Asertividad sexual, autoeficacia y conductas sexuales de riesgo en adolescentes: Una revisión de literatura

Objective: To identify the available scientific literature on sexual assertiveness, self-efficacy and risky sexual behavior in adolescents. Method: Integrative review, in order to clarify the following question: What is the relationship between sexual assertiveness, self-efficacy and sexual risk behaviors in adolescents? The search was performed in the Web Of Science (WOS), EBSCOhost¸Scopus and GoogleScholar databases. Main results: 6 studies were analyzed, and their main findings are that self-efficacy influences CSR; condom use is not associated with self-efficacy, and self-efficacy is positively related to sexual debut; self-efficacy and self-efficacy in condom use is associated with saying no to engaging in sexual activity; self-efficacy was found to be a protective factor against health risk behaviors and CSR. General conclusion: Sexual assertiveness and self-efficacy may be factors that contribute to the development of skills to prevent CSR, behaviors that in recent years have caused various health problems in adolescents, who tend to be more prone to risky practices, this perhaps due to what the process of adolescence as such entails.Objetivo: Identificar en literatura científica disponible acerca del asertividad sexual, autoeficacia y conductas sexuales de riesgo en adolescentes. Método: Revisión integrativa, con el fin de aclarar la siguiente cuestión: ¿Cuál es la relación entre la asertividad sexual, autoeficacia y conductas sexuales de riesgo en adolescentes? La búsqueda se realizó en las bases de datos Web Of Science (WOS), EBSCOhost¸Scopus y GoogleScholar. Resultados principales: Se analizaron 7 estudios y sus principales hallazgos son que la autoeficacia tiene influencia en las Conductas Sexuales de Riesgo (CSR); el uso de condón no se asocia con la autoeficacia, y la autoeficacia se relaciona positivamente con el debut sexual; la autoeficacia y autoeficacia en el uso de condón se asocia a decir no a realizar actividad sexual; la autoeficacia se encontró como factor protector ante las conductas de riesgo para la salud y CSR. Conclusión general: La asertividad sexual y la autoeficacia pueden ser factores que contribuyan en el desarrollo de habilidades para prevenir las CSR, conductas que en los últimos años han causado diversos problemas de salud en los adolescentes, los cuales suelen ser más propensos a realizar prácticas riesgosas, esto quizá debido a lo que conlleva el proceso de la adolescencia como tal

Diseño de una prueba de evaluación clínica objetiva estructurada de cuidados de enfermería del primer curso de prácticas clínicas

Objective: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. Method: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. Results: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. Conclusion: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program

Teaching empathy to nursing students: A randomised controlled trial

Background: Empathy has been reported to produce a positive effect on improving patient health outcomes, becoming a fundamental skill in any health personnel-patient relationship. Objective: To evaluate the effectiveness of an intervention designed to improve the nursing students' empathy, the learning perception, the improvement of the perception in the understanding of the content, and in the degree of difficulty as well as the acquisition of skills. Design: Multicentre randomised controlled trial. Setting: This research was conducted at two schools of nursing at a public university in the Southwest of Spain. Participants: 116 nursing students were randomly assigned to an experimental ora control group (delayed intervention group once the post-training analysis was completed) during the second semester of the 2015/ 2016 academic year. Methods: Pre-test, post-test, and follow-up data were obtained for each group using a simulated clinical interview. Empathy was the primary outcome (The Consultation and Relational Empathy Measure, Jefferson Scale of Empathy student version, Reynolds Empathy Scale, and Carkhuff Scale). The students' perceived knowledge, the learning perception, the self-esteem (Rosenberg Self-Esteem Scale) and the understanding of the content and acquisition of skills (ad-hoc questions) were also analysed. Results: The results were improved in ali the measures conducted in the experimental groups at the different centres after the intervention. The mean post-test simulation seores were higher than the pre-test with statistically significan! differences. The results were maintained in the follow-up. The student's perception of learning and the perception of understanding of the content and the acquisition of ski lls were improved as well. Conclusion: The study support that training in empathic competence is effective

FENOLES DEL POLEN DE STENOCACTUS, ECHINOCEREUSY MAMMILLARIA(CACTACEAE)

A variable number of phenolics have beendetected in pollen of the following speciesof Cactaceae: Stenocactus multicostatussubsp. zacatecasensis, Echinocereusenneacanthus, Echinocereus pectinatus,Echinocereus triglochidiatus var.coccineus and Mammillaria heyderi sensulato. The phenolics were characterized by means of chromatographic (HPLC) andspectrometric (UV) properties. The mostabundant flavonols were 3-O-glycosidederivatives of kaempferol and 3-Oglycoside derivatives of quercetin. 3-Oglycoside derivatives of herbacetin werefound in lower abundance. Each species hada particular pollen phenolic profile.Intrapopulation variability in phenolicprofiles was detected in all cases. Thephenolic composition of these species isreported for the first time.Un número variable de compuestosfenólicos ha sido detectado en el polen deStenocactus multicostatus subsp.zacatecasensis (Britton et Rose) U. Guzmánet Vázquez-Benítez, comb. et stat. nov.,Echinocereus enneacanthus Engelm.,Echinocereus pectinatus (Scheidw.)Engelm., Echinocereus triglochidiatus var.coccineus (Engelm.) U. Guzmán, comb. etstat. nov. y Mammillaria heyderi sensulato, todas de la familia Cactaceae. Loscompuestos fenólicos fueron caracterizados por sus propiedades cromatográficas (HPLC) y espectrométricas (UV).Los fenoles encontrados fueron derivadosde ácidos fenólicos y flavonoides. Estosúltimos estuvieron representados porflavonoles, de éstos los más abundantesfueron los 3-O-glicósidos derivados decanferol y quercetina. En menor abundancia se encontraron derivados 3-O-glicósidos deherbacetina. Variabilidad intrapoblacionalen la composición fenólica del polen fueregistrada en todos los casos. Cada unode los taxa presentó un perfil fenólicoparticular. La composición de fenoles delpolen de estas especies es presentada porprimera vez

El uso interdisciplinar de los cómics de Astérix como instrumento de enseñanza-aprendizaje en los Grados de Maestro

Memoria ID-0217. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Extinction risk of Mesoamerican crop wild relatives

Ensuring food security is one of the world's most critical issues as agricultural systems are already being impacted by global change. Crop wild relatives (CWR)—wild plants related to crops—possess genetic variability that can help adapt agriculture to a changing environment and sustainably increase crop yields to meet the food security challenge. Here we report the results of an extinction risk assessment of 224 wild relatives of some of the world's most important crops (i.e. chilli pepper, maize, common bean, avocado, cotton, potato, squash, vanilla and husk tomato) in Mesoamerica—an area of global significance as a centre of crop origin, domestication and of high CWR diversity. We show that 35% of the selected CWR taxa are threatened with extinction according to The International Union for Conservation of Nature (IUCN) Red List demonstrates that these valuable genetic resources are under high anthropogenic threat. The dominant threat processes are land use change for agriculture and farming, invasive and other problematic species (e.g. pests, genetically modified organisms) and use of biological resources, including overcollection and logging. The most significant drivers of extinction relate to smallholder agriculture—given its high incidence and ongoing shifts from traditional agriculture to modern practices (e.g. use of herbicides)—smallholder ranching and housing and urban development and introduced genetic material. There is an urgent need to increase knowledge and research around different aspects of CWR. Policies that support in situ and ex situ conservation of CWR and promote sustainable agriculture are pivotal to secure these resources for the benefit of current and future generations