Risk of Type 2 Diabetes in University Students at the University of Extremadura: A Cross-Sectional Study.

The prevalence of type 2 diabetes is increasing worldwide. The aim of our study was to detect people susceptible to DM among a university population aged 18 to 45 years and analyze the existence of modifiable risk factors in order to implement prevention programs, in addition to analyzing BMI data related to the variables under study. We proposed a descriptive, cross-sectional study following the recommendations of cross-sectional studies (STROBE), with a sample of 341 subjects, students enrolled at the University of Extremadura, carried out by two researchers. The research protocol was approved by the Bioethics Committee of the University of Extremadura (165/2021). The study considered the Findrisk questionnaire in Spanish, validated by the Blackboard Study, a stadiometer to measure height, a bioimpedance meter to evaluate weight and body composition parameters, and a blood pressure monitor to measure blood pressure. The results indicated that the participants had a low risk of suffering T2DM. The highest Findrisk test scores were found in those with a BMI value above 25, lower physical activity, poor dietary intake of fruits and vegetables, and increased fat mass. Our future research will be the implementation of T2DM prevention programs, acting on modifiable factors.

Young nursing and medical students' knowledge and attitudes towards sexuality and contraception in two spanish universities: an inferential study.

BACKGROUND: Living safely sexuality and without risk to one's health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying a nursing or a medical degree. METHODS: A descriptive cross-sectional study of young medical and nursing students was conducted. The selection of participants was made by convenience. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann-Whitney U test or the Kruskal-Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors. Data collection was carried out from October 2020 to March 2021. RESULTS: The sample comprised 657 health university students. Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during their university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. CONCLUSION: The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree (87.13% of the participants obtain more than 50% of items correct). The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.

Assessment of Diabetic Foot Prevention by Nurses.

Diabetic foot is a severe complication of diabetes, with serious consequences such as amputations and high mortality rates as well as elevated economic costs. To evaluate whether or not nursing staff follow the recommendations of national and international organizations regarding diabetic foot prevention, a cross-sectional and observational descriptive study was carried out using an ad hoc self-administered questionnaire validated by seven experts, with a Cronbach's alpha of 0.731. Of the total 164 participants, 157 met the inclusion criteria. Findings showed that 96.58% asked their patients to remove their footwear, 78.34% performed thorough examinations, and 80.25% assessed the risk of developing diabetic foot. Participants educated their patients in self-care and evaluated skills related to diabetic foot control either frequently (84.07%) or very frequently (62.42%), and only 19.11% of them carried out group activity workshops. Significant statistical differences were found in the performance of activities in the groups by participant age intervals, whether working in primary health care or a hospital, having specific training, and the participant's DM patient ratio. We obtained high percentages of compliance in the assessed activities in comparison to other studies. Nevertheless, we believe it is necessary to encourage screening in specialized care, skills testing, and the implementation of educational group activities and workshops.

The psychological impact on frontline nurses in Spain of caring for people with COVID-19.

AIM: To understand the perceptions of National Health System nurses who have been working on the frontline of the psychological impact of caring for people with COVID-19 during the first and second waves. METHODS: A qualitative study, the design and analysis of which was based on phenomenology. For data collection, a semi-structured interview was administered to a sample of nurses who worked on the frontline in public hospitals in Extremadura and Madrid, Spain. The interviews, which followed a script including various topics, were conducted between May and November 2020 so as to include the experiences of the first and second waves of the pandemic. Sample collection continued until data saturation. The data were analysed following the phenomenological method of Giorgi with the help of the Atlas-Ti software. RESULTS: Two main themes emerged from the data analysis that explained the nurses' perceptions: (i) the main psychological repercussions of being frontline carers (anxiety, fear, stress, impotence, frustration, and an increase in obsessions and obsessive behaviours) and (ii) psychological coping strategies (collapse in the face of the situation, dissociative amnesia, leaning on colleagues and working as a team, resigning oneself, perceiving the situation as a war, and being aware of psychological repercussions). DISCUSSION: Caring as the first line causes great psychological repercussions for nurses. It is necessary to implement psychological and emotional support programmes to address the post-traumatic stress that nurses can suffer.

Efficacy of an Online Educational Intervention in Reducing Body Weight in the Pre-Diabetic Population of 18-45 Years Old, a Randomized Trial Protocol.

Aim: to analyze the efficacy of an educational online intervention focused on lifestyle changes in reducing body weight from baseline to 6 months in the pre-diabetic population of 18−45 years old in Extremadura (Spain). Methods: a single-blind, multicenter randomized parallel-comparison trial with two intervention groups in a 1:1 ratio will be carried out. Participants will be randomly assigned to intervention A or B with 37 cases in each group according to inclusion criteria of being enrolled or working at Extremadura University, scoring >7 points on the Findrisc test and not having diagnosed diabetes mellitus or physical disabilities. Intervention-A group will have access to online information about healthy diet and exercise. Intervention-B group will have access to a six-session educational program regarding behavioral changes in diet and exercise habits. They will complete follow-up activities and have a personal trainer and motivation. The primary outcome will be identifying changes in body weight from baseline to 1 and 6 months and between groups. The secondary outcomes will be accomplishing regular physical activity (>30 min/day or >4 h/week), decreasing sugary food intake or avoiding it altogether, increasing vegetable/fruit intake and lowering HbA1c levels to non-diabetic status when necessary.

Leadership as a Facilitator of Evidence Implementation by Nurse Managers: A Metasynthesis.

Evidence-based practice is often not implemented in nursing for reasons relating to leadership. This article aims to cast light on the factors that facilitate nursing evidence implementation perceived by nurse managers in their practical experiences of this implementation. It is a qualitative, narrative metasynthesis of primary studies on nurse managers' leadership-related facilitation experiences, following the Joanna Briggs Institute meta-aggregative approach and the Promoting Action on Research Implementation in Health Services (PARiHS) model. Eleven primary studies were included and three general categories were identified as leadership-related factors facilitating evidence implementation: teamwork (communication between managers and staff nurses), organizational structures (strategic governance), and transformational leadership (influence on evidence application and readiness for change among leaders). Nurse managers act as facilitators of evidence-based practices by transforming contexts to motivate their staff and move toward a shared vision of change. Always providing support as managers and colleagues, sharing their experience in the clinic environment.

Metabolic Syndrome and Its Components in Patients with COVID-19: Severe Acute Respiratory Syndrome (SARS) and Mortality. A Systematic Review and Meta-Analysis.

Recent meta-analysis studies have reported that metabolic comorbidities such as diabetes, obesity, dyslipidaemia and hypertension are associated with higher risk of severe acute respiratory syndrome (SARS) and mortality in patients with COVID-19. This meta-analysis aims to investigate the relationship between metabolic syndrome (MetS) and its components with SARS and mortality in COVID-19 patients. METHODS: A systematic search was conducted in the several databases up until 1 September 2021. Primary observational longitudinal studies published in peer review journals were selected. Two independent reviewers performed title and abstract screening, extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale. RESULTS: The random effects meta-analysis showed that MetS was significantly associated with SARS with a pooled OR (95% CI) of 3.21 (2.88-3.58) and mortality with a pooled OR (95% CI) of 2.32 (1.16-4.63). According to SARS, the pooled OR for MetS was 2.19 (1.71-2.67), p < 0.001; significantly higher than the hypertension component. With regard to mortality, although the pooled OR for MetS was greater than for its individual components, no significant differences were observed. CONCLUSIONS: this meta-analysis of cohort studies, showed that MetS is better associated to SARS and mortality in COVID-19 patients than its individual components.

Method for Malaria Diagnosis Based on Extractions of Samples Using Non-Invasive Techniques: An Opportunity for the Nursing Clinical Practice.

Malaria has been for millennia one of the best known and most destructive diseases affecting humans. Its high impact has aroused great interest for the development of new effective and reliable diagnostic techniques. Recently it has been recently published that hairs from mammal hosts are able to capture, hold and finally remove foreign DNA sequences of Leishmania parasites. The aim of this study was to check if Plasmodium falciparum (P. falciparum) DNA remains stable in blood samples deposited in Whatman paper after suffering different transport and storage conditions, and to compare the sensitivity of these results with those offered by thick a smear and Rapid Diagnostic Test, and besides to examine whether P. falciparum DNA would be detected and quantified by Real time quantitative PCR (qPCR) from hairs of people with different types of malaria. P. falciparum Histidine Repeat Protein II (pHRP-II) antigen detection and P. falciparum DNA were detected in 18 of 19 dry blood samples adhered to Whatman paper (94.74%), besides, Plasmodium DNA was also detected in seven out of 19 hair samples analyzed (36.84%), remaining stable until analysis for several months under the exposure to different environmental conditions. Although the sensitivity of PCR for the diagnosis of malaria in hair samples is not as high as blood analysis, the study of Plasmodium DNA presence in blood and hair could constitute a complementary tool with numerous advantages in sample collection, transport and storage. We suggest that the method could be also applied to medical, forensic and paleo-parasitological diagnosis, not only for malaria but also for searching many other pathogens in hair samples.

Young Nursing Student's Knowledge and Attitudes about Contraceptive Methods.

PURPOSE: Adolescence is considered a period in which individuals are particularly at risk of negative consequences related to sexual health. Increased knowledge levels have traditionally been used as an indicator of the effectiveness of educational programs, but attitudes are not addressed and are a key element for the success of such programs. The aim of this study is to determine the level of knowledge and attitudes toward the use of contraceptive methods among nursing students. A multicenter cross-sectional study was carried out. In total, 2914 university students (aged 18-25 years) enrolled in the study. Participants completed two validated scales to measure knowledge level and attitudes toward contraceptive use. Nursing degree students who received training about contraceptives obtained a success rate of over 70%, compared to 15.3% among students who had not received such training (p < 0.001). The mean attitude score was 43.45 points (10-50), but there were no significant differences in terms of student training (p = 0.435), although they were significantly higher among students who used contraceptives at first or last sexual intercourse (p < 0.001). There was a significant weak correlation between the level of knowledge and attitudes toward the use of contraceptives. An adequate level of knowledge about sexuality and contraceptive methods does not correspond to positive attitudes toward their use, although having an excellent attitude toward contraceptive use is related to their use during youth and adolescence.

Context as a Facilitator of the Implementation of Evidence-based Nursing: A Meta-synthesis.

Nurses have numerous difficulties in implementing science due to obstacles related to the work context. The aim is to explore the work-context-related facilitators of the application of evidence in clinical practice by nursing professionals. Qualitative meta-synthesis of primary studies on nurses' experiences of work-context-related facilitators, as defined by the Promoting Action on Research Implementation in Health Services model. Using the Qualitative Appraisal and Review Instrument of the Joanna Briggs Institute. Of the total 57 primary research articles included, an explanatory model of the facilitating factors related to the work context was generated on the basis of four general categories: institutional support (leadership), multidisciplinary support (teamwork and communication), culture of improving quality of care (nursing professionals' attitudes towards change) and use of research (valuing research). Action can be taken on the facilitating factors of the evidence-based practice application in nursing clinical environments, providing resources and motivation from the organization.

Enfermedades importadas en España: dificultades en la atención sanitaria / Imported diseases in Spain: difficulties in health care

Introducción: En España, desde el 2000 hasta el 2010, existían medidas que fomentaban la igualdad en salud y acceso a los servicios sanitarios de la población inmigrante. Con el inicio de la crisis y las reducciones del gasto público en salud, se instauraron medidas, que no solo tienen consecuencias negativas para este colectivo sino también para la salud pública en general, viéndose en aumento el número de casos de enfermedades importadas, también relacionadas con el aumento de viajes internacionales.Objetivos: Evaluar la presencia de enfermedades importadas en España y conocer la problemática del inmigrante en el Sistema Sanitario. Método: Revisión bibliográfica de estudios en lengua inglesa y castellana publicados entre 2007 y 2017 recogidos varias bases de datos y en informes de instituciones y organizaciones científicas.Resultados: Se obtuvo un total de 173 artículos indexados en las bases de datos. De estos, 32 se ajustaron a los criterios de inclusión, de los que se seleccionaron 15 para responder a los objetivos.15 producciones se adaptaron al objetivo del presente estudio. Los estudios afirman que los movimientos poblacionales como migraciones o a viajes internacionales, elevan la presencia de enfermedad importada en España. Esto junto con las medidas legislativas impuestas por el gobierno en materia de sanidad, dificultan al inmigrante irregular la posibilidad de acceder al Sistema Sanitario español. Destacan además otras dificultades para el inmigrante como son el idioma y el desconocimiento del correcto acceso y uso de las prestaciones sanitarias.Conclusión: Todo esto, crea desconfianza en el inmigrante, el cual aplaza el contacto con el servicio sanitario, pudiendo llegar a ocasionar un grave problema en la salud pública, principalmente por el retraso en el diagnóstico, tratamiento y seguimiento de enfermedades infecciosas importadas

Introduction: In Spain, from 2000 to 2010, there were measures that promoted equality in health and permitted access to health services for the immigrant population. Because of the economic crisis and the reductions in public expenditure on health, security measures were put in place, which not only had negative consequences for this group, also for public health in general. Therefore, the number of imported diseases cases have increased in direct relation to international travels.Objectives: To evaluate the presence of imported diseases in Spain and to know the problem of the immigrant in the Health System.Method: the literature review of studies in English and Spanish published between 2007 and 2017, including several databases and reports from institutions and scientific organizations.Results: A total of 173 articles indexed in the databases were obtained. 32 of these articles were adjusted to the inclusion criteria, of which 15 were selected to respond to the objectives. The studies affirm that population movements such as migrations or international trips, increase the presence of imported diseases in Spain. In addition, legislative measures imposed by the government on health matters, complicate access to the Spanish Health System for irregular immigrants. They also highlight other difficulties for the immigrant, such as the language and the lack of knowledge of the correct access and use of health services.Conclusion: The sum of all the above mentioned, creates lack of confidence in the immigrant, which postpones contact with the health service, and may lead to a serious problem in public health, mainly due to the delay in the diagnosis, treatment, and monitoring of imported infectious diseases

[Evolution of education in nursing]. / Evolución de la formación en enfermería.

PURPOSE: This study focuses on investigating the evolution of nursing studies in order to know how much this transformation has contributed to the development of the nursing profession. METHODS: Literature review with data sources from different national and international databases. These sources provide an update on the ongoing evolution of nursing studies and the progress of this profession as a result of change. CONCLUSIONS: The competencies and skills that add value to the nursing profession are: an evidence-based practice; empathic communication; and other broad-range skills such as critical thinking. All are necessary in order to develop the profession alongside the constant changes in the health systems and the improvement of quality care. These competencies and skills should be evaluated and their achievement is being reached through the "portfolio". Innovations that enable the development of these skills can be found in education, strategies and tools used by educators and institutions.

PROPÓSITO: El propósito de este estudio es indagar en la evolución de los estudios de enfermería y en sus competencias, para conocer el aporte del resultado final de esta transformación al desarrollo de la profesión enfermera. METODOLOGÍA: Revisión bibliográfica de tipo descriptivo, cuyas fuentes han sido recopiladas de diferentes bases de datos nacionales e internacionales. Estas proporcionan al lector una puesta al día sobre la constante evolución de los estudios de enfermería y su progreso como profesión, resultante de ese cambio. CONCLUSIONES: Las competencias y habilidades que aportan valor a la profesión enfermera son: la práctica basada en la evidencia; la comunicación empática; y otras capacidades transversales como el pensamiento crítico. Todas ellas sirven para hacer frente al constante cambio del sistema de salud y mejora de los cuidados de calidad. Estas deben ser evaluadas y su logro se está alcanzando mediante el “portafolio”. La innovación facilitadora del desarrollo de todas estas habilidades se encuentra en la educación, en estrategias y herramientas por parte de educadores e instituciones que asuman riesgos y liderazgo.