Good practices in perinatal bereavement care in public maternity hospitals in Southern Spain

Funding sources The Department of Nursing from University of Granada pro- vided infrastructure and funding for the realization of the study (documents, material, software, web platforms etc.). Funding for open access charge: Universidad de Granada/CBUA. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.midw.2023.103749Objective To assess the attitudes and care practices of midwives and nurses in the province of Granada in relation to death care and perinatal bereavement, to determine their degree of adaptation to international standards and to identify possible differences in personal factors among those who best adapt to international recommendations. Design A local survey of 117 nurses and midwives from the five maternity hospitals in the province was conducted using the Lucina questionnaire developed to explore professionals' emotions, opinions, and knowledge during perinatal bereavement care. Adaptation of practices to international recommendations was assessed using the CiaoLapo Stillbirth Support (CLASS) checklist. Socio-demographic data were collected to establish their association with increased compliance with recommendations. Findings The response rate was 75.4%, the majority were women (88.9%), with a mean age of 40.9 (SD=1.4) and 17.4 (SD= 10.58) years of work experience. Midwives were the most represented (67.5%) and reported having attended more cases of perinatal death (p = 0.010) and having more specific training (p<0.001.) Of these, 57.3% would recommend immediate delivery, 26.5% would recommend the use of pharmacological sedation during delivery and 47% would take the baby immediately if the parents expressed their wish not to watch them. On the other hand, only 58% would be in favour of taking photos for the creation of memories, 47% would bathe and dress the baby in all cases, and 33.3% would allow the company of other family members. The percentage that matched each recommendation on memory-making was 58%, 41.9% matched the recommendations on respect for the baby and parents, and 23% and 10.3% matched the appropriate delivery and follow-up options, respectively. The factors associated with 100% of the recommendations, according to the care sector, were being a woman, a midwife, having specific training and having personally experienced the situation. Key conclusions Although the levels of adaptation observed are more favourable than in other nearby contexts, serious deficiencies are identified in the province of Granada with respect to internationally agreed recommendations on perinatal bereavement care. More training and awareness-raising of midwives and nurses is needed, which also considers factors related to better compliance. Implication for practice This is the first study to quantify the degree of adaptation to international recommendations in Spain reported by midwives and nurses, as well as the individual factors associated with a higher level of compliance. Areas for improvement and explanatory variables of adaptation are identified, which allow support for possible training and awareness-raising programmes aimed at improving the quality of care provided to bereaved families.Funding for open access charge: Universidad de Granada/CBU

Municipal Solid Waste Management in a Decentralized Composting Scenario: Assessment of the Process Reproducibility and Quality of the Obtained Composts

Over the last several years, the models for organic waste management have changed to implement circular economy in the productive cycle. In this context, new scenarios have emerged, where the management of different organic waste streams by composting is conducted with decentralized models that manage organic wastes in a more local way. However, in these new models, the standardization of the process control and of the end-product characteristics is necessary to guarantee the quality and agronomic value of the compost obtained, avoiding potential risks for human health and the environment. Thus, the aim of this work was to study two different scenarios of community composting of the organic fraction of municipal solid waste separately collected in order to guarantee the effectiveness and reproducibility of the composting processes and the quality of the composts obtained. For this, the development of the process and the characteristics of the composts at agronomic, hygienic–sanitary and environmental levels were assessed in real conditions and during three cycles of the process. The results obtained show high similarity among the different composting cycles, indicating an important degree of reproducibility among the processes. In addition, the composts obtained showed a good sanitary quality, absence of phytotoxicity and low contents of potentially toxic elements, which guarantee their use in agriculture without posing any risk to human health and to the environment.EEA Hilario AscasubiFil: Álvarez-Alonso, Cristina. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Pérez-Murcia, María Dolores. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Sánchez-Méndez, Silvia. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Martínez-Sabater, Encarnación. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Irigoyen, Ignacio. Public University of Navarre. Department of Agricultural Production; EspañaFil: López, Marga. Universitat Politècnica de Catalunya (UPC). Campus del Baix Llobregat. Department d‘Enginyeria Agroalimentària i Biotecnologia; EspañaFil: Nogués, Isabel. National Research Council. Research Institute of Terrestrial Ecosystems; ItaliaFil: Paredes, Concepción. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Orden, Luciano. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Orden, Luciano. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: García-Rández, Ana. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); EspañaFil: Bustamante, María Ángeles. Universidad Miguel Hernández. Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH); Españ

Yeast Biodiversity in Fermented Doughs and Raw Cereal Matrices and the Study of Technological Traits of Selected Strains Isolated in Spain

[EN] Bakers use pure microorganisms and/or traditional sourdoughs as the leavening agent for making bread. The performance of each starter and the substances produced by the microorganisms greatly affect the dough rheology and features of breads. Modern sourdoughs inoculated with selected lactic acid bacteria and yeasts are microbiologically stable, safer than traditional sourdoughs, and easy to use. However, the commercial repertoire of baker’s yeasts is still limited. Therefore, there is a demand for new strains of yeast species, capable of conferring distinctive traits to breads made from a variety of agri-food matrices, in the design of innovative starters. In this context, we report the first comprehensive study on yeasts isolated from a wide range of fermented doughs, cereal flours, and grains of Spain. Nine yeast species were identified from 433 isolates, which were distributed among separate clades. Moreover, phenotypic traits of potential technological relevance were identified in selected yeast strains. Mother doughs (MDs) showed the greatest yeast biodiversity, whereas commercial Saccharomyces starters or related and wild strains often dominated the bakery doughs. A metataxonomic analysis of wheat and tritordeum MDs revealed a greater richness of yeast species and percentage variations related to the consistency, flour type, and fermentation time of MDs

UGR Empática: programa de intervención para el desarrollo de la empatía en el alumnado de Ciencias de la Salud y Ciencias de la Educación

La capacidad empática es fundamental para garantizar el éxito profesional en las carreras de Ciencias de la Educación y Ciencias de la Salud. En tanto que se trata de una capacidad que puede entrenarse, este proyecto pretende desarrollar la empatía en el estudiantado de estas ramas del conocimiento. Para ello se diseñó una acción de innovación docente consistente en una serie de materiales didácticos en formato multimedia en los que se abordan diferentes aspectos de la empatía y que han sido empleados por los docentes de diferentes materias durante sus clases. Los materiales se han agrupado en 8 sesiones, cada una de ellas conteniendo dos actividades breves. Las actividades han sido presentaciones en videos en torno a 5 minutos y casos prácticos de elaboración propia de los componentes del equipo del PID. En cada sesión se ha incluido un ejercicio de aprendizaje por autoevaluación. La duración ha sido de 8 semanas, a razón de una sesión compuesta por las 2 actividades cada semana. Para determinar la eficacia de la acción innovadora se ha evaluado la capacidad de empatía en el estudiantado antes de iniciar el proyecto y tras la finalización del mismo, a través del Índice de Reactividad Interpersonal (IRI), una escala que mide la empatía de forma multidimensional. El IRI ofrece una medida compuesta de la empatía, incluyendo su dimensión cognitiva y afectiva. La empatía cognitiva se mide mediante el grado en el que la persona comprende el punto de vista de otra persona. El IRI tiene 2 escalas para medir empatía cognitiva: a) la Escala de Toma de Perspectiva, que evalúa cómo la persona intenta adoptar las perspectivas de otras personas y ver las cosas desde su punto de vista; y b) la Escala de fantasía, que mide la tendencia a identificarse con los personajes de las películas, novelas, obras teatrales y otras situaciones ficticias. La de mayor interés para este proyecto es la primera. En cuanto a la empatía afectiva o emocional, el IRI intenta captar la respuesta emocional de la persona cuando observa el estado afectivo de otras personas, y lo hace con otras 2 escalas: c) Escala de Preocupación Empática consta de ítems sobre los sentimientos de simpatía, compasión y preocupación por los demás; y d) la Escala de Angustia Personal, que valora si la persona experimenta ansiedad y malestar cuando observa que otros están atravesando por experiencias negativas. En nuestro estudio, el interés estaba en que aumentase la puntuación en la escala de preocupación empática, pero no en la de angustia personal. Los objetivos específicos fueron la mejora en las dimensiones de la capacidad empática más relevantes, considerando que la toma de perspectiva y la preocupación empática son las más relacionadas con el desempeño profesional del estudiantado al que iba dirigido el proyecto. En general, los resultados indican que el conjunto del alumnado que ha participado en el PID ha mejorado su capacidad empática. Por tanto, podemos considerar que los materiales creados son válidos para tal fin y pueden ser de aplicación práctica a la docencia.Empathic skills are fundamental to ensure professional success in the fields of Education and Health Sciences. As it is an ability that can be trained, this project aims to develop empathy in students of these branches of knowledge. To this end, a teaching innovation action was designed consisting of a series of teaching materials in multimedia format in which different aspects of empathy are addressed and which have been used by teachers of different subjects during their classes. The materials have been grouped into 8 sessions, each containing two short activities. The activities consisted of 5-minute video presentations and case studies developed by the IDP team. Each session included a self-assessment learning exercise. The duration was 8 weeks, with one session consisting of the 2 activities each week. To determine the effectiveness of the innovative action, the students' capacity for empathy was assessed before the start of the project and after its completion, using the Interpersonal Reactivity Index (IRI), a scale that measures empathy in a multidimensional way. The IRI provides a composite measure of empathy, including both cognitive and affective dimensions. Cognitive empathy is measured by the degree to which a person understands another person's point of view. The IRI has 2 scales to measure cognitive empathy: a) the Perspective Taking Scale, which assesses how the person tries to adopt other people's perspectives and see things from their point of view; and b) the Fantasy Scale, which measures the tendency to identify with characters in films, novels, plays and other fictional situations. Of most interest for this project is the first one. As for affective or emotional empathy, the IRI attempts to capture the person's emotional response when observing the affective state of other people, and does so with 2 other scales: c) the Empathic Concern Scale consists of items on feelings of sympathy, compassion and concern for others; and d) the Personal Distress Scale, which assesses whether the person experiences anxiety and discomfort when observing that others are going through negative experiences. In our study, the focus was on increasing scores on the empathic concern scale, but not on the personal distress scale. The specific objectives were to improve the most relevant dimensions of empathic ability, considering that perspective-taking and empathic concern are the most related to the professional performance of the target students. In general, the results indicate that the students who participated in the IDP as a whole have improved their empathic ability. Therefore, we can consider that the materials created are valid for this purpose and can be of practical application in teaching

Clínica jurídica de acción social

Memoria ID-0032. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018

Infective Endocarditis in Diabetic Patients: A Different Profile with Prognostic Consequences

Background. Infective Endocarditis (IE) is a severe condition. Diabetes mellitus (DM) has been associated with a poor prognosis in other settings. Our aim was to describe the profile and prognosis of IE with and without DM and to analyze the prognostic relevance of DM-related organ damage. Methods. Retrospective analysis of the Spanish IE Registry (2008–2020). Results. The cohort comprises 5590 IE patients with a mean age of 65.0 ± 15.5 years; 3764 (67.3%) were male. DM was found in 1625 patients (29.1%) and 515 presented DM-related organ damage. DM prevalence during the first half of the study period was 27.6% vs. 30.6% in the last half, p = 0.015. Patients with DM presented higher in-hospital mortality than those without DM (521 [32.1%] vs. 924 [23.3%], p < 0.001) and higher one-year mortality (640 [39.4%] vs. 1131 [28.5%], p < 0.001). Among DM patients, organ damage was associated with higher in-hospital (200 [38.8%] vs. 321 [28.9%], p < 0.001) and one-year mortality (247 [48.0%] vs. 393 [35.4%], p < 0.001). Multivariate analyses showed an independent association of DM with in-hospital (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.16–1.55, p < 0.001) and one-year mortality (OR = 1.38, 95% CI: 1.21–1.59, p < 0.001). Among DM patients, organ damage was independently associated with higher in-hospital (OR = 1.37, 95% CI: 1.06–1.76, p = 0.015) and one-year mortality (OR = 1.59, 95% CI = 1.26–2.01, p < 0.001) Conclusions. The prevalence of DM among patients with IE is increasing and is already above 30%. DM is independently associated with a poor prognosis, particularly in the case of DM with organ damage

Innovaciones y mejoras en el proyecto tutoría entre compañeros. Curso 2015-2016

Memoria ID-0137. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2015-2016

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio