Adaptación transcultural y validación de la Rúbrica de Juicio Clínico de Lasater (RJCL ) en la docencia de Grado de Enfermería en el contexto educativo español.

Introducción: Tanner lo describe el juicio clínico como la interpretación acerca de las necesidades del paciente, a fin de tomar decisiones. Experiencia, habilidades y conocimiento son esenciales para emitir juicios clínicos adecuados. Objetivos: Desarrollar la adaptación transcultural y validación de Rúbrica de Juicio Clínico de Lasater (RJCL) en la docencia de Grado de Enfermería y su implementación en el contexto educativo español. 1. Obtener una versión adaptada culturalmente al contexto educativo 2. Analizar la fiabilidad y validez de constructo en nuestro contexto. 3. Analizar posibles diferencias en las dimensiones medidas por RJCL en función distintos escenarios de simulación y de características de los estudiantes Metodología: Estudio prospectivo observacional de validación psicométrica de la RJCL. Participantes estudiantes de 4º de Grado en Enfermería.Proceso de traducción y retrotraducción: Se han seguido las recomendaciones de ISPOR (International Society for Pharmacoeconomics and Outcomes Research) y PROMIS (Patient-Reported Outcomes Measurement Information System). La recogida de muestra se realizó durante la evaluación de competencias objetivas estructuradas en la Facultad de Ciencias de la Salud de la Universidad de Málaga. Resultados: La versión adaptada fue evaluada sobre 76 alumnos/as (N=76), con dos observaciones en escenarios distintos, con evaluadores independientes para cada simulación (Número de observaciones= 152). El 70,9% de los alumnos fueron mujeres, edad media 23,91 (DE: 3,77).La fiabilidad interobservador, coeficiente de correlación intraclase, arrojó un valor de 0,93 (IC 95%: 0,92 a 0,95) (p=0,0001) para la puntuación total. Consistencia interna: El alpha de Cronbach obtenido fue de 0,93. Las correlaciones inter-items fueron de 0,570 de media (rango: 0,312 a 0,849). El índice de homogeneidad de la escala ofreció valores por encima de 0.5.Análisis factorial exploratorio: Mediante extracción del eje principal y rotación oblimin aportó 2 factores que explicaban un 72.86% de la varianza. La matriz de correlaciones entre ambos factores ofreció un r=0.536. Análisis factorial confirmatorio: El ajuste del modelo fue satisfactorio en todos los índices, con un valor 2/gl de 1.08, GFI de 0.96, TLI 0.99, NFI 0.97 y un RMSEA de 0.24 IC90%(0.000 a 0.066). Conclusiones: 1. Se ha obtenido una versión adaptada culturalmente al contexto educativo español de la RJCL. 2. No se detectan diferencias en los escenarios de simulación y características de los estudiantes. 3. La RJCL traducida al español es un instrumento válido y fiable para la medición del juicio clínico de estudiantes de grado de enfermería. 4. En adelante sería recomendable realizar estudios prospectivos que permitan evaluar la sensibilidad al cambio, la trasferencia y el coste-beneficio de distintos diseños de simulación.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Este proyecto fue financiado por la Convocatoria 2015-2017 de Proyectos de Innovación Docente de la Universidad de Málaga (PIE 144-2015

Therapists’ verbal behavior category system

En este trabajo se presentan los fundamentos teóricos y metodológicos para el desarrollo de un sistema de categorización de la conducta verbal del psicólogo clínico durante la intervención terapéutica, que nos permita el estudio de ésta desde una perspectiva analítico-funcional basada en una rigurosa metodología observacional. El procedimiento de construcción de dicho sistema es detallado desde las etapas iniciales de observación exploratoria hasta la observación sistemática de la conducta a analizar con la ayuda del software The Observer XT. Asimismo, se lleva a cabo un estudio del grado de acuerdo inter e intra observadores mediante el cálculo del coeficiente kappa y la consideración de los factores que afectan a los valores de dicho índice. Los resultados del análisis muestran altos niveles de precisión de los observadores (entre un 87 y un 93%, aproximadamente) que justifican la utilización del sistema de categorías elaborado para el estudio del lenguaje de los terapeutas en la clínicaThis paper presents the theoretical and methodological basis of a therapist’s verbal behavior category system that allows us to study clinical psychologists’ language from a functional-analytic framework and with a rigorous observation method. The procedure to develop the coding system is explained in detail from a very early stage of exploratory observation, to the systematic observation through the use of The Observer XT software. An analysis of intra-and inter-rater reliability using the kappa coefficient and taking into account the factors that affect the values of Cohen’s index was carried out. Results show high levels of observer accuracy (between approximately 87% and 93%) that justify the application of this category system to study therapists’ verbal behavior in sessionParte de este trabajo ha sido financiado por el Ministerio de Ciencia e Innovación en el marco del Plan Nacional de I+D+i 2004-2007 (Proyecto SEJ2007_66537_PSIC). Asimismo, durante el tiempo de realización de este estudio Montserrat Montaño y Ana Calero disfrutaron de una beca FPI otorgada por la Consejería de Educación de la Comunidad de Madrid para el desarrollo de sus respectivas tesis doctorale

Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis

Muscle ultrasonography of the quadriceps rectus femoris (QRF) is a technique on the rise in the assessment of muscle mass in application of nutritional assessment. The aim of the present study is to assess the usefulness of muscle ultrasonography in patients with cystic fibrosis, comparing the results with other body composition techniques such as anthropometry, bioelectrical impedance analysis (BIA), dual-energy X-ray absorptiometry (DXA), and handgrip strength (HGS). At the same time, we intend to assess the possible association with the nutritional and respiratory status. Methods: This was a prospective observational study in adult patients with cystic fibrosis in a clinically stable situation. Muscle ultrasonography of the QRF was performed, and the results were compared with other measures of body composition: anthropometry, BIA, and DXA. HGS was used to assess muscle function. Respiratory parameters were collected, and nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Results: A total of 48 patients were included, with a mean age of 34.1 ± 8.8 years. In total, 24 patients were men, and 24 patients were women. Mean BMI was 22.5 ± 3.8 kg/m2. Mean muscular area rectus anterior (MARA) was 4.09 ± 1.5 cm2, and mean muscular circumference rectus was 8.86 ± 1.61 cm. A positive correlation was observed between the MARA and fat-free mass index (FFMI) determined by anthropometry (r = 0.747; p < 0.001), BIA (r = 0.780; p < 0.001), and DXA (r = 0.678; p < 0.001), as well as muscle function (HGS: r = 0.790; p < 0.001) and respiratory parameters (FEV1; r = 0.445, p = 0.005; FVC: r = 0.376, p = 0.02; FEV1/FVC: r = 0.344, p = 0.037). A total of 25 patients (52.1%) were diagnosed with malnutrition according to GLIM criteria. Differences were observed when comparing the MARA based on the diagnosis of malnutrition (4.75 ± 1.65 cm2 in normo-nourished vs. 3.37 ± 1.04 in malnourished; p = 0.014). (...)This study was partially funded by an unrestricted grant from Vegenat Laboratories (Spain) and the Fundación SEEN-Nutricia 2021 Grant for the assessment of body composition by ultrasound. Partial funding for open access charge: Universidad de Málag

Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016

Encephalitis; Enterovirus; OutbreaksEncefalitis; Enterovirus; Brot epidèmicEncefalitis; Enterovirus; Brote epidémicoIntroductionEnterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions.AimOur objective was to investigate the epidemiology and clinical characteristics of the outbreak.MethodsWe carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3'-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries.ResultsMost EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported.ConclusionAn emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases

Artificial-intelligence-augmented telemedicine applied to the management of diet-treated gestational diabetes

Gestational diabetes (GD) confers an increased risk of complications as well as future type 2 diabetes. We assess the safety and efficacy of an artificial intelligence (AI)-augmented telemedicine system (ruled-based reasoning) that includes a blood glucose (BG) classifier (C4.5 Quinlan decision tree) in comparison with the standard care in the management of GD while insulin is not required

Monitoring of airborne biological particles in outdoor atmosphere. Part 1: Importance, variability and ratios

The first part of this review ("Monitoring of airborne biological particles in outdoor atmosphere. Part 1: Importance, variability and ratios") describes the current knowledge on the major biological particles present in the air regarding their global distribution, concentrations, ratios and influence of meteorological factors in an attempt to provide a framework for monitoring their biodiversity and variability in such a singular environment as the atmosphere. Viruses, bacteria, fungi, pollen and fragments thereof are the most abundant microscopic biological particles in the air outdoors. Some of them can cause allergy and severe diseases in humans, other animals and plants, with the subsequent economic impact. Despite the harsh conditions, they can be found from land and sea surfaces to beyond the troposphere and have been proposed to play a role also in weather conditions and climate change by acting as nucleation particles and inducing water vapour condensation. In regards to their global distribution, marine environments act mostly as a source for bacteria while continents additionally provide fungal and pollen elements. Within terrestrial environments, their abundances and diversity seem to be influenced by the land-use type (rural, urban, coastal) and their particularities. Temporal variability has been observed for all these organisms, mostly triggered by global changes in temperature, relative humidity, et cetera. Local fluctuations in meteorological factors may also result in pronounced changes in the airbiota. Although biological particles can be transported several hundreds of meters from the original source, and even intercontinentally, the time and final distance travelled are strongly influenced by factors such as wind speed and direction

Monitoring of airborne biological particles in outdoor atmosphere. Part 2: Metagenomics applied to urban environments

The air we breathe contains microscopic biological particles such as viruses, bacteria, fungi and pollen, some of them with relevant clinic importance. These organisms and/or their propagules have been traditionally studied by different disciplines and diverse methodologies like culture and microscopy. These techniques require time, expertise and also have some important biases. As a consequence, our knowledge on the total diversity and the relationships between the different biological entities present in the air is far from being complete. Currently, metagenomics and next-generation sequencing (NGS) may resolve this shortage of information and have been recently applied to metropolitan areas. Although the procedures and methods are not totally standardized yet, the first studies from urban air samples confirm the previous results obtained by culture and microscopy regarding abundance and variation of these biological particles. However, DNA-sequence analyses call into question some preceding ideas and also provide new interesting insights into diversity and their spatial distribution inside the cities. Here, we review the procedures, results and perspectives of the recent works that apply NGS to study the main biological particles present in the air of urban environments

Competències d'exposició oral acadèmica: treball en equip docent interassignatures en el grau de Psicologia

Podeu consultar la Setena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/43352Con el presente trabajo queremos dar a conocer los primeros resultados de un Pro-yecto de Innovación Docente (UB), “Competencias de exposición oral en contextos académicos: trabajo en equipo docente interasignaturas”; concretamente dos mate-riales elaborados en el marco de desarrollo del mencionado proyecto

Rich oleocanthal and oleacein extra virgin olive oil and inflammatory and antioxidant status in people with obesity and prediabetes. The APRIL study: A randomised, controlled crossover study

Background: Oleocanthal and oleacein are olive oil phenolic compounds with well known anti inflammatory and anti-oxidant properties. The main evidence, however, is provided by experimental studies. Few human studies have examined the health benefits of olive oils rich in these biophenols. Our aim was to assess the health properties of rich oleocanthal and oleacein extra virgin olive oil (EVOO), compared to those of common olive oil (OO), in people with prediabetes and obesity. Methods: Randomised, double-blind, crossover trial done in people aged 40e65 years with obesity (BMI 30e40 kg/m2 ) and prediabetes (HbA1c 5.7e6.4%). The intervention consisted in substituting for 1 month the oil used for food, both raw and cooked, by EVOO or OO. No changes in diet or physical activity were recommended. The primary outcome was the inflammatory status. Secondary outcomes were the oxidative status, body weight, glucose handling and lipid profile. An ANCOVA model adjusted for age, sex and treatment administration sequence was used for the statistical analysis. Results: A total of 91 patients were enrolled (33 men and 58 women) and finished the trial. A decrease in interferon-g was observed after EVOO treatment, reaching inter-treatment differences (P ¼ 0.041). Total antioxidant status increased and lipid and organic peroxides decreased after EVOO treatment, the changes reaching significance compared to OO treatment (P < 0.05). Decreases in weight, BMI and blood glucose (p < 0.05) were found after treatment with EVOO and not with OO. Conclusions: Treatment with EVOO rich in oleocanthal and oleacein differentially improved oxidative and inflammatory status in people with obesity and prediabetes.Funding for open access charge: Universidad de Málaga/CBU