Microlearning through TikTok in Higher Education. An evaluation of uses and potentials.

While social media is evolving rapidly, understanding its underlying and persistent features with the potential to support high-quality learning would provide opportunities to enhance competence acquisition and collaborative work in higher education. Moreover, the adoption of tools that students already use in their everyday lives facilitates the integration of new forms of learning. In this context, we have developed an initiative to disseminate content through TikTok in three modules of the Bachelor's Degree in Nursing course, with the aim of promoting quality learning through these microlearning environments. To this end, we have implemented these learning environments and evaluated the users' perceptions, as well as their level of acceptance of the technology according to the Technology Acceptance Model. Overall, our results show high levels of satisfaction with regard to engagement and the content generated, as well as in terms of the acceptance of the technology. Our results do not show gender-specific variations, but we did detect slight variations depending on the subject in which the microlearning tool was deployed. Although for the most part these variations do not change the participants' assessment of their experience, it will be necessary in the future to determine the underlying reasons for these variations. In addition, our results suggest that it is possible to design a content creation system to promote quality learning through microlearning that can be transferred to other subjects, at least in the Bachelor's Degree in Nursing. Supplementary Information: The online version contains supplementary material available at 10.1007/s10639-023-11904-4.

Culinary Solitude in the Diet of People with Functional Diversity.

This qualitative ethnographic study identifies how problems in the feeding process of a group of people with functional diversity influence different eating situations. The study, which was carried out in the Autonomous Community of Castilla La Mancha, Spain, is based on interviews conducted at the headquarters of the different participating associations for functionally diverse people, at the participants' homes, and in public spaces. The study included 27 subjects aged between 18-75 years. Their functional diversity had caused significant changes in their sociability, particularly in contexts associated with food consumption. The analysis identified three main themes: social ghettoisation and culinary loneliness; stigma, shame, feeling like a burden, and loneliness; and exclusion or self-exclusion at the dining table. Our participants' narratives underscored the importance of acknowledging the significance of changes in eating-related sociability due to functional diversity. For the study subjects, grief, loneliness, and shame contributed to disassociating food consumption from social celebrations, withdrawing from restaurant meals, or conversations while eating to avoid other people's stares.

Eating experiences and quality of life in patients with larynx cancer in Spain. A qualitative study.

PURPOSE: This paper aims at describing the eating experience of people diagnosed with and treated for laryngeal cancer. Going beyond the mere conceptualization of "after-effect" or the quantification of the disease's impact on the basis of standardized questionnaires, we present a qualitative analysis of the narratives of such experiences. METHODS: Ethnographic study. Data is obtained from conversations, semi-structured interviews, participant observation, and written documents. A discourse analysis of the narrative information was conducted, with process coding and using the constant comparative method, inductive content analysis, category analysis, units of meaning associated with each other, and triangulation. RESULTS: The impact of cancer on eating processes is not limited to nutrition, but also affects the social and cultural value of food, which is put into question. The symbolic and social values which accompany the traditional way of eating are modified, which is connected with impaired quality of life. CONCLUSIONS: The impact on the eating process and its relationship with quality-of-life impairment are clear and connect with the importance of eating ways in culture and social organization. Greater attention should be paid to these contexts in clinical practice, which can affect even more than the impact on communicative processes.

Rationale and Methods of Evaluation for ACHO, A New Virtual Assistant to Improve Therapeutic Adherence in Rural Elderly Populations: A User-Driven Living Lab.

Low therapeutic adherence is a concern for health professionals as it decreases therapeutic efficiency while increasing costs, especially in elderly populations. To increase therapeutic adherence in elderly populations, the technology applied in the medical devices that are used must be adapted to improve usability. This paper outlines the rationale behind, and methods applied to assess the usability of, ACHO (Assistant on Care and Health Offline), a voice assistant that provides elderly patients with reminders of medical appointments to attend and when they need to take their medication. This work is a descriptive, cross-sectional, observational study, and will include a three-phase (analysis, testing and refinement) multidimensional usability analysis of an initial prototype, in the setting of a user-driven Living Lab, which enables the needs and characteristics of the end users to be identified and incorporated into the prototype with each iteration, in which a multidisciplinary team of researchers and users will participate as co-creators. This methodology will allow us to develop a better prototype, increasing usability and, thus, increasing therapeutic adherence.

Memories of hunger, continuities, and food choices: An ethnography of the elderly in extremadura (Spain).

Food choices are a complex subject of study. This study reviews existing literature on the topic, while also offering new perspectives. It introduces empirical materials that suggest the existence of continuities between childhood memories of food insecurity and current nutritional choices and practices among older adults. This is a qualitative study, based on grounded theory, which explores memories of hunger in the aftermath of the Spanish Civil War through ethnographic fieldwork conducted in 12 rural localities in Extremadura (Spain) - analysing current food practices and ideologies among surviving post-war children and tracing continuities between the past and the present. It provides results in the field of food continuities and shows how experiences and memories of hunger have an impact on food choices many decades later Data analysis and interpretation revealed three main categories: food memories of the so-called "years of hunger"; present-day food practices; and continuities between past and present. The inductive-deductive analysis revealed enduring memories that shaped present-day attitudes towards food - i.e. maximisation of ingredients and "zero-waste" practices; conspicuous consumption at particular times of the year; the central role of bread; and even certain food taboos. More than seventy years later, memories of deprivation and hunger are still pervasive and permeate present-day dietary practices and choices.

The Denied Pleasure of Eating: A Qualitative Study with Functionally Diverse People in Spain.

This qualitative study explores the difficulties in experiencing eating-derived pleasure within a group of functionally diverse people, based on personal interviews and Grounded Theory. Understanding the feelings and subjective experiences of functionally diverse people can help develop new approaches to address their loss of pleasure and motivation regarding food intake. The study included 27 participants, aged between 18 and 75 years, all of whom had a functional deficiency that affected the occupational aspects of the eating process. Interviews were conducted in clinical settings and several centres for differently abled people. Four main themes emerged from the analysis: eating through obligation; fear of eating; the social life of food; and the importance of the taste and visual aesthetics of food. These themes underscore the importance of taking into account the phenomenological experiences of pleasure in the eating process.

Treatment Adherence in Chronic Conditions during Ageing: Uses, Functionalities, and Cultural Adaptation of the Assistant on Care and Health Offline (ACHO) in Rural Areas.

The increasingly common scenario of an ageing population is related to a rise in the prevalence of problems associated with chronic conditions and comorbidities. Polypharmacy is frequent among this population, and it is a situation that can create medication management and adherence issues. This article introduces the features and functionalities of a voice assistant (Assistant on Health and Care Offline, ACHO) that aims to facilitate treatment adherence among elderly adults. Specifically adapted for its use in rural contexts, it does not require an Internet connection. Its development consisted of two stages: a first stage of problem diagnosis, in which the classic tools of ethnographic fieldwork were used, and a second stage of design implementing methodologies developed by Ambient Assisted Living (AAL) programmes. The main design characteristic of this new digital care system is that it is adapted to the needs of its end-users. It includes features such as voice customisation and the personal identification of medication, it can be connected to other digital devices, and information is introduced and supervised by healthcare professionals. These custom features introduce a safer medication administration procedure, improve supervision strategies, and increase patients' trust in the prescription process.

Family Orchards and Health-Related Quality of Life in the Elderly. A Protocol for a Study in Las Hurdes (Spain) Based on an Ethnographic Approach.

Demographic evolution is resulting on an aged population increment in Spain. This growth has been more relevant in rural areas, where the population has traditionally lived under hard socio-economic conditions and leveraging the natural resources such as food from family orchards to survive. Studies that have investigated the possibilities and uses of these traditional family orchards today in relation to health-related quality of life in the elderly are scarce. Based on a previous ethnography, this mixed research aims to describe a protocol that will evaluate the effects of the use of traditional family orchards as a daily resource on fitness and quality of life of the elderly population in Las Hurdes (Spain). Body composition, fitness, mental health, health-related quality of life, and activity-related behaviors of participants will be assessed. The outcomes of this study might enable us to design further tailored physical exercise-based interventions using family orchards as an adequate resource to improve the health-related quality of life and fitness of the elderly in rural areas. In addition, the study detailed here might also be applied to other similar rural areas in Spain and worldwide.

Eating Experiences of People with Disabilities: A Qualitative Study in Spain.

BACKGROUND: Disability causes changes in the eating process, which is central to the definition of each individual's social and psychological spaces. METHODS: This is a qualitative study based on grounded theory. Interviews were carried out in clinical hospital settings and headquarters of several disability organisations. The study included 27 individuals, aged between 18-75 years. All participants had a disability that caused a functional deficiency in the occupational aspects of the eating process. RESULTS: The respondents' narratives were analysed through observations made in different contexts, allowing us to describe and understand the significance attributed by the participants to their reality and experiences. Three key themes emerged from the analysis: (1) waning bodies (assumption of a diminished corporality); (2) redefinition of food-related social spaces; and (3) perceived burdensomeness, shame, and loneliness. CONCLUSIONS: Assisted feeding tends to prioritise the nutritional component of food ingestion. However, cultural, social, and contextual factors have a critical impact on an individual's well-being and quality of life. This study stresses the importance of re-addressing intervention models affecting differently-abled people and incorporating approaches that take into account the contextual aspects of occupational therapy.

Health and Nutritional Beliefs and Practices among Rural Elderly Population: An Ethnographic Study in Western Spain.

BACKGROUND: Demographic transition is causing an increasingly aged society, which has a significant impact on public health strategies. Increases in the size of the elderly cohort create a wider stratification and pose specific challenges. Nutrition and diet are one key issue. This study aims to describe food-related practices, beliefs, and representations of non-institutionalized older adults in rural communities in Extremadura (Western Spain). METHOD: The ethnographic-based fieldwork was conducted from January to July 2019. Empirical material was collected through different research relationships (semi-structured interviews and informal conversations) and direct observation in various locations in Extremadura-involving a variety of agents associated with different aspects of the nutritional process. RESULTS: Data analysis revealed four major themes: (1) Limitations on choice and quality of food available; (2) food preferences and cooking methods; (3) the role of nostalgia in the construction of taste preferences; and (4) perceptions of what "healthy" food is and how respondents relate to the advice provided by health professionals. CONCLUSIONS: Nutritional choices among the group studied presented significant differences from medical advice-which was seen as a series of "bans" that did not carry enough authority to alter the symbolic value attached to their traditions.

Los enfoques culturales en la alimentación de personas mayores rurales. Una necesidad multidimensional para la agenda del cuidado / Cultural approaches of feeding in elderly rural people. First-rate issues and evidences

OBJETIVO: Revisar la bibliografía existente en Ciencias de la salud sobre percepciones, representaciones y prácticas en torno al universo de la alimentación entre población anciana rural. METODOLOGÍA: Hemos revisado las publicaciones disponibles en 6 bases de datos tanto generalistas como especializadas. RESULTADOS: Se seleccionaron un total de 14 artículos que se ajustaban a los criterios de inclusión. En ellos se repetían categorías tales como la génesis de la elección, la importancia del género, las barreras a la alimentación saludable o el universo simbólico de la comida. CONCLUSIÓN: Pese al evidente carácter sociocultural que constituyen los procesos alimentarios, la literatura biomédica que aborda estas cuestiones es escasa. Los artículos incluidos en este trabajo, realizados desde enfoques cualitativos, muestran, por ejemplo, la importancia de la emotividad en la elección o de las limitaciones asociadas a cuestiones materiales y estructurales

OBJECTIVE: To review the existing bibliography in Health Sciences on perceptions, representations and practices around the universe of food among rural elderly population. METHODOLOGY: We have reviewed the publications available in 6 generalist and specialized databases. RESULTS: A total of 14 articles were selected that met the inclusion criteria. They repeated categories such as the genesis of choice, the importance of gender, barriers to healthy eating or the symbolic universe of food. CONCLUSION: Despite the obvious socio-cultural character of food processes, the reis little biomedical literature addres sing these issues. The articles included in this work, carried out from qualitative approaches, show, for example, the importance of emotion in the choice or the limitations associated with material and structural issues

Cuidados basados en narrativas. Redefiniendo la jerarquía de la evidencia / Narrative-based care. Redefining the hierarchy of evidence

Desde finales de los noventa proliferan trabajos que, aglutinados como Narrative Based Medicine (NBM), persiguen redefinir la práctica clínica orientándola hacia el paciente y su narrativa. Emergidos como un discurso eminentemente crítico y contestatario sobre la ortodoxia de la Evidence Based Medicine (EBM), actualmente persiguen perspectivas integracionistas que pretenden incluir sendos movimientos en un modelo de atención que reconstruya las nociones y jerarquía de la "evidencia". Ideológicamente, la NBM propone una redefinición de la ethos de la práctica médica resituando la experiencia del paciente como evidencia de primer orden. Sin embargo, el impacto de este movimiento en los cuidados enfermeros ha sido prácticamente nulo. Este artículo, primero de una serie, explora las bases teóricas y principios de la NBM sugiriendo un marco de trabajo que cimiente unos cuidados de Enfermería Basados en Narrativas, incluyendo una revisión de los estudios enmarcados en esta orientación y una reflexión sobre su carácter "vanguardista" (AU)

Since the late 90´, several papers have been rise under the name of "Narrative Based Medicine", a movement that pretend to focus the clinical practice toward the patient and his narrative. Although the origins constituted a criticism of the postulates of Evidence Based Medicine, at the present time, this movement involves a integrationist perspective that reconstructs notions and hierarchies of evidence. Ideologically, NMB proposes a medical practice that places the patient's experience as a first order. However, the impact of this movement in nursing care has been virtually null and void. This paper, first of a series, explores the theoretical bases and principles of the NBM suggesting a framework that underpins a nursing care based on narratives including also a review of its "avant-garde" character (AU)

La prevención de la desnutrición en el oriente de Guatemala. Nuevos cuidados, mismas representaciones / The prevention of desnutrition in the eastern of Guatemalan. New cares, the same representations

Las múltiples retóricas que encierran los procesos de salud y enfermedad permiten construir los procesos patológicos de modos diversos. Los C'hortís del oriente de Guatemala mantienen una particular forma de construir la desnutrición infantil, en ocasiones muy diferente al modelo biomédico en aspectos como la etiología del trastorno o la responsabilidad del mismo. Desde una perspectiva netamente cualitativa, se realiza un repaso de las prácticas y representaciones sobre su prevención. La desnutrición infantil es, en este contexto, un trastorno social que se asocia de forma muy evidente a determinadas prácticas maternas y un modelo social y moral determinado, y se desliga de la carencia de alimentos, de forma que la prevención del trastorno pasa por modificar esos comportamientos maternos. Los intensos procesos de cambio social y la incipiente presencia del discurso alopático han introducido modificaciones en esa forma particular de concebir el padecimiento. No obstante, estos cambios han implantado nuevas prácticas sin apenas modificar las representaciones existentes, responsabilizando de nuevo a las madres, lo que pone de manifiesto las dificultades de un diálogo intercultural en salud entre cosmovisiones diferentes y las implicaciones de las intervenciones en salud en estos contextos, que deben prestar atención a los diferentes significados del padecimiento (AU)

The manifolds rhetoric’s that contain the health and disease process permit to construct the pathologies process of different ways. The C'hortís from eastern of Guatemalan have a particular manner of constructing the children’s desnutrition, sometimes very different from biomedical model, such as the aetiology or his responsibility. From a qualitative perspective, we have done a description of practices and representations about his prevention. The children’s desnutrition is, in this contexts, a social disorder associated with specified maternal practices and a moral and social order, and is unbound, separated of the food lack; therefore the disorder’s prevention must to modify those maternal behaviours. The intensive process of social change and the incipient presence of biomedical discourse have introduced modifications in that particular manner of understating the disorder. However, this changes have introduced new practices without modify the pre-existent representations, blaming mothers again, what shows the difficult of an intercultural health-dialogue and the implications of the health interventions in this contexts, that have to pay attention to the different meanings of the disorder (AU)

Trastornos de la alimentación y culto al cuerpo más allá de la anorexia y la bulimia: ortorexia, vigorexia y síndrome del gourmet / Changes in the habits of eating and obsession for the body: beyond anorexia, bulimia, ortorexia, vigorexia and the gourmet syndrom

Los trastornos de la alimentación y culto al cuerpo se van extendiendo en nuestra sociedad de forma alarmante, es una nueva epidemia caracterizada por la obsesión de la búsqueda del cuerpo perfecto. Más allá de las ya conocidas y divulgadas anorexia y bulimia aparecen nuevas formas como son la vigorexia, la ortorexia o el síndrome del Gourmet. En estas nuevas patologías cada vez más extendidas y que comienzan a emerger de forma creciente, centramos nuestro artículo estudiando el componente sociocultural en el que tienen su origen.La creciente obsesión por el culto al cuerpo influida por los factores socioculturales de la época provoca la aparición de nuevos trastornos de la alimentación que suponen un reto más para el personal de enfermería. Sólo el estudio y la investigación de estos trastornos por parte de los profesionales enfermeros nos darán la capacidad para actuar de forma dinámica y eficaz en este tipo de patologías. La Educación para la Salud, en la que los profesionales de Enfermería tienen un protagonismo destacado, vuelve a ser arma imprescindible de trabajo que nos permitirá una prevención adecuada para impedir la extensión de esta nueva epidemia (AU)

Cuidados y cuidadores transculturales. En el hospital Fernando Fonseca (Portugal) / Transcultural cares in the Fernando Fonseca hospital

El Hospital Fernando Fonseca se encuentra ubicado en la periferia de Lisboa. Este hospital presenta unas características que hacen que sea una institución de referencia en la enfermería transcultural. Por un lado, mantiene un personal enfermero multicultural, procedente de lugares tan diversos como Brasil, España o Angola, lo que implica una dificultad y cierto grado de choque teórico y metodológico en la prestación de cuidados, diferentes concepciones de lo que debe ser una enfermera y sus responsabilidades y competencias. Por otro, el hospital ofrece una cobertura sanitaria a una población también multicultural; con muchos emigrantes procedentes de antiguas colonias portuguesas o grupos étnicos como los gitanos que mantienen formas muy diferentes de entender los procesos de enfermar. La enfermería se enfrenta a los problemas que de ello se derivan, las diferentes expectativas y modelos de cuidado, formando una autentica realidad enfermera transcultural (AU)

La educación para la salud. Un abordaje transcultural / Health education: a transcultural approach /orientation

La estructura social contemporánea se caracteriza por la interacción de diferentes grupos o culturas con rasgos propios e identitarios, formando una sociedad multicultural. La concepción de la salud es inherentemente relativa en términos culturales, lo que se traduce en diferentes significaciones en cada grupo e implica un carácter polisémico y multidimensional de la salud. La promoción y la educación para la salud deben tener en cuenta dichas singularidades a la horade emprender sus programas y acciones preventivas, que deben descansar sobre la tolerancia, el respeto a la diversidad y el relativismo cultural, trabajando en una educación para la salud intercultural. El modelo que proponemos, con una orientación culturalista, pretende modificar los patrones culturales en los ámbitos que intervienen en la salud y el autocuidado, trabajando en los procesos de endoculturacion y socialización, formando culturas o subculturas saludables, a través de la intervención conjunta en los individuos y las estructuras. La aparente contradicción de perseguir el cambio cultural y mantener el respeto a la diversidad se resuelve a través del diálogo intercultural y al relativizar el valor salud y la identidad cultural hasta mínimos en los que todos nos sintamos representados (AU)

Actuación en drogodependencias desde Atención Primaria. Ideas para la elaboración de un protocolo / Performance in drogadiction from primary care. Ideas for the procesing of a protocol

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