Needs of patients with multi-morbidity and heart failure for the development of a mHealth to improve their self-management: A qualitative analysis.

Objective: To provide practical information regarding needs, preferences of content and format of an app to assist the self-management in patients with multi-morbidity and heart failure (HF). Methods: The three-phase study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. Results: Integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes that captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way. Conclusions: The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development.

Correction: Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/35945.].

Effectiveness of a multimodal intervention and the simulation flow to improve empathy and attitudes towards older adults in nursing students: A crossover randomised controlled trial.

AIM: The aims of this study were (1) to develop a multimodal intervention according to the NLN Jeffries Simulation Theory planned to improve attitudes and empathy towards older adults in undergraduate nursing students using theoretical contents, age simulation suits, and storytelling of old participants, and (2) to evaluate the influence of the simulation flow on the effectiveness of this intervention in improving attitudes and empathy towards older adults. BACKGROUND: The increase in longevity in recent decades has led to an increase in the demand for professionals linked to the care of the older adults. Some studies indicate that health care professionals lack empathy and understanding toward older adults. Therefore, it is essential to introduce innovative teaching strategies to improve attitudes and empathy toward older adults in future health professionals. DESIGN: A crossover randomised controlled trial. METHODS: A three-period crossover randomised controlled trial with an experimental group, a control group (that transitions to a delayed experimental group) was conducted on 70 nursing students after the initial 73 were allocated. A multimodal intervention was used that, in addition to geriatric nursing theory, incorporated complex age simulation suit and student-older adult interaction. Pre-test and post-test data were obtained through the Jefferson Scale of Empathy and Kogan's Attitudes towards Older People Scale. Thus, students in the experimental group 1 received the following simulation flow: Geriatric Nursing Theory + Seminar with age simulation suit + student-older adult interaction. The students in the delayed experimental group 2 received this order: Geriatric Nursing Theory +Seminar without Age simulation suit + student-older adult interaction + Age simulation suit. RESULTS: Statistically significant differences were observed in both empathy (t = 3.155, p = 0.001, d = 0.782), and attitudes (t=3.256, p=0.001, d=0.803) when comparing control group scores (who only received the theoretical contents of the seminar) and experimental group 1 scores after receiving the full multimodal simulation (i.e. a seminar wearing an age simulation suit + volunteer interaction with an older adult). Regarding the order of educational strategies in the simulation flow, there were significant differences in the empathy scores found when both groups had received the full intervention. Accordingly, training with age simulation suits followed by storytelling provides better scores in empathy than in the opposite direction (t = 2.028, p = 0.048, d = 0.54). CONCLUSIONS: The use of a multimodal intervention, implementing an age simulation suit and the narration of an older adult's life experiences (in this order), improves attitudes and empathy.

Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

BACKGROUND: Patients with multimorbidity and complex health needs are defined as a priority by the World Health Organization (WHO) and the European Union. There is a need to develop appropriate strategies with effective measures to meet the challenge of chronicity, reorienting national health systems. The increasing expansion of mobile health (mHealth) interventions in patient communication, the reduction of health inequalities, improved access to health care resources, adherence to treatment, and self-care of chronic diseases all point to an optimistic outlook. However, only few mobile apps demonstrate their effectiveness in these patients, which is diminished when they are not based on evidence, or when they are not designed by and for users with different levels of health literacy (HL). OBJECTIVE: This study aims to evaluate the efficacy of an mHealth intervention relative to routine clinical practice in improving HL and self-management in patients with multimorbidity with heart failure (HF) and complex health needs. METHODS: This is a randomized, multicenter, blinded clinical trial evaluating 2 groups, namely, a control group (standard clinical practice) and an intervention group (standard clinical practice and an ad hoc designed mHealth intervention previously developed), for 12 months. RESULTS: The contents of the mHealth intervention will address user-perceived needs based on the development of user stories regarding diet, physical exercise, cardiac rehabilitation, therapeutic adherence, warning signs and symptoms, and emotional management. These contents have been validated by expert consensus. The creation and development of the contents of the mHealth intervention (app) took 18 months and was completed during 2021. The mobile app is expected to be developed by the end of 2022, after which it will be applied to the experimental group as an adjunct to standard clinical care during 12 months. CONCLUSIONS: The trial will demonstrate whether the mobile app improves HL and self-management in patients with HF and complex health needs, improves therapeutic adherence, and reduces hospital admissions. This study can serve as a starting point for developing other mHealth tools in other pathologies and for their generalization to other contexts. TRIAL REGISTRATION: ClinicalTrials.gov NCT04725526; https://tinyurl.com/bd8va27w. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35945.

Revisión de la obra sanitaria de Fernando Camúñez del Puerto (1883-1952) / Review of the sanitary work by Fernando Camúñez del Puerto (1883-1952)

En este trabajo presentamos la biografía académica y el estudio de las publicaciones científicas realizadas por Fernando Camúñez del Puerto (1883-1952), incluyendo su tesis doctoral sobre la leishmaniasis, defendida en 1913 y publicada al año siguiente. Exponemos también sus cargos profesionales en el Laboratorio Municipal de Higiene, el Instituto Provincial de Higiene y la Facultad de Medicina de Cádiz. En esta última institución fue Escultor Anatómico y profesor de Histología. Concluimos nuestro estudio aportando documentación sobre los últimos años de su vida y su enfermedad, relacionada con su ejercicio profesional (AU)

In this work, we present the academic biography and the study of the scientific publications made by Fernando Camúñez del Puerto (1883-1952), including his doctoral thesis on leishmaniasis, defended in 1913 and published the following year. We also present his professional positions in the Municipal Laboratory of Hygiene, the Provincial Institute of Hygiene and the Faculty of Medicine of Cadiz. In this last institution, he was an Anatomical Sculptor and Professor of Histology. We conclude our study by providing documentation on the last years of his life and his illness, related to his professional practice (AU)

Continuous ultrafiltration during extracorporeal circulation and its effect on lactatemia: A randomized controlled trial.

INTRODUCTION: Hyperlactatemia occurs during or after extracorporeal circulation in the form of lactic acidosis, increasing the risk of postoperative complications and the mortality rate. The aim of this study was to evaluate whether continuous high-volume hemofiltration with volume replacement through a polyethersulfone filter during the extracorporeal circulation procedure decreases postoperative lactatemia and its consequences. MATERIALS AND METHODS: This was a randomized controlled trial. Patients were randomly divided into two groups of 32: with or without continuous high-volume hemofiltration through a polyethersulfone membrane. Five patients were excluded from each group during the study period. The sociodemographic characteristics, filter effects, and blood lactate levels at different times during the procedure were evaluated. Secondary endpoints were studied, such as the reduction in the intubation time and time spent in ICU. RESULTS: Lactatemia measurements performed during the preoperative and intraoperative phases were not significantly different between the two groups. However, the blood lactate levels in the postoperative period and at 24 hours in the intensive care unit showed a significant reduction and a possible clinical benefit in the hemofiltered group. Following extracorporeal circulation, the mean lactate level was higher (difference: 0.77 mmol/L; CI 0.95: 0.01-1.53) in the nonhemofiltered group than in the hemofiltered group (p<0.05). This effect was greater at 24 hours (p = 0.019) in the nonhemofiltered group (difference: 1.06 mmol/L; CI 0.95: 0.18-1.93) than in the hemofiltered group. The reduction of lactatemia is associated with a reduction of inflammatory mediators and intubation time, with an improvement in liver function. CONCLUSIONS: The use and control of continuous high-volume hemofiltration through a polyethersulfone membrane during heart-lung surgery could potencially prevent postoperative complications. The reduction of lactatemia implied a reduction in intubation time, a decrease in morbidity and mortality in the intensive care unit and a shorter hospital stay.

Effectiveness of Global Postural Reeducation in Ankylosing Spondylitis: A Systematic Review and Meta-Analysis.

The aim of this study was to determine the role of global postural reeducation for people with ankylosing spondylitis. We compared the effects of treatments on pain, dysfunction (using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index), range of motion, and chest expansion in a specific population aged over 18 years old with ankylosing spondylitis. We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. The search was conducted using the PubMed, Physiotherapy Database (PEDro), Scientific Electronic Library Online (SciELO), and Web of Science (WoS) databases. Clinical trials and systematic reviews/meta-analysis were reviewed. Results: 154 studies were found. Finally, four were included. Conclusions: global postural reeducation is beneficial for ankylosing spondylitis, but no more so than other conventional treatments, except for spinal mobility, where Global Postural Reeducation demonstrated an advantage.

The Classification of Causes of Historical Mortality (CCHM): A proposal of the study of death records.

OBJECTIVE: To compare and contrast the Classification of Causes of Historical Mortality (CCHM) with the International Classification of Diseases 4th Revision (ICD-4) as methodological elements that can be implemented in historical mortality studies. MATERIALS AND METHODS: We conducted a longitudinal descriptive study of the causes of death in two different localities in Spain, namely, Cadiz and Vejer de la Frontera (1900-1950), to compare the International Classification of Diseases 4th Revision (ICD-4) and the Classification of Causes of Historical Mortality (CCHM). This study proposes the CCHM and its use in statistical analyses of mortality, especially from the mid-19th century to the second half of 20th century. It is a methodological instrument based on the theoretical precepts of Thomas McKeown, expanded through knowledge gained in studies of historical mortality and contrasted with editions of the ICD. RESULTS: The results showed several differences between the ICD-4 and the CCHM. The ten main causes of death (CoDs) in the CCHM account for 74.3% in Cadiz, compared to 56.6% accounted for by the ICD-4. According to the ICD-4, the number of infectious CoDs exceed the number of noninfectious ones in Cadiz every year. On the other hand, based on the CCHM, we observed that while infectious CoD causes of death predominated over noninfectious ones, there was a change in trend, with noninfectious CoDs predominating the following year. During the interval from 1915 to 1937 in Vejer de la Frontera, there were 12 deaths due to ill-specified causes (ICD-4: 18.200) and 0 due to ill-defined causes (CCHM: 3.0.0.0). CONCLUSIONS: The CCHM accurately determines the differences between infectious and noninfectious causes of death and explains sociodemographic and health-related aspects in the population and its use in employment, illegitimacy or place-of-death studies. Moreover, it has more advantages, such as the incorporation of new diagnostic expressions, and it can be constantly updated, thus facilitating its use over long periods of time.

Consenso Victoria I: otra perspectiva cara al futuro de los incidentes con múltiples víctimas intencionados / Another perspective on the management of multiple intentional-injury victims in the future: the Victory I Consensus

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Una aproximación a la reglamentación hospitalaria inglesa y española a finales del siglo XIX: el caso del Gran Hospital de Santiago (1893) y la Royal Glasgow Infirmary (1894) / Anapproach to the English and Spanish hospital regulations at theend of the 19th century: the case of the Great Hospital of Santiago (1893) and the Royal Glasgow Infirmary (1894)

OBJETIVO PRINCIPAL: contrastar la legislación hospitalaria española e inglesa a finales del siglo XIX mediante los reglamentos hospitalarios publicados en Santiago de Compostela (1893) y en Glasgow (1894). METODOLOGÍA: se trata de un estudio cualitativo en el que se han empleado los métodos hermenéutico y análisis en la interpretación de textos históricos locales. Resultados principales: la admisión hospitalaria difería en buena medida. A pesar de las figuras sanitarias diferentes entre ambas reglamentaciones estudiadas, existieron funciones y jerarquías comunes entre ellas, destacando labores de cuidados orientados al aseo de los pacientes, el arreglo de las camas y la administración de medicamentos. Conclusión principal: los reglamentos del Gran Hospital de Santiago y la Real Enfermería de Glasgow presentan ciertas similitudes como consecuencia del cuidado como valor universal, pero también diferencias entre ellos debido a los diferentes sistemas hospitalarios

OBJECTIVE: To contrast the Spanish and English hospital legislation at the end of the 19th century through the hospital regulations published in Santiago de Compostela (1893) and in Glasgow (1894). METHODS: This is a qualitative study in which hermeneutic and analytical interpretation of local historical texts methods have been used. RESULTS: Hospital admission differed greatly. In spite of the different sanitary figures between both regulations studied, there were common functions and hierarchies among them, highlighting care tasks aimed at the patient hygiene, the making of beds and the administration of medicines. CONCLUSIONS: The regulations of the Great Hospital of Santiago and the Royal Infirmary of Glasgow present certain similarities as a consequence of the care as a universal value, but also differences among them due to the different hospital systems

La prensa profesional como fuente de información historiográfica en la Historia de la Enfermería / A imprensa profissional como uma fonte de informação historiográfica sobre a História da Enfermagem / The professional press as a source of historiographical information on the History of Nursing

La prensa profesional enfermera y de sus antecedentes profesiones auxiliares, constituye una fuente valiosa para el estudio de la evolución que desarrollaron y su interrelación entre las diferentes disciplinas sanitarias. Conocer y estudiar las publicaciones seriadas de este sector nos permite acercarnos a la realidad e identidad profesional, formativa y de actualidad por la que atravesaban. En el presente artículo se propone una guía metodológica para la búsqueda de este tipo de fuente de información historiográfica y un modelo para el estudio histórico de la prensa profesional enfermera basado a los últimos avances en la metodología historiográfica; apoyado en el análisis por separado de la estructura de la prensa mediante los preceptos de Jaques Kayser y de su contenido por ejes temáticos a través los métodos heurístico, hermenéutico e histórico en la interpretación de textos (AU)

A imprensa profissional enfermeiro e suas profissões antecedentes de saúde é uma fonte valiosa para o estudo da evolução que desenvolveu e sua inter-relação entre as diferentes disciplinas da saúde. Conhecer e estudar folhetins nesse setor nos permite abordar a realidade e identidade profissional, educacional e tópica que atingiu. Neste artigo tenciona um guia metodológico para encontrar este tipo de fonte de informação historiográfica e um modelo para o estudo histórico da imprensa profissional enfermeiro com base nos mais recentes desenvolvimentos na metodologia historiográfica; suportado pela análise separada da estructura da imprensa os preceitos de Jaques Kayser e seu conteúdo por temas através de heurística, hermenêutica e método histórico na interpretação de textos (AU)

The nurse and previous auxiliary professions press, is a valuable source for the study of evolution developed and its interrelationship between different health disciplines. Knowing and studying serials publications in this sector allow us to approach reality and professional identity, educational and current which hit. In this article is proposed a metodological guide for finding this kind of source of historiographical information and a model for the historical study of the nurse professional press based on the latest developments in the historiographical methodology; supported on separate analysis of the structure of the press by the precepts of Jaques Kayser and its contents by themes through heuristic, hermeneutic and historical methods in the interpretation of texts (AU)