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This study, conducted in France, sought to describe the organization of the content of the social representations that high school students in transition construct of work and their own future, taking into account two variables: their type of secondary school and the anticipated length of their post-secondary education. For this purpose, 669 adolescents enrolled at three types of secondary schools (middle school, general high school, and vocational high school) were given two free-association tasks (with the inducers "work" and "your future"). Prototypical analyses for each of the variables considered were carried out on the corpus of words collected. The results highlight the place occupied by money and post-secondary education in the set of representations and the advantage of taking into account the subjective variable "anticipated length of post-secondary education" to better understand the role that contemporary uncertainties play. Thus, students who do not plan to pursue higher studies seem more worried about their future than others. On the theoretical level, the article notably highlights the benefit of integrating certain concepts developed in social psychology along with studies developed in the field of career guidance. In terms of practice, finally, it argues for a better integration of anticipations in the support aimed at helping students plan their transitions.

Background Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability.Objectives To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact.Methods Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity.Results 3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for ‘Practice activation.’ A sample between 60–90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for ‘Practice activation’ and ‘Harm burden’ but showed excellent fit after reducing the response categories.Conclusion The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-than-expected test-rest reliability merits further examination .

Resumen: Objetivo: Evaluar el valor de la prestación de servicios de diálisis concertada frente a la hospitalaria para el tratamiento de la enfermedad renal crónica en España mediante la metodología de análisis de decisión multicriterio. Método: Se utilizó el marco de evaluación EVIDEM (Evidence and Value: Impact on Decision Making) para el cálculo del valor estimado de ambos modelos de prestación de la diálisis (concertada vs. hospitalaria) mediante un taller virtual en el que participaron diferentes perfiles: directivos y gestores, profesionales y responsables de unidades y representantes de pacientes y familiares. Las puntuaciones se combinaron mediante un modelo lineal aditivo, que combinó la ponderación del modelo con la puntuación individual de los criterios, y cada valor se transformó a una escala entre el 0 y 1. Resultados: La estimación del valor para la diálisis concertada fue de 0,29 (DE: ±0,2) y de 0,39 (DE: ±0,2) para la diálisis hospitalaria. Todos los perfiles otorgaron un mayor valor a la hemodiálisis hospitalaria. El mayor valor para la diálisis hospitalaria fue de los pacientes (0,44); el menor valor medio fue de los directivos (0,36) y el rango para la diálisis concertada estuvo entre los pacientes (0,31) y los cargos intermedios (0,27). Conclusiones: La hemodiálisis hospitalaria obtuvo un mayor valor que la diálisis concertada. En general, los panelistas afirmaron que resulta un ejercicio útil e interesante y que, en cierta medida, aporta seguridad en la toma de decisiones, ya que permite ordenar, racionalizar y considerar, de manera explícita y transparente, los diferentes criterios involucrados. Abstract: Objective: To evaluate the value of the provision of contracted versus hospital dialysis services for the treatment of chronic kidney disease in Spain using the multicriteria decision analysis methodology. Method: The EVIDEM (Evidence and Value: Impact on Decision Making) evaluation framework was used to calculate the estimated value of both dialysis delivery models (arranged vs. hospital) through a virtual workshop in which different profiles participated: directors and managers, professionals and heads of units and representatives of patients and relatives. The scores were combined using an additive lineal model, which combined the weight of the model with the individual score of the criteria, and each value was transformed to a scale between 0 and 1. Results: The estimated value for arranged dialysis was 0.29 (DS: ±0.2) and 0.39 (DS: ±0.2) for hospital dialysis. All profiles gave a higher value to hospital hemodialysis compared to contracted hemodialysis. The highest value for hospital dialysis was for patients (0.44), with the lowest mean value for directors (0.36) and the range for arranged dialysis being between patients (0.31) and intermediate positions (0.27). Conclusions: Hospital hemodialysis obtained a higher value than concerted dialysis. In general, the panelists affirmed that it is a useful and interesting exercise and that, to a certain extent, it provides security in decision-making, since it allows ordering, rationalizing and considering, in an explicit and transparent manner, the different criteria involved.

Objective: To evaluate the value of the provision of contracted versus hospital dialysis services for the treatment of chronic kidney disease in Spain using the multicriteria decision analysis methodology. Method: The EVIDEM (Evidence and Value: Impact on Decision Making) evaluation framework was used to calculate the estimated value of both dialysis delivery models (arranged vs. hospital) through a virtual workshop in which different profiles participated: directors and managers, professionals and heads of units and representatives of patients and relatives. The scores were combined using an additive lineal model, which combined the weight of the model with the individual score of the criteria, and each value was transformed to a scale between 0 and 1. Results: The estimated value for arranged dialysis was 0.29 (DS: ±0.2) and 0.39 (DS: ±0.2) for hospital dialysis. All profiles gave a higher value to hospital hemodialysis compared to contracted hemodialysis. The highest value for hospital dialysis was for patients (0.44), with the lowest mean value for directors (0.36) and the range for arranged dialysis being between patients (0.31) and intermediate positions (0.27). Conclusions: Hospital hemodialysis obtained a higher value than concerted dialysis. In general, the panelists affirmed that it is a useful and interesting exercise and that, to a certain extent, it provides security in decision-making, since it allows ordering, rationalizing and considering, in an explicit and transparent manner, the different criteria involved. Resumen: Objetivo: Evaluar el valor de la prestación de servicios de diálisis concertada frente a la hospitalaria para el tratamiento de la enfermedad renal crónica en España mediante la metodología de análisis de decisión multicriterio. Método: Se utilizó el marco de evaluación EVIDEM (Evidence and Value: Impact on Decision Making) para el cálculo del valor estimado de ambos modelos de prestación de la diálisis (concertada vs. hospitalaria) mediante un taller virtual en el que participaron diferentes perfiles: directivos y gestores, profesionales y responsables de unidades y representantes de pacientes y familiares. Las puntuaciones se combinaron mediante un modelo lineal aditivo, que combinó la ponderación del modelo con la puntuación individual de los criterios, y cada valor se transformó a una escala entre el 0 y 1. Resultados: La estimación del valor para la diálisis concertada fue de 0,29 (DE: ±0,2) y de 0,39 (DE: ±0,2) para la diálisis hospitalaria. Todos los perfiles otorgaron un mayor valor a la hemodiálisis hospitalaria. El mayor valor para la diálisis hospitalaria fue de los pacientes (0,44); el menor valor medio fue de los directivos (0,36) y el rango para la diálisis concertada estuvo entre los pacientes (0,31) y los cargos intermedios (0,27). Conclusiones: La hemodiálisis hospitalaria obtuvo un mayor valor que la diálisis concertada. En general, los panelistas afirmaron que resulta un ejercicio útil e interesante y que, en cierta medida, aporta seguridad en la toma de decisiones, ya que permite ordenar, racionalizar y considerar, de manera explícita y transparente, los diferentes criterios involucrados.

Abstract Background INES (INteractive model for Extrapolation of Survival and cost) provides an open-access tool powered by R that implements three-state partitioned survival models (PSM). This article describes the properties of the tool, and the situations where INES may or may not be suitable. Methods INES is designed to be used by investigators or healthcare professionals who have a good grasp of the principles of economic evaluation and understand the strengths and weaknesses of partitioned survival models, but are not sufficiently familiar with a statistical package such as Excel or R to be able to construct and test a de-novo PSM themselves. INES is delivered to the user via a batch file. Once downloaded to the user’s hard drive, it interacts with the user via a portable version of R with web interactivity built in Shiny. INES requires absolutely no knowledge of R and the user does not need to have R or any of its dependences installed. Hence the user will deal with a standalone Shiny app. Inputs (digitalized survival curves, unit costs, posology, hazard ratios, discount rate) can be uploaded from a template spreadsheet. Results The INES application provides a seamlessly integrated package for estimating a set of parametric hazard functions for progression free and overall survival, selecting an appropriate function from this menu, and applying this as an input to a PSM to calculate mean costs and quality-adjusted life years. Examples are given that may serve as a tutorial. Conclusion INES offers a rapid, flexible, robust and transparent tool for parametric survival analysis and calculating a PSM that can be used in many different contexts.

BackgroundAdverse events in the primary care setting result in a direct cost equivalent to at least 2.5% of total healthcare spending. Across OECD countries, they lead to more than seven million avoidable hospital admissions annually. In this manuscript, we describe the protocol of a trial aimed at evaluating the effectiveness of SinergiAPS (a patient-centered audit and feedback intervention) in reducing avoidable hospital admission and explore the factors that may affect its implementation.MethodsWe will conduct a 24-month, parallel, open-label, multicenter, pragmatic, hybrid type 1 randomized clinical trial. 118 primary healthcare centers with wide geographical distribution in Spain will be randomly assigned (ratio 1:1) to two groups. The intervention group will receive two audits (baseline and intermediate at 12 months) based on information collected through the administration of the PREOS-PC questionnaire (a measure of patient-reported patient safety) to a convenience sample of 100 patients per center. The intervention group will receive reports on the results of both audits, along with educational resources aimed at facilitating the design and implementation of safety improvement plans. The control group will receive care as usual. The primary outcome will be the rate of avoidable hospitalizations (administrative data). Secondary outcomes: patient-reported patient safety experiences and outcomes (PREOS-PC questionnaire); patient safety culture as perceived by professionals (MOSPSC questionnaire); adverse events reported by healthcare professionals (ad hoc questionnaire); the number of safety improvement actions which the re has implemented (ad hoc questionnaire). Outcome data will be collected at baseline and 24 months follow-up. For the evaluation of the implementation of the SinergiAPS intervention, we will draw on the Consolidated Framework for Implementation Research (CFIR). We will collect and analyze qualitative and quantitative data (30 individual interviews, implementation logbooks; questionnaires for professionals from intervention centers, and level of use of the SinergiAPS web tool).DiscussionThis study will expand the scarce body of evidence existing regarding the effects and implementation of interventions aimed at promoting patient and family engagement in primary healthcare, specifically for enhancing patient safety. The study has the potential to produce an impact on clinical practice, healthcare systems, and population health.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05958108?term=sinergiAPS&rank=1 (NCT05958108).

Resumen: Introducción: La enfermedad renal crónica representa un importante problema de salud, tanto por su elevada incidencia y prevalencia, como por su importante morbimortalidad y coste socioeconómico. Objetivo: Comparar la efectividad y consecuencias económicas de la diálisis concertada frente a la diálisis hospitalaria. Metodología: Revisión de alcance, para lo cual se consultaron diferentes bases de datos, mediante términos controlados y libres. Se incluyeron aquellos artículos que comparasen la diálisis concertada frente a la hospitalaria en términos de efectividad. Igualmente, se incluyeron aquellas publicaciones que comparasen, en el ámbito español, el coste entre ambas modalidades de prestación de servicios y las tarifas de precios públicos de las diferentes Comunidades Autónomas. Resultados: En esta revisión se incluyeron 11 artículos: ocho sobre comparación de la efectividad, todos ellos en EE. UU. y tres sobre costes. Se observó una mayor tasa de hospitalización en aquellos centros concertados, pero no se observaron diferencias en mortalidad. Además, una mayor competencia entre proveedores se asoció a menores tasas de hospitalización. Los estudios de costes revisados muestran que la hemodiálisis hospitalaria es más costosa que en centros concertados, debido a los costes de estructura. Los datos de las tarifas públicas de las diferentes Comunidades Autónomas muestran una amplia heterogeneidad en el pago de los conciertos. Conclusiones: La coexistencia en España de centros públicos y concertados, la variabilidad en la prestación y costes de las técnicas de diálisis y la escasa evidencia sobre la efectividad de la externalización del tratamiento ponen de manifiesto la necesidad de seguir potenciando estrategias que redunden en una mejora de la atención a la enfermedad renal crónica. Abstract: Introduction: Chronic kidney disease represents an important health problem, due to its high incidence and prevalence, as well as its significant morbidity and mortality and socioeconomic cost. Aims: Compare the effectiveness and economic consequences of outsourcing versus hospital dialysis. Method: A scoping review, for which different databases were consulted, using controlled and free terms. Those articles that compared concerted versus in hospital dialysis in terms of effectiveness were included. Likewise, those publications that compared, in the Spanish field, the cost between both modes of service provision and the public price rates of the different Autonomous Communities were included. Results: 11 articles were included in this review: 8 on comparison of effectiveness, all of them in the USA, and 3 on costs. A higher rate of hospitalization was observed in subsidized centers, but no differences in mortality were observed. Additionally, greater competition among providers was associated with lower hospitalization rates. The cost studies reviewed show that hospital hemodialysis is more expensive than in subsidized centers, due to the structural costs. The data of the public rates of the different Autonomous Communities show a wide heterogeneity in the payment of the concerts. Conclusions: The coexistence in Spain of public and subsidized centers, the variability in the provision and costs of dialysis techniques, and the low of evidence on the effectiveness of outsourcing treatment show all the need to continue promoting strategies that result in improvement in the care for chronic kidney disease.

Introduction: Chronic kidney disease represents an important health problem, due to its high incidence and prevalence, as well as its significant morbidity and mortality and socioeconomic cost. Aims: compare the effectiveness and economic consequences of outsourcing versus hospital dialysis. Method: A scoping review, for which different databases were consulted, using controlled and free terms. Those articles that compared concerted versus in hospital dialysis in terms of effectiveness were included. Likewise, those publications that compared, in the Spanish field, the cost between both modes of service provision and the public price rates of the different Autonomous Communities were included. Results: 11 articles were included in this review: 8 on comparison of effectiveness, all of them in the USA, and 3 on costs. A higher rate of hospitalization was observed in subsidized centers, but no differences in mortality were observed. Additionally, greater competition among providers was associated with lower hospitalization rates. The cost studies reviewed show that hospital hemodialysis is more expensive than in subsidized centers, due to the structural costs. The data of the public rates of the different Autonomous Communities show a wide heterogeneity in the payment of the concerts. Conclusions: the coexistence in Spain of public and subsidized centers, the variability in the provision and costs of dialysis techniques, and the low of evidence on the effectiveness of outsourcing treatment show all the need to continue promoting strategies that result in improvement in the care for Chronic Kidney Disease. Resumen: Introducción: La enfermedad renal crónica representa un importante problema de salud, tanto por su elevada incidencia y prevalencia, como por su importante morbimortalidad y coste socioeconómico. Objetivo: Comparar la efectividad y consecuencias económicas de la diálisis concertada frente a la diálisis hospitalaria. Metodología: Revisión de alcance, para lo cual se consultaron diferentes bases de datos, mediante términos controlados y libres. Se incluyeron aquellos artículos que comparasen la diálisis concertada frente a la hospitalaria en términos de efectividad. Igualmente, se incluyeron aquellas publicaciones que comparasen, en el ámbito español, el coste entre ambas modalidades de prestación de servicios y las tarifas de precios públicos de las diferentes Comunidades Autónomas. Resultados: En esta revisión se incluyeron 11 artículos: 8 sobre comparación de la efectividad, todos ellos en EEUU y 3 sobre costes. Se observó una mayor tasa de hospitalización en aquellos centros concertados, pero no se observaron diferencias en mortalidad. Además, una mayor competencia entre proveedores se asoció a menores tasas de hospitalización. Los estudios de costes revisados muestran que la hemodiálisis hospitalaria es más costosa que en centros concertados, debido a los costes de estructura. Los datos de las tarifas públicas de las diferentes Comunidades Autónomas muestran una amplia heterogeneidad en el pago de los conciertos. Conclusiones: la coexistencia en España de centros públicos y concertados, la variabilidad en la prestación y costes de las técnicas de diálisis y la escasa evidencia sobre la efectividad de la externalización del tratamiento ponen de manifiesto la necesidad de seguir potenciando estrategias que redunden en una mejora de la atención a la Enfermedad Renal Crónica.

BackgroundThe use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population?ObjectiveTo describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic.MethodsScoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included.ResultsSixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data.ConclusionsConsistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.

Scientific production is experiencing exponential growth, making it essential for professionals and the academic community to possess tools and skills for efficiently retrieving relevant information. To address this need, information must be reformulated into answerable questions, with the PICO format (an acronym for Patient, Intervention, Comparison, and Outcome) proving particularly useful. Utilizing this framework will facilitate the identification of critical elements within our question and serve as a guide throughout the information retrieval process, aiding in the development and structuring of search strategies. This paper outlines the principles for formulating questions using the PICO format to enhance the efficacy of literature searches. [ABSTRACT FROM AUTHOR]

IJCLab has been leading the development and deployment of low-β Superconducting Radio Frequency (SRF) cavities for proton and heavy ion accelerators. We are launching an electron accelerator project for sustainable Energy Recovery Linac (iSAS/PERLE) with state-of-the-art SRF cavities at 800MHz. Our proposal includes advanced heat treatment of such cavities to reach an excellent quality factor of 3 × 1010 at 22 MV/m. In this paper, we overview the status of this activity.

The Human Phenotype Ontology (HPO)-a standardized vocabulary of phenotypic abnormalities associated with 7000+ diseases-is used by thousands of researchers, clinicians, informaticians and electronic health record systems around the world. Its detailed descriptions of clinical abnormalities and computable disease definitions have made HPO the de facto standard for deep phenotyping in the field of rare disease. The HPO's interoperability with other ontologies has enabled it to be used to improve diagnostic accuracy by incorporating model organism data. It also plays a key role in the popular Exomiser tool, which identifies potential disease-causing variants from whole-exome or whole-genome sequencing data. Since the HPO was first introduced in 2008, its users have become both more numerous and more diverse. To meet these emerging needs, the project has added new content, language translations, mappings and computational tooling, as well as integrations with external community data. The HPO continues to collaborate with clinical adopters to improve specific areas of the ontology and extend standardized disease descriptions. The newly redesigned HPO website (www.human-phenotype-ontology.org) simplifies browsing terms and exploring clinical features, diseases, and human genes.

Abstract Background The lack of transparency in the methodology of unit cost estimation and the usage of confidential or undisclosed information prevents cost comparisons and makes the transferability of the results across countries difficult. The objective of this article is to compare the methodologies used in the estimation of the cost of a day case cataract extirpation that are described in the official and publicly available sources and to study how these translate into different unit cost estimates. Methods A literature review was conducted to identify the main sources of unit costs of cataract extirpation. A semi-structured questionnaire to obtain information on national costing methodologies was developed and sent to consortium partners in nine European countries. Additionally, publicly available sources of unit cost of cataract surgery in those countries included in the European Healthcare and Social Cost Database (EU HCSCD) were analysed. Results The findings showed a considerable diversity across countries on unit costs varying from 432.5€ in Poland (minor degree of severity) to 3411.96€ in Portugal (major degree of severity). In addition, differences were found in the year of cost publication and on the level of detail of different types of cataract surgery. The unit of activity were Diagnosis-Related Groups in all countries except Slovenia. All unit costs include direct costs and variable overheads (except Germany where nursing costs are financed separately). Differences were identified in the type of fixed overheads included in unit costs. Methodological documents explaining the identification, measurement and evaluation of resources included in the unit costs, as well as use of appropriate cost drivers are publicly available only in England, Portugal and Sweden. Conclusions We can conclude that while unit costs of cataract extirpation are publicly available, the information on methodological aspects is scarce. This appears to pose a significant problem for cross-country comparisons of costs and transferability of results from one country to another.

Abstract Introduction Costs are one of the critical factors for the transferability of the results in health technology assessment and economic evaluation. The objective is to develop a cost database at the European level to facilitate cross-border cost comparisons in different settings and explains the factors that lead to differences in healthcare costs in different countries, taking into account the differences between health systems and other factors. Methodology The core of the database is compounded of three main categories (primary resources, composite goods and services, and complex processes and interventions) organized into 13 subcategories. A number of elements providing as detailed information of unit cost as possible were identified in order to mitigate the problem of comparability. Consortium partners validated both the database structure and selected costing items. Results Twenty-seven costing items included in the EU HCSCD resulted in 1450 unit costs when taking into account all item subtypes and countries. Cross-country differences in costs are driven by the type of resources included in the costing items (e.g., overhead costs in case of complex processes and interventions) or by the variety of existing brands and/or models and the type of unit value in most of the primary resources. Conclusion The EU HCSCD is the only public unit healthcare and social cost database at European level that gather data on unit costs and explains differences in costs across countries. Its maintenance and regular data updating will enable establishing specific systems for generating and recording information that will meet many of its current limitations.

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Deep phenotyping has been defined as the precise and comprehensive analysis of phenotypic abnormalities in which the individual components of the phenotype are observed and described. The three components of the Human Phenotype Ontology (HPO; www.human-phenotype-ontology.org) project are the phenotype vocabulary, disease-phenotype annotations and the algorithms that operate on these. These components are being used for computational deep phenotyping and precision medicine as well as integration of clinical data into translational research. The HPO is being increasingly adopted as a standard for phenotypic abnormalities by diverse groups such as international rare disease organizations, registries, clinical labs, biomedical resources, and clinical software tools and will thereby contribute toward nascent efforts at global data exchange for identifying disease etiologies. This update article reviews the progress of the HPO project since the debut Nucleic Acids Research database article in 2014, including specific areas of expansion such as common (complex) disease, new algorithms for phenotype driven genomic discovery and diagnostics, integration of cross-species mapping efforts with the Mammalian Phenotype Ontology, an improved quality control pipeline, and the addition of patient-friendly terminology.