Study of stress detection and proposal of stress-related features using commercial-off-the-shelf wrist wearables

This paper discusses the possibility of detecting personal stress making use of popular wearable devices available in the market. Different instruments found in the literature to measure stress-related features are reviewed, distinguishing between subjective tests and mechanisms supported by the analysis of physiological signals from clinical devices. Taking them as a reference, a solution to estimate stress based on the use of commercial-off-the-shelf wrist wearables and machine learning techniques is described. A mobile app was developed to induce stress in a uniform and systematic way. The app implements well-known stress inducers, such as the Paced Auditory Serial Addition Test, the Stroop Color-Word Interference Test, and a hyperventilation activity. Wearables are used to collect physiological data used to train classifiers that provide estimations on personal stress levels. The solution has been validated in an experiment involving 19 subjects, offering an average accuracy and F-measures close to 0.99 in an individual model and an accuracy and F-measure close to 0.85 in a global 2-level classifier model. Stress can be a worrying problem in different scenarios, such as in educational settings. Thus, the last part of the paper describes the proposal of a set of stress related indicators aimed to support the management of stress over time in such settings.Agencia Estatal de Investigación | Ref. TIN2016-80515-RUniversidade de Vig

Hacia una normalización de la representación de flujogramas en el ámbito hospitalario

This article presents a proposal of standardization for the representation of hospital protocols using flowcharts. In the clinical field, highly complex processes are typically developed. If these processes are not appropriately managed, fatal consequences for patients and the healthcare personnel could appear. Using a clear notation for modelling the tasks to be performed is mandatory to keep the risks under control. In practice, the most widely used flowchart language for years (due to its simplicity and versatility) is defined in ISO 5807:1985 standard. However, this language is insufficiently expressive to represent all the essential aspects of a health protocol. In recent years, this type of protocols has become increasingly sophisticated in order to improve the control of critical aspects that influence the safety of medicines, patients and practitioners. In this way, a widespread practice has been the implementation of the HACCP methodology for hazard analysis and control. During the modelling of these protocols (and because of the expressivity problems of traditional flowchart notation), each hospital has adopted its proposal that complements the elements included in the ISO (International Organization for Standardization) standard. This practice forces practitioners to become familiar with the ad-hoc defined notation for that center. In addition, these adaptations usually fall into ambiguous and non-formal definitions. In the standardization proposal presented in this article, new graphic stereotypes are introduced. These can be easily integrated into the ISO notation and are designed to represent the critical aspects of the HACCP (Hazard Analysis and Critical Control Points) plan. For the definition of these new elements, a series of requirements have been prioritized. First, it is taken into account the tools that are commonly used and the simplicity for final users. Moreover, it is mandatory to avoid ambiguities assuring that the introduced elements do not interfere with the base notation contained in the original ISO standard. This standardization proposal enriches the ISO5807:1985 language with expression mechanisms to represent essential information related to protocol security by reducing ambiguities and proposing a standardized notation.En este artículo se presenta una propuesta de normalización para la representación de protocolos hospitalarios a través de diagramas de flujo. En el ámbito clínico se desarrollan procesos de gran complejidad que, si no se gestionan adecuadamente, podrían dar lugar a consecuencias fatales para los pacientes o el personal sanitario implicado. Utilizar una notación clara que formalice las tareas que deben realizarse es un aspecto fundamental para mantener los riesgos controlados. En la práctica, el lenguaje de flujogramas más utilizado desde hace años debido a su sencillez y versatilidad es el definido por la norma ISO 5807:1985. No obstante, este lenguaje resulta insuficientemente expresivo para representar todos los aspectos importantes de un protocolo sanitario. Durante los últimos años este tipo de protocolos han aumentado su complejidad con el fin de dar un paso hacia adelante en el control de aspectos críticos que influyen en la seguridad de los medicamentos, pacientes y personal sanitario. En esta línea, una práctica muy común ha sido la implantación de la metodología APPCC (Análisis de Peligros y Puntos Críticos de Control). Durante el modelado de estos protocolos (dado que la notación de flujogramas tradicional no es suficientemente expresiva) cada centro hospitalario ha adoptado una propuesta propia que complementa los elementos incluidos en la norma ISO (International Organization for Standardization). Con esta práctica se obliga a que el personal tenga que familiarizarse con la notación definida ad-hoc para ese centro que, además de no estar estandarizada, cae en ocasiones en definiciones ambiguas y poco formales. En la propuesta de normalización presentada en este artículo se plantean nuevos estereotipos gráficos fácilmente integrables en la notación ISO y diseñados para representar los aspectos críticos de la metodología APPCC. Para la definición de estos nuevos elementos se han priorizado una serie de requisitos que tienen en cuenta tanto los aspectos relativos a las herramientas software ya existentes como la simplicidad para los usuarios finales en la práctica diaria. Al mismo tiempo se tratan de evitar ambigüedades asegurando que los elementos introducidos no interfieren con la notación base contenida en la norma ISO original. En definitiva, esta propuesta de normalización consigue enriquecer el lenguaje ISO5807:1985 con mecanismos de expresión suficientes para representar la información básica relacionada con la seguridad de los protocolos reduciendo las ambigüedades y facilitando una notación estandarizada

Derecho a una buena visión en los mayores: evitar la ceguera evitable. Prevención y cuidados para una atención integral

Este documento, que constituye el nº 8 de la colección Promoción de la salud en las personas mayores, pretende abordar buena parte de los problemas de salud de este colectivo aportando criterios y metodología para la intervención a sus cuidadores y responsables de salud

Contribucións ao ámbito da trazabilidade en contextos con monitorización non exhaustiva mediante o enriquecemento dos modelos de proceso

Traceability procedures allow us to know and trace the history, application or location of the different entities involved in the life cycle of a given product or service. These procedures are becoming increasingly common and are often used in combination with quality and safety control techniques, process management and data analysis. As a result of a series of previous works related to the field of traceability and process monitoring, a series of needs have been identified in certain areas with the presence of non-exhaustive monitoring. The working dynamics of some scenarios imply that a large part of the knowledge of the domain, if it is available in a direct fashion, is only available in documents in natural language and in an informal way. In addition, the presence of activities that do not generate monitoring is an added challenge. Therefore, the proposal is to develop mechanisms to tackle the identified cases and problems in order to take into account what information is available and in what formats it is presented. These mechanisms should, as far as possible, make up for the shortcomings generated by the information deficits present in the contexts analysed.Los procedimientos de trazabilidad nos permiten conocer y rastrear la historia, aplicación o localización de las diferentes entidades involucradas en el ciclo de vida de un determinado producto o servicio. Estos procedimientos son cada vez más habituales y suelen utilizarse en combinación con técnicas de control de calidad y seguridad, de gestión de procesos y de análisis de datos. A raíz de una serie de trabajos previos relacionados con el ámbito de la trazabilidad y la monitorización de procesos, se han identificado una serie de necesidades en ciertos ámbitos con presencia de monitorización no exhaustiva. La propias dinámicas de trabajo de algunos escenarios implican que una gran parte del conocimiento del dominio en caso de estar disponible de un modo directo, sólo lo está en documentos en lenguaje natural y de modo informal. Además, la presencia de actividades que no generan monitorización supone un reto añadido. Así pues, la propuesta que se plantea es desarrollar mecanismos que permitan atajar las casuísticas y problemas identificados de modo que se tenga en cuenta qué información es la que está disponible y en qué formatos se presenta. Estos mecanismos deberán, en la medida de lo posible, suplir las carencias generadas por los déficits de información presentes en los contextos analizados.Os procedementos de trazabilidade permítennos coñecer e rastrexar a historia, aplicación ou localización das diferentes entidades involucradas no ciclo de vida dun determinado produto ou servizo. Estes procedementos son cada vez máis habituais e adoitan utilizarse en combinación con técnicas de control de calidade e seguridade, de xestión de procesos e de análise de datos. A partir dunha serie de traballos previos relacionados co ámbito da trazabilidade e a monitoraxe de procesos, identificáronse unha serie de necesidades en certos ámbitos con presenza de monitoraxe non exhaustiva. As propias dinámicas de traballo dalgúns escenarios implican que unha gran parte do coñecemento do dominio, en caso de estar dispoñible dun modo directo, só o está en documentos en linguaxe natural e de maneira informal. Ademais, a presenza de actividades que non xeran monitoraxe supón un reto engadido. Así pois, a proposta que se expón é desenvolver mecanismos que permitan atallar as casuísticas e problemáticas identificadas de modo que se teña en conta que información é a que está dispoñible e en que formatos se presénta. Estes mecanismos deberán, na medida do posible, suplir as carencias xeradas polos déficits de información presentes nos contextos analizados

Guidelines for safe handling of hazardous drugs: a systematic review

Objective: To review the scientific literature related to the safe handling of hazardous drugs (HDs). Method: Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. Results: In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. Conclusions: Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.Instituto de Salud Carlos III | Ref. PI16/0078

Anti-Sexism Alert System: Identification of Sexist Comments on Social Media Using AI Techniques

Social relationships in the digital sphere are becoming more usual and frequent, and they constitute a very important aspect for all of us. Violent interactions in this sphere are very frequent, and have serious effects on the victims. Within this global scenario, there is one kind of digital violence that is becoming really worrying: sexism against women. Sexist comments that are publicly posted in social media (newspaper comments, social networks, etc.), usually obtain a lot of attention and become viral, with consequent damage to the persons involved. In this paper, we introduce an anti-sexism alert system, based on natural language processing (NLP) and artificial intelligence (AI), that analyzes any public post, and decides if it could be considered a sexist comment or not. Additionally, this system also works on analyzing all the public comments linked to any multimedia content (piece of news, video, tweet, etc.) and decides, using a color-based system similar to traffic lights, if there is sexism in the global set of posts. We have created a labeled data set in Spanish, since the majority of studies focus on English, to train our system, which offers a very good performance after the validation experiments

Nosocomial COVID-19 Infection in a Long-Term Hospital in Spain: Retrospective Observational Study

Background and Objectives. The aim of this study is to compare clinical and epidemiological characteristics and outcomes in patients with versus without nosocomial COVID-19 after exposure to SARS-CoV-2 and to analyze the risk factors for severe outcomes of COVID-19 in a long-term hospital in Spain. Materials and methods. This retrospective, single-center observational study included all inpatients in a long-term hospital during a COVID-19 outbreak from 21 January to 15 March 2021. Results. Of 108 admitted patients, 65 (60.2%) were diagnosed with nosocomial COVID-19 disease (n = 34 women (52.3%), median age 77 years). In the univariable analysis, risk factors associated with nosocomial COVID-19 were dementia (OR 4.98 95% CI 1.58–15.75), dyspnea (OR 5.34 95% CI 1.69–16.82), asthenia (OR 5.10, 95% CI 1.40–18.60) and NECesidades PALiativas (NECPAL) (OR 1.28 95% CI 1.10–1.48). In the multivariable analysis, risk factors independently associated with nosocomial COVID-19 infection were dyspnea (aOR 7.39; 95% CI 1.27–43.11) and NECPAL (aOR 1.25; 95% CI 1.03–1.52). Of the 65 patients diagnosed with nosocomial COVID-19, 29 (44.6%) died, compared to 7/43 (16.2%) non-infected patients (OR 4.14, 95% CI 1.61–10.67). Factors associated with mortality in nosocomial COVID-19 were confusion (aOR 3.83; 95% CI 1.03–14.27) and dyspnea (aOR 7.47; 95% CI 1.87–29.82). The NECPAL tool played an important predictive role in both nosocomial COVID-19 infection and mortality (aOR 1.19, 95% CI: 1.00–1.41). Conclusions. In a long-term hospital, nosocomial COVID-19 main clinical characteristics associated with infection were dyspnea and NECPAL. Mortality was higher in the group with nosocomial COVID-19; risk factors were confusion and dyspnea. The NECPAL tool may help to predict progression and death in COVID-19

Guidelines for safe handling of hazardous drugs: A systematic review

<div><p>Objective</p><p>To review the scientific literature related to the safe handling of hazardous drugs (HDs).</p><p>Method</p><p>Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017.</p><p>Results</p><p>In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs.</p><p>Conclusions</p><p>Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.</p></div

Timeline of guidelines developed.

<p>Timeline of guidelines developed.</p