Efectividad de un audiovisual como preparación para la cirugía en pacientes pediátricos

Las investigaciones sobre los pacientes pediátricos quirúrgicos, ponen en evidencia la urgente necesidad de preparlos psicológicamente para la hospitalización y la intervención. A este respecto, estudios realizados fuera de nuestro país han demostrado que la visualización de un audiovisual acerca de la hospitalización y el proceso quirúrgico es una técnica eficaz para ayudar a los niños y a sus progenitores a afrontar dicha situación. El objetivo del presente trabajo ha consistido en comprobar la eficacia de esta técnica en nuestro contexto hospitalario. Los resultados indican que la proyección de un audiovisual antes de la hospitalización es muy recomendable, dado que: 1) aclara dudas; 2) da una imagen más familiar del hospital; 3) estimula a los padres a hablar con sus hijos y 4) aumenta la satisfacción de los padres respecto a la información. Uno de los datos obtenidos que mayor refleja la eficacia del audiovisual es que el 98.2% de los padres recomendaría la visualización del audiovisual a otras familias.Research on paediatric surgical patients points to the urgent need to prepare them psychologically for hospitalisation and surgery. In this respect, studies conducted outside Spain have shown that seeing a video on hospitalisation and procedures for surgery is an effective technique for helping children and their parents to deal with this situation. The aim of the present work was to verify the effectiveness of this technique within the context of our hospitals. The results indicate that it is highly advisable to show such a video to patients and their parents before admission to hospital, since this: 1) clears up any doubts they might have; 2) gives a friendlier image of the hospitil; 3) encourages parents to talk to their children and 4) increases satisfaction among parents concerning the information they receive. One of the dadta which most clearly reflects the effectiveness of using the type of the audiovisual described is that 98.2% of parents would recommend other families to see it

Feasibility of Model-Assisted Probability of Detection Principles for Structural Health Monitoring Systems Based on Guided Waves for Fiber-Reinforced Composites

In many industrial sectors, structural health monitoring (SHM) is considered as an addition to nondestructive testing (NDT) that can reduce maintenance effort during the lifetime of a technical facility, structural component, or vehicle. A large number of SHM methods are based on ultrasonic waves, whose properties change depending on structural health. However, the wide application of SHM systems is limited due to the lack of suitable methods to assess their reliability. The evaluation of the system performance usually refers to the determination of the probability of detection (POD) of a test procedure. Up until now, only a few limited methods exist to evaluate the POD of SHM systems, which prevents them from being standardized and widely accepted in the industry. The biggest hurdle concerning the POD calculation is the large number of samples needed. A POD analysis requires data from numerous identical structures with integrated SHM systems. Each structure is then damaged at different locations and with various degrees of severity. All of these are connected to high costs. Therefore, one possible way to tackle this problem is to perform computer-aided investigations. In this work, the POD assessment procedure established in NDT according to the Berens model is adapted to guided wave-based SHM systems. The approach implemented here is based on solely computer-aided investigations. After efficient modeling of wave propagation phenomena across an automotive component made of a carbon-fiber-reinforced composite, the POD curves are extracted. Finally, the novel concept of a POD map is introduced to look into the effect of damage position on system reliability

Error analysis of free probability approximations to the density of states of disordered systems

Theoretical studies of localization, anomalous diffusion and ergodicity breaking require solving the electronic structure of disordered systems. We use free probability to approximate the ensemble- averaged density of states without exact diagonalization. We present an error analysis that quantifies the accuracy using a generalized moment expansion, allowing us to distinguish between different approximations. We identify an approximation that is accurate to the eighth moment across all noise strengths, and contrast this with the perturbation theory and isotropic entanglement theory.Comment: 5 pages, 3 figures, submitted to Phys. Rev. Let

GATEKEEPER’s Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases

Background: The World Health Organization’s strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. Objective: We aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform. Methods: The selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities. Results: Seven European countries were selected, covering Europe’s geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence–based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. Conclusions: This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space

Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-speficic sub-acute low back pain in the working population : cluster randomised trial

Background: Non-specific low back pain is a common cause for consultation with the general practitioner, generating increased health and social costs. This study will analyse the effectiveness of a multidisciplinary intervention to reduce disability, severity of pain, anxiety and depression, to improve quality of life and to reduce the incidence of chronic low back pain in the working population with non-specific low back pain, compared to usual clinical care. Methods/Design: A Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and its surrounding areas. The centres are randomly allocated to the multidisciplinary intervention or to usual clinical care. Patients between 18 and 65 years old (n = 932; 466 per arm) and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, in addition to a biopsychosocial multidisciplinary intervention consisting of group educational sessions lasting a total of 10 hours. The main outcome is change in the score in the Roland Morris disability questionnaire at three months after onset of pain. Other outcomes are severity of pain, quality of life, duration of current non-specific low back pain episode, work sick leave and duration, Fear Avoidance Beliefs and Goldberg Questionnaires. Outcomes will be assessed at baseline, 3, 6 and 12 months. Analysis will be by intention to treat. The intervention effect will be assessed through the standard error of measurement and the effect-size. Responsiveness of each scale will be evaluated by standardised response mean and receiver-operating characteristic method. Recovery according to the patient will be used as an external criterion. A multilevel regression will be performed on repeated measures. The time until the current episode of low back pain takes to subside will be analysed by Cox regression. Discussion: We hope to provide evidence of the effectiveness of the proposed biopsychosocial multidisciplinary intervention in avoiding the chronification of low back pain, and to reduce the duration of non-specific low back pain episodes. If the intervention is effective, it could be applied to Primary Health Care Centres