Medio didáctico para el tema Asistencia de enfermería a pacientes con ventilación mecánica artificial

The new learning models have presented diverse possibilities of application of the most modern information and communication technologies in their training programs. This is why the objective of this research is to implement a didactic method for the teaching-learning process of nursing assistance to patients with artificial ventilation in the nursing in emergencies subject, which allows increasing the development of skills in the students. For this purpose, a study of educational intervention was carried out to implement a didactic method in the teaching-learning process of nursing Assistance to patients with artificial ventilation at the Haydee Santamaria Cuadrado medical sciences filial in Manzanillo. The study universe consisted of all students of the fourth year of the bachelor's degree in nursing, 9 brigades in total with 154 students. A brigade with 24 students representing 15.6 % was selected as sample. For the preparation of the software, the mediator 8.0 application was used. As a result, 16.6 % of the students surveyed who presented a good initial level increased by 79.2 % after applying the educational software. The number of students with a good level of knowledge in the subject previously mentioned that resulted in the survey is significantly higher than the number obtained in the initial diagnosis, so that the level of knowledge insufficient decreased significantly. Los nuevos modelos de aprendizaje han planteado diversas posibilidades de aplicación de las más modernas tecnologías de información y comunicaciones en sus programas de formación. Es por ello que el objetivo de esta investigación es implementar un medio didáctico informático, para el proceso de enseñanza-aprendizaje del tema Asistencia de enfermería a pacientes con ventilación mecánica artificial en la asignatura Enfermería en Urgencias, que permita elevar el desarrollo de habilidades en los estudiantes. Para eso se realizó un estudio de intervención educativa para implementar un medio didáctico en el proceso de enseñanza- aprendizaje del tema mencionado en la Filial de Ciencias Médicas Haydee Santamaría Cuadrado de Manzanillo. El universo de estudio estuvo constituido por todos los estudiantes de cuarto año de la carrera de Licenciatura en Enfermería, 9 brigadas en total con 154 estudiantes. Se seleccionó como muestra una brigada con 24 estudiantes que representa un 15,6 %. Para la confección del software se utilizó la aplicación Mediator 8.0. Se obtuvieron como resultados que de un 16,6 % de los estudiantes encuestados que presentó un nivel inicial bueno se incrementó en un 79,2 % después de aplicado el software educativo. El número de estudiantes con nivel de conocimiento bueno en el tema antes citado que arrojó la encuesta supera significativamente al número obtenido en el diagnóstico inicial, por lo que el nivel de conocimientos insuficiente disminuyó significativamente

Medio didáctico para el tema Asistencia de enfermería a pacientes con ventilación mecánica artificial

RESUMEN Los nuevos modelos de aprendizaje han planteado diversas posibilidades de aplicación de las más modernas tecnologías de información y comunicaciones en sus programas de formación. Es por ello que el objetivo de esta investigación es implementar un medio didáctico informático, para el proceso de enseñanza-aprendizaje del tema Asistencia de enfermería a pacientes con ventilación mecánica artificial en la asignatura Enfermería en Urgencias, que permita elevar el desarrollo de habilidades en los estudiantes. Para eso se realizó un estudio de intervención educativa para implementar un medio didáctico en el proceso de enseñanza- aprendizaje del tema mencionado en la Filial de Ciencias Médicas Haydee Santamaría Cuadrado de Manzanillo. El universo de estudio estuvo constituido por todos los estudiantes de cuarto año de la carrera de Licenciatura en Enfermería, 9 brigadas en total con 154 estudiantes. Se seleccionó como muestra una brigada con 24 estudiantes que representa un 15,6 %. Para la confección del software se utilizó la aplicación Mediator 8.0. Se obtuvieron como resultados que de un 16,6 % de los estudiantes encuestados que presentó un nivel inicial bueno se incrementó en un 79,2 % después de aplicado el software educativo. El número de estudiantes con nivel de conocimiento bueno en el tema antes citado que arrojó la encuesta supera significativamente al número obtenido en el diagnóstico inicial, por lo que el nivel de conocimientos insuficiente disminuyó significativamente. ABSTRACT The new learning models have presented diverse possibilities of application of the most modern information and communication technologies in their training programs. This is why the objective of this research is to implement a didactic method for the teaching-learning process of nursing assistance to patients with artificial ventilation in the nursing in emergencies subject, which allows increasing the development of skills in the students. For this purpose, a study of educational intervention was carried out to implement a didactic method in the teaching-learning process of nursing Assistance to patients with artificial ventilation at the Haydee Santamaria Cuadrado medical sciences filial in Manzanillo. The study universe consisted of all students of the fourth year of the bachelor's degree in nursing, 9 brigades in total with 154 students. A brigade with 24 students representing 15.6 % was selected as sample. For the preparation of the software, the mediator 8.0 application was used. As a result, 16.6 % of the students surveyed who presented a good initial level increased by 79.2 % after applying the educational software. The number of students with a good level of knowledge in the subject previously mentioned that resulted in the survey is significantly higher than the number obtained in the initial diagnosis, so that the level of knowledge insufficient decreased significantly

Hiperentorno educativo para los contenidos del tema Asistencia de Enfermería a pacientes con Afecciones Respiratorias Agudas

Introduction: to increase the scientific level of Nursery students and professors using developing learning methods and means where the intensive and efficient use of computer tools has a leading role. Objective: to implement an educational hyper-environment for the contents of the Nursing care to patients with acute respiratory diseases to increase the development of the skills in the students. Methods: it was carried out an intervention study related to the implementation of an educative hyper-environment in regards to the nursing care to patients with acute respiratory diseases including the Emergency nursing subject. The universe of study consisted of all students in the fourth year of the Bachelor´s Degree in Nursing, 12 groups with 174 students. It was selected as a sample a group of the Polyclinic No. 3 René Vallejo Ortiz de Manzanillo with 24 students representing 14%. Results: the number of students with a High level of knowledge, 4 to 16.6%, which yielded the initial diagnosis, exceeded the number obtained after its implementation, 19 to 79.2%. Conclusions: the number of students with a High level of knowledge on the nursing care in patients with acute respiratory conditions that yielded the initial diagnosis was exceeded after the implementation.Introducción: elevar el nivel científico de estudiantes y profesores de Enfermería valiéndose para ello de métodos y medios de aprendizaje desarrolladores en lo cual la utilización intensiva y eficiente de las herramientas informáticas tiene un rol protagónico. Objetivo: implementar un hiperentorno educativo para los contenidos del tema Asistencia de enfermería a pacientes con afecciones respiratorias agudas que permita elevar el desarrollo de habilidades en los estudiantes. Métodos: se realizó un estudio de intervención relacionado con la implementación de un hiperentorno educativo referente al tema Asistencia de enfermería a pacientes con afecciones respiratorias agudas que incluye la asignatura Enfermería en Urgencias. El universo de estudio estuvo constituido por todos los estudiantes de cuarto año de la carrera de Licenciatura en Enfermería, 12 brigadas en total con 174 estudiantes. Se seleccionó como muestra una brigada del Policlínico Docente #3 René Vallejo Ortiz de Manzanillo con 24 estudiantes que representa un 14 %. Resultados: el número de estudiantes con nivel de conocimiento Alto, 4 para un 16,6 %, que arrojó el diagnóstico inicial se supera al número obtenido una vez de su implementación, 19 para un 79,2 %. Conclusiones: el número de estudiantes con nivel de conocimiento Alto en el tema Asistencia de Enfermería en pacientes con afecciones respiratorias agudas que arrojó el diagnóstico inicial se supera después de su implementación

Valor pronóstico del índice de riesgo nutricional en receptores de trasplante cardiaco

[Abstract] Introduction and objectives. To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). Methods. We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Results. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI < 83.5), moderate nutritional risk (83.5 ≤ NRI < 97.5), and mild nutritional risk (97.5 ≤ NRI < 100) was 5%, 22%, and 10%, respectively. One year post-transplant mortality rates in these 4 categories were 18.2%, 25.3%, 7.9% and 10.2% (P < .001), respectively. The NRI was independently associated with a lower risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P < .001). Conclusions. Malnourished patients have a higher risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention.[Resumen] Introducción y objetivos. Analizar el impacto del estado nutricional preoperatorio, evaluado mediante el índice de riesgo nutricional (IRN), en el pronóstico tras el trasplante cardiaco (TxC). Métodos. Se realizó un estudio retrospectivo de 574 pacientes que recibieron un TxC entre 1991 y 2014 en un centro. El IRN preoperatorio se calculó como 1,519 × albúmina (g/l) + 41,7 × (peso real [kg] / peso ideal [kg]). La asociación entre IRN preoperatorio y eventos clínicos posoperatorios se analizó mediante modelos multivariables de regresión logística y regresión de Cox. Resultados. El IRN preoperatorio medio de la población del estudio era de 100,9 ± 9,9. Según este parámetro, las prevalencias de riesgo nutricional grave (IRN < 83,5), moderado (83,5 ≤ IRN < 97,5) y leve (97,5 ≤ IRN < 100) antes del TxC eran el 5, el 22 y el 10% respectivamente. Las tasas de mortalidad a 1 año tras el TxC en estas 4 categorías fueron del 18,2, el 25,3, el 7,9 y el 10,2% (p < 0,001) respectivamente. El IRN preoperatorio resultó predictor independiente de menor riesgo de infección posoperatoria (odds ratio ajustada [ORa] = 0,97; intervalo de confianza del 95% [IC95%], 0,95-1,00; p = 0,027) y ventilación mecánica prolongada posoperatoria (ORa = 0,96; IC95%, 0,94-0,98; p = 0,001). Los pacientes con riesgo nutricional moderado a grave mostraron mayor mortalidad a 1 año tras el TxC (hazard ratio ajustada = 1,55; IC95%, 1,22-1,97; p < 0,001). Conclusiones. Los pacientes desnutridos tienen mayor riesgo de complicaciones posoperatorias y muerte tras el TxC. La determinación del IRN podría facilitar la identificación de candidatos a TxC que se beneficien de intervenciones nutricionales en espera del órgano

Bases conceptuales de las actividades profesionales a confiar para la educación de profesionales de la salud en Latinoamérica

The concept of entrustable professional activities emerged as an attempt to overcome some of the criticisms to the competency-based medical education approach; it has had a broad impact in practice and health professions education research. It has been disseminated internationally with its English acronym: EPA. This approach proposes to orient assessment and teaching to specific activities in the profession, which allows the integration of several competencies, and to determine which responsibilities can be entrusted to the trainee, in a gradual and explicit manner. The model assumes the definition of levels of supervision that allow progressive autonomy for each EPA, in students or residents, once they demonstrate the required competencies. Practice, supervision and feedback in real clinical scenarios are key to the development of autonomy in EPA performance. The dissemination of the EPA approach is still limited in Latin America, but it has the potential to create a significant contribution to curriculum design and evaluation, and to assessment practices of health professionals across their careers. It provides a deep review of the assumptions under which healthcare professional practice decisions are made, at under and postgraduate levels.Revisión por pare

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio