SAS - D.S.A.P. Granada

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Public Perception of Organ Donation and Transplantation Policies in Southern Spain.
(2022-03-15) Díaz-Cobacho, Gonzalo; Cruz-Piqueras, Maite; Delgado, Janet; Hortal-Carmona, Joaquín; Martínez-López, M Victoria; Molina-Pérez, Alberto; Padilla-Pozo, Álvaro; Ranchal-Romero, Julia; Rodríguez-Arias, David
This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain. Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain.
Diagnostic performance of brief cognitive tests in cognitive impairment screening.
(2019-08-08) Carnero-Pardo, C; Rego-García, I; Mené Llorente, M; Alonso Ródenas, M; Vílchez Carrillo, R
This study aims to assess and compare the diagnostic performance of brief cognitive tests for cognitive impairment (CI) screening recommended by the Spanish guidelines for the integral care of people with Alzheimer's disease and other dementias. We performed a phase iii study into the accuracy of diagnostic tests, including patients with suspected CI in a primary care setting. All patients completed the Mini-Mental State Examination (MMSE), the Mini Examen Cognoscitivo (MEC), the Short Portable Mental Status Questionnaire (SPMSQ), the Memory Impairment Screen (MIS), the Clock Drawing Test (CDT), the Eurotest, the Fototest, and the Memory Alteration Test (M@T). CI was diagnosed independently by researchers blinded to scores on these tests. Diagnostic performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC). The study included 141 individuals (86 with CI). The Eurotest and M@T (AUC ± SE: 0.91 ± 0.02 and 0.90 ± 0.02, respectively) took longer to administer (mean [SD]: 7.1 [1.8] and 6.8 [2.2] min, respectively) and have significantly better diagnostic performance compared to the MMSE, MEC, SPMSQ, and CDT, but not compared to MIS or Fototest (both with an AUC of 0.87 ± 0.03), with the latter taking less than half as long to administer (2.8 [0.8] min). The M@T and MIS only evaluate memory, and the latter cannot be administered to illiterate people. The most advisable tests for CI screening in primary care are the Eurotest, M@T, and Fototest, with the latter being the most efficient as it takes half as long to administer.
[Reflections on the future of home care. Short and medium-term priorities].
(2022-06-16) Melguizo Jiménez, Miguel; García Caballos, Marta
Global Distribution of COVID-19 Vaccine: Mine First
(Mdpi, 2022-10-01) Hortal-Carmona, Joaquin; Diaz-Cobacho, Gonzalo; [Hortal-Carmona, Joaquin] Ctr Salud Albayzin, Granada 18010, Spain; [Diaz-Cobacho, Gonzalo] Univ Granada, Dept Philosophy 1, Granada 18071, Spain; MCIN/AEI
The COVID-19 (SARS-CoV-2) pandemic dealt a severe blow to society as a whole and required countries to confront a situation that exceeded the limits of their borders. In this paper, we analyze how these countries as well as supranational organizations responded to this unprepared global emergency. We also explore what alternative models have been proposed in the wake of this crisis and propose some changes-other ways of acting-so that in future pandemics or global emergencies, we can deal with the situation more effectively.
Decision-Tree-Based Approach for Pressure Ulcer Risk Assessment in Immobilized Patients.
(2022-09-06) Vera-Salmerón, Eugenio; Domínguez-Nogueira, Carmen; Romero-Béjar, José L; Sáez, José A; Mota-Romero, Emilio
Applications where data mining tools are used in the fields of medicine and nursing are becoming more and more frequent. Among them, decision trees have been applied to different health data, such as those associated with pressure ulcers. Pressure ulcers represent a health problem with a significant impact on the morbidity and mortality of immobilized patients and on the quality of life of affected people and their families. Nurses provide comprehensive care to immobilized patients. This fact results in an increased workload that can be a risk factor for the development of serious health problems. Healthcare work with evidence-based practice with an objective criterion for a nursing professional is an essential addition for the application of preventive measures. In this work, two ways for conducting a pressure ulcer risk assessment based on a decision tree approach are provided. The first way is based on the activity and mobility characteristics of the Braden scale, whilst the second way is based on the activity, mobility and skin moisture characteristics. The results provided in this study endow nursing professionals with a foundation in relation to the use of their experience and objective criteria for quick decision making regarding the risk of a patient to develop a pressure ulcer.
Pressure Ulcers Risk Assessment According to Nursing Criteria.
(2022-07-31) Vera-Salmerón, Eugenio; Mota-Romero, Emilio; Romero-Béjar, José Luis; Dominguez-Nogueira, Carmen; Gómez-Pozo, Basilio
Pressure ulcers (PU) represent a health problem with a significant impact on the morbidity and mortality of immobilized patients, and on the quality of life of affected people and their families. Risk assessment of pressure ulcers incidence must be carried out in a structured and comprehensive manner. The Braden Scale is the result of an analysis of risk factors that includes subscales that define exactly what should be interpreted in each one. The healthcare work with evidence-based practice with an objective criterion by the nursing professional is an essential addition for the application of preventive measures. Explanatory models based on the different subscales of Braden Scale purvey an estimation to level changes in the risk of suffering PU. A binary-response logistic regression model, supported by a study with an analytical, observational, longitudinal, and prospective design in the Granada-Metropolitan Primary Healthcare District (DSGM) in Andalusia (Southern Spain), with a sample of 16,215 immobilized status patients, using a Braden Scale log, is performed. A model that includes the mobility and activity scales achieves a correct classification rate of 86% (sensitivity (S) = 87.57%, specificity (SP) = 81.69%, positive predictive value (PPV) = 91.78%, and negative preventive value (NPV) = 73.78%), while if we add the skin moisture subscale to this model, the correct classification rate is 96% (S = 90.74%, SP = 88.83%, PPV = 95.00%, and NPV = 80.42%). The six subscales provide a model with a 99.5% correct classification rate (S = 99.93%, SP = 98.50%, PPV = 99.36%, and NPV = 99.83%). This analysis provides useful information to help predict this risk in this group of patients through objective nursing criteria.
Dietary Patterns and Prostate Cancer: CAPLIFE Study.
(2022-07-17) Lozano-Lorca, Macarena; Rodríguez-González, Margarita; Salcedo-Bellido, Inmaculada; Vázquez-Alonso, Fernando; Arrabal, Miguel; Martín-Castaño, Benita; Sánchez, María-José; Jiménez-Moleón, José-Juan; Olmedo-Requena, Rocío
The etiology of prostate cancer (PCa) remains uncertain, and the role of diet is unclear. We aimed to evaluate the role of diet, through dietary patterns, on PCa, considering tumor aggressiveness and extension. The CAPLIFE study is a population-based case-control study including a total of 428 incident PCa cases and 393 controls aged 40-80 years. Dietary information was collected through a validated food frequency questionnaire. Three dietary patterns were identified through principal component analysis: "Mediterranean," "Western," and "Unhealthy," which were categorized into tertiles according to the control group cutoff points. Tumor aggressiveness and extension was determined. Logistic regression models were used to assess the association between dietary patterns and PCa. High adherence to an unhealthy dietary pattern was associated with higher odds of PCa, ORT3vsT1 = 1.52 (95% CI 1.02-2.27), especially for cases with ISUP 1-2 and localized PCa tumors. This association was not observed with a Western or Mediterranean pattern. In conclusion, adherence to an unhealthy diet appears to be associated with higher odds of PCa, especially for cases with ISUP 1-2 and localized PCa tumors.
Health-related quality of life in patients newly diagnosed with prostate cancer: CAPLIFE study.
(2022-11-21) Lozano-Lorca, Macarena; Barrios-Rodríguez, Rocío; Redondo-Sánchez, Daniel; Cózar, José-Manuel; Arrabal-Martín, Miguel; García-Caballos, Marta; Salcedo-Bellido, Inmaculada; Sánchez, María-José; Jiménez-Moleón, José-Juan; Olmedo-Requena, Rocío
To analyse the Health-Related Quality of Life (HRQoL) at diagnosis of patients with prostate cancer (PCa) according to tumour extension and urinary symptomatology and to explore factors associated with HRQoL. 408 Controls and 463 PCa cases were included. Eligibility criteria were a new diagnosis of PCa (cases), 40-80 years of age, and residence in the participating hospitals' coverage area for ≥ 6 months before recruitment. HRQoL was evaluated using the 12-Item Short-Form Health Survey, Mental (MCS) and Physical Component Summaries (PCS), and urinary symptoms with the International Prostate Symptom Score. HRQoL scores for all PCa cases, according to tumour extension and urinary symptoms, were compared with controls. In addition, information about lifestyles and comorbidities was collected and its association with low HRQoL (lower scores) were explored using logistic regression models. Overall cases had similar PCS score, but lower MCS score than controls. The lowest standardised scores for both PCS and MCS were reached by cases with severe urinary symptoms and a metastatic tumour [mean (SD); PCS: 41.9 (11.5), MCS: 42.3 (10.3)]. Having "below" PCS and MCS scores was associated with the presence of three or more comorbidities in the cases [aOR = 2.86 (1.19-6.84) for PCS and aOR = 3.58 (1.37-9.31) for MCS] and with severe urinary symptomatology [aOR = 4.71 (1.84-12.08) for PCS and aOR = 7.63 (2.70-21.58) for MCS]. The mental dimension of HRQoL at diagnosis of patients with PCa was lower than in controls, especially for cases with severe urinary symptoms and a metastatic tumour. Comorbidities and urinary symptoms were variables associated with the HRQoL of PCa cases.
Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome.
(2022-09-30) Valle-Hita, Cristina; Becerra-Tomás, Nerea; Díaz-López, Andrés; Vázquez-Ruiz, Zenaida; Megías, Isabel; Corella, Dolores; Goday, Albert; Martínez, J Alfredo; Alonso-Gómez, Ángel M; Wärnberg, Julia; Vioque, Jesús; Romaguera, Dora; López-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Lapetra, José; Serra-Majem, Lluís; Bueno-Cavanillas, Aurora; Tur, Josep A; Martín-Sánchez, Vicente; Pintó, Xavier; Gaforio, José J; Matía-Martín, Pilar; Vidal, Josep; Amengual-Galbarte, Angela; Daimiel, Lidia; Ros, Emilio; García-Arellano, Ana; Barragán, Rocío; Fitó, Montse; Peña-Orihuela, Patricia J; Asencio-Aznar, Alberto; Gómez-Gracia, Enrique; Martinez-Urbistondo, Diego; Morey, Marga; Casas, Rosa; Garrido-Garrido, Eva María; Tojal-Sierra, Lucas; Damas-Fuentes, Miguel; Goñi, Estibaliz; Ortega-Azorín, Carolina; Castañer, Olga; Garcia-Rios, Antonio; Gisbert-Sellés, Cristina; Sayón-Orea, Carmen; Schröder, Helmut; Salas-Salvadó, Jordi; Babio, Nancy
Diets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (UACR). Older adults with overweight/obesity and metabolic syndrome (mean age 65 ± 5 years, 48% women) from the PREDIMED-Plus study who had available data on eGFR (n = 5,874) or UACR (n = 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline from a food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year-changes in eGFR and UACR were set as the primary outcomes. We secondarily assessed ≥ 10% eGFR decline or ≥10% UACR increase. After multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, β: -0.64 ml/min/1.73 m2; 95% CI: -1.21 to -0.08 and NEAP, β: -0.56 ml/min/1.73 m2; 95% CI: -1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing ≥10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07-1.54 and NEAP, OR: 1.24; 95% CI: 1.03-1.50) and ≥10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04-1.46) compared to individuals with lower dietary acid load. Higher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity and metabolic syndrome.
An examination of the fear of COVID-19 and professional quality of life among nurses: A multicultural study.
(2022-03-20) Baysal, Ebru; Selçuk, Aslı Karakuş; Aktan, Gül Güneş; Andrade, Eric Francelino; Notarnicola, Ippolito; Stievano, Alessandro; Blanque, Raquel Rodríguez
To determine the factors that influence nurses' fear of COVID-19 and professional quality of life as well as their attitudes towards COVID-19 in four different countries. The emergence of COVID-19 has affected the psychological and professional quality of life of the frontline health care workers, especially nurses. An online cross-sectional multicultural study. A total of 1071 nurses from Turkey, Brazil, Spain and Italy were selected by convenience sampling. All participants were invited to complete the Fear of COVID-19 Scale and Professional Quality of Life Scale through online form from October 2020 to January 2021. It has been seen that nurses' fear of COVID-19 has been above the average and their professional quality of life has been affected negatively during the pandemic. Almost one out of three nurses (28.6%) thought of quitting their job during the pandemic. The majority of nurses (91.0%) thought their professional quality of life changed during the pandemic. The mean score of the Fear of COVID-19 Scale is higher in nurses who are working in Brazil, are female, have a chronic illness and are working in an outpatient clinic. Professional quality of life is even lower in nurses who are younger than 40, have a professional experience of less than 15 years, are working in Brazil and have concerns about themselves and their relatives because of COVID-19. It was determined that there was a relationship between fear of COVID-19 and professional quality of life subscales of nurses. Nurse leaders have an important role in supporting nurses actively during and after the COVID-19 pandemic and providing them with good working conditions, sufficient resources and rewards. In order for nurses to be able to cope with the challenges brought about by the pandemic, particularly the fear of COVID-19, and to avoid thoughts of quitting the profession, it would be beneficial to take certain administrative measures on institutional and territorial basis. It is recommended that employees with a chronic disease work in low-risk clinics, the number of nurses be increased in busier clinics, working hours be reduced and nurses be provided with psychosocial support by experts to cope with stress. On the other hand, effective infection control, personal protective measures and implementing institutional policies and protocols can help to reduce the fear of COVID-19 and increase their professional quality of life.
Nursing students' experience using an escape room for training clinical skills and competencies on emergency care: A qualitative observational study.
(2022-07-29) Gómez-Urquiza, José Luis; Hueso-Montoro, César; Correa-Rodríguez, María; Suleiman-Martos, Nora; Martos-Cabrera, María Begoña; Gómez-Salgado, Juan; Albendín-García, Luis
Game-based learning is increasing in nursing education. Also, the assessment of the utility of the escape room game is growing. To explore nursing students' opinion about the escape room as an evaluation game, a qualitative observational study with nursing students was carried out. An ad hoc questionnaire with open questions was sent after the game learning experience. The escape room included knowledge and techniques from different specialties. The escape room learning game was a positive experience for the students. The main highlighted characteristics were fun, dynamic, and motivating way to study and learn. Other interesting variables were: "Working as a team and under pressure" (It's a group activity in which everyone must work together. It is a good challenge to learn how to work in urgent situations) and "Different way to assess students´ learning" (In this type of game, I can show more things and not only theoretical knowledge). Game-based learning is increasing in nursing education, as well as the assessment of the utility of the escape room game. Using an escape room for assessing nursing students' knowledge is a positive experience. This learning experience can be also used with nurses in different specialties to promote teamwork and working under pressure.
Heterogeneity in the association between prediabetes categories and reduction on glomerular filtration rate in a 5-year follow-up.
(2022-05-05) Manouchehri, Marjan; Cea-Soriano, Lucía; Franch-Nadal, Josep; Ruiz, Antonio; Goday, Albert; Villanueva, Rosa; Diez-Espino, Javier; Mata-Cases, Manel; Giraldez-García, Carolina; Regidor, Enrique; PREDAPS Study Group
Prediabetes and not just diabetes can cause kidney damage. This study assess the association of prediabetes with development of impaired renal function (IRF). We used data from PREDAPS prospective study a cohort of 1072 subjects with prediabetes and another cohort of 772 subjects without prediabetes were follow-up from 2012 to 2017. Prediabetes was defined according to American Association of Diabetes criteria. IRF was defined as having a glomerular filtration rate
Effectiveness of an intervention to improve diabetes self-management on clinical outcomes in patients with low educational level
(Elsevier, 2017-01-01) de Labry Lima, Antonio Olry; Bermudez Tamayo, Clara; Pastor Moreno, Guadalupe; Bolivar Munoz, Julia; Ruiz Perez, Isabel; Johri, Mira; Quesada Jimenez, Fermin; Cruz Vela, Pilar; de Los Rios Alvarez, M.; Prados Quel, Miguel Angel; Moratalla Lopez, Enrique; Dominguez Martin, Susana; Lopez de Hierro, Jose Andres; Ricci Cabello, Ignacio; [de Labry Lima, Antonio Olry] Campus Univ Cartuja, Escuela Andaluza Salud Publ, Granada, Spain; [Bermudez Tamayo, Clara] Campus Univ Cartuja, Escuela Andaluza Salud Publ, Granada, Spain; [Pastor Moreno, Guadalupe] Campus Univ Cartuja, Escuela Andaluza Salud Publ, Granada, Spain; [Bolivar Munoz, Julia] Campus Univ Cartuja, Escuela Andaluza Salud Publ, Granada, Spain; [Ruiz Perez, Isabel] Campus Univ Cartuja, Escuela Andaluza Salud Publ, Granada, Spain; [de Labry Lima, Antonio Olry] Inst Invest Biosanitaria Granada, Granada, Spain; [Bermudez Tamayo, Clara] Inst Invest Biosanitaria Granada, Granada, Spain; [Bolivar Munoz, Julia] Inst Invest Biosanitaria Granada, Granada, Spain; [Ruiz Perez, Isabel] Inst Invest Biosanitaria Granada, Granada, Spain; [de Labry Lima, Antonio Olry] Univ Granada, Hosp Univ Granada, Granada, Spain; [Bermudez Tamayo, Clara] Univ Granada, Hosp Univ Granada, Granada, Spain; [Bolivar Munoz, Julia] Univ Granada, Hosp Univ Granada, Granada, Spain; [Ruiz Perez, Isabel] Univ Granada, Hosp Univ Granada, Granada, Spain; [de Labry Lima, Antonio Olry] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain; [Bermudez Tamayo, Clara] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain; [Bolivar Munoz, Julia] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain; [Ruiz Perez, Isabel] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain; [Ricci Cabello, Ignacio] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain; [Johri, Mira] Univ Montreal, Div Global Hlth, Montreal, PQ, Canada; [Johri, Mira] Hosp Res Ctr CRCHUM, Montreal, PQ, Canada; [Quesada Jimenez, Fermin] Ctr Salud Cartuja, Granada, Spain; [Cruz Vela, Pilar] Ctr Salud Cartuja, Granada, Spain; [de Los Rios Alvarez, M.] Ctr Salud Cartuja, Granada, Spain; [Prados Quel, Miguel Angel] Ctr Salud Cartuja, Granada, Spain; [Moratalla Lopez, Enrique] Ctr Salud Cartuja, Granada, Spain; [Dominguez Martin, Susana] Ctr Salud Cartuja, Granada, Spain; [Lopez de Hierro, Jose Andres] Ctr Salud Cartuja, Granada, Spain; [Ricci Cabello, Ignacio] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford OX1 2JD, England; Regional Health Ministry (Andalusia, Spain)
Objective: To determine whether an intervention based on patient-practitioner communication is more effective than usual care in improving diabetes self-management in patients with type 2 diabetes with low educational level.Methods: 12-month, pragmatic cluster randomised controlled trial. Nine physicians and 184 patients registered at two practices in a deprived area of Granada (Andalusia, Spain) participated in the study. Adult patients with type 2 diabetes, low educational level and glycated haemoglobin (HbAlc) > 7% (53.01 mmol/mol) were eligible. The physicians in the intervention group received training on communication skills and the use of a tool for monitoring glycaemic control and providing feedback to patients. The control group continued standard care. The primary outcome was difference in HbAl c after 12 months. Dyslipidaemia, blood pressure, body mass index and waist circumference were also assessed as secondary outcomes. Two-level (patient and provider) regression analyses controlling for sex, social support and comorbidity were conducted.Results: The HbAl c levels at 12 months decreased in both groups. Multilevel analysis showed a greater improvement in the intervention group (between-group HbAl c difference=0.16; p = 0.049). No statistically significant differences between groups were observed for dyslipidaemia, blood pressure, body mass index and waist circumference.Conclusions: In this pragmatic study, a simple and inexpensive intervention delivered in primary care showed a modest benefit in glycaemic control compared with usual care, although no effect was observed in the secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients. (C) 2016 SESPAS. Published by Elsevier Espaila, S.L.U.
A New Tool for Assessment of Professional Skills of Occupational Therapy Students.
(2021-09-22) Romero-Ayuso, Dulce; Ortiz-Rubio, Araceli; Moreno-Ramírez, Paz; Martín-Martín, Lydia; Triviño-Juárez, José Matías; Serrano-Guzmán, María; Cano-Detell, Enrique; Novoa-Casasola, Erika; Gea, Miguel; Ariza-Vega, Patrocinio
The assessment of the acquisition of professional skills is an essential process in occupational therapy students. Until now, there has been no standardized and validated instrument for evaluating these skills in Spanish occupational therapy students. This study reports the development and testing of the psychometric properties of the professional skills in students of occupational therapy during their practical training. A new instrument was developed to assess the professional skills of occupational therapy students, called CPTO. A total of 69 occupational therapists participated in evaluating 295 occupational therapy students from the University of Granada, between the 2018 and 2021 academic years. Of a total of 79 items, the factor analysis yielded a final solution of 33 items, which explains 70.22% of the variance with the following three dimensions: (1) self-appraisal and professional responsibility (α = 0.951); (2) communication skills and delivering intervention (α = 0.944); and (3) clinical reasoning for assessing and planning the intervention (α = 0.947). The instrument allows students with low, medium, high and excellent clinical skills to be differentiated according to the cutting points established by the quartiles. the instrument has good psychometric properties, and is a useful tool to assess professional competencies in occupational therapy students during their practice placement education.
Changes in Resilience in Students of Occupational Therapy After Their First Exposure to Practice Placement Education.
(2021-05-07) Rodríguez-Martínez, María Del Carmen; Toledano-González, Abel; Triviño-Juárez, José-Matías; Polonio-López, Begoña; Segura-Fragoso, Antonio; López-Martín, Olga; Cantero-Garlito, Pablo; Rodríguez-Hernández, Marta; Corregidor-Sánchez, Ana-Isabel; Romero-Ayuso, Dulce
Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture. Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first time to practice placement education. Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga (UMA) and Castilla-La Mancha (UCLM) (Spain). Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale (CD-RISC). All these instruments were also completed 1 week after the end of the clinical practice. Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women (13.85 points; p
[Family Medicine in the face of the law on medical aid in dying responsibility and guarantees].
(2021-04-16) Novoa-Jurado, Abel; Melguizo-Jiménez, Miguel
The approval of the euthanasia law represents a challenge for medicine and culminates a process of civic maturation of society in the face of death. There are challenges that the application of the law will have to meet. Seeking an objective and irreversible medical solution to subjective suffering - where there may be conditioning social determinants - implies a serious risk of inequity that requires policies that establish a pre-decisional guaranteeing framework. Euthanasia should be an exception thanks to the existence of strong clinical, informational and relational safeguards that can only be guaranteed in the context of a solvent primary care that accompanies people throughout their lives. In this primarist and community context, euthanasia can be the last resort of a professional committed to not abandoning a patient with severe and irreversible suffering who requests it.
Depression and Anxiety in Patients with Rare Diseases during the COVID-19 Pandemic.
(2021-03-21) Sánchez-García, Juan Carlos; Cortés-Martín, Jonathan; Rodríguez-Blanque, Raquel; Marín-Jiménez, Ana Eugenia; Montiel-Troya, Maria; Díaz-Rodríguez, Lourdes
Scientific knowledge on depression and anxiety in patients with rare diseases during the COVID-19 pandemic is scarce; however, it is essential to perform comprehensive management of these patients. The aim of this study was to research how the situation caused by the SARS-CoV-2 pandemic has influenced the lives of patients with rare diseases regarding depression and anxiety. This Spanish study considered a heterogeneous population sample of 86 patients with confirmed diagnosis of different rare diseases. Participants took part in a cross-sectional online study by completing specific questionnaires on the study topic. Depression was measured using the Patient Health Questionnaire (PHQ-9), and the General Anxiety Disorder Scale (GAD-7) was used for evaluating anxiety. Data collection through an online questionnaire allowed for a greater population scope and therefore the inclusion patients of other nationalities in the study sample. Finally, as a general result, this study found that, in the face of the pandemic, anxiety and depression remained at a higher level in this group than in the general population, making these patients a vulnerable population group.
Activities of Daily Living and Categorization Skills of Elderly with Cognitive Deficit: A Preliminary Study.
(2021-02-10) Romero-Ayuso, Dulce; Cuerda, Cristian; Morales, Carmen; Tesoriero, Ricardo; Triviño-Juárez, José Matías; Segura-Fragoso, Antonio; Gallud, José A
Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p
Effectiveness of Virtual Reality-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis.
(2021-01-21) Romero-Ayuso, Dulce; Toledano-González, Abel; Rodríguez-Martínez, María Del Carmen; Arroyo-Castillo, Palma; Triviño-Juárez, José Matías; González, Pascual; Ariza-Vega, Patrocinio; González, Antonio Del Pino; Segura-Fragoso, Antonio
This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = -1.38; p = 0.009), correct hits (SMD = -1.50; p = 0.004), and perceptual sensitivity (SMD = -1.07; p = 0.01); and moderate for commissions (SMD = -0.62; p = 0.002) and reaction time (SMD = -0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.
[PCR for COVID-19 positive, then negative and again positive Reinfection at 55 days?].
(2020-12-23) Martín Enguix, David; Aguirre Rodríguez, Juan Carlos; Sánchez Cambronero, María; Hidalgo Rodríguez, Abraham

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