Diseño y creación de formatos audiovisuales para enseñanza en campus virtuales: recursos educativos abiertos realizados por alumnos para MOOC y NOOC

Memoria del Proyecto de innovación sobre la creación de contenidos audiovisuales para cursos online o semipresenciale

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Design and implementation of support and planning for 360º video recording: Video Recording techniques and problem solving derived from it

El objetivo principal del proyecto es potenciar las habilidades y capacidades de los alumnos mediante su involucración en proyectos relacionados con la práctica profesional y el espíritu de investigación, dentro de las áreas académicas pertenecientes a las Ciencias de la Información:Comunicación Audiovisual, Publicidad y Periodismo. En este sentido, los estudiantes desarrollan su potencial en un área, el entorno 360, en el que la industria se encuentra, en estos momentos, en una fase de búsqueda de soluciones que ofrezcan un producto satisfactorio no solo desde el punto de vista de su eficacia técnica y comunicativa, sino desde una perspectiva económica, esto es, del abaratamiento de costes.The main objective of the project is to enhance the skills and abilities of students through their involvement in projects related to professional practice and the spirit of research, within the academic areas belonging to the Communication Sciences: Audiovisual Communication, Advertising and Journalism. In this sense, students develop their potential in an area, the 360 ​​environment, in which the industry is currently in a phase of searching for solutions. It is important to offer a satisfactory product not only from the point of view of its technical and communicative efficiency, but from an economic perspective, that is, cost reduction.Depto. de Ciencias de la Comunicación AplicadaFac. de Ciencias de la InformaciónFALSEsubmitte

Realization of audiovisual content and video apps for blended and online education: students as creator of open educational resources for virtual campuses and MOOC

Los objetivos de este proyecto de investigación son: - Aplicar los recursos de los contenidos, servicios y herramientas de las tecnologías emergentes digitales a la innovación educativa de carácter narrativo interdisciplinar en la Universidad y operar con las técnicas básicas para desarrollar actividades de enseñanza/aprendizaje en los entornos hipermedia. - Desarrollar aplicaciones digitales para la realización de materiales videográficos con móviles y tablets para democratizar el uso de las infraestructuras y Proyecto de Innovación Convocatoria 2016/2017 Proyecto 256 Realización de contenidos audiovisuales y de apps de vídeo para enseñanza semipresencial y online: el alumnado como creador de recursos educativos abiertos para campus virtuales y MOOC María Luisa García Guardia Facultad de Ciencias de la Información Departamento de Comunicación Audiovisual y Publicidad 2 equipamientos audiovisuales de las tecnologías emergentes de la comunicación. - Conocer los nuevos sistemas de aprendizaje masivo abierto en línea (MOOC) y la utilización de campus virtuales. - Facilitar la interacción didáctica de los profesores y de los alumnos, así como la interacción de los profesores entre ellos mismos y la de los alumnos entre sí, utilizando los contenidos, servicios y herramientas tecnológicas avanzadas para mejorar los procesos de trabajo cooperativo con la finalidad de potenciar un modelo de colaboración personalizado, en diferentes niveles de agrupamiento, basado en prácticas metodológicas activas que propicien la autonomía de aprendizaje y fomenten el pensamiento autónomo y crítico. - Proponer un modelo de innovación educativa interdisciplinar a través del descubrimiento de las relaciones de convergencia entre la Narrativa Audiovisual y otras materias, buscando su aplicabilidad a través de los contenidos audiovisuales e hipermedia. - Seleccionar y activar aquellos métodos, contenidos o estrategias educativas, transferidas de las materias en cuestión que se puedan compartir a través de criterios de interdisciplinariedad e innovación.The objectives of this research project are: - To apply the resources of the contents, services and tools of the emerging digital technologies to educational innovation of an interdisciplinary narrative nature in the University and to operate with the basic techniques to develop teaching / learning activities in the hypermedia environments. - Develop digital applications for the production of videographic materials with mobiles and tablets to democratize the use of infrastructures and Innovation Project Call for proposals 2016/2017 Project 256 Realization of audiovisual content and video apps for blended and online education: students as creator of open educational resources for virtual campuses and MOOC María Luisa García Guardia Faculty of Information Science Department of Audiovisual Communication and Advertising 2 audiovisual equipment of emerging communication technologies. - Understand the new mass online learning systems (MOOC) and the use of virtual campuses. - To facilitate the didactic interaction of teachers and students, as well as the interaction of teachers between themselves and that of the students, using advanced contents, services and technological tools to improve cooperative work processes for the purpose to foster a model of personalized collaboration, at different levels of grouping, based on active methodological practices that foster autonomy of learning and foster autonomous and critical thinking. - To propose a model of interdisciplinary educational innovation through the discovery of the relations of convergence between the Audiovisual Narrative and other subjects, seeking their applicability through audiovisual and hypermedia contents. - Select and activate those methods, contents or educational strategies, transferred from the subjects in question that can be shared through criteria of interdisciplinarity and innovation.Fac. de Ciencias de la InformaciónFALSEsubmitte

Diseño y creación de formatos audiovisuales para enseñanza en campus virtuales: recursos educativos abiertos realizados por alumnos para MOOC y NOOC

Memoria del Proyecto de innovación sobre la creación de contenidos audiovisuales para cursos online o semipresencialesDepto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids