Dementia care in times of COVID-19: Experience at Fundació ACE in Barcelona, Spain

Background: Fundació ACE is a non-profit organization providing care based on a holistic model to persons with cognitive disorders and their families for 25 years in Barcelona, Spain. Delivering care to this vulnerable population amidst the COVID-19 pandemic has represented a major challenge to our institution. Objective: To share our experience in adapting our model of care to the new situation to ensure continuity of care. Methods: We detail the sequence of events and the actions taken within Fundació ACE to swiftly adapt our face-to-face model of care to one based on telemedicine consultations. We characterize individuals under follow-up by the Memory Unit from 2017 to 2019 and compare the number of weekly visits in 2020 performed before and after the lockdown was imposed. Results: The total number of individuals being actively followed by Fundació ACE Memory Unit grew from 6,928 in 2017 to 8,147 in 2019. Among those newly diagnosed in 2019, most patients had mild cognitive impairment or mild dementia (42% and 25%, respectively). Weekly visits dropped by 60% following the suspension of face-to-face activity. However, by April 24 we were able to perform 78% of the visits we averaged in the weeks before confinement began. Discussion: We have shown that Fundació ACE model of care has been able to successfully adapt to a health and social critical situation as COVID-19 pandemic. Overall, we were able to guarantee the continuity of care while preserving the safety of patients, families, and professionals. We also seized the opportunity to improve our model of care

Modos de intervención criminal punible en crímenes de atrocidad: un análisis jurídico-penal a partir de los aportes de la criminología

790 p.The aforementioned PhD addresses the difficult task of establishing the criminal liability of each of the numerous individuals who take part in the perpetration of atrocity crimes, which are massive by nature. In order to achieve such a goal, the thesis is divided into three parts.The first part is dedicated to the criminological analysis of the reality of atrocity crimes, and it studies the various factors which have an effect on the aetiology of such type of crimes. These factors are analyzed at three levels (macro, meso and micro), and a specific chapter is dedicated to the aetiology of the crime of genocide. The second part is the longest one. It is aimed at studying the different modes of liability in International Criminal Law: direct perpetration, co-perpetration, indirect perpetration, indirect co-perpetration, participation, and the Responsibility of Superiors. With that purpose in mind, the second part is based on a comparative analysis of the case law of the ad hoc tribunals and of the International Criminal Court. The present PhD supports the theory of control over the crime, in particular, its third expression: indirect perpetration through control over the will. The adequacy in International Criminal Law of indirect perpetration and indirect co-perpetration through an Organized Power Apparatus has been outlined.The third part combines the results of the criminological analysis with the knowledge regarding the modes of liability, and it suggests a general frame of modes of liability which can be applied to every individual who takes part in the perpetration of atrocity crimes. Furthermore, it suggests that such modes of liability are taken into consideration at the sentencing phase

Planifificación de un proyecto de obra civil

Duración (en horas): Más de 50 horas. Destinatario: Estudiante[EU]Enpresa eraikitzailearen ikuspegitik, azpiegitura publikoen lehiaketa batean parte hartzeko derrigorrezko den obraren plangintza osatzea da xedea. Obra zibil baten plangintza eta programazioa gauzatzea du helburu, proiektu teknikoa abianpuntu izanik. Hala, jorratzen diren eduki teorikoak plangintza metodoak dira. Programazioa gauzatzeko erabiltzen den euskarria, proiektu kudeaketako Msproject softwarea da. Aldi berean, proiektu teknikoen azterketa eta interpretazioa, bai eta obren jarraipen eta kontrol dokumentuen ezagutza lantzen dira.[ES]El objetivo principal es crear el plan de una obra civil, requerimiento obligatorio de la documentación a presentar en los concursos públicos de adjudicación de obras, siendo el objetivo de aprendizaje de la asignatura la realización de la programación de las fases de una obra partiendo del análisis e interpretación del proyecto técnico correspondiente. El cuerpo principal del programa docente son el aprendizaje de diferentes metodologías de planificación. Se complementa con el aprendizaje del software de gestión de proyectos Msproject (oficce

Planifificación de un proyecto de obra civil

Duración (en horas): Más de 50 horas. Destinatario: Estudiante[EU]Enpresa eraikitzailearen ikuspegitik, azpiegitura publikoen lehiaketa batean parte hartzeko derrigorrezko den obraren plangintza osatzea da xedea. Obra zibil baten plangintza eta programazioa gauzatzea du helburu, proiektu teknikoa abianpuntu izanik. Hala, jorratzen diren eduki teorikoak plangintza metodoak dira. Programazioa gauzatzeko erabiltzen den euskarria, proiektu kudeaketako Msproject softwarea da. Aldi berean, proiektu teknikoen azterketa eta interpretazioa, bai eta obren jarraipen eta kontrol dokumentuen ezagutza lantzen dira.[ES]El objetivo principal es crear el plan de una obra civil, requerimiento obligatorio de la documentación a presentar en los concursos públicos de adjudicación de obras, siendo el objetivo de aprendizaje de la asignatura la realización de la programación de las fases de una obra partiendo del análisis e interpretación del proyecto técnico correspondiente. El cuerpo principal del programa docente son el aprendizaje de diferentes metodologías de planificación. Se complementa con el aprendizaje del software de gestión de proyectos Msproject (oficce

A Cost-Consequence Analysis of Different Screening Procedures in Alzheimer's Disease: Results from the MOPEAD Project

Background: For care planning and support, under-detection and late diagnosis of Alzheimer's disease (AD) is a great challenge. Models of Patient-Engagement for Alzheimer's Disease (MOPEAD) is an EU-funded project aiming at testing different strategies to improve this situation. Objective: To make a cost-consequence analysis of MOPEAD. Methods: Four screening strategies were tested in five countries (Germany, the Netherlands, Slovenia, Spain, and Sweden): 1) a web-approach; 2) Open-House initiative; 3) in primary care; and 4) by diabetes specialists. Persons-at-risk of AD in all strategies were offered referral to a hospital-based specialist. The primary health-economic outcome was the cost per true-positive case (TP) of AD from the screened population. Results: Of 2,847 screened persons, 1,121 screened positive (39%), 402 were evaluated at memory clinics (14%), and 236 got an AD diagnosis (8%). The cost per TP of those screened was (sic)3,115 with the web-approach, (sic)2,722 with the Open-House, (sic)1,530 in primary care, and (sic)1,190 by diabetes specialists. Sensitivity analyses that more likely reflect the real-world situation confirmed the results. The number-needed-to-screen was 30 with the web-approach, 8 with the Open-House and primary care, and 6 with the diabetes specialists. There were country differences in terms of screening rates, referrals to memory clinics, staff-types involved, and costs per TP. Conclusion: In primary care and by the diabetes specialist, the costs per TP/screened population were lowest, but the capacity of such settings to identify cases with AD-risk must be discussed. Hence new diagnostic strategies such as web-solutions and Open-House initiatives may be valuable after modifications

The MOPEAD project: Advancing patient engagement for the detection of “hidden” undiagnosed cases of Alzheimer's disease in the community

In most, if not all health systems, dementia is underdiagnosed, and when diagnosis occurs, it is typically at a relatively late stage in the disease process despite mounting evidence showing that a timely diagnosis would result in numerous benefits for patients, families, and society. Moving toward earlier diagnoses in Alzheimer's disease (AD) requires a conscientious and collective effort to implement a global strategy addressing the multiple causes hindering patient engagement at different levels of society. This article describes the design of the Models of Patient Engagement for Alzheimer's Disease project, an ongoing EU-funded public-private multinational initiative that will compare four innovative patient engagement strategies across five European countries regarding their ability to identify individuals with prodromal AD and mild AD dementia, which are “hidden” in their communities and traditionally not found in the typical memory clinic setting. The strategies include an online AD citizen science platform, an open house initiative at the memory clinics, and patient engagement at primary care and diabetologist clinics

The MOPEAD project: Advancing patient engagement for the detection of hidden undiagnosed cases of Alzheimer's disease in the community

In most, if not all health systems, dementia is underdiagnosed, and when diagnosis occurs, it is typically at a relatively late stage in the disease process despite mounting evidence showing that a timely diagnosis would result in numerous benefits for patients, families, and society. Moving toward earlier diagnoses in Alzheimer's disease (AD) requires a conscientious and collective effort to implement a global strategy addressing the multiple causes hindering patient engagement at different levels of society. This article describes the design of the Models of Patient Engagement for Alzheimer's Disease project, an ongoing EU-funded public-private multinational initiative that will compare four innovative patient engagement strategies across five European countries regarding their ability to identify individuals with prodromal AD and mild AD dementia, which are hidden in their communities and traditionally not found in the typical memory clinic setting. The strategies include an online AD citizen science platform, an open house initiative at the memory clinics, and patient engagement at primary care and diabetologist clinics. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)