Limitacions i reptes de la implicació ciutadana en la planificació de la ciutat. El cas de Va Cabanyal!

Amb aquest article es pretén generar un espai de reflexió sobre les limitacions i els reptes presents en la implicació de la ciutadania en els processos de planificació i transformació urbana a través de l’estudi de cas del barri del Cabanyal a València. Després de divuit anys amenaçat per la prolongació de l’avinguda Blasco Ibáñez, el nou govern local va promoure un procés participatiu durant l’últim trimestre del 2015 per a la redacció d’una Estratègia de Desenvolupament Urbà Sostenible i Integrat (EDUSI) per al barri, amb l’objectiu d’obtenir fons europeus per a regenerar la zona. Un conflicte urbà tan estès en el temps i amb tanta complexitat de capes i discursos com el del Cabanyal permet analitzar la participació social des d’un marc conflictualista que és difícil obviar. A través de la implicació en aquest procés d’investigació de l’acció participativa, s’ha aprofundit en la transformació del conflicte, en les potencialitats d’un enfocament holístic i dialèctic, així com en les limitacions imposades, entre altres, per un marc administratiu molt rígid

Beyond simulation: collaborative redaction of I.S.U.D. in Cabanyal-Canyamelar-Cap de França (Valencia)

El barrio del Cabanyal-Canyamelar-Cap de França es uno de los conjuntos urbanos más destacables de la ciudad de Valencia. Un Plan parcial urbanístico promovido por el Ayuntamiento a finales de los noventa preveía alterar notablemente su morfología, ante la posición contraria de un vecindario que se movilizó y consiguió atenuar parte del impacto del plan. En una nueva etapa, el Ayuntamiento encarga una estrategia sostenible para el barrio que respete el patrimonio e incluya el punto de vista de los ciudadanos. Esa estrategia deberá intentar recabar fondos europeos a través de la convocatoria EDUSI del Ministerio de Fomento. El equipo Va Cabanyal gana el concurso para diseñar esa estrategia otorgando un peso importante a las técnicas dialécticas. En esta nota metodológica se relata el proceso desarrollado en un tiempo limitado y con el corsé de las directrices de una convocatoria de la UE. Al mismo tiempo, se apunta el tipo de participación deseable una vez estén disponibles los fondos y se ponga en marcha la estrategia

Dos familias de controladores en modo de deslizamiento para un generador de inducción doblemente alimentado en un sistema aislado

En este artículo se considera el control en modo de deslizamiento (SMC1) de un generador de inducción doblemente alimentado (DFIG) que suministra a una carga RL aislada, en un sistema de generación de velocidadvariable/frecuencia-constante (VSCF). Para el control del DFIG parece conveniente utilizar una técnica robusta, debido a la existencia de variaciones en sus parámetros, causadas por razones como cambios en la temperatura de los devanados, histéresis y saturación. Por ello es que se ha considerado el SMC. Éste tiene varias características atractivas, como reducción de orden, robustez, rechazo a perturbaciones y, en ocasiones, implementación sencilla. En este trabajo, algunas ideas de SMC, que han sido usadas por Utkin y colaboradores para el control de par/velocidad del motor de inducción jaula de ardilla, se aplican para diseñar dos familias de controladores para regular la amplitud y la frecuencia del voltaje generado por el DFIG. También, se incluyen los primeros resultados de simulación.Peer Reviewe

Healthcare Experience and their Relationship with Demographic, Disease and Healthcare-Related Variables: A Cross-Sectional Survey of Patients with Chronic Diseases Using the IEXPAC Scale

Health Administration; Public Health; Quality of Life ResearchAdministración sanitaria; Salud pública; Investigación de calidad de vidaAdministració sanitària; Salut pública; Investigació sobre la qualitat de vidaBackground Patient experience is acknowledged as a principal aspect of quality healthcare delivery, and it has implications with regard to outcomes. Objectives Our objective was to evaluate the healthcare experience of patients with chronic diseases to identify patient-perceived healthcare gaps and to assess the influence of demographic and healthcare-related variables on patient experiences. Methods A cross-sectional survey was delivered to adult patients with chronic diseases: diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, inflammatory bowel disease (IBD) or rheumatic diseases. Patient experiences were assessed with the Instrument for Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire, with possible scores ranging from 0 (worst) to 10 (best experience). Results Of the 2474 patients handed the survey, 1618 returned it (response rate 65.4%). Patients identified gaps in healthcare related mainly to access to reliable information and services, interaction with other patients and continuity of healthcare after hospital discharge. The mean ± standard deviation (SD) IEXPAC score was 6.0 ± 1.9 and was higher for patients with HIV (6.6 ± 1.7) than for those with rheumatic disease (5.5 ± 2.0), IBD (5.9 ± 2.0) or DM (5.9 ± 1.9) (p < 0.001). In multivariate models, better overall IEXPAC experience was associated with follow-up by the same physician, follow-up by a nurse, receiving healthcare support from others and treatment with subcutaneous or intravenous drugs. The multivariate model that confirmed patients with HIV or DM had better experience than did those with rheumatic diseases. Conclusions Through IEXPAC, patients identified aspects for healthcare quality improvements and circumstances associated with better experience, which may permit greater redirection of healthcare toward patient-centered goals while facilitating improvements in social care and long-term healthcare quality.This project was funded by Merck Sharp and Dohme, Spain

The Influence of Patient Experience with Healthcare on the Health-Related Quality of Life of People Living with HIV: An Observational Cross-Sectional Survey

[Abstract] Introduction Patient experience is central to the quality of healthcare delivery, showing positive associations with several outcome measures. The main objectives of this study are to analyze the influence of patient experience on the health-related quality of life in people living with HIV and the role played by treatment complexity and clinical care. Methods We conducted a cross-sectional survey with 467 patients with HIV. We used the Instrument for Evaluation of the Experience of Chronic Patients and the Health-related Quality of Life Questionnaire (EQ-5D-5L). We analyzed a predictive model through the partial least squares (PLS) method. Results The patient self-management scores showed the highest positive relationship with the patient’s health-related quality of life (β = 0.24, β = 0.32, p  50 years old (p < 0.05). Conclusions Patient experience mainly influenced the health-related quality of life of older people living with HIV. The treatment and clinical care complexity played an important role in degrading the patients' experience and their quality of life. More integrated care would benefit the health-related quality of life of people living with HIV

The experience of inflammatory bowel disease patients with healthcare: a survey with the IEXPAC instrument

[Abstract] To assess inflammatory bowel disease (IBD) patients' experience of chronic illness care and the relationship with demographic and healthcare-related characteristics.This cross-sectional survey used the Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC) questionnaire to identify parameters associated with a better healthcare experience for IBD patients. IEXPAC questionnaire responses are grouped into 3 factors - productive interactions, new relational model, and patient self-management, scoring from 0 (worst) to 10 (best experience). Scores were analyzed by bivariate comparisons and multiple linear regression models.Surveys were returned by 341 of 575 patients (59.3%, mean age 46.8 (12.9) years, 48.2% women). Mean (SD) IEXPAC score was 5.9 (2.0); scores were higher for the productive interactions (7.7) and patient self-management factors (6.7) and much lower for the new relational model factor (2.2). Follow-up by a nurse, being seen by the same physician, and being treated with a lower number of medicines were associated with higher (better) overall patient experience score, and higher productive interactions and self-management factor scores. A higher productive interactions score was also associated with patients receiving medication subcutaneously or intravenously. Higher new relational model scores were associated with follow-up by a nurse, affiliation to a patients' association, receiving help from others for healthcare, a lower number of medicines and a higher educational level.In patients with IBD, a better overall patient experience was associated with follow-up by a nurse, being seen by the same physician, and being treated with a lower number of medicines

Anàlisis per a la valoració de la normativa del 22@

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The Experience With Health Care of Patients With Inflammatory Arthritis: A Cross-sectional Survey Using the Instrument to Evaluate the Experience of Patients With Chronic Diseases

[Abstract] Background: Patients' experience with health care is becoming a key component for the provision of a patient-centered health care model. The aim of this study was to assess the experience with health care of patients with inflammatory arthritis and patient- and health care-related factors. Methods: Patients responded to an anonymous survey provided by their treating clinical teams. The survey comprised the validated 12-item IEXPAC (Instrument to Evaluate the EXperience of PAtients with Chronic diseases) tool and demographic variables and health care-related characteristics that may affect patients' experience. Results: A total of 359 of 625 surveys were returned (response rate, 57.4%). Overall, patient responses were positive (>60% gave "always/mostly" answers) for statements assessing the interaction between patients and health care professionals or patient self-management following health care professional guidance. However, positive patient responses for items regarding patient interaction with the health care system via the internet or with other patients were less than 13%. Only 25.6% of patients who had been hospitalized reported receiving a follow-up call or visit following discharge. In the bivariate analysis, experience scores were higher (better experience) in men, those seen by fewer specialists or by the same physician, and in patients treated with a fewer number of drugs or with subcutaneous/intravenous drugs. Multivariate analyses identified regular follow-up by the same physician and treatment with subcutaneous/intravenous drugs as variables associated with a better patient experience. Conclusions: This study identifies areas of care for patients with inflammatory arthritis with the potential to improve patients' experience and highlights the importance of patient-physician relationships and comprehensive patient care

Healthcare experience and their relationship with demographic, disease and healthcare-related variables: a cross-sectional survey of patients with chronic diseases using the IEXPAC scale.

[Abstract] BACKGROUND: Patient experience is acknowledged as a principal aspect of quality healthcare delivery, and it has implications with regard to outcomes. OBJECTIVES: Our objective was to evaluate the healthcare experience of patients with chronic diseases to identify patient-perceived healthcare gaps and to assess the influence of demographic and healthcare-related variables on patient experiences. METHODS: A cross-sectional survey was delivered to adult patients with chronic diseases: diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, inflammatory bowel disease (IBD) or rheumatic diseases. Patient experiences were assessed with the Instrument for Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire, with possible scores ranging from 0 (worst) to 10 (best experience). RESULTS: Of the 2474 patients handed the survey, 1618 returned it (response rate 65.4%). Patients identified gaps in healthcare related mainly to access to reliable information and services, interaction with other patients and continuity of healthcare after hospital discharge. The mean ± standard deviation (SD) IEXPAC score was 6.0 ± 1.9 and was higher for patients with HIV (6.6 ± 1.7) than for those with rheumatic disease (5.5 ± 2.0), IBD (5.9 ± 2.0) or DM (5.9 ± 1.9) (p < 0.001). In multivariate models, better overall IEXPAC experience was associated with follow-up by the same physician, follow-up by a nurse, receiving healthcare support from others and treatment with subcutaneous or intravenous drugs. The multivariate model that confirmed patients with HIV or DM had better experience than did those with rheumatic diseases. CONCLUSIONS: Through IEXPAC, patients identified aspects for healthcare quality improvements and circumstances associated with better experience, which may permit greater redirection of healthcare toward patient-centered goals while facilitating improvements in social care and long-term healthcare quality