Hotels : estudi estratègic de reconversió urbanística del sector turístic a Barcelona

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Early detection of deterioration in COVID-19 patients by continuous ward respiratory rate monitoring: a pilot prospective cohort study

BackgroundTachypnea is among the earliest signs of pulmonary decompensation. Contactless continuous respiratory rate monitoring might be useful in isolated COVID-19 patients admitted in wards. We therefore aimed to determine whether continuous monitoring of respiratory patterns in hospitalized patients with COVID-19 predicts subsequent need for increased respiratory support.MethodsSingle-center pilot prospective cohort study in COVID-19 patients who were cared for in routine wards. COVID-19 patients who had at least one escalation of pulmonary management were matched to three non-escalated patients. Contactless respiratory monitoring was instituted after patients enrolled, and continued for 15 days unless hospital discharge, initiation of invasive mechanical ventilation, or death occurred. Clinicians were blinded to respiratory rate data from the continuous monitor. The exposures were respiratory features over rolling periods of 30 min, 24 h, and 72 h before respiratory care escalation. The primary outcome was a subsequent escalation in ventilatory support beyond a Venturi mask.ResultsAmong 125 included patients, 13 exhibited at least one escalation and were each matched to three non-escalated patients. A total of 28 escalation events were matched to 84 non-escalation episodes. The 30-min mean respiratory rate in escalated patients was 23 breaths per minute (bpm) ranging from 13 to 40 bpm, similar to the 22 bpm in non-escalated patients, although with less variability (range 14 to 31 bpm). However, higher respiratory rate variability, especially skewness over 1 day, was associated with higher incidence of escalation events. Our overall model, based on continuous data, had a moderate accuracy with an AUC 0.81 (95%CI: 0.73, 0.88) and a good specificity 0.93 (95%CI: 0.87, 0.99).ConclusionOur pilot observational study suggests that respiratory rate variability as detected with continuous monitoring is associated with subsequent care escalation during the following 24 h. Continuous respiratory monitoring thus appears to be a valuable increment over intermittent monitoring.Strengths and limitationsOur study was the initial evaluation of Circadia contactless respiratory monitoring in COVID-19 patients who are at special risk of pulmonary deterioration. The major limitation is that the analysis was largely post hoc and thus needs to be confirmed in an out-of-sample population

Aplec de materials multimèdia per a l'àrea d'Educació Física

Resumen tomado parcialmente del autorSe presenta una recopilación de materiales de Educación Física para los niveles de Primaria y Secundaria con los contenidos siguientes: 1, vídeos de cursos hechos en años anteriores; 2, presentaciones de contenidos sobre deportes: bicicleta de montaña, balonmano, hockey, béisbol, juegos, y hábitos saludables: nutrición, cuidado del cuerpo, orientación... El objetivo de este material es facilitar la comunicación y el intercambio de información de recursos y experiencias entre el profesorado del área de Educación Física de diferentes centros educativos. En el proyecto participaron 23 profesores que se encargaron de explorar y crear materiales multimedia de utilidad didáctica, trabajar y analizar software, profundizar en el conocimiento de los recursos y en su aplicación al aula y reflexionar sobre los cambios metodológicos y didácticos que comporta el uso de estos recursos en el área de Educación FísicaBalearesES