La participación del paciente en su seguridad

El enfoque de atención centrada en el paciente y los avances normativos desarrollados en los últimos años han promovido la implicación del paciente en la toma de decisiones sobre pruebas diagnósticas y tratamientos. En otros aspectos, como la participación en su seguridad, aún queda mucho por hacer. Hasta hace poco tiempo se ha considerado al paciente como mero receptor de los servicios sanitarios, no como parte activa del sistema, ni mucho menos como barrera de seguridad frente a los fallos y errores que acontecen durante la asistencia. Algunos pacientes se han activado con base en sus experiencias. Pero muchos otros no. Por eso es necesario sensibilizar, informar y formar al paciente de forma proactiva para que participe en su seguridad. No se trata de traspasarle la responsabilidad, sino de facilitar y promover su participación reforzando su seguridad durante el proceso asistencial. El sistema sanitario debe estar comprometido, y el paciente informado y formado. Aportamos herramientas y recursos online para su aplicación en atención primaria

Influenza vaccination among multiple sclerosis patients during the COVID-19 pandemic

In the context of the COVID-19 pandemic, the co-circulation of influenza and SARS-CoV-2 viruses may have severe complications for vulnerable populations. For this reason, the World Health Organization pointed to the 2020–2021 anti-influenza campaign as being of special relevance. Our aim was to assess the 2020–2021 influenza vaccination coverage, and its associated factors, among patients in a Spanish multiple sclerosis (MS) unit. A cross–sectional study was conducted. People attending the MS unit of the Clinical Hospital of Zaragoza during 2020 were included. Variables were obtained by reviewing records. Associations with 2020–2021 influenza vaccination were analyzed using bivariate analysis and a multiple logistic regression model. A total of 302 patients were studied; 62.6% were women, whose mean age (standard deviation) was 47.3 (11.5) years. The 2020–2021 influenza vaccination coverage was 55.3% (59.8% in women and 47.8% in men). A total of 89.7% had at least one other indication for vaccination (e.g., immunosuppressive treatment in 225 patients). The variables associated with getting vaccinated were being female (adjusted odds ratio (95% confidence interval) (aOR (95%CI) = 2.12 (1.12–3.99)), having received the 2019–2020 influenza vaccine (aOR (95%CI) = 31.82 (14.71–68.86)) and being born in Spain (aOR (95%CI) = 12.91 (1.07–156.28)). Coverage is moderate compared to other countries. It is necessary to develop strategies to improve it, especially in men and those born outside Spain

Influenza vaccination coverage among multiple sclerosis patients: evolution over time and associated factors

Our objective was to determine the influenza vaccination rate in a Spanish cohort of multiple sclerosis (MS) patients. A retrospective cohort study was carried out. Patients who attended the MS unit of the Lozano Blesa Hospital of Zaragoza between January 2015 and 2020 were included. The variables were obtained by reviewing the specialized and primary care records. Associations between receiving the vaccine in each flu season and the other variables were analyzed using bivariate analysis and multiple logistic regression models. A total of 260 patients were studied, with a median age of 31 years at the time of diagnosis. A total of 62.3% (162/260) were women. Vaccination coverage ranged from 20.4% in the 2015–2016 and 2016–2017 seasons to 41.5% in the 2019–2020 season (p = 0.000). Having been vaccinated in the previous season (ORa: 16.47–390.22; p = 0.000) and receiving a vaccination recommendation from the hospital vaccination unit (ORa: 2.44–3.96; p < 0.009) were associated with being vaccinated. The coverage is in an intermediate position compared to other countries. It is necessary to improve the referral system of these patients to the hospital vaccination unit because the information obtained by this service contributed to higher vaccination rates

Complex evolutionary history of the Mexican stoneroller Campostoma ornatum Girard, 1856 (Actinopterygii: Cyprinidae)

<p>Abstract</p> <p>Background</p> <p>Studies of the phylogeography of Mexican species are steadily revealing genetic patterns shared by different species, which will help to unravel the complex biogeographic history of the region. <it>Campostoma ornatum </it>is a freshwater fish endemic to montane and semiarid regions in northwest Mexico and southern Arizona. Its wide range of distribution and the previously observed morphological differentiation between populations in different watersheds make this species a useful model to investigate the biogeographic role of the Sierra Madre Occidental and to disentangle the actions of Pliocene tecto-volcanic processes <it>vs </it>Quaternary climatic change. Our phylogeographic study was based on DNA sequences from one mitochondrial gene (<it>cytb</it>, 1110 bp, n = 285) and two nuclear gene regions (S7 and RAG1, 1822 bp in total, n = 56 and 43, respectively) obtained from 18 to 29 localities, in addition to a morphological survey covering the entire distribution area. Such a dataset allowed us to assess whether any of the populations/lineages sampled deserve to be categorised as an evolutionarily significant unit.</p> <p>Results</p> <p>We found two morphologically and genetically well-differentiated groups within <it>C. ornatum</it>. One is located in the northern river drainages (Yaqui, Mayo, Fuerte, Sonora, Casas Grandes, Santa Clara and Conchos) and another one is found in the southern drainages (Nazas, Aguanaval and Piaxtla). The split between these two lineages took place about 3.9 Mya (CI = 2.1-5.9). Within the northern lineage, there was strong and significant inter-basin genetic differentiation and also several secondary dispersal episodes whit gene homogenization between drainages. Interestingly, three divergent mitochondrial lineages were found in sympatry in two northern localities from the Yaqui river basin.</p> <p>Conclusions</p> <p>Our results indicate that there was isolation between the northern and southern phylogroups since the Pliocene, which was related to the formation of the ancient Nazas River paleosystem, where the southern group originated. Within groups, a complex reticulate biogeographic history for <it>C. ornatum </it>populations emerges, following the taxon pulse theory and mainly related with Pliocene tecto-volcanic processes. In the northern group, several events of vicariance promoted by river or drainage isolation episodes were found, but within both groups, the phylogeographic patterns suggest the occurrence of several events of river capture and fauna interchange. The Yaqui River supports the most diverse populations of <it>C. ornatum</it>, with several events of dispersal and isolation within the basin. Based on our genetic results, we defined three ESUs within <it>C. ornatum </it>as a first attempt to promote the conservation of the evolutionary processes determining the genetic diversity of this species. They will likely be revealed as a valuable tool for freshwater conservation policies in northwest Mexico, where many environmental problems concerning the use of water have rapidly arisen in recent decades.</p

Consideraciones teóricas sobre la formación bioética del médico general integral durante la práctica pediátrica. (Revisión)

Las condiciones de la globalización, los avances de la tecnociencia y el desarrollo humano acentúan la necesidad del enfoque bioético en las relaciones sanitarias, con una relevancia especial para la práctica pediátrica que realiza el médico general integral en el nivel primario. Surge así la necesidad de realizar la presente investigación, con el objetivo de reflexionar sobre elementos teóricos cardinales del proceso formativo, que contribuyan a develar los rasgos esenciales que deben caracterizar a la formación bioética posgraduada. La literatura científica advierte sobre la relevancia del tema, aunque desde las ciencias pedagógicas no se evidencia un constructo teórico que tenga en cuenta las características de este profesional, sus intereses y necesidades, en vínculo con el contexto de actuación. La investigación profundiza en la formación bioética posgraduada del médico general integral desde una perspectiva integradora que favorezca la integralidad de la formación acorde con el encargo social,  además, revela rasgos esenciales del proceso formativo para afrontar las exigencias de la práctica pediátrica actual, lo que contribuye a sustentar en el orden científico la modelación teórica.The conditions of globalization, advances in techno-science and human development, emphasize the necessity of the bioethical approach in health relationships with a special relevance for the pediatric practice performed by the integral general doctor at the primary level. The need arises to carry out the present investigation with the objective of reflecting on cardinal theoretical elements of the formative process that contribute to reveal the essential features that should characterize the postgraduate bioethical formation. The scientific literature warns about the relevance of the subject, although from the pedagogical sciences, is not evidenced a theoretical construct that takes into account the characteristics of this professional, their interests and necessities in relation to the context of action. The research deepen in the postgraduate bioethical formation of the integral general doctor from an integrative perspective that favors the integrality of the training according to the social duty, also reveals essential features of the training process to face the demands of the current pediatric practice, which contributes to sustain in the scientific order the theoretical modeling

Metodología para el tratamiento del componente económico en la formación humanista del profesional de la Cultura Física (original)

The humanist formation in the universities reaches bigger force, once they intend to give answer to the necessities of the professional formation that today demands the society, to understand and to approach with more scientific demand the complex problems that require analysis from multiple dimensions. To prepare the students to approach the complexity of the reality from multiple looks, it requires of the cooperative work among educational that commit to identify topics, investigation lines that should be treated from several disciplines and subjects, with a clear coordination in the programming and boarding of contents and procedures, from the integration interdisciplines, in an economic context characterized by the changes and the appearance of new production models based on the knowledge and their applications, for they should be reinforced it and to be renewed the bonds among the higher education, the world of the work and other sectors of the society.La formación humanista en las universidades alcanza mayor fuerza, una vez que se proponen dar respuesta a las necesidades de la formación profesional que hoy demanda la sociedad, para comprender y abordar con mayor exigencia científica los problemas complejos que requieren análisis desde múltiples dimensiones. Preparar a los estudiantes para abordar la complejidad de la realidad desde múltiples miradas, requiere del trabajo cooperativo entre docentes que se comprometen a identificar tópicos, líneas de investigación que deben ser tratadas desde varias disciplinas y asignaturas, con una clara coordinación en la programación y abordaje de contenidos y procedimientos, desde la integración interdisciplinar, en un contexto económico caracterizado por los cambios y la aparición de nuevos modelos de producción basados en el saber y sus aplicaciones, por ello deberían reforzarse y renovarse los vínculos entre la enseñanza superior, el mundo del trabajo y otros sectores de la sociedad

La formación humanista del profesional. Una mirada desde el componente económico en la cultura física en Cuba (original)

The investigation is framed in the professional humanist formation of the Physical Culture, with the objective to achieve the treatment of the economic component for its improvement, what requires of the theoretical methodological preparation  of teachers, starting from interdisciplinary relation and the potentialities of the contents that allow its contextualization, what behaves in an insufficient way, taking into account  it was necessary to carry out a theoretical foundation of the process, a valuation of the humanist formation of the professional of the Physical Culture and of the place and importance of the economic component in it, identifying their regularities. The diagnosis allowed the current state of the teachers and students in this context national and international researches have been taking into account with the objective to elaborate a methodology content of the interdisciplinary logic integration that allows the pedagogical treatment of the economic component from the acting context of the different disciplines and subjects of the third year of this career. Final result that helps the formative integrity of the professional, so as improving ideas and quality.La investigación se enmarca en la formación humanista del profesional de la Cultura Física, con el objetivo de lograr el tratamiento pedagógico del componente económico para su perfeccionamiento, aspectos que requieren de la preparación teórico - metodológica de los docentes, a partir de relaciones interdisciplinarias y las potencialidades de los contenidos que permiten su contextualización, lo cual se comporta de manera insuficiente. En tal sentido fue necesario realizar la fundamentación teórica del proceso, una valoración de la formación humanista del profesional de la Cultura Física y del lugar y papel del componente económico en ella, identificando sus regularidades. El diagnóstico  permitió determinar el estado actual  de los docentes  y estudiantes en relación con el tema que se aborda. Se tienen en cuenta las valoraciones de investigadores nacionales e internacionales; con este propósito se elabora  una metodología contentiva de la lógica de integración interdisciplinaria que permite desde el contexto actuante de las diferentes disciplinas y asignaturas del tercer año de la carrera, el tratamiento pedagógico del componente económico, resultado que favorece la integralidad formativa del profesional, así como su pertinencia y calidad

Prevención de infecciones relacionadas con la asistencia sanitaria en atención primaria. Lecciones de la pandemia

El sistema sanitario falló a la hora de garantizar la seguridad tanto de los profesionales como de las personas que acudieron a los centros al inicio de la pandemia. La falta de materiales y directrices para la prevención de infecciones provocó en España la peor catástrofe de la historia de la seguridad del paciente y de la salud laboral en el ámbito sanitario. Sucedió también en otros países, pero España tuvo las mayores tasas de sanitarios infectados del mundo. Fue una catástrofe, en buena parte, evitable. Revisamos qué medidas se han tomado para la prevención de infecciones en los centros de atención primaria, como la higiene de manos, las mascarillas y el material de protección personal o el mantenimiento de la distancia interpersonal, entre otras. Actualizamos las recomendaciones y planteamos las perspectivas en una situación que exige flexibilidad y capacidad de adaptación para mantener una atención de calidad y segura

Pasado, presente y futuro de la seguridad del paciente en Atención Primaria

[No abstract available