Evaluation of satisfaction among relatives of mentally disabled patients who were users of a dental care protocol under general anaesthesia

Objectives: In the field of action of disease associated with dependence the Third Health Plan of Castilla y León aims specifically at promoting the adjustment of health assistance to the needs of disabled people, according to their situation. Our objectives were: General: To know the satisfaction level among relatives or caregivers of people who were treated according to a protocol of dental care for mentally disabled people. Specific: To know if satisfaction is related to any sociodemographic characteristics of patients or to their pathology. Study design: Cross-sectional study by telephone survey, set in the Primary Health Area of Salamanca. The target population includes relatives or caregivers of mentally disabled patients who were sent to the hospital for treatment under general anaesthesia after being attended in Primary Dental Care Units, from 1st of June/2005 to 31st of May/2006. Social and demographic variables and patients' diseases, as well as level of satisfaction with the service, were studied through a survey. Results: 67.4% of patients' relatives or caregivers answered the survey, among whom 94.7% (C.I. 95%: 89-100%) were quite or very satisfied with the service in general. Conclusion: The protocol has high acceptance despite its diffi culties and it has achieved considerable improve- difficulties improvements in several aspects of patients' life. This level of satisfaction was not related to any sociodemographic or clinical patient characteristics. Nevertheless, accessibility aspects and communication with patients may still be improved. © Medicina Oral S. L

Results of a dental care protocol for mentally handicapped patients set in a primary health care area in Spain

Objective: Disabled people have the same right as other people to receive the health care they need, but they sometimes have difficulties to achieve it. In Castilla y Leon it has come into effect a law to guarantee Primary and Secondary Care coordination to provide dental treatment under sedation or anaesthesia to mentally disabled people who need it. Our aim is to evaluate the results of the implementation of such a law through a specific protocol in our health setting. Study design: Descriptive, made in a Health Area over a year, on mentally disabled people who were sent to hospital for treatment under anaesthesia after Primary Dental Care Units assessment. It has been studied the age, gender, mental disease, dental diagnosis and treatment undergone. Results: 108 patients attended the program (51% male), with a mean age of 31 years. 67% presented profound learning disability, 19% mental illness with disability, 11% presented cerebral palsy and another 3% had autism. Most frequent dental pathologies were caries (86%) and dental plaque (71%). Most common dental procedures were tooth extraction (78%), professional tooth cleaning (75%) and fillings (67%). Conclusions: We achieved to provide necessary dental treatment to a large number of disabled people, who would not have received it otherwise. It was a challenge to plan and implement the protocol coordinating Health Care Levels and workers. It still has to be done an economic and efficiency analysis of procedures and a patient satisfaction study

Evaluación del estado y composición de la Comunidad Fitoplanctónica de las agua del Mar Menor, Murcia (mayo de 2016)

La preocupación, compartida con todos los ciudadanos, por el deterioro de la laguna en las últimas décadas, nos ha llevado a centrar parte de nuestro esfuerzo investigador en el Mar Menor. En este sentido, los indicadores observados durante el pasado año, parecían adelantar la visualización dramática de la situación actual. Los elementos de tampón y autoprotección de la laguna que hasta el momento se consideraban que podían controlar, en parte, las graves presiones antrópicas, estaban siendo alterados (temperaturas cálidas durante todo el año, alteración en los bloom de medusas habituales los últimos años, disminución de la cobertura del tapiz de Caulerpa prolifera, como especie de gran eficiencia en la retirada de nutrientes, etc) y hacían prever la proximidad de un "colapso ambiental". En esta situación, comenzó la inquietud de colectivos y usuarios en general, entre otros, el colectivo de pescadores. Estos últimos, vieron agravada su preocupación, "como consecuencia de la observación de baba en los últimos meses y la turbidez de las aguas en la época (invierno), que a diferencia de otros años resulta superior". Por ello, la Cofradía de Pescadores de San Pedro del Pinatar, solicitó en el mes de enero y posteriormente el mes de mayo del presente año, la realización de un informe/investigación relativo al estado de las aguas del Mar Menor. Solicitud que fue canalizada en el marco de la Unidad mixta UA-IEO. Tras una primera prospección de las posibles actuaciones llevadas a cabo por las diferentes administraciones competentes, se llegó a la conclusión de que no existía, en ese momento (o al menos de forma pública), ningún equipo de investigación técnico y/o científico que estuviese realizando campañas de muestreo sobre la comunidad fitoplanctónica o parámetros asociados en la laguna. Es por ello que en pro del bien común, se asumió la realización de este estudio. En el mes de febrero, se detectó la presencia de un evento de Floración Algal Nocivo (FAN), dominado por la especie Cylindrotheca closterium. La cual es considerada una especie fitoplanctónica nociva por la producción de mucílagos cuando está presente en elevadas concentraciones, situación observada en las muestras analizadas, y causante de la "baba" descrita por los pescadores. Estos primeros resultados nos llevaron a la realización de una segunda campaña de muestreo, asumida con recursos propios del mismo equipo investigador. Se muestrearon mediante metodología estandarizada, 14 puntos distribuidos de forma regular en toda la laguna, tal y como se explica en el informe adjunto. Los resultados mostraron que todas las muestras poseían una elevada abundancia celular, persistiendo la existencia de un evento de Floración Nociva Algal (FAN). El incremento de dinoflagelados hacía aconsejable un análisis específico de toxinas en el medio y en los organismos afectados. Asumiendo nuestro compromiso y responsabilidad como investigadores de instituciones públicas, y acogiéndonos a las obligaciones marcadas por la Directiva INSPIRE 2007/2/CE y la Ley 19/2013, de 9 de diciembre, de transparencia, acceso a la información pública y buen gobierno, los resultados se hacen públicos. En base a estos resultados las administraciones competentes deberían activar un protocolo de seguimiento con una periodicidad mínima semanal y en el que se llevase a cabo un estudio de la evolución de la comunidad fitoplanctónica, así como análisis específicos de toxinas. Con el fin de poder analizar la evolución del estado de la laguna en estos meses críticos

Comparación del índice de vegetación de diferencia normalizada obtenido a diferentes escalas en pastos de dehesa

Las imágenes satelitales son una importante fuente de información para el seguimiento de la vegetación y de la cartografía de la tierra en varias escalas. Varios índices de vegetación se han empleado para evaluar la calidad y cantidad de la vegetación utilizando datos satelitales. Dado que las características de las bandas espectrales del infrarrojo cercano (NIR, radiación reflejada en la longitud de onda 800 nm) y el rojo (RED, radiación reflejada en la longitud de onda 670 nm) son muy distintas según el tipo de sensor, los valores del Índice de Vegetación de la Diferencia Normalizada (NDVI) variarán según el tamaño del píxel y de la heterogeneidad y la escala de las superficies. Se seleccionaron dos zonas de dehesa (Salamanca y Córdoba) y se tomaron imágenes mensuales del satélite DEIMOS-1 con una resolución espacial de 22 m × 22 m. El objetivo de este estudio es establecer una comparación entre diferentes resoluciones, mediante los valores de NDVI obtenidos en diferentes épocas del año en el que la actividad fotosintética de las plantas varía. Los resultados a diferentes escalas mostraron un comportamiento fractal del NDVI por lo que puede concluirse que las áreas de pasto herbáceo evaluadas presentan un comportamiento homogéneo

Aplicación de índices de vegetación para evaluar la falta de producción de pastos y montaneras en dehesas.

El ganado porcino ibérico aprovecha los recursos naturales de la dehesa mediante montanera, principalmente la bellota y los pastos existentes. La línea 133 de los seguros agrarios españoles recoge el seguro de compensación por pérdida de pastos, solo para bovino reproductor y de lidia, ovino, caprino y equino, no incluyen los cerdos en montanera. Emplea un Índice de Vegetación de la Diferencia Normalizada (NDVI) medido por satélite sobre pastos desarbolados. El objetivo es comprobar si se puede utilizar un índice de vegetación para estimar la producción de pasto y bellota. Se han tomado datos del aforo de montaneras desde 1999 al 2005, y del pasto en dehesas de Salamanca (Vitigudino), Cáceres (Trujillo) y Córdoba (Pozoblanco) durante 2010 al 2012. Con los datos de 2010 y 2011 se estableció una función de producción del pasto fresco en función del NDVI, mostrando un coeficiente de correlación de 0,975, altamente significativa. Los datos obtenidos en 2012 se utilizaron para validar la función de producción de pasto fresco. La comparación entre los valores observados y simulados para 2012 ha mostrado un coeficiente de correlación de 0,734. Como conclusión, el NDVI puede ser un buen estimador de la cantidad de pasto fresco en dehesas españolas

Application of Vegetation Indices to Estimate Acorn Production at Iberian

The Iberian pig valued natural resources of the pasture when fattened in mountain. The variability of acorn production is not contained in any line of Spanish agricultural insurance. However, the production of arable pasture is covered by line insurance number 133 for loss of pasture compensation. This scenario is only contemplated for breeding cows and brave bulls, sheep, goats and horses, although pigs are not included. This insurance is established by monitoring ten-day composites Normalized Difference Vegetation Index (NDVI) measured by satellite over treeless pastures, using MODIS TERRA satellite. The aim of this work is to check if we can use a satellite vegetation index to estimate the production of acorns

Comparison of NDVI fields obtained from different remote sensors

Satellite image data have become an important source of information for monitoring vegetation and mapping land cover at several scales. Beside this, the distribution and phenology of vegetation is largely associated with climate, terrain characteristics and human activity. Various vegetation indices have been developed for qualitative and quantitative assessment of vegetation using remote spectral measurements. In particular, sensors with spectral bands in the red (RED) and near-infrared (NIR) lend themselves well to vegetation monitoring and based on them [(NIR - RED) / (NIR + RED)] Normalized Difference Vegetation Index (NDVI) has been widespread used. Given that the characteristics of spectral bands in RED and NIR vary distinctly from sensor to sensor, NDVI values based on data from different instruments will not be directly comparable. The spatial resolution also varies significantly between sensors, as well as within a given scene in the case of wide-angle and oblique sensors. As a result, NDVI values will vary according to combinations of the heterogeneity and scale of terrestrial surfaces and pixel footprint sizes. Therefore, the question arises as to the impact of differences in spectral and spatial resolutions on vegetation indices like the NDVI and their interpretation as a drought index. During 2012 three locations (at Salamanca, Granada and Córdoba) were selected and a periodic pasture monitoring and botanic composition were achieved. Daily precipitation, temperature and monthly soil water content were measurement as well as fresh and dry pasture weight. At the same time, remote sensing images were capture by DEIMOS-1 and MODIS of the chosen places. DEIMOS-1 is based on the concept Microsat-100 from Surrey. It is conceived for obtaining Earth images with a good enough resolution to study the terrestrial vegetation cover (20x20 m), although with a great range of visual field (600 km) in order to obtain those images with high temporal resolution and at a reduced cost. By contranst, MODIS images present a much lower spatial resolution (500x500 m). The aim of this study is to establish a comparison between two different sensors in their NDVI values at different spatial resolutions. Acknowledgements. This work was partially supported by ENESA under project P10 0220C-823. Funding provided by Spanish Ministerio de Ciencia e Innovación (MICINN) through project no. MTM2009-14621 and i-MATH No. CSD2006-00032 is greatly appreciated

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio