RESUMEN
PURPOSE: The purpose of this paper is to highlight the joint impact of competitive culture and knowledge behaviors (sharing, hoarding and hiding) on workplace happiness among healthcare professionals. It addresses a literature gap that critiques the development of happiness programs in healthcare that overlook organizational, social and economic dynamics. The study is based on the Social Exchange Theory, the Conservation of Resources Theory and the principles of Positive Psychology. DESIGN/METHODOLOGY/APPROACH: The study analyzes a linear relationship between variables using a structural equation model and a partial least squares approach. The data are sourced from a survey of 253 healthcare professionals from Portuguese healthcare organizations. FINDINGS: The data obtained from the model illustrate a positive correlation between competitive culture and knowledge hoarding as well as knowledge hiding. Interestingly, a competitive culture also fosters workplace happiness among healthcare professionals. The complex relationship between knowledge behaviors becomes evident since both knowledge hoarding and sharing positively affected these professionals' workplace happiness. However, no direct impact was found between knowledge hiding and workplace happiness, suggesting that it negatively mediates other variables. ORIGINALITY/VALUE: This research addresses a previously identified threefold gap. First, it delves into the pressing need to comprehend behaviors that enhance healthcare professionals' workplace satisfaction. Second, it advances studies by empirically examining the varied impacts of knowledge hiding, hoarding and sharing. Finally, it sheds light on the repercussions of knowledge behaviors within an under-explored context - healthcare organizations.
Asunto(s)
Felicidad , Personal de Salud , Lugar de Trabajo , Humanos , Personal de Salud/psicología , Lugar de Trabajo/psicología , Adulto , Masculino , Femenino , Portugal , Encuestas y Cuestionarios , Persona de Mediana Edad , Cultura Organizacional , Satisfacción en el TrabajoRESUMEN
Blood testing has traditionally been the gold standard for the physiological analysis and monitoring of professional athletes. In recent years, blood testing has moved out of the laboratory thanks to portable handheld devices, such as lactate meters. However, despite its usefulness and widespread use, blood testing has several drawbacks and limitations, such as the need for the athlete to stop exercising for blood extraction and the inability to have data continuously collected. In this scenario, sweat has become an alternative to blood testing because of its rich content of electrolytes and metabolites, as well as small quantities of sugars, proteins, and ions. Nevertheless, there are few devices capable of analyzing this biofluid and providing useful information to users. In this paper, an electronic system designed for the autonomous analysis of sweat electrolytes and metabolites along with heart rate dynamics is presented. This system is part of a novel wearable device tailored for athletes that offers to the user a real-time assessment of their physiological status and performance.
Asunto(s)
Técnicas Biosensibles , Deportes , Dispositivos Electrónicos Vestibles , Humanos , Sudor/química , Electrólitos , Biometría , Monitoreo FisiológicoRESUMEN
The incorporation of biomacromolecules onto silicon waveguiding microstructures constitutes a growing trend that pushes towards compact and miniaturized biosensing systems. This paper presents the integration of one-dimensional periodic nanostructures of proteins on the surface of micrometric silicon waveguides for transducing binding events between biomacromolecules. The study demonstrates this new bioanalytical principle by experimental results and theoretical calculations, and proves that rib waveguides (1--1.6-µm width) together with protein gratings (495--515-nm period) display suitable spectral responses for this optical biosensing system. Protein assemblies of bovine serum albumin are fabricated on the surface of silicon nitride waveguides, characterized by electron microscopy, and their response is measured by optical frequency domain reflectometry along the fabrication process and the subsequent stages of the biorecognition assays. Detection and quantification limits of 0.3 and 3.7 µg·mL-1, respectively, of specific antibodies are inferred from experimental dose-response curves. Among other interesting features, the results of this study point towards new miniaturized and integrated sensors for label-free bioanalysis.
Asunto(s)
Técnicas Biosensibles , Nanoestructuras , Dispositivos Ópticos , Técnicas Biosensibles/métodos , Nanoestructuras/química , Albúmina Sérica BovinaRESUMEN
This study was carried out to analyze the evolution of the quality indicators in the Spanish National Hip Fracture Registry, after disseminating a series of recommendations based on available clinical practice guidelines to the participating hospitals. Six of the seven proposed quality indicators showed a significant improvement. PURPOSE: The Spanish National Hip Fracture Registry (RNFC) arises from the need to know the process and improve the quality of care. Our goal was to analyze the changes in the RNFC's quality indicators after an intervention based on disseminating specific recommendations among the participating hospitals, following available clinical practice guidelines. METHODS: Study comparing before and after performing an intervention in hospitals participating in the RNFC. Data from the hospitals that registered cases in 2017, and that kept registering cases in 2019. Seven quality indicators were chosen, and a standard to be achieved for each indicator was proposed. The intervention consisted in the dissemination of 25 recommendations with practical measures to improve each quality indicator, based on available clinical practice guidelines, by drafting and publishing a scientific paper and sending it via email and printed cards. Fulfilment of each quality indicator was measured after carrying out the intervention. RESULTS: Forty-three hospitals registered 2674 cases between January and May, 2017, and 8037 during 2019. The quality indicators chosen and the degree of compliance were (all with p<0.05): (1) surgery ≤48 h increased from 38.9 to 45.8%; (2) patients mobilised on the first postoperative day increased from 58.9 to 70.3%; (3) patients with anti-osteoporotic medication at discharge increased from 34.5 to 49.8%; (4) patients with calcium supplements at discharge increased from 48.7 to 62.8%; (5) patients with vitamin D supplements at discharge increased from 71.5 to 84.7%; (6) patients developing a grade >2 pressure ulcer during admission decreased from 6.5 to 5.0%; (7) patients able to move on their own at 1 month fell from 58.8 to 56.4%. More than 48% of hospitals improved the proposed indicators. CONCLUSION: Establishing quality indicators and standards and intervening through the dissemination of specific recommendations to improve these indicators achieved an improvement in hospital performance results on a national level.
Asunto(s)
Fracturas de Cadera , Indicadores de Calidad de la Atención de Salud , Fracturas de Cadera/cirugía , Hospitalización , Humanos , Sistema de Registros , España/epidemiologíaRESUMEN
Adaptable and complex optical characterization of photonic integrated devices, permitting to unearth possible design and fabrication errors in the different workflow steps are highly desired in the community. Here, we propose a technique capable of resolving full optical amplitude and phase response, in both frequency and time domains, of a photonic integrated device. It relies on optical frequency domain interferometry and makes use of a novel integrated architecture; a 3-way interferometer enabling single input and single output detection. We derive the test structure design rules and provide extensive experimental validation in silicon nitride and silicon on insulator technologies, by testing relevant devices such as arrayed waveguide grating, Mach-Zehnder interferometers, and ring resonators. Horizontal and vertical chip coupling, different external setup arrangements, and the optical dispersion de-embedding inherent to the technique are demonstrated. Finally, we discuss why this characterization approach might lay the groundwork of a standard testing tool for photonic integrated devices.
RESUMEN
In this paper we report the experimental realization of a reconfigurable reflective arrayed waveguide grating on silicon nitride technology, using optimization algorithms borrowed from machine learning applications. A dozen of band-shape responses, as well as a spectral resolution change, are demonstrated in the optical telecom C-band, alongside a proof of operation of the same device in the O-band. In the context of programmable and reconfigurable integrated photonics, this building block supports multi-wavelength/band spectral shaping of optical signals that can serve to multiple applications.
RESUMEN
Legionella is a pathogenic bacterium, ubiquitous in freshwater environments and able to colonise man-made water systems from which it can be transmitted to humans during outbreaks. The prevention of such outbreaks requires a fast, low cost, automated and often portable detection system. In this work, we present a combination of sample concentration, immunoassay detection, and measurement by chronoamperometry. A nitrocellulose microfiltration membrane is used as support for both the water sample concentration and the Legionella immunodetection. The horseradish peroxidase enzymatic label of the antibodies permits using the redox substrate 3,3',5,5'-Tetramethylbenzidine to generate current changes proportional to the bacterial concentration present in drinking water. Carbon screen-printed electrodes are employed in the chronoamperometric measurements. Our system reduces the detection time: from the 10 days required by the conventional culture-based methods, to 2-3 h, which could be crucial to avoid outbreaks. Additionally, the system shows a linear response (R2 value of 0.99), being able to detect a range of Legionella concentrations between 101 and 104 cfu·mL-1 with a detection limit (LoD) of 4 cfu·mL-1.
Asunto(s)
Agua Potable/microbiología , Inmunoensayo , Legionella pneumophila/aislamiento & purificación , Anticuerpos , Bencidinas , Peroxidasa de Rábano Silvestre , Microbiología del AguaRESUMEN
Vertical-cavity surface-emitting lasers (VCSELs) are the predominant technology for high-speed short-range interconnects in data centers. Most short-range interconnects rely on GaAs-based multi-mode VCSELs and multi-mode fiber links operating at 850 nm. Recently, GaAs-based high-speed single-mode VCSELs at wavelengths > 1 µm have been demonstrated, which increases the interconnect reach using a single-mode fiber while maintaining low energy dissipation. If a suitable platform for passive wavelength- and space-multiplexing were developed in this wavelength range, this single-mode technology could deliver the multi-Tb/s interconnect capacity that will be required in future data centers. In this work, we show the first passive Si3N4 platform in the 1-µm band (1030-1075 nm) with an equivalent loss < 0.3 dB/cm, which is compatible with the system requirements of high-capacity interconnects. The waveguide structure is optimized to achieve simultaneously single-mode operation and low bending radius, and we demonstrate a wide range of high-performance building blocks, including arrayed waveguide gratings, Mach-Zehnder interferometers, splitters and low-loss fiber interfaces. This technology could be instrumental in scaling up the capacity and reducing the footprint of VCSEL-based optical interconnects and, thanks to the broad transparency in the near-infrared and compatibility with the Yb fiber amplifier window, enabling new applications in other domains as optical microscopy and nonlinear optics.
RESUMEN
This study examines the effects that ambidextrous relationships, i.e., oriented relationships within a firm towards the development of exploitation activities and oriented relationships towards the development of exploration activities, have on employee performance in terms of creativity, research and development (R&D), and sustainable innovation performance. We contend that informal relationships affect employee creativity and R&D. However, formal relationships affect employee creativity and sustainable innovation performance. The purpose of this study is to inject new positive relationships into firms by examining ambidextrous relationships and the moderating role of social capability in the relationships-innovation effect. We empirically tested our hypotheses by using multisource data collected from 245 Spanish firms across 14 industries. Our structural equation models suggest that these two types of relationship predict employee creativity, which in turn increases sustainable innovation performance and R&D. The results reveal that the effects between informal relationships and creativity are stronger, as are the effects between formal relationships and sustainable innovation performance. A multigroup structural analysis also reveals that effects between informal and formal relationships, employee creativity, R&D, and sustainable innovation performance are stronger within firms that have employees with high social capability. The efforts and investments made in employee social capital support the development of new ideas, R&D, and innovation success. Support is provided for an ambidextrous Human Resource Management (HRM) approach which is relevant for innovation, and several practical recommendations and implementation guidelines for Small and Medium Enterprises (SMEs) are provided. This study provides a plausible explanation of two important management mechanisms for enhancing creativity-R&D and sustainable innovation performance. Relationships are malleable, and this study suggests that fostering formal and informal relationships might hold the key to sustainable innovation performance and unlocking desirable employee behavior.
Asunto(s)
Creatividad , Investigación , Capital Social , Humanos , Inversiones en SaludRESUMEN
In this work, formulations based on composites of a linear polypropylene (L-PP), a long-chain branched polypropylene (LCB-PP), a polypropylene-graft-maleic anhydride (PP-MA), a styrene-ethylene-butylene-styrene copolymer (SEBS), glass fibers (GF), and halloysite nanotubes (HNT-QM) have been foamed by using the improved compression molding route (ICM), obtaining relative densities of about 0.62. The combination of the inclusion of elastomer and rigid phases with the use of the LCB-PP led to foams with a better cellular structure, an improved ductility, and considerable values of the elastic modulus. Consequently, the produced foams presented simultaneously an excellent impact performance and a high stiffness with respect to their corresponding solid counterparts.
RESUMEN
OBJECTIVE: The Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera or RNFC) is a Spanish, prospective, multi- centric registry, commenced in 2017. The goal of this paper is to present the data from the first annual report and to compare them with autonomic registries and recent prospective multi-centric studies performed in Spain. METHODS: We included persons 75 years or older treated for fragility hip fractures in any of the centers participating in the RNFC between January and October 2017. The descriptive statistics of each variable used the mean (and standard deviation) or the median (and interquartile ranges) for the ordinal variables and the percentage for the categoric variables. A descriptive analysis of the casemix was performed and compared with available data from the aforementioned studies. RESULTS: The RNFC included 7.208 patients from 54 hospitals, with a mean age of 86.7 (SD 5.6) years; 75.4% were women, and 36.4% showed cognitive decline. Mean surgical delay was 75.7 (SD 63.6) hours, and length of stay averaged 10.9 (SD 6.7) days. Of the patients who lived at home (75.4%), less than half (37.0%) returned home at discharge. One-month mortality was 7.1%. Comparison with other studies showed important differences, especially regarding patients newly sent to nursing homes (7.7-29.4%) and with antiosteoporotic treatment at discharge (14.5-36.7%). CONCLUSIONS: The RNFC is the largest prospective database to date that offers data regarding the characteristics of patients hospitalized for hip fractures in Spain. Comparison with recent studies showed some important differences.
OBJETIVO: El Registro Nacional de Fracturas de Cadera (RNFC) es un registro español multicéntrico, prospectivo y continuo, que comenzó en 2017. El objetivo de este artículo fue presentar los datos del primer informe anual y compararlos con los registros autonómicos y los estudios multicéntricos realizados recientemente en España. METODOS: Se incluyeron las personas de 75 años o más atendidas con el diagnóstico de fractura de cadera por fragilidad en alguno de los hospitales participantes en el RNFC, entre enero y octubre de 2017. En el análisis estadístico se utilizó la media y desviación estándar o mediana y rangos intercuartílicos para las variables numéricas y los porcentajes para las variables categóricas. Se realizó un análisis descriptivo global de la casuística y se comparó con los datos disponibles de los estudios previos mencionados. RESULTADOS: Se registraron 7.208 personas de 54 hospitales, con una edad media de 86,7 años (DE 5,6). El 75,4% fueron mujeres y el 36,4% presentaron deterioro cognitivo previo. La demora quirúrgica media fue de 75,7 horas (DE 63,6) y la estancia media fue de 10,9 días (DE 6,7). De las personas que vivían en un domicilio antes de la fractura (75,4%), menos de la mitad (37,0%) volvieron a él tras el alta hospitalaria. Al mes, había fallecido el 7,1%. La comparación con los otros estudios mostró algunas diferencias importantes, sobre todo en la ubicación previa, en el porcentaje de pacientes institucionalizados de novo (7,7-29,4%) y en el porcentaje con tratamiento antiosteoporótico al alta (14,5-36,7%). CONCLUSIONES: El RNFC es la mayor base de datos prospectiva que aporta datos sobre el perfil de los pacientes hospitalizados por fractura de cadera en España. La comparación con otros estudios recientes muestra algunas diferencias importantes.
Asunto(s)
Fracturas de Cadera , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Fijación de Fractura/estadística & datos numéricos , Anciano Frágil , Fracturas de Cadera/diagnóstico , Fracturas de Cadera/epidemiología , Fracturas de Cadera/rehabilitación , Fracturas de Cadera/cirugía , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Estudios Prospectivos , Sistema de Registros , España , Tiempo de Tratamiento/estadística & datos numéricosRESUMEN
Background: The Spanish National Hip Fracture Registry (or Registro Nacional de Fractura de Cadera, RNFC) is a database of hip fracture patients admitted to Spanish hospitals. Its goals include assessment and continuous improvement of the care process. Objectives: To (1) establish a series of indicators, (2) evaluate their initial fulfillment, (3) propose quality standards, (4) suggest recommendations to facilitate standards compliance, and (5) monitor the indicators. Method: The indicators fulfilled the criteria of (1) evaluating the process or outcome, (2) being clinically relevant for patients, (3) being modifiable through changes in healthcare practice, and (4) being considered important by the RNFC participants. The first quartile obtained by the group of hospitals in each of the respective variables was proposed as the standard. The Indicators Advisory Committee (IAC) elaborated a list of recommendations for each indicator, based on the available evidence. Results: Seven indicators were chosen. These indicators (its baseline compliance vs. the standard to be reached, respectively) were: the proportion of patients receiving surgery within 48h (44% vs. 63%), mobilized the first postoperative day (56% vs. 86%), with antiosteoporotic medication at discharge (32% vs. 61%), with calcium supplements at discharge (46% vs. 77%), with vitamin D supplements at discharge (67% vs. 92%), who developed pressure ulcers during hospitalization (7.2% vs. 2.1%) and with independent mobility at 30 days (58% vs. 70%). The IAC has established 25 recommendations for improving care. Conclusion: The indicators and standards chosen are presented, as well as the list of recommendations. This process completes the first step to improve quality of care. The results will be evaluated 6 months after implementing the recommendations
Antecedentes: El Registro Nacional de Fractura de Cadera (RNFC) es una base de datos de pacientes con fractura de cadera ingresados en hospitales españoles. Entre sus objetivos se encuentran el conocimiento y la mejora continua del proceso asistencial. Objetivos: 1) establecer una serie de indicadores, 2) evaluar su cumplimiento inicial, 3) proponer unos estándares, 4) sugerir recomendaciones para facilitar el cumplimiento de los estándares y 5) realizar una monitorización de los indicadores. Método: Los indicadores cumplían los criterios de: 1) evaluar proceso o resultados, 2) tener relevancia clínica para los pacientes, 3) ser potencialmente modificables mediante cambios en la práctica asistencial y 4) ser considerados importantes por los participantes del RNFC. Se propuso como estándar el primer cuartil obtenido por el grupo de hospitales en cada una de las variables respectivas. El Comité de Indicadores (CI) elaboró una lista de recomendaciones basadas en la evidencia disponible. Resultados: Se eligieron 7 indicadores. Estos indicadores (con su grado de cumplimiento inicial vs. el estándar a alcanzar, respectivamente) fueron la proporción de pacientes intervenidos en menos de 48h (44 vs. 63%), levantados el primer día del postoperatorio (56 vs. 86%), con tratamiento anti-osteoporótico al alta (32 vs. 61%), con tratamiento de calcio al alta (46 vs. 77%), con tratamiento de vitamina D al alta (67 vs. 92%), que desarrollaron úlceras por presión durante la hospitalización (7,2 vs. 2,1%) y con movilidad independiente a los 30 días (58 vs. 70%). El CI ha establecido una serie de 25 recomendaciones para la mejora asistencial. Conclusión: Se presentan los indicadores y estándares elegidos, así como las recomendaciones. Este proceso completa el primer paso de mejora de calidad asistencial, cuyo resultado deberá ser evaluado tras 6 meses de implementación de las recomendaciones elegidas
Asunto(s)
Humanos , Anciano , Fracturas de Cadera/cirugía , Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud/normas , Sistema de Registros , EspañaRESUMEN
BACKGROUND: The Spanish National Hip Fracture Registry (or Registro Nacional de Fractura de Cadera, RNFC) is a database of hip fracture patients admitted to Spanish hospitals. Its goals include assessment and continuous improvement of the care process. OBJECTIVES: To (1) establish a series of indicators, (2) evaluate their initial fulfillment, (3) propose quality standards, (4) suggest recommendations to facilitate standards compliance, and (5) monitor the indicators. METHOD: The indicators fulfilled the criteria of (1) evaluating the process or outcome, (2) being clinically relevant for patients, (3) being modifiable through changes in healthcare practice, and (4) being considered important by the RNFC participants. The first quartile obtained by the group of hospitals in each of the respective variables was proposed as the standard. The Indicators Advisory Committee (IAC) elaborated a list of recommendations for each indicator, based on the available evidence. RESULTS: Seven indicators were chosen. These indicators (its baseline compliance vs. the standard to be reached, respectively) were: the proportion of patients receiving surgery within 48h (44% vs. 63%), mobilized the first postoperative day (56% vs. 86%), with antiosteoporotic medication at discharge (32% vs. 61%), with calcium supplements at discharge (46% vs. 77%), with vitamin D supplements at discharge (67% vs. 92%), who developed pressure ulcers during hospitalization (7.2% vs. 2.1%) and with independent mobility at 30 days (58% vs. 70%). The IAC has established 25 recommendations for improving care. CONCLUSION: The indicators and standards chosen are presented, as well as the list of recommendations. This process completes the first step to improve quality of care. The results will be evaluated 6 months after implementing the recommendations.
Asunto(s)
Fracturas de Cadera/cirugía , Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud/normas , Anciano , Humanos , Sistema de Registros , EspañaRESUMEN
In this work, an isotactic polypropylene (PP) and a polyethylene-octene copolymer (POE) have been blended and injection-molded, obtaining solids and foamed samples with a relative density of 0.76. Different mold temperature and injection temperature were used. The Izod impact strength was measured. For solids, higher mold temperature increased the impact resistance, whereas in foams, the opposite trend was observed. In order to understand the reasons of this behavior, the morphology of the elastomeric phase, the crystalline morphology and the cellular structure have been studied. The presence of the elastomer near the skin in the case of high mold temperature can explain the improvement produced with a high mold temperature in solids. For foams, aspects as the elastomer coarsening in the core of the sample or the presence of a thicker solid skin are the critical parameters that justify the improved behavior of the materials produced with a lower mold temperature.
RESUMEN
Hip fracture registries have helped improve quality of care and reduce variability, and several audits exist worldwide. The results of the Spanish National Hip Fracture Registry are presented and compared with 13 other national registries, highlighting similarities and differences to define areas of improvement, particularly surgical delay and early mobilization. INTRODUCTION: Hip fracture audits have been useful for monitoring current practice and defining areas in need of improvement. Most established registries are from Northern Europe. We present the results from the first annual report of the Spanish Hip Fracture Registry (RNFC) and compare them with other publically available audit reports. METHOD: Comparison of the results from Spain with the most recent reports from another ten established hip fracture registries highlights the differences in audit characteristics, casemix, management, and outcomes. RESULTS: Of the patients treated in 54 hospitals, 7.208 were included in the registry between January and October 2017. Compared with other registries, the RNFC included patients ≥ 75 years old; in general, they were older, more likely to be female, had a worse prefracture ambulation status, and were more likely to have extracapsular fractures. A larger proportion was treated with intramedullary nails than in other countries, and spinal anesthesia was most commonly used. With a mean of 75.7 h, Spain had by far the longest surgical delay, and the lowest proportion of patients mobilized on the first postoperative day (58.5%). Consequently, development of pressure ulcers was high, but length of stay, mortality, and discharge to home remained in the range of other audits. CONCLUSIONS: National hip fracture registries have proved effective in changing clinical practice and our understanding of patients with this condition. Such registries tend to be based on an internationally recognized common dataset which would make comparisons between national registries possible, but variations such as age inclusion criteria and follow-up are becoming evident across the world. This variation should be avoided if we are to maximize the comparability of registry results and help different countries learn from each other's practice. The results reported in the Spanish RNFC, compared with those of other countries, highlight the differences between countries and detect areas of improvement, particularly surgical delay and early mobilization.
Asunto(s)
Fracturas de Cadera/terapia , Fracturas Osteoporóticas/terapia , Factores de Edad , Anciano , Anciano de 80 o más Años , Anestesia/métodos , Bases de Datos Factuales , Ambulación Precoz/estadística & datos numéricos , Europa (Continente) , Femenino , Fijación de Fractura/métodos , Fijación de Fractura/normas , Fracturas de Cadera/epidemiología , Humanos , Internacionalidad , Tiempo de Internación/estadística & datos numéricos , Masculino , Auditoría Médica/métodos , Persona de Mediana Edad , Fracturas Osteoporóticas/epidemiología , Calidad de la Atención de Salud , Sistema de Registros , España/epidemiología , Tiempo de TratamientoRESUMEN
In this paper the concept and design of an integrated optical device featuring evanescent field sensing and spectrometric analysis is presented. The device, termed integrated optics sensing spectrometer (IOSS), consists of a modified arrayed waveguide grating (AWG) which arms are engineered into two sets having different focal points. Half of the arms are exposed to the outer media, while the other half are left isolated, thus the device can provide both sensing and reference spectra. Two reference designs are provided for the visible and near-infrared wavelengths, aimed at the determination of the concentration of known solutes through absorption spectroscopy.
RESUMEN
OBJETIVO: El Registro Nacional de Fracturas de Cadera (RNFC) es un registro español multicéntrico, prospectivo y continuo, que comenzó en 2017. El objetivo de este artículo fue presentar los datos del primer informe anual y compararlos con los registros autonómicos y los estudios multicéntricos realizados recientemente en España. MÉTODOS: Se incluyeron las personas de 75 años o más atendidas con el diagnóstico de fractura de cadera por fragilidad en alguno de los hospitales participantes en el RNFC, entre enero y octubre de 2017. En el análisis estadístico se utilizó la media y desviación estándar o mediana y rangos intercuartílicos para las variables numéricas y los porcentajes para las variables categóricas. Se realizó un análisis descriptivo global de la casuística y se comparó con los datos disponibles de los estudios previos mencionados. RESULTADOS: Se registraron 7.208 personas de 54 hospitales, con una edad media de 86,7 años (DE 5,6). El 75,4% fueron mujeres y el 36,4% presentaron deterioro cognitivo previo. La demora quirúrgica media fue de 75,7 horas (DE 63,6) y la estancia media fue de 10,9 días (DE 6,7). De las personas que vivían en un domicilio antes de la fractura (75,4%), menos de la mitad (37,0%) volvieron a él tras el alta hospitalaria. Al mes, había fallecido el 7,1%. La comparación con los otros estudios mostró algunas diferencias importantes, sobre todo en la ubicación previa, en el porcentaje de pacientes institucionalizados de novo (7,7-29,4%) y en el porcentaje con tratamiento antiosteoporótico al alta (14,5-36,7%). CONCLUSIONES: El RNFC es la mayor base de datos prospectiva que aporta datos sobre el perfil de los pacientes hospitalizados por fractura de cadera en España. La comparación con otros estudios recientes muestra algunas diferencias importantes
OBJECTIVE: The Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera or RNFC) is a Spanish, prospective, multi-centric registry, commenced in 2017. The goal of this paper is to present the data from the first annual report and to compare them with autonomic registries and recent prospective multi-centric studies performed in Spain. METHODS: We included persons 75 years or older treated for fragility hip fractures in any of the centers participating in the RNFC between January and October 2017. The descriptive statistics of each variable used the mean (and standard deviation) or the median (and interquartile ranges) for the ordinal variables and the percentage for the categoric variables. A descriptive analysis of the casemix was performed and compared with available data from the aforementioned studies. RESULTS: The RNFC included 7.208 patients from 54 hospitals, with a mean age of 86.7 (SD 5.6) years; 75.4% were women, and 36.4% showed cognitive decline. Mean surgical delay was 75.7 (SD 63.6) hours, and length of stay averaged 10.9 (SD 6.7) days. Of the patients who lived at home (75.4%), less than half (37.0%) returned home at discharge. One-month mortality was 7.1%. Comparison with other studies showed important differences, especially regarding patients newly sent to nursing homes (7.7-29.4%) and with antiosteoporotic treatment at discharge (14.5-36.7%). CONCLUSIONS: The RNFC is the largest prospective database to date that offers data regarding the characteristics of patients hospitalized for hip fractures in Spain. Comparison with recent studies showed some important differences
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Fracturas de Cadera/diagnóstico , Fracturas de Cadera/epidemiología , Fracturas de Cadera/rehabilitación , Fracturas de Cadera/cirugía , Estudios de Seguimiento , Fijación de Fractura/estadística & datos numéricos , Anciano Frágil , Hospitalización/estadística & datos numéricos , Estudios Prospectivos , Sistema de Registros , España , Tiempo de Tratamiento/estadística & datos numéricosRESUMEN
Because of the demand for advanced measurement systems in the field of modern photonic integrated circuits, optical frequency domain reflectometry (OFDR) is a robust technique for characterizing design-to-fabrication deviations. In this paper we report an OFDR device where the interferometric part is monolithically integrated along with the device under test. We discuss the advantages in terms of compactness and performance, and the importance of the incorporated dispersion de-embedding mechanism. Experimental validation is carried out by interrogating an arrayed waveguide grating on a silicon nitride platform. The results establish the proposed device as a first step in the quest for a universal test structure for integrated devices.
RESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Hipoglucemia/complicaciones , Neoplasias Pleurales/diagnóstico , Nódulo Pulmonar Solitario/diagnóstico , Biomarcadores de Tumor/análisis , Biopsia con Aguja FinaRESUMEN
Objective: To ascertain the current situation and clinical variability of the provision of care for Hip Fracture (HF) in Spain and the factors related to it by using a National Registry (NHFR) with high patient numbers and territorial representation NHFR, and to compare results on a national and international level and propose standards and criteria to improve healthcare quality. Design: Continuous registry for at least three years of a representative sample of patients admitted to Spanish hospitals due to HF using the Minimum Common Dataset - international Fragility Fracture Network (FFN) MCD, adapted for Spanish. Study scope and subjects: all patients over the age of 74 years who are hospitalized with a diagnosis of a fragility HF at the participating hospitals distributed throughout the Spanish territory. Initially 48 hospitals are included, and we expect to incorporate the highest number of sites possible. Results: It is expected to ascertain the current situation of provision of care for HF in Spain. Each hospital will be offered information regarding their results and their situation compared to the rest. The results from national hospitals will be compared to others included in the registry and to hospitals abroad, which use the same database. Variability will be studied, care standards will be established, and objectives will be proposed for the continuous improvement of the care process of this condition
Objetivo: Conocer la situación actual y la variabilidad clínica del proceso asistencial a la Fractura de Cadera (FC) en España y los factores relacionados con la misma mediante la utilización de un Registro Nacional (RNFC) con elevada casuística y representación territorial RNFC, así como comparar resultados en el ámbito nacional e internacional y proponer estándares y criterios para mejorar la calidad asistencial. Diseño: Registro continuo durante al menos tres años de una muestra representativa de los pacientes ingresados por FC en los hospitales españoles mediante el Minimum Common Dataset - MCD internacional de la Fragility Fracture Network (FFN) adaptado al castellano. Ámbito y sujetos del estudio: se incluirán todos los pacientes mayores de 74 años hospitalizados con el diagnóstico de FC por fragilidad en los hospitales participantes repartidos por el territorio español. Inicialmente están incluidos 48 hospitales, a los que se espera que se vayan incorporando el mayor número posible de centros. Resultados: Se pretende conocer la situación actual de la atención a este proceso en España Se ofrecerá a cada hospital la información de sus resultados y su situación en relación al resto, se compararán los resultados de los hospitales nacionales entre sí y con los hospitales extranjeros incluidos en registros que usan la misma base de datos. Se estudiará la variabilidad, se establecerán estándares asistenciales y se plantearán objetivos para la mejora continua del proceso en la atención a esta patología