Prevalencia y calidad asistencial percibida por una cohorte de pacientes pluripatológicos y sus cuidadores: estudio prospectivo multicéntrico en cuatro zonas básicas de salud del Área metropolitana de Sevilla

Falta palabras claveIntroducción: La comorbilidad ha mostrado una importante influencia en múltiples aspectos de los servicios de salud, ya que los pacientes que la presentan tienen gran contacto con la asistencia a distintos niveles; en Andalucía el proceso de atención a pacientes pluripatológicos permite seleccionar un grupo con comorbilidad dentro de la población general. Por otra parte, la calidad percibida de la asistencia sanitaria es un indicador de los servicios de salud que ha mostrado creciente interés por su utilidad para establecer puntos cuya mejora pueda aumentar la calidad del servicio. Objetivos: Identificar y caracterizar la población de pacientes pluripatológicos en un área de atención primaria, medir su percepción de la calidad de la asistencia sanitaria recibida así como factores asociados a la misma. Métodos: Estudio transversal en cuatro centros de salud del área del hospital ‘Virgen del Rocío’ (Sevilla). Identificación activa de los pacientes pluripatológicos mediante revisión de historias clínicas y entrevistas con los médicos de familia que tenían asignados a los pacientes. Encuesta a los pacientes pluripatológicos y a sus cuidadores, incluyendo datos demográficos, clínicos, asistenciales, situación socio-familiar, funcional y cognitiva, de relación con profesionales de salud y un cuestionario de calidad percibida de la asistencia siguiendo el modelo SERVQUAL, validado en España para pacientes ambulatorios. Resultados: Los pacientes pluripatológicos suponían el 1,3% de la población adulta. Se realizaron 472 encuestas a pacientes y cuidadores (70 % de la población elegible). La calidad percibida de la asistencia sanitaria tuvo una valoración de 3,68 en una escala de cinco puntos, cerca de la percepción ‘mejor de lo esperado’ a la que correspondía el valor ‘4’. El único ítem que tuvo una valoración ‘por debajo de lo esperado’ fue el tiempo de espera para entrar en consultas. Se encontraron diferencias en la valoración de la calidad percibida de la asistencia sanitaria en función de: género del paciente, localidad de residencia, convivientes, número de categorías de comorbilidad, categorías y enfermedades padecidas, situación funcional, situación cognitiva, número de consultas con el médico de atención primaria, contacto telefónico con el médico y el enfermero de atención primaria, seguimiento por especialidades, identificación de enfermero, valoración de la relación con enfermero y médico de familia, y presencia de un cuidador para el paciente. Los predictores de la calidad percibida de la asistencia explicaron el 35 % de la varianza en dicha valoración; eran, por orden de influencia de mayor a menor: la valoración de la relación del paciente con el médico de familia, el seguimiento por especialidades, el tipo de convivientes, tener cuidador, el número de consultas con el médico de familia, la localidad de residencia, el contacto telefónico con el enfermero y la identificación del enfermero. Conclusiones: Medidas que mejorasen la relación del paciente con los profesionales, aumentasen el apoyo a cuidadores y familiares además de al propio paciente, y potenciasen el control del paciente desde atención primaria en vez de hacerlo desde atención especializada podrían mejorar la valoración de la calidad de la asistencia recibida por parte de los pacientes pluripatológicos

Caracterización física de los suelos sulfatados ácidos del distrito de riego del alto chicamocha (boyacá) y su aplicación al manejo

Se evaluaron las propiedades físicas de los Suelos Sulfatados Ácidos (SSA) del Distrito de Riego del Alto Chicamocha, con el fin de determinar sus limitantes de tipo físico, su relación con las propiedades químicas y, con base en su identificación, establecer el tipo de manejo adecuado en riego, drenaje y labranza. Para lograrlo, el Grupo Interinstitucional de Investigación en Suelos Sulfatados Ácidos Tropicales (GISSAT), de la Universidad Pedagógica y Tecnológica de Colombia, realizó un levantamiento de suelos en el que identificó, describió y clasificó sistemáticamente cinco perfiles modales de SSA, en los cuales determinó la densidad real y aparente, porosidad, textura, estabilidad estructural, consistencia, módulo de ruptura, constantes de humedad y conductividad hidráulica para sus dos primeros horizontes. Los resultados más relevantes indican que los SSA se encuentran limitados por alta plasticidad, moderada a baja estabilidad estructural en horizontes orgánicos; altos contenidos de arcillas en horizontes minerales, que en conjunto afectan la distribución de poros, retención de humedad y capacidad de aireación, sumado a una profundidad efectiva limitada por la presencia de horizontes sulfúricos y nivel freático fluctuante, situación que permite deducir las prácticas de manejo del medio físico de los SSA para su recuperación y explotación sostenible

Analysis of Psychometric Properties of the Quality and Satisfaction Questionnaire Focused on Sustainability in Higher Education

The aim of this research was to develop and validate a questionnaire to assess the quality of education, from a sustainability perspective, in higher education institutions of Naples (Italy), and determine whether differences exist between the groups (families, teachers and, students) with respect to their level of satisfaction concerning that quality, since it is important that education policies promote that assessment from an economic, social, environmental, and organisational dimension. The questionnaire was validated using a quantitative, quasi experimental, cross sectional method. A multivariate analysis of variance (MANOVA) was conducted on a sample of n = 1091 subjects to study the differences between the groups and their level of satisfaction. The results show a good reliability and validity. In this MANOVA, significant differences and large effect sizes were found. Families and teachers consider that quality management in higher education is adequate. The three groups are very satisfied with teaching management, and the teachers’ group has the higher level of satisfaction with teaching planning. It is concluded that this validated questionnaire provides information on the opinions about the quality of education from a sustainability perspective and that the self-assessment of those responsible for teaching is essential to achieve continuous improvementHUM-98

Analysis of the interface and mechanical properties of field-assisted sintered duplex stainless steels

The development of duplex stainless steels produced by powder metallurgy represents an interesting alternative to conventional fabrication routes, since typical routes imply a strict control of composition and temperature during the processing path in order to avoid undesirable brittle phases. This work proposes a sintering route, designated as field-assisted hot pressing technique, in which an alternating current is applied to consolidate duplex stainless steels with different initial austenite percentages, always higher than ferrite. In all the cases, a thin and hard planar interface composed by two different microconstituents is generated between austenite and ferrite, growing inside the ferritic phase. The good mechanical properties achieved by these field-assisted sintered duplex stainless steels, in terms of nanohardness, elastic modulus, yield strength, ultimate tensile stress and ductility, establish these steels as promising candidates to be introduced in the market.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors wish to express their gratitude to Dr. M.A. Monclús and Dr. M. Castillo-Rodríguez for their experimental and technical suppor

Quality in Higher Education and Satisfaction among Professors and Students

This research received external funding by Project HUM-983 (ITACA): “Research through transforming learning and contexts.” Principal Researcher: Eva María Olmedo-Moreno.The aim of this study was to analyze the significant differences in satisfaction with educational quality in higher education in Italy (Naples) among students and professors. The sample consisted of 501 higher education students and 121 professors, resulting in a total sample size of 622 subjects. Once the quality parameters of the instrument were determined, reliability was confirmed, and data collection was initiated. In order to analyze the results, a test of independent means (Student’s t-test) was performed, interrelating the variables of educational quality, concerning both management and satisfaction with higher education. Based on the results, we concluded that there are significant differences between the group of students and the group of professors, highlighting a higher level of satisfaction with quality reported by students regarding the coordination of teachers and staff in the educational process; therefore, the inclusion of students in the direct management of the center should be more active and an indicator to be taken into account in self-evaluation. Despite the limitations in the sample at the regional level, it offers many possibilities for future research.HUM-98

MAPPING THE EVOLUTION OF MENTAL HEALTH RESEARCH IN RELATION TO PHYSICAL ACTIVITY: PRE AND POST GLOBAL PANDEMIC PERSPECTIVES

The research highlights the significant impact of the COVID-19 pandemic on mental health, leading to stress, anxiety, and depression. Physical activity is recognized as a preventive strategy for overall well-being and a beneficial factor for mental health, reducing symptoms of depression and anxiety. The study uses a quantitative-bibliometric method based on keywords related to mental health, exercise, sport, social health, cognitive health, wellbeing, human development, and sports fan. The goal is to locate possible future directionalities and fields of study yet to be discovered and to study the evolution of scientific research on mental health in the social sciences in recent years. The results show that the key concepts have been evolving towards a worsening of mental health, and research linking mental health with physical activity has multiplied, particularly due to the negative effect of the readaptation to the new normality caused by the pandemic. The discussion also emphasizes the importance of social support and engagement in physical activity for mental health outcomes. The research states that group-based exercise programs and social connections are crucial for reducing symptoms of depression and anxiety. The future direction of research is also highlighted to identify effective strategies for promoting physical activity and social support during times of stress and uncertainty. Overall, understanding the relationship between physical activity and mental health can lead to improved coping skills and overall well-being

Validation of the Smart City as a Sustainable Development Knowledge Tool: The Challenge of Using Technologies in Education during COVID-19

The objective of this research was to design and validate a questionnaire for teachers on the knowledge and use of smart city concepts and their usefulness in online learning during the COVID-19 pandemic based on a sustainable approach at different educational levels. It is important to analyze the use of online education based on the construction of intelligent learning environments, which favor the interaction between the environment and the student. With a quasi-experimental methodology, the psychometric properties of the questionnaire were analyzed through structural equation modeling (SEM), and the model was adjusted through a multivariate regression analysis to relate response patterns to a set of latent factors that cannot be directly observed, but exist in continuous dimensions of the people evaluated, and to create a valid and reliable instrument as a measurement tool using a sample of n = 973 subjects. The sample distribution consisted of 22.36% primary school teachers, 59.01% high school teachers, and 18.56% university teachers. The results showed a high reliability and construct validity through two models, and adjustment of the original model produced better goodness-of-fit parameters. We conclude that the designed questionnaire is a useful and valid tool for understanding how teachers have approached online teaching during the pandemic and their knowledge and use of Smart City concepts

Study on the Attitudes and Knowledge of Teachers and Future Teachers about Immediate Health Care Measures at School

The level and need for immediate health care measures training for teachers are of growing concern for two main reasons: on the one hand, these contents are part of the school curriculum and, on the other hand, teachers are the first adults to intervene in case of school injury. However, in Spain, first aid (FA) does not appear as obligatory content in the university training of teachers. The aim of the present study was to design and validate a questionnaire on the attitude of preschool and primary school teachers towards first aid knowledge adapted to the school context and to analyze its psychometric properties. First of all, the psychometric values of the questionnaire were tested: through its validation and reliability. Subsequently, a correlation study was carried out as well as a logistic regression in order to know the knowledge and attitudes of teachers and future teachers about the importance of the Immediate Attention Measures at school. The sample consisted of 392 participants: active teachers (71%) and future teachers (29%, the latter being final year students) of the infant and primary stages from the northern, central and southern areas of Spain. The results show adequate psychometric values, establishing three factors: attitude towards general knowledge in FA and learning methodology; attitude towards wounds and CPR algorithm (most frequent and/or serious events); self-perception of knowledge or skill in FA. Pearson’s correlation test identified significant values (p < 0.01) and positive association between Factors 1 and 2 (r = 0.422) and between 1 and 3 (0.244). The conclusions of the results of the validation process of the questionnaire on the attitude of teachers and future teachers to knowledge for immediate health care measures training are valid and reliable to an acceptable degree. Regression study demonstrates the importance of including first aid training in teachers’ degrees.INTEREDUC/UFM EDU2017-88641-Rproject "Study of training needs of the Autonomous City of Melilla"University of GranadaBusiness Consulting (ASME) 13/11_20Autonomous City of Melill

Sobrecarga sentida por la figura del cuidador principal en una cohorte de pacientes pluripatológicos

ObjetivoConocer el perfil del cuidador principal (CP) y los factores relacionados con la sobrecarga sentida, en una cohorte multicéntrica de pacientes pluripatológicos (PP).DiseñoEstudio transversal, multicéntrico.EmplazamientoCuatro zonas básicas de salud del área sanitaria de los Hospitales Universitarios Virgen del Rocío, Sevilla.ParticipantesLa cohorte de PP se generó prospectivamente mediante el censado de todos los pacientes que cumplían los criterios de PP de la Consejería de Salud (2002): aquellos que tienen enfermedades crónicas de dos o más de las 7 categorías clínicas definidas.Mediciones principalesEl perfil del cuidador se determinó a todos los PP. El cansancio del CP se determinó mediante el índice de esfuerzo del cuidador (IEC). Los factores predictores se analizaron mediante los tests de la t de Student, ANOVA y Pearson.Posteriormente se realizó una regresión lineal multivariable paso a paso hacia delante.ResultadosAccedieron a la entrevista 461 (69% de los 662 elegibles) PP; 293 (63,6%) pacientes tenían CP, que en el 88% eran familiares de primer grado (146 [49,7%] de ellos, el cónyuge), de 62±15 años de edad, y el 80%, mujeres. El IEC fue > 7 puntos en el 41,5% y en general fue 5,35±3,5, mayor en los que cuidaban de PP con enfermedades neurológicas (7±3,2 frente a 4,5±3,3; p<0,0001). El IEC se correlacionó directamente con la vulnerabilidad clínica del PP (R=0,37; p<0,001), con el deterioro cognitivo por escala de Pfeiffer (R=0,4; p<0,0001), e inversamente con la situación funcional por índice de Barthel (R=−0,67; p<0,0001). La edad del paciente (p=0,03), su vulnerabilidad clínica (p=0,016) y el deterioro funcional (p<0,0001) y cognitivo (p=0,019) predijeron de forma independiente el IEC.ConclusionesEl perfil del CP de los PP se correspondió con mujeres familiares en primer grado de unos 60 años. Más de la tercera parte estaban sobrecargadas; los factores predictores fueron la edad, la vulnerabilidad clínica y el deterioro funcional y cognitivo del PP.ObjectiveTo determine the profile of the main caregiver (MC) and the factors associated with her/his care burden, in a multi-centre cohort of patients with multiple pathologies (PMP).DesignMulti-centre cross-sectional study.SettingFour health districts in the Virgen del Rocío University Hospitals Health Area, Seville, Spain.ParticipantsThe PMP cohort was created by checking all the patients who satisfied the health department criteria for PMP (2002): patients suffering from chronic diseases in 2 or more of the 7 clinical categories defined.Main measurementsThe profile of PMP caregiver was determined for all patients. The caregiver strain index (CSI) was determined by the index of care stress (ICS). Predictive factors were analysed by the Student t, ANOVA, and Pearson's tests. Multivariate analysis was performed by a forward stepwise linear regression model.ResultsThe interview was attended by 461 (69%) out of 662 eligible PMP. Of these, 293 (63.6%) had an MC whose mean age was 62 (15) years; 80% of them were women. First-degree relatives made up 88% of caregivers, with spouses 49.7% of them (n=146). In 41.5%, the CSI was >7points (mean CSI was 5.35 [3.5]). This was higher in those caring for PMP with neurological illnesses (7 [3.2 vs 4.5 [3.3]; P=.0001).The CSI was compared directly with the medical vulnerability of the PMP (R=0.37; P=.001), cognitive deterioration on the Pfeiffer scale (PS) (R=0.4; P=.0001), and inversely with functional status on Barthel's scale (BS) (R=-0.67; P=.0001). Patient's age (P=.03), his/her medical vulnerability (P=.016) and functional (P<.0001) and cognitive (P=.019) deterioration were independently associated with the CSI.ConclusionsThe profile of the MC of the PMP cohort corresponded mainly to first-degree female relatives around sixty years old. The burden of care was high in more than a third of them. Predictive factors were age, medical vulnerability, and the functional and cognitive deterioration of the PMP

Análisis financiero para la implementación de un sistema de energía solar fotovoltaica para el centro recreacional “Club Naval de Oficiales Santa Cruz de Castillogrande”

Globalization has brought with it more open markets and more consumerist people, which requires industries to develop economies of scale to meet demand. Due to this, the impact of industrialization and the consequences of human action on the environment, such as the emission of greenhouse gases in recent years, environmental trends have taken center stage. The National Navy wanted to contribute to these efforts with the investigation of the energy consumption pattern of the Naval Club of Officers through the visit of experts in electrical engineering and topography, to analyze and determine what would be the possible model of photovoltaic cells necessary to meet the needs energy of the club. The implementation and start-up of this project efficiently contributes to the reduction of greenhouse gas emissions, in particular CO2, and also helps to reduce the dependence of the national system on energy. In the same way, this model allows in the short term to return the investment costs and turn it into a self-sufficient unit, which at the same time makes it possible to use the resources that were previously used in other projects aimed at complying with the 17 agreements signed by the countries. of the United Nations, which refer to sustainable development, among which is Colombia.La globalización ha traído consigo mercados más abiertos y personas más consumistas, lo cual exige a las industrias el desarrollo de economías a escala para satisfacer la demanda. A razón de esto, del impacto de la industrialización y de las consecuencias de la acción humana en el medioambiente, como la emisión de gases de efecto invernaderos en los últimos años las corrientes medioambientales han adquirido protagonismo. La Armada Nacional quiso contribuir a estos esfuerzos con la investigación del patrón de consumo de energía del Club Naval de Oficiales mediante la visita de expertos en ingeniería eléctrica y topografía, para analizar y determinar cuál sería el posible modelo de celdas fotovoltaicas necesarias para cubrir las necesidades energéticas del club. La implementación y puesta en marcha de este proyecto contribuye eficientemente a la reducción de las emisiones de gases de efecto invernadero, en particular del CO2, y así mismo, ayuda a reducir la dependencia de la energía del sistema nacional. De igual forma, este modelo permite a corto plazo retornar los costos de inversión y convertirla en una unidad autosuficiente, lo que a la vez hace posible utilizar los recursos que anteriormente se utilizaban en otros proyectos encaminados al cumplimiento de los 17 acuerdos firmados por los países de las Naciones Unidas, que refieren al desarrollo sostenible, dentro de los cuales está Colombia