Efficacy of the use of video games on mood, anxiety and depression in stroke patients: preliminary findings of a randomised controlled trial.

BACKGROUND: In the different published studies, there is no consensus on the efficacy of virtual reality as an adjuvant treatment of mood states. AIM: The aim of this study is to evaluate the impact of no immersive virtual reality with the Nintendo Switch device in rehabilitation treatment on mood, anxiety and depression in stroke patients admitted to neurorehabilitation units. METHODS: Fifty-eight patients admitted to neurorehabilitation units underwent a 1:3 multicentre randomised clinical trial. The intervention group consisted of 17 patients and the control group of 41 patients. The intervention group performed 6 virtual reality sessions together with the conventional treatment, and the control group performed only the conventional rehabilitation sessions. Primary and secondary clinical outcomes were measured before and six weeks after the intervention. RESULTS: Comparing the intervention group and control group, the anxiety levels of the intervention group decreased compared to the results observed in the control group (p = 0.01), as did the dependence of the intervention group (0.015). On the other hand, the results obtained after the intervention by the control group for anxiety (0.479) and depression (0.292) were not statistically significant. CONCLUSION: Rehabilitation VR used as an adjuvant treatment to conventional treatment has a beneficial impact on the neurological status and state of anxiety of stroke patients admitted to neurorehabilitation units. TRIAL REGISTRATION: Registered in the https://clinicaltrials.gov/ repository (NTC NCT05143385). Protocol registration date 7 October 2021, retrospectively registered.

Impact of virtual reality-based therapy on post-stroke depression: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Post-stroke depression is the most common neuropsychiatric consequence and reduces rehabilitation effectiveness. However, the efficacy of virtual reality (VR) on mental health treatment for patients after a stroke is uncertain. AIMS: The aim of this study was to evaluate the efficacy of VR as a co-adjuvant form of treatment to reduce depression in stroke patients admitted to neurorehabilitation units. METHODS: We systematically searched medical databases including PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception to November 16, 2023. Clinical trials comparing the use of VR as an adjuvant form of treatment in stroke patients' rehabilitation with the usual treatment were included. Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses were performed according to type of stroke, VR characteristics, and the scale used to measure depression. Meta-regression analysis was performed for intervention duration and to determine the mean age of the participants. RESULTS: Eight studies and 388 stroke patients were included. The VR interventions were associated with a lower risk of depression in patients (ES = -0.69; 95% CI [-1.05, -0.33]; I2 = 57.6%; p ≤ .02). The estimates were not affected by the type of stroke, the type of VR used, the blinding process, the type of scale used to detect depression, the duration of the intervention (weeks and minutes), and the total number of sessions. Meta-regression shows that younger samples (p = .00; 95% CI [0.01, 0.08) and longer interventions (p = < .05; 95% CI [-0.00, -0.00) lead to a greater reduction in depression. LINKING EVIDENCE TO ACTION: This review provides an important basis for treating depression in patients after a stroke. Professionals working in stroke neurorehabilitation units should consider VR as a form of co-adjuvant treatment for depression in patients. SYSTEMATIC REVIEW REGISTRATION: CRD42022303968.

Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis.

AIM: To assess the effects of virtual reality (VR) on the depressive state of patients with stroke admitted to neuro-rehabilitation units. Design: Systematic review and meta-analysis protocol. METHODS: Randomized Controlled Trials (RCTs) focusing on the effects of virtual reality on depressive state as a primary outcome will be included. Grey literature and the following databases will be consulted: PubMed, Cinahl, PsycInfo, Scopus, Embase, Cochrane Library and Web of Science. The recently revised Cochrane risk of bias tool will be used to assess the quality of included studies. Data will be extracted and meta-analyses will be performed within the specific condition of the emotional state of stroke patients admitted to neurorehabilitation units. Meta-regression and subgroup analyses will be used to identify effective modes and patterns of therapy delivery. The approach of assessment, development and evaluation of recommendations will be applied to reach a convincing conclusion. DISCUSSION: An accurate, transparent and standardized review process is expected to provide recommendations on the use of VR technology in the healthcare of stroke patients. IMPACT: Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. VR seems to have an important role in the treatment and depression in neurological patients, as it is able to improve levels of well-being, coping strategies and social relationships. The systematic review may contribute to a more convincing and specific conclusion compared to existing studies of this type. TRIAL REGISTRATION: Systematic review registration: CRD42022303968.

Training of volunteer nurses during the Spanish Civil War (1936-1939): A historical study.

BACKGROUND: The Spanish Civil War (1936-1939) is an example of a historic event involving nurses, with the participation of professional and volunteer nurses from Spain and other countries. In this context, nurses were trained over short periods of time and recruited to work at hospitals serving the two warring camps. OBJECTIVES: To identify the characteristics of the training received by volunteer nurses on both sides in the Spanish Civil War and compare it with previous experiences in the history. DESIGN: Historical research. METHODS: Heuristic and hermeneutical analysis of nurse training manuals and news articles from 1936 to 1939. Spanish primary sources were consulted at the Red Cross Documentation Centre Archive in Madrid, the General Military Archive in Ávila, the Municipal Newspaper Archive in Madrid, and the archives of Spanish daily newspapers ABC and La Vanguardia. The following variables were analysed: duration, entry requirements, and theoretical content of the training courses. Consolidated Criteria for Reporting Qualitative Research (COREQ) has been used. FINDINGS: Both sides in the conflict offered a varied training programme, which was supported by official institutions and private initiatives. The courses lasted between one week and two months. Entry requirements were influenced by education level, age, moral conduct, health status, and social and political background. Training content focused on the techniques needed in conflict settings and covered specific moral values. CONCLUSIONS: Despite the different social and political characteristics of the two warring factions, the variety of training programmes on offer, the entry requirements, and the theoretical content of volunteer nurse training were similar on both sides. At the end of the Spanish Civil War, volunteer nurses on the Republican side suffered reprisals or had to go into exile. We now know that some countries involved in World War II provided training courses for volunteer nurses. It would therefore be interesting to ascertain whether Spanish volunteer nurses contributed their experience to these courses.

Flash Glucose Monitoring and Patient Satisfaction: A Meta-Review of Systematic Reviews.

Flash glucose monitoring (FGM) systems have been suggested to have clinical beneficial effects in patients with diabetes mellitus, although their improvements in terms of quality of life (QoL) and patients' satisfaction are not always addressed or are considered a secondary outcome. Thus, the aim of this meta-review is to establish the benefits of FGM in terms of patients' satisfaction and QoL in both type 1 and type 2 diabetes patients using evidence from past systematic reviews and meta-analyses. Major databases were searched for systematic reviews (with or without meta-analyses) that assessed the satisfaction or QoL of type 1 or 2 diabetes patients using FGM compared with other glucose monitoring systems. The quality of the included systematic reviews was addressed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. Six systematic reviews (including two meta-analyses) were included in the meta-review. Evidence suggests that FGM systems seem to improve patients' satisfaction and QoL compared with self-monitoring of blood glucose, although the high variability in the measurement tools, the clinical significance and the quality of the systematic reviews included do not allow us to state FGM benefits with any certainty. Further research, including high-quality randomised clinical trials, differentiating the needs of both type 1 and type 2 diabetes patients and focusing on psychosocial benefits for these patients is needed to optimise clinical decisions between patients and professionals by developing the right health technology assessment for FGM systems.

La Agrupación Profesional de Médicos Liberales: la respuesta progresista del asociacionismomédico español (1935-1939) / The Professional Association of Liberal Doctors: the progressive response of Spanish medical associations (1935-1939)

Este trabajo es una aportación a la escasa historiografía sobre el asociacionismo profesional médico en España en la primera mitad del siglo XX. La Agrupación Profesional de Médicos Liberales (APML), creada durante la II República Española, no sólo intentó romper con los antecedentes asociativos tradicionales de la profesión médica, sino que participó activa-mente a nivel político y social con el objetivo de obtener una medicina comprometida con la sociedad. Este posicionamiento activo hizo que la APML fuera considerada un enemigo más del régimen de Franco, y sus afiliados víctimas de la represión y el exilio (AU)

Prevalence Rates of Loneliness and Its Impact on Lifestyle in the Healthy Population of Madrid, Spain.

BACKGROUND: The Spanish population presents higher levels of loneliness than citizens of countries in Northern Europe. Numerous studies have linked loneliness to increased morbidity and mortality, but very few studies have associated loneliness with healthy lifestyles. The objectives of this research are to identify the feeling of unwanted loneliness in various age and gender groups in the city of Alcalá de Henares (Madrid, Spain), to determine lifestyle habits in the areas of diet and physical exercise, and to examine the association between lifestyle habits and perceived loneliness. METHODS: A cross-sectional, observational and analytical study on the perception of loneliness among men (59.06%) and women (60.06%) in a sample (n = 611) of the general population (N = 198,945), by means of random assignment of a health survey, was conducted. The data were collected using an ad hoc questionnaire. The data were stratified and analyzed with the IBM SSPS® v.25 software package. RESULTS: The frequency of loneliness is stratified by sex and age, and healthy lifestyle habits in terms of diet and physical exercise are analyzed. CONCLUSIONS: People with perceived loneliness do not have worse lifestyle habits. However, women living with other people have a higher perception of loneliness than those living alone. Specifically, the perception of loneliness in young adult women could suggest a low level of moderate physical exercise.

Barriers and Facilitators Perceived by Spanish Experts Concerning Nursing Research: A Delphi Study.

The identification of research priorities in line with current health needs and nursing competencies is a priority. Nevertheless, barriers and facilitators perceived by nurses to performing nursing research have scarcely been investigated. The main aim of this study was to explore the situation in nursing research in Spain, as perceived by Spanish experts. A Delphi study technique in two phases was applied using an online survey tool. A panel of 20 nursing experts in nursing, teaching and management positions participated. The strengths highlighted were the possibility of reaching the PhD level, the possibility of receiving continuous training in research methodology, and access to scientific knowledge through the Internet. The weaknesses identified were the lack of Spanish nursing journals in which to publish the research results, the lack of funding in nursing care research, and the lack of connection between the healthcare institutions and the university. According to the experts, elements that could enhance leadership in research are the creation of nursing research units in hospitals, the economic recognition of nurses with PhDs, and considering research work as part of their daily tasks in clinical settings. The idea of being subordinated to physicians still remains in nurses' ways of thinking.

La enfermería en el exilio republicano español de 1939 a Francia una aproximación para su estudio / No disponible

Entre enero y febrero de 1939 pasaron por la frontera pirenaica cerca de medio millón de refugiados republicanos españoles -movimiento poblacional conocido como la «Retirada»-. A pesar de que el colectivo de enfermería fue el grupo profesional sanitario más numeroso en el exilio, apenas contamos con investigaciones que visibilicen su labor durante los primeros meses de la «Retirada» en Francia. Este trabajo pretende identificar la labor asistencial desarrollada por el colectivo de enfermería, español y francés, entre enero y septiembre de 1939, y analizar las variables de invisibilidad y desigualdad de género sobre la actuación de las enfermeras. Para ello se ha consultado documentación de once archivos franceses, prensa histórica, literatura sanitaria de la época y testimonios de algunas enfermeras y refugiados. Se ha podido visibilizar el cuidado ejercido por las enfermeras de la Cruz Roja francesa, que fue desvirtuado por la prensa conservadora francesa, y el de las enfermeras españolas, que quedaron en un segundo plano debido a su condición subalterna y femenina. Finalmente, se identifican cuáles son las principales dificultades y oportunidades para futuros trabajos sobre la enfermería española en el exilio republicano de 1939 en Francia

No disponible

Asistencia sanitaria y salud pública en Talavera de la Reina durante la Guerra Civil (1936-1939) / Health Care and Public Health in Talavera de la Reina during the Spanish Civil War (1936-1939)

El presente trabajo pretende analizar de forma integrada los efectos de la guerra civil española sobre la población y los servicios sanitarios de Talavera de la Reina, ciudad clave en el desarrollo de la contienda debido a su ubicación geográfica entre Andalucía occidental, Extremadura y Madrid. Para ello, se ha trabajado con documentación del Archivo Municipal de Talavera de la Reina, del Archivo del Centro Secundario de Higiene Rural de Talavera de la Reina, del Archivo Histórico Provincial de Toledo y del Archivo General Militar de Ávila. En primer lugar, se presenta el grupo de cinco hospitales militares que funcionaron en la ciudad, su organización y actividad, reconstruida a partir de los diferentes modelos de fichas utilizadas. La actividad preventiva se analiza desde dos puntos de vista, las órdenes emanadas de la autoridad militar, centradas en la higiene, alimentación y prevención de enfermedades infecciosas, y las actuaciones llevadas a cabo por las autoridades locales, centradas en asegurar un correcto abastecimiento de agua y recogida de residuos. Además, se expone la situación insalubre de las prisiones de la ciudad, siendo un claro ejemplo del estado sanitario del momento

This work aims to comprehensively analyse the effects of the Spanish civil war on the population and the sanitary services of Talavera de la Reina, a key city in the development of the contest due to its geographic location between Andalusia Western, Extremadura and Madrid. To this end, he has worked with documentation of the Municipal Archives of Talavera de la Reina, the archive of the secondary Centre of Rural hygiene in Talavera de la Reina, the Provincial historical archive of Toledo and the military general archive of Ávila. First, appears the Group of five military hospitals that operated in the city, its organization and activity, reconstructed from different models used chips. Preventive activity is analysed from two points of view, the orders emanating from the military authority, with a focus on hygiene, food and prevention of infectious diseases, and the actions carried out by the local authorities, centred ensure a proper water supply and waste collection. In addition, exposed the unhealthy situation in prisons in the city, is a clear example of the State of the health of the moment

El Museo de Historia de la Enfermería de Madrid, una cita pendiente con nuestro pasado profesional / The Museum of Nursing History in Madrid: a pending appointment with our professional past

No disponible

La situación sociosanitaria de los refugiados civiles españoles en Francia, marzo-junio de 1939 / The socio-health reality of Spanish civil refugees in France, March-June 1939

El artículo intenta aproximarse a la realidad sociosanitaria de más de 210 mil refugiados civiles que cruzaron la frontera pirenaica en el invierno de 1939. Este colectivo estuvo constituido principalmente por mujeres, niños y ancianos. A su llegada a Francia, la población civil fue reconducida hacía más de 1.500 centros de alojamiento. Nos encontramos ante espacios que se diferenciaron de los campos de concentración en lo que respecta a libertad y trato humano. Hemos podido acercarnos a esta realidad gracias a los informes emitidos por las delegadas de la Commission d'Aide aux Enfants Espagnols Refugies en France entre marzo y junio de 1939

The aim of this paper consist in approaching the socio-health reality of more than 210,000 civilian refugees who crossed the Pyrenean border during the winter of 1939. This group mainly comprised women, children, and the elderly. Upon arrival in France, these civilians were redirected to more than 1,500 housing centers, which differed from concentration camps in terms of freedom and human treatment. We have been able to know details about their experience thanks to reports by the delegates of the Commission d'Aide aux Enfants Espagnols Refugies en France between March and June 1939

La asistencia sanitaria a los heridos y enfermos del exilio republicano español en Francia: de la improvisación inicial a los campos de concentración (enero-septiembre 1939) / Healthcare to wounded and sick refugees in the spanish republican exile in france: from the initial improvisation to the concentration camps (january-september 1939)

El final de la Guerra Civil Española en Cataluña supuso un punto de inflexión en la vida de casi medio millón de refugiados españoles que traspasaron la frontera pirenaica en el invierno de 1939. En este gran afluente, existieron más de 13.000 heridos y enfermos que tuvieron que ser atendidos por toda la geografía francesa. Con esta investigación, se visibiliza cuáles fueron los itinerarios de los heridos, dónde fueron atendidos y qué características tuvo la asistencia sanitaria hasta que la mayoría de los pacientes fueron reconducidos a campos de concentración situados en el sur de Francia. Nos encontramos ante una realidad compleja que ha sido abordada con documentación localizada en una docena de archivos históricos franceses, testimonios directos y prensa general. Entre los resultados, cabe destacar la necesidad de improvisación de la III República Francesa en materia asistencial, ya que el 70% de los refugiados fueron asistidos en centros acondicionados para la ocasión. En los hospitales, quienes atendieron fueron en su mayoría profesionales sanitarios españoles. Realizaron su labor de una manera digna, a pesar de las restricciones de las autoridades francesas hacia lo que ellos consideraron "el problema español"

The end of the Spanish Civil War in Catalonia influenced the lives of almost half a million of Spanish refugees that crossed the Pyrenean border in the winter of 1939. In this large migration wave, more than 13,000 wounded and sick people had to be treated within French territory. With this research, we examine the routes of the wounded, the places where they were treated, and the features of their healthcare before they were transported to the concentration camps in southern France. This information has been analysed using documentation of 12 French historical archives, direct testimonials and general press. The results emphasize the Third French Republic’s ability to improvise in the healthcare field, where 70% of the refugees were treated in specially equipped healthcare centres. Those who treated refugees in hospitals were mostly Spanish healthcare professionals. They carried out their work in a dignified manner, despite restrictions from French authorities towards what they considered to be "the Spanish problem"