Exploring Sentiment and Care Management of Hospitalized Patients During the First Wave of the COVID-19 Pandemic Using Electronic Nursing Health Records: Descriptive Study.

Background: The COVID-19 pandemic has changed the usual working of many hospitalization units (or wards). Few studies have used electronic nursing clinical notes (ENCN) and their unstructured text to identify alterations in patients' feelings and therapeutic procedures of interest. Objective: This study aimed to analyze positive or negative sentiments through inspection of the free text of the ENCN, compare sentiments of ENCN with or without hospitalized patients with COVID-19, carry out temporal analysis of the sentiments of the patients during the start of the first wave of the COVID-19 pandemic, and identify the topics in ENCN. Methods: This is a descriptive study with analysis of the text content of ENCN. All ENCNs between January and June 2020 at Guadarrama Hospital (Madrid, Spain) extracted from the CGM Selene Electronic Health Records System were included. Two groups of ENCNs were analyzed: one from hospitalized patients in post–intensive care units for COVID-19 and a second group from hospitalized patients without COVID-19. A sentiment analysis was performed on the lemmatized text, using the National Research Council of Canada, Affin, and Bing dictionaries. A polarity analysis of the sentences was performed using the Bing dictionary, SO Dictionaries V1.11, and Spa dictionary as amplifiers and decrementators. Machine learning techniques were applied to evaluate the presence of significant differences in the ENCN in groups of patients with and those without COVID-19. Finally, a structural analysis of thematic models was performed to study the abstract topics that occur in the ENCN, using Latent Dirichlet Allocation topic modeling. Results: A total of 37,564 electronic health records were analyzed. Sentiment analysis in ENCN showed that patients with subacute COVID-19 have a higher proportion of positive sentiments than those without COVID-19. Also, there are significant differences in polarity between both groups (Z=5.532, P0.8) and with significant P values between both groups. Through Structural Topic Modeling analysis, the final model containing 10 topics was selected. High correlations were noted among topics 2, 5, and 8 (pressure ulcer and pharmacotherapy treatment), topics 1, 4, 7, and 9 (incidences related to fever and well-being state, and baseline oxygen saturation) and topics 3 and 10 (blood glucose level and pain). Conclusions: The ENCN may help in the development and implementation of more effective programs, which allows patients with COVID-19 to adopt to their prepandemic lifestyle faster. Topic modeling could help identify specific clinical problems in patients and better target the care they receive.post-print353 K

12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility

Since there was no Portuguese questionnaire to evaluate cutaneous allodynia, which has been pointed out as a risk factor of migraine, we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its measurement properties. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no difficulties being reported. The mean filling out time was 3'36", and the internal consistency was 0.76. To test reproducibility, 15 other subjects filled out the questionnaire at two different times, it was classified as moderate (weighted kappa=0.58). We made available to Brazilian population an easy, quick and reliable questionnaire.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Apoio ao Ensino, Pesquisa e Assistencia of HCFMRP (FAEPA)Fundacao de Apoio ao Ensino, Pesquisa e Assistencia of HCFMRP (FAEPA

Aplicación metodología cualitativa para el estudio del impacto de la pandemia COVID-19 en titulaciones de Ciencias de la Salud, Terapia Ocupacional y Fisioterapia

[EN] The COVID-19 pandemic forced a sudden adaptation of higher education to a complex and changing reality, by incorporating new technologies for teaching. The Health Sciences degrees have adapted their curriculum to this new reality, where the teaching and learning process has been modified by incorporating new technologies, distance learning and limitation of clinical practices in health centers. It is necessary to analyze dimensions such as the teaching and learning process, the modification of the material used, the integration of theoretical and practical content, and the participation of students in the development of educational material. The objective of this work is to present 6 qualitative research proposals that help to understand the adaptation of professors and students to this new reality, together with the teaching and learning process and the incorporation of new tools and teaching methods (e-learning) during the pandemic.[ES] La educación superior ha precisado adaptarse a una nueva realidad compleja debido a la pandemia del COVID-19. Esto ha obligado incorporar nuevas tecnologías para la enseñanza superior. Como consecuencia, las titulaciones universitarias, como las de las ciencias de la salud, han ido realizando modificaciones y adaptándose incorporando nuevas tecnologías y metodología de enseñanza. Pero existen dimensiones como las prácticas clínicas en centros sanitarios que siguen planteando retos dentro del proceso de enseñanza y aprendizaje en estas titulaciones. Es preciso analizar en Ciencias de la Salud, dimensiones como el proceso de enseñanza y aprendizaje, la modificación del material docente utilizado, la integración de los contenidos teóricos y prácticos, y la participación de los estudiantes en el desarrollo de material docente. El objetivo de esta comunicación es presentar 6 propuestas de investigación cualitativa, que ayuden a desarrollar y elaborar estudios que analicen y profundicen en la perspectiva de los profesores y estudiantes en esta nueva realidad, junto al proceso de enseñanza e incorporación de métodos de enseñanza (e-learning) durante la pandemia.Moro, P.; Palacios-Ceña, D.; Lima Florencio, L.; Perez Corrales, J.; Gueita Rodriguez, J.; Martinez Piedrola, R.; Perez De Heredia, M.... (2021). Aplicación metodología cualitativa para el estudio del impacto de la pandemia COVID-19 en titulaciones de Ciencias de la Salud, Terapia Ocupacional y Fisioterapia. En IN-RED 2021: VII Congreso de Innovación Edicativa y Docencia en Red. Editorial Universitat Politècnica de València. 970-982. https://doi.org/10.4995/INRED2021.2021.13743OCS97098

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

(1) Background: To assess time trends in the incidence and in-hospital outcomes of urinary tract infection (UTI) in older people (≥65 years) in Spain (2001–2018) according to sex and to identify the factors independently associated with in-hospital mortality (IHM). (2) Methods: Using the Spanish National Hospital Database, we analyzed comorbidity, procedures, diagnosis, isolated microorganisms, and outcomes. (3) Results: We included 583,693 admissions (56.76% women). In both sexes, the incidence increased with age over time (p 84 years) with values of 9.16% and 8.6%, respectively. The prevalence of bacteremia increased from 4.61% to 4.98% from 2001 to 2018 (p 84 years) (OR 3.63; 95% CI 3.5–3.78) and with almost all comorbidities. Urinary catheter was a risk factor for women (OR 1.1; 95% CI 1.02–1.18) and protective for men (OR 0.71; 95% CI 0.66–0.76). Isolation of Staphylococcus aureus increased the risk of IHM by 40% among men (OR 1.4; 95% CI 1.28–1.53). After adjusting for confounders, IHM decreased over time. (4) Conclusions: The incidence of UTIs was higher in older patients and increased over time; however, IHM decreased during the same period. Female sex, age, comorbidities, sepsis, and a Staphylococcus aureus isolation increased risk of IHM

Cross-cultural adaptation and reliability of the 12 item Allodynia Symptom Checklist for the Brazilian population

O objetivo foi realizar a adaptação transcultural do 12 item Allodynia Symptom Checklist para a população brasileira e testar a confiabilidade dessa versão, já que não havia nenhum questionário de avaliação da alodínia cutânea em migranosos, sintoma que tem sido apontado como sinalizador da sensibilização central e como fator de cronificação dessa doença. A adaptação transcultural foi realizada em seis estágios: tradução, síntese, retrotradução, revisão pelo comitê de especialistas na área, pré-teste e submissão dos documentos ao comitê de especialistas. No estágio do pré-teste, foram aplicados 30 questionários em migranosos de ambos os sexos, que relataram dificuldades de compreensão e, dessa maneira, uma segunda versão foi criada e aplicada em mais 30 sujeitos, para a qual não foram relatadas dificuldades adicionais. O tempo médio de preenchimento foi de 336 e a consistência interna foi considerada adequada demonstrando uma boa correlação entre os itens ( de Cronbach = 0,77). Para testar a confiabilidade, outros 30 sujeitos preencheram o questionário, em dois momentos, sendo que para 15 deles o questionário foi autoaplicável e para os outros 15 a avaliação foi feita no formato de entrevista. A confiabilidade foi classificada como moderada (kappa ponderado linear = 0,58) e excelente ( kappa ponderado linear =0,84) respectivamente. Portanto, foi possível através desse estudo, disponibilizar em língua portuguesa um questionário válido, confiável e de fácil aplicação para a avaliação da alodínia em migranosos da população brasileira.Since there was no portuguese questionnaire to evaluate cutaneous allodynia in migraine population, which has been pointed out as a central sensibilization flag and as risk factor of migraine chronification we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its reliability. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest, and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no others difficulties being reported. The mean filling out time was 336and the internal consistency was considered adequate showing a good interrelation between items (Cronbachs = 0,77). To test reliability, 30 other subjects filled out the questionnaire at two different times, 15 of them in a self-report administration and 15 in a structured interview. It was classified as moderate (linear weighted kappa = 0.58) and as excellent (linear weighted kappa = 0.84) respectively. In this study, it was possible to make available in portuguese a valid, reliable and easy tool for cutaneous allodynia assessment in Brazil

Avaliação da força máxima e do controle motor da coluna cervical pela dinamometria e pela eletromiografia de superfície em mulheres com migrânea e migrânea crônica: estudo controlado

Objectives: to verify if women with migraine present altered neck muscles function and altered muscle activity in comparison to non-headache subjects. Moreover, we aimed to identify if there is any relationship between neck muscles dysfunction and the chronicity of migraine attacks. Methods: women with migraine, stratified by episodic and chronic, and age-matched non headache women were the subject of the current thesis. Neck pain relateddisability was assessed by the Neck Disability Index. Neck muscles strength was assessed by a customized hand-held dynamometer. Myoelectrical signals of the sternocleidomastoid, anterior scalene, splenius capitis and upper trapezius were assessed using surface electromyography. Experimental conditions involved maximal isometric voluntary contractions in flexion, extension and lateral bending directions and; craniocervical flexion test, a low load test applied to verify deep cervical flexors ability to supply adequate cervical spine stability. Finally, identification of myofascial trigger points and head and cervical posture photogrammetric evaluation were made in order to be correlated to the muscles electrical activity in the craniocervical flexion test. Results: Although both groups presents high prevalence of neck related disability, subjects with chronic migraine are more likely to report neck related disability, especially the most disabling forms, than episodic migraine. Episodic migraine demonstrated to different neck muscle control only under maximal voluntary tasks. Chronic migraine presented alterations in comparison with controls at maximal conditions, i.e., lower extension force; more time to produce maximal force; greater antagonist coactivation and greater fatigability. During craniocervical flexion test, chronic migraine also differs from control group presenting greater activity of neck extensors. Presence of active trigger points in neck muscles and extended head posture can influence the neck muscles activity during the craniocervical flexion test. Conclusions: migraine is associated to a deterioration of neck muscles functions and to an altered motor control. We can assume an interaction between chronicity of migraine frequency and cervical dysfunction, specially related to neck extensors. More severe disabilities and the majority of the altered function or motor control could only be evidenced in the chronic formObjetivos: verificar se mulheres com migrânea apresenta alteração na função e atividade dos músculos do pescoço quando comparados a mulheres sem cefaleia. Ainda, objetivamos identificar se há relação entre disfunção cervical muscular e a cronicidade da frequência de crises migranosas. Materiais e métodos: mulheres com migrânea, estratificada entre episódica e crônica, e mulheres sem cefaleia com idade semelhante foi o objeto de estudo dessa tese. Foi investigada a incapacidade relacionada à dor cervical pelo questionário Neck Disability Index e a força muscular cervical utilizando um dinamômetro manual customizado. Ainda, a atividade elétrica dos músculos esternocleidomastoideo, escaleno anterior, esplênio da cabeça e trapézio superior foi verificada pela eletromiografia de superfície. Os procedimentos experimentais foram contração isométrica voluntária máxima em flexão, extensão e inclinação lateral; e o teste de flexão craniocervical, que avalia a habilidade dos músculos flexores cervicais profundos em prover adequada estabilidade para esse segmento. Por fim, a identificação de pontos gatilhos nos músculos cervicais e a avaliação da postura da cabeça e do pescoço por foto foram realizadas a fim de correlacionar os achados com a atividade eletromiográfica. Resultados: embora ambos os grupos de migrânea tenham apresentado alta prevalência de incapacidade relacionada à dor cervical, a migrânea crônica apresenta maior risco de relatar incapacidades mais severas em relação a migrânea episódica. O grupo de migrânea episódica apresentou controle muscular cervical alterado em condição de contração voluntária máxima. Já o grupo migrânea crônica apresentou alterações sob condições máximas, como por exemplo, redução da força dos extensores, mais tempo para gerar pico de força em flexão e inclinação lateral, maior coativação do antagonista e maior susceptibilidade à fadiga. Ainda, durante o teste de flexão craniocervical, o grupo migrânea crônica apresentou maior atividade dos extensores indicando alteração no controle motor. A presença de pontos gatilhos nos músculos do pescoço e a postura em extensão de cabeça pode influenciar a atividade elétrica dos músculos cervicais durante a execução do teste de flexão craniocervical. Conclusões: a migrânea está associada a uma deteriorização da função e do controle motor cervical. Podemos assumir ainda que há uma interação entre a cronicidade da frequência das crises migranosas e a disfunção muscular cervical, especialmente relacionada aos extensores. Incapacidades mais severas e a maioria das disfunções musculares e alteração no controle motor só puderam ser evidenciadas para o grupo com migrânea crônic

Avaliação da força máxima e do controle motor da coluna cervical pela dinamometria e pela eletromiografia de superfície em mulheres com migrânea e migrânea crônica: estudo controlado

Objectives: to verify if women with migraine present altered neck muscles function and altered muscle activity in comparison to non-headache subjects. Moreover, we aimed to identify if there is any relationship between neck muscles dysfunction and the chronicity of migraine attacks. Methods: women with migraine, stratified by episodic and chronic, and age-matched non headache women were the subject of the current thesis. Neck pain relateddisability was assessed by the Neck Disability Index. Neck muscles strength was assessed by a customized hand-held dynamometer. Myoelectrical signals of the sternocleidomastoid, anterior scalene, splenius capitis and upper trapezius were assessed using surface electromyography. Experimental conditions involved maximal isometric voluntary contractions in flexion, extension and lateral bending directions and; craniocervical flexion test, a low load test applied to verify deep cervical flexors ability to supply adequate cervical spine stability. Finally, identification of myofascial trigger points and head and cervical posture photogrammetric evaluation were made in order to be correlated to the muscles electrical activity in the craniocervical flexion test. Results: Although both groups presents high prevalence of neck related disability, subjects with chronic migraine are more likely to report neck related disability, especially the most disabling forms, than episodic migraine. Episodic migraine demonstrated to different neck muscle control only under maximal voluntary tasks. Chronic migraine presented alterations in comparison with controls at maximal conditions, i.e., lower extension force; more time to produce maximal force; greater antagonist coactivation and greater fatigability. During craniocervical flexion test, chronic migraine also differs from control group presenting greater activity of neck extensors. Presence of active trigger points in neck muscles and extended head posture can influence the neck muscles activity during the craniocervical flexion test. Conclusions: migraine is associated to a deterioration of neck muscles functions and to an altered motor control. We can assume an interaction between chronicity of migraine frequency and cervical dysfunction, specially related to neck extensors. More severe disabilities and the majority of the altered function or motor control could only be evidenced in the chronic formObjetivos: verificar se mulheres com migrânea apresenta alteração na função e atividade dos músculos do pescoço quando comparados a mulheres sem cefaleia. Ainda, objetivamos identificar se há relação entre disfunção cervical muscular e a cronicidade da frequência de crises migranosas. Materiais e métodos: mulheres com migrânea, estratificada entre episódica e crônica, e mulheres sem cefaleia com idade semelhante foi o objeto de estudo dessa tese. Foi investigada a incapacidade relacionada à dor cervical pelo questionário Neck Disability Index e a força muscular cervical utilizando um dinamômetro manual customizado. Ainda, a atividade elétrica dos músculos esternocleidomastoideo, escaleno anterior, esplênio da cabeça e trapézio superior foi verificada pela eletromiografia de superfície. Os procedimentos experimentais foram contração isométrica voluntária máxima em flexão, extensão e inclinação lateral; e o teste de flexão craniocervical, que avalia a habilidade dos músculos flexores cervicais profundos em prover adequada estabilidade para esse segmento. Por fim, a identificação de pontos gatilhos nos músculos cervicais e a avaliação da postura da cabeça e do pescoço por foto foram realizadas a fim de correlacionar os achados com a atividade eletromiográfica. Resultados: embora ambos os grupos de migrânea tenham apresentado alta prevalência de incapacidade relacionada à dor cervical, a migrânea crônica apresenta maior risco de relatar incapacidades mais severas em relação a migrânea episódica. O grupo de migrânea episódica apresentou controle muscular cervical alterado em condição de contração voluntária máxima. Já o grupo migrânea crônica apresentou alterações sob condições máximas, como por exemplo, redução da força dos extensores, mais tempo para gerar pico de força em flexão e inclinação lateral, maior coativação do antagonista e maior susceptibilidade à fadiga. Ainda, durante o teste de flexão craniocervical, o grupo migrânea crônica apresentou maior atividade dos extensores indicando alteração no controle motor. A presença de pontos gatilhos nos músculos do pescoço e a postura em extensão de cabeça pode influenciar a atividade elétrica dos músculos cervicais durante a execução do teste de flexão craniocervical. Conclusões: a migrânea está associada a uma deteriorização da função e do controle motor cervical. Podemos assumir ainda que há uma interação entre a cronicidade da frequência das crises migranosas e a disfunção muscular cervical, especialmente relacionada aos extensores. Incapacidades mais severas e a maioria das disfunções musculares e alteração no controle motor só puderam ser evidenciadas para o grupo com migrânea crônic

Cross-cultural adaptation and reliability of the 12 item Allodynia Symptom Checklist for the Brazilian population

O objetivo foi realizar a adaptação transcultural do 12 item Allodynia Symptom Checklist para a população brasileira e testar a confiabilidade dessa versão, já que não havia nenhum questionário de avaliação da alodínia cutânea em migranosos, sintoma que tem sido apontado como sinalizador da sensibilização central e como fator de cronificação dessa doença. A adaptação transcultural foi realizada em seis estágios: tradução, síntese, retrotradução, revisão pelo comitê de especialistas na área, pré-teste e submissão dos documentos ao comitê de especialistas. No estágio do pré-teste, foram aplicados 30 questionários em migranosos de ambos os sexos, que relataram dificuldades de compreensão e, dessa maneira, uma segunda versão foi criada e aplicada em mais 30 sujeitos, para a qual não foram relatadas dificuldades adicionais. O tempo médio de preenchimento foi de 336 e a consistência interna foi considerada adequada demonstrando uma boa correlação entre os itens ( de Cronbach = 0,77). Para testar a confiabilidade, outros 30 sujeitos preencheram o questionário, em dois momentos, sendo que para 15 deles o questionário foi autoaplicável e para os outros 15 a avaliação foi feita no formato de entrevista. A confiabilidade foi classificada como moderada (kappa ponderado linear = 0,58) e excelente ( kappa ponderado linear =0,84) respectivamente. Portanto, foi possível através desse estudo, disponibilizar em língua portuguesa um questionário válido, confiável e de fácil aplicação para a avaliação da alodínia em migranosos da população brasileira.Since there was no portuguese questionnaire to evaluate cutaneous allodynia in migraine population, which has been pointed out as a central sensibilization flag and as risk factor of migraine chronification we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its reliability. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest, and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no others difficulties being reported. The mean filling out time was 336and the internal consistency was considered adequate showing a good interrelation between items (Cronbachs = 0,77). To test reliability, 30 other subjects filled out the questionnaire at two different times, 15 of them in a self-report administration and 15 in a structured interview. It was classified as moderate (linear weighted kappa = 0.58) and as excellent (linear weighted kappa = 0.84) respectively. In this study, it was possible to make available in portuguese a valid, reliable and easy tool for cutaneous allodynia assessment in Brazil

Time Trends in the Co-use of Cannabis and the Misuse of Tranquilizers, Sedatives and Sleeping Pills among Young Adults in Spain between 2009 and 2015

The aims of this study were: (a) to estimate time trends in the prevalence of the co-use of cannabis and other cannabis-based products (CBP) with the misuse of tranquilizers, sedatives, and sleeping pills (TSSp) between 2009 and 2015; and (b) to identify the factors associated with the probability of the co-use of CBP with TSSp misuse during this period among Spanish younger adults (15–34 years old). We analyzed data collected from the Spanish National Surveys on Alcohol and Other Drugs (EDADES) in 2009, 2011, 2013, and 2015. CBP co-use with TSSp misuse were the dependent variables. We also analyzed sociodemographic features, self-perceived health status, lifestyle habits, perceived health risk of consumption, and perceived availability of substance using logistic regression models. The prevalence of CBP co-use with TSSp misuse has decreased in Spain. The factors associated with co-use were a lack of education (OR 2.34), alcohol (OR 7.2), tobacco (OR 6.3) and other illicit psychoactive drug (OR 6.5) consumption, perceived non-health risk for the consumption of CBP and TSSp (OR 3.27), and perceived availability of CBP (OR 2.96). Our study identified several factors that appear to affect CBP and TSSp co-use in younger adults, with potential implications for healthcare providers