“You knew you had to be there, it had to be done”: Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain

Introduction: The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. Methods: We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi’s 7-step data analysis method. Results: During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. Conclusion: In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemi

Personal support networks and informal care: differences by sex and place? (CUIDAR-SE II study)

nObjetivo: Comparar la composición y la funcionalidad de apoyo social de redes personales de personascuidadoras de Granada y Gipuzkoa en función del sexo y la provincia.Método: Estudio transversal con metodología de análisis de redes personales. Se seleccionó una muestrade 66 personas cuidadoras segmentada por sexo en cada provincia. Se recogieron variables de compo-sición, funcionalidad de apoyo y contenido relacional de 1650 contactos personales que conforman lasredes estudiadas. Se utilizó el software EgoNet para la recogida, el análisis y la representación gráfica delas redes. Se midió la asociación de las características de la red con el sexo (de las personas cuidadoras yde las que componen sus redes) mediante la prueba de ji al cuadrado. Se analizaron los vínculos dentrode las redes.Resultados: Las redes de las personas cuidadoras de Granada están más feminizadas que las de Gipuzkoa.Las mujeres de Gipuzkoa cuentan con redes compuestas por menos familiares que las de Granada y conmayor número de relaciones entre las personas que las apoyan. Además, cuentan con más apoyo dehombres que de mujeres en todas las tareas analizadas, excepto en atención a la enfermedad. En ambasprovincias, los hombres cuidadores presentan en sus redes más mujeres que ayudan en tareas específicasde cuidado que hombres. Solo en actividades fuera del hogar en Granada hay más hombres que ayudanque mujeres (76,1% vs. 57%; p = 0,026).Conclusión: Se aprecian diferencias según el sexo y entre provincias en la composición de las redes y enel modo en que hombres y mujeres reciben y ofrecen apoyo en el cuidado.tObjective: To compare the composition and functionality of social support of personal networks of care-givers of Granada and Gipuzkoa (Spain) according to sex and province.Method: Cross-sectional study with personal network analysis methodology. A sample of 66 caregiverssegmented by sex in each province was selected. We collected variables of composition, functional andrelational content in social support of 1,650 personal relationships of the networks studied. The EgoNetsoftware was used for the collection, analysis and graphic representation of the networks. The associationof the characteristics of the network with sex (of the caregivers and those who make up their networks)was measured, using Chi-square. The links within the networks were analyzed.Results: The networks of caregivers in Granada are more feminized than those in Gipuzkoa. The women ofGipuzkoa have less familiar networks than those of Granada and with a greater number of relationshipsamong the people who support them. They also have more support from men than women in all the tasksanalyzed, except in attention to the disease. In both provinces, male caregivers show in their networksmore women who help in specific care tasks than men. Only in activities outside the home in Granadathere are more men who help than women (76.1% vs. 57%; p = 0.026).Conclusion: Gender differences between provinces can be seen in the composition of the networks and in the way in which men and women receive and offer support in care

Gender Differences in Social Support Received by Informal Caregivers: A Personal Network Analysis Approach

Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers? personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the association between different network characteristics and self-perceived health among caregivers. We performed a social network analysis study using a convenience sample of 25 female and 25 male caregivers. A descriptive analysis of the caregivers and bivariate analyses for associations with self-perceived health were performed. The structural metrics analyzed were density; degree centrality mean; betweenness centrality mean; and number of cliques, components, and isolates. The variability observed in the structure of the networks was not explained by gender. Some significant differences between men and women were observed for network composition and function. Women received help mainly from women with a similar profile to them. Men?s networks were broader and more diverse and they had more help from outside family circles, although these outcomes were not statistically significant. Our results indicate the need to develop strategies that do not reinforce traditional gender roles, but rather encourage a greater sharing of responsibility among all parties.Funding: This project has received funding from Consejería de Salud (Junta de Andalucía) (PS-0280–2016) and from Instituto de Salud Carlos III and the European Regional Development Fund (PI16/00207

“You knew you had to be there, it had to be done”: Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain

IntroductionThe COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned.MethodsWe carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi’s 7-step data analysis method.ResultsDuring the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic.ConclusionIn the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic

Diseño de prácticas externas curriculares del Centro Universitario de la Defensa de San Javier en el marco del EEES. Una metodología innovadora

[SPA] Este trabajo presenta el proceso seguido por el Equipo de Innovación Docente de Prácticas Externas del Centro Universitario de la Defensa de San Javier para el desarrollo de las prácticas curriculares de los alumnos del Grado de Ingeniería y futuros oficiales del Ejército del Aire, que se impartirán dentro del nuevo modelo de enseñanza militar. La metodología propuesta se presenta como un ejemplo de adaptación a un nuevo modelo de enseñanza dentro del EEES que busca solventar deficiencias de modelos universitarios previos como eran la falta de especificación de las tareas en las prácticas o la realización de otras no vinculadas a la titulación (Ballesteros-Velázquez et al. 2001). Se propone una adaptación de los contenidos de las prácticas a partir de un análisis in situ, de los centros donde se realizarán y utilizando como criterio para la selección de puestos y tareas su vinculación con asignaturas del grado y a profesionales con distinto rango de responsabilidad y cualificación. Así, el alumno puede aprender a utilizar las competencias concretas y necesarias para ejercer su profesión, porque las recibe de profesionales que están aplicando capacidades distintas en función de la etapa de la vida laboral en la que se encuentran. [ENG] This paper presents the process followed by the teaching innovation team at the Defence University Centre in San Javier for the design of a traineeship for Industrial Organization Engineering students, future officers of the Air Force, according to the new military education programme. The traineeship design steps are described as a specific example of a methodology adapted to a new specialized education programme within the European Space for Higher Education (EEES) in order to solve the limitations of educational models previous to EEES (Ballesteros-Velázquez et al. 2001). The authors propose in situ monitoring on the part of lecturers in each of the centres where students will carry out their traineeship to properly identify tasks and adapt the traineeship contents linking them to the degree courses and to reference professionals at different stages of their career. In this way, the student can fully apply concrete and necessary competences in the particular area where he/she Will practise his/her profession

MADRID (Marco Activo De Recursos de Innovación Docente). Madrid - Comunidad

Fac. de Ciencias BiológicasFALSEsubmitte

Marco activo de recursos de innovación docente: Madrid

Una guía de espacios e instituciones para actividades educativas complementarias en enseñanza secundaria y Formación Profesional

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

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume