Rationale, aims and objectives Given the increasing prevalence of cataract and demand for cataract extraction surgery, patients must often wait to undergo this procedure. We validated a previously developed priority scoring system in terms of clinical variables, pre-intervention health status, appropriateness of surgery and gain in visual acuity (VA) and health-related quality of life (HRQoL).Methods Explicit prioritization criteria for cataract extraction created by a variation of the Research and Development (RAND) and University of California Los Angeles appropriateness methodology were retrospectively (...) applied to a prospective cohort of 5257 patients on waiting lists to undergo cataract by phacoemulsification at 17 hospitals in Spain. Demographic data, clinical data and data related to surgical technique were collected by trained ophthalmologists. Patients were evaluated by their ophthalmologist before the intervention and 6 weeks afterward. They also completed, by mail, the Visual Function Index (VF-14) before the intervention and 3 months afterward.Results High-priority patients experienced greater improvement in VA and HRQoL than those classified as intermediate or low-priority (P < 0.0001), even after adjusting by VA and the VF-14 score at baseline. The time to intervention was the same for high-priority patients as it was for intermediate and low-priority patients.Conclusions The priority score we developed identified patients most likely to experience the greatest improvements from cataract extraction. Use of this tool could provide a fairer and more rational way to prioritize patients for cataract extraction. (shrink)

Childhood obesity, linked to a sedentary lifestyle and an unbalanced diet, is one of the main problems in today’s Western societies. In this sense, the aim of the study was to analyze students’ perceived satisfaction in physical education classes with learning strategies and engagement in learning and critical thinking as determinants of healthy lifestyle habits. The study involved 2,439 high school students aged 12–18 years (M= 14.66,SD= 1.78). Structural equation modeling was conducted to analyze the predictive relationships between the study (...) variables. The results showed that teaching, teaching mastery, and cognitive development are precursors to deep thinking on the part of students, indicators of the adoption of healthy lifestyle habits. These results reflect the importance of the methodology adopted by the teacher in order to positively influence the students’ habits. (shrink)

Etude de l'extension par la negation semi-intuitionniste de la logique positive des propositions appelee logique C, developpee par A. Urquhart afin de definir une semantique relationnelle valable pour la logique des valeurs infinies de Lukasiewicz (Lw). Evitant les axiomes de contraction et de reduction propres a la logique classique de Dummett, l'A. propose une semantique de type Routley-Meyer pour le systeme d'Urquhart (CI) en tant que celle-la ne fournit que des theories consistantes pour la completude de celui-ci.

Purpose: Performance measurement systems (PMS) in Nonprofit Organizations (NPOs) are more complex than in for-profit organizations. NPOs have an orientation towards social mission and values, and they consider not only organizational efficiency and viability, but also the social impact of the organization. This research provides a comprehensive synthesis of PMSs in NPOs. Design/methodology/approach: Using a literature review, supported by bibliometric and network analyses. A paper set of 240 articles related to this research field is examined. Topics that are the most (...) prevalent in this research area and their interrelationships are identified, presenting an outline of current efforts. Findings: Despite the descriptive analyses for the paper set, a framework is proposed for organizing the design-implementation factors of PMSs in nonprofit organizations, identifying the main requirements for their successful development. Originality/value: Investigation on performance measurement in nonprofit organizations is still in its early stages of development with many opportunities to further develop the field. Conceptual frameworks and models, as well as specific theories, are being generated for this field of research, and the process of adapting models from the general field of performance measurement is taking place. The meta-framework that organizes the main research topics of PMS in nonprofit organizations and the framework that consolidates factors that influence the design-implementation of PMSs in nonprofit organizations developed represents this paper contribution. (shrink)

Background: Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits have been shown to benefit from serious games.Aim: The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients (...) with gambling disorder. Preliminary results from a pilot sample are also reported.Method: A pilot sample of 26 patients undergoing treatment for GD was recruited. Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate and heart rate variability data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia.Results and Discussion: e-Estesia performed comparatively well for all the explored groups. Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men. (shrink)

In the graphical representation of ontologies, it is customary to use graph theory as the representational background. We claim here that the standard graph-based approach has a number of limitations. We focus here on a problem in the graph-based representation of ontologies in complex domains such as biomedical, engineering and manufacturing: lack of mereotopological representation. Based on such limitation, we proposed a diagrammatic way to represent an entity’s structure and various forms of mereotopological relationships between the entities.

Automatic control of physiological variables is one of the most active areas in biomedical engineering. This paper is centered in the prediction of the analgesic variables evolution in patients undergoing surgery. The proposal is based on the use of hybrid intelligent modelling methods. The study considers the Analgesia Nociception Index to assess the pain in the patient and remifentanil as intravenous analgesic. The model proposed is able to make a one-step-ahead prediction of the remifentanil dose corresponding to the current state (...) of the patient. The input information is the previous remifentanil dose, the ANI variable and the electromyogram signal. Modelling techniques used are Artificial Neural Networks and Support Vector machines for Regression combined with clustering methods. Both training and validation were done with a real dataset from different patients. Results obtained show the potential of this methodology to calculate the drug dose corresponding to a given analgesic state of the patient. (shrink)

Background:The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students.Objectives:To explore the ethical dilemmas and ethical conflicts experienced by final-year nursing students who worked during the first outbreak of the COVID-19 pandemic in Spain.Research design:A qualitative exploratory study was conducted using purposive sampling. Semi-structured interviews were carried out using a question guide. Interviews took place via a private video chat room platform. A thematic, inductive (...) analysis was performed of the information gathered.Participants and research context:Eighteen nursing students were recruited from two universities of Madrid, aged between 18 and 65 years old, enrolled in the fourth year of nursing studies and who were hired under a relief contract for health professionals during the pandemic.Ethical considerations:The present study was carried out in accordance with the Declaration of Helsinki, and the study was approved by the Local Ethics Committee of Universidad Rey Juan Carlos.Results:Three specific themes emerged: (a) coping with patient triage, (b) difficulties in providing end-of-life care, and (c) coping with patient death. Nursing students participated in the process of patient selection for resource allocation and ICU bed occupancy. They were shown how to care for patients who were not admitted to the ICU, in their last moments and were faced with the difficulties of applying end-of-life care. Finally, the nursing students were confronted with the death of their patients, in overwhelming numbers and under adverse conditions.Conclusions:These findings can help shed light on the ethical dilemmas and ethical conflicts faced by novice nursing students, incorporated into the workforce during the COVID-19 pandemic. Moreover, it was described that students may normalize the death due to the exhaustion and overwhelmed routine. (shrink)

In the visual representation of ontologies, in particular of part-whole relationships, it is customary to use graph theory as the representational background. We claim here that the standard graph-based approach has a number of limitations, and we propose instead a new representation of part-whole structures for ontologies, and describe the results of experiments designed to show the effectiveness of this new proposal especially as concerns reduction of visual complexity. The proposal is developed to serve visualization of ontologies conformant to the (...) Basic Formal Ontology. But it can be used also for more general applications, particularly in the biomedical domain. (shrink)

The notion that patients’ medical decision-making capacity depends on risk considerations has some acceptance in the bioethical literature. However, it arouses some criticism since it seems to give rise to paternalistic attitudes. In addition, the idea of capacity assessment as a collaborative space in which aid is given to the patient is emphasized so that they can decide about their life. It does not seem ethically acceptable to pose the evaluation as a simple observer report. Capacity assessment can sometimes be (...) impossible or inconsequential. In short, capacity assessment is a procedure that, used wisely, can allow the patient to take charge of their life. Misused, it can be the gateway to unjustified paternalistic actions. (shrink)