A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

Iron supply for erythropoiesis in the rabbit

Marrow radioiron uptake and marrow blood flow were measured in order to evaluate iron supply for erythropoiesis. Normal, phenylhydrazine-treated and bled animals were studied. The plasma iron turnover of seven normal rabbits was 1.49 +/- 0.22 mg/dl whole blood per d, of 11 rabbits treated 4 d before with phenylhydrazine was 5.16 +/- 1.81, and of four bled animals the plasma iron turnover was 3.75 +/- 1.61. The cardiac output and the percentage of blood flow to the marrow was increased in phenylhydrazine-treated and bled animals. Marrow iron flow in phenylhydrazine-treated animals was 38.3 +/- 32.6 micrograms/min per kg as compared with control values of 7.0 +/- 1.3 (P less than 0.01). This was due to an increase in marrow flow, an increase in plasma iron, and an increase in plasmatocrit. In bled animals, in spite of an increased marrow blood flow, marrow iron flow of 7.3 +/- 2.2 was similar to that of control animals due to a lower plasma iron concentration. The calculated marrow iron extraction of 3.7 +/- 2.4% in phenylhydrazine-treated animals was not different from that of control animals of 4.3 +/- 1.1, whereas extraction was increased in bled animals to 7.9 +/- 1.3 (P less than 0.01). In additional studies of transfused animals, acutely induced anemia was associated with an increased cardiac output, but also with a relative decrease in marrow flow, which left marrow iron supply unaffected. It would appear from these studies that an important mechanism for meeting the increased iron requirement of the hyperplastic erythroid marrow is an increase in marrow blood flow.

Un gegant del cel en perill d'extinció : socialització i divulgació de la reintroducció del voltor negre a Catalunya

La interacció de l’home amb les diferents espècies amb les quals cohabita ha creat casos com el del Voltor Negre (Aegypius monachus), l’au necròfaga més gran d’Europa, que actualment es troba en perill d’extinció. La utilització del territori per a ús antropogènic (ramaderia, xarxes elèctriques, zones urbanes,...) ha fet disminuir la població d’aquesta espècie. Així com la incursió, de manera indirecta, en aquestes poblacions degut a l’acció de l’home podem destacar-ne’n dos, el més rellevant és la intoxicació per verí, degut a l’ús il·legal d’aquestes substàncies per al control de depredadors fa que els tòxics vagin pujant per la piràmide tròfica. La segona causa rellevant és la disminució d’aliment degut a la mixomatosis i a la normativa existent d’obligatorietat de retirada dels animals morts a muntanya per sota dels 1400m. Al fer l’anàlisi de problemàtiques, s’observa que la gran majoria són antròpiques, degudes a la desinformació i al desconeixement, per tant; per a realitzar un bon pla de reintroducció és necessari fer un treball previ de socialització de les poblacions de la zona per a que el projecte sigui eficient. El projecte consisteix en fer una conscienciació social als diferents grups implicats (turisme, escoles i població; ramaders i caçadors), mitjançant documents gràfics, material educatiu, material de suport i materials i mètodes de divulgació. Per a que la vall d’Alinyà i Boumort passin a ser destacades per la presencia establerta de les quatre aus necròfagues més rellevants d’Europa; l’Aufrany, el Trencalòs, el voltor comú i el nostre protagonista: el Voltor Negre.

Color sensation in figurative painting

The figurative painter accesses very complex levels of knowledge. To produce a painting requires, first, a deep analysis of the image of the reality and, afterwards, the study of the reconstruction of this reality. This is not about a process of copying, but a process of the comprehension of the concepts that appear in the representation. The drawing guides us in the process of the production of the surface and in the distribution of the colours that, after all, are the data with which the vision mechanism builds the visual reality. Knowing the colour and its behaviour have always been a requirement for the figurative painter. From that knowledge we can draw wider conclusions.

L’Experimentació com a mètode de coneixement a l'escola primària : el cas de l'Arenal de Llevant

Aquest estudi consisteix en l’anàlisi de les practiques educatives que porta a terme una escola pública d’Educació Infantil i Primària, en relació a les estratègies d’ensenyament i aprenentatge de les ciències. Per aquest motiu, es presenta què proposa actualment la recerca educativa sobre l’ensenyament i aprenentatge de les ciències, la qual emfatitza en la necessitat de situar l’infant en el centre del seu procés educatiu, partint del seu coneixement intuïtiu, per tal que pensi, faci i comuniqui d’una manera similar a la que segueix la comunitat científica. Aquesta manera d’entendre l’educació científica és, segons els estudis actuals, condició sine qua non per a que l’alumne desenvolupi la competència científica, és a dir, aprengui ciència, aprenent com funciona la ciència i aprenent sobre la ciència. En base a aquesta teoria, s’han portat a terme observacions directes a diferents cursos, les quals s’han recollit en un diari d’observacions, per tractar d’analitzar com el centre escolar desenvolupa la pràctica educativa de les ciències en el seu dia a dia.

Desarrollo de aplicaciones móviles con herramientas del Campus UOC

El objetivo de este trabajo es implementar una herramienta segura, intuitiva y útil de dispositivo electrónico móvil para que un alumno interactúe con el entorno educativo virtual creado por el Campus de Trabajo UOC. La herramienta ayuda al alumno a trabajar con la UOC sin necesidad de conectarse directamente desde un portátil, desde cualquier lugar, siempre y cuando, se tenga conexión a Internet. El TFG está enfocado a desarrollarse en el entorno de Windows Phone.

Traducción comentada de «Management of the Clinically Positive Axilla» y «Management of the Internal Mammary Lymph Nodes», Essentials of Breast Surgery

La transmisión de conocimiento científico constituye una de las necesidades de traducción más importantes; es preciso realizar un estudio sobre la traducción del inglés médico. Este trabajo presenta una traducción inédita de fragmentos de Essentials of Breast Surgery y un análisis de esta jerga mediante un glosario y problemas de traducción.

How to redesign a virtual library website: a case study

This abstract presents how we redesigned, with user-centred design methods, the way we organize and present the content on the UOC Virtual Library website. The content is now offered in a way that is more intuitive, usable and easy to understand, based on criteria of customization, transparency and proximity.The techniques used to achieve these objectives included benchmarking, interviews and focus groups during the user requirement capture phase and user tests to assess the process and results.

FOSS License Selection and Code Management

With nearly 2,000 free and open source software (FLOSS) licenses, software license proliferation¿ can be a major headache for software development organizations trying to speed development through software component reuse, as well as companies redistributing software packages as components of their products. Scope is one problem: from the Free Beer license to the GPL family of licenses to platform-specific licenses such as Apache and Eclipse, the number and variety of licenses make it difficult for companies to ¿do the right thing¿ with respect to the software components in their products and applications. In addition to the sheer number of licenses, each license carries within it the author¿s specific definition of how the software can be used and re-used. Permissive licenses like BSD and MIT make it easy; software can be redistributed and developers can modify code without the requirement of making changes publicly available. Reciprocal licenses, on the other hand, place varying restrictions on re-use and redistribution. Woe to the developer who snags a bit of code after a simple web search without understanding the ramifications of license restrictions.

Installation Information requirements in the GPLv3 and LGPLv3

One of the major changes introduced in the GPLv3 and LGPLv3 is the clause preventing "tivoisation". Richard Stallman defines Tivoisation as "the practice of designing hardware so that a modified version cannot function properly". In this presentation we will go through the reasons of why the information installation requirement was introduced, how you can comply with this requirement and why you may want to think about it now rather than later.

Forecasting tourism demand to Catalonia: neural networks vs. time series models

The increasing interest aroused by more advanced forecasting techniques, together with the requirement for more accurate forecasts of tourismdemand at the destination level due to the constant growth of world tourism, has lead us to evaluate the forecasting performance of neural modelling relative to that of time seriesmethods at a regional level. Seasonality and volatility are important features of tourism data, which makes it a particularly favourable context in which to compare the forecasting performance of linear models to that of nonlinear alternative approaches. Pre-processed official statistical data of overnight stays and tourist arrivals fromall the different countries of origin to Catalonia from 2001 to 2009 is used in the study. When comparing the forecasting accuracy of the different techniques for different time horizons, autoregressive integrated moving average models outperform self-exciting threshold autoregressions and artificial neural network models, especially for shorter horizons. These results suggest that the there is a trade-off between the degree of pre-processing and the accuracy of the forecasts obtained with neural networks, which are more suitable in the presence of nonlinearity in the data. In spite of the significant differences between countries, which can be explained by different patterns of consumer behaviour,we also find that forecasts of tourist arrivals aremore accurate than forecasts of overnight stays.

How to redesign a virtual library website: a case study

This abstract presents how we redesigned, with user-centred design methods, the way we organize and present the content on the UOC Virtual Library website. The content is now offered in a way that is more intuitive, usable and easy to understand, based on criteria of customization, transparency and proximity.The techniques used to achieve these objectives included benchmarking, interviews and focus groups during the user requirement capture phase and user tests to assess the process and results.

Quantitative developmental response to the length of exposure to long photoperiod in wheat and barley

The present study was designed to analyse the effect of the length of exposure to a long photoperiod imposed c. 3 weeks after sowing in spring wheat (cv. UQ189) and barley (cv. Arapiles) to (i) establish whether the response to the number of cycles of exposure is quantitative or qualitative, (ii) determine the existence of a commitment to particular stages well before the stage has been observable, and (iii) study the interrelationships between the effects on final leaf number and phyllochron when the stimulus is provided several days after seedling emergence. Both wheat and barley seemed to respond quantitatively to the number of long-day cycles they were exposed to. However, wheat showed a requirement of approximately 4 long-day cycles to be able to produce a significant response in time to heading. The barley cultivar used in the study was responsive to the minimum length of exposure. The response to extended photoperiod cycles during the stem elongation phase was due to the ‘ memory’ photoperiod effects being related, in the case of wheat, to the fact that the pre-terminal spikelet appearance phase saturated its photoperiod response well before that stage was reached. Therefore, the commitment to the terminal spikelet appearance in wheat may be reached well before this stage could be recognized. As the response in duration to heading exceeded that of the final leaf number, and the stem elongation phase responded to memory effects of photoperiod, the phyllochron of both cereals was responsive to the treatments accelerating the average phyllochron when exposed to longer periods of long days. The response in average phyllochron was due to a switch from bi-linear to linear models of leaf number v. time when the conditions were increasingly inductive, with the phyllochron of the initial (6–8) leaves being similar for all treatments (within each species), and from then on increased.