Self-management using the CONTECI telehealth program is feasible for patients with PAD. The program promotes patient expertise, encourages proactivity, increases QoL and satisfaction with disease control, and improves health resource use, with no evidence of clinical inferiority to conventional practices.

BACKGROUND the high failure rate of innovation projects motivates to understand the perceptions about resistances and barriers of the main stakeholders to improve success rates. OBJECTIVE this study aims at analysing the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital, prior to its implementation. METHODS online, voluntary, and anonymous survey using the Normalisation MeAsure Development questionnaire (NoMAD) to gather views and perceptions among a selected group of healthcare professionals at Germans Trias i Pujol University Hospital. RESULTS all groups of professionals involved see the value of the project and are willing to enrol and support it. Respondents show the highest scores in Cognitive Participation (4.45/5) and high scores in Coherence (3.83/5) and Reflective Monitoring (3.78/5). The weakest score is in Collective Action (3,52/5). There is no statistically relevant score differences between roles along the survey. CONCLUSIONS the 3D project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation as well as to understand, assess and communicate the ways that the new set of practices affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground towards development of a more efficient health innovation system and as a catalysator for transformation.

Background The high failure rate of innovation projects motivates us to understand the perceptions about resistances and barriers of the main stakeholders to improving success rates. Objective This study aims to analyze the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital prior to its implementation. Methods We used a web-based, voluntary, and anonymous survey using the Normalization Measurement Development questionnaire (NoMAD) to gather views and perceptions from a selected group of health care professionals at Germans Trias i Pujol University Hospital. Results In this study, 58 professionals, including heads of service (n=30, 51%), doctors (n=18, 31%), nurses (n=7, 12%), and support staff (n=3, 5%), responded to the questionnaire. All groups saw the value of the project and were willing to enroll and support it. Respondents reported the highest scores (out of 5) in cognitive participation (mean 4.45, SD 0.04), coherence (mean 3.72, SD 0.13), and reflective monitoring (mean 3.80, SD 0.25). The weakest score was in collective action (mean 3.52, SD 0.12). There were no statistically significant differences in scores among professions in the survey. Conclusions The 3D printing project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation. It should also understand, assess, and communicate the ways in which the new set of practices can affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground toward the development of a more efficient health innovation system and as a catalyst for transformation.

In ACST-1, 3120 patients with severe asymptomatic carotid stenosis thought suitable for revascularization were randomly assigned to CEA or indefinite deferral of surgery. To investigate this, we analysed first asymptomatic CEA's in the surgical cohort. In a univariate logistic regression, baseline patient characteristics (age, gender, medical history, medical treatment, blood pressure, grade of stenosis, echolucency, infarction on imaging) were used to compare odds ratios for periprocedural (<30 days) stroke or death. Then, multivariate analysis was performed using risk factors with a p-value <0.3 from univariate analysis. Results: CEA was performed on a total of 1425 patients in the surgical cohort (1560 patients). In total, 42 patients (2.9%) had periprocedural death or stroke, of which most (48%) occurred on the day of surgery. In univariate analysis diastolic blood pressure >90 mmHg was the only risk factor significantly associated with periprocedural stroke or death (OR ¼ 1.90; 95% CI 1.03e3.51, p ¼ .04). Mean sBP and dBP at randomization were 154 mmHg (SD ¼ 22) and 83 mmHg (SD 11). In multivariate analysis dBP remained the only independent risk factor (OR ¼ 2.06; 95% CI 1.04e4.06, p ¼ .04). Conclusion: In ACST-1, diastolic blood pressure was the only independent risk factor for stroke or death following CEA in asymptomatic patients. This suggests that careful treatment to lower diastolic blood pressure in asymptomatic patients undergoing CEA could prevent stroke or death. This important finding is in concordance with recent evidence from symptomatic patients.