Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements.

Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.

Transcriptomic and lipidomic analysis of the differential pathway contribution to the incorporation of erucic acid to triacylglycerol during Pennycress seed maturation.

Thlaspi arvense (Pennycress) is an emerging feedstock for biofuel production because of its high seed oil content enriched in erucic acid. A transcriptomic and a lipidomic study were performed to analyze the dynamics of gene expression, glycerolipid content and acyl-group distribution during seed maturation. Genes involved in fatty acid biosynthesis were expressed at the early stages of seed maturation. Genes encoding enzymes of the Kennedy pathway like diacylglycerol acyltransferase1 (TaDGAT1), lysophosphatidic acid acyltransferase (TaLPAT) or glycerol 3-phosphate acyltransferase (TaGPAT) increased their expression with maturation, coinciding with the increase in triacylglycerol species containing 22:1. Positional analysis showed that the most abundant triacylglycerol species contained 18:2 at sn-2 position in all maturation stages, suggesting no specificity of the lysophosphatidic acid acyltransferase for very long chain fatty acids. Diacylglycerol acyltransferase2 (TaDGAT2) mRNA was more abundant at the initial maturation stages, coincident with the rapid incorporation of 22:1 to triacylglycerol, suggesting a coordination between Diacylglycerol acyltransferase enzymes for triacylglycerol biosynthesis. Genes encoding the phospholipid-diacylglycerol acyltransferase (TaPDAT1), lysophosphatidylcholine acyltransferase (TaLPCAT) or phosphatidylcholine diacylglycerolcholine phosphotransferase (TaPDCT), involved in acyl-editing or phosphatidyl-choline (PC)-derived diacylglycerol (DAG) biosynthesis showed also higher expression at the early maturation stages, coinciding with a higher proportion of triacylglycerol containing C18 fatty acids. These results suggested a higher contribution of these two pathways at the early stages of seed maturation. Lipidomic analysis of the content and acyl-group distribution of diacylglycerol and phosphatidyl-choline pools was compatible with the acyl content in triacylglycerol at the different maturation stages. Our data point to a model in which a strong temporal coordination between pathways and isoforms in each pathway, both at the expression and acyl-group incorporation, contribute to high erucic triacylglycerol accumulation in Pennycress.

Community Care Needs of Highly Complex Chronic Patients: An Epidemiological Study in a Healthcare Area.

One of the priorities in family and community care is the epidemiological surveillance of the care needs and dysfunctionality present in populations of highly complex chronic patients (HCCPs) using standardised nursing languages. The aim of this study is to establish the prevalence of care needs and dysfunctionality among HCCPs in a specific health area by municipalities and geographical areas (metropolitan, north, and south) while verifying correlations with sociodemographic, financial, and health characteristics. This is an epidemiological, observational, descriptive, cross-sectional study carried out with a sample of 51,374 HCCPs, whose data were grouped into 31 municipalities. Data were collected on the following variables: sociodemographic, financial, health, functional status (health patterns), and care needs (nursing diagnoses). The mean age of the HCCPs was 73.41 (1.45) years, of which 56.18 (2.86)% were women. The municipalities in the northern area have a significantly higher proportion of older patients, HCCPs, lower incomes, and higher unemployment rates. The southern area had higher proportions of non-Spanish nationals and professionals in the hotel and catering industry, and the metropolitan area had a higher proportion of employed individuals and higher levels of education. Northern municipalities had a higher prevalence of illnesses and anxiolytic and anti-psychotic treatments. Dysfunctionality frequencies did not differ significantly by area. However, a higher prevalence of 13 nursing diagnoses was observed in the north. A high number of correlations were observed between population characteristics, dysfunctionality, and prevalent diagnoses. Finally, the frequencies of dysfunctionality in the population and the most common care needs were mapped by municipality. This research sought to ascertain whether there was an unequal distribution of these two aspects among HCCPs in order to gain a deeper epidemiological understanding of them from a family and community perspective using standardised nursing languages. This study was not registered.

Continuing Bonds in grieving men: A comparative description of Costa Rica and Spain.

Continuing Bonds among grieving men from Costa Rica and Spain were compared, with the primary hypothesis that there would be significant differences between the two groups. A descriptive, comparative, and cross-sectional research study was conducted. Non-probability and convenience sampling was employed, involving 227 grieving men who completed an online questionnaire comprising sociodemographic data, mediators of mourning, and the Continuing Bonds Scale. The results did not reveal significant differences in Continuing Bonds expressions. However, upon controlling for the interaction between degree of kinship with the deceased person, notable differences emerged in Continuing Bonds and internalized and externalized Continuing Bonds (p < 0.05). The influence of sociocultural factors in each country on Continuing Bonds expressions is considered. The findings could support the development of strategies centered on grieving men, Continuing Bonds, and their specific needs.

Continuidad de vínculos en hombres que experiencian duelo por un ser querido / Continuing bonds in men grieving a loved one / Manutenção de vínculos em homens em luto por um ente querido

Objetivo: examinar la continuidad de vínculos interna y externa en hombres que experiencian duelo por un ser querido. Método: estudio correlacional, descriptivo y transversal. Muestra a conveniencia de 170 hombres dolientes. Las variables fueron mediadores del duelo, continuidad de vínculos y datos sociodemográficos. Se utilizó un cuestionario en línea compuesto por mediadores de duelo, escala de continuidad de vínculos y datos sociodemográficos. Se empleó estadística descriptiva, análisis de varianza y coeficiente de Spearman. El nivel de significancia correspondió a p<0,05. Resultados: la media de edad de los participantes fue de 36,61 años (DE=13,40), y el 80,00% tenía educación superior. Los valores medios de continuidad de vínculos interna y externa fueron 24,85 (DE=7,93) y 7,68 (DE=2,33), respectivamente. Se establecieron diferencias significativas referentes a la continuidad de vínculos interna y externa entre parentesco de la persona fallecida (p<0,001), y ninguna con la causa de muerte o con el tiempo transcurrido desde el fallecimiento. No se precisaron correlaciones significativas entre continuidad de vínculos interna/externa y mediadores del duelo. Conclusión: los hombres dolientes expresan la continuidad de vínculos interna de manera frecuente y la externa en ocasiones, con diferencias respecto a quién era la persona fallecida. La Enfermería podría diseñar estrategias específicas que fortalezcan el afrontamiento del duelo en este grupo.

Objective: to examine internalized and externalized continuing bonds in men grieving a loved one. Method: a correlational, descriptive and cross-sectional study. Convenience sample comprised by 170 mourning men. The variables were mediators of mourning, continuing bonds and sociodemographic data. The instrument used was an online questionnaire comprised by mediators of mourning, a continuing bonds scale and sociodemographic data. Descriptive statistics, analysis of variance and Spearman's coefficient were used. The significance level adopted was p<0.05. Results: the participants' mean age was 36.61 years old (SD=13.40), and 80.00% had Higher Education. The mean values corresponding to internalized and externalized continuing bonds were 24.85 (SD=7.93) and 7.68 (SD=2.33), respectively. Significant differences were established referring to internalized and externalized continuing bonds in terms of kinship with the deceased person (p<0.001), and none with the cause of death or with the time elapsed since the event. No significant correlations were defined between internalized/externalized continuing bonds and mediators of mourning. Conclusion: grieving men express internalized and externalized continuing bonds frequently and occasionally, respectively, with differences according to who the deceased person was. The Nursing discipline might devise specific strategies that strengthen coping with grief in this population group.

Objetivo: examinar a manutenção de vínculos interna e externa em homens vivenciando o luto por um ser querido. Método: estudo correlacional, descritivo e de corte transversal. Amostra de conveniência de 170 homens em luto. As variáveis foram: mediadores do luto, manutenção de vínculos e dados sociodemográficos. Utilizou-se um questionário online composto por mediadores de luto, escala de manutenção de vínculos e dados sociodemográficos. Empregou-se estatística descritiva, análise de variância e coeficiente de Spearman. Nível de significância p<0,05. Resultados: os participantes tinham uma média de idade de 36,61 anos (DP=13,40) e 80,00% tinham ensino superior. A média de manutenção interna dos vínculos foi de 24,85 (DP=7,93) e a de manutenção externa foi de 7,68 (DP=2,33). Foram estabelecidas diferenças significativas para a manutenção dos vínculos internos e externos entre os parentes do falecido (p<0,001), nenhuma com a causa da morte ou o tempo decorrido desde a morte. Não foram encontradas correlações significativas entre a manutenção dos vínculos internos e externos e os mediadores do luto. Conclusão: os homens em luto expressaram a manutenção interna dos vínculos com frequência e a manutenção externa dos vínculos ocasionalmente, com diferenças a respeito de quem era a pessoa falecida. A enfermagem poderia criar estratégias específicas para fortalecer o enfrentamento do luto nesse grupo.

Spanish cardiac catheterization and coronary intervention registry. 32nd official report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2022).

INTRODUCTION AND OBJECTIVES: This article presents the annual activity report of the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) for the year 2022. METHODS: All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company in collaboration with the members of the board of the ACI-SEC. RESULTS: A total of 111 centers participated. The number of diagnostic studies increased by 4.8% compared with 2021, while that of percutaneous coronary interventions (PCI) remained stable. PCIs on the left main coronary artery increased by 22%. The radial approach continued to be preferred for PCI (94.9%). There was an upsurge in the use of drug-eluting balloons, as well as in intracoronary imaging techniques, which were used in 14.7% of PCIs. The use of pressure wires also increased (6.3% vs 2021) as did plaque modification techniques. Primary PCI continued to grow and was the most frequent treatment (97%) in ST-segment elevation myocardial infarction. Most noncoronary procedures maintained their upward trend, particularly percutaneous aortic valve implantation, atrial appendage closure, mitral/tricuspid edge-to-edge therapy, renal denervation, and percutaneous treatment of pulmonary arterial disease. CONCLUSIONS: The Spanish cardiac catheterization and coronary intervention registry for 2022 reveals a rise in the complexity of coronary disease, along with a notable growth in procedures for valvular and nonvalvular structural heart disease.

Beyond scientific and technical training: Assessing the relevance of empathy and assertiveness in future physiotherapists: A cross-sectional study.

Background and Aims: Empathy and assertiveness are two essential social skills for a health professional such as a physiotherapist and are necessary for developing moral thinking. Previous studies show that the development of empathy and other social skills improves as students progress in their studies. However, other authors show deterioration of empathy as students progress in their studies and acquire clinical experience. Training in soft skills, such as assertiveness, among health science students will have an impact on the quality of patient care. Effective communication, conflict resolution and the ability to work as part of a team are competencies that have been put to one side as a result of the recent COVID-19 pandemic and it is important to resume training students in soft skills. The objective of this study is to investigate to determine the empathic and assertive state of physiotherapy university students. Methods: A descriptive cross-sectional study of physiotherapy university students was conducted in the 2022/2023 academic year. The Interpersonal Reactivity Index (IRI) scales for empathy and the Rathus test for assertiveness (RAS) were used as study tools. Finally, 127 students participated in the study, 52.91% of the total population of physiotherapy students. The questionnaire was available for 4 weeks in November and December 2022. Results: The empathetic and assertive development of the students was found to be acceptable. Significant differences were also observed according to the gender variable in the students, with female students presenting better results (p = 0.01). Students who are working or have clinical experience in other professions score lower on the empathy personal distress subscale (p < 0.001). Conclusion: Future research should be considered to help improve clinical and professional expertise in physiotherapy students about empathic and assertive development. The findings provide new evidence on the levels of empathy and assertiveness in physiotherapy students.

Continuing bonds in men grieving a loved one. / Continuidad de vínculos en hombres que experiencian duelo por un ser querido.

OBJECTIVE: to examine internalized and externalized continuing bonds in men grieving a loved one. METHOD: a correlational, descriptive and cross-sectional study. Convenience sample comprised by 170 mourning men. The variables were mediators of mourning, continuing bonds and sociodemographic data. The instrument used was an online questionnaire comprised by mediators of mourning, a continuing bonds scale and sociodemographic data. Descriptive statistics, analysis of variance and Spearman's coefficient were used. The significance level adopted was p<0.05. RESULTS: the participants' mean age was 36.61 years old (SD=13.40), and 80.00% had Higher Education. The mean values corresponding to internalized and externalized continuing bonds were 24.85 (SD=7.93) and 7.68 (SD=2.33), respectively. Significant differences were established referring to internalized and externalized continuing bonds in terms of kinship with the deceased person (p<0.001), and none with the cause of death or with the time elapsed since the event. No significant correlations were defined between internalized/externalized continuing bonds and mediators of mourning. CONCLUSION: grieving men express internalized and externalized continuing bonds frequently and occasionally, respectively, with differences according to who the deceased person was. The Nursing discipline might devise specific strategies that strengthen coping with grief in this population group. (1) It was usual to continue the bond with the deceased loved one. (2) The expression of internalized continuing bonds was frequent after the death. (3) When facing the loss, there was occasional expression of externalized continuing bonds. (4) There were differences in internalized and externalized continuing bonds according to kinship. (5) There were no associations between continuing bonds and mediators of mourning.

Continuidad de vínculos, hombres y mujeres en duelo por un ser querido: un análisis secundario / Continuing bonds, men, and women in bereavement: A secondary analysis

Introducción: El duelo es una respuesta compleja ante la pérdida de un ser querido que exhibe diferentes rutas para su ajuste, la continuidad de vínculos forma parte de su naturaleza. Objetivo: Analizar la experiencia de duelo por un ser querido en hombres y mujeres relacionada a percepción de cercanía con la persona fallecida, continuidad de vínculos y diagnósticos de Enfermería. Materiales y Métodos: Análisis secundario. Muestra a conveniencia de 251 dolientes, adultos, residentes de Canarias, hispanohablantes. Recolección con encuesta en línea compuesta por características sociodemográficas y de salud, y relacionadas con la pérdida, Escala de inclusión del otro en el yo, Escala de Continuidad de Vínculos y diagnósticos de Enfermería. Se utilizó análisis descriptivo, U de Mann-Whitney, coeficiente de Spearman. Nivel de significancia p<0,05. Resultados: Edad media de 45,09 años ±10,38. Un 22,70% (57) fue hombre, 77,30% (194) mujer. Se identificaron diferencias significativas entre hombres y mujeres en percepción de cercanía con el fallecido (p<0,05), y relaciones significativas entre percepción de cercanía con el fallecido, continuidad de vínculos y diagnósticos de Enfermería (p=0,001). Discusión: Al confrontar los resultados con otros estudios se presentan algunas consistencias y diferencias en el comportamiento de las variables demostrando el dinamismo del fenómeno. Conclusiones: Para este grupo de participantes, la experiencia de duelo no estaría ligada a construcciones sociales de género si no que contesta a una respuesta de afrontamiento según sus necesidades. La comprensión del proceso de duelo permite a la Enfermería de Salud Mental implementar acciones fundamentadas en el Proceso de Enfermería.

Introduction: Grief is a complex response to the loss of a loved one with different ways of adjustment, and Continuing Bonds are part of its nature. Objective: To analyze men's and women's experiences of grief in terms of perception of closeness to the deceased, Continuing Bonds, and Nursing diagnoses. Materials and Methods: Secondary analysis. A convenience sample of 251 Spanish-speaking adult mourners, residents of the Canary Islands, was used. Data was collected via an online survey consisting of socio-demographic, health, and loss-related characteristics, the Inclusion of Other in the Self scale, the Continuing Bonds Scale, and Nursing diagnoses. Descriptive analysis, Mann-Whitney U test, and Spearman's coefficient were used. Level of significance p<0.05. Results: The mean age was 45.09 years ±10.38 years; 22.70% (57) were male, and 77.30% (194) were female. Significant differences were found between men and women in the perception of closeness to the deceased (p<0.05), and significant relationships were found between the perception of closeness to the deceased, Continuing Bonds, and Nursing diagnoses (p=0.001). Discussion: A comparison of the results with other studies shows some consistencies and differences in the behavior of the variables, demonstrating the dynamism of the phenomenon. Conclusions: For this group of participants, the experience of grief would not be linked to social constructions of gender but instead respond to a coping response according to their needs. Understanding the grieving process allows Mental Health Nursing to implement interventions based on the Nursing Process.

Introdução: O luto é uma resposta complexa à perda de um ente querido que apresenta diferentes caminhos de ajustamento, a continuidade dos laços faz parte da sua natureza. Objetivo: Analisar a vivência do luto por um ente querido em homens e mulheres relacionada à percepção de proximidade com a pessoa falecida, continuidade de vínculos e diagnósticos de Enfermagem. Materiais e Métodos: Análise secundária. Amostra para conveniência de 251 enlutados, adultos, residentes nas Ilhas Canárias, falantes de espanhol. Coleção com inquérito online composto por características sociodemográficas e de saúde, e relacionadas à perda, Escala de inclusão do outro no eu, Escala de Continuidade de Vínculos e diagnósticos de Enfermagem. Foram utilizadas análise descritiva, U de Mann-Whitney, coeficiente de Spearman. Nível de significância p<0,05. Resultados: Idade média de 45,09 anos ±10,38. 22,70% (57) eram homens, 77,30% (194) eram mulheres. Foram identificadas diferenças significativas entre homens e mulheres na percepção de proximidade com o falecido (p<0,05), e relações significativas entre percepção de proximidade com o falecido, continuidade de vínculos e diagnósticos de Enfermagem (p=0,001). Discussão: Ao comparar os resultados com outros estudos, apresentam-se algumas consistências e diferenças no comportamento das variáveis, demonstrando o dinamismo do fenômeno. Conclusões: Para este grupo de participantes, a vivência do luto não estaria ligada a construções sociais de género, mas responde a uma resposta de enfrentamento de acordo com as suas necessidades. A compreensão do processo de luto permite à Enfermagem em Saúde Mental implementar ações pautadas no Processo de Enfermagem.

Knowledge of Diabetic Retinopathy among Primary Care Nurses Performing Fundus Photography and Agreement with Ophthalmologists on Screening.

Diabetic retinopathy (DR) is one of the complications of diabetes mellitus (DM), with macular oedema being one of the leading causes of avoidable blindness among individuals with DM worldwide. Fundus screening is the only method for early detection and treatment. High-quality training programmes for professionals performing primary care screening are essential to produce high-quality images that facilitate accurate lesion identification. This is a two-phase observational, descriptive, and cross-sectional study. The first phase analysed DR knowledge in a sample of nurses. The second phase explored agreement on DR screening between referral ophthalmologists in image assessment (gold standard) and a small group of nurses involved in the previous phase. In phase 1, the agreement rate for screening results was 90%. In phase 2, the overall raw agreement on the screening of fundus photography results between nurses and ophthalmologists was 75% (Cohen's kappa = 0.477; p < 0.001). Agreement on screening with ophthalmologists was moderate, suggesting that implementing a specific training programme for nurse-led imaging screening would help develop this competence among nurses, ensuring a good level of agreement and patient safety and adding value for users, and also for the sustainability of the healthcare system. This study was not registered.

Consequences of the COVID-19 Pandemic on Child Development: An Integrative Literature Review / Consecuencias en el desarrollo infantil derivadas de la pandemia por covid-19: revisión integrativa de literatura / Consequências no desenvolvimento infantil derivadas da pandemia de COVID-19: revisão integrativa da literatura

Introduction: The COVID-19 pandemic reduced the possibilities of generating stimulating spaces for children's development, as all the systems with which a child interacts during this phase were affected. Objective: To identify the existing scientific evidence about the effects on child development in children aged less than 5 years old that were living with their parents while the social distancing measures adopted due to COVID-19 were in force. Method: An integrative review guided by the framework proposed by Whittemore and Knafl and the PRISMA statement, to consult the following databases: Medline, ScienceDirect, Scopus and SciELO, with a search performed in English using these descriptors: "child development," "growth and development," "parenting," "teleworking," "infant care," "home nursing," "social isolation," "coronavirus infections," and "COVID-19." The eligibility criteria were as follows: quantitative or qualitative studies that addressed the direct effects of the pandemic on children aged less than 5 years old; in turn, the exclusion criteria corresponded to articles with a population comprised of children with diagnosed developmental disorders or disabilities. Results: A total of 17 articles were included, whose findings were classified into the following categories: Exposure to risk stimuli, Deprivation of stimuli, and Exposure to protective stimuli. It is revealed that parental stress, absence of games and lower exposure to interactions that promote development are connected to changes in cognitive, emotional, and learning processing, in addition to exerting a negative impact on motor and language development. Conclusion: The evidence suggests that social distancing can be the main cause for the onset of delays in child development, in its motor, language, cognitive, and socioemotional areas.

Introducción: la pandemia por la covid-19 disminuyó las posibilidades de generar espacios estimulantes para el desarrollo de los niños, puesto que todos los sistemas con los que interactúa un niño en desarrollo se vieron impactados. Objetivo: identificar la evidencia científica que hay sobre los efectos en el desarrollo infantil en menores de 5 años que convivieron con sus padres y madres durante las medidas de distanciamiento social tomadas por causa de la covid-19. Método: revisión integrativa guiada por el marco propuesto por Whittemore y Knafl, y The Prisma Statement, para consultar las bases de datos: Medline, ScienceDirect, Scopus y Scielo, con una búsqueda realizada en inglés, utilizando los descriptores: "child development", "growth and development", "parenting", "teleworking", "infant care", "home nursing", "social isolation", "coronavirus infections", "COVID-19". Los criterios de elegibilidad: estudios cuantitativos o cualitativos que abordaran los efectos directos de la pandemia en niños menores de 5 años; y de exclusión: artículos con población de niñez con trastornos del desarrollo diagnosticados o discapacidad. Resultados: fueron incluidos 17 artículos, cuyos hallazgos se clasifican en las categorías: exposición a estímulos de riesgo, privación de estímulos y exposición a estímulos protectores. Se revela que el estrés parental, la ausencia de juego y una menor exposición a interacciones promotoras del desarrollo se vinculan con alteraciones en el procesamiento cognitivo, emocional y de aprendizaje, y tuvieron un impacto negativo en el desarrollo motriz y del lenguaje. Conclusión: la evidencia sugiere que el distanciamiento social puede ser la causa principal en la aparición de retrasos en el desarrollo infantil, en sus áreas: motriz, de lenguaje, cognitivo y socioemocional.

Introdução: a pandemia de COVID-19 diminuiu as possibilidades de criar espaços estimulantes para o desenvolvimento das crianças, uma vez que todos os sistemas com os quais uma criança em desenvolvimento interage foram afetados. Objetivo: identificar a evidência científica sobre os efeitos no desenvolvimento infantil das crianças com menos de 5 anos que viveram com os pais durante as medidas de distanciamento social adoptadas devido à pandemia de COVID-19. Método: revisão integrativa orientada pelo quadro proposto por Whittemore e Knafl, e The PRISMA Statement, para consultar as seguintes bases de dados: Medline, ScienceDirect, Scopus e SciELO, com uma pesquisa efetuada em inglês, utilizando os descritores: "child development", "growth and development", "parenting", "teleworking", "infant care", "home nursing", "social isolation", "coronavirus infections", "COVID-19". Critérios de elegibilidade: estudos quantitativos ou qualitativos que abordem os efeitos diretos da pandemia em crianças com menos de 5 anos de idade; e critérios de exclusão: artigos com uma população de crianças com distúrbios de desenvolvimento diagnosticados ou deficiência. Resultados: foram incluídos 17 artigos, cujos resultados se enquadram nas categorias: exposição a estímulos de risco, privação de estímulos e exposição a estímulos protetores. Verificou-se que o stress parental, a ausência de brincadeiras e a menor exposição a interações de apoio ao desenvolvimento estavam associados a alterações no processamento cognitivo, emocional e de aprendizagem, e tinham um impacto negativo no desenvolvimento motor e da linguagem. Conclusão: os dados sugerem que o distanciamento social pode ser a principal causa de atrasos no desenvolvimento da criança nas áreas motora, linguística, cognitiva e socioemocional.

Psychosocial Care Needs, Personality Styles, and Coping Strategies of Mourners in a Rural Municipality in Spain: An Observational Study.

Grieving is a natural, self-limiting process of adaptation to a new reality following a significant loss, either real or perceived, with a wide range of manifestations that have an impact on the health of the grieving individual. This study aims to analyse the relationships between interpersonal styles, coping strategies, and psychosocial care needs in a sample of mourners in a rural municipality. Initial hypothesis: there are associations between types of grief and psychosocial needs, as well as between types of grief and interpersonal styles or coping strategies. An observational, descriptive, analytical, cross-sectional study was carried out with a sample of 123 people. Female participants represented 64.2% of all participants. The mean age was 42.7 (±13.2) years, and 86.2% of participants reported continuing to suffer from the loss, with a 10.5% prevalence of maladaptive grieving. Regarding the associations identified between coping strategies and the interpersonal characteristics of the mourners, we found that those with the best coping scores described themselves as self-confident, boastful, jovial, forceful, gentle-hearted, self-assured, outgoing, and/or neighbourly. By contrast, mourners who obtained poorer coping scores self-identified as shy, unsparkling, timid, unsociable, unbold, and/or bashful. This provides a clinical profile linked to maladaptive grieving in which emotional, self-perception, and social problems are prevalent.

Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia.

(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia were recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: five language dimensions explained 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen's κ: 0.9; p < 0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen's κ: 0.6; p < 0.001), and concordances of up to 96% (Cohen's κ: 0.9; p < 0.001) using NOC indicators. The internal consistency (Cronbach's alpha) was 0.98. Reliability tests revealed test-retest concordances of 76-100% (p < 0.001). (4) Conclusions: the CEECCA is an easy-to-use, valid, and reliable instrument to assess the ability to communicate among individuals with aphasia.

Knowledge, Perceptions, and Practices on Risks and Disasters Among Medical Students. A Multicenter Cross-Sectional Study in 9 Latin American and Caribbean Countries.

Purpose: The objective of this study was to describe the level of knowledge, perceptions, and practices in relation to risks and disasters in medical schools in Latin America and the Caribbean. Participants and Methods: Multicenter, observational, analytical, non-probabilistic convenience sample study with 2546 medical students in 9 countries of Latin America and the Caribbean. An online survey was conducted between October 2020 and November 2020, using an instrument validated in each country to assess knowledge, perceptions, and practices regarding risk and disaster prevention measures. Frequencies, percentages, mean and standard deviation (SD) were used for descriptive analysis. Differences resulting from the relationship between the variables studied and the level of knowledge were obtained using the Chi-square test. P-value <0.05 was accepted as statistically significant for all analyses. Results: The highest proportion of responses came from women, third-semester students, and those studying in public universities. Students from Colombia and Honduras had the highest percentage of high levels of knowledge about disasters, while Peruvian students had the highest percentage of low levels of knowledge. Women and students from public universities showed a higher proportion of high levels of knowledge. 52.7% considered that they live in a country with a medium risk of natural disasters, while 91.2% said that Latin American and Caribbean countries are not prepared to face natural disasters. Only 43.6% believe they are prepared to help in the event of a natural disaster. Conclusion: Most of medical students from Latin America and Latin America and the Caribbean have high and medium level of knowledge in risks and disasters. However, the implementation of disaster training programs for medical students has the potential to improve the preparedness, knowledge, and skills that are important for medical personnel to improve their self-confidence, and their ability to respond, resulting in more effective systems.

Nursing Diagnoses, Planned Outcomes and Associated Interventions with Highly Complex Chronic Patients in Primary Care Settings: An Observational Study.

The information logged by nurses on electronic health records (EHRs) using standardised nursing languages can help us identify the characteristics of highly complex chronic patients (HCCP) by focusing on care in terms of patients' health needs. The aim of this study was to describe the profile of HCCPs using EHRs from primary care (PC) facilities, presenting patients' characteristics, functional status based on health patterns, NANDA-I nursing diagnoses, health goals based on Nursing Outcomes Classification (NOC), and care interventions using Nursing Interventions Classification (NIC). With an observational, descriptive, cross-sectional, epidemiological study design, this study was carried out with a sample of 51,374 individuals. The variables were grouped into sociodemographic variables, clinical variables, resources, functional status (health patterns), nursing diagnoses, outcomes, and interventions. A total of 57.4% of the participants were women, with a mean age of 73.3 (12.2), and 51% were frail or dependent. Prevalent conditions included high blood pressure (87.2%), hyperlipidaemia (80%), osteoarthritis (67.8%), and diabetes (56.1%). The participants were frequent users of healthcare services, with 12.1% admitted to hospital in the past year. Some 49.2% had one to four health patterns assessed, with more information on biological and functional aspects than on psychosocial aspects. The mean number of nursing diagnoses was 7.3 (5.2), NOC outcomes 5.1 (4.1), and NIC interventions 8.1 (6.9). Moderately and highly significant differences were observed between dysfunction in physical activity/exercise health pattern and age group, and between dysfunction in other health patterns and classification as a frail or dependent elderly person. Regarding the presence of certain nursing diagnoses, significant differences were observed by age group, classification of elderly person status, and presence of diseases. A total of 20 NIC interventions showed moderately or relatively strong associations for older age groups, higher levels of dependency, and chronic health conditions.

Resultados de la cirugía bariátrica en pacientes obesos internados en el Hospital Nacional de Itauguá / Results of bariaric surgery in obese patients admitted to Itauguá National Hospital

Introducción: La obesidad es la segunda causa de muerte susceptible de prevención. El tratamiento quirúrgico es el único tratamiento eficaz y demostrado para pacientes con obesidad grave (índice de masa corporal > 40 kg/m²). Las operaciones bariátricas prolongan la supervivencia y corrigen las enfermedades asociadas con la obesidad grave. Objetivos: Caracterizar los resultados de la cirugía bariátrica en pacientes obesos internados en el Hospital Nacional de Itauguá de marzo a diciembre del año 2019. Materiales y métodos: Estudio observacional, descriptivo de corte transversal, retrospectivo con muestreo no probabilístico a conveniencia. Se incluyeron pacientes de ambos sexos, mayores a 16 años con obesidad sometidos a cirugía bariátrica en el Servicio de Cirugía General del Hospital Nacional de Itauguá. Resultados: Se incluyeron a 24 pacientes, cuyo promedio de peso fue de 117,5 kg y un promedio del IMC de 43,5. El 67% presentó obesidad grado III y el 70% un ASA III. La técnica quirúrgica empleada con mayor frecuencia fue gastrectomía vertical en manga laparoscópica. El promedio de pérdida de exceso de peso post quirúrgico a los 12 meses fue de 56,4 kg. La estancia hospitalaria post quirúrgico en promedio fue de 48 horas. En el 96% de los casos no se presentaron complicaciones. Conclusión: El resultado de nuestro estudio sugiere que la cirugía bariátrica ha demostrado ser una alternativa con excelentes resultados para el tratamiento de la obesidad, mejorando así no solo patologías clínicas crónicas sino también la calidad de vida del paciente.

Introduction: Obesity is the second cause of death susceptible to prevention. Surgical treatment is the only effective and proven treatment for severely obese patients (body mass index > 40 kg/m²). Bariatric operations prolong survival and correct diseases associated with severe obesity. Objectives: To determine the short-term and long-term results of bariatric surgery in obese patients admitted to the National Hospital of Itauguá from March to December 2019. Materials and methods: Observational, descriptive cross-sectional, retrospective study with non-probabilistic sampling at convenience. We included patients of both sexes, over 16 years of age with obesity who underwent bariatric surgery and were admitted to the General Surgery Service of the Hospital Nacional de Itauguá in 2019. Results: Twenty-four patients were followed up in the study, with an average weight of 117.5 kg and a mean BMI of 43.5. 67% presented with grade III obesity and 70% with ASA III. The most frequently used surgical technique was vertical gastrectomy in the laparoscopic sleeve. The average postoperative weight loss at 12 months was 56.4 kg. The average postoperative hospital stay was 48 hours. There were no complications in 96% of cases. Conclusion: The result of our study suggests that bariatric surgery has proven to be an alternative with excellent results for the treatment of morbid obesity, , thus improving not only chronic clinical pathologies but also the quality of life of the patient with increased life expectancy.

Esplenectomía laparoscópica en pacientes adultos con enfermedades hematológicas en el servicio de cirugía general del Hospital Nacional de Itauguá

Introducción: La esplenectomía es una opción terapéutica para una variedad de patologías hematológicas. La cirugía laparoscópica ha tomado ventaja y, actualmente, se ha convertido en el abordaje estándar en pacientes sometidos a esplenectomía de forma electiva para patologías hematológicas. Objetivo: Evaluar las indicaciones, condiciones generales y complicaciones intraoperatorias más frecuentes en pacientes adultos con enfermedades hematológicas, sometidos a esplenectomía laparoscópica. Materiales y métodos: Estudio descriptivo, retrospectivo de corte longitudinal con muestreo no probabilístico de casos consecutivos. Se realizó revisión de expedientes clínicos de todos los pacientes con patología esplénica que fueron sometidos a esplenectomía laparoscópica con intención curative. Resultados: El estudio comprendió a 10 pacientes con una media de edad de 47 años. El tiempo de operación fue de 215 ±60 minutos; el ASA score de 3; los días de internación fueron de 14 días en promedio y la pérdida de sangre estimada en mililitros fue de 213 ±366. Siete pacientes requirieron cirugía laparoscópica, cuatro de ellos finalizaron sin complicaciones, mientras que tres requirieron conversión a cirugía convencional. Se identificó bazo accesorio en 1 paciente. Las indicaciones para la esplenectomía han sido púrpura trombocitopénica idiopática; síndromes linfoproliferativos; síndrome de Felty; anemia hemolítica autoimmune y anemia hemolítica no autoimmune. Discusión: La esplenectomía continúa siendo un procedimiento útil para numerosas patologías hematológicas. Se debe tener en cuenta la necesidad de realizar las vacunaciones y profilaxis antibiótica correspondientes, además de contar con el equipo quirúrgico entrenado en técnicas convencionales como en laparoscópicas.

Introduction: muscle strength may decrease in patients with chronic kidney failure due to various causes. Objective: to determine the anthropometric and clinical variables and muscle strength in adult patients with chronic kidney failure. Methodology: an observational, descriptive, cross-sectional design was applied. Men and women, older than 17 years, with chronic kidney failure who attended the National Hospital (Itauguá) and Military Hospital (Asunción), Paraguay, between April and November 2021 were included. Anthropometric, clinical and laboratory variables were determined. Muscle strength was measured with a hand dynamometer. A group of healthy young subjects was used for the comparison of muscle strength. Descriptive statistics were applied with the statistical program Epi Info 7 ™. The research was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: 119 subjects entered the study, being 62 (52%) males with a mean age 56 ± 15 years and 57 (48%) females, with a mean age 51 ± 16 years. The mean creatinine clearance was 16.4 ± 17.9 mL / min. The most common etiology was the association of arterial hypertension and diabetes mellitus (45%). The healthy group included 99 women with a mean age 25 ± 5 years and 51 men with a mean age 26 ± 5 years. When comparing strength between patients and healthy subjects, 66.4% decreased muscle strength was found among patients with chronic renal failure. Conclusion: muscle strength is decreased in 66.4% of chronic kidney failure patients. Early detection and early treatment of muscle strength deficit is recommended in this group of patients.

Happiness and Mental Disorders.

The research object is the approach the meaning of happiness for people with severe mental illness (SMI) under follow-up in a mental health unit in Tenerife. The research aims to improve the care they receive. This qualitative, phenomenological study uses convenience and intentional sampling. Questions were administered to a focus group consisting of 4 women and 1 man, aged 35-69, and 16 individual interviews were conducted with 8 women and 8 men, aged 20-62. The interviews were audio-recorded, with prior consent, transcribed verbatim, coded, and analyzed using QSR N-Vivo Release 1.4.1 (851), Spain. Happiness has three dimensions: personal, interpersonal-relational, and temporal. The personal dimension includes personality, positive emotions, health, motivations for establishing personal goals, and engaging in activities. The interpersonal-relational dimension includes family support; social support and relationships; social and occupational functioning; overcoming deaths, breakups, or job losses; and the absence of stigma on mental illness. The temporal dimension establishes that happiness can be comprised of either a set of happy moments or a continuous state of happiness that varies throughout life. Based on the results of this research, it could be proposed that future research should focus on the effectiveness of nursing interventions, addressing the life goals of people with mental disorders, and the pursuit of their happiness.