Aplicaciones móviles en salud: potencial, normativa de seguridad y regulación

The objective of the present study is to analyze the implications and the potential of the denominated mobile health or mHealth, as well as to revise the normative and regulations about security, developed by mobile applications in health. The use of mobile technologies to support the achievement of health goals has the potential to transform health care delivery worldwide. This includes rapid advances in technology and the exponential growth of mobile applications, leading to new opportunities for the integration of mobile health into health services. However, the quality of these applications is very variable, in terms of both their content and their functionality. Many of them are of doubtful reliability and most are not integrated into the health care system. This disorderly growth makes it necessary to establish regulatory mechanisms to ensure that these applications are used safely. The present paper discusses the steps taken on an international, regional and national level (Spain) to regulate the professional and patient use of mobile health applications and other applications aimed at disease prevention and the building of healthy habits. An analysis of the most outstanding health regulations in the field reveals that some of the applications considered to be safe by some regulatory agencies, do not pass some of the mobile security tests, such as the OWASP, established by the Open Web Application Security Project. It is therefore recommended that steps are taken to minimize the possible risks of using mobile health applications

¿Son útiles y seguras las aplicaciones móviles en salud?

[ES] La tecnología móvil ha cambiado la forma en que vivimos, trabajamos y nos comunicamos afectando a todas las esferas de nuestra vida. Oficialmente según GSMA ya hay más dispositivos móviles que personas en el mundo (Julio Alonso-Arévalo, 2017)3. El campo de la salud móvil se ha convertido en un sub-segmento de la eSalud, que tiene que ver con el uso de los avances tecnológicos, tales como teléfonos móviles, GPS, apps o monitores de pacientes en los servicios de Salud e información. Así, el uso de las tecnologías móviles para apoyar el logro de objetivos de salud se denomina Salud móvil o mHealth, y tiene un potencial importante para transformar la prestación de servicios de salud en todo el mundo, tal como se reconoce el Libro Verde sobre la Salud móvil publicado por la Comisión Europe

Mobile health applications: potential, regulation and security

[ES] El objetivo del presente trabajo es analizar las implicaciones y el potencial de lo que se ha denominado salud móvil o mHealth, así como revisar las normativas y regulaciones sobre seguridad desarrolladas por aplicaciones móviles en salud. Entendemos por seguridad móvil, la capacidad de hacer un uso confiable de una aplicación móvil, en términos de rendimiento, medición adecuada y privacidad de los datos. El uso de las tecnologías móviles para apoyar el logro de los objetivos de salud tiene el potencial de transformar la prestación de servicios de salud en todo el mundo. Esto incluye rápidos avances en el ámbito tecnológico y el crecimiento exponencial de las aplicaciones móviles, lo que conlleva nuevas oportunidades para la integración de la salud móvil en los servicios sanitarios. Sin embargo, la calidad de estas apps es muy variable, tanto en contenidos como en funcionalidades. Muchas de ellas son de dudosa fiabilidad y la mayoría no están integradas en el sistema sanitario. Este crecimiento desordenado hace necesario establecer mecanismos de regulación que garanticen que estas aplicaciones se utilicen con seguridad. En este documento se analizan los esfuerzos de regulación a nivel internacional, regional y nacional (España) de las aplicaciones móviles sobre salud, tanto para uso profesional como para el uso por parte de pacientes, y otras aplicaciones orientadas hacia la prevención y los hábitos saludables. Tras un análisis de las normativas de salud más destacadas en el ámbito, se observa que algunas de las aplicaciones que son consideradas como seguras por parte de algunos organismos reguladores, no superan algunos de los tests de seguridad móvil, tales como Open Web Application Security Project, por lo cual se recomienda la existencia de medidas que minimicen los posibles riesgos del uso de aplicaciones móviles en salud

La lectura y su relación con la salud y el bienestar de las personas

The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better

La lectura y su relación con la salud y el bienestar de las personas

[ES] El objetivo de este estudio fue identificar los elementos de la lectura que nos implican más poderosamente en esta actividad y su relación con la salud. Para esto se diseñó y distribuyó una encuesta entre personas que habitualmente leen, pertenecientes a las Comunidades autónomas de Castilla y León, Extremadura, Madrid y Asturias. En esta, los encuestados tenían que valorar aquellos aspectos que consideraban más importantes para ellos respecto a la lectura: tranquilidad, diversión, información y otros. Recogidas y analizadas 255 respuestas, los resultados pusieron de relieve que por encima de las funciones tradicionales relacionadas con las actividades formativas e informativas, lo que más valoran los encuestados son los aspectos protectores de la lectura, como paliar la soledad, evitar pensamientos negativos y gestionar mejor las emociones.[ENG} The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better.Infomed - Centro Nacional de Información de Ciencias Médica

La lectura y su relación con la salud y el bienestar de las personas

The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better

Beneficios de la lectura sobre la salud y el bienestar de las personas. Estudio sobre aspectos preventivos de la lectura

The aim of this study is to identify and analyse the elements associated with reading in order to find out how reading habits affect health. For this purpose, a cross-sectional sample study was carried out by means of a survey among people who usually read and which was distributed online through distribution lists and social networks interested in the field of reading and health. In it, the respondents had to assess those aspects that they consider most important for them regarding reading such as: tranquility, fun, information and others. A total of 1,511 surveys were completed from various countries, especially from Spain and Latin American countries. The results observed show that, in addition to valuing the importance of reading in relation to traditional functions such as training and information activities, the respondents also use and value the capacity that reading has in relation to preventive and healthy aspects such as: alleviating loneliness, avoiding negative thoughts and better managing emotions

Proyecto de innovación y buenas prácticas de educación inclusiva en relación con alumnos con discapacidad

Memoria ID-0101. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

New Prognostic Factors in Operated Extracapsular Hip Fractures: Infection and GammaTScore

[EN]There is no universal postoperative classification of extracapsular hip fractures (ECFs). We wondered if infection (according to infection after fracture fixation criteria (IAFF)), immediate partial weight bearing (PWB) and/or the new GammaTScore tool could predict early cut-out. We also examined the correlation between GammaTScore and time to consolidation and studied long-term survival. This was a retrospective cohort study of low-energy complete ECFs operated with Gamma3T nailing in 2014 and fully monitoring, in patients aged over 65. Ten not distally locked cases, one late cut-out, one cut-through, one osteonecrosis and one pseudarthrosis were discarded. Patients were classified into early cut-out (7/204; 3.55%) and no early cut-out (197/204; 96.45%). There was a lower percentage of A2 fractures according to the AO Foundation/Orthopaedic Trauma Association classification (AO/OTA, 1997) in early cut-out. IAFF and only the GammaTScore reduction parameter were different for early cut-out, in opposition to immediate PWB, tip-to-apex distance (TAD) or the Baumgaertner-Fogagnolo classification. GammaTScore inversely correlated with consolidation (p < 0.01). Long-term survival time was not statistically significantly lower in the early cut-out group. Small sample of cases may limit our results. Apart from an important role of IAFF, GammaTScore would be useful for predicting consolidation, avoiding complications and reducing costs. Further studies are needed for reliability

Long-term outcomes of distal locking in extracapsular fractures treated with trochanteric Gamma3 nails

[EN]Background: Few publications have assessed long-term results of distal locking of short endomedullary nails for extracapsular hip fracture. Virtually all of them focus on immediate differences. Criteria for the use of static or dynamic locking are unclear in most nailing systems, and use is advised in unstable fracture patterns or with risk of bell-clapper effect, but often influenced by the “orthopaedic school”. Materials and methods: This is a historical cohort study on patients diagnosed and operated in 2014 and followed up until endpoint, considered as consolidation or major complication, plus evaluation of overall long-term survival. They were categorised as static distal locking (ST) or dynamic distal locking (DN). Both are comparable, except for all stable pre-operative classifications, Fracture Mobility Score (FMS) at discharge, and immediate post-operative loading,all of which were in favour of DN. Results: Consolidation took place in > 95% of patients, with a non-statistically significant delay trend in ST. Less than 6% in both ST and DN had major complications, with no differences. Most cases suffered early cut-out. Significant fracture collapse was the most frequent minor complication. There were more statistically significant minor and total complications in ST. Infection, without differences, can precede cut-out. Lateral thigh pain was similar and could be related to back-out. In DN, 21.1% of cases were truly dynamised. We did not find differences in mobility or in longterm survival. Conclusions: Any type of distal locking seems to be safe for consolidation, despite a slightly longer consolidation time in static locking. Early cut-out was the main complication, while others were very infrequent, which is an advantage over helical blade devices. There was a higher rate of minor and overall mechanical complications in ST, but infection and lateral thigh pain were similar. Most non-traumatic mechanical complications occurred around 5–6 weeks. About one in five of the DN truly dynamised, with all cases occurring before 8 weeks. Mobility until endpoint and overall long-term survival were not influenced by the locking mode used. Level of evidence: Therapeutic study, level 2b