Estudio sobre la prevalencia del burnout en los médicos del Área Sanitaria de Talavera de la Reina

ObjetivoDeterminar el grado de burnout, o desgaste profesional, en los médicos del Área Sanitaria de Talavera de la Reina y los factores asociadosDiseñoEstudio descriptivo transversalSujetosMédicos dedicados a la atención primaria (AP) (n = 106) y atención especializada (AE) (n = 129)MedicionesCuestionario Maslach Burnout Inventory (MBI) y encuesta con variables sociodemográficas y sugerencias. Ambos anónimos y autoadministrablesResultadosContestaron 144 médicos (61,27%), 63 de AP y 81 de AE, varones el 72,2% y con una media de edad de 45 años (con una escasa variabilidad entre AP y AE). La media de años trabajados fue de 18,65. Realizan guardias 102 (70,83%). El tipo de contrato es fijo en 85 (59,02%), interino en 49 (34,02%) y "otros" en 10(6,94%). Presenta burnout el 76,4% de los profesionales (moderado en el 38,9% y alto en el 37,5%). Resulta estadísticamente significativa la diferencia entre burnout de AP y AE (el 85,7 frente al 69,1%). En el resto de las variables estudiadas edad, sexo, estado civil, realización de guardias no encontramos diferencias significativas. Como sugerencias para mitigar el burnout destacan la petición de apoyo de mejoras laborales, un mayor reconocimiento personal y profesional, la implicación de la Administración y la Gerencia, la remuneración económica, facilitar formación e investigación, etcConclusiones.El grado de desgaste profesional (burnout) es muy elevado en nuestra área, con un mayor porcentaje en AP que en AEObjectiveTo determine the degree of burnout or professional wear-and-tear in doctors from the Talavera de la Reina Health Area and linked factorsDesignTransversal, descriptive studyParticipantsDoctors in primary care (PC)(n=106) and specialist care (SC) (n=129)Measurements and ResultsMaslach Burnout Inventory (MBI) questionnaire and a survey with social and demographic variables and suggestions. Both were anonymous and self-administeredResults144 (61.27%) answered, 63 from PC and 81 SC. 72.2% were male, with a meanage of 45 (with little variability between PC and SC). Average years worked were 18.65.102 (70.83%) worked cover. 85 (59.02%) had an indefinite contract, 49 (34.02%) a temporary one, and 10 (6.94%) other kinds.76.4% of the professionals suffered burnout(moderate in 38.9% and high in 37.5%). The difference between PC and SC burnout(85.7% vs 69.1%) was statistically significant.In the remaining variables studied (age, sex, marital status, working of cover shifts…) we found no significant differences. Among suggestions to mitigate burnout were demands to support improvements in working conditions, greater personal and professional recognition, involvement of the government and management, economic remuneration,providing more training and research, etcConclusionsProfessional wear-and-tear or burnout is very high in our area, and is higher in PC than in S

Aspectos a considerar en el diseño y ejecución de espigones de baja cota : el caso del espigón de Fuentebravía

Los espigones de baja cota de coronación se han utilizado con éxito como obras necesarias para evitar la pérdida lateral de arena, en los casos en que se minimicen los efectos negativos que dichos espigones puedan causar en las playas cercanas. Han sido varios los espigones de baja cota de coronación utilizados en el litoral gaditano (Playas de Santa María del Mar en Cádiz, Regla en Chipiona, La Costilla en Rota, y Fuentebravía, en El Puerto de Santa María). Entre los factores a tener en cuenta en su diseño, destacan principalmente los siguientes aspectos (Gómez Pina, 2003): i) Técnicos, ii) Ambientales, iii) Económicos, iv) De integración en el entorno, v) Estéticos, vi) Recreacionales. Todos estos aspectos deben abordarse de una forma integral, siendo los tres últimos—aunque puedan parecer de menor importancia—cruciales a la hora de obtener la aceptación social, entre los distintos grupos que utilizan la playa

Personal Autonomy Rehabilitation in Home Environments by a Portable Assistive Robot

Increasingly disabled and elderly people with mobility problems want to live autonomously in their home environment. They are motivated to use robotic aids to perform tasks by themselves, avoiding permanent nurse or family assistant supervision. They must find means to rehabilitate their abilities to perform daily life activities (DLAs), such as eating, shaving, or drinking. These means may be provided by robotic aids that incorporate possibilities and methods to accomplish common tasks, aiding the user in recovery of partial or complete autonomy. Results are highly conditioned by the system's usability and potential. The developed portable assistive robot ASIBOT helps users perform most of these tasks in common living environments. Minimum adaptations are needed to provide the robot with mobility throughout the environment. The robot can autonomously climb from one surface to another, fixing itself to the best place to perform each task. When the robot is attached to its wheelchair, it can move along with it as a bundle. This paper presents the work performed with the ASIBOT in the area of rehabilitation robotics. First, a brief description of the ASIBOT system is given. A description of tests that have been performed with the robot and several impaired users is given. Insight into how these experiences have influenced our research efforts, especially, in home environments, is also included. A description of the test bed that has been developed to continue research on performing DLAs by the use of robotic aids, a kitchen environment, is given. Relevant conclusions are also included.This work has been supported by the CAM Project S2009/DPI-1559/ROBOCITY2030 I

System size resonance in an attractor neural network

We study the response of an attractor neural network, in the ferromagnetic phase, to an external, time-dependent stimulus, which drives the system periodically two different attractors. We demonstrate a non-trivial dependance of the system via a system size resonance, by showing a signal amplification maximum at a certain finite size.Comment: 7 pages, 9 figures, submitted to Europhys. Let

Synergic effect of corneal hysteresis and central corneal thickness in the risk of early‑stage primary open‑angle glaucoma progression

Received: 2 September 2020. Revised: 9 March 2021. Accepted: 19 April 2021. Published online: 7 May 2021.Purpose: To evaluate corneal hysteresis (CH), acquired with ocular response analyzer (ORA), as a risk factor for glaucoma progression in early-stage primary open-angle glaucoma (POAG). Methods: In a historical cohort study, patients diagnosed in 2011 with early-stage POAG according to the Hodapp, Parrish and Anderson classification modified for Octopus perimetry and followed up until glaucomatous progression development; otherwise, observations were censored in October 2018. Cox regression was used to obtain hazard ratios (HR) to evaluate baseline variables (CH, central corneal thickness, gender, age IOP and glaucoma family history) as risk factors for perimetric glaucoma progression. A likelihood ratio test for interaction was performed in order to assess the effect of the combination of CH and CCT on the risk of progression. Results: Of the cohort of 1573 patients, 11.38% developed early-stage POAG progression during the follow-up. The mean follow-up time was 3.28 ± 1.92 years. Patients without progression had a higher CH (11.35 ± 1.43 vs 9.07 ± 1.69 mmHg; p < 0.001) and CCT (570.75 ± 17.71 vs 554.51 ± 23.20; p < 0.001). In the multivariate analysis, each 1 mmHg of lower CH was associated with an increase of 2.13 times in the HR of progression (95% CI: 1.92–2.32; p < 0.001). CH hazard ratio was modified by CCT, with higher values of CCT and CH resulting in a higher HR of early glaucoma progression (p < 0.001). Conclusions: CH can be considered as a risk factor of progression in early-stage POAG. The risk associated with CH changed depending on CCT values, acting synergistically slowing the risk of glaucoma progression with higher values.Depto. de Inmunología, Oftalmología y ORLUnidad Docente de Inmunología, Oftalmología y ORLFac. de PsicologíaFac. de MedicinaFac. de Óptica y OptometríaTRUEinpres

Gaze-based Human-Robot Interaction System for Object Manipulation

[Resumen] En este artículo, se presenta una solución completa de interacción humano-robot basada en la mirada para ayudar al usuario en tareas de manipulación de objetos. El usuario utiliza unas gafas de seguimiento ocular y se detecta la intención en su mirada de coger un objeto entre varios situados sobre una mesa. El robot, una vez identificado el objeto seleccionado, procede a recogerlo y se lo acerca al usuario. Nuestra solución se compone de diferentes componentes, como la estimación de forma y posición de los objetos utilizando supercuádricas en el sistema de referencia del robot, la identificación y selección del objeto coincidente en la imagen del robot mediante redes siamesas, y un proceso adicional que permite al robot recoger el objeto seleccionado por el usuario de manera efectiva. Esta solución proporciona una forma innovadora y efectiva de interacción para realizar tareas asistenciales de manipulación, sin necesidad de marcadores ni posiciones predefinidas de los objetos, mejorando la fluidez en la comunicación y facilitando la interacción natural entre el usuario y el robot.[Abstract] In this article, we present a complete solution for gaze-based human-robot interaction to assist the user in object manipulation tasks. The user wears eye-tracking glasses, and their intention to pick up an object among several placed on a table is detected through their gaze. Once the selected object is identified, the robot proceeds to grasp it and bring it closer to the user. Our solution consists of various components, including the estimation of object shape and position using superquadrics in the robot’s reference frame, the identification and selection of the matching object in the robot’s image using Siamese networks, and an additional process that enables the robot to pick-up the object selected by the user. This solution offers an innovative and effective way of interaction to perform assistive manipulation tasks, without the need for markers or predefined object positions, enhancing communication fluency and facilitating natural interaction between the user and the robot.Comunidad de Madrid; Y2020/NMT-6660Ministerio de Economía, Industria y Competitividad; PID2020-13194GBI0

System size resonance in coupled noisy systems and in the Ising model

We consider an ensemble of coupled nonlinear noisy oscillators demonstrating in the thermodynamic limit an Ising-type transition. In the ordered phase and for finite ensembles stochastic flips of the mean field are observed with the rate depending on the ensemble size. When a small periodic force acts on the ensemble, the linear response of the system has a maximum at a certain system size, similar to the stochastic resonance phenomenon. We demonstrate this effect of system size resonance for different types of noisy oscillators and for different ensembles -- lattices with nearest neighbors coupling and globally coupled populations. The Ising model is also shown to demonstrate the system size resonance.Comment: 4 page

Reward devaluation disrupts latent inhibition in fear conditioning

Three experiments explored the link between reward shifts and latent inhibition (LI). Using consummatory procedures, rewards were either downshifted from 32% to 4% sucrose (Experiments 1–2), or upshifted from 4% to 32% sucrose (Experiment 3). In both cases, appropriate unshifted controls were also included. LI was implemented in terms of fear conditioning involving a single tone-shock pairing after extensive tone-only preexposure. Nonpreexposed controls were also included. Experiment 1 demonstrated a typical LI effect (i.e., disruption of fear conditioning after preexposure to the tone) in animals previously exposed only to 4% sucrose. However, the LI effect was eliminated by preexposure to a 32%-to-4% sucrose devaluation. Experiment 2 replicated this effect when the LI protocol was administered immediately after the reward devaluation event. However, LI was restored when preexposure was administered after a 60- min retention interval. Finally, Experiment 3 showed that a reward upshift did not affect LI. These results point to a significant role of negative emotion related to reward devaluation in the enhancement of stimulus processing despite extensive nonreinforced preexposure experience

Impacto de la formación en el manejo de la patología locomotriz axial atraumática en la actividad asistencial del médico interno residente

El objetivo del presente estudio es el determinar el efecto de la aplicación de un programa formativo para médicos internos residentes sobre manejo de patología atraumática axial en un entorno de medicina de urgencias.El programa formativo consiste en la aplicación de una jornada de charlas magistrales de 4 horas lectivas que se imparten a lo largo del año a residentes que van a empezar su segundo año de programa de especialización y que realizan actividad en el servicio de urgencias.El estudio consistió en valorar la aplicación de los conocimientos impartidos en la labor asistencial durante las jornadas de atención continuada (guardias de puerta) en términos de necesidad de reevaluaciones por urgencias, uso de pruebas complementarias y necesidad de hospitalización por mal control analgésico.La cifra de solicitud de pruebas radiológicas complementarias se redujo significativamente después de la ejecución del curso optativo sin embargo en los siguientes meses la cifra retornó a su valor inicial. El asistir al curso no modificó significativamente el tiempo hasta que los pacientes volvieron a consultar por el mismo motivo aunque se evidenció una tendencia a la prolongación de este en pacientes atendidos por residentes que hicieron el curso. La especialidad de procedencia de los MIRes fue la variable que más influyó en la curva de supervivencia.Concluimos que el impacto de la formación en el manejo de la patología axial depende de los cursos impartidos y del interés que estos generen en los MIRes