Parachute trial: on the subject of knee arthroplasties

The concept "parachute trial" has been adopted to visualize that when a treatment is really effective perhaps one should not invest money in demonstrating what everyone knows, just as no one would think to make an essay on the effectiveness of the parachute. The New England Journal of Medicine has published a clinical trial (Skou 2015) that evaluates the clinical effectiveness of knee arthroplasty, and the journalist of the magazine asks: Did it have to be done? Arthroscopic knee replacements are one of the most significant advances in modern medicine. Everyone knows that many older people who could not leave the house, invalidated by pain, now not only go out every day to the market square but they often go cruising. Seen like this, is this not a "parachute trial"? A waste?

Keep calm and leave the mobile for a while

Josep Mª Monguet

The trade fairs tend to present the technological innovations somewhat passed by the commercial magic, which puts at risk the necessary objectivity to evaluate what they will actually contribute. This is aggravated if we consider that technology is nowadays advancing much faster than human capabilities. As technological innovation progresses exponentially, the adaptive and changing capacity of individuals and organizations is logarithmic.

In general, to take advantage of the new options that technology offers, you have to know where you want to go and what to do to get there; the problem is that we just grope. The good news, however, and the fair is a good exponent, is that so many of us are doing it that the possibilities for progress don’t stop multiplying. Remember Edison when he said he had discovered 10,000 ways of not making a light bulb.

Emergency services specific to the elderly

Elderly care is best resolved at the primary care level, with a geriatric orientation and in a community setting. However, sometimes older people need to go to the emergency room for a variety of reasons, such as a fracture, fibrillation, retention, sudden choking or blockage, to name just a few reasons. What happens then is easy to imagine, the geriatric patient is subjected to a triage that leads to a box full of devices, with many people asking the same things repeatedly, some of them with very little tact and almost always with little respect for intimacy, not to mention the discomfort caused by the racking in the corridor, bells and alarms, noise from machines and monitors, and a long etcetera, that easily produces the disorientation of the elderly patient, or delirium in the worst cases.

Improving by playing

David Font

Volkswagen launched a campaign, The Fun Theory, aiming to improve habits by introducing game techniques. Let's look at an example.

Anna Sort, a nurse, a professor at several universities and an expert in gamification (a new word) in health, in her blog Lost Nurse in the Digital Era defines gamification as "the use of playing techniques in activities that initially contained no play" with the objective of involving people and solving problems. She argues that we are all potential players and that video games have introduced the game into many aspects of our lives. Mechanics such as collecting, awarding points, providing feedback, promoting exchanges or personalizing, favour motivation and involvement. The challenge is to transform any activity into fun and to make the game difficult enough for people to be enthusiastic about solving it, without finding it impossible.