1,654 research outputs found

    Optimal solution of a diffusion equation with a discrete source term

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    In this paper we study the numerical behavior of a diffusion equation with a discrete control source term. The equation is discretized in space by finite differences and in time by an implicit scheme. The control variables are calculated in order to minimize an objective function, taking into account some restrictions. We define two strategies to obtain the optimal solution and present some numerical results in a context of a model that describes the oxygen concentration in a single chamber microbial fuel cell

    Statistical Mechanics Characterization of Neuronal Mosaics

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    The spatial distribution of neuronal cells is an important requirement for achieving proper neuronal function in several parts of the nervous system of most animals. For instance, specific distribution of photoreceptors and related neuronal cells, particularly the ganglion cells, in mammal's retina is required in order to properly sample the projected scene. This work presents how two concepts from the areas of statistical mechanics and complex systems, namely the \emph{lacunarity} and the \emph{multiscale entropy} (i.e. the entropy calculated over progressively diffused representations of the cell mosaic), have allowed effective characterization of the spatial distribution of retinal cells.Comment: 3 pages, 1 figure, The following article has been submitted to Applied Physics Letters. If it is published, it will be found online at http://apl.aip.org

    A Technological-Based Platform for Risk Assessment, Detection, and Prevention of Falls Among Home-Dwelling Older Adults: Protocol for a Quasi-Experimental Study

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    Background: According to the United Nations, it is estimated that by 2050, the number of people aged 80 years and older will have increased by 3 times. Increased longevity is often accompanied by structural and functional changes that occur throughout an individual’s lifespan. These changes are often aggravated by chronic comorbidities, adopted behaviors or lifestyles, and environmental exposure, among other factors. Some of the related outcomes are loss of muscle strength, decreased balance control, and mobility impairments, which are strongly associated with the occurrence of falls in the elderly. Despite the continued undervaluation of the importance of knowledge on fall prevention among the elderly population by primary care health professionals, several evidence-based (single or multifaceted) fall prevention programs such as the Otago Exercise Program (OEP) have demonstrated a significant reduction in the risk of falls and fall-related injuries in the elderly within community settings. Recent studies have strived to integrate technology into physical exercise programs, which is effective for adherence and overcoming barriers to exercise, as well as improving physical functioning. Objective: This study aims to assess the impact of the OEP on the functionality of home-dwelling elderly using a common technological platform. Particularly, the impact on muscle strength, balance, mobility, risk of falling, the perception of fear of falling, and the perception of the elderly regarding the ease of use of technology are being examined in this study. Methods: A quasi-experimental study (before and after; single group) will be conducted with male and female participants aged 65 years or older living at home in the district of Porto. Participants will be recruited through the network COLABORAR, with a minimum of 30 participants meeting the study inclusion and exclusion criteria. All participants will sign informed consent forms. The data collection instrument consists of sociodemographic and clinical variables (self-reported), functional evaluation variables, and environmental risk variables. The data collection tool integrates primary and secondary outcome variables. The primary outcome is gait (timed-up and go test; normal step). The secondary outcome variables are lower limb strength and muscle resistance (30-second chair stand test), balance (4-stage balance test), frequency of falls, functional capacity (Lawton and Brody - Portuguese version), fear of falling (Falls Efficacy Scale International - Portuguese version), usability of the technology (System Usability Scale - Portuguese version), and environmental risk variables (home fall prevention checklist for older adults). Technological solutions, such as the FallSensing Home application and Kallisto wearable device, will be used, which will allow the detection and prevention of falls. The intervention is characterized by conducting the OEP through a common technological platform 3 times a week for 8 weeks. Throughout these weeks, the participants will be followed up in person or by telephone contact by the rehabilitation nurse. Considering the COVID-19 outbreak, all guidelines from the National Health Service will be followed. The project was funded by InnoStars, in collaboration with the Local EIT Health Regional Innovation Scheme Hub of the University of Porto. Results: This study was approved on October 9, 2020 by the Ethics Committee of Escola Superior de Enfermagem do Porto (ESEP). The recruitment process was meant to start in October, but due to the COVID-19 pandemic, it was suspended. We expect to restart the study by the beginning of the third quarter of 2021. Conclusions: The findings of this study protocol will contribute to the design and development of future robust studies for technological tests in a clinical context.info:eu-repo/semantics/publishedVersio

    Physical Exercise Program on Fall Prevention Using Technological Interface: Pretest Study

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    Background: Prevention of falls among older adults has boosted the development of technological solutions, requiring testing in clinical contexts and robust studies that need prior validation of procedures and data collection tools. Objective: The objectives of our study were to test the data collection procedure, train the team, and test the usability of the FallSensing Games app by older adults in a community setting. Methods: This study was conducted as a pretest of a future pilot study. Older adults were recruited in a day care center, and several tests were applied. Physical exercise sessions were held using the interactive FallSensing Games app. Nurse training strategies was completed. Results: A total of 11 older adults participated. The mean age was 75.08 (SD 3.80) years, mostly female (10/11, 91%) and with low (3-6 years) schooling (10/11, 91%). Clinically, the results show a group of older adults with comorbidities. Cognitive evaluation of the participants through the Mini Mental State Examination showed results with an average score of 25.64 (SD 3.5). Functional capacity assessed using the Lawton Instrumental Activities of Daily Living Scale (overall score from 0-23, with lower scores reflecting worse capacity to perform activities) showed impairment in different instrumental activities of daily living (average score 14.27). The data collection tool proved to enable easy interpretation; however, its structure needed small adjustments to facilitate the data collection process. Despite the length of the questionnaire, its implementation took an average of 21 minutes. For the assessment of the prevalence of fear of falling, the need to add a question was identified. The performance of functional tests under the guidance and presence of rehabilitation nurses ensured the safety of the participants. The interactive games were well accepted by the participants, and the physical exercises allowed data collection on the functionality of the older adults, such as the number of repetitions in the tests, range of movement (angle), duration of the movements, and execution of each cycle. Concerning the training of the nurses, it was crucial that they had experience with the platform, specifically the position of the chair facing the platform, the position of the feet, the posture of participants, and the use of sensors. Conclusions: In the future pilot study, the researchers point out the need to design a study with mixed methods (quantitative and qualitative), thus enriching the study results.info:eu-repo/semantics/publishedVersio

    La coconstrucción de un modelo de apoyo a los familiares cuidadores

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    Background: The approach to informal caregivers poses new challenges to nursing, supporting the conception of care based on the best available scientific evidence. Care documentation in information systems should create indicators that reflect the nurses’ role as facilitators of a healthy transition. Objective: To redefine the conception of care to the family caregiver though the analysis of records that mirrors the nurses’ activity with caregivers. Methodology: Qualitative study based on the assumptions of participatory action research in health with 16 nurses from primary health care units. Field notes were taken and Bardin’s content analysis method was used. Results: Three categories emerged: work organization, limitations to nursing documentation, and standardization of records. A family caregiver support model was developed in collaboration with the participants. Conclusion: The assumptions of participatory action research in health facilitated the redefinition of the care model to improve the quality of care and documentation process in nursing information systems.Enquadramento: A abordagem aos cuidadores informais coloca novos desafios à enfermagem, que deve sustentar a conceção de cuidados na melhor evidência científica. A documentação dos sistemas de informação deve gerar indicadores que espelhem o papel dos enfermeiros como facilitadores de uma transição saudável. Objetivo: Redefinir a conceção de cuidados ao familiar cuidador a partir da análise dos registos que espelha a atividade dos enfermeiros com os cuidadores. Metodologia: Estudo com abordagem qualitativa assente na pesquisa ação participativa em saúde, desenvolvido com uma amostra de 16 enfermeiros em atividade de cuidados de saúde primários. Recorreu-se às notas de campo e considerou-se os pressupostos defendidos por Bardin para a análise de conteúdo. Resultados: Emergiram três categorias, organização do trabalho dos enfermeiros, limitações à documentação em enfermagem e uniformização dos registos. Em conjunto com os participantes desenvolveu-se um modelo de acompanhamento aos familiares cuidadores. Conclusão: Os pressupostos da pesquisa-ação participativa em saúde facilitaram a redefinição do modelo assistencial conducente a melhoria na qualidade de cuidados e documentação nos sistemas de informação em enfermagem.Marco contextual: El enfoque hacia los cuidadores informales plantea nuevos retos a la enfermería, que debe apoyar el diseño de cuidados basados en la mejor evidencia científica. La documentación de los sistemas de información debe generar indicadores que reflejen el papel de los enfermeros como facilitadoras de una transición saludable. Objetivo: Redefinir el concepto de cuidados al familiar cuidador a partir del análisis de los registros que reflejan la actividad de los enfermeros con los cuidadores. Metodología: Estudio con enfoque cualitativo basado en la investigación-acción participativa en salud, desarrollado con una muestra de 16 enfermeros que trabajan en atención primaria. Se utilizaron notas de campo y se tuvieron en cuenta los supuestos defendidos por Bardin para el análisis de contenido. Resultados: Surgieron tres categorías, organización del trabajo de los enfermeros, limitaciones a la documentación en enfermería y normalización de los registros. En conjunto con los participantes, se elaboró un modelo de apoyo a los familiares cuidadores. Conclusión: Las premisas de la investigación-acción participativa en salud facilitaron la redefinición del modelo de atención que condujo a la mejora de la calidad de los cuidados y la documentación en los sistemas de información de enfermería.info:eu-repo/semantics/publishedVersio

    La concepción de los cuidados de enfermería dirigida a los prestadores de cuidados se refleja en la documentación

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    Abstract Background: Caregivers must acquire knowledge and develop skills that ensure the safety of the care delivered and guarantee their own self-care. Nurses take on the role of facilitators in this transition process, with nursing information systems being used as tools to safeguard the continuity and quality of care. Objective: To understand nursing care design for caregivers. Methodology: This is a mixed method study with a descriptive exploratory research design, analyzing 163 files of caregiver documentation and using a questionnaire (N = 72). Results: It was possible to identify the underreporting of caregivers. Caregivers were predominantly elderly women with moderate burden who reported difficulties in instrumental activities and needed support from an additional caregiver or a formal support network. Conclusion: Identifying the needs and difficulties of caregivers combined with the observed underreporting strengthens the need for bringing the models in use closer to the models presented, thus translating this process into an improvement of quality standards in nursing care for caregivers.Enquadramento: A assunção do papel de cuidador exige a aquisição de conhecimentos e habilidades, garantindo a segurança dos cuidados à pessoa cuidada e assegurar o seu próprio autocuidado. O enfermeiro assume o papel de facilitador neste processo de transição, sendo os sistemas de informação em enfermagem uma ferramenta que garante a continuidade e qualidade dos cuidados. Objetivo: Compreender a conceção de cuidados de enfermagem relativa ao prestador de cuidados. Metodologia: Estudo descritivo exploratório com abordagem mista, através da análise da documentação do prestador de cuidados em 163 processos e aplicação de um questionário (N = 72). Resultados: Identificou-se subnotificação no prestador de cuidados. Estes eram predominantemente mulheres, com idade avançada e sobrecarga moderada. Expressaram dificuldades nas atividades instrumentais e necessidade de apoio de outro cuidador/redes formais. Conclusão: A identificação das necessidades e dificuldades do prestador de cuidados em confronto com a subnotificação observada reforça a necessidade de uma aproximação dos modelos em uso aos modelos expostos, traduzindo este processo numa melhoria dos padrões de qualidade em enfermagem dirigida aos prestadores de cuidadosMarco contextual: La asunción del papel de cuidador requiere la adquisición de conocimientos y habilidades, lo que garantiza la seguridad de los cuidados a la persona cuidada y asegura su propio autocuidado. El enfermero asume el papel de facilitador en este proceso de transición, y los sistemas de información de enfermería son una herramienta que garantiza la continuidad y la calidad de los cuidados. Objetivo: Comprender la concepción de los cuidados de enfermería en relación con el cuidador. Metodología: Estudio descriptivo exploratorio con un enfoque mixto, para el cual se analizó la documentación del proveedor de cuidados en 163 procesos y se aplicó un cuestionario (N = 72). Resultados: Se identificó un subregistro en el cuidador. Eran predominantemente mujeres, con una edad avanzada y una sobrecarga moderada. Manifestaron dificultades en las actividades instrumentales y necesidad de apoyo de otro cuidador/redes formales. Conclusión: La identificación de las necesidades y dificultades del cuidador frente al subregistro observado refuerza la necesidad de una aproximación de los modelos en uso a los modelos expuestos, lo que traduce este proceso en una mejora de los estándares de calidad en enfermería dirigidos a los cuidadoresinfo:eu-repo/semantics/publishedVersio
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