Big Data and Public Health Systems: Issues and Opportunities

Over the last years, the need for changing the current model of European public health systems has been repeatedly addressed, in order to ensure their sustainability. Following this line, IT has always been referred to as one of the key instruments for enhancing the information management processes of healthcare organizations, thus contributing to the improvement and evolution of health systems. On the IT field, Big Data solutions are expected to play a main role, since they are designed for handling huge amounts of information in a fast and efficient way, allowing users to make important decisions quickly. This article reviews the main features of the European public health system model and the corresponding healthcare and management-related information systems, the challenges that these health systems are currently facing, and the possible contributions of Big Data solutions to this field. To that end, the authors share their professional experience on the Spanish public health system, and review the existing literature related to this topic

Application of information and communication technologies for health systems in Belgium, Denmark, Spain, the United Kingdom and Sweden

Incluye BibliografíaThis document describes and analyzes implementation of eHealth in several European countries, as well as strengths and weaknesses, using this experience in order to support the management and execution of this kind of projects in other scenarios. Five EU member States evidencing different degrees of advancement in their national eHealth projects have been selected for this purpose: Belgium, Denmark, Spain, the United Kingdom and Sweden. In addition to these five cases, a brief study has been made of several international collaboration projects for the implementation of cross-border spaces for eHealth that most of these countries are currently participating in

Markov Models for Economic Evaluation in Osteoporosis Treatment

[EN] Osteoporosis is frequent in elderly people, causing bone fractures and lowering their quality of life. The costs incurred by these fractures constitute a problem for public health. Markov chains were used to carry out an incremental cost-utility analysis of the four main drugs used in Spain to treat osteoporosis (alendronate, risedronate, denosumab and teriparatide). We considered 14 clinical transition states, from starting osteoporotic treatment at the age of 50 until death or the age of 100. Cost-effectiveness was measured by quality adjusted life years (QALYs). The values used in the Markov model were obtained from the literature. Teriparatide is the cost-effective alternative in the treatment of osteoporosis in patients with fractures from the age of 50, establishing a payment threshold of 20,000 EUR/QALY. However, it is the most expensive therapy, not appearing cost-effective in cases that do not present fracture and in ages over 80 years with fracture. Alendronate and denosumab therapies are presented as cost-effective osteoporosis treatment alternatives depending on the age of onset and duration of treatment. From the perspective of cost-effectiveness, establishing a payment threshold of 20,000 EUR/QALY, teriparatide is the cost-effective alternative in patients with fracture from the age of 50 to 70 years old in Spain.Osca Guadalajara, M.; Díaz-Carnicero, J.; González-De Julián, S.; Vivas-Consuelo, D. (2021). Markov Models for Economic Evaluation in Osteoporosis Treatment. Mathematics. 9(18):1-20. https://doi.org/10.3390/math9182331S12091

Desarrollo de la empatía y valores éticos a través de los juegos de rol como innovación para la educación en valores

For some authors, the development of empathy is a central aspect of the development of ethical values. Role-playing games can be the ideal vehicle to transfer learning from fiction to reality. The present study analyzes in an exploratory and descriptive way the scores obtained in the Test of Cognitive and Affective Empathy (TECA) of a total sample of 208 participants. Although no major differences were found between those who had previously participated in role-playing games and those who had not, there was a tendency to obtain higher mean scores than those obtained by the TECA through its scales.Para algunos autores, el desarrollo de la empatía es un aspecto central del desarrollo de los valores éticos. Los juegos de rol pueden ser el vehículo ideal para trasladar aprendizajes de la ficción a la realidad. El presente estudio analiza de forma exploratoria y descriptiva las puntuaciones obtenidas en el Test de Empatía Cognitiva y Afectiva (TECA) de una muestra total de 208 participantes. Aunque no se han hallado grandes diferencias entre las personas que habían participado con anterioridad en juegos de rol y las que no lo habían hecho, si se detecta una tendencia a obtener puntuaciones medias superiores a las que lanza el TECA a través de sus baremos.Universidad Pablo de Olavid

Predicting healthcare cost of diabetes using machine learning models

González-Rodríguez, J.; Díaz Carnicero, J.; Vivas-Consuelo, D.; González-De Julián, S.; Pinzón Espitia, OL. (2019). Predicting healthcare cost of diabetes using machine learning models. R. Company, J. C. Cortés, L. Jódar and E. López-Navarro. 99-104. http://hdl.handle.net/10251/180540S9910

Cerebroespinal fluid control of neurogenesis induced by retinoic acid during early brain development

Producción CientíficaEmbryonic-cerebrospinal fluid (E-CSF) plays crucial roles in early brain development including the control of neurogenesis. Although FGF2 and lipoproteins present in the E-CSF have previously been shown to be involved in neurogenesis, the main factor triggering this process remains unknown. E-CSF contains all-trans-retinol and retinol-binding protein involved in the synthesis of retinoic acid (RA), a neurogenesis inducer. In early chick embryo brain, only the mesencephalic-rombencephalic isthmus (IsO) is able to synthesize RA. Here we show that in chick embryo brain development: (1) E-CSF helps to control RA synthesis in the IsO by means of the RBP and all-trans-retinol it contains; (2) E-CSF has retinoic acid activity, which suggests it may act as a diffusion pathway for RA; and (3) the influence of E-CSF on embryonic brain neurogenesis is to a large extent due to its involvement in RA synthesis. These data help to understand neurogenesis from neural progenitor cells2015-05-2

Teachers’ Perception on the Inclusion of Students with Disabilities in the Regular Education Classroom in Ecuador

Nowadays, contradictory viewpoints are showed when defining disability. On the one hand, there are theoretical frameworks focused on the personal limitations, while, on the other hand, each time it is more extended those ones which highlight the restrictions on the social fabric. It becomes essential to integrate both frameworks considering disability as a social phenomenon besides the collective responsibility that demands further action by society as a whole.Currently, Ecuador is suffering an economic recession due to the drop in the price of oil and the appreciation of the dollar, together with the catastrophic effects of the earthquake recorded in 2016. Before 2014, Ecuador was experiencing economic growth resulting in major investment in social areas such as education, thus promoting educational and labour market inclusion of people with disabilities.This study shows the perspective of teachers in Ecuador towards students with disabilities before the development of a program of postgraduate studies for specializing them to cater for the special educational needs. Moreover, the aim is to assess abilities and barriers that teachers have to face up with regard to inclusion of disability in the regular classroom. The majority of teachers in Ecuador are unanimous in stating that academic career training on the issue of education inclusion and accessibility will entail a maximum support carrying out their teaching assignments as well as materials adapted to suit the students’ needs. Furthermore, a wide range of teachers were aware of the case of students with disabilities in the classroom. Besides, among the main problems, architectural barriers and the lack of inclusion were the most important for the participants.Taking all of this into consideration, it is perceived that teachers from Ecuador are not fully prepared for having students with disabilities. That is why a deeper training in special educational needs should be necessary

Denitrification in a hypersaline lake–aquifer system (Pétrola Basin, Central Spain): The role of recent organic matter and Cretaceous organic rich sediments

Agricultural regions in semi-arid to arid climates with associated saline wetlands are one of the most vulnerable environments to nitrate pollution. The Pétrola Basin was declared vulnerable to NO3 − pollution by the Regional Government in 1998, and the hypersaline lake was classified as a heavily modified body of water. The study assessed groundwater NO3 − through the use of multi-isotopic tracers (δ15N, δ34S, δ13C, δ18O) coupled to hydrochemistry in the aquifer connected to the eutrophic lake. Hydrogeologically, the basin shows two main flow components: regional groundwater flow from recharge areas (Zone 1) to the lake (Zone 2), and a density-driven flow from surface water to the underlying aquifer (Zone 3). In Zones 1 and 2, δ15NNO3 and δ18ONO3 suggest that NO3 − from slightly volatilized ammonium synthetic fertilizers is only partially denitrified. The natural attenuation of NO3 − can occur by heterotrophic reactions. However, autotrophic reactions cannot be ruled out. In Zone 3, the freshwater–saltwater interface (down to 12–16 m below the ground surface) is a reactive zone for NO3 − attenuation. Tritium data suggest that the absence of NO3 − in the deepest zones of the aquifer under the lake can be attributed to a regional groundwater flow with long residence time. In hypersaline lakes the geometry of the density-driven flow can play an important role in the transport of chemical species that can be related to denitrification processes.Depto. de Geodinámica, Estratigrafía y PaleontologíaFac. de Ciencias GeológicasTRUECastilla–La Mancha GovernmentSpanish GovernmentCatalan Governmentpu

FGF2 plays a key role in embryonic cerebrospinal fluid trophic properties over chick embryo neuroepithelial stem cells

Producción CientíficaDuring early stages of brain development, neuroepithelial stem cells undergo intense proliferation as neurogenesis begins. Fibroblast growth factor 2 (FGF2) has been involved in the regulation of these processes, and although it has been suggested that they work in an autocrine–paracrine mode, there is no general agreement on this because the behavior of neuroepithelial cells is not self-sufficient in explants cultured in vitro. In this work, we show that during early stages of development in chick embryos there is another source of FGF2, besides that of the neuroepithelium, which affects the brain primordium, since the cerebrospinal fluid (E-CSF) contains several isoforms of this factor. We also demonstrate, both in vitro and in vivo, that the FGF2 from the E-CSF has an effect on the regulation of neuroepithelial cell behavior, including cell proliferation and neurogenesis. In order to clarify putative sources of FGF2 in embryonic tissues, we detected by in situ hybridization high levels of mRNA expression in notochord, mesonephros and hepatic primordia, and low levels in brain neuroectoderm, corroborated by semiquantitative PCR analysis. Furthermore, we show that the notochord segregates several FGF2 isoforms which modify the behavior of the neuroepithelial cells in vitro. In addition, we show that the FGF2 ligand is present in the embryonic serum; and, by means of labeled FGF2, we prove that this factor passes via the neuroepithelium from the embryonic serum to the E-CSF in vivo. Considering all these results, we propose that, in chick embryos, the behavior of brain neuroepithelial stem cells at the earliest stages of development is influenced by the action of the FGF2 contained within the E-CSF which could have an extraneural origin, thus suggesting a new and complementary way of regulating brain development. © 2006 Elsevier Inc. All rights reserved

Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain

[EN] This study analyzed the prevalence, costs and economic impact of chronic kidney disease CKD in patients with T2D in a Spanish Health District using real-world data. Observational cross-sectional study in adult patients with T2D was through data extracted from the information systems of the Valencia Clinico-La Malvarrosa Health District in the year 2015. Patients were stratified with the KDIGO classification for CKD. Additionally, patients were assigned to Clinical Risk Groups (CRGs) according to multimorbidity. Direct costs of primary and specialized care, and medication were estimated. The prevalence of T2D in the database population (n = 28,345) was 10.8% (mean age (SD) = 67.8 years (13.9); 51.5% male). Up to 14.935 patients (52.6%) had data on kidney function. According to the KDIGO classification, 66.2% of the patients were at low risk of CKD, 20.6% at moderately increased risk, 7.9% at high risk, and 5.2% at very high risk. The average healthcare costs associated with these four risk groups were EUR 3437, EUR 4936, EUR 5899 and EUR 7389, respectively. The large number of T2D patients with CKD in the early stages of the disease generated a significant increase in direct healthcare costs. The economic impact could be mitigated by early and comprehensive therapeutic approaches.This research was funded by Boehringer-Ingelheim Espana, S.A.Usó-Talamantes, R.; González-De Julián, S.; Díaz-Carnicero, J.; Saurí-Ferrer, I.; Trillo-Mata, JL.; Carrasco-Pérez, M.; Navarro-Pérez, J.... (2021). Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain. International Journal of Environmental research and Public Health (Online). 18(18):1-14. https://doi.org/10.3390/ijerph18189853S114181