Consideraciones sobre el trabajo de la inspección educativa partiendo de la realidad canaria

En este trabajo se realiza un análisis del trabajo de la Inspección Educativa partiendo de la realidad social existente en el archipiélago canario. La necesidad de condicionar la labor del Inspector con la realidad de los centros educativos en aras de compatibilizar el derecho a la educación, la calidad del servicio educativo que se ofrece en la red de centros públicos y la compensación de las desigualdades que están presentes en nuestra sociedad requiere que la función Inspectora asuma el papel dinamizador del proceso de cambio mediante el estímulo y el trabajo mediador con las comunidades educativas que sustentan a la escuela como institución.Eje: Organización escolarRed de Universidades con Carreras en Informática (RedUNCI

Consideraciones sobre el trabajo de la inspección educativa partiendo de la realidad canaria

En este trabajo se realiza un análisis del trabajo de la Inspección Educativa partiendo de la realidad social existente en el archipiélago canario. La necesidad de condicionar la labor del Inspector con la realidad de los centros educativos en aras de compatibilizar el derecho a la educación, la calidad del servicio educativo que se ofrece en la red de centros públicos y la compensación de las desigualdades que están presentes en nuestra sociedad requiere que la función Inspectora asuma el papel dinamizador del proceso de cambio mediante el estímulo y el trabajo mediador con las comunidades educativas que sustentan a la escuela como institución.Eje: Organización escolarRed de Universidades con Carreras en Informática (RedUNCI

La autoevaluación en el proceso de calidad educativa para un centro de secundaria (I): consideraciones iniciales

Los autores hacen una serie de consideraciones sobre el proceso de calidad educativa, en relación con su evaluación, en un centro de secundaria de Tenerife (España) a través de un proyecto de formación en centros educativos. En este primer reporte, los autores adaptan el trabajo de Escudero (1997) sobre el proceso de calidad que ha permitido reflexionar sobre qué es y qué se pretende con la evaluación interna de un centro de secundaria y de la necesidad de un modelo autoevaluativo que se adapte a las peculiaridades de cada centro.Eje: Evaluación calidad sistema educativoRed de Universidades con Carreras en Informática (RedUNCI

La autoevaluación en el proceso de calidad educativa para un centro de secundaria (I): consideraciones iniciales

Los autores hacen una serie de consideraciones sobre el proceso de calidad educativa, en relación con su evaluación, en un centro de secundaria de Tenerife (España) a través de un proyecto de formación en centros educativos. En este primer reporte, los autores adaptan el trabajo de Escudero (1997) sobre el proceso de calidad que ha permitido reflexionar sobre qué es y qué se pretende con la evaluación interna de un centro de secundaria y de la necesidad de un modelo autoevaluativo que se adapte a las peculiaridades de cada centro.Eje: Evaluación calidad sistema educativoRed de Universidades con Carreras en Informática (RedUNCI

Telemedicine Strategy to Rescue CPAP Therapy in Sleep Apnea Patients with Low Treatment Adherence: A Pilot Study

Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient's adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average treatment duration below the effectiveness threshold (4 h/night). Herein, our aim was to describe and evaluate a novel telemedicine strategy for rescuing CPAP treatment in patients with low adherence after several months/years of treatment. This two-week intervention includes (1) patient support using a smartphone application, phone and voice recorder messages to be answered by a nurse, and (2) daily transmission and analysis of signals from the CPAP device and potential variation of nasal pressure if required. On average, at the end of the intervention, median CPAP adherence considerably increased by 2.17 h/night (from 3.07 to 5.24 h/night). Interestingly, the procedure was able to markedly rescue CPAP adherence: the number of patients with poor adherence (<4 h/night) was considerably reduced from 38 to 7. After one month, adherence improvement was maintained (median 5.09 h/night), and only 13 patients had poor adherence (<4 h/night). This telemedicine intervention (103€ per included patient) is a cost-effective tool for substantially increasing the number of patients with CPAP adherence above the minimum threshold for achieving positive therapeutic effects

Telemedicine Strategy for CPAP Titration and Early Follow-up for Sleep Apnea During COVID-19 and Post-Pandemic Future.

WiththeacutefirstwaveoftheCOVID-19pandemicover,1thelongwaitinglistforsleeptestsforOSAmanagementhasbeenfurtherincreased.2,3ThenewpreventivehealthmeasuresagainstCovid-19implythatpatientsgotothehealthcentersaslittleaspossible,whichiswhyitisnecessarytoimplementandstartupatelematicworkflowwithhomestudiestoguaranteesleeptests,4especiallyCPAPtitration.5-8WeaimedtotestanewtelematicworkflowtodeliverCPAPtherapytoOSApatientsandtoevaluateitintermsofCPAPcompliance,costs,residualevents,symptomsandsatisfactionofpatients.Theusualtitrationstrategyhasthefollo-wingsteps.Thepatientisscheduledtothedaytime-hospitalforinformation,andeducationalandpracticaltrainingsessionwiththedevice(45min).Then,ourCPAPequipmentisdeliveredtohim/herforhometitration(tobereturnedthenextday),thedataisdownloaded,andafixedpressureisprescribed.Iftheregistra-tionisincorrect,thetitrationisrepeatedanotherday.Finally,thepatientisscheduledbytheservicecompanyprovidingCPAPequip-mentthatinformsagainhowtheequipmentworks,selectsafinalmaskfortreatment,andgiveashortpracticalsessionoftheCPAPuse

Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial

Introduction: Obstructive sleep apnea (OSA) is a prevalent disease associated with significant morbidity and high healthcare costs. Information and communication technology could offer cost-effective management options. Objectives: To evaluate an out-of-hospital Virtual Sleep Unit (VSU) based on telemedicine to manage all patients with suspected OSA, including those with and without continuous positive airway pressure (CPAP) therapy.Methods: This was an open randomized controlled trial. Patients with suspected OSA were randomized to hospital routine (HR) or VSU groups to compare the clinical improvement and cost-effectiveness in a non-inferiority analysis. Improvement was assessed by changes in the Quebec Sleep Questionnaire (QSQ), EuroQol (EQ-5D and EQ-VAS), and Epworth Sleepiness Scale (ESS). The follow-up was 3 months. Cost-effectiveness was assessed by a Bayesian analysis based on quality-adjusted life-years (QALYs).Results: The HR group (n: 92; 78% OSA, 57% CPAP) compared with the VSU group (n: 94; 83% OSA, 43% CPAP) showed: CPAP compliance was similar in both groups, the QSQ social interactions domain improved significantly more in the HR group whereas the EQ-VAS improved more in the VSU group. Total and OSA-related costs were lower in the VSU group than the HR. The Bayesian cost-effectiveness analysis showed that VSU was cost-effective for a wide range of willingness to pay for QALYs. Conclusions: The VSU offered a cost-effective means of improving QALYs than HR. However, the assessment of its clinical improvement was influenced by the choice of the questionnaire; hence, additional measurements of clinical improvement are needed. Our findings indicate that VSU could help with the management of many patients, irrespective of CPAP use

Bayesian Variable Selection in Cost-Effectiveness Analysis

Linear regression models are often used to represent the cost and effectiveness of medical treatment. The covariates used may include sociodemographic variables, such as age, gender or race; clinical variables, such as initial health status, years of treatment or the existence of concomitant illnesses; and a binary variable indicating the treatment received. However, most studies estimate only one model, which usually includes all the covariates. This procedure ignores the question of uncertainty in model selection. In this paper, we examine four alternative Bayesian variable selection methods that have been proposed. In this analysis, we estimate the inclusion probability of each covariate in the real model conditional on the data. Variable selection can be useful for estimating incremental effectiveness and incremental cost, through Bayesian model averaging, as well as for subgroup analysis