Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness

Objective: To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. Methods: The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. Discussion: Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR)

Variability of indication criteria in knee and hip replacement: an observational study

<p>Abstract</p> <p>Background</p> <p>Total knee (TKR) and hip (THR) replacement (arthroplasty) are effective surgical procedures that relieve pain, improve patients' quality of life and increase functional capacity. Studies on variations in medical practice usually place the indications for performing these procedures to be highly variable, because surgeons appear to follow different criteria when recommending surgery in patients with different severity levels. We therefore proposed a study to evaluate inter-hospital variability in arthroplasty indication.</p> <p>Methods</p> <p>The pre-surgical condition of 1603 patients included was compared by their personal characteristics, clinical situation and self-perceived health status. Patients were asked to complete two health-related quality of life questionnaires: the generic SF-12 (Short Form) and the specific WOMAC (Western Ontario and Mcmaster Universities) scale. The type of patient undergoing primary arthroplasty was similar in the 15 different hospitals evaluated.</p> <p>The variability in baseline WOMAC score between hospitals in THR and TKR indication was described by range, mean and standard deviation (SD), mean and standard deviation weighted by the number of procedures at each hospital, high/low ratio or extremal quotient (EQ_5-95), variation coefficient (CV_5-95) and weighted variation coefficient (WCV_5-95) for 5-95 percentile range. The variability in subjective and objective signs was evaluated using median, range and WCV_5-95. The appropriateness of the procedures performed was calculated using a specific threshold proposed by Quintana et al for assessing pain and functional capacity.</p> <p>Results</p> <p>The variability expressed as WCV_5-95was very low, between 0.05 and 0.11 for all three dimensions on WOMAC scale for both types of procedure in all participating hospitals. The variability in the physical and mental SF-12 components was very low for both types of procedure (0.08 and 0.07 for hip and 0.03 and 0.07 for knee surgery patients). However, a moderate-high variability was detected in subjective-objective signs. Among all the surgeries performed, approximately a quarter of them could be considered to be inappropriate.</p> <p>Conclusions</p> <p>A greater inter-hospital variability was observed for objective than for subjective signs for both procedures, suggesting that the differences in clinical criteria followed by surgeons when indicating arthroplasty are the main responsible factors for the variation in surgery rates.</p

Comparación entre el porcentaje de masa grasa y la amplitud de movimiento isquiosural en escolares de gimnasia rítmica

The evaluation of the body composition and in particular, the fat percentage (%F) is used as an instrument in order to establish the athletic performance. The purpose of this study is to check if exists a relationship between the fat mass percentage (%MF) and the range of motion. To that end, 40 athletes (gymnast) who do an initial level of rhythmic gymnastics were assessed. We also have to take into account that these athletes have an average age of 10 ± 1.10 years, an average height of 130.28 ± 22.44 cm, an average weight of 34.07 ± 6.63 kg, an average %F of 25.85 ± 5.61 % and an average of achieved centimeters in the sit and reach test (SRT) of 32.2 cm ± 5.98 cm. They were weighed with a Tanita BC-532 scale in order to estimate the %F. The correlation coefficient and the coefficient of determination between the %MG and the achieved centimeters in the SRT were calculated. The correlation coefficient for the athletes who were born in 2005, 2004, 2003 and 2002 is 0.13, 0.07, 0.03, 0.62, respectively, and the whole sample has a correlation coefficient of 0.23. At the end of our study, we realized that there is no relationship between both variables. However, we are able to suggest that the data is homogenized at the same time that athletes grew up; therefore, we can say that there is a counter-intuitive relationship between the %MF and the achieved centimeters in the SRT.La evaluación de la composición corporal y, concretamente el porcentaje de grasa (%G), es usado como instrumento para determinar el rendimiento deportivo. La finalidad de este estudio es comprobar si existe relación entre el porcentaje de masa grasa (%MG) y la amplitud de movimiento. Para ello se evaluaron 40 deportistas de escuela de gimnasia rítmica, de nivel inicial con edad media de 10 ± 1,10 años, estatura media de 130,28 ± 22,44 cm, peso medio de 34,07 ± 6,63 kg, %G medio de 25,85 ± 5,61 % y con una media de centímetros alcanzados en el sit and reach test (SRT) de 32,2 cm ± 5,98 cm. Fueron pesadas en la báscula Tanita BC-532 para estimar el %G. Se calcularon los coeficientes de correlación y determinación entre el %MG y los centímetros alcanzados en el SRT. Los coeficientes de correlación son de un valor de -0,13 para las nacidas en 2005, un valor de 0,07 para las nacidas en 2004, un valor de -0,03 para las nacidas en 2003, un valor de -0,62 para las nacidas en 2002 y un valor de -0,23 para la muestra completa. Al final de nuestro estudio comprobamos que no hay relación entre ambas variables, pero podemos sugerir que conforme las deportistas van creciendo, se homogeneizan los datos estableciéndose una relación inversa entre el %MG y los centímetros alcanzados en el SRT

Bajo el signo de la luz : la fundación de una utopía andaluza

Esta publicación obtuvo el Primer Premio Joaquín Guichot a investigaciones, experiencias y materiales sobre Andalucía y su cultura en la edición XXVI del curso 2013/2014Se trata de un proyecto intercentros en el que se pretende convertir en aula a la comunidad. Nace para dar respuesta a las inquietudes de un alumnado y una población que ignoran, en buena medida, sus orígenes y los de sus antepasados. Como respuesta a esa necesidad, se vuelve sobre las huellas del tiempo para descubrir la epopeya de las nuevas poblaciones de Sierra Morena y Andalucía; una iniciativa que respondió a los ideales del Siglo de las Luces y a la necesidad de poblar los extensos terrenos que bordeaban el Camino Real. Con el formato de aprendizaje-servicio a la comunidad, el alumnado descubrirá que sus raíces culturales, sus apellidos y tradiciones, lejos de los localismos, provienen de Europa Central y suponen un ejemplo de integración cultural. "Bajo el signo de la luz" va más allá y sueña con llevar la utopía a la educación e intenta convertirse en un paradigma de integración del trabajo de Educación Infantil, Primaria y Secundaria, o de cualesquiera otras enseñanzas, y se apoya en el deseo idealista de dar a conocer la cultura andaluza al alumnado de nuestra Comunidad Autónoma.AndalucíaES

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk