Characterization, conservation and loss of dignity at the end-of- life in the emergency department. A qualitative protocol

Aims: to explore and understand the experiences of terminally-ill patients and their relatives regarding dignity during end-of-life care in the emergency department. Background: the respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account. Design: a phenomenological qualitative study. Methods: the protocol was approved in December 2016 and will be carried out from December 2016 to December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the Emergency Department, in-depth interviews with terminally-ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes. Discussion: emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the Emergency Department are expected to be found. This study's results could have important implications in the implementation of new interventions in Emergency Departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment, and assumption (takeover) of dignified actions and attitudes (respect for human rights)

Sexuality throughout all the stages of pregnancy: experiences of expectant mothers

Objective: To explore and understand the sexual experiences of expectant mothers during their pregnancy. Methods: The study was carried out in two healthcare centers in the Almería Health District, in southern Spain. The participants included pregnant women who received prenatal care and/or maternity education. The inclusion criteria were being pregnant, maintaining sexual activity and agreeing to participate in the study. The exclusion criteria were having limitations on sexual activity by medical prescription. The sample consisted of 15 expectant women selected using a convenience sample, of which 5 took part in a focus group (FG) and 10 in in-depth interviews (IDI). Data was collected between the months of June and December 2016. Participants were contacted by the main researcher and an appointment was made to carry out the FGs or the IDIs. Results: Three main categories emerged: False beliefs and a holistic approach to sexuality during pregnancy, which is related to the concept of sexuality, false beliefs, and limited sexual counseling during pregnancy. Limitations: From fear at the beginning to physical diffi culty at the end, referring to the fluctuations in sexual desire as well as the physical changes that limit sexual activity. Adapting to changes: safe practices and satisfaction with one’s body image, which encompasses concerns about the risks and the relationship between body image and self-esteem. Conclusion: A lack of sexual counseling during pregnancy leads to the creation of false beliefs, which, together with physical changes, concerns about the risk, and fl uctuations in sexual desire and interest, bring about a decrease in sexual activity. But sexuality remains an important aspect of pregnancy, toward which the participants must adopt a broader approach, not limited to intercourse, and adopt sexual practices that are adapted to the physical and emotional changes that happen during this time

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

Fundamental care and knowledge interests: implications for nursing science

Aims and objectives: The aim of this discursive paper was to characterize the intra-theoretical interests of knowledge in nursing science as an epistemological framework for fundamental care. Background: For Jürgen Habermas, theory does not separate knowledge interests from life. All knowledge, understanding and human research is always interested. Habermas formulated the knowledge interests in empirical-analytical, historical hermeneutic and critical social sciences; but said nothing about health sciences and nursing science. Design: Discursive paper. Results: The paper is organised into five sections that develop our argument about the implications of the Habermasian intra theoretical interests in nursing science and fundamental care: the persistence of a technical interest, the predominance of a practical interest, the importance of an emancipatory interest, “being there” to understand individuals’ experience and an “existential crisis” that uncovers the individual’s subjectivity. Conclusions: The nursing discipline can take on practical and emancipatory interests (together with a technical interest) as its fundamental knowledge interests. Nurses’ privileged position in the delivery of fundamental care gives them the opportunity to gain a deep understanding of the patient’s experience and illness process through physical contact and empathic communication. Relevance to clinical practice and nursing research: In clinical, academic and research environments, nurses should highlight the importance of fundamental care, showcasing the value of practical and emancipatory knowledge. This process could help to improve nursing science’s leadership, social visibility and idiosyncrasy

Improving integrability via absolute summability: a general version of Diestel s Theorem

[EN] A classical result by J. Diestel establishes that the composition of a summing operator with a (strongly measurable) Pettis integrable function gives a Bochner integrable function. In this paper we show that a much more general result is possible regarding the improvement of the integrability of vector valued functions by the summability of the operator. After proving a general result, we center our attention in the particular case given by the -absolutely continuous operators, that allows to prove a lot of special results on integration improvement for selected cases of classical Banach spaces-including C(K), and Hilbert spaces-and operators-p-summing, (q, p)-summing and p-approximable operators.D. Pellegrino acknowledges with thanks the support of CNPq Grant 401735/2013-3 (Brazil). P. Rueda acknowledges with thanks the support of the Ministerio de Economia y Competitividad (Spain) MTM2011-22417. E.A. Sanchez Perez acknowledges with thanks the support of the Ministerio de Economia y Competitividad (Spain) MTM2012-36740-C02-02.Pellegrino, D.; Rueda, P.; Sánchez Pérez, EA. (2016). Improving integrability via absolute summability: a general version of Diestel s Theorem. Positivity. 20(2):369-383. https://doi.org/10.1007/s11117-015-0361-5S369383202Botelho, G., Pellegrino, D., Rueda, P.: A unified Pietsch domination theorem. J. Math. Anal. Appl. 365(1), 269–276 (2010)Defant, A., Floret, K.: Tensor norms and operator ideals. North-Holland, Amsterdam (1992)Diestel, J.: An elementary characterization of absolutely summing operators. Math. Ann. 196, 101–105 (1972)Diestel, J., Jarchow, H., Tonge, A.: Absolutely summing operators. Cambridge University Press, Cambridge (1995)Farmer, J., Johnson, W.B.: Lipschitz p-summing operators. Proc. Amer. Math. Soc. 137, 2989–2995 (2009)Jarchow, H.: Localy convex, spaces. Teubner, Stuttgart (1981)López Molina, J.A., Sánchez Pérez, E.A.: Ideales de operadores absolutamente continuos, Ciencias Exactas, Físicas y Naturales, Madrid. Rev. Real Acad. 87, 349–378 (1993)López Molina, J.A., Sánchez Pérez, E.A.: The associated tensor norm to $$(q, p)$$ ( q , p ) -absolutely summing operators on $$C(K)$$ C ( K ) -spaces. Czec. Math. J. 47(4), 627–631 (1997)López, J.A., Molina, Sánchez-Pérez, E.A.: On operator ideals related to $$(p,\sigma )$$ ( p , σ ) -absolutely continuous operator. Studia Math. 131(8), 25–40 (2000)Matter, U.: Absolute continuous operators and super-reflexivity. Math. Nachr. 130, 193–216 (1987)Pellegrino, D., Santos, J.: A general Pietsch domination theorem. J. Math. Anal. Appl. 375(1), 371–374 (2011)Pellegrino, D., Santos, J., Seoane-Sepúlveda, J.B.: Some techniques on nonlinear analysis and applications. Adv. Math. 229, 1235–1265 (2012)Pietsch, A.: Operator Ideals. Deutsch. Verlag Wiss., Berlin, 1978; North-Holland, Amsterdam-London-New York-Tokyo (1980)Pisier, G.: Factorization of operators through $$L_{p\infty }$$ L p ∞ or $$L_{p1}$$ L p 1 and noncommutative generalizations. Math. Ann. 276(1), 105–136 (1986)Rodríguez, J.: Absolutely summing operators and integration of vector-valued functions. J. Math. Anal. Appl. 316(2), 579–600 (2006

Effects of web-based electrocardiography simulation on strategies and learning styles

Objective: To identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students. Method: A descriptive and correlational design with a one-group pretest– posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree. Results: No significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning. Conclusion: The use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students

Emergency care for women irregular migrants who arrive in Spain by small boat: a qualitative study

Background: this study aimed to describe and understand the experiences and health needs of women irregular migrants during emergency care provision upon arrival in Spain by small boat. Methods: a qualitative study based on Gadamer’s phenomenology was used. The data collection included 13 in-depth interviews with women irregular migrants and 10 in-depth interviews with key informants. The study took place in the Spanish Red Cross’ facilities between February 2017 and April 2018. Results: two main themes emerged from the data analysis: the need for emergency care focused on women irregular migrants with the sub-themes ‘Women irregular migrants as objects of sexual exploitation’ and ‘The mother-child dyad as the axis in human trafficking’; and developing an emergency care gender policy for women irregular migrants, with the subthemes ‘Healthcare in a police-controlled setting: detecting weaknesses’ and ‘Promoting screening and safety protocols focused on women irregular migrants’. Conclusions: women irregular migrants who arrive in Spain by small boat have specific needs and healthcare problems. Due to strict safety conditions during emergency care provision, rape and human trafficking can go unnoticed. Implications: interdisciplinary care protocols and new health policies that have a gender perspective are needed to improve the emergency care provided to women irregular migrants

Electrical-thermal analytical modeling of monopolar RF thermal ablation of biological tissues: determining the circumstances under which tissue temperature reaches a steady state

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in MATHEMATICAL BIOSCIENCES doi:10.3934/mbe.2015003 AND ENGINEERING following peer review. The definitive publisher-authenticated version Mathematical Biosciences and Engineering (MBE) Pages: 281 - 301, Volume 13, Issue 2, April 2016 is available online at http://www.aimsciences.org/journals/displayArticlesnew.jsp?paperID=11998[EN] It has been suggested that during RF thermal ablation of biological tissue the thermal lesion could reach an equilibrium size after 1-2 minutes. Our objective was to determine under which circumstances of electrode geometry (needle-like vs. ball-tip), electrode type (dry vs. cooled) and blood perfusion the temperature will reach a steady state at any point in the tissue. We solved the bioheat equation analytically both in cylindrical and spherical coordinates and the resultant limit temperatures were compared. Our results demonstrate mathematically that tissue temperature reaches a steady value in all cases except for cylindrical coordinates without the blood perfusion term, both for dry and cooled electrodes, where temperature increases infinitely. This result is only true when the boundary condition far from the active electrode is considered to be at infinitum. In contrast, when a finite and sufficiently large domain is considered, temperature reaches always a steady state.This work received financial support from the Spanish "Plan Estatal de Investigacion, Desarrollo e Innovacion Orientada a los Retos de la Sociedad" under Grant TEC2014-52383-C3-R (TEC2014-52383-C3-1-R).López Molina, JA.; Rivera Ortun, MJ.; Berjano, E. (2016). Electrical-thermal analytical modeling of monopolar RF thermal ablation of biological tissues: determining the circumstances under which tissue temperature reaches a steady state. Mathematical Biosciences and Engineering. 13(2):281-301. https://doi.org/10.3934/mbe.2015003S28130113