Sistemas de apoyo clínico en Atención primaria: uso de e-learning e ilustraciones médicas en la toma de decisiones compartidas

Comunicación oral presentada en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: La digitalización de la historia clínica supone un nuevo paradigma en la consulta de atención primaria permitiendo la continuidad asistencial y una gran accesibilidad a la información. Incorporar la participación del paciente aumenta su confianza y satisfacción hacia el profesional disminuyendo la iatrogenia y el coste sanitario. Esta visita personalizada requiere más tiempo, pero el aprendizaje electrónico mutuo (e-learning) aumenta la precisión diagnóstica y terapéutica, minimizando errores y efectos secundarios. Objetivos: evaluar el uso del e-learning e ilustraciones médicas en la toma de decisiones compartidas en el Centro de Atención Primaria Raval Sud de Barcelona; valorar la efectividad en la utilización de imágenes y gráficos para empoderar a la población atendida para comprender y participar en la toma de decisiones referentes a su salud; conocer la satisfacción y preferencias de uso del paciente y del profesional. Metodología: Diseño: Estudio cualitativo fenomenológico. Ámbito de estudio: Centro de Atención Primaria Raval Sud de Barcelona (zona urbana socialmente deprimida, 60% población inmigrada). Población de estudio: Pacientes atendidos por cualquier motivo (muestreo por bola de nieve) que accedan a participar en nuestro estudio. Técnicas de recogida de información: Observaciones y entrevistas individuales semiestructuradas. Durante la visita se observa la comunicación médico-paciente mediante la utilización del soporte visual electrónico, posteriormente se entrevista al paciente y al profesional para conocer su opinión. Análisis: Las observaciones y entrevistas son grabadas (grabadora de sonido) con posterior transcripción literal del texto y marcaje de citas, códigos y categorías. Análisis de contenido temático y categorización a posteriori. Resultados: Tras una prueba piloto se observa mayor facilitación y comprensión tras la visita, el paciente se muestra satisfecho y prefiere el uso del e-learning e ilustraciones médicas a la visita tradicional

Integrating Curriculum-Based Dynamic Assessment in Computerized Adaptive Testing: Development and Predictive Validity of the EDPL-BAI Battery on Reading Competence

In recent decades there have been significant changes in the conceptualization of reading as well as in the perception of how this activity should be assessed. Interest in the analysis of reading processes has led to the emergence of new explanatory models based primarily on the contributions of cognitive psychology. In parallel, there have been notable advances in measurement procedures, especially in models based on Item Response Theory (IRT), as well as in the capacity and performance of specific software programs that allow data to be managed and analyzed. These changes have contributed significantly to the rise of testing procedures such as computerized adaptive tests (CATs), whose fundamental characteristic is that the sequence of items presented in the tests is adapted to the level of competence that the subject manifests. Likewise, the incorporation of elements of dynamic assessment (DA) as the prompts are gradually offered allows for obtaining information about the type and degree of support required to optimize the subject¿s performance. In this sense, the confluence of contributions from DA and CATs offers a new possibility for approaching the assessment of learning processes. In this article, we present a longitudinal research developed in two phases, through which a computerized dynamic adaptive assessment battery of reading processes (EDPL-BAI) was configured. The research frame involved 1,831 students (46% girls) from 13 public schools in three regions of Chile. The purpose of this study was to analyze the differential contribution on reading competence of dynamic scores obtained in a subsample composed of 324 (47% girls) students from third to sixth grade after the implementation of a set of adaptive dynamic tests of morpho-syntactic processes. The results achieved in the structural equation modeling indicate a good global fit. Individual relationships show a significant contribution of calibrated score that Frontiers in Psychology | www.frontiersin.org 1 August 2018 | Volume 9 | Article 1492 fpsyg-09-01492 August 25, 2018 Time: 10:59 # 2 Navarro et al. Curriculum-Based Dynamic Computerized-Adaptive Assessment reflects estimated knowledge level on reading competence, as well as dynamic scores based on the assigned value of graduated prompts required by the students. These results showed significant predictive values on reading competence and incremental validity in relation to predictions made by static criterion tests

Universidad y sociedad: comunicación e integración en empresas e instituciones públicas y organizaciones no lucrativas. Nuevos avances

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Screening mutations in myosin binding protein C3 gene in a cohort of patients with Hypertrophic Cardiomyopathy

<p>Abstract</p> <p>Background</p> <p><it>MyBPC3 </it>mutations are amongst the most frequent causes of hypertrophic cardiomyopathy, however, its prevalence varies between populations. They have been associated with mild and late onset disease expression. Our objectives were to establish the prevalence of <it>MyBPC3 </it>mutations and determine their associated clinical characteristics in our patients.</p> <p>Methods</p> <p>Screening by Single Strand Conformation Polymorphisms (SSCP) and sequencing of the fragments with abnormal motility of the <it>MyBPC3 </it>gene in 130 unrelated consecutive HCM index cases. Genotype-Phenotype correlation studies were done in positive families.</p> <p>Results</p> <p>16 mutations were found in 20 index cases (15%): 5 novel [D75N, V471E, Q327fs, IVS6+5G>A (homozygous), and IVS11-9G>A] and 11 previously described [A216T, R495W, R502Q (2 families), E542Q (3 families), T957S, R1022P (2 families), E1179K, K504del, K600fs, P955fs and IVS29+5G>A]. Maximum wall thickness and age at time of diagnosis were similar to patients with <it>MYH7 </it>mutations [25(7) vs. 27(8), p = 0.16], [46(16) vs. 44(19), p = 0.9].</p> <p>Conclusions</p> <p>Mutations in <it>MyBPC3 </it>are present in 15% of our hypertrophic cardiomyopathy families. Severe hypertrophy and early expression are compatible with the presence of <it>MyBPC3 </it>mutations. The genetic diagnosis not only allows avoiding clinical follow up of non carriers but it opens new possibilities that includes: to take preventive clinical decisions in mutation carriers than have not developed the disease yet, the establishment of genotype-phenotype relationship, and to establish a genetic diagnosis routine in patients with familial HCM.</p

EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting

<p>Abstract</p> <p>Background</p> <p>High blood pressure (HBP) is a major risk factor for cardiovascular disease (CVD). European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation) project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD;</p> <p>Methods/Design</p> <p>This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups), all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg). All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded;</p> <p>Discussion</p> <p>The EDUCORE method could provide a simple, inexpensive means of improving blood pressure control, and perhaps other health problems, in the primary healthcare setting;</p> <p>Trial registration</p> <p>The trial was registered with ClinicalTrials.gov, number NCT01155973 [<url>http://ClinicalTrials.gov</url>].</p

Anales de Edafología y Agrobiología Tomo 36 Número 1-2

Duración efectiva del índice de sequedad, por M. P. Garmendía y J. Garmendía.-- Adsorción y evolución de manganeso en arcillas, por O. Carpena, I. Tovar, A. Lax y F. Costa.-- Ecología de leguminosas en relación con algunos factores ambientales en Guadalajara. I. Aspectos florísticos y relación con la clase ele suelo, por M. Morey.-- Variaciones del contenido de nitrógeno en una plantación de Lolium perenne,por Esther Simón Martínez.-- Predicción de temperaturas máximas diarias, por E. Hernández, J. A. Hernández, J. F. Sánchez y J. Garmendía.-- Efectos del almacenaje sobre las propiedades físicas y biológicas de muestras tamizadas de suelos orgánicos, por F. Díaz-Fierros Viqueiro.-- Morfometría del cuarzo y circón aplicada al estudio genético de un suelo policíclico, por M. C. Villar Celorio.-- Contribución al estudio de la terra rossa española. II. Mineralogía de la fracción arcilla, por L. J. Alías, M. Nieto y J. Albaladejo.-- Entisoles del Campo de Cartagena (Murcia). Características generales y mineralógicas, por L. J. Alías y R. Ortiz Silla.-- Estudio sobre la composición química de variedades de almendra del sureste español, por F. Romojaro, J. F. García y F. J. López Andreu.-- Componentes del plátano canario y sus variaciones durante la maduración, por A. Carlos Blesa, M. A. Rodríguez Raymond y A. Maestre.-- Contribución al estudio de la platanera canaria. Relación entre la actividad respiratoria y la maduración de los plátanos, por A. Carlos Blesa, M. A Rodríguez Raymoud, C. D. Lorenzo e Isabel López.-- Notas.-- Reestructuración del C. S. I. C.-- Nombramiento del Prof. Casas Peláez como Presidente del C. S. I. C. 1.-- Carta del Presidente del C. S. I. C. al personal del mismo.-- Nombramiento del Prof. Snárez y Suárez como Director general de Educación Bastea.-- 6.° Curso Internacional de Fertilidad de Suelos y Nutrición Vegetal.—8ª Reunión Internacional de Micromorfología de Suelos.—19ª Conferencia General de la UNESCO.-- Sociedad Española de Ciencia del Suelo.-- Nombramiento de Secretario del Centro de Edafología y Biología Aplicada de Salamanca.-- Dimisión del Director del Centre de Edafología y Biología Aplicada del Cuarto (Sevilla).-- Propuesta de Director del Centro de Edafología y Biología Aplicada del Cuarto.-- Viaje del Prof. Troncoso.-- Grupo Español de Trabajo del Cuaternario.-- Autorizaciones para realizar función docente.-- Invitaciones a Profesores extranjeros.-- Programa de cooperación internacional con lberoamérica: bolsas de estudio y viaje .-- Conferencia del Prof. Salerno.-- Viaje realizado a Hispanoamérica por el Dr. D. Francisco Girela Vilchez.-- Creación del Centro de Formaci.ón y Promoción de Personal del C. S. I. C. (C. F. P. P.)Peer reviewed2019-08.- CopyBook.- Libnova.- Biblioteca ICA

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

re-habitar El Carmen : Un proyecto sobre patrimonio contemporáneo

El proyecto _re-HABITAR suponía para el propio proceder de la institución un avance más allá del reconocimiento, registro, inventario o protección patrimonial de la arquitectura del siglo XX y del Movimiento Moderno para posicionarse en la acción preventiva y conservativa de ese legado contemporáneo. Para ello, la praxis patrimonial se aferraba a un modelo: el de la vivienda social en España en la segunda mitad del siglo XX; a un caso concreto: el de la barriada de Nuestra Señora del Carmen (Recasens Méndez-Queipo de Llano, 1958); y a un requisito fundamental: analizar un objeto vivo y en uso, aún con la presencia de quienes lo vivieron y usaron desde su origen