BackgroundEDUCERE (“Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders”) is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school. Thirty multidisciplinary professionals and three nursery schools worked in the EDUCERE project between 2014 and 2017 and they obtained satisfactory results. Related to EDUCERE, we found studies based on providing networks of connected smart objects and the interaction between toys and social networks.ObjectiveThis research includes the design, implementation, and validation of an EDUCERE smart toy aimed to automatically detect delays in psychomotor development. The results from initial tests led to enhancing the effectiveness of the original design and deployment. The smart toy, based on stackable cubes, has a data collector module and a smart system for detection of developmental delays, called the EDUCERE developmental delay screening system (DDSS).MethodsThe pilot study involved 65 toddlers aged between 23 and 37 months (mean=29.02, SD 3.81) who built a tower with five stackable cubes, designed by following the EDUCERE smart toy model. As toddlers made the tower, sensors in the cubes sent data to a collector module through a wireless connection. All trials were video-recorded for further analysis by child development experts. After watching the videos, experts scored the performance of the trials to compare and fine-tune the interpretation of the data automatically gathered by the toy-embedded sensors.ResultsJudges were highly reliable in an interrater agreement analysis (intraclass correlation 0.961, 95% CI 0.937-0.967), suggesting that the process was successful to separate different levels of performance. A factor analysis of collected data showed that three factors, trembling, speed, and accuracy, accounted for 76.79% of the total variance, but only two of them were predictors of performance in a regression analysis: accuracy (P=.001) and speed (P=.002). The other factor, trembling (P=.79), did not have a significant effect on this dependent variable.ConclusionsThe EDUCERE DDSS is ready to use the regression equation obtained for the dependent variable “performance” as an algorithm for the automatic detection of psychomotor developmental delays. The results of the factor analysis are valuable to simplify the design of the smart toy by taking into account only the significant variables in the collector module. The fine-tuning of the toy process module will be carried out by following the specifications resulting from the analysis of the data to improve the efficiency and effectiveness of the product.

Neuro-evolutive development from birth until the age of six years is a decisive factor in a child's quality of life. Early detection of development disorders in early childhood can facilitate necessary diagnosis and/or treatment. Primary-care pediatricians play a key role in its detection as they can undertake the preventive and therapeutic actions requested to promote a child's optimal development. However, the lack of time and little specific knowledge at primary-care avoid to applying continuous early-detection anomalies procedures. This research paper focuses on the deployment and evaluation of a smart system that enhances the screening of language disorders in primary care. Pediatricians get support to proceed with early referral of language disorders. The proposed model provides them with a decision-support tool for referral actions to trigger essential diagnostic and/or therapeutic actions for a comprehensive individual development. The research was conducted by starting from a sample of 60 cases of children with language disorders. Validation was carried out through two complementary steps: first, by including a team of seven experts from the fields of neonatology, pediatrics, neurology and language therapy, and, second, through the evaluation of 21 more previously diagnosed cases. The results obtained show that therapist positively accepted the system proposal in 18 cases (86%) and suggested system redesign for single referral to a speech therapist in three remaining cases.

Abstract-This paper details the full design, implementation, and validation of an e-health service in order to improve the community health care services for patients with cognitive disorders.

Sra. Directora:La telemedicina es el uso de la telecomunicación avanzada para proveer información y servicios relacionados con el cuidado de la salud, cuya finalidad es mejorar la atención a la salud y a la calidad de vida en el domicilio del paciente. Así se podrían evitar la mayoría de los desplazamientos del paciente al hospital. Aplicada a Diálisis Peritoneal, además de lo anterior, proporcionaría al paciente una mayor seguridad en la técnica al sentirse apoyado sobre todo en situaciones de urgencia. Puede ser un complemento o sustituto del contacto telefónico con el centro. Podríamos orientar al paciente ante situaciones de líquido turbio dudoso, orificio posiblemente infectado, etc. Este proyecto se realizó en nuestra unidad de Diálisis Peritoneal con 8 pacientes, 3 hombres y 5 mujeres, con edades comprendidas entre 30 y 68 años, todos ellos videntes y autónomos. Sólo un 20% tenía alguna formación tecnológica previa. Se utilizó el equipamiento siguiente:• Hospital: un ordenador personal más VCON-Escort 25 Videoconfor: h.323 ITU Estandart, una conexión a la red (xDSL, ATM, 3RDSI) y las bases de datos de los pacientes• Domicilio paciente: TV más mando a distancia, PC más VCON-Escort 25 Videoconfor, aplicación de televisiva y conexión a la red de banda ancha. Con el uso de la telemedicina en Diálisis Peritoneal podemos:• Valorar el estado del paciente: estado general, edemas, estado del orificio peritoneal y del líquido drenado, ver como se cura el paciente por si mismo, ver la gráfica del paciente y revisar el peso y la tensión arterial • Reentrenar al paciente en cuanto a : intercambio manual, uso de cicladora, administración de medicación en bolsa, actuación ante peritonitis, presencia de sangre y fibrina en líquido, etc. Creemos que además sería de gran utilidad para la comunicación entre enfermería de atención primaria y especializada, e incluso se podría hacer un seguimiento de hospitalización en domicilio. Para valorar la eficacia del proyecto se utilizó un cuestionario de satisfacción para el paciente que medía: interacción del sistema, satisfacción del audio, satisfacción del vídeo, comodidad y necesidad de ir al hospital. Siete pacientes consideraron la interacción con el centro muy satisfactoria, en el sentido de que podían ver al médico y a la enfermera, y prefiriendo asimismo, el servicio a demanda. En cuanto al personal sanitario creen que con este sistema se podría evitar el 90 % de las visitas programadas del paciente al hospital. Por todo lo anterior podemos decir que la valoración del uso de la televisiva por parte de los pacientes y del personal sanitario ha sido muy positiva. El uso de nuevas tecnologías puede servir para facilitar un mejor control de la terapia domiciliaria que realiza el paciente, proporcionándole una mayor seguridad. Aplicación de la telemedicina en diálisis peritoneal

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