Actitudes de los pacientes de atención primaria ante los momentos finales de la vida / No disponible

Objetivo: conocer las actitudes de los pacientes de atención primaria ante su futura asistencia sanitaria en los momentos finales de la vida. Material y método: Diseño: estudio descriptivo transversal mediante encuesta. Emplazamiento: zona básica de salud urbana. Participantes:selección de 300 pacientes de atención primaria, por muestreo consecutivo no probabilístico, según el orden de citación en consulta. Mediciones principales: cuestionario anónimo autoadministrado de preguntas cerradas. Resultados: el número de respuestas fue de 131 (43%), con una media de edad de 53,3 años (DE: 17,7). El 96,1% considera útil el documento de voluntades anticipadas (DVA). El 61,9% comentaría el DVA solamente con sus seres queridos, el 13,5% con el médico únicamente, y el 24,6% con ambos. Respecto a una futura situación de incapacidad para tomar decisiones por una enfermedad grave e irreversible, el 52% cree que serían sus seres queridos quienes velarían mejor para que se respetasen sus deseos, mientras un 32,3% confía exclusivamente en el DVA. Existe una asociación estadísticamente significativa (p = 0,045) entre un más alto nivel de estudios y una mayor preferencia por morir fuera de un hospital. Conclusiones: los pacientes que han participado en la encuesta piensan que el DVA es útil, y no tienen inconveniente en hablar con su médico de la futura asistencia sanitaria en los momentos finales de su vida. Al mismo tiempo, manifiestan querer incluir en ese diálogo, y de un modo preferente, a sus seres queridos. El impacto del nivel de estudios de los pacientes sugiere que el futuro abordaje de las cuestiones acerca de los momentos finales de la vida se desarrolle de una forma asequible para quienes tienen menos formación académica (AU)

Objective: to explore attitudes towards end-of-life issues among primary-care patients. Material and method: Design: a cross-sectional descriptive study by means of a survey. Setting: an urban primary healthcare center. Participants: the survey protocol was designed so that 300 primary-care patients were selected by consecutive sampling. Main measurements: anonymous self-administered questionnaire with closed questions. Results: respondents were 43% (131/300). Mean age was 53.3 (SD17.7). Most respondents (96.1%) had a positive attitude toward the living wills document (LWD); 61.9% would deal with the LWD only with their loved ones, 13.5% with their physician, and 24.6% with both; 52% believed that their loved ones would ensure that their wishes be respected in case they became mentally handicapped later in life, and 32.3% confided exclusively in the LWD. Higher levels of education were associated with dying out of hospital (p = 0.045). Conclusions: patients find LWD useful in dealing with end-of-life issues, but prefer to implicate loved ones in making decisions. The consistent impact of education suggests that future efforts about end-of-life issues should include efforts to access elders with less education, and should include educational materials that could be readily understood by persons with lower education levels (AU)

Experimental studies of applications of time-reversal acoustics to noncoherent underwater communications.

The most difficult problem in shallow underwater acoustic communications is considered to be the time-varying multipath propagation because it impacts negatively on data rates. At high data rates the intersymbol interference requires adaptive algorithms on the receiver side that lead to computationally intensive and complex signal processing. A novel technique called time-reversal acoustics (TRA) can environmentally adapt the acoustic propagation effects of a complex medium in order to focus energy at a particular target range and depth. Using TRA, the multipath structure is reduced because all the propagation paths add coherently at the intended target location. This property of time-reversal acoustics suggests a potential application in the field of noncoherent acoustic communications. This work presents results of a tank scale experiment using an algorithm for rapid transmission of binary data in a complex underwater environment with the TRA approach. A simple 15-symbol code provides an example of the simplicity and feasibility of the approach. Covert coding due to the inherent scrambling induced by the environment at points other than the intended receiver is also investigated. The experiments described suggest a high potential in data rate for the time-reversal approach in underwater acoustic communications while keeping the computational complexity low.

Acoustic einstein-hopf drag on a bubble

Theoretical results show that the drag on a bubble can be modified by the presence of isotropic, homogeneous, broadband acoustic noise, when the band overlaps the bubble's resonance width. While these results constitute an acoustic analog to the Einstein-Hopf drag on an oscillating dipole in the presence of electromagnetic fluctuations, an important difference is that band-limited acoustic noise can reduce the drag when the lower frequency of the spectrum coincides with the resonant frequency of the bubble. Applications to bubble migration, heat transfer, and acoustophoresis are suggested.

[Risk for injuries in traffic accidents among drivers under the effect of alcohol in Navarra]. / El riesgo de lesión en accidente de tráfico por conducir bajo los efectos del alcohol en Navarra.

We conducted a retrospective analysis of the levels of alcohol in the blood of a group of 54 drivers who required hospital emergency care after having suffered a traffic accident on roads in the Health Area III of Navarra (Spain) from June to September 1989, and compared them to another group of 219 drivers, not victims of traffic accidents, submitted to the breathalyser (test of alcoholaemia) on the roads of the same Health Area over the same period of time. In the group of 54 accident victims, the median alcoholaemia was 100 mg/dl, with a quartile deviation of 88 mg/dl, and the percentage of positives (alcoholaemia equal to or greater than 80 mg/dl) was 50.9%. In the group of 219 drivers not victims of traffic accidents, the median alcoholaemia was 16 mg/dl, the quartile deviation 18.5 mg/dl and the percentage of positive alcoholaemia was 1.8%. Drivers with a level of blood alcohol equal to or greater than 80 mg/dl have an estimated risk (Odds Ratio) of being injured in a traffic accident 55.82 times higher than drivers with a lower level.