Efficiency as a determinant of loyalty among users of a community of clinical practice: a comparative study between the implementation and consolidation phases

A community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels. The present work seeks to analyse whether ECOPIH makes it possible to reduce the number of referrals. To that end, the objectives are: (1) To find out the degree of loyalty among ECOPIH users, by comparing the medical professionals' profiles in the tool's implementation phase to those in its consolidation phase. (2) To evaluate the degree of fulfilment of users' expectations, by establishing the determining factors that had an influence on the physicians' intention to use ECOPIH in the implementation phase and observing whether its use had an effective, direct impact on the number of patient referrals that primary care physicians made to specialist care professionals. Two studies were conducted. Based on a survey of all the physicians in a Primary Care area, Study 1 was a descriptive study in ECOPIH's implementation phase. Study 2 was a randomised intervention study of ECOPIH users in the tool's consolidation phase. The results from both studies were compared. Various bivariate and multivariate statistical techniques (exploratory factor analysis, cluster analysis, logistic regression analysis and ANOVA) were used in both studies, which were conducted on a sample of 111 and 178 physicians, respectively. We confirmed the existence of an ECOPIH user profile stable across both phases: under-50-year-old women. Regarding the second objective, there were two particular findings. First, the discriminant factors that had an influence on greater ECOPIH use were habitual Social media website and app use and Perceived usefulness for reducing costs. Second, PC professionals who were ECOPIH members made fewer referrals to SC professionals in Cardiology, Endocrinology and Gastroenterology than older PC professionals who were not ECOPIH members. The use of a community of clinical practice by primary care and specialist care professionals helps to reduce the number of referrals among medical professionals

Manejo odontológico integral de paciente con antecedentes de ictus cerebral. Reporte de un caso

Introduction: Stroke are a set of pathologies which affect the blood vessels that supply the blood to the brain causing an alteration of the function of a certain region. The group of pathologies are popularly known as embolisms or strokes and are suddenly manifested. These disorders have in common their abrupt presentation and usually affect older people; although, they can also be presented in youth. Objective: To introduce to health professionals the implications and consequences that should be taken in the habitual dental practice and at the time of using treatments such as fixed prosthetic rehabilitation or the placement of dental implants in patients with heart disease, in order to avoid accidents and prevent postoperative hemorrhages. Results: Satisfactory esthetic and functional results were obtained in the surgical and oral rehabilitation treatments carried out to the patient. Conclusions: Due to the risk of stroke, the patients are usually subjected to antiplatelet therapy, whose side effect is the tendency to bleed. Therefore, it is important to carry out a multidisciplinary management with the specialist doctor when using surgical treatments in this type of patients in order to avoid complications and obtain adequate results

Telemedicine, Psychology and Diabetes: Evaluation of results and cost analysis

The Psychosocial Aspects of Diabetes (PSAD) Study Group is an official Study Group of the European Association for the Study of Diabetes (EASD).AIMS: Evidences of benefits of telemedicine in T1DM patients on continuous subcutaneous insulin infusion (CSII) treatment are limited. Aims: 1) to analyse the differences in clinical and psychological variables between subjects with T1DM on CSII treatment who were included in a Telecare (TC) program, and subjects with T1DM on CSII treatment who received Conventional care (CC); 2) Perform a cost analysis of the use of telemedicine in DM1 patients treated with CSII (TC versus CC). METHODS and PARTICIPANTS: Cross-over randomized clinical trial with duration of 18 months. 51 patients signed informed consent. Participants were randomly assigned to receive TC program or CC during 6 months, and after a 3 months wash-out period, patients changed to CC or to TC respectively. TC program included monthly visits using an Internet platform. CC comprised face-to-face visits every three months. Sociodemographic, clinical and psychological data was measured at the beginning and at the end of TC and CC. The direct and indirect costs were also measured. T Student was performed to assess differences between first and last visits in both groups (TC / CC). RESULTS: Patients with telemedicine at the end of treatment, have fewer hyperglycemia / week, less distress and greater adherence. Considering both direct and indirect costs, the cost per treatment (TC / CC) is similar. CONCLUSIONS: Telemedicine has significant implications for clinical and psychological variables and has the same cost (total) than the conventional treatment. Therefore, it can be a useful alternative for treatment of DM1 patients with CSII. However, studies with a larger sample size are needed.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Collective action , youth activism and State in Latin America and The Caribbean

Fil: Feixa Pampols, Carles. Universidad de Lleida; EspañaFil: Vazquez, Melina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Domínguez, Maria Isabel. Universidad de La Habana; CubaFil: Unda Lara, Rene. Universidad Politecnica Salesiana; Ecuado

Teoría y práctica de la acción socioeducativa

El objetivo de este artículo es presentar una propuesta formativa que permita practicar la teoría en la formación de profesionales del campo social y educativo. Con ella justificamos la necesidad de vincular elementos teóricos, metodológicos y éticos con las situaciones concretas que se producen en el mundo laboral. El estudio de casos a través del cine nos sirve para ejemplificar, en esta ocasión, conceptos relacionados con los psicodinamismos del trauma infantil por abuso y violencia intrafamiliar y las formas de abordarlo. Para el desarrollo y validación de esta propuesta, se convocó a dos Grupos Focales de Expertos (gfe) con los que se analizó la película Precious, que sirvió como estudio de caso. A partir de las ideas más significativas que surgieron de la discusión, se analizan diferentes aspectos en torno a las prácticas profesionales y los modelos de trabajo social y educativo. Se concluye que el visionado de este filme y la discusión de las coordenadas que surgen de su análisis pueden ser útiles como material complementario al académico en la formación de futuros profesionales del campo socioeducativo.The aim of this paper is to present a training proposal to allow the realization of the training of professionals in both social and educational ways. With it we justify the need to link the theoretical, methodological and ethical actual situations occurring in the workplace. The case of study through the movies allows illustrating, this time, concepts related to childhood trauma psychodynamics of abuse and domestic violence and ways to address it. For the development and validation of this proposal, we convened two Expert Focus Groups (efg) analyzed the movie Precious, which served as case of study. From the most significant ideas that emerged from the discussion, we analyze different aspects related to professional practices and models of social work and education. We conclude that by watching this movie and with the discussion of the coordinate guidelines that arise from their analysis may be useful as supplementary material to the academic training of future professionals into the socio-educational field.Le but de cet article est de présenter une proposition de formation pour permettre à la théorie à la pratique dans la formation des professionnels sociaux et éducatifs. Avec elle on va justifier la nécessité de relier les situations théoriques, méthodologiques et éthiques réels que se produisent dans le lieu de travail. L’étude de cas à travers du cinéma on va servir pour illustrer, cette fois, les concepts liés á une psycho dynamique traumatisme de l’enfance causés par l’abus et la violence domestique et les moyens pour y remédier. Pour le développement et la validation de cette proposition, nous avons convoqué deux groupes d’experts pour analyser le film Precious, ce film a servi comme étude de cas. A partir des idées les plus importantes de la discussion, nous analysons différents aspects liés aux pratiques professionnelles et des modèles de travail social et éducatif. Nous concluons qu’avec la visualisation du film et la discussion sur les coordonnées de cette analyse sera utile comme matériel complémentaire pour la formation académique des professionnels du terrain socio-éducatif

Instrumento de evaluación del programa de democracia participativa Ágora infantil

En el presente documento se detalla los instrumentos construidos para la evaluación del programa de democracia participativa Ágora Infantil (AI). Esta política es analiza para conocer sus efectos psicosociales por un equipo interdisciplinar de la Universidad de Málaga y de la Universidad de Huelva tal y como figura en el contrato 8.07/5.38.4408. En el presente documento se detallan los instrumentos utilizados por el equipo de investigación, asegurando así su registro. Por lo tanto, el uso parcial o total de los mismo requeriría la cita de la correspondiente autoría

Atención residencial a personas con demencia. Intervención desde el Trabajo Social

Se pretende identificar la forma de intervenir en la atención a personas que sufren demencias desde la disciplina del Trabajo Social, enmarcado en el ámbito de un Servicio Social Especializado, en un centro de atención residencial y dentro de un método de trabajo interdisciplinar. Al mismo tiempo se ha reflexionado, desde la práctica, sobre la importancia del rol del (de la) trabajador(a) social en la atención de las personas que sufren demencias y sus familias