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Damian J.,Carlos III Institute of Health | Damian J.,CIBER ISCIII | Pastor-Barriuso R.,Carlos III Institute of Health | Pastor-Barriuso R.,CIBER ISCIII | And 3 more authors.
BMC Geriatrics | Year: 2015

Background: Although physician-rated health is emerging as a potentially useful variable in research, with implications in practice, it has not been analyzed. Moreover, one of its most important aspects, namely, concordance with patients' objective health state, has not been investigated. This study sought to measure concordance between physician-rated health and an objective health measure, and assess both measures' validity in predicting death. Methods: The data for the study were drawn from a 1998-1999 survey and subsequent mortality follow-up of residential and nursing homes in Madrid (Spain). Study subjects were 630 residents aged ≥65 years, and their respective facility physicians. Measures included agreement between physicians' rating of residents' overall health (good, intermediate or poor) and an objective measure of residents' health (good, intermediate or poor), based on functional capacity, cognitive status, and number of chronic conditions. Overrating was defined as any case where health, rated as good by a physician, was objectively rated as poor. Results: Whereas 45 % of physicians and 55 % of residents rated their health as good, only 4 % of such residents had good objective health. Of those who received a physician rating of good/very good health, 39.0 % had poor objective health. There was evidence of clear overrating in 18 % of the population, and clear to moderate overrating in 73 % of the population. In terms of power to predict mortality, the pattern of behavior shown by the objective health measure was good, graded and congruent, and better than that shown by physician-rated health. Conclusion: Physician overrating of the overall health of older persons in residential and nursing homes, would appear to be very high. Although some degree of contextualization by physicians in this setting might be considered reasonable, the degree of overrating in our population seems nevertheless excessive. © 2015 Damián et al.


Juanola Roura X.,Hospital Universitari Of Bellvitge | Juanola Roura X.,Institute Dinvestigacio Biomedica Of Bellvitge | Collantes Estevez E.,Grupo de Estudio de las Espondiloartritis de la SER | Collantes Estevez E.,Instituto Maimonides Of Investigacion Biomedica Of Cordoba | And 10 more authors.
Reumatologia Clinica | Year: 2015

Objective: To design a strategy for the early detection and referral of patients with possible spondyloarthritis based on recommendations developed, agreed upon, and directed to primary care physicians. Methods: We used a modified RAND/UCLA methodology plus a systematic literature review. The information was presented to a discussion group formed by rheumatologists and primary care physicians. The group studied the process map and proposed recommendations and algorithms that were subsequently submitted in two Delphi rounds to a larger group of rheumatologists and primary care physicians. The final set of recommendations was derived from the analysis of the second Delphi round. Results: We present the recommendations, along with their mean level of agreement, on the early referral of patients with possible spondyloarthritis. The panel recommends that the study of chronic low back pain in patients under 45 years be performed in four phases 1) clinical: key questions, 2) clinical: extra questions, 3) physical examination, and 4) additional tests. Conclusions: The level of agreement with these simple recommendations is high. It is necessary to design strategies for the education and sensitization from rheumatology services to maintain an optimal collaboration with primary care and to facilitate referral to rheumatology departments. © 2014 Elsevier España, S.L.U.


Ramos D.L.,Arroyo Center
Revista del Hospital Psiquiatrico de la Habana | Year: 2013

Introduction: An important impediment of former studies from a model of favorable and risk factors is the fact of do not have into consideration the auto regulative mechanism of personality and how these mechanism are interrelated with other categories of behavior expression , such as lifestyle, shortage studied on abstemious alcoholic. This insufficiency was gained in the present research, behaviour focal point towards a personologic that easies the understanding of the psychological dynamics that underlies on the personality of individuals on psychosocial rehabilitation process which is a point of start of a former study. Objective: To describe the lifestyle of a group of ten abstemious alcoholics. Methods: A transversal cut and quality - descriptive research with non experimental design was carried out. Interview, Factors questionnaire, as well as, Activity Register, Indirect and Direct Method and Dembo-Rubinstein Scale psychological tests were used. Results: The lifestyles of the abstemious alcoholic were characterized for being optimum on 9 participants and adequate on one of them. It means that they are working and in occasions with more than one economic activity, recovered families, lack of free time, association to social groups and a wide social relation. A very favorable psychosocial function concerning to the social, familiar work and personal areas, as well as, treatment fulfillment, social reinsertion and personal development signs centered on the creation of values and the overcome of negative qualities of the character. The comparison of the lifestyles of this group with one group of the alcoholics in recovery phase allowed appreciating remarkable differences on both groups in relation with the explored variables. Conclusion: Thus, psychosocial rehabilitation of alcoholic is visible through the quality of lifestyles and its psychosocial functioning.


PubMed | Maimónides University, Hospital Universitario Central Of Asturias, Institute Salud Musculoesqueletica, Hospital Parc Tauli and 2 more.
Type: Journal Article | Journal: Reumatologia clinica | Year: 2015

To design a strategy for the early detection and referral of patients with possible spondyloarthritis based on recommendations developed, agreed upon, and directed to primary care physicians.We used a modified RAND/UCLA methodology plus a systematic literature review. The information was presented to a discussion group formed by rheumatologists and primary care physicians. The group studied the process map and proposed recommendations and algorithms that were subsequently submitted in two Delphi rounds to a larger group of rheumatologists and primary care physicians. The final set of recommendations was derived from the analysis of the second Delphi round.We present the recommendations, along with their mean level of agreement, on the early referral of patients with possible spondyloarthritis. The panel recommends that the study of chronic low back pain in patients under 45 years be performed in four phases 1) clinical: key questions, 2) clinical: extra questions, 3) physical examination, and 4) additional tests.The level of agreement with these simple recommendations is high. It is necessary to design strategies for the education and sensitization from rheumatology services to maintain an optimal collaboration with primary care and to facilitate referral to rheumatology departments.


Torre M.S.,Arroyo Center | Salvide M.,Arroyo Center | Masoller C.,Polytechnic University of Catalonia
2013 6th "Rio De La Plata" Workshop on Laser Dynamics and Nonlinear Photonics | Year: 2013

We study numerically the output polarization of a vertical-cavity surface-emitting laser (VCSEL) subject to orthogonal optical injection. We focus on the width of the hysteresis cycle induced by the variation of the detuning of the injected light. For positive detuning and strong enough optical injection we find that the hysteresis width is proportional to the birefringence parameter; for negative detuning the hysteresis width is narrow and is unaffected by the injection strength. Our results are in good agreement with recent experimental observations.


Tola-Arribas M.A.,Hospital Universitario Rio Hortega | Yugueros M.I.,Hospital Universitario Rio Hortega | Garea M.J.,Hospital Universitario Rio Hortega | Ortega-Valin F.,Hospital Universitario Rio Hortega | And 7 more authors.
PLoS ONE | Year: 2013

Objective:To describe the prevalence of dementia and subtypes in a general elderly population in northwestern Spain and to analyze the influence of socio-demographic factors.Methods:Cross-sectional, two-phase, door-to-door, population-based study. A total of 870 individuals from a rural region and 2,119 individuals from an urban region of Valladolid, Spain, were involved. The seven-minute screen neurocognitive battery was used in the screening phase. A control group was included.Results:A total of 2,170 individuals aged 65 to 104 years (57% women) were assessed. There were 184 subjects diagnosed with dementia. The crude prevalence was 8.5% (95% CI: 7.3-9.7). Age- and sex-adjusted prevalence was 5.5 (95% CI: 4.5-6.5). Main subtypes of dementia were: Alzheimer's disease (AD) 77.7%, Lewy Body disease, 7.6% and vascular dementia (VD) 5.9%. Crude prevalences were 6.6% (AD), 0.6% (Lewy Body disease), and 0.5% (VD). Dementia was associated with age (OR 1.14 for 1-year increase in age), female sex (OR 1.79) and the absence of formal education (OR 2.53 compared to subjects with primary education or more).Conclusion:The prevalence of dementia in the study population was lower than the most recent estimates for Western Europe. There was a high proportion of AD among all dementia cases and very low prevalence of VD. Old age, female sex, and low education level were independent risk factors for dementia and AD. © 2013 Tola-Arribas et al.


Ramos D.L.,Arroyo Center | Armando Alonso Alvarez C.,University of Habana | Penedo H.G.,University of Habana
Revista del Hospital Psiquiatrico de la Habana | Year: 2013

Objectives: To characterize the specific positive psychological factors in the alcoholic abstinence on a group of rehabilitated alcoholic individuals; to characterize the personality self regulators mechanisms of the abstinent individuals (motivational system, self assessment and temporal dimension); to identify the difference between abstinent individual and consumers according to the study variable.Methods: a non experimental design, transversal and descriptive- qualitative research was carried out. The questionnaire of Factors, Interview and the psychological tests Register of Activities and Direct and Indirect Methods and Dembo - Rubenstein Self -Assessment Scale were used.Results: there were found differences between both groups according to the categories of study and a prevalence of positive factors in the alcoholic abstinence on the group of alcoholic individual, meanwhile on the group of consumers the risks of the abstinence prevailed. Conclusions: the personality self regulators mechanisms of the abstinent individuals are: optimism before complex situations, positive self assessment towards emotional self control, temporal dimension, useful use of time, awareness of the disease, trust on rehabilitation therapy, they do not believe that they are able to consume alcohol with control, they believe in God or in a Superior Divinity Power, they develop moral principles, they become stable with their couple and also with their worḱs duties, they become liable with other alcoholic individuals, they are able to make plans for the future and to have a good disposition, they also have a regular participation to Anonym Alcoholic Groups or to Psychotherapy Groups among other characteristics.


Fierro Urturi A.,Arroyo Center
Pediatria Integral | Year: 2016

Purpura are injuries caused by the extravasation of blood cells into the skin and/ or mucous membranes due to hemostasis disorders. They are caused by many diseases. Primary immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated low platelet count and the absence of any other cause of the thrombocytopenia. There is no clinical or analytical parameter that allows the diagnosis, being of exclusion. Most cases in children are mild and self-limiting, but may have serious clinical complications related to the risk of bleeding. The main goal of treatment is to prevent bleeding and get a good quality of life with minimal toxicity associated with therapy. High-dose corticosteroids in short course and intravenous immunoglobulin are the treatment of choice. Second- and further-line treatments should be monitored in specialized centers. Several guidelines have been published based on evidence PTI to help health professionals in the diagnosis and treatment of these patients. © 2016, Ediciones Ergon SA. All rights reserved.


Objective: to define the main features that characterizes professional motivation on students from of group 102 from the Design High School during the course 2013- 2014. Methods: A descriptive research was carried out with a transversal non experimental design with a sample of 25 individuals. Open techniques were applied. The results were analyzed by components and levels of professional motivation. Results: On the main features that characterize professional motivation on the individuals studied were found that the majority presents one partial cognitive component and one positive affective component, meanwhile the autovalorative component and the future projection components are partially developed. Conclusion: The majority of the individuals are localized on level II of the professional motivation.


Monteserin A.,Arroyo Center | Amandi A.,Arroyo Center | Amandi A.,CONICET
Applied Intelligence | Year: 2010

Knowing how a user builds his/her arguments during a discussion gives useful advantages if we want to assist the user or analyse his/her argumentative skills. This paper presents a novel mechanism to build user argumentative models, which captures the argumentative style to generate arguments. To this end, we observe how users generate arguments, and apply a generalised association rules algorithm to discover rules for argument generation. These rules depict the argumentative style of the user. They are composed of an antecedent, which represents the conditions to build an argument, and a consequent, which represents such argument. To evaluate this proposal, we show results obtained in the domain of meeting scheduling. We discovered interesting rules from a group of users discussing in that domain, and checked that about 60% of the arguments that users had generated in a test situation can be also generated from the rules previously learnt, at least partially. Finally, although this work focuses on modelling users' argumentative style, we discuss how this promising approach could be applied in different knowledge domains. © 2008 Springer Science+Business Media, LLC.

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