Principle of progressive autonomy, participation, and recognition of agency. Substantive citizenship in the transition from childhood to adolescence

It is necessary to talk about children's and adolescents' education for citizenship beyond the vindication of spaces for citizen action. It is necessary to incorporate the principle of progressive autonomy highlighted by the Convention on the Rights of the Child of 1989 in terms of 'evolving capacities', from the knowledge of their rights and their exercise. This article aims to analyse the concept of substantive citizenship of children and adolescents based on their right to participation and from the recognition of their agency, as well as the promotion of and respect for the principle of progressive autonomy. Based on a participatory narrative research with a socio-critical perspective, 23 discussion groups were carried out with 210 young people between 15 and 19 years old in five Iberoamerican cities: Barcelona, Buenos Aires, Mexico City, Madrid and Sao Paolo. From the content analysis of their contributions, three dimensions emerge: to know oneself as a subject of rights from the knowledge of these rights, the importance of intergenerational relations in recognising progressive autonomy, and the incidence of age in the development of their autonomy. As conclusions, it should be noted that young people in the five cities know their rights and recognise that family, school and social networks favour their recognition as subjects of rights and responsibilities. It also reveals that age is a limiting element and a fundamental factor for the development of substantive citizenship

On the implicit equation of conics and quadrics offsets

A new determinantal representation for the implicit equation of offsets to conics and quadrics is derived. It is simple, free of extraneous components and provides a very compact expanded form, these representations being very useful when dealing with geometric queries about offsets such as point positioning or solving intersection purposes. It is based on several classical results in ?A Treatise on the Analytic Geometry of Three Dimensions? by G. Salmon for offsets to non-degenerate conics and central quadrics.This research was funded by the Spanish Ministerio de Economía y Competitividad and by the European Regional Development Fund (ERDF), under the project MTM2017-88796-P

Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery

Deep endometriosis (DE) occurs in 15-30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25-49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien-Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.50% (noA group) (p?<?0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI 1.90-11.30; p?=?0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p?<?0.001). Adenomyosis is an independent preoperative risk factor for surgical complications in DE surgery after adjustment for known demographic, clinical and surgical risk factors.© 2022. The Author(s)

Temporal variability analysis reveals biases in electronic health records due to hospital process reengineering interventions over seven years

[EN] Objective To evaluate the effects of Process-Reengineering interventions on the Electronic Health Records (EHR) of a hospital over 7 years. Materials and methods Temporal Variability Assessment (TVA) based on probabilistic data quality assessment was applied to the historic monthly-batched admission data of Hospital La Fe Valencia, Spain from 2010 to 2016. Routine healthcare data with a complete EHR was expanded by processed variables such as the Charlson Comorbidity Index. Results Four Process-Reengineering interventions were detected by quantifiable effects on the EHR: (1) the hospital relocation in 2011 involved progressive reduction of admissions during the next four months, (2) the hospital services re-configuration incremented the number of inter-services transfers, (3) the care-services re-distribution led to transfers between facilities (4) the assignment to the hospital of a new area with 80,000 patients in 2015 inspired the discharge to home for follow up and the update of the pre-surgery planned admissions protocol that produced a significant decrease of the patient length of stay. Discussion TVA provides an indicator of the effect of process re-engineering interventions on healthcare practice. Evaluating the effect of facilities¿ relocation and increment of citizens (findings 1, 3¿4), the impact of strategies (findings 2¿3), and gradual changes in protocols (finding 4) may help on the hospital management by optimizing interventions based on their effect on EHRs or on data reuse. Conclusions The effects on hospitals EHR due to process re-engineering interventions can be evaluated using the TVA methodology. Being aware of conditioned variations in EHR is of the utmost importance for the reliable reuse of routine hospitalization data.F.J.P.B, C.S., J.M.G.G. and J.A.C. were funded Universitat Politecnica de Valencia, project "ANALISIS DE LA CALIDAD Y VARIABILIDAD DE DATOS MEDICOS". www.upv.es. J.M.G.G.is also partially supported by: Ministerio de Economia y Competitividad of Spain through MTS4up project (National Plan for Scientific and Technical Research and Innovation 2013-2016, No. DPI2016-80054-R); and European Commission projects H2020-SC1-2016-CNECT Project (No. 727560) and H2020-SC1-BHC-2018-2020 (No. 825750). The funders did not play any role in the study design, data collection and analysis, decision to publish, nor preparation of the manuscript.Perez-Benito, FJ.; Sáez Silvestre, C.; Conejero, JA.; Tortajada, S.; Valdivieso, B.; Garcia-Gomez, JM. (2019). Temporal variability analysis reveals biases in electronic health records due to hospital process reengineering interventions over seven years. PLoS ONE. 14(8):1-19. https://doi.org/10.1371/journal.pone.0220369S119148Aguilar-Savén, R. S. (2004). Business process modelling: Review and framework. International Journal of Production Economics, 90(2), 129-149. doi:10.1016/s0925-5273(03)00102-6Poulymenopoulou, M. 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IEEE; 2017. pp. 230–237. doi: https://doi.org/10.1109/PDCAT.2017.00045Chou, Y.-C., Chen, B.-Y., Tang, Y.-Y., Qiu, Z.-J., Wu, M.-F., Wang, S.-C., … Chuang, W.-C. (2010). Prescription-Filling Process Reengineering of an Outpatient Pharmacy. Journal of Medical Systems, 36(2), 893-902. doi:10.1007/s10916-010-9553-5Leu, J.-D., & Huang, Y.-T. (2009). An Application of Business Process Method to the Clinical Efficiency of Hospital. Journal of Medical Systems, 35(3), 409-421. doi:10.1007/s10916-009-9376-4Gand K. Investigating on Requirements for Business Model Representations: The Case of Information Technology in Healthcare. 2017 IEEE 19th Conference on Business Informatics (CBI). IEEE; 2017. pp. 471–480. doi: https://doi.org/10.1109/CBI.2017.36Ferreira, G. S. A., Silva, U. R., Costa, A. L., & Pádua, S. I. D. de D. (2018). The promotion of BPM and lean in the health sector: main results. Business Process Management Journal, 24(2), 400-424. doi:10.1108/bpmj-06-2016-0115Abdulrahman Jabour RM. Cancer Reporting: Timeliness Analysis and Process. 2016; Available: https://search.proquest.com/openview/4ecf737c5ef6d2d503e948df8031fe54/1?pq-origsite=gscholar&amp;cbl=18750&amp;diss=yHewitt M, Simone J V. Enhancing Data Systems to Improve the Quality of Cancer Care [Internet]. National Academy Press; 2000. Available: http://www.nap.edu/catalog/9970.htmlWeiskopf, N. G., & Weng, C. (2013). Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research. Journal of the American Medical Informatics Association, 20(1), 144-151. doi:10.1136/amiajnl-2011-000681Saez C, Robles M, Garcia-Gomez JM. Comparative study of probability distribution distances to define a metric for the stability of multi-source biomedical research data. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS. IEEE; 2013. pp. 3226–3229. doi: https://doi.org/10.1109/EMBC.2013.6610228Sáez, C., Rodrigues, P. 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Predicting morbidity by local similarities in multi-scale patient trajectories

[EN] Patient Trajectories (PTs) are a method of representing the temporal evolution of patients. They can include information from different sources and be used in socio-medical or clinical domains. PTs have generally been used to generate and study the most common trajectories in, for instance, the development of a disease. On the other hand, healthcare predictive models generally rely on static snapshots of patient information. Only a few works about prediction in healthcare have been found that use PTs, and therefore benefit from their temporal dimension. All of them, however, have used PTs created from single-source information. Therefore, the use of longitudinal multi-scale data to build PTs and use them to obtain predictions about health conditions is yet to be explored. Our hypothesis is that local similarities on small chunks of PTs can identify similar patients concerning their future morbidities. The objectives of this work are (1) to develop a methodology to identify local similarities between PTs before the occurrence of morbidities to predict these on new query individuals; and (2) to validate this methodology on risk prediction of cardiovascular diseases (CVD) occurrence in patients with diabetes. We have proposed a novel formal definition of PTs based on sequences of longitudinal multi-scale data. Moreover, a dynamic programming methodology to identify local alignments on PTs for predicting future morbidities is proposed. Both the proposed methodology for PT definition and the alignment algorithm are generic to be applied on any clinical domain. We validated this solution for predicting CVD in patients with diabetes and we achieved a precision of 0.33, a recall of 0.72 and a specificity of 0.38. Therefore, the proposed solution in the diabetes use case can result of utmost utility to secondary screening.This work was supported by the CrowdHealth project (COLLECTIVE WISDOM DRIVING PUBLIC HEALTH POLICIES (727560)) and the MTS4up project (DPI2016-80054-R).Carrasco-Ribelles, LA.; Pardo-Más, JR.; Tortajada, S.; Sáez Silvestre, C.; Valdivieso, B.; Garcia-Gomez, JM. (2021). Predicting morbidity by local similarities in multi-scale patient trajectories. Journal of Biomedical Informatics. 120:1-9. https://doi.org/10.1016/j.jbi.2021.103837S1912

Hepatitis A virus vaccine escape variants and potential new serotype emergence.

Six hepatitis A virus antigenic variants that likely escaped the protective effect of available vaccines were isolated, mostly from men who have sex with men. The need to complete the proper vaccination schedules is critical, particularly in the immunocompromised population, to prevent the emergence of vaccine-escaping variants