QR como herramienta para promover entornos y conductas saludables: efectividad de una intervención en alumnos de secundaria en SVB

Cartel presentado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: Sabiendo que la RCP básica sustituye, de forma precaria, las funciones vitales, que multitud de estudios han demostrado cómo las tasas de supervivencia de las paradas cardíacas descienden si la RCP básica no es iniciada por los testigos antes de la llegada de los equipos profesionalizados, que la capacidad de aprendizaje de esta población y que el coste de la intervención en conocimiento de Soporte Vital Básico (SVB) en relación con los beneficios que aportaría en un futuro son ínfimos, es por lo que nos planteamos estudiar la efectividad de una intervención en Soporte Vital Básico en alumnos de secundaria de la Zona Básica de Salud de San Fernando, Cádiz, aplicando la herramienta quick-response code. El proyecto se enmarca dentro del programa Forma Joven de Andalucía. Objetivo: Evaluar la efectividad de la intervención educativa de SVB en términos de mejora de conocimientos teóricos y habilidades prácticas. Metodología: Sujetos de estudio: Alumnos de 4º de Enseñanza Secundaria Obligatoria. Diseño: Estudio cuasiexperimentsal pre-post intervención. Procedimiento: Elaboración QR; Presentación al director; Explicar el proyecto a los alumnos y pasarles cuestionario auto administrado pre/post-intervención; Realizar la intervención educativa grupal. Tras dos semanas de la intervención realización nuevamente cuestionario auto administrada pre/post-intervención y entrega de material formativo con el quick response code; Reevaluación al mes, tres y seis meses. Conclusiones y resultados: Mejoraríamos en los chic@s los conocimientos y habilidades en SVB; conseguiríamos que la información en SVB sea accesible en cualquier momento; la Institución mejora la responsabilidad y aporta valor añadido

La enfermería especialista como pilar fundamental en el abordaje del Trastorno Mental Grave

Cartel presentado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: está constatado ampliamente que las personas con trastorno mental grave (TMG) presentan grandes dificultades para poder desempeñar su rol laboral. El personal que los atiende debe tener unos conocimientos, habilidades y aptitudes que no suelen estar al alcance de un único profesional. Proponemos la creación de un programa específico de detección-intervención que mejore el estado de salud de los trabajadores con TMG. Dicho programa será llevado a cabo por enfermera especialista en Enfermería del Trabajo y enfermera Especialista en Salud Mental. Objetivo: evaluar la efectividad de un programa psicoeducativo en trabajadores de centros sanitarios del SAS de la ciudad de Sevilla con trastorno mental grave que estén incluidas en el Censo del Trastorno Mental Grave del Proceso Asistencial Integrado (PAI TMG) entre 1 de enero de 2015 y el 31 de diciembre de 2016, ambos inclusive. Metodología: sujetos de estudio: profesionales del Sistema Andaluz de Salud diagnosticados de trastorno mental grave. Diseño: Estudio cuantitativo con dos fases, donde la primera es una fase observacional descriptiva transversal y la segunda será cuasi experimental (ensayo clínico pre y post). Procedimiento: Programa de abordaje psicoeducativo multidisciplinar llevado a cabo por la enfermera especialista en enfermería del trabajo y la enfermera especialista en salud mental. Conclusiones y resultados: se persigue: Conocimiento por parte del trabajador con TMG de: la enfermedad, tratamiento y pronóstico; Incrementar la calidad de vida del trabajador con TMG: Ansiedad y su control; Mejorar el estigma social y rehabilitación del trabajador con TMG; Asegurar la correcta integración laboral de los trabajadores con TMG

Soporte vital básico: Efectividad de una intervención en adolescentes empleando el QR = Basic Life Support: Effectiveness of an intervention in adolescents using the QR

Resumen: Objetivo: Determinar la efectividad de una intervención educativa en Soporte Vital Básico (SVB) empleando el quick response code (QR) en términos de mejora de conocimientos teóricos y habilidades prácticas en alumnos de 4º ESO de San Fernando (Cádiz),España. Metodología: Compuesta de dos etapas:1ªinvestigación bibliográfica desde 2008 a 2014 en las bases de datos PubMed, CuidenPlus, Dialnet, SciELO, Embase, el Índice Médico Español (IME) y 2ª Investigación cuasi-experimental pre y post intervención con la participación de 246 adolescentes a quienes se les realizó una intervención y posteriormente se les aplicó un cuestionario auto administrado de conocimiento teórico, un check-list de habilidades prácticas y un cuestionario de satisfacción. Se empleó la prueba ANOVA y prueba de rango post hoc HSD de Tukey. Resultados: La variable conocimiento teórico muestra diferencias significativas (p=0%) para todos los momentos a excepción de los momentos post-intervención inmediata y la post-intervención de los 6 meses, en cambio la variable adquisición habilidades prácticas muestra diferencias significativas (p=0%) para todos los momentos de la intervención. El grado de satisfacción global es del 99%. Conclusión: Existe evidencia estadísticamente significativa (p<0.0000) de la efectividad de la intervención en SVB con empleo del QR y un elevado grado de satisfacción por parte de los alumnos.Palabras clave: Resucitación Cardio Pulmonar básica, Educación Secundaria, Enfermería, Tecnología de la Información, Proyectos de Tecnologías de Información y ComunicaciónAbstract: Objective: To assess the usefulness of an educational intervention to teach the theory and practical skills about basic life support to high school students from San Fernando(Cádiz). Methods: It is a study which consists of two reports:1ª A literature review of the year 2008-2013 in English and Spanish in the database PubMed, CuidenPlus, Dialnet, SciELO, Embase and Índice Médico Español (IME). 2ª Semi-experimental research carried out in a sample of 246 secondary school students in San Fernando, Cádiz. An educational intervention was developed according to the ILCOR 2015 guidelines. The students, who were an experimental group and a control group at the same time, took a test before and after instruction in order to detect change in knowledge and skills. ANOVA’s test was used to assess the differences in the score changes of the dimensions of the scale employed. Results: Viable data were obtained for 246 students. After analysis of variance, the variable theoretical knowledge shows significant differences (p=0 %) for all the moments with the exception of the moments immediate post-intervention and the post-intervention of 6 months and the variable practical skills shows significant differences (p=0 %) for all the moments of the intervention. The grade of global satisfaction was 99%. Conclusions: The educational intervention in basic life support with QR achieved a significant increase in theoretical knowledge and practical skills. The relevance of these results rests on the lower cost per instructional session for the QR, which can be used an unlimited number of times without supervision. Furthermore, the QR can be distributed free of charge to institutions or individuals.Keywords: Cardiopulmonary Resuscitation, Education Secondary, Nursing, Information Techonlogy, Information Technologies and Communication Projects doi: http://dx.doi.org/10.20318/recs.2016.345

Es hora de un cambio. Entrevista motivacional

Cartel presentado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroduccion: la entrevista motivacional fue ideada por William Miller y Steve Rollnich en 1991, con la intención de trabajar la motivación, centrándose en el paciente, ayudándolo a resolver contradicciones sobre conductas o hábitos insanos y a desarrollar habilidades propias. Se trata de una “estrategia” de asistencia directa centrada en la persona. Pretende promover un cambio interno, entendiendo esta “motivación” como un proceso que consiste en influir de alguna manera en la conducta. La entrevista motivacional resalta la necesidad de adoptar una actitud empática, en la que el paciente se siente apoyado y no juzgado, de modo que favorezca el cambio. Objetivo: aumentar los conocimientos sobre la entrevista motivacional. Metodología: se realiza revisión bibliográfica en diferentes bases de datos: Pubmed y Cuiden. Resultados: según Miller y Rollnick, la entrevista motivacional constaba de 2 fases, una primera donde se construye la motivación para el cambio y una segunda donde se produce un fortalecimiento para el mismo. A su vez la entrevista motivacional, se basa en 4 principios : Expresar empatía, desarrollar discrepancias, Darle un giro a las resistencias y apoyar la autoeficacia. La entrevista motivacional puede ser usada en las etapas del cambio que describió Prochaska y DiClemente. Conclusión: se ha demostrado que la entrevista motivacional es una técnica eficaz para promover el cambio de comportamiento en los usuarios, se han descrito múltiples aplicaciones dentro de la psiquiatría, por ser un entorno donde aparecen muchas resistencias al cambio, además mejora la relación enfermero-paciente y aumenta la eficiencia de la consulta

Effectiveness of Core Stability Exercises and Recovery Myofascial Release Massage on Fatigue in Breast Cancer Survivors: A Randomized Controlled Clinical Trial

The purpose of the present paper was to evaluate the effects of an 8-week multimodal program focused on core stability exercises and recovery massage with DVD support for a 6-month period in physical and psychological outcomes in breast cancer survivors. A randomized controlled clinical trial was performed. Seventy-eight (n = 78) breast cancer survivors were assigned to experimental (core stability exercises plus massage-myofascial release) and control (usual health care) groups. The intervention period was 8 weeks. Mood state, fatigue, trunk curl endurance, and leg strength were determined at baseline, after the last treatment session, and at 6 months of followup. Immediately after treatment and at 6 months, fatigue, mood state, trunk curl endurance, and leg strength exhibited greater improvement within the experimental group compared to placebo group. This paper showed that a multimodal program focused on core stability exercises and massage reduced fatigue, tension, depression, and improved vigor and muscle strength after intervention and 6 months after discharge

Colorectal cancer pain upon diagnosis and after treatment: a cross‑sectional comparison with healthy matched controls

Ethics approval The study protocols were approved by the Research Ethics Committee of the University of Granada (0572-M1-16 and 1087-N-16), and the study was performed in accordance with Law 14/2007 on Biomedical Research and the guidelines of the WMA Declaration of Helsinki.Availability of data and material Data will be available upon request from the corresponding author.Background The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. Methods An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s d and Hedge’s effect size, as appropriate. Results The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). Conclusion Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatmentsUniversidad de Granada/CBUASpanish Ministry of Education Culture and Sport (MECD) (FPU17/00939, FPU18/03575)European Social Fund, the Carlos III Health Institute (FI19/00230)CEIBiotic Universidad de Granada (CEI13-MP18 and CEI14-MPBS40

Factors that influence treatment delay in patients with colorectal cancer

A prospective study was performed of patients diagnosed with colorectal cancer (CRC), distinguishing between colonic and rectal location, to determine the factors that may provoke a delay in the first treatment (DFT) provided.2749 patients diagnosed with CRC were studied. The study population was recruited between June 2010 and December 2012. DFT is defined as time elapsed between diagnosis and first treatment exceeding 30 days.Excessive treatment delay was recorded in 65.5% of the cases, and was more prevalent among rectal cancer patients. Independent predictor variables of DFT in colon cancer patients were a low level of education, small tumour, ex-smoker, asymptomatic at diagnosis and following the application of screening. Among rectal cancer patients, the corresponding factors were primary school education and being asymptomatic.We conclude that treatment delay in CRC patients is affected not only by clinicopathological factors, but also by sociocultural ones. Greater attention should be paid by the healthcare provider to social groups with less formal education, in order to optimise treatment attentio

Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol

Pain is one of the most persistent symptoms after cancer treatment. The central nervous system can erroneously stay in its alarm phase, altering the pain experience of patients who have cancer. Pain neuroscience education (PNE) with multimodal approaches may benefit these patients.“Subvenciones para la Financiación de la Investigación, Desarrollo e Innovación (I+D+I) Biomédica y en Ciencias de la Salud, Consejería de Salud y Familias”, of the Andalusian Regional Government (PI-0171-2020

Exploiting the passenger ACO1-deficiency arising from 9p21 deletions to kill T-cell lymphoblastic neoplasia cells

Precursor T-cell lymphoblastic neoplasms are aggressive malignancies in need for more effective and specific therapeutic treatments. A significant fraction of these neoplasms harbor deletions on the locus 9p21, targeting the tumor suppressor CDKN2A but also deleting the aconitase 1 (ACO1) gene, a neighboring housekeeping gene involved in cytoplasm and mitochondrial metabolism. Here we show that reducing the aconitase activity with fluorocitrate decreases the viability of T-cell lymphoblastic neoplasia cells in correlation to the differential aconitase expression. The consequences of the treatment were evidenced in vitro using T-cell lymphoblastic neoplasia cell lines exhibiting 9p21 deletions and variable levels of ACO1 expression or activity. Similar results were observed in melanoma cell lines, suggesting a true potential for fluorocitrate in different cancer types. Notably, ectopic expression of ACO1 alleviated the susceptibility of cell lines to fluorocitrate and, conversely, knockdown experiments increased susceptibility of resistant cell lines. These findings were confirmed in vivo on athymic nude mice by using tumor xenografts derived from two T-cell lines with different levels of ACO1. Taken together, our results indicate that the non-targeted ACO1 deficiency induced by common deletions exerts a collateral cellular lethality that can be used as a novel therapeutic strategy in the treatment of several types of cancerInstituto de Salud Carlos III (ACCI-CIBERER-17); Spanish Ministerio de Economía y Competitividad (SAF2015-70561 R;MINECO/FEDER, EU); Spanish Ministerio de Ciencia, Innovación y Universidades (RTI2018-093330-B-I00; MCIU/FEDER, EU); Universidad Autónoma de Madrid, Spain (B2017/BMD-3778; LINFOMAS-CM); Spanish Association Against Cancer (AECC, 2018; PROYE18054PIRI); Fundación Ramón Areces (CIVP19S7917); Institutional grants from Fundación Ramón Areces and Banco de Santander to Centro de Biología Molecular Severo Ochoa are also acknowledge

Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry

Background: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. Results: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide) and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the 'candy cane' roux limb, with resolution of hypoglycemia in all cases. Conclusions: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure