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Introduction: Spain is one of the leading countries in the application of proactive and personalised telecare to help support frail and vulnerable service users to live independently in their own homes for longer*. Concern was however noted regarding potential impacts on ambulance mobilisations as time in the service, and mean age at cessation, increased by 1.3 years. Aims, Objectives, Theory and Methods: The purpose of this study was to investigate these impacts. A longitudinal study of a telecare service user population in Spain (n=202.1k to 247.9k) was undertaken using anonymised operational data collected in the delivery of proactive and personalised telecare services by Televida Servicios Sociosanitarios over the period 2014-18. The population was subject to change over time as new service users became eligible to register for the service, and others ceased the service. Each of these factors were also studied to assess potential confounding or covariate factors in the population also influencing the mobilisation of ambulances. Key Findings: For the studied population, ambulance mobilisation on a per-person/per-annum (pp/pa) basis reduced over the period despite the increasing age profile at cessation and with the characteristics of the population at registration remaining otherwise similar over the period. Overall mobilisations reduced by 27.9% (0.665 to 0.479 pp/pa) over the period whilst for ambulances there was a reduction of 33.3% (0.461 to 0.307 pp/pa). There were also smaller reductions in the number for family and state security mobilisations. The study identified the positive correlation coefficient between ambulance mobilisations and service user's dependency levels, and marginal negative correlation in older age bands. We are aware of no other studies which have investigated the impact on ambulance mobilisations of advanced proactive telecare and the increasing age of the services users supported to continue living independently. We believe this paper, therefore, contributes new insight which extends the existing research literature. Conclusions: The increasing age at cessation has not correlated with an increased proportion of higher dependency service users. The share of those over 85 years in the high dependency level decreased. This indicates that the changes in the telecare service contributing to increased time living independently may also have helped service users remain in lower risk bands. Limitations: There is a risk that use of mean annual measures may obscure important variations within the data. Changes in levels of proactivity, personalisation and increased use of sophisticated monitoring sensors of the telecare services are not the subject of this paper, but addressed in part in allied research. [ABSTRACT FROM AUTHOR]

This paper expands upon a session, entitled, "Special Challenges in Pediatric Drug Development," that was presented as part of a two-day meeting on Pediatric Drug Development at the International Society for Central Nervous System (CNS) Clinical Trials and Methodology (ISCTM) Autumn Conference in Boston, Massachusetts, in October 2020. Drug development in this age group is particularly important because many illnesses have their onset in this age group, many other illnesses that are more common in adults also occur in this time period, and many rare conditions that require special consideration (i.e., orphan conditions) are commonly detected in childhood as well. The special challenges addressed by our speakers in this session were cognitive and functional capacity assessment, challenges of recruitment and assessment of children for research and development of appropriate biomarkers for use in child populations, and the special challenges in training raters to address symptoms in pediatric populations. The speakers have written summaries of their talks. The session's lead chair was Philip D. Harvey, PhD, who wrote introductory and closing comments. This paper should serve as an expert-informed reference to those interested in and involved in addressing the special challenges facing those involved in CNS pediatric drug development. [ABSTRACT FROM AUTHOR]

Introduction: After several years of promoting integrated care pathways (ICP), in 2020 Osakidetza published the corporate document for the design, implementation and evaluation of corporate integrated care pathways (CICP) throughout its network of integrated care organisations (ICOs). This paper describes its elaboration, contrast and some reflections on its extension. Aims, Objectives: integrated care continues to be one of Osakidetza's strategic challenges, after having completed the integration of primary care and hospital care throughout the entire service in thirteen ICOs over the past decade. The ICPs are intended to be the operative space in which the various fundamental elements of integrated care come together. It is necessary to standardise the use of this tool in the ICOs as a whole, and to this end it was decided to draw up a reference guide for the entire network. Highlights: Definition of ICP: one of the first issues to be resolved was the concept of ICP, which is often confused with terms like clinical practice guideline, protocol, etc. The definition developed takes a dual perspective, from the professional-managerial point of view and from the point of view of the patient and their relatives. Differential elements of ICP: the proposed concept of ICP inherently entails: - agreement among all actors, including patients and relatives, - explicit description of the goals and key elements of treatments and care based on evidence, best practices and the expectations of patients and their relatives, - coordination of the care process - recording, monitoring and evaluation of variability and outcomes. Checklist: a tool is proposed to enable ICOs to assess their existing ARs and to guide the design of new ICPs. This checklist is composed of 18 questions with a Likert scale of 1 to 7 grouped into six domains: - ICP rationale, shared leadership and institutional momentum - Constitution, functioning, independence of the ICP Elaboration Group - Pathway design (scope, usability and external review) - Incorporation of evidence into the ICP Training, dissemination and implementation - Monitoring and evaluation. Conclusions: The checklist was piloted with the COPD care pathways that several ICOs had been working with previously. The usefulness of the corporate document and its checklist has been confirmed, with both the Corporate level and ICOs stating that they will use it for the design and implementation of new ICPs or for the adaptation of existing ICPs. Implications For Applicability And Limitations: one of the reflections provoked by this process is the as yet unresolved issue of extending the use of this guide to the whole of the Osakidetza's network of ICOs. There are two main alternatives, with intermediate possibilities between, depending on which criterion is given more weight: 1. Under a more centralised and standardising criterion for the creation of CICPs, the development of corporate ICPs to be implemented locally by the ICOs. 2. Under a criterion of greater autonomy for each organisation but based on common characteristics set out in this corporate guide, local ICP developed directly by each ICO. [ABSTRACT FROM AUTHOR]

This broad review summarizes recent advances and "hot" research topics in nanophononics and elastic, acoustic, and mechanical metamaterials based on results presented by the authors at the EUROMECH 610 Colloquium held on April 25–27, 2022 in Benicássim, Spain. The key goal of the colloquium was to highlight important developments in these areas, particularly new results that emerged during the last two years. This work thus presents a "snapshot" of the state-of-the-art of different nanophononics- and metamaterial-related topics rather than a historical view on these subjects, in contrast to a conventional review article. The introduction of basic definitions for each topic is followed by an outline of design strategies for the media under consideration, recently developed analysis and implementation techniques, and discussions of current challenges and promising applications. This review, while not comprehensive, will be helpful especially for early-career researchers, among others, as it offers a broad view of the current state-of-the-art and highlights some unique and flourishing research in the mentioned fields, providing insight into multiple exciting research directions. [ABSTRACT FROM AUTHOR]