Variables relacionadas con la reducción de la satisfacción de los usuarios de emergencias

The information received by patients about the severity of their condition, the type of tests to be performed, or the average waiting time in the service are factors that influence their degree of satisfaction and, therefore, their possible anger and/or aggressiveness. Users' discomfort can sometimes lead to violence towards health workers, and this, in turn, can lead to the commonly associated physical and psychological consequences. Our main objective is to explore the relationship between the waiting time, patients' perceived satisfaction with the service, as well as the other variables under study. We used a cross-sectional design was used to evaluate 320 hospital patients in the Region of Murcia (Spain). Our indicate that receiving information about their process, waiting time until the doctor's consultation, the degree of satisfaction with the professional, and the resolution of the doubts are predictors of the degree of overall patient satisfaction with the clinical experience.La información recibida por los pacientes sobre la gravedad de su condición, el tipo de pruebas a realizar o el tiempo promedio de espera en el servicio son factores que influyen en el grado de satisfacción. La incomodidad de los usuarios a veces puede conducir a la violencia hacia los trabajadores de salud, y esto, a su vez, a las consecuencias físicas y psicológicas comúnmente asociadas. Nuestro objetivo es explorar la relación entre el tiempo de espera, la satisfacción del paciente con el servicio y otras variables de interés. Se utilizó un diseño transversal para evaluar a 320 pacientes hospitalarios en la Región de Murcia (España). Los resultados indican que recibir información sobre su proceso, el tiempo de espera hasta la consulta, el grado de satisfacción con el profesional y la resolución de dudas son predictores del grado de satisfacción general del paciente con la experiencia clínica

Tough Love Lessons: Lateral Violence among Hospital Nurses

Background: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field

Users’ perception of violence and conflicts with professionals in primary care centers before and during covid-19. a qualitative study

Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users’ point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide

Profiles of lateral violence in nursing personnel of the Spanish public health system

Background Workplace violence in healthcare settings has long been studied in scientific literature, particularly in the nursing profession. Research has explored mostly user violence probably for its high prevalence and impact on health and job satisfaction. Yet this focus may overshadow another dangerous type of workplace violence: coworker violence. Exerted by co-workers with similar status, lateral violence differs from that yielded by a co-worker with a higher rank, known as vertical. This study aims to deepen the knowledge about lateral violence perceived by nurses and its interaction with other variables commonly associated with workplace violence in healthcare: burnout, job satisfaction, and self-perceived health. Method A random block sampling was performed, prompting a total sample of 925 nursing professionals from 13 public hospitals located in the southeast of Spain. The sample distribution (mean and standard deviation) and the response percentages according to the study variables of the ad-hoc questionnaire were analyzed and classified with cluster analysis. Results Through the cluster analysis, two subgroups were obtained: Cluster 1, composed of 779 participants, with low scores in the variables used for the classification, high levels of both extrinsic and intrinsic satisfaction, low levels of emotional exhaustion and cynicism, and low rates of somatization, anxiety, social dysfunction and depression; and Cluster 2, composed of 115 participants and characterized by moderate-high scores in the variables used for the classification, moderate extrinsic satisfaction, and low intrinsic satisfaction, high emotional exhaustion and cynicism and lower somatization, anxiety, social dysfunction, and depression scores. Excluded cases amounted to 31. Conclusion Nursing professionals who experience lateral violence reveal a lower intrinsic satisfaction, feeling less self-accomplished in their job, and less positive work experience. Emotional exhaustion rises as a concerning progressive and long-term outcome of experiencing this type of violence

TAXONOMÍA Y REGISTROS DE CHRYSOPIDAE (INSECTA: NEUROPTERA) EN EL ESTADO DE MORELOS, MÉXICO

A total of 21 species of Chrysopidae occurring in the State of Morelos are presented, these are included in nine genera in the subfamily Chrysopinae. A key is given for the genera as well as keys to species in each genus and diagnosis and distribution data for each species. The identified species were as follows: Ceraeochrysa cincta (Schneider), Ceraeochrysa cubana (Hagen), Ceraeochrysa everes (Banks), Ceraeochrysa sanchezi (Navás), Ceraeochrysa valida (Banks), Chrysopa sp., Chrysoperla comanche (Banks), Chrysoperla exotera (Navás), Chrysoperla rufilabris (Burmeister), Eremochrysa hageni Banks, Leucochrysa maculata Navás, Leucochrysa pretiosa Banks, Leucochrysa texana Adams, Meleoma antennensis Tauber, Meleoma colhuaca Banks, Meleoma mexicana Banks, Meleoma pipai Tauber, Meleoma tezcucana (Banks), Plesiochrysa brasiliensis (Schneider), Plesiochrysa elongata (Navás) y Yumachrysa apache (Banks); 15 species are new records for Morelos, one of which (P. elongata) is a new record for Mexico. Ceraeochrysa and Meleoma were the genera with the largest number of species although Ceraeochrysa was the genus with the largest number of individuals. The most important species as far as their abundance in descending order were: Ceraeochrysa cincta, C. valida, C. cubana, Leucochrysa texana y Chrysoperla comanche.Se presentan 21 especies de Chrysopidae que ocurren en el Estado de Morelos, agrupadas en ocho géneros de la subfamilia Chrysopinae. Se proporciona una clave para los géneros y claves para las especies de cada género, diagnosis y datos de distribución de cada especie, así como imágenes que ilustran las claves. Las especies identificadas fueron: Ceraeochrysa cincta (Schneider), Ceraeochrysa cubana (Hagen), Ceraeochrysa everes (Banks), Ceraeochrysa sanchezi (Navás), Ceraeochrysa valida (Banks), Chrysopa sp., Chrysoperla comanche (Banks), Chrysoperla exotera (Navás), Chrysoperla rufilabris (Burmeister), Eremochrysa hageni Banks, Leucochrysa maculata Navás, Leucochrysa pretiosa Banks, Leucochrysa texana Adams, Meleoma antennensis Tauber, Meleoma colhuaca Banks, Meleoma mexicana Banks, Meleoma pipai Tauber, Meleoma tezcucana (Banks), Plesiochrysa brasiliensis (Schneider), Plesiochrysa elongata (Navás) y Yumachrysa apache (Banks); 15 especies son nuevos registros para Morelos, una de las cuales (P. elongata) representa un nuevo registro para México. Ceraeochrysa y Meleoma fueron los géneros con mayor número de especies, aunque Ceraeochrysa fue el género con el mayor número de individuos. Las especies más importantes por su abundancia en orden descendente fueron: Ceraeochrysa cincta, C. valida, C. cubana, Leucochrysa texana y Chrysoperla comanche

Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study

[Objectives] The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS).[Background] CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain.[Methods] The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs).[Results] A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001).[Conclusions] The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.This study was supported by a Spanish grant from the Instituto de Salud Carlos III (ISCIII-FIS IP14/00971, 2014–2017). The ITRIBIS project has the registration number REGPOT-2013-1. Cooperative Cerebrovascular Disease Research Network (INVICTUS+) (RD16/0019/0015). Dr. Mancha is supported by a Río Hortega contract (CM16/00015). Abbott and Grifols have partial financial supported the conduction of the HISPANIAS project but had no role in the design of the study, interpretation of the data, or manuscript approval.Peer reviewe

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

EDUCACIÓN AMBIENTAL Y SOCIEDAD. SABERES LOCALES PARA EL DESARROLLO Y LA SUSTENTABILIDAD

Este texto contribuye al análisis científico de varias áreas del conocimiento como la filosofía social, la patología, la educación para el cuidado del medio ambiente y la sustentabilidad que inciden en diversas unidades de aprendizaje de la Licenciatura en Educación para la Salud y de la Maestría en Sociología de la SaludLas comunidades indígenas de la sierra norte de Oaxaca México, habitan un territorio extenso de biodiversidad. Sin que sea una área protegida y sustentable, la propia naturaleza de la región ofrece a sus visitantes la riqueza de la vegetación caracterizada por sus especies endémicas que componen un paisaje de suma belleza

Análisis morfométrico (macro-microscópico) del diente y su aplicación al cálculo de la edad / Ana Dolores Morales Casas ; directores Aurelio Luna Maldonado, Manuel López Nicolás.

Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 507.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-1516

Tratamientos que provocan un alto número de reacciones adversas a la medicación y sus síntomas

Objectives. Adverse drug reactions (ADRs) are an important cause of morbidity and mortality world­wide and generate high health costs. Therefore, the aims of this study were to determine the treatments which produce more ADRs in general population and the main symptoms they generate. Methods. An observational, cross-sectional study consisting in performing a self-rated questionnaire was carried out. 510 patients were asked about the treatments, illnesses and ADRs, they had suffered from. Results. 26.7% of patients had suffered from some ADR. Classifying patients according to the type of prescribed treatment and studying the number of ADR that they had, we obtained significant differ­ences (p ≤ 0.05) for treatments against arthrosis, anemia and nervous disorders (anxiety, depression, insomnia). Moreover, determining absolute frequencies of these ADRs appearance in each treatment, higher frequencies were again for drugs against arthrosis (22.6% of patients treated for arthrosis suffered some ADR), anemia (14.28%), nerve disorders (13.44%) and also asthma (16%). Regarding the symptoms produced by ADRs, the most frequent were gastrointestinal (60% of patients who suffered an ADR, had gastrointestinal symptoms) and nervous alterations (dizziness, headache, sleep disturbances etc) (24.6%). Conclusion. Therapeutic groups which produce more commonly ADRs are those for arthrosis, anemia, nervous disorders and asth­ma. In addition, symptoms which are generated more frequently are gastrointestinal and nervous problems. This is in accordance with the usual side effects of mentioned treatments. Health profes­sionals should be informed about it, so that they would be more alert about a possible emergence of an ADR in these treatments. They also could provide enough information to empower patients and thus, they probably could detect ADR events. This would fa­cilitate ADR detection and would avoid serious consequences gen­erated to both patients’ health and health economics.Las Reacciones Adversas a Medicamentos (RAM) constituyen una importante fuente de morbilidad y mortalidad en todo el mundo, generando altos costes económicos. Por ello, el objetivo de este estudio fue determinar aquellos tratamientos que producen una mayor cantidad de RAM en la po­blación general así como conocer los principales síntomas que generan. Material y métodos. Se realizó un estudio transversal observacional mediante la cumplimentación de un cuestionario. Para ello, 510 pacientes fueron encuestados sobre qué patologías tenían diagnosticadas, sus tratamientos farmacológicos y las RAM sufridas. Resultados. Un 26,7% de los pacientes encuestados había sufrido alguna RAM. Obtuvimos resultados estadísticamente significativos (p ≤ 0.05) al clasificar a los pacientes según el tratamiento prescrito y el número de RAM sufridas para los tratamientos farmacológicos de artrosis, anemia y enfermedades del sistema nervioso (ansiedad, depresión, insomnio). Además cuantificamos frecuencias de aparición de RAM mayores en aquellos fármacos prescritos contra la artrosis (22,6% de los casos sufrieron RAM), anemia (14,28%), alteraciones nerviosas (13,44%) y asma (16%). En cuanto a los síntomas producidos, los más frecuentes fueron gastrointestinales (60% de los pacientes) y alteraciones nerviosas (mareos, dolor de cabeza, problemas de conciliación del sueño, 24,6%). Discusión. La principal conclusión de nuestro estudio es que aquellos fármacos que producen mayor número de RAM están prescritos para el tratamiento de la artrosis, la anemia, las alteraciones nerviosas y el asma. Además, los síntomas que aparecen principalmente tras una RAM son alteraciones gastrointes­tinales y nerviosas. Los profesionales sanitarios deberían estar alerta ante la posible aparición de RAM en dichos tratamientos y proporcionar a sus pacientes el empoderamiento necesario para que ellos mismos pudieran detectarse RAM. Esto evitaría consecuencias negativas tanto en su estado de salud como en el gasto sanitario