Característiques clíniques i fragilitat dels usuaris de l'atenció domiciliària a la ciutat de Barcelona

Objectiu. Identificar les característiques sociodemogràfiques i clíniques dels usuaris de l'atenció docimiliària en Atenció Primària de Salut. Metodologia. Estudi descriptiu transversal als equips d'Atenció Primària de la Gerència Territorial de Barcelona de l'Institut Català de la Salut. Els participants de l'estudi van ser tots els usuaris del programa d'atenció domiciliària durant l'any 2019. Es van excloure les persones institucionalitzades. Les variables principals eren: sociodemogràfiques (edat, sexe, viure sol), criteris de complexitat clínica, polifarmàcia, nivell de fragilitat (efragicap), dependència funcional, deteriorament cognitiu, risc social, sobrecàrrega del cuidador, nombre i tipus de visites. Resultats. Es van analitzar un total de 13 044 persones que romanien en el programa d'atenció domiciliària a final de l'any. La majoria eren dones (72%) i la edat mitjana era de 86,1 anys (DE 10,5). Un 51,8% tenien identificada complexitat clínica i un 7,4 % una malaltia crònica avançada. La polifarmàcia era elevada (88,3%) Hi havia una alta prevalença de dependència (90%) i aproximadament la meitat de les persones tenien el cribratge de deteriorament cognitiu alterat. Un 10,8% presentaven nafres i un 68,7% incontinència. Un 18,3% vivien sols. La majoria dels problemes clínics tenien una correlació positiva amb la fragilitat. La fragilitat greu era la majoritària, amb un 69,2% dels casos, seguida de la moderada amb un 26,1% i la lleu amb un 4,1%. Conclusions. Els usuaris del programa d'atenció domiciliària tenen principalment edat avançada, complexitat clínica i una fragilitat moderada/greu. L'instrument efragicap pot avaluar fàcilment la fragilitat a partir de la història clínica electrònica en Atenció Primàri

The effectiveness of a health promotion with group intervention by clinical trial. Study protocol

<p>Abstract</p> <p>Background</p> <p>The promotion of health and the interventions in community health continue to be one of the pending subjects of our health system. The most prevalent health problems (cardiovascular diseases, cancer, diabetes...) are for the most part related to life habits. We propose a holistic and integral approach as the best option for tackling behavior and its determinants. The research team has elaborated the necessary educational material to realize group teaching, which we call "Health Workshops". The goal of the present study is to evaluate the effectiveness of these Health Workshops in the following terms: Health Related Quality of Life (HRQOL), incorporate and maintain a balanced diet, do physical activity regularly, maintain risk factors such as tension, weight, cholesterol within normal limits and diminish cardiovascular risk.</p> <p>Methods/Design</p> <p>Controlled and random clinical testing, comparing a group of persons who have participated in the Health Workshops with a control group of similar characteristics who have not participated in the Health Workshops.</p> <p>Field of study: the research is being done in Health Centers of the city of Barcelona, Spain.</p> <p>Population studied: The group is composed of 108 persons that are actually doing the Health Workshops, and 108 that are not and form the control group. They are assigned at random to one group or the other.</p> <p>Data Analysis: With Student's t-distribution test to compare the differences between numerical variables or their non parametric equivalent if the variable does not comply with the criteria of normality. (Kolmogorov-Smirnof test). Chi-square test to compare the differences between categorical variables and the Logistic Regression Model to analyze different meaningful variables by dichotomous analysis related to the intervention.</p> <p>Discussion</p> <p>The Health Workshop proposed in the present study constitutes an innovative approach in health promotion, placing the emphasis on the person's self responsibility for his/her own health.</p> <p>The rhythm of a weekly session during 8 weeks with recommended activities to put into practice, as well as the support of the group is an opportunity to incorporate healthy habits and make a commitment to self-care. The sheets handed out are a Health Manual that can always be consulted after the workshop ends.</p> <p>Trial registration</p> <p>Clinical Trials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01440738">NCT01440738</a></p

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements