Effectiveness of technology-based interventions in detection, prevention, monitoring and treatment of patients at risk or diagnosed with mild cognitive impairment: protocol for a systematic review

Introduction: The gradual changes over the decades in the longevity and aging of European society as a whole can be directly related to the prolonged decline in the birth rate and increase in life expectancy. According to the WHO, there is an increased risk of dementia or other cognitive disorders as the population ages, which have a major impact on public health. Mild cognitive impairment (MCI) is described as a greater than expected cognitive decline for an individual's age and level of education, but that does not significantly interfere with activities of daily living. Patients with MCI exhibit a higher risk of dementia compared with others in the same age group, but without a cognitive decline, have impaired walking, and a 50% greater risk of falling. The urban lifestyle and advent of smartphones, mobility, and immediate access to all information via the internet, including health information, has led to a totally disruptive change in most general aspects. This systematic review protocol is aimed at evaluating the effectiveness of technology-based interventions in the detection, prevention, monitoring, and treatment of patients at risk or diagnosed with MCI. Methods and analysis: This review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. The search will be performed on MEDLINE (PubMed), CENTRAL, CINAHL Plus, ISI Web of Science, and Scopus databases from 2010 to 2020. Studies of interventions either randomized clinical trials or pre-post non-randomized quasi-experimental designs, published in English and Spanish will be included. Articles that provide relevant information on the use of technology and its effectiveness in interventions that assess improvements in early detection, prevention, follow-up, and treatment of the patients at risk or diagnosed with MCI will be included. Ethics and dissemination: Ethics committee approval is not required. The results will be disseminated in publications and congresses. Keywords: dementia; geriatric medicine; health informatics; mental health; preventive medicine.This paper is a result of the NEXTPERCEPTION project (www.nextperception.eu), which is jointly funded by the European Commission and national funding agencies under the ECSEL joint undertaking (grant agreement: 876487). This research was funded by the Agencia Estatal de Investigación (AEI/10.13039/501100011033) Ministry of Science and Innovation (MICINN) (PCI2020-112270) CERCA Programme/Generalitat de Catalunya. IRBLleida - Fundació Dr. Pifarré

Poor sleep quality experience and self-management strategies in fibromyalgia: a qualitative metasynthesis

Poor sleep quality is a major concern and a highly prevalent symptom in fibromyalgia. We aimed to develop a metasynthesis of qualitative studies to assess how people diagnosed with fibromyalgia experience and manage poor sleep quality following the concepts of the Symptom Management Theory. The principles of metasynthesis established by Sandelowski and Barroso were utilized. A pre-planned comprehensive search was implemented in PubMed, Scopus, ISIWebofScience, and Cinahl Plus databases. The methodological quality was assessed following the CASP Qualitative Checklist. The findings of the studies were subjected to a metasummary and a metasynthesis. Seventeen studies were included in the metasynthesis. Two overarching themes were pre-established: (1) experience of poor sleep quality in Fibromyalgia and (2) poor sleep quality management strategies in Fibromyalgia. Four sub-themes emerged from the results: (1) evaluation of poor sleep quality, (2) response to poor sleep quality, (3) management strategies to favor sleep, and (4) managing the consequences of a sleepless night. Poor sleep quality is a severe and disabling symptom that negatively impacts the general health status of people diagnosed with FM. Prescribed treatments are commonly seen as ineffective and self-management strategies are a last resort and do not show beneficial effectsThe principal investigator of this research was supported by a grant for predoctoral researchers at the University of Lleida for 2016. Ordinary call (BUL2016B) and Promotion of research (BUL2016P). This work was funded by the Institute for Social and Territorial Development of the University of Lleida, grant number X19005 and by the “Cátedra de Salud, Educación y Calidad de Vida” of the UdL-ASISA Foundation

Use of a gamified website to increase pain neurophysiology knowledge and improve satisfaction and motivation among students studying for a degree in physiotherapy: a quasi‑experimental study

Background: The scientific evidence highlights the difficulties that healthcare professionals experience when managing patients with chronic pain. One of the causes of this difficulty could be related to the acquired training and the lack of knowledge about the neurophysiology of pain. In the present study, we assessed the effectiveness of a gamified web platform in acquiring knowledge about pain neurophysiology and determining the satisfaction and motivation of students of the Degree in Physiotherapy at the University of Lleida. Methods: A quasi-experimental study was carried out with a sample of 60 students who had access to a gamified web platform that included notes, videos, and clinical cases prepared by the teaching staff and was based on a previous study that included patients and healthcare professionals. Results: The results show that after the intervention, there was a statistically significant increase in knowledge about the neurophysiology of pain, and the effect size was in the desired area of effect. Likewise, many students considered that their motivation had increased as a result of the methodology used in the present study. Conclusions: The results support the use of this methodology to promote knowledge about the neurophysiology of pain while improving students' motivation

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

Conceptualization of poor sleep quality in the context of fibromyalgia: from patient experience to management

L'objectiu general d'aquesta tesi doctoral va ser el de conceptualitzar la baixa qualitat del son en el context de la fibromiàlgia prenent la Teoria de Maneig Simptomàtic com a marc conceptual des d’una perspectiva biopsicosocial. Els objectius específics van ser: i) Desenvolupar un protocol per a una intervenció educativa terapèutica basada en la web sobre el son i el dolor per a dones diagnosticades amb fibromiàlgia (estudi I), ii) Identificar i sintetitzar la literatura qualitativa disponible sobre l'experiència de la baixa qualitat del son en el context de la fibromiàlgia (estudi II), iii) Explorar com les dones adultes espanyoles diagnosticades amb fibromiàlgia experimenten i manegen la baixa qualitat del son (estudi III), iv) Descriure i analitzar les propietats psicomètriques de les mesures de resultat autoinformades validades per avaluar la qualitat del son en la fibromiàlgia (estudi IV). Els estudis inclosos en aquesta tesi doctoral es varen abordar utilitzant diferents enfocaments metodològics. L'estudi I és un protocol de metodologia mixta amb disseny exploratori seqüencial. En el cas de l'estudi II, es va realitzar una meta-síntesi d'estudis qualitatius. En l'estudi III es va implementar un enfocament qualitatiu, realitzant entrevistes personals semiestructurades a 21 dones adultes de la regió de Lleida diagnosticades amb fibromiàlgia. Finalment, l'estudi IV va ser una revisió sistemàtica COSMIN. En conjunt, els resultats dels estudis II i III van mostrar que la baixa qualitat del son és percebuda com un símptoma sever de la fibromiàlgia i els problemes més comuns són els relacionats amb l'inici i manteniment del son, així com insatisfacció amb la quantitat de son diària. Les dones amb fibromiàlgia responen a la baixa qualitat del son desenvolupant pensaments catastròfics i senten impotència i frustració per no poder dormir. Perceben que les seves estratègies d’automaneig són inefectives perquè no reben suficient informació per part dels professionals sanitaris, donat que l'enfocament terapèutic és principalment farmacològic. Les dones amb fibromiàlgia reclamen com una necessitat bàsica tenir un major coneixement sobre el son en el context de la seva condició de salut i ser educades en com desenvolupar estratègies de maneig efectives. L'estudi IV va evidenciar que hi ha cinc mesures de resultat autoinformades validades per valorar la qualitat del son en persones amb fibromiàlgia. En conclusió, la baixa qualitat del son és percebuda com un dels símptomes de major severitat i impacte en el context de la fibromiàlgia. A més, és necessari el desenvolupament d'enfocaments terapèutics des d'una perspectiva biopsicosocial que incloguin programes d'educació centrats en les necessitats de les persones i que contribueixin a modificar cognicions maladaptatives relacionades amb el son i, al seu torn, facilitin el desenvolupament d'estratègies efectives d’automaneig.El objetivo general de esta tesis doctoral fue el de conceptualizar la baja calidad del sueño en la fibromialgia tomando la Teoría de Manejo Sintomático como marco conceptual desde una perspectiva biopsicosocial. Los objetivos específicos fueron: i) Desarrollar un protocolo para una intervención educativa terapéutica basada en la web sobre el sueño y el dolor para mujeres diagnosticadas con fibromialgia (estudio I), ii) Identificar y sintetizar la literatura cualitativa disponible sobre la experiencia de la baja calidad del sueño en el contexto de la fibromialgia (estudio II), iii) Explorar cómo las mujeres adultas españolas diagnosticadas con fibromialgia experimentan y manejan la mala calidad del sueño (estudio III), iv) Describir y analizar las propiedades psicométricas de las medidas de resultado autoinformadas validadas para evaluar la calidad del sueño en la fibromialgia (estudio IV). Cada uno de los estudios incluidos en esta tesis doctoral se abordó utilizando diferentes enfoques metodológicos. El estudio I es un protocolo de metodología mixta con diseño exploratorio secuencial. En el caso del estudio II, se realizó una meta-síntesis de estudios cualitativos. En el estudio III se implementó un enfoque cualitativo, realizando entrevistas personales semi-estructuradas a 21 mujeres adultas de la región de Lleida diagnosticadas con fibromialgia. Finalmente, el estudio IV fue una revisión sistemática COSMIN. En conjunto, los resultados de los estudios II y III mostraron que la baja calidad del sueño es percibida como un síntoma severo de la fibromialgia y los problemas más comunes son los relacionados con el inicio y mantenimiento del sueño, así como insatisfacción con la cantidad de sueño diaria. Las mujeres con fibromialgia responden a la baja calidad del sueño desarrollando pensamientos catastróficos y sienten impotencia y frustración por no poder dormir. Perciben que sus estrategias de automanejo son inefectivas porque no reciben suficiente información por parte de los profesionales sanitarios, cuyo enfoque terapéutico es principalmente farmacológico. Las mujeres con fibromialgia reclaman como una necesidad básica tener un mayor conocimiento sobre el sueño en el contexto de su condición de salud y ser educadas en cómo desarrollar estrategias de manejo. El estudio IV evidenció que existen cinco medidas de resultado autoinformadas para valorar la calidad del sueño en personas con fibromialgia. En conclusión, la baja calidad del sueño es percibida como uno de los síntomas de mayor severidad e impacto en el contexto de la fibromialgia. Además, es necesario el desarrollo de enfoques terapéuticos desde una perspectiva biopsicosocial que incluyan programas de educación centrados en las necesidades de las personas y que contribuyan a modificar cogniciones maladaptativas relacionadas con el sueño y, a su vez, faciliten el desarrollo de estrategias efectivas de automanejo.The general objective of this doctoral thesis was to conceptualize poor sleep quality in the context of fibromyalgia taking the Symptom Management Theory as a biopsychosocial conceptual framework. The specific objectives were: i) To develop a protocol for a Web-Based Therapeutic Education Intervention about sleep and pain for women diagnosed with Fibromyalgia (study I), ii) To identify and synthesize the available qualitative literature on the experience of poor sleep quality in the context of Fibromyalgia (study II), iii) To explore how Spanish adult women diagnosed with Fibromyalgia experience and manage poor sleep quality (study III), iv) To describe and analyze the psychometric properties of the validated Self-Reported Outcome Measures for assessing sleep quality in Fibromyalgia (study IV). Each of the studies included in this doctoral thesis was developed using different methodological approaches. Study I was a mixed methodology protocol with a sequential exploratory design. With study II, a meta-synthesis of qualitative studies was performed. In study III, a qualitative approach was implemented, conducting semi-structured personal interviews with 21 adult women from the Lleida region diagnosed with fibromyalgia. Finally, study IV was a COSMIN systematic review. Taken together, the results of studies II and III showed that poor sleep quality is perceived as a severe symptom of fibromyalgia and the most common problems are those related to the initiation and maintenance of sleep, and dissatisfaction with the amount of daily sleep. Women diagnosed with fibromyalgia respond to poor sleep quality by developing catastrophic thoughts and feeling helplessness and frustration at not being able to sleep. They perceive that their self-management strategies are ineffective because they do not receive enough information from health care professionals, whose therapeutic focus is mainly pharmacological. Women with fibromyalgia claim as a basic need to have a greater knowledge about sleep in their health condition and to be educated on how to develop effective management strategies that allow them to have a good quality of sleep. Study IV showed that there are five self-reported outcome measures to assess the quality of sleep validated in people with fibromyalgia, although the psychometric measures of the Fibromyalgia Sleep Diary, which is the only measure developed specifically for fibromyalgia, have not been investigated. In conclusion, poor sleep quality is perceived as one of the symptoms of greater severity and impact in fibromyalgia. In addition, it is necessary to develop therapeutic approaches from a biopsychosocial perspective that include education programs focused on people's needs and that contribute to modifying maladaptive cognitions related to sleep and, in turn, facilitate the development of effective self-management strategies

Detección de mutaciones en IDH1 en pacientes con colangiocarcinoma

Colangiocarcinoma; Gen IDH1; Detecció de mutacionsColangiocarcinoma; Gen IDH1; Detección de mutacionesCholangiocarcinoma; IDH1 gene; Mutation detectionAquest document és una fitxa d'Avaluació de Tecnologies Sanitàries Noves i Emergents. El seu objectiu és proporcionar la informació disponible que permeti que l'avaluació es pugui dur a terme en una fase primerenca de l'aparició d'una tècnica, tecnologia o procediment, que es preveu que tingui impacte en la qualitat de vida i el sistema sanitari. Es contribueix, així, a facilitar la presa de decisions sobre la incorporació de les tecnologies noves i emergents al sistema sanitari, quan correspongui dur-la a terme.Este documento es una ficha de Evaluación de Tecnologías Sanitarias Nuevas y Emergentes. Su objetivo es proporcionar la información disponible que permita que la evaluación pueda llevarse a cabo en una fase temprana de la aparición de una técnica, tecnología o procedimiento, que se prevé va a tener impacto en la calidad de vida y en el sistema sanitario. Se contribuye, así, a facilitar la toma de decisiones sobre la incorporación de las tecnologías nuevas y emergentes al sistema sanitario, cuando corresponda llevarla a cabo.This document is an Evaluation sheet for New and Emerging Health Technologies. Its objective is to provide the available information that allows the evaluation to be carried out in an early phase of the appearance of a technique, technology or procedure, which is expected to have an impact on the quality of life and the health system. It thus contributes to facilitating decision-making on the incorporation of new and emerging technologies in the healthcare system, when appropriate

Experiencia de innovación docente en el grado de Turismo: FUTUR Feria Universitaria de Turismo

Se presenta una experiencia educativa realizada en la Universidad de Alicante, en la asignatura “protocolo y organización de eventos en turismo” del Grado en Turismo. Se trata de compatibilizar exigencias de formación en competencias profesionales, con una buena fundamentación teórica, y al mismo tiempo alcanzar cotas altas de calidad docente atendiendo a un número elevado de estudiantes inscritos. La experiencia ha consistido en la organización de una “Feria Turística” por parte del alumnado, siendo el proceso monitorizado en equipo, por la docente coordinadora de la asignatura, la coordinadora del grado y el decano de la Facultad de Filosofía y Letras (de la que depende la citada titulación), y con una importante colaboración del Ayuntamiento de Alicante. El objetivo académico era la búsqueda de nuevas fórmulas docentes para fomentar en los y las estudiantes la visión crítica y multidisciplinar que les permita, a partir de las nociones teóricas recibidas y su aplicación práctica en un caso real con toda su complejidad, construir nuevos conocimientos y ampliar su campo de visión en relación con el grado que estudian, de modo que descubran nuevas oportunidades de desarrollo de carrera profesional. Se abordaron ocho temáticas relevantes en el campo del turismo, representadas en una feria, a la que denominaron FUTUR, jugando con el doble significado de Feria Universitaria de Turismo, y “futur” como futuro