A modified McCabe score for stratification of patients after intensive care unit discharge: the Sabadell score

INTRODUCTION: Mortality in the ward after an intensive care unit (ICU) stay is considered a quality parameter, and is described as a source of avoidable mortality. Additionally, the attending intensivist frequently anticipates fatal outcome after ICU discharge. Our objective was to test the ability of a new score to stratify patients according to ward mortality after ICU discharge. METHODS: A prospective cohort study was performed in the general ICU of a university-affiliated hospital. In 2003 and 2004 we prospectively recorded the attending intensivist's subjective prognosis at ICU discharge about the hospital outcome for each patient admitted to the ICU (the Sabadell score), which was later compared with the real hospital outcome. RESULTS: We studied 1,521 patients with a mean age of 60.2 ± 17.8 years. The median (25–75% percentile) ICU stay was five (three to nine) days. The ICU mortality was 23.8%, with 1,156 patients being discharged to the ward. Post-ICU ward mortality was 9.6%, mainly observed in patients with a Sabadell score of 3 (81.3%) or a score of 2 (41.1%), whereas lower mortality was observed in patients scoring 1 (17.2%) and scoring 0 (1.7%). Multivariate analysis selected age and the Sabadell score as the only variables associated with ward mortality, with an area under the receiver operating curve of 0.88 (95% CI 0.84–0.93) for the Sabadell score. CONCLUSION: The Sabadell score at ICU discharge works effectively to stratify patients according to hospital outcome

Development and validation of a life skills evaluation tool for online learning based on the framework of the capability approach

The promotion of life skills in learners is especially challenging in distance and online environments where the learners’ physical absence from the classroom hinders the evaluation of these types of skills. Due to the great challenges brought about by this physical absence, there is a lack of empirical studies attempting to examine life skills in web-based scenarios. This study therefore aimed to fill the existing gap in operationalizing the role of life skills for online learning through the capability approach (CA). This exploration was conducted under the umbrella of Nussbaum’s version of the CA. Specifically, our study contributes by devising an integrative and comprehensive teaching and learning framework for open educational practices based on the CA, and by introducing a new instrument that has been adapted to this context. Methodologically, the design and validation of the instrument involved a four-stage process. First, Nussbaum’s list of central human capabilities was operationalized for online learning. Then, in the second stage, a qualitative content validity check was performed to verify whether the instrument was appropriate and comprehensive in terms of what it was intended to measure. The aim of the third and fourth stages was to quantitatively assess the reliability and validity of the questionnaire. For the third stage, the instrument was pre-tested through a modified version of the Q-sort method. In the fourth stage, non-parametric tests were used to validate the internal consistency and content validity of the questionnaire. Thirty experts from the areas of online education, philosophy, and statistics took part in these stages.Financed by Beijing municipal educational science foundation No. AHDB19030.info:eu-repo/semantics/publishedVersio

Prediction of standard particleboard mechanical properties utilizing an artificial neural network and subsequent comparison with a multivariate regression model

The physical properties (specific gravity, moisture content, thickness swelling and water absorption) and mechanical properties (internal bond strength, bending strength and modulus of elasticity) were determined on 93 Spanish-manufactured standard particleboards of different thicknesses selected randomly at the end of the production process. The testing methods of the corresponding European standards (EN) were used, except in the case of the thickness swelling and absorption tests, for which the Spanish UNE standard was used. The thickness and the values obtained for the physical properties were entered into an artificial neural network in order to predict the mechanical properties of the board. The fit was compared with the usual multivariate regression models. The use of a neural network made it possible to obtain the values of bending strength, modulus of elasticity and internal bond strength of the boards utilizing the known data, not only of thickness, moisture content and specific gravity, but also of thickness swelling and water absorption. The neural network proposed is much better adapted to the observed values than any of the multivariate regression models obtained

Análisis de la reparación administrativa en Colombia a la luz de la jurisprudencia de la Corte Interamericana de Derechos Humanos.

This article is part of a research project, which aims to analyze whether the Administrative reparation in Colombia is consistent with the Inter-American Court on Human Rights standards of reparation. This article identifies the integral reparation standards in light of the jurisprudence of that court.  It states the administrative reparation concept and its extent in Colombia, and it finally presents an analysis of compliance with the standards in the reparation granted to 50 victims of the armed conflict, who were assisted in the Consultorio Jurídico de Desplazamiento Forzado de la Universidad de Cartagena.El presente artículo hace parte del proyecto titulado de la misma manera,4 el cual tiene por objeto analizar si la reparación administrativa en Colombia se encuentra conforme con los estándares de reparación de la Corte Interamericana de Derechos Humanos (CIDH). Específicamente, se identifican los estándares de reparación integral a la luz de la jurisprudencia de la citada Corte, se determina el concepto y alcance de la reparación administrativa en Colombia y finalmente se concreta el cumplimiento de los estándares en la reparación otorgada a 50 víctimas del conflicto armado, que fueron asistidas en el Consultorio Jurídico de Derecho y Desplazamiento de la Universidad de Cartagena

Rediseño de asignaturas para su impartición en formato semipresencial o a distancia.

Esta comunicación presenta un conjunto de proyectos coordinados de innovación educativa cuyo objetivo principal es la generación y adaptación de materiales didácticos con el fin de implantar una docencia con seguimiento mixto por parte de los alumnos, sustituyendo gran parte de las clases en aula convencionales, o aplicar modelos completamente a distancia, empleando, para ello, objetos de aprendizaje, que favorecen la estructuración y secuenciación de contenidos y actividades, y proporcionan una guía al alumno en su estudio. Se muestran enfoques diferentes que conducen a soluciones y al uso de herramientas adaptadas a cada caso concreto (diseño de páginas web, uso de plataformas de teleformación, diversas formas de presentación de contenidos y apoyo al aprendizaje según el curso en el que está encuadrada la materia)

Adverse birth outcomes in the vicinity of industrial installations in Spain 2004-2008

Industrial activity is one of the main sources of ambient pollution in developed countries. However, research analyzing its effect on birth outcomes is inconclusive. We analyzed the association between proximity of mother's municipality of residence to industries from 24 different activity groups and risk of very (VPTB) and moderate (MPTB) preterm birth, very (VLBW) and moderate (MLBW) low birth weight, and small for gestational age (SGA) in Spain, 2004-2008. An ecological study was defined, and a "near vs. far" analysis (3.5 km threshold) was carried out using Hierarchical Bayesian models implemented via Integrated Nested Laplace Approximation. VPTB risk was higher for mothers living near pharmaceutical companies. Proximity to galvanization and hazardous waste management industries increased the risk of MPTB. Risk of VLBW was higher for mothers residing near pharmaceutical and non-hazardous or animal waste management industries. For MLBW many associations were found, being notable the proximity to mining, biocides and animal waste management plants. The strongest association for SGA was found with proximity to management animal waste plants. These results highlight the importance of further research on the relationship between proximity to industrial sites and the occurrence of adverse birth outcomes especially for the case of pharmaceutical and animal waste management activities.We would like to acknowledge the support of the Fondo de Investigación Sanitaria (PI081330), Spanish Ministry of Science and Innovation (SEJ 2005/07679 and CD11/00018), and the CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.S

Geographical variations in the risk of adverse birth outcomes in Spain

The objective of this study was to describe the spatial risk-patterns of prematurity and low birth weight in Spain. A descriptive spatial analysis of births registered in the Spanish Vital Statistics during 2004–2008 using municipalities as the observation unit was carried out. Besag-York-Mollié autoregressive spatial models were adjusted using the Integrated Nested Laplace approximation to calculate relative risks and posterior probabilities of having very and moderate preterm or low weight newborns. Results were represented in maps to assess geographic risk-patterns. Spatial analysis shows geographical variations in the risk of adverse reproductive outcomes in Spain highlighting three main high-risk zones, namely, municipalities in Asturias, Madrid City and Murcia. The specific risk patterns identified on each zone suggests some differences regarding the potential underlying risk factors and specific areas for future research. A differential exposure during pregnancy to some risks potentially related to industry or agriculture and other contextual factors could underlie an unequal vulnerability to adverse reproductive outcomes in some Spanish regions.Fondo de Investigación Sanitaria (PI081330); Spanish Ministry of Science and Innovation (SEJ 2005/07679); CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.S

Utilización de objetos de aprendizaje en asignaturas heterogéneas de la Universidad Politécnica de Madrid. Resultados y valoración de la experiencia.

Durante el curso 2007/08 un grupo de profesores de distintas Escuelas de la UPM ha participado en un proyecto coordinado cuyo objetivo principal el la generación y adaptación de materiales didácticos para transformar de forma progresiva la docencia a formato semi-presencial o completamente a distancia. Como recursos educativos se han utilizado los Objetos de Aprendizaje. La novedad de las asignaturas implicadas, no sólo por su temática, sino en otros aspectos de gran importancia práctica como la diferenca en número y procedencia de los alumnos que las cursan, nivel en el Plan de Estudos , etc. En este trabajo se describe la experiencia y se muestran algunos de los materiales proparados. También se presentan los resultados académicos alcanzados por los alumnos y la valoración cualitativa que hacen los estudiantes respecto a disponer de objetos digitales de aprendizaje