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- Bousquet, J. Jean, et al.
(författare)
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Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases
- 2019
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Ingår i: Clinical and Translational Allergy. - : BMC. - 2045-7022 .- 2045-7022. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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| 2. |
- Elyn, Antoine, et al.
(författare)
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End of life care practice and symptom management outcomes of nursing home residents with dementia : secondary analyses of IQUARE trial
- 2019
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Ingår i: European Geriatric Medicine. - : Springer Science and Business Media LLC. - 1878-7649 .- 1878-7657. ; 10:6, s. 947-955
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Tidskriftsartikel (refereegranskat)abstract
- Purpose End-of-life care is a central issue in nursing homes. Poor care outcomes have been reported, especially among residents with dementia. Our aim was two-fold: to assess whether the diagnosis of dementia was associated with specific patterns of care and symptom management for residents with dementia during the last 6 months of life, and to compare these patterns of care between residents with dementia who died within 6 months and those who survived longer. Methods Secondary prospective analyses of the IQUARE trial (trial registration number NCT01703689). 175 nursing homes in South West France. Residents with and without dementia at baseline (May-June 2011), stratified according to their vital status at 6-month follow-up. Results Of 6275 residents enrolled in IQUARE study (including 2688 with dementia), 494 (7.9%) died within 6 months. Compared to residents without dementia (n = 254), those with dementia (n = 240) were less likely to be self-sufficient (OR = 0.08, 95% CI 0.01-0.64). They were more likely to have physical restraints (OR = 1.65, 95% CI 1.08-2.51) and less likely to be prescribed benzodiazepines (OR = 0.58, 95% CI 0.38-0.88). Among residents with dementia, those who died during the first 6 months of follow-up were more likely to be identified with a formal end-of-life status (OR = 5.71, 95% CI 3.48-9.37) although such identification remains low with only 15% of them. They were more likely to experience pain (OR = 1.43, 95% CI 1.04-1.97) and to be physically restrained (OR = 1.46, 95% CI 1.08-1.98). However, pain relief and psychological distress management were not improved. Conclusions Poor quality indicators such as physical restraints are associated with end-of-life care for residents with dementia. Among symptom management outcomes, pain medication remains low even if pain complaint increased at life end.
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| 3. |
- Rolland, Nicolas, et al.
(författare)
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Can Mobility Negative Temperature Coefficient Be Reconciled with the Hopping Character of Transport in Conducting Polymers?
- 2019
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Ingår i: ACS APPLIED POLYMER MATERIALS. - : AMER CHEMICAL SOC. - 2637-6105. ; 1:11, s. 2833-2839
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Tidskriftsartikel (refereegranskat)abstract
- Poly(3,4-ethylenedioxythiophene) (PEDOT) is a conducting polymer that is used in a wide range of applications such as electronics, optoelectronics, and bio-electronics, where the fundamental understanding of the charge transport, and in particular of the electrical conductivity sigma, is a prerequisite to develop new high performance devices. There are many reports in the literature where the conductivity of archetypical conducting polymer PEDOT doped with tosylate (PEDOT:TOS) exhibits a dry negative temperature coefficient, d sigma/dT < 0, which is strikingly different from the activated-type behavior with d sigma/dT > 0 commonly observed in most conducting polymers. This unusual temperature dependence was attributed to the transition from the photon-assisted hopping to the metallic behavior, which is however difficult to rationalize taking into account that this transition occurs at high temperatures. In order to understand the origin of this unusual behavior, multiscale mobility calculations in PEDOT:TOS for the model of hopping transport were performed, where changes in the morphology and the density of states (DOS) with the temperature were explicitly taken into account. The morphology was calculated using the Molecular Dynamics simulations, and the hopping rates between the chains were calculated quantum-mechanically following the Miller-Abrahams formalism. Our results reproduce the observed negative temperature coefficient, where however the percolation analysis shows that this behavior mainly arises because of the changes in morphology upon heating when the system becomes less ordered. This results in a less efficient pi-pi stacking and hence lower mobility in the system. We therefore conclude that experimentally observed negative mobility temperature coefficient in conducting polymers at high temperatures is consistent with the hopping transport, and does not necessarily reflect the transition to a metallic band-like transport. Based on our multiscale modeling, we introduce a simple Gaussian Disorder Model for the efficient mobility calculations, where the DOS broadening is a function of the temperature, and where the transfer integral distribution is a bimodal distribution evolving with temperature.
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