An Interdisciplinary Intervention Based on Prescription of Physical Activity, Diet, and Positive Mental Health to Promote Healthy Lifestyle in Patients with Obesity: A Randomized Control Trial.

This study used a multimodal approach to address the issue of obesity among individuals with a Body Mass Index (BMI) between 30 and 40 residing in a rural region of north-east Spain. A pretest-posttest model was employed in a clinical trial design, comparing an intervention group with a control group. The intervention, which lasted for a period of nine months, was based on three main strategies: the prescription of physical activity, the promotion of healthy nutritional habits, and the management of emotional wellbeing through Positive Mental Health (PMH). A variety of assessment tools were employed, including the CLASS-AF scale and a stress test for physical activity levels; advanced anthropometry and blood analysis for metabolic and body composition variables; a Mediterranean diet adherence questionnaire for nutritional habits; and a PMH multifactorial questionnaire for the assessment of emotional management. The results revealed significant improvements in the level of physical activity and adherence to the Mediterranean diet in favor of the intervention group, where 89.4% (n = 17) of the participants went from being not very active/sedentary to being active. Also, adherence to the Mediterranean diet improved with a mean increase of 2.2 points on the scale [mean: 10.5 (CI 95%: 9.90, 11.09)]. In addition, significant reductions in body fat [mean: -2.50 kg (CI 95%: -3.56, -1.44)] and free fat mass [mean: -3.38% (IC 95%: -4.34, -2.41), along with decreased cholesterol levels (196 vs. 182 mg/dL), were observed, suggesting a decrease in cardiovascular and metabolic risk. In conclusion, this multimodal intervention was effective at improving the lifestyle of people with obesity and reducing their cardiovascular and metabolic risk. The combination of interventions focused on physical activity, diet, Positive Mental Health, and metabolic changes and were perceived as a comprehensive and complementary strategy in obesity care. These findings highlight the importance of approaching this condition from multiple perspectives to ensure optimal health outcomes.

The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). AIM: The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. METHODS AND PROCEDURES: Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. RESULTS: Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. CONCLUSION: The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. OUTCOMES AND RESULTS: Knowledge and understanding of these events should allow for better management of similar situations in the future.

This study contributes to a growing body of research that examines the experiences of IDD individuals and their families during the early months of the COVID-19 pandemic. A qualitative phenomenological interpretative approach was used following the recommendations of qualitative research practices in health care. Our findings reveal that relatives of persons with IDD who lived in residential care homes felt that the residents were not adequately cared for by the staff, who applied measures for containment and contagion prevention that were disproportionate, resulting in their needs not being considered; these recommended measures had been developed for elderly care homes. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. The present findings show that residential care homes for persons with IDD require specific action protocols in crisis situations that are adapted to the needs and characteristics of each centre,thus adopting a model of care based on human rights.

Análisis de las complicaciones del acceso vascular en hemodiálisis. Una revisión sistemática / Analysis of complications of vascular access in hemodialysis: A systematic review

Introducción:El acceso vascular sigue siendo uno de los retos más importantes en todas las unidades de diálisis, por todas las complicaciones derivadas de su uso y el gran impacto en la mor-bimortalidad del enfermo renal. Los tres tipos de acceso vascu-lar más utilizados son la fístula arteriovenosa nativa, el injerto o fístula arteriovenosa protésica y el catéter venoso central. Objetivo: Analizar y evaluar la situación actual y la incidencia de las complicaciones relacionadas con los diferentes accesos vasculares en hemodiálisis. Metodología: Se realizó una revisión sistemática en las bases de datos PubMed, CINAHL, SCOPUS y SciELO. Se incluyeron todos los artículos originales de menos de 5 años de antigüe-dad en los que uno de sus objetivos fuera analizar la preva-lencia o incidencia de las complicaciones de cualquier acceso vascular en hemodiálisis en población adulta. Resultados: El número de artículos para el análisis fueron 15. De ellos, 14 fueron estudios observacionales y uno, un ensa-yo clínico multicéntrico. Se analizaron datos demográficos de los pacientes, la prevalencia de complicaciones entre todos los accesos vasculares y la incidencia de complicaciones se-gún fístula nativa/protésica/catéter venoso central.Conclusiones: La fístula arteriovenosa nativa es el acceso vas-cular de elección ya que tiene tasas de complicaciones muy bajas. De entre ellas, la trombosis, es la complicación con más incidencia. El uso de catéter venoso central todavía es muy habitual, pese a ser el acceso vascular que presenta mayores tasas de complicaciones como las infecciones y la bacteriemia, produciéndose en un 10%-17% de los pacientes portadores.(AU)

Introduction: Vascular access remains one of the most important challenges in all dialysis units due to the complications associated with its use and its significant impact on the morbidity and mortality of renal patients. The three most used types of vascular access are native arteriovenous fistula, graft or prosthetic arteriovenous fistula, and central venous catheter. Objective: To analyze and evaluate the current situation and incidence of complications related to different vascular accesses in hemodialysis. Methodology : A systematic review was conducted using the PubMed, CINAHL, SCOPUS, and SciELO databases. All original articles published within the last 5 years that aimed to analyze the prevalence or incidence of complications related to any vascular access in hemodialysis in the adult population were included. Results: A total of 15 articles were included for analysis. Among them, 14 were observational studies, and one was a multicenter clinical trial. Demographic data of the patients, the prevalence of complications across all vascular accesses, and the incidence of complications for native fistula/prosthetic fistula/central venous catheter were analyzed. Conclusions: Native arteriovenous fistula is the preferred vascular access due to its very low complication rates. Among the complications, thrombosis has the highest incidence. The use of central venous catheters is still common, despite having higher rates of complications such as infections and bacteremia, occurring in 10%-17% of the patients.(AU)

Programa de formación basado en técnicas de comunicación básica y asistida para las enfermeras de extrahospitalaria / A training communication program designed for emergency nurses working at ambulance

La comunicación es la clave para comprender la vulnerabilidad emocional de los pacientes en estado crítico. Un cambio repentino en la salud, experimentado por estas personas debido a un accidente o enfermedad, puede causar un efecto psicoemocional como la ansiedad o el estrés postraumático. Objetivo principal: Evaluar un programa de formación en técnicas de comunicación básica y asistida (CONECTEM) para enfermeras pre-hospitalarias y conocer la utilidad y la satisfacción percibida del programa de formación. Métodos: El estudio presenta un diseño observacional-descriptivo cuasi experimental. La muestra fue de 12 enfermeras pre-hospitalarias seleccionadas según los criterios de inclusión. Se realizó un test post formación para evaluar los conocimientos adquiridos de las enfermeras. Resultados: El 100% de las enfermeras que realizaron el entrenamiento en CONECTEM fueron aptas para implementar la intervención comunicativa en la ambulancia. El 60% de las enfermeras consideró que la formación fue muy útil para mejorar la calidad de la atención en los pacientes críticos trasladados en ambulancia. La satisfacción percibida por las enfermeras de la formación CONECTEM, fue muy buena en un 42,4% y buenas, en un 58,3%. Conclusiones: Los resultados respaldan la importancia de la formación en técnicas de comunicación asistida y alternativa (CAA) para mejorar las curas integrales al paciente crítico y ponen de manifiesto la necesidad de formación en comunicación de las enfermeras de pre-hospitalaria. (AU)

Communication is the key to understanding the emotional vulnerability of patients in critical condition. A sudden change in health experienced by these individuals due to an accident or illness can lead to serious psycho-emotional outcomes. Main objective: To conduct and evaluate an augmentative alternative communication training program (CONCETEM) for pre-hospital nurses and determine its utility and the satisfaction of the nurses. Methods: The study has an observational-descriptive design. The sample was 12 pre-hospital nurses selected by inclusion criteria. Post-training evaluation was conducted by the research team to learn whether nurses could perform the communicative intervention. Results: 100% of the nurses who underwent CONECTEM training were prepared to implement communicative intervention in the ambulance. 60% of the nurses considered that the training was very useful for improving the quality of care for critically ill patients transferred by ambulance. The nurses' satisfaction with the communication training was ‘very good' for 42.4% and ‘good' for 58.3%. Conclusions: The results support the importance of Augmentative Alternative Communication training to improve outcomes in critically ill patients and reveal that nurses feel that more training is needed. (AU)