Security and privacy in a DACS

The management of electronic health records (EHR), in general, and clinical documents, in particular, is becoming a key issue in the daily work of Healthcare Organizations (HO). The need for providing secure and private access to, and storage for, clinical documents together with the need for HO to interoperate, raises a number of issues difficult to solve. Many systems are in place to manage EHR and documents. Some of these Healthcare Information Systems (HIS) follow standards in their document structure and communications protocols, but many do not. In fact, they are mostly proprietary and do not interoperate. Our proposal to solve the current situation is the use of a DACS (Document Archiving and Communication System) for providing security, privacy and standardized access to clinical documents.Peer ReviewedPostprint (published version

Mejora de la interoperabilidad con un DACS: el caso salud de la mujer DEXEUS

Salud de la Mujer Dexeus está mejorando la interoperabilidad entre todos sus sistemas de información añadiendo una solución VNA (Vendor Neutral Archive). Con ello obtiene además nuevas funcionalidades, como un visor único de documentos y un acceso seguro y estructurado a su información desde diversos lugares y dispositivos. La solución se basa en el uso de un DACS (Document Archiving and Communication System), que almacena documentos clínicos estructurados con HL7 CDA.Peer ReviewedPreprin

Potential risk factors related to pig body weight variability from birth to slaughter in commercial conditions

The aim of this observational study is to identify risk factors associated with body weight (BW) variability in three data sets (DS) in commercial conditions. A total of 1,009 (DS1), 460 (DS2), and 1304 (DS3) male and female crossbreed pigs (Pietrain × [Landrace × Large White]), respectively, were included in each trial. Pigs were periodically weighed until slaughter. Then, variables such as length of gestation, length of lactation, parity, litter size, sex, birth BW, and ADG were considered. Pigs remaining on the farm after two loads to the slaughterhouse were defined as last group of animals sent to slaughterhouse (LGS). Descriptive statistics of variability were calculated, and a risk analysis approach was used to look for the factors related to LGS. A multiple logistic regression was performed to identify all variables that were significant (P < 0.05). The risk ratio (RR), odds ratio (OR), and population attributable risk (PAR) were calculated for all of the significant variables after transforming all of them into binary factors using the 25th percentile as the cut-off point. Results showed that the major part of the variability (as CV) comes from birth (20% to 25%) and increased only a little during lactation and 14-d post weaning. From this point onwards, CV tended to decrease, as pigs got closer to the marketing weight (down 11.5% to 12.7%). Regarding the indicators selected, RR, OR, and PAR presented similar trends in the three DS studied. Therefore, for the variables finally included, these indicators had their minimum values at the start of the cycle and then gradually increased at the end. Those results, based on an epidemiological approach, suggest that the closer to the end of the cycle the greater the probability for a light piglet of being/becoming LGS. It might be explained by the shorter available time to efficiently implement preventive measures aimed to improve the performance of delayed pigs and, thus, reducing variability.Those results, based on an epidemiological approach, make sense as the probability for a light piglet to be a LGS increases the closer to the end of the cycle, due to the short time to implement preventive measures and increase the performance of delayed pigs and reduce variability. The differential PAR associated with both, the nursery and the growing period, was 1.7% and 1.5% for DS1, 5.1% and 3.1% for DS2, and 3.7% and 2.8% for DS3. For the lactation period, the results were 4.3% for DS2 and 4.5% for DS3. Results suggest that the most critical periods, in relation to retardation of growth in swine, are lactation and nursery. Implementing measures that maintain risk factors under or above thresholds, especially in the initial phases of growth, will reduce the percentage of LGS pigs and positively affect the overall homogeneity of the batch

Què recorden del què han aprés de matemàtiques els estudiants que accedeixen als graus de mestre?

En aquesta comunicació, presentem l'examen de competència logicomatemàtica de la Prova d'Aptitud Personal per a l'accés als graus de mestre a partir del curs 2017-18, establim el significat de Coneixement Matemàtic Fonamental, i presentem el procés de validació d'una prova per a avaluar-lo. Els resultats del procés de validació ens permeten identificar llacunes en el coneixement matemàtic inicial dels estudiants que accedeixen als graus de mestr

Completeness of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The completeness of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the completeness of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the completeness of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 4 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 30%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the completeness of reporting

Quality of reporting acupuncture interventions for chronic obstructive pulmonary disease : Review of adherence to the STRICTA statement

The quality of reporting of acupuncture interventions is critical to ensure the applicability and reproducibility of acupuncture clinical trials. In the past, different publications have evaluated the quality of reporting of acupuncture interventions for different clinical situations, such as knee osteoarthritis, neurological diseases or cancer. However, this has not been done for acupuncture trials for chronic obstructive pulmonary disease (COPD). To assess the quality of reporting of acupuncture interventions in trials for COPD. A total of 11 English and Chinese databases were screened up until May 2019 for randomised or quasi-randomised control trials of acupuncture for COPD. The STRICTA checklist was used to determine the quality of the reporting of acupuncture interventions. Results: A total of 28 trials were included in our review. Out of the 16 STRICTA checklist subitems analysed, only 3 were considered appropriately reported in more than 70% of the trials, while 7 were correctly reported in less than 40%. The adherence to STRICTA guidelines of acupuncture trials for COPD is suboptimal, and future efforts need to be addressed to improve the quality of reporting

Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial

Background: Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes signifcantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefts. The aim of this study is to evaluate the short-, medium- and long-term efectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in ofce staf with DM2. Secondary aims. To evaluate the efectiveness on glycaemic control and lipid profle at 6- and 12-month follow-up; anthropometric profle, blood pres‑ sure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12months. Methods: Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n=110) or intervention group (n=110), with post-intervention follow-ups at 6 and 12months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary ofce desk-based jobs. The control group will receive usual healthcare and information on the health benefts of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sit‑ ting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Diferences between groups pre- and post- intervention on the average value of the vari‑ ables will be analysed. Discussion: If the mHealth intervention is efective in reducing sedentary time and increasing physical activity in ofce employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.The study was funded by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI17/01788) and the predoctoral research grant Isabel Fernández 2020 from the Spanish Society of Family and Community Medicine (semFYC). The funders had no role in the design, analysis, data interpretation or writing of the manuscript

Porcine Digestible Peptides (PDP) in Weanling Diets Regulates the Expression of Genes Involved in Gut Barrier Function, Immune Response and Nutrient Transport in Nursery Pigs

CRAG 10.3390/ani10122368This study was conducted to investigate the effects of dietary supplementation of porcine digestible peptides (PDP), spray-dried plasma (SDP), or a combination of both, on growth performance and the expression of genes related to intestinal function of weaned pigs. A total of 180 piglets (trial 1) and 198 piglets (trial 2) were used to evaluate the partial substitution of soybean ingredients with 2% SDP or 2% PDP (trial 1), and with 3% SDP or the combination of 1% SDP and 2% PDP (SDP-PDP; trial 2) during the pre-starter period (0-14 days). The gene expression of 56 genes was quantified in a qPCR platform in jejunum and ileum samples obtained from piglets 14 d after weaning (trial 2). Piglets fed SDP, PDP and SDP-PDP had a higher body weight (BW), average daily gain (ADG) and feed efficiency (G:F) than the soybean control on day 14 (p < 0.05). In addition, the combination of SDP and PDP upregulated ten genes in jejunum samples (p < 0.05) related to intestinal function. More research is needed to confirm that gene expression upregulation by PDP in combination with SDP has an impact on intestinal function and to elucidate its underlying mechanisms

Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Background and objectives Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals. Methods A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered. Results 464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary 6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes), those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting. Conclusions In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.