently in other cetacean species. Case presentation: A juvenile female common bottlenose dolphin (Tursiops truncatus) was found stranded alive in Lanzarote (Canary Islands, Spain) in 2005, but died shortly after. On physical examination, the dolphin showed a moderate body condition and was classified as code 2 (fresh dead) at the time of necropsy. The main gross findings were severe multiorgan parasitism, thickened and congested leptomeninges, and (sero)fibrino-suppurative and proliferative arthritis of the shoulder joint. Histopathological examination revealed the distinct features of a sub-acute systemic disease associated with Cetacean Morbillivirus (CeMV) infection. However, brain lesions diverged from those reported in systemic CeMV infection. This led to suspect that there was a coinfecting pathogen, based on the characteristics of the inflammatory response and the lesion distribution pattern in the central nervous system. Brucella sp. was detected in the brain tissue by PCR and Brucella antigen was demonstrated by immunohistochemistry in the brain and shoulder joint lesions. Conclusions: The zoonotic potential of marine mammal strains of Brucella has been demonstrated both in natural and laboratory conditions. In this study, PCR detected Brucella sp. in the brain of a common bottlenose dolphin stranded in the Canary Islands; the dolphin was also co-infected with CeMV. This is the first detection of Brucella sp. infection in a stranded cetacean in this archipelago. Therefore, we stress the importance of taking adequate measures during the handling of these species to prevent the transmissions of the infection to humans. [ABSTRACT FROM AUTHOR]

The African brown snapper Lutjanus dentatus is a fish native of the West African coastal zone of the Atlantic Ocean. Here we document the first recorded capture of this species in the Canary Islands, an archipelago close to Africa, in August 2013. [ABSTRACT FROM PUBLISHER]

A specimen of West African fiddler crab, Uca tangeri, was collected in October 2011 on the north-east coast of Gran Canaria (Canary Islands). This species is frequent along the shores of the east Atlantic from Portugal to Angola, but is very rare in the Canary Islands. There is only a previous record from 1971, but that did not report the place where it was found in the archipelago. [ABSTRACT FROM AUTHOR]