Reproducible SUmmation under HUB Format

Version diferente del paper presentado en el congresoFloating point reproducibility is a property claimed by programmers and end users. Half-Unit-Biased (HUB) is a new representation format in which the round to nearest is carried out by truncation, preventing any carry propagation and saving time and area. In this paper we study the reproducible summation of HUB numbers by using a errorfree vector transformation technique, providing both a specific architecture and the usage of combined HUB/Standard floating point adders to achieve a reproducible resultUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Attention to the adolescent in primary care centers

Trabajo fin de grado en EnfermeríaIntroducción: La adolescencia se presenta como un periodo singularmente vulnerable en el desarrollo humano. Por ello los profesionales de la salud deben aspirar a una Atención Primaria integral que contemple y actúe en base a las singularidades de este grupo. Objetivo: Conocer las opiniones de adolescentes sobre la atención recibida en Centros de Atención Primaria de Salud. Metodología: Revisión narrativa mediante una búsqueda bibliográfica en las bases de datos Pubmed®, Cinahl®, PsycINFO®, Cochrane Library®, Cuiden®, Scielo® y en revistas especializadas, de estudios publicados entre 2011 y 2018. Los artículos fueron seleccionados en base a criterios de inclusión, exclusión y limitadores. Resultados: Se seleccionaron y analizaron 9 artículos cuyo contenido fue clasificado en tres temáticas: 1) Accesibilidad y utilización de los servicios de Atención Primaria, donde se obtuvieron los datos relacionados con la utilización de este grupo, así como las barreras que limitan el acceso. 2) Relación de los adolescentes con los profesionales de la salud, donde se recogen el respeto, la comunicación y la confianza percibidos por los adolescentes, que influyen en el establecimiento de la relación terapéutica. 3) Problemas o consultas atendidos en los centros de Atención Primaria hacia este grupo. Conclusiones: A pesar de encontrar datos contradictorios y escasos, los adolescentes manifiestan: dificultades a la hora de relacionarse con los profesionales de Atención Primaria, e insatisfacción ante el trato recibido. Refieren además barreras que disminuyen la utilización de los servicios. Los profesionales deben tomar conciencia de sus acciones e identificar las necesidades de este grupo.Background: Adolescence appears as a vulnerable period in human development. Therefore, health professionals should aspire to comprehensive primary care that includes and acts based on the unique characteristics of this group. Purpose: To know the opinions of adolescents about Primary Health Care. Method: A narrative review was conducted using the databases Pubmed®, Cinahl®, PsycINFO®, Cochrane Library®, Cuiden®, Scielo® and specialized journals, searching studies published between 2011 and 2018 Inclusive, exclusive criteria and limiters were established. Articles were selected based on inclusion, exclusion and limiting criteria. Results: There were selected and analyzed 9 articles whose content was classified into three themes: 1) Accessibility and utilization of Primary Care services, where there were obtained data related with the utilization of the adolescents, as well as accessibility barriers that decrease their access. 2) Relationship of adolescents with health professionals, where the respect, the communicative abilities and the confidence perceived by the adolescents were addressed requirements of the therapeutic relationship. 3) Problems or consultations attended in Primary Care Centers towards this group Conclusions: Despite finding contradictory and scarce data, the adolescents state: difficulties when interacting with Primary Care professionals, and dissatisfaction with the treatment received. They also refer to barriers that reduce the use of services. Professionals should be aware of their actions and identify the needs of this grou

Ratio of observed to expected length of stay in the andalusian public health service

Objetivo: Mostrar las insuficiencias metodológicas de los dos procesos de obtención del índice de utilización de estancias (IUE) en el Sistema Sanitario Público de Andalucía (SSPA), realizados por el Servicio Andaluz de Salud (SAS) y por la Escuela Andaluza de Salud Pública (EASP), y proponer un método teórico válido. Material y métodos: Ambas instituciones han aplicado el procedimiento de comparación sobre la media a las altas producidas en el SSPA durante el año 2008. El SAS expresa los valores del IUE con datos puntuales y establece una clasificación de cinco categorías. La EASP no muestra los valores de forma numérica, sino mediante la asignación de símbolos a los tres grados de una escala obtenida con un nivel de confianza del 99,9%. Resultados: La EASP no muestra los valores esperados de estancia media de cada hospital. En 15 de los 33 hospitales del SSPA, el IUE no es distinto de la unidad. Discusión: La metodología empleada por el SAS no es válida porque no responde a criterios estadísticos y la aplicada por la EASP es inadecuada por la escasa información que aporta. Alternativamente, se ha propuesto el método epidemiológico-estadístico mediante la formulación de un contraste de hipótesis y la estimación del IUE por intervalo de confianza.Objective: To demonstrate the methodological shortcomings of the two processes used to calculate the ratio of observed to expected length of stay (OLOS/ELOS) in the Andalusian Public Health Service by the Andalusian Health Service (AHS) and the Andalusian School of Public Health (ASPH), and to propose a theoretical valid method. Material and methods: Both institutions used comparison of mean discharge figures in the Andalusian Public Health Service during 2008. The AHS expresses OLOS/ELOS data as single values without confidence intervals and establishes a five-category classification. The ASPH does not report values in numerical form but with a set of symbols on a scale of three levels, with 99.9% confidence. Results: The APHS does not report the expected mean length of stay values for each hospital. At 15 of the 33 hospitals in the Andalusian Public Health Service, the OLOS/ELOS does not differ from unity. Discussion: The method used by the AHS is not valid because it does not reflect statistical criteria and that used by the ASPH is inadequate because of limitations in the information it provides. As an alternative I propose the epidemiological-statistical method, based on hypothesis-testing, to obtain single-figure values for OLOS/ELOS with confidence intervals for each hospital

El método de la exposición inducida y su aplicación a los accidentes de tráfico en España

Tesis Univ. Granada. Departamento de Medicina Preventiva y Salud Pública. Leída el 7 de mayo de 200

Outliers in diagnosis-related groups

Objetivo: Demostrar que la exclusión de las altas con valores extremos de estancia (outliers) del sistema de clasificación de pacientes de los grupos diagnósticos relacionados para el cálculo de los indicadores clave de casuística y funcionamiento hospitalarios del Sistema Nacional de Salud carece de fundamento estadístico y es por tanto inadecuada. Métodos: Se ha aplicado una prueba de hipótesis con un nivel de confianza del 95% a cada uno de los 676 grupos diagnósticos relacionados que componen la versión All-Patient 23 para contrastar la distribución Normal de las estancias hospitalarias correspondientes a las 3 742 850 altas válidas del conjunto mínimo básico de datos del año 2009 en España. Además, se han calculado los coeficientes de asimetría y de curtosis de cada grupo diagnóstico relacionado. Resultados: Sin tener en cuenta dos grupos que presentan un único registro, solamente un grupo diagnóstico no obtiene la significación estadística. Es decir, las estancias hospitalarias de la casi totalidad de los grupos diagnósticos relacionados no se distribuyen de forma Normal, para un error α de 0,05. Las causas de la no Normalidad son una asimetría con un marcado sesgo positivo y una curtosis con un pronunciado apuntamiento. Conclusiones: La detección y eliminación de los outliers se basan en la hipótesis de Normalidad de los datos. La distribución de las estancias hospitalarias no es Normal. En consecuencia, la exclusión de las altas con valores extremos de estancia de los grupos diagnósticos relacionados para la obtención de indicadores no es adecuada.Objective: To show that excluding discharges with extreme hospital stay values (outliers) from the All-Patient Diagnosis-Related Groups classification before calculating key indicators for case mix and hospital performance in the National Health System is not justified on statistical grounds and is therefore inappropriate. Methods: A hypothesis test was applied with 95% confidence to each of the 676 diagnosis-related groups in the version All-Patient 23 classification system to determine whether length of hospital stay was distributed normally in a total of 3 742 850 valid hospital discharge records from the minimum basic data set for the year 2009 in Spain. In addition, the coefficients of skewness and kurtosis of each diagnosis-related group were calculated. Results: After two groups with a single record each were excluded, only one diagnosis group failed to reach statistical significance. That is, the hospital stays of almost all of the diagnosis-related groups not normally distributed, with a 5% alpha level. The causes of non-normal distribution were asymmetry characterized by a strong positive skew and markedly spiky kurtosis. Conclusions: The identification and removal of outliers is based on hypothetically normal data distribution. The distribution of hospital stays is not normal. Consequently, excluding discharges with extreme values for length of stay from diagnosis-related groups is inappropriate in the procedure to obtain the indicators

Desarollo de la propuesta "si se necesita más energía… que no se hagan más centrales" en un aula de educación primaria

Un análisis de los últimos programas oficiales de la educación primaria pone de manifiesto que el tema de las fuentes de energía debe abordarse en esta etapa educativa. Tras utilizar un modelo de planificación, se diseñó la propuesta de enseñanza «Si se necesita más energía… que no se hagan más centrales». El trabajo presenta los resultados del seguimiento de su puesta en práctica a partir del diario del maestro y de las respuestas de los alumnos en sus cuadernos de trabajo. También se realiza un análisis de la adquisición de competencias durante el proceso de aprendizaje.An analysis in the latest official programs of Primary School shows up that the sources energy subject must be tackled on this educational period. Afterwards a planning model was used, there was a proposal designed for teaching: "If more power is needed... Not necessary more stations". The research has the results of monitoring in practice, according to the teacher diary and pupils' answers in the notebooks. We also analyze the competences achieved during the learning process.Una anàlisi dels últims programes oficials de l'educació primària posa de manifest que el tema de les fonts d'energia s'ha d'abordar en aquesta etapa educativa. Després d'utilitzar un model de planificació, es va dissenyar la proposta d'ensenyament «Si es necessita més energia ... que no es facin més centrals ». El treball presenta els resultats del seguiment de la seva posada en pràctica a partir del diari del mestre i de les respostes dels alumnes en els seus quaderns de treball. També es realitza una anàlisi de l'adquisició de competències durant el procés d'aprenentatge

Non-Pharmacological Strategies for Self-Directed and Interpersonal Violence in People with Severe Mental Illness: a Rapid Overview of Systematic Reviews

Introduction Self-directed and interpersonal violence among people with severe mental illness has become a health priority. Though non-pharmacological interventions have been investigated, to our knowledge, no summary of all systematic reviews on this topic has been reported. We will conduct a rapid overview of reviews to synthesise evidence available by identifying systematic reviews on non-pharmacological interventions for self-directed or interpersonal violence in people with severe mental illness. Methods and analysis This is a protocol for a rapid overview of reviews. The overview will include any systematic reviews (with or without meta-analyses) of randomised controlled trials (RCTs) or cluster RCTs that examine the effect of non-pharmacological interventions on self-directed or interpersonal violence in people with severe mental illness. This protocol applies the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols, the criteria for conducting overviews of reviews in the Cochrane Handbook of Systematic Reviews of Interventions and the criteria for the Cochrane Rapid Reviews. To identify studies, a search will be performed in the following databases: PubMed, EMBASE, PsycINFO, CINAHL, LILACS, SciELO, Web of Science, Scopus, ProQuest, the Cochrane Database of Systematic Reviews through the Cochrane Library and the Epistemonikos database of systematic reviews. The searches date from inception to September 2020. The study selection process will be described using a PRISMA flow diagram, we will assess the quality of evidence in systematic reviews included and the quality of the systematic reviews themselves and the main results will be summarised in categories to provide a map of the evidence available.This work was supported by the Department of Health of the Government of the Basque Country, Spain (Grant number 2017111101). The funder has had no involvement in any aspect of the protocol or the decision to submit for publication and will not be involved in the study

A new geometrical method for 3D evaluation of non-rigid registration methods for radiotherapy in prostate cancer

Three-dimensional conformal radiotherapy aims at delivering a high dose of radiation to the tumour, while sparing the surrounding normal tissue to a maximum extent. Image registration is an essential tool for monitoring radiation therapies, since allows morphological comparisons in presence of anatomic variations. The evaluation of non-rigid registration methods is very complicated owe to the absence of a known pointwise correspondence. The use of analysis of variations in target volume delineations has been proposed in the past for the evaluation of non-rigid registration methods. Delineation of the target volume is usually accomplished by outlining the contour of the volume in each separate tomographic slice. In the studies of reference, the 3D surface is rendered from the contours by means of a Delauney triangulation. This geometrical method only works correctly for convex structures. However the volumes involved on pelvic anatomy, such as bladder or prostate including the seminal vesicles, have relevant concavities that introduce a huge error in the evaluation. A new geometrical method for the evaluation of convex-concave target volumes delineation is proposed

In Vitro Toxicity Assessment of Stilbene Extract for Its Potential Use as Antioxidant in the Wine Industry

The reduction of sulfur dioxide in wine is a consumer’s demand, considering the allergic effects that may occur in people who are sensitive to it. Stilbenes are candidates of great interest for this purpose because of their antioxidant/antimicrobial activities and health properties, and also because they are naturally found in the grapevine. In the present study, the in vitro toxicity of an extract from grapevine shoots (with a stilbene richness of 45.4%) was assessed in two human cell lines. Significant damage was observed from 30 μg/mL after 24 h, and 40 µg/mL after 48 h of exposure. Similarly, the ultrastructural study revealed a significant impairment of cell growing. The extract was able to protect cells against an induced oxidative stress at all concentrations studied. In view of the promising results, a more exhaustive toxicological assessment of the extract is needed to confirm the safety of its further use as additive in wine.España,Ministerio de Economía, Industria y Competitividad and INIA for the financial support for this project (RTA2015-00005-C02-02

Social support from developmental contexts and adolescent substance use and well-being: a comparative study of Spain and Portugal

The aim of this study was to analyse the contribution of social support from family, friend and school (teacher and classmate) contexts in substance use (tobacco and alcohol use) and well-being (life satisfaction and health-related quality of life). Participants were 5,784 Portuguese and 22,610 Spanish adolescents aged 11 to 16 years, from the 2014 edition of the Health Behavior in School-aged Children (HBSC) study in Portugal and Spain. Results showed that for a higher life satisfaction, family ( p < .001, partial η 2 = .032), teacher ( p < .001, partial η 2 = .018) and classmate ( p < .001, partial η 2 = .031) support were important in Portugal, and family ( p < .001, partial η 2 = .056) and friend ( p < .001, partial η 2 = .015) support in Spain. Similarly, for a better health-related quality of life, all the social support variables were relevant in Portugal (family: p < .001, partial η 2 = .063; teacher: p < .001, partial η 2 = .032; classmate: p < .001, partial η 2 = .054; friend: p < .001, partial η 2 = .034) and in Spain (family: p < .001, partial η 2 = .054; teacher: p < .001, partial η 2 = .014; classmate: p < .001, partial η 2 = .018; friend: p < .001, partial η 2 = .040). In contrast, only family support ( p < .001, partial η 2 = .014) was relevant in Portugal for tobacco use. Therefore, social support was more relevant for adolescent well-being than for adolescent substance use, and the most relevant source of support was family support, in both Spain and Portugal