Predictor factors of perceived health in family caregivers of people diagnosed with mild or moderate Alzheimer's disease

Caring for a person diagnosed with Alzheimer’s disease has a negative impact on family caregivers’ psychological health. This study examined the factors related to ‘perceived health’ and ‘presence of new-onset mental health problems’ in family caregivers of people diagnosed with mild and moderate Alzheimer’s disease. A cross-sectional observational study carried out in Almeria’s Healthcare District (Spain). A total of 255 family caregivers (42.4% cared for people with mild Alzheimer’s disease and 57.6% cared for people with moderate Alzheimer’s disease) participated in the study from January to December 2015. Mainly, caregivers were women (81.5% in the mild Alzheimer’s disease group and 88.4% in the moderate Alzheimer’s disease group), and their average age was 56.54 years (standard deviation (SD) = 13.13) and 54.47 years (SD = 11.71), respectively. Around 47% of the caregivers had been caring for the person with Alzheimer’s between two and five years. The Goldberg General Health Questionnaire was used to measure perceived health and the presence of new-onset mental health problems. An exploratory descriptive analysis and a multivariate logistic regression analysis were conducted. For caregivers of people with mild Alzheimer’s disease, ‘perceived health’ was related to ‘perceived social support’ (r = −0.21; p = 0.028), ‘person’s level of dependency’ (r = −0.24, p = 0.05), ‘severity of the person’s neuropsychiatric symptoms’ (r = 0.22; p = 0.05), and ‘caregiver’s emotional distress in response to the person’s neuropsychiatric symptoms’ (r = 0.22; p = 0.05). For caregivers of people with moderate Alzheimer’s disease, ‘perceived health’ was related to ‘perceived social support’ (r = −0.31; p ˂ 0.01), ‘presence of neuropsychiatric symptoms’ (r = 0.27, p = 0.01), ‘severity of the person’s neuropsychiatric symptoms’ (r = 0.32, p = 0.01) and ‘caregiver’s emotional distress in response to the person’s neuropsychiatric symptoms’ (r = 0.029; p = 0.01). The presence of new-onset mental health problems was detected in 46.3% (n = 50) of caregivers of people with mild Alzheimer’s and 61.9% (n = 91) of caregivers of people with moderate Alzheimer’s. When people are diagnosed with mild Alzheimer’s disease, intervention programs for caregivers should aim to regulate emotions and promote positive coping strategies. When people are diagnosed with moderate Alzheimer’s disease, intervention programs for caregivers must allow them to adapt to caregiving demands that arise with the progression of Alzheimer’s disease

Design and psychometric analysis of the COVID-19 prevention, recognition and home-management self-efficacy scale

In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People’s self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and psychometrically test the COVID-19 prevention, detection, and home-management self-efficacy scale (COVID-19-SES). We conducted an observational cross-sectional study. Six-hundred and seventy-eight people participated in the study. Data were collected between March and May 2020. The COVID-19-SES’ validity (content, criterion, and construct), reliability (internal consistency and test-retest reliability), and legibility were studied. The COVID-19-SES’ reliability was high (Cronbach’s alpha = 0.906; intraclass correlation coefficient = 0.754). The COVID-19-SES showed good content validity (scale’s content validity index = 0.92) and good criterion validity when the participants’ results on the COVID-19-SES were compared to their general self-efficacy (r = 0.38; p 0.001). Construct validity analysis revealed that the COVID-19-SES’ three-factor structure explained 52.12% of the variance found and it was congruent with the World Health Organisation’s recommendations to prevent COVID-19 contagion and spread. Legibility analysis showed that the COVID-19-SES is easy to read and understand by laypeople. The COVID-19-SES is a psychometrically robust instrument that allows for a valid and reliable assessment of people’s self-efficacy in preventing, detecting symptoms, and home-managing COVID-19

Accompanied child irregular migrants who arrive to Spain in small boats: experiences and health needs

The European Union is the preferred destination of child irregular migrants arrived from northern Africa, who risk their lives crossing the Mediterranean Sea in small boats. Accompanied Child Irregular Migrants (AChIMs) are exposed to physical and psychological risk. The objective of our study is to describe and understand the experiences and health needs of AChIMs who arrive to Spain in small boats, through the testimony of adults who accompany them on the journey. A qualitative study, based on Gadamer's hermeneutic phenomenology, was performed. After obtaining approval from the Ethics and Research Committee, we conducted in-depth interviews on 32 adults who travelled with AChIMs. Two main themes emerged: (1) The journey a child should never have to take, with the subthemes 'AChIMs as a paradigm of vulnerability' and 'Crossing the sea, playing with death' and (2) Characterising emergency care to AChIMs, with the subthemes 'Prioritising specific care', 'Identifying high-risk situations' and 'The detaining of innocent children'. AChIMs, along with adults, risk their lives in such a dangerous and perilous journey, therefore, finding out about their experiences may contribute to improving the treatment of their specific health needs during the phases of rescue and emergency care

Experiences of mothers of extremely preterm infants after hospital discharge

The purpose of this study was to describe and understand the experiences of mothers of extremely preterm infants during the first twelve months at home following discharge from a neonatal intensive care unit. A qualitative, interpretative approach using Gadamer's philosophical hermeneutics was carried out. One focus group and fifteen in-depth, semi-structured interviews were conducted twelve months after hospital discharge. Responses were recorded, transcribed and analyzed using computer-assisted qualitative data analysis. The study´s participants were twenty women. The following themes emerged from the data analysis: 1) 'The journey home: the discharge process', which included the sub-themes 'escaping the hospital environment: between desire and fear' and 'preparing parents for hospital discharge: practice and formal support'; and 2) 'The difficulty of living with an extremely preterm infant', including the sub-themes 'the challenge of an unexpected form of childcare', 'overprotection of and bond with a child with special needs' and 'disturbance in the social/familiar setting: when a mother becomes a nurse'. The process of hospital discharge and the first months at home are difficult. The birth and care of an extremely preterm infant affect the mothers' quality of life as well as their family and social life. Practice and early discharge programmes can make the discharge process easier. The knowledge and understanding of the experience of mothers of extremely preterm infants in the first months at home after hospital discharge could help healthcare professionals to develop educational strategies and counselling interventions in accordance with the mothers' needs. [Abstract copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Few-mode field quantization of arbitrary electromagnetic spectral densities

We develop a framework that provides a few-mode master equation description of the interaction between a single quantum emitter and an arbitrary electromagnetic environment. The field quantization requires only the fitting of the spectral density, obtained through classical electromagnetic simulations, to a model system involving a small number of lossy and interacting modes. We illustrate the power and validity of our approach by describing the population and electric field spatial dynamics in the spontaneous decay of an emitter placed in a complex hybrid plasmonic-photonic structure.This work has been funded by the European Research Council through Grant ERC-2016-StG-714870 and by the Spanish Ministry for Science, Innovation, and Universities—Agencia Estatal de Investigación through grants RTI2018-099737-B-I00, PCI2018-093145 (through the QuantERA program of the European Commission), and MDM-2014-0377 (through the María de Maeztu program for Units of Excellence in R&D). It was also supported by a Leonardo Grant for Researchers and Cultural Creators, BBVA Foundation. I. M. thanks the nanophotonics group for the warm hospitality during his stay at UAM, and acknowledges funding from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES) through Grant 88887.368031/2019-0

Understanding violence against women irregular migrants who arrive in Spain in small boats

African irregular migrants risk their lives crossing the Mediterranean Sea in small boats hoping to reach Europe. Women irregular migrants (WIMs) are an especially vulnerable group that suffer from violence and sexual aggression, but little is known about their actual experiences. The objective of our study is to describe and understand the violence against WIMs who arrive in Spain in small boats. A qualitative study based on Gadamer’s phenomenology was used. The data collection included twenty-six in-depth interviews with WIMs. Three main themes arose: “Poverty and discrimination push WIMs into migrating”; “WIMs as a paradigm of extreme vulnerability”, and “WIMs in small boats should raise the alarm”. WIMs who arrive to Europe in small boats have a history of violence, rape, prostitution, forced pregnancy, and human trafficking. Emergency care must include gynecological examinations and must make detecting sexual violence and human trafficking of WIMs part of their care protocols

Serum proteomics of active tuberculosis patients and contacts reveals unique processes activated during Mycobacterium tuberculosis infection.

Tuberculosis (TB) is the most lethal infection among infectious diseases. The specific aim of this study was to establish panels of serum protein biomarkers representative of active TB patients and their household contacts who were either infected (LTBI) or uninfected (EMI-TB Discovery Cohort, Pontevedra Region, Spain). A TMT (Tamdem mass tags) 10plex-based quantitative proteomics study was performed in quintuplicate containing a total of 15 individual serum samples per group. Peptides were analyzed in an LC-Orbitrap Elite platform, and raw data were processed using Proteome Discoverer 2.1. A total of 418 proteins were quantified. The specific protein signature of active TB patients was characterized by an accumulation of proteins related to complement activation, inflammation and modulation of immune response and also by a decrease of a small subset of proteins, including apolipoprotein A and serotransferrin, indicating the importance of lipid transport and iron assimilation in the progression of the disease. This signature was verified by the targeted measurement of selected candidates in a second cohort (EMI-TB Verification Cohort, Maputo Region, Mozambique) by ELISA and nephelometry techniques. These findings will aid our understanding of the complex metabolic processes associated with TB progression from LTBI to active disease

Design and psychometric evaluation of the 'Clinical Communication Self-Efficacy Toolkit'

Nursing students experience difficulties when communicating in clinical practice. Their self-efficacy in clinical communication should be explored as part of their competence assessment before they are exposed to real human interactions in the clinical setting. The aim of this study was to design and psychometrically evaluate a toolkit to comprehensively assess nursing students’ self-efficacy in clinical communication. The study followed an observational cross-sectional design. A sample of 365 nursing students participated in the study. The ‘Clinical Communication Self-Efficacy Toolkit’ (CC-SET) was comprised of three tools: the ‘Patient-Centered Communication Self-efficacy Scale’ (PCC-SES), the ‘Patient clinical Information Exchange and interprofessional communication Self-Efficacy Scale’ (PIE-SES), and the ‘Intrapersonal communication and Self-Reflection Self-Efficacy Scale’ (ISR-SES). The tools’ reliability, validity (content, criterion, and construct) and usability were rigorously tested. The Cronbach’s alpha coefficient of the three tools comprising the CC-SET was very high and demonstrated their excellent reliability (PCC-SES = 0.93; PIE-SES = 0.87; ISR-SES = 0.86). The three tools evidenced to have excellent content validity (scales’ content validity index > 0.95) and very good criterion validity. Construct validity analysis demonstrated that the PCC-SES, PIE-SES, and ISR-SES have a clear and theoretically-congruent structure. The CC-SET is a comprehensive toolkit that allows the assessment of nursing students’ self-efficacy in interpersonal, interprofessional, and intrapersonal communication

Experience of parents who have suffered a perinatal death in two Spanish hospitals: a qualitative study

Background: Perinatal grief is a process that affects families in biological, psychological, social and spiritual terms. It is estimated that every year there are 2.7 million perinatal deaths worldwide and 4.43 deaths for every 1000 births in Spain. The aim of this study is to describe and understand the experiences and perceptions of parents who have suffered a perinatal death. Methods: A qualitative study based on Gadamer’s hermeneutic phenomenology. The study was conducted in two hospitals in the South of Spain. Thirteen mothers and eight fathers who had suffered a perinatal death in the 5 years prior to the study participated in this study. In-depth interviews were carried out for data collection. Inductive analysis was used to find themes based on the data. Results: Eight sub-themes emerged, and they were grouped into three main themes: ‘Perceiving the threat and anticipating the baby’s death: “Something is going wrong in my pregnancy”’; ‘Emotional outpouring: the shock of losing a baby and the pain of giving birth to a stillborn baby’; “We have had a baby”: The need to give an identity to the baby and legitimise grief’. Conclusion: The grief suffered after a perinatal death begins with the anticipation of the death, which relates to the mother’s medical history, symptoms and premonitions. The confirmation of the death leads to emotional shock, characterised by pain and suffering. The chance to take part in mourning rituals and give the baby the identity of a deceased baby may help in the grieving and bereavement process. Having empathy for the parents and notifying them of the death straightaway can help ease the pain. Midwives can help in the grieving process by facilitating the farewell rituals, accompanying the family, helping in honouring the memory of the baby, and supporting parents in giving the deceased infant an identity that makes them a family member

Perspectivas de desarrollo de un espacio audiovisual en los países del Cono Sur de América Latina : elementos para un análisis y diagnóstico de la televisión : tesis doctoral /

Consultable des del TDXTítol obtingut de la portada digitalitzadaEl objetivo de la presente tesis doctoral es determinar los elementos de la televisión como empresa y actor dentro de la sociedad e identificar las similitudes y diferencias de la industria de este medio en los países que conforman el Cono Sur de América Latina: Argentina, Bolivia, Brasil, Chile, Paraguay y Uruguay. Una vez definidos los elementos para el diagnóstico de la televisión y realizado su análisis, se estudiarán las dinámicas de la televisión en la región de estudio y las posibilidades de desarrollo de un espacio audiovisual. Para ello se toman como herramientas metodológicas la economía industrial y la economía política. La primera entrega la visión de la secuencia real de los mercados (condiciones de base, estructura, estrategias y acciones, y resultados); mientras que la segunda explica las grandes relaciones que existen entre los medios de comunicación y los estados, a través de la existencia de los canales de televisión públicos, la relación e influencia mutua entre el sector privado de la televisión y los diferentes gobiernos y mediante la legislación que regula el sector. La hipótesis planteada es que a partir del análisis de las televisiones de la región y de sus contextos, se puede afirmar que existen las bases estructurales en el mercado como para desarrollar un espacio audiovisual en el macroespacio regional Cono Sur de América Latina. Esto se traduce en que las televisiones de los países que conforman este macroespacio regional tienen las mismas características en su estructura, constituyen oligopolios, con fuertes componentes de concentración empresarial de carácter multimedia y constituyen un modelo mixto de propiedad, donde persisten televisiones públicas con diversos grados de éxito. El análisis comparado de las televisiones de los países de la región en estudio según la metodología descrita, arroja semejanzas y diferencias en la conformación del mercado de la televisión abierta de libre recepción, que durante el período de dictaduras militares, y particularmente al finalizar éstas, se caracteriza por una tendencia hacia un modelo comercial en el medio. La introducción de nuevas tecnologías de transmisión de televisión, como el cable y el satélite DTH, formó un segundo mercado de televisión, esta vez pagada. Este hecho, junto con el surgimiento de las redes y el fenómeno de globalización, conforman un nuevo panorama en el cual la televisión presenta nuevas dinámicas. En este contexto se presenta el desafío de la creación de un espacio audiovisual en el marco dado por el MERCOSUR y sus países asociados, Chile y Bolivia. Para la comprensión del proceso se consideran los esfuerzos que desde hace más de una década buscan incluir los aspectos culturales -entre ellos los medios de comunicación y la televisión como un medio masivo- en el proceso de integración. La necesidad de políticas que vayan más allá del patrimonio material y el desarrollo de un sentimiento de unidad manteniendo la diversidad, se plantean como desafíos para la formación de un espacio audiovisual en el Cono Sur de América Latina.The objective of the present doctoral thesis is to determine the elements of the television like company and actor within the society and to identify the similarities and differences of the television industry in the countries that form the South Cone of Latin America: Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay. Once defined the elements for the diagnosis of the television and made their analysis, it will study the dynamics of the television industry in views to development of an audio-visual space. For this thesis, the methodological tools will be the industrial economy and the political economy. The first one deliveries the vision of the real sequence of the markets (conditions of base, structure, strategies and actions, and results); the second explains the relations that exist between mass media and the governments, through the existence of the television channels public, the relation and influences mutual between the deprived sector of the television and the different governments and by means of the legislation that regulates the sector. From the analysis of the televisions of the region and its contexts, it is possible to identify the structural bases in the market that would help to development an audiovisual space in the South Cone of Latin America. This means that the televisions of these countries have the same characteristics in their structure, constitute oligopolies, with multimedia mergers and a mixed model of property, where persist public televisions with diverse degrees of success. The analysis compared of the televisions of the countries throws similarities and differences in the conformation of the market of the free reception television -which during the period of military dictatorships, and particularly in the last years- is characterized by a tendency towards a commercial model in media. The introduction of new technologies of television transmission, like the cable and satellite DTH, formed a second market of television. This fact, along with the rising of the networks and the phenomenon of globalization, conform a new panorama in which the television displays new dynamic. In this context the challenge of the creation of an audiovisual space appears in MERCOSUR and their associated countries, Chile and Bolivia. To understand the process, the cultural aspects of the MERCOSUR integration process will be considered. The region needs policies that go beyond the material patrimony. The development of a unit feeling maintaining the diversity is one of the challenges for the creation of an audiovisual space in the South Cone of Latin America