The clinical and molecular cardiometabolic fingerprint of an exploratory psoriatic arthritis cohort is associated with the disease activity and differentially modulated by methotrexate and apremilast

Objectives: (1) To evaluate clinical and molecular cardiovascular disease (CVD) signs and their relationship with psoriatic arthritis (PsA) features and (2) to identify a clinical patient profile susceptible to benefit from methotrexate (MTX) and/or apremilast regarding CVD risk. Methods: This cross-sectional study included 100 patients with PsA and 100 age-matched healthy donors. In addition, an exploratory cohort of 45 biologically naïve patients treated for 6 months with apremilast, MTX or combined therapy according to routine clinical practice was recruited. Extensive clinical and metabolic profiles were obtained. Ninety-nine surrogate CVD-related molecules were analysed in plasma and peripheral blood mononuclear cells (PBMCs). Hard cluster analysis was performed to identify the clinical and molecular phenotypes. Mechanistic studies were performed on adipocytes. Results: Cardiometabolic comorbidities were associated with disease activity and long-term inflammatory status. Thirty-five CVD-related proteins were altered in the plasma and PBMCs of PsA patients and were associated with the key clinical features of the disease. Plasma levels of some of the CVD-related molecules might distinguish insulin-resistant patients (MMP-3, CD163, FABP-4), high disease activity (GAL-3 and FABP-4) and poor therapy outcomes (CD-163, LTBR and CNTN-1). Hard cluster analysis identified two phenotypes of patients according to the rates of cardiometabolic comorbidities with distinctive clinical and molecular responses to each treatment. Conclusions: (1) Novel CVD-related proteins associated with clinical features could be emerging therapeutic targets in the context of PsA and (2) the pleiotropic action of apremilast could make it an excellent choice for the management of PsA patients with high CVD risk, targeting metabolic alterations and CVD-related molecules

El sentido de la coherencia y el compromiso laboral de las enfermeras en el ámbito sociosanitario de Girona

L’objectiu d’aquest estudi és conèixer el sentit de coherència de les infermeres de l’àmbit sociosanitari de Girona i relacionar-lo amb la salut percebuda, l’optimisme disposicional, el compromís laboral i la síndrome de desgast professional. Estudi descriptiu i transversal. Es van estudiar variables sociodemogràfiques, personals, laborals i de salut. Els resultats mostren que han participat 109 infermeres. S’ha observat que les infermeres amb puntuacions majors de SOC, presenten millor percepció de salut, més optimisme, compromís laboral i realització personal, i menor cansament emocional i despersonalització. Les conclusions indiquen que les infermeres de l’àmbit sociosanitari de Girona presenten un sentit de coherència elevat. El cansament emocional de les infermeres s’associa negativament amb el SOC. També el sentit de coherència i el compromís laboral expliquen parcialment l’absència de cansament emocional de les infermeres.The aim of this study is to find out the sense of coherence of nurses working in care homes in Girona and relate this to self-reported heath status, dispositional Optimism, work engagement and professional burnout. Descriptive and cross-sectional study. Sociodemographic, occupational and health variables were studied through a self-administered. The results show that 109 nurses participated. It is observed that nurses with the higher SOC scores have a better perception of their health, greater optimism, greater work engagement and personal accomplishment, and less Emotional Exhaustion and Depersonalisation on the professional burnout. The conclusions suggest that nurses working in care homes in Girona have a high sense of coherence. Emotional exhaustion of the nurses negatively associates with SOC, less emotional exhaustion with greater SOC. Sense of coherence and work engagement seem to explain part of the absence of emotional exhaustion in the nurses

"Sóc" a la professió infermera

El propòsit de la present investigació és conèixer el model Salutogènic i la seva aplicació en el treball diari dels professionals d’infermeria. La disciplina infermera es caracteritza pel tracte amb les persones, el seu paradigma està basat en les cures cap a aquestes. Aquest fet causa que formin part de la professió els estímuls estressants tant de l’ambient com de l’interior dels professionals i és important que aquests prenguin consciència d’aquesta realitat i desenvolupin recursos i mecanismes que possibilitin realitzar les cures de gran qualitat. Creiem que el model Salutogènic i el seu constructe principal, el Sentit de Coherència ens col·loquen en bon camí per poder aprofundir en aquest tema. (Extret de la introducció

Mental health nursing practicum: Student and mentor perspectives on stress and satisfaction

Nursing students begin to complete practicum experiences during their first year, increasing the number of applied credits as they progress toward degree completion. This contributes to integrating knowledge and skills from all of their courses and to obtaining the basic competencies of the nursing profession. It is also essential to identify the student’s sources of stress in order to provide strategies to confront them and diminish the potential consequences. Therefore, it is a priority to ascertain the perception of stress and the stressors. This study applied both quantitative and quality methods to achieve its objectives: to analyze the perception of stress and the stress-generating factors faced by third- and fourth-year nursing students during the mental health practicum, and to determine satisfaction with the new mental health practicum in a student survey and in a focus group of mentor nurses. Study results identified four major stress factors before students began the practicum: the difficulty of providing nursing care for the patient with a mental disorder, knowing how to react in an unfamiliar situation, lack of knowledge about mental health services, and the possibility of patient aggression. Only the latter remained as a stressor after the practicum was completed. Student satisfaction with the mental health practicum was highly positive. Mentor nurses were particularly satisfied with the changes in student follow-up and evaluation, emphasizing the importance of reflective practice and students’ self-management of their learning experience as set out by the European Higher Education Area

El pràcticum d’infermeria en Salut Mental : Visió de l’estudiant i la infermera tutora

En el Grau d’Infermeria el pràcticum es duu a terme des del primer curs, incrementant el número de crèdits de forma progressiva. S'integren els coneixements i habilitats de totes les assignatures del curs, així com el desenvolupament d'actituds pròpies de la professió infermera. Identificar les fonts d'estrès és primordial per proporcionar als estudiants estratègies que els ajudin a afrontar-lo i disminuir les seves conseqüències. En aquesta línea, es considera com una acció prioritària el conèixer la percepció d'estrès i els elements que ho afavoreixen en els estudiants durant el pràcticum de salut mental, així com conèixer la percepció dels professors tutors sobre el pràcticu

Reducing health inequities affecting immigrant women: a qualitative study of their available assets

Background: Immigrant women often experience health inequities, whether for reasons of gender, country of origin, or socioeconomic status. The view of immigrant women has always focussed on their needs, without taking into account their available assets. A salutogenic approach incorporating an assets analysis could provide a new perspective on the design of health promotion interventions to reduce health inequities. The study objective was to identify the assets of this group of women as a necessary first step in changing the paradigm used in such health promotion interventions. Methods: This qualitative study combined focus groups, in-depth interviews, and a photovoice session. The aim was to describe the assets of this group, based on Antonovsky’s salutogenic approach and assets model. Qualitative results were interpreted with a phenomenological focus, identifying each individual’s internal, community, and institutional assets. Results: The self awareness of skills was linked to a person’s description of herself as being optimistic, having religious beliefs, and having motivations and objectives in life, for herself, her family or her children. Being motivated helped the women to persist in doing or learning things that could be useful in confronting difficult situations. Another selfawareness skill was feeling useful to others, whether this was due to religious beliefs about their role in life or to the importance of the mutual support of interpersonal relationships. Conclusions: High optimism, strong capacity for struggle and self-initiative, the importance of religious beliefs, social support, and concern for their children’s future were described as assets of immigrant women. Identification of these assets allows us to develop more in-depth knowledge and better tools for health promotion programs and policies intended to reduce health inequities in this population of immigrant wome

Avaluació complexa basada en competències de l'assignatura prácticum II en els estudis de grau en infermeria de la Universitat de Girona

El Pràcticum en Infermeria representa un total del 32% dels crèdits de la titulació. Aquest espai formatiu precisa d'una atenció especial pel fet de ser on l'estudiant on s'han d'integrar l'assoliment de les seves competències. Per aconseguir avaluar l'assoliment de competències en aquest espai formatiu, és necessari treballar de forma conjunta amb tot el professorat i realitzar una proposta d'avaluació complexa, amb activitats alhora formatives i avaluadores. Aquestes activitats a partir d eles quals s'avaluarà a l'estudiant a través de la creació d'unes rúbriques, són la observació, la tutoria, els seminaris, el diari reflexiu i el portafol

Activitat observacional emmarcada en el practicum de 1er de Grau d'Infermeria

Descripció de l'incorporada en el Pràcticum de Primer de Grau d'Infermeria de l’Escola Universitària d'Infermeria de la UdG i primera valoració de la seva implantaci