Mediation criteria for interactive serious games aimed at improving learning in children with attention deficit hyperactivity disorder (ADHD)

The PASS intelligence theory (Planning, Attention-Arousal, Simultaneous and Successive) was used together with Feuerstein’s mediation model to develop a system of categories for mediation in educational games. This system was used to analyze and improve the design of interactive games that can enhance mediation in learning, particularly in children with attention deficit hyperactivity disorder (ADHD). To this end, interactive games designed for a tabletop device were evaluated within an educational context. 27 children (3–14 years old), who had been diagnosed with ADHD, took part. The tabletop has an intuitive system that allows children to interact directly with objects with which they are familiar, providing opportunities for play and communication. These games were evaluated by the participant observation of individual and group playing experiences, interviews, and two focus groups. The results show that mediation recommendations can be useful in the design of the games. They also confirm the need to improve the adaptability of the games to enable children with ADHD to mediate, plan, and focus their attention. With the aid of a facilitator, the mediating function of learning-games can therefore be applied in the development of the executive functions that are key to learning

Improving the oscillating wear response of cold sprayed Ti-6Al-4V coatings through a heat treatment

Cold spray (CS) coating technique is being studied as a potential solution for repairing aircraft Ti-6Al-4V components. This work is focused on the restoration of damaged components due to wear induced by vibrations. It is known that Ti-6Al-4V CS deposition shows difficulties to obtain non-porous coatings due to the high strength of this material, that is detrimental for wear resistance. In this sense, performing a post-heat treatment leads to lower porosity CS Ti-6Al-4V coatings and improves their mechanical properties, and thus, a better tribological behaviour is also expected. Therefore, the objective of this study was to determine the effect of a post-heat treatment on the wear resistance of Ti-6Al-4V coatings deposited by the CS technique. Ti-6Al-4V CS coatings were used, which have been sprayed with nitrogen as process gas at a temperature of 1100 °C and a pressure of 50 bar. The coatings were subjected to a solution heat treatment followed by a precipitation heat treatment. Oscillating and unidirectional sliding wear experiments were conducted on the coatings at room temperature and at 450 °C. A pin on disc configuration was used with a bearing steel counterbody. The results were compared to those obtained on the substrate (which represents the material to be repaired) and on the as-sprayed coating, which were derived from a previous work. The heat treated coating presented improved wear behaviour as compared to the substrate as well as to the as-sprayed coating, particularly during the high temperature tests. Wear at high temperature was dominated by material transference from the counterbody to the Ti-6Al-4V coating

STANDARDIZED CATCH RATES FOR MEDITERRANEAN SWORDFISH (XIPHIAS GLADIUS LINNAEUS, 1758) FROM THE SPANISH LONGLINE FISHERY. 1988-2018

Standardized relative abundance indices for swordfish (Xiphias gladius Linnaeus, 1758) caught by the Spanish surface longline in the western Mediterranean Sea were estimated for the period 1988-2018. Standardized CPUEs in number were estimated through a General Linear Mixed Modeling (GLMM) approach under a negative binomial (NB) error distribution assumption. Standardized CPUEs in biomass were estimated through a General Linear Mixed Modeling (GLMM) approach under a log-normal error distribution assumption. The main factors in the standardization analysis were fishing area and time of the year (quarter). The standardized indices showed notable annual fluctuations without any definite trend for the period under studyEn prens

STANDARDIZED CATCH RATES OF ALBACORE (THUNNUS ALALUNGA BONNATERRE, 1788) IN THE SPANISH RECREATIONAL FISHERY IN THE WESTERN MEDITERRARREAN IN THE PERIOD 2005-2019

Catch and effort data from the Spanish recreational fishery in the Balearic Sea (Western Mediterranean) were analysed to estimate an index of relative abundance for albacore for the years 2005-2019. Standardized catch per unit effort (CPUE) in number were estimated through a General Linear Mixed Modeling (GLMM) approach under a negative binomial (NB) error distribution assumption. Nominal catch rates and a standardized abundance index are presented along with estimates of 95% confidence limits of the predicted means. These indices show an upward trend from the start of the series 2005 peaking in 2013; followed by a decrease until 2015. For the latest four-year period (2016-2019), the index shows a relatively stable trend fluctuating around a level two times lower than the maximum abundance recorded in the time series.En prens

Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study

Objective: To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. Methods: Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH <6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. Results: We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4–11): 2934 (34.3%) had a LOH 15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0–64.9) when LOH was 11–15 days, and by 72.0% (95%CI = 42.6–107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4–36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. Conclusions: Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments

Registro Español de Trasplante Cardiaco. XXXI Informe Oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología

Introducción y objetivos Se presentan las características clínicas y los resultados de los trasplantes cardiacos realizados en España con la actualización correspondiente a 2019. Métodos Se describen las características clínicas y los resultados de los trasplantes cardiacos realizados en 2019, así como las tendencias de estos en el periodo 2010-2018. Resultados En 2019 se realizaron 300 trasplantes (8.794 desde 1984; 2.745 entre 2010 y 2019). Respecto a años previos, los cambios más llamativos son el descenso hasta el 38% de los trasplantes realizados en código urgente, y la consolidación en el cambio de asistencia circulatoria pretrasplante, con la práctica desaparición del balón de contrapulsación (0, 7%), la estabilización del uso del oxigenador extracorpóreo de membrana (9, 6%) y el aumento de los dispositivos de asistencia ventricular (29%). La supervivencia en el trienio 2016-2018 es similar a la del trienio 2013-2015 (p = 0, 34), y ambas mejores que la del trienio 2010-2012 (p = 0, 002 y p = 0, 01 respectivamente). Conclusiones Se mantienen estables tanto la actividad del trasplante cardiaco en España como los resultados en supervivencia en los últimos 2 trienios. Hay una tendencia a realizar menos trasplantes urgentes, la mayoría con dispositivos de asistencia ventricular. Introduction and objectives: The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019. Methods: We describe the clinical characteristics and outcomes of heart transplants performed in Spain in 2019, as well as trends in this procedure from 2010 to 2018. Results: In 2019, 300 transplants were performed (8794 since 1984; 2745 between 2010 and 2019). Compared with previous years, the most notable findings were the decreasing rate of urgent transplants (38%), and the consolidation of the type of circulatory support prior to transplant, with an almost complete disappearance of counterpulsation balloon (0.7%), stabilization in the use of extracorporeal membrane oxygenation (9.6%), and an increase in the use of ventricular assist devices (29.0%). Survival from 2016 to 2018 was similar to that from 2013 to 2015 (P = .34). Survival in both these periods was better than that from 2010 to 2012 (P = .002 and P = .01, respectively). Conclusions: Heart transplant activity has remained stable during the last few years, as have outcomes (in terms of survival). There has been a trend to a lower rate of urgent transplants and to a higher use of ventricular assist devices prior to transplant

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines