Artículos (Enfermería)

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Effects of respiratory training on pulmonary function, cough, and functional independence in patients with amyotrophic lateral sclerosis
(Mdpi Ag, 2024-11-01) Magni, Eleonora; Hochsprung, Anja; Cáceres Matos, Rocío; Pabón Carrasco, Manuel; Heredia-Camacho, Beatriz; Solís-Marcos, Ignacio; Luque Moreno, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Fisioterapia
Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspi ratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function
Stress in novice nurses in new work environments: a systematic review
(Frontiers media SA, 2024) Narbona-Gálvez, Ángela; García-Iglesias, Juan Jesús; Ayuso Murillo, Diego; Fontán-Vinagre, Guadalupe; Gómez Salgado, Juan; Allande Cussó, Regina; Fagundo-Rivera, Javier; Macías-Toronjo, Israel; Ruiz-Frutos, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: Inexperienced nursing care can compromise the quality of care and the well-being of patients. The aim of this study was to assess the main sources of stress encountered by nurses and novice nurses in a setting not previously experienced. Methods: A systematic review was conducted following the PRISMA format in Pubmed, Scopus, Web of Science, and CINAHL electronic databases in March 2024. A total of 395 studies were identified, of which 16 met the inclusion criteria. Selection was made on the basis of topic relevance and methodological quality, assessed using the critical tools of the Joanna Briggs Institute (JBI). Results: A total of 16 studies were included in this review. Of the 16 selected, 10 were cross-sectional studies, 3 were cohort studies, 2 were qualitative, and 1 was a systematic review. The studies revealed that the main stressors for novice nurses included time management, workload, and interpersonal relationships. The results underline that organizational factors, such as lack of support and high work demands, play a key role in generating stress. Conclusion: Identifying and addressing the key challenges faced by novice nurses, such as workload, adjustment to the environment, professional expectations, and interpersonal relationships, is crucial to sustain their professional engagement and ensure the quality of health care. This understanding is essential for creating efficient policies and practices that enhance the occupational well-being and stability of nurses in the workforce
Intervention strategies to reduce maternal mortality in the context of the sustainable development goals: a scoping review
(MDPI, 2024-10-28) Olea-Ramirez, Lucia Macarena; León Larios, Fátima; Corrales-Gutiérrez, Isabel; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. HUM-873: Centro de Investigación y Acción Comunitaria de la Universidad de Sevilla; Universidad de Sevilla. CTS-607: Salud reproductiva de la mujer
According to the United Nations Population Fund, approximately every two minutes, a woman dies, totalling approximately 800 deaths per day for reasons related to a maternal causes. Therefore, within the Sustainable Development Goals of the 2030 Agenda, the goal is to reduce the global maternal mortality rate to less than 70 deaths per 100,000 live births by 2030. We aim to analyse strategies to reduce maternal mortality in the context of the Sustainable Development Goals, identify barriers that hinder their implementation, and analyse the impact of the COVID-19 pandemic on their achievement. We performed a scoping review of the following databases and distributors of specialised information in the health area: PubMed, Medes, Lilacs, Cuiden, Cinahl, Scopus, SciELO, and websites of the United Nations (UN), United Nations Population Fund (UNFPA), and Cooperanda. A total of 24 articles were reviewed. The results obtainded determined that reviewed studies agree that despite efforts to reduce maternal mortality, significant social and structural barriers still exist in developing countries that slow the implementation of strategies to protect maternal health, especially in the most at-risk populations, and the improvement of the health system. The main strategy consists of increasing the number of deliveries attended by qualified personnel, which is the greatest indicator of progress in reducing maternal mortality. To conclude, Economic, social, and political barriers remain in developing countries in the context of the Sustainable Development Goals. The intervention that has shown the most success is the attendance of deliveries by qualified personnel. It is essential to prioritise maternal care, triangular cooperation, and effective connection between the different Sustainable Development Goals.
Nursing students’ satisfaction with clinical simulation: a cross-sectional observational study
(MDPI, 2024-10-25) Jiménez-Álvarez, Juan Antonio; Guerra Martín, María Dolores; Borrallo Riego, Álvaro; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-969: Innovacion en cuidados y determinantes sociales en salud
Clinical Simulation improves results in the students’ learning tests and allows for preserving acquired knowledge for longer periods of time, promoting more significant learning. This study was conducted to analyze Nursing students’ satisfaction with Clinical Simulation in three centres attached to a university from southern Spain. Methods: A quantitative, non-experimental and cross-sectional descriptive study was carried out. The students included were attending their third year of the Nursing undergraduate course and had already taken part in training sessions by means of Clinical Simulation. The Satisfaction Scale with High-Fidelity Clinical Simulation in Students (SSHF) was used for data collection. This scale has been validated and has 33 items grouped into eight factors. The SPSS software (version 28), was used for data analysis, establishing p-values < 0.05 for the statistically significant differences. Results: The participants were 180 students, with a mean age of 22.17 years old. Of them, 90.56% belonged to the female gender. A mean score of 3.82 out of 5 was obtained in the SSHF items. The items that obtained the highest scores were the following: benefits of Clinical Simulation as it relates theory with practise; possibility of learning based on the mistakes made; and comfort and respect while the sessions were developed. The item that obtained the lowest score was “timing for each simulation case”. We found significant differences in the results obtained according to each attached centre. Conclusions: The students showed high satisfaction levels regarding High-Fidelity Clinical Simulation in each of the three attached centres included in the study. Nevertheless, they stated the need to invest more time in Clinical Simulation sessions.
Priorities and challenges in social and healthcare policies for older people living in the Mediterranean basin: A Delphi panel study
(BMC, 2024-10-08) Allande Cussó, Regina; Porcel Gálvez, Ana María; Fernández García, Elena; Essawi, Salma; Salama, Mohamed; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud; Universidad de Sevilla. CTS-1141: Investigación Clínica Aplicada a los Cuidados y Nuevos Paradigmas Asistenciales
Background: Recently, the countries in the Mediterranean basin (which share cultural ties) have been showing a common trend of declining social support for the elderly, with deficiencies in social care models for this demographic. Thus, this Delphi panel study analyzed the gaps in social and integrated care among the participating countries in a European research project. Methods: This three-round Delphi panel study focused on the European countries of Greece and Spain and the non-European countries of Egypt, Lebanon, and Tunisia. In this project, experts were identified according to their level of expertise in the subject matter, their gender, and their membership in different social groups. Subsequently, they were asked to identify the current situation of social care, set future goals, and locate the gaps regarding the social and healthcare models for older people in the participating countries. The median score (Mdn) and interquartile range (IQR) were calculated to assess the degree of consensus on the different priorities. Results: Among the participating countries, there was a lack of state agreements to maintain social care models, a lack of coordination between public and private institutions to provide social care services, territorial inequalities in terms of access and coverage of rights, and job insecurity for professionals. The desired situation was to integrate social and healthcare services with a person-centered social care model, thus promoting autonomy and empowering users and families in participation and decision-making. Conclusions: This Delphi study reveals significant disparities in social and healthcare policies for older adults across Mediterranean countries, highlighting shared challenges and specific national needs. European nations like Greece and Spain face fragmented systems, while non-European countries such as Lebanon, Egypt, and Tunisia lack specialized geriatric services and social security. All countries urgently need better professional training, social and economic empowerment of older adults, and integrated national strategies. These findings offer key insights for policymakers to develop equitable, sustainable solutions for aging populations.
Leadership in a hospital of the Andalusian Public Health System
(Elsevier, 2023-10) Bárcenas Villegas, Daniel; Vázquez Santiago, María Soledad; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Objective: To analyse, from a gender perspective, the characteristics and perception of the effects of leadership of nurses in a hospital of the Andalusian Public Health System. Methodology: Qualitative study with a phenomenological approach. The participants were nurses in care and intermediate positions with a contract of more than 6 months. A qualitative content analysis was carried out. Four phases were established for data analysis, from which 5 categories resulted. NVivo 11 software was used to analyse the dialogues. Results: The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender. Conclusions: The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.
Socio‐healthcare for older people in the Mediterranean basin: an integrative review and quality appraisal600933319
(Wiley, 2024-10-15) Porcel Gálvez, Ana María; Allande Cussó, Regina; Fadden, Isotta Mac; Ferentinou, Eleni; Zafiropoulou, Maria; Lima Serrano, Marta; Universidad de Sevilla. Departamento de Enfermería
Objectives: The aging Mediterranean Basin population presents complex challenges for healthcare systems, which require innovative care approaches. The study aimed to critically assess 19 socio-healthcare practices in the Mediterranean Basin that target the elderly population by analyzing their theoretical foundations, integration of care services, ethical considerations, gender-specific approaches, and use of technology. Design: An integrative literature review was conducted using a structured methodology. Sample: Diverse sources across multiple languages were searched, with the inclusion criteria focusing on the alignment of socio- healthcare practices with the components of the nursing metaparadigm, the incorporation of transversal values, and relevance to the elderly population. Results: The socio-healthcare practices exhibited common themes, such as person-centered care, interdisciplinary collaboration, and incorporation of technology for coordinated care delivery. Ethical principles of autonomy, dignity, and respect were central, with some socio-healthcare practices addressing gender-specific care needs. Evidence-based findings emphasized holistic care, integration, ethics, and innovation in elderly socio-healthcare. Conclusions: New eldercare frameworks should integrate these aspects, which offer a comprehensive approach to addressing the complex needs of elderly patients. Managers should design systems prioritizing patient well-being, whereas policymakers should develop equitable and high-quality care policies that collectively improve the well-being of the elderly population in the Mediterranean Basin.
Evaluation of red blood cell biochemical markers and coagulation profiles following cell salvage in cardiac surgery: a systematic review and meta-analysis
(MDPI, 2024-10-11) Cáceres Matos, Rocío; Luque Oliveros, Manuel; Pabón Carrasco, Manuel; Universidad de Sevilla. Departamento de Enfermería
Background: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell Salvage is necessary to prevent potential surgical complications. Objective: To evaluate the efficacy of Cell Salvage in relation to the biochemical parameters of the red blood series and coagulation, as well as the risk of hemorrhage. Methods: A systematic review, accompanied by a meta-analysis, was executed via an extensive literature exploration encompassing Medline, CINAHL, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria comprised studies in English or Spanish, without year restrictions, conducted in adults and with a randomized controlled trial design. Results: Twenty-six studies were included in the systematic review, involving a total of 2850 patients (experimental group = 1415; control group = 1435). Cell Salvage did not demonstrate superior outcomes compared to allogeneic transfusions in the management of post-surgical hemorrhage, as well as in total blood loss, platelet count, fresh frozen plasma, and fibrinogen. However, Cell Salvage showed a greater effectiveness for hemoglobin (moderate evidence), hematocrit (low evidence), post intervention D-dimer (low evidence), and some coagulation-related parameters (low evidence) compared to allogeneic transfusions. Finally, better results were found in the control group for INR parameters. Conclusions: The use of the Cell Salvage system holds high potential to improve the postoperative levels of biochemical and coagulation parameters. However, the results do not provide definitive evidence regarding its effectiveness for hemorrhage control, platelet count, fresh frozen plasma, and fibrinogen. Therefore, it is recommended to increase the number of studies to assess the impact of the Cell Salvage system on improvements in the red blood cell count and patient coagulation patterns. In addition, protocols should be homogenized, and variables such as the sex of the participants should be taken into account.
Effect of foot orthoses and footwear in people with rheumatoid arthritis: an updated systematic review
(MDPI, 2024-10-11) Cabrera-Sánchez, José Manuel; Reina Bueno, María; Palomo Toucedo, Inmaculada Concepción; Vázquez-Bautista, Carmen; Nuñez Baila, María de los Ángeles; González López, José Rafael; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Podología; Universidad de Sevilla. CTS-1136: Patología y función del pie.; Universidad de Sevilla. CTS-601: HERMES; Universidad de Sevilla. CTS-284: Promoción de la salud
Background/Objectives: Rheumatoid arthritis is a chronic, systemic, inflammatory disease of an autoimmune nature that causes pain and disability in affected patients. Foot pain has become a challenge due to its negative impact on physical function. The objective of this updated systematic review is to describe the effect of foot orthoses and/or footwear in patients with rheumatoid arthritis and foot problems. Methods: Scopus, PubMed, CINALH, WOS, and Dialnet were searched for all articles published from January 2013 to September 2024. Inclusion criteria included randomised clinical trials and crossover trials (level of evidence I), published within the last 10 years, involving adults with a diagnosis of rheumatoid arthritis, with no restrictions on gender, race, or ethnicity. All studies that addressed the use of foot orthoses and/or shoe therapy in any type of comparison between these interventions were considered relevant. Review Manager was used to carry out the bias analysis of the selected studies. The reporting was based on the new PRISMA guidelines. Results: A total of 9 relevant articles were selected from an initial sample of 438. These articles analyse and compare the effectiveness of various types of foot orthoses in reducing pain, functional limitation, and disability, as well as improving balance and kinetic and kinematic parameters affected by rheumatoid arthritis. Conclusions: Foot orthoses reduce pain and disability in rheumatoid arthritis, improving balance and kinematic parameters. However, no significant improvements in the patients’ functionality and walking ability have been demonstrated. Customised ones with good arch control, heel reinforcement, and metatarsal pad are more effective. No results on the impact of footwear on patients with rheumatoid arthritis have been found in the last 10 years. This systematic review was registered in PROSPERO (CRD42023405645).
High prevalence of tobacco consumption among pregnant women in a southern European city (Seville): a challenge for the health system
(MDPI, 2024-10-09) Mendoza Berjano, Ramón; León Larios, Fátima; Corrales-Gutiérrez, Isabel; Gomez-Baya, Diego; Medero-Canela, Rocío; Baena-Antequera, Francisca; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Enfermería
The prevalence of prenatal tobacco exposure remains high in many countries, particularly in southern Europe. The aims of this study were to estimate the prevalence of smoking among pregnant women in a southern Spanish city (Seville) and to identify the associated sociodemographic and obstetric characteristics. In a descriptive, cross-sectional study, a random sample of pregnant women who were scheduled to undergo a morphology scan at their public referral hospital in their 20th week of gestation were interviewed in person. At the start of pregnancy, 38.2% of the pregnant women were smokers. In the twentieth week, 19.1% continued to smoke, and the same percentage had quit. The prevalence of smoking in pregnant women was higher among those with a low level of education (60% among pregnant women with no studies and 30.4% in those with primary education) and among those who had had abortions (38.5%). Pregnant smokers with obesity were the least likely to have given up smoking during pregnancy. Women with a lower educational level should be a prime target for cross-sectoral interventions aimed at preventing prenatal tobacco exposure. Implementation of support measures for providing effective clinical advice in preconception and prenatal care regarding healthy lifestyles is particularly needed.
Alerta cannabis: a tailored-computer web based program for the prevention of cannabis use in adolescents: a cluster-randomized controlled trial protocol
(BMC, 2024-04-10) Lima Serrano, Marta; Barrera-Villalba, Carmen; Mac Fadden, Isotta; Mesters, Ilse; De Vries, Hein; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. CTS969 : Innovación en cuidados y determinantes sociales en salud.
Background The growing use of cannabis in adolescence is a public health problem that must be addressed through prevention. In Spain, the average age of initiation of cannabis use in the adolescent population is 14.8 years. At 14 years, the lifetime prevalence of cannabis use is 11.7%, which increases to 51.,5% at the age of 18; the prevalence of cannabis use in the population aged 14 to 18 years is 28.6%, a figure that must be tried to reduce, that is why this school prevention program is proposed: Alerta Cannabis. Methods The Alerta Cannabis research project consists of design, implementation, and evaluation. In the first phase, a computer-tailored eHealth program (Alerta Cannabis) is developed based on the I-Change Model, an integrated model based on three main behavioral change processes: awareness, motivation, and action. This program consists of four 30-minute sessions that will provide culturally adapted and personalized advice to motivate students not to use cannabis through text feedback, animations, and gamification techniques. This phase will also include usability testing. In the implementation phase, secondary school students from Western Andalusia, Spain (Seville, Cádiz, Huelva, and Córdoba) and Eastern Andalusia (Jaén, Málaga, and Granada) will be randomized to an experimental condition (EC) or a control condition (CC) for a cluster randomized clinical trial (CRCT). Each condition will have 35 classes within 8 schools. GI will receive the online intervention Alerta Cannabis. EC and CC will have to fill out a questionnaire at baseline, six months, and twelve months of follow-up. In the last phase, the effect of Alerta Cannabis is evaluated. The primary outcomes are the lifetime prevalence of cannabis use and its use in the last 30 days and at 6 months. At 12 months of follow-up, the prevalence in the last 12 months will also be assessed. The secondary outcome is the intention to use cannabis. Discussion The study tests the effect of the innovative program specifically aimed to reduce the use of cannabis in the adolescent population through eHealth in Spain. The findings aim to develop and implement evidence based cannabis prevention interventions, which could support school prevention, for instance, the assistance of school nurses. If the program proves to be effective, it could be useful to prevent cannabis use on a national and international scale.
A multimodal database for the collection of interdisciplinary audiological research data in Spain
(Asociación Española de Audiología, 2024-09-27) Callejón Leblic, María Amparo; Blanco Trejo, Sergio; Villarreal-Garza, Brenda; Picazo-Reina, Ana María; Tena García, Beatriz; Lara-Delgado, Ana; Lazo-Maestre, Manuel; Sánchez Gómez, Serafín; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Enfermería
Hearing loss constitutes a major disability that hinders communica- tion and quality of life. Recent evidence has uncovered its impact on cognitive decline, thus highlighting its multifactorial dimension and the outstanding need for creating multimodal hearing data- sets that further cover clinical data across different health domains. The aim of this study is to develop a multi-collaborative database to systematically collect and analyze interdisciplinary data for audiological research, including auditory thresholds, speech tests, auditory evoked potentials, cognitive and quality-of-life tests, and medical images, among others. The database has been imple- mented in the Otorhinolaryngology Service of the Virgen Macarena University Hospital in Seville, integrated in the Intranet of the Andalusian Health Service, connected to the electronic patients’ medical records. This database relies on open-source software and complies with national and international guidelines on data protection. A specific registry module has been designed to auto- matically import auditory thresholds and auditory evoked poten- tials from clinical devices into the platform. A mobile app has also been implemented to collect questionnaires from patients remotely. A demo web version of the platform is freely available to the audiology community. The multimodal platform developed paves the way towards a multi-collaborative and unified framework for audiology research in Spain. Nevertheless, support from clini- cians and healthcare stakeholders remains critical to develop more evidence and high-quality multimodal open datasets in hearing research.
Vedolizumab and ART in recent HIV-1 infection unveil the role of α4β7 in reservoir size
(American Society for Clinical Investigation, 2024-08-22) Jimenez-Leon, Maria Reyes; Gasca-Capote, Carmen; Roca-Oporto, Cristina; Espinosa, Nuria; Sobrino, Salvador; Fontillon-Alberdi, Maria; Cervera Barajas, Antonio; Bachiller, Sara; López Cortés, Luis Fernando; Ruiz-Mateos, Ezequiel; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; Bioquímica Médica y Biología Molecular e Inmunología; Conocimiento, Empresas y Universidad; Conserjeria de Economia; Instituto de Salud Carlos III (Fondo Europeo de Desarrollo Regional, "a way to make Europe,"; Junta de Andalucia; Red Tematica de Investigacion Cooperativa en SIDA; Spanish National Research Council
BACKGROUNDWe evaluated the safety and viral rebound, after analytical treatment interruption (ATI), of vedolizumab and ART in recent HIV-1 infection. We used this model to analyze the effect of α4β7 on the HIV-1 reservoir size.METHODSParticipants started ART with monthly vedolizumab infusions, and ATI was performed at week 24. Biopsies were obtained from ileum and cecum at baseline and week 24. Vedolizumab levels, HIV-1 reservoir, flow cytometry, and cell-sorting and antibody competition experiments were assayed.RESULTSVedolizumab was safe and well tolerated. No participant achieved undetectable viremia off ART 24 weeks after ATI. Only a modest effect on the time to achieve more than 1,000 HIV-1 RNA copies/mL and the proportion of participants off ART was observed, being higher in the vedolizumab group compared with historical controls. Just before ATI, α4β7 expression was associated with HIV-1 DNA and RNA in peripheral blood and with PD1 and TIGIT levels. Importantly, a complete blocking of α4β7 was observed on peripheral CD4+ T cells but not in gut (ileum and cecum), where α4β7 blockade and vedolizumab levels were inversely associated with HIV-1 DNA.CONCLUSIONOur findings support α4β7 as an important determinant in HIV-1 reservoir size, suggesting the complete α4β7 blockade in tissue as a promising tool for HIV-cure combination strategies.TRIAL REGISTRATIONClinicalTrials.gov NCT03577782.FUNDINGThis work was supported by the Instituto de Salud Carlos III (Fondo Europeo de Desarrollo Regional, "a way to make Europe," research contracts FI17/00186 and FI19/00083 and research projects PI18/01532, PI19/01127, PI22/01796), Conserjería de Economía, Conocimiento, Empresas y Universidad, Junta de Andalucía (research projects P20/00906), the Red Temática de Investigación Cooperativa en SIDA (RD16/0025/0020), and the Spanish National Research Council.
Effectiveness of virtual reality for managing pain, fear, and anxiety in children and adolescents undergoing needle-related procedures: systematic review with meta-analysis
(MDPI, 2024-09-19) Cáceres Matos, Rocío; Castillo-García, Mario; Magni, Eleonora; Pabón Carrasco, Manuel; Universidad de Sevilla. Departamento de Enfermería
The most frequently performed invasive procedures in hospitals and healthcare centers are needle-related procedures, such as intravenous cannulation and phlebotomy, and they are identified as the major sources of pain, fear, and anxiety in children and adolescents. The objective of this systematic review was to evaluate the effectiveness of VR as a distraction measure to reduce pain, fear, and anxiety in children and adolescents undergoing needle-related invasive procedures. For this purpose, the CINAHL, Scopus, WOS, and Cochrane Library scientific databases were used. The protocol review was registered in PROSPERO (ID:42024563245), and inclusion and exclusion criteria were applied. Twenty-one studies were included in the systematic review, involving a total of 2663 participants. Significant differences favored the use of virtual reality for the control of pain intensity (WBFSpatients p = 0.001; MD = −1.83; 95% CI −2.93 to −0.72; WBFSparents p = 0.0002; MD = −2.61; 95% CI −4.00 to −1.23; WBFSnurses p = 0.0001; MD = −2.71; 95% CI −2.82 to −2.60; VAS/NRS p = 0.001, MD = −0.71; 95% CI −1.13 to −0.28), anxiety (CAMpatient p = 0.02, MD = −2.92; 95% CI −5.45 to −0.38; CAMparents p = 0.01, MD = −3.87; 95% CI −6.99 to −0.75) and fear (CFSpatients p = 0.0005, MD = −1.27; 95% CI −1.99 to −0.56; CFSparents p = 0.0005, MD = −1.33; 95% CI −2.08 to −0.58; and CFSnurses p = 0.04, MD = −1.13; 95% CI −2.24 to −0.03). However, high heterogeneity was noted. The use of virtual reality as a distraction appears to be a valuable strategy for reducing pain, fear, and anxiety during needle-related procedures, although further studies with higher methodological rigor, based on a standardized protocol, are needed.
Effects of haptic feedback interventions in post-stroke gait and balance disorders: a systematic review and meta-analysis
(MDPI, 2024) Gomez-Risquet, Maria; Cáceres Matos, Rocío; Magni, Eleonora; Luque Moreno, Carlos; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Fisioterapia
Background: Haptic feedback is an established method to provide sensory information (tactile or kinesthetic) about the performance of an activity that an individual can not consciously detect. After a stroke, hemiparesis usually leads to gait and balance disorders, where haptic feedback can be a promising approach to promote recovery. The aim of the present study is to understand its potential effects on gait and balance impairments, both after interventions and in terms of immediate effects. Methods: This research was carried out using the following scientific databases: Embase, Scopus, Web of Science, and Medline/PubMed from inception to May 2024. The Checklist for Measuring quality, PEDro scale, and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Results: Thirteen articles were chosen for qualitative analysis, with four providing data for the meta-analysis. The findings did not yield definitive evidence on the effectiveness of haptic feedback for treating balance and gait disorders following a stroke. Conclusions: Further research is necessary in order to determine the effectiveness of haptic feedback mechanisms, with larger sample sizes and more robust methodologies. Longer interventions and pre–post design in gait training with haptic feedback are necessary.
GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19
(Nature Research, 2023-05-17) Pairo-Castineira, E.; Rawlik, K.; Bretherick, A.D.; Qi, T.; Wu, Y.; Nassiri, I.; Calderón Sandubete, Enrique José; Delgado de la Cuesta, Juan; Medrano Ortega, Francisco Javier; Morilla Romero de la Osa, Rubén; Valido-Morales, Agustín S.; Baillie, J.K.; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; Banco de Santander; BBSRC Institute Program Support Grant; British Heart Foundation; Cabildo Insular de Tenerife; Centro de Supercomputacion de Galicia (CESGA); Centro National de Genotipado (CEGEN); Data and Connectivity National Core Study by Health Data Research UK; Department of Health and Social Care (DHSC), Illumina, LifeArc; Diabetes UK; Edinburgh Clinical Academic Track (ECAT) programme; European Union (ERDF) `A way of making Europe'; Fundación Amancio Ortega; Fundacion Canaria Instituto de Investigacion Sanitaria de Canarias; Health Data Research UK; Instituto de Salud Carlos III; Intensive Care Society; Medical Research Council; National Council for Scientific and Technological Development (CNPq)-Brazil; Office for National Statistics; RCUK Innovation Fellowship from the National Productivity Investment Fund; Roslin Institute Strategic Programme Grants from the BBSRC; Sepsis Research (the Fiona Elizabeth Agnew Trust); UKRI; Wellcome Intermediate Clinical Fellowship; Wellcome PhD training fellowship for clinicians; Wellcome Trust Senior Research Fellowship; Welsh Assembly Government; Westlake Education Foundation
Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte–macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).
Mapping the human genetic architecture of COVID-19
(Nature Research, 2021-07-08) Romero Gómez, Manuel; Calderón Sandubete, Enrique José; Medrano Ortega, Francisco Javier; Morilla Romero de la Osa, Rubén; Ampuero Herrojo, Javier; Delgado de la Cuesta, Juan; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; NIMH NIH HHS
The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
Big Data en salud: Un nuevo paradigma para regular, un desafío para la justicia social
(Ministerio de Sanidad y Consumo, 2021-10-07) Cabezón Ruiz, Soledad; Morilla Romero de la Osa, Rubén; Universidad de Sevilla. Departamento de Enfermería
Además de las oportunidades que supone el uso de Big Data en salud, también genera desafíos importantes en el campo de la investigación, especialmente desde el punto de vista de su gestión y de las consideraciones éticas. La Unión Europea ha estado promoviendo diferentes iniciativas que permitan la explotación de estos datos en el contexto de la economía del conocimiento. El Comité de Ética de la UNESCO ha identificado tres principios éticos a tener en cuenta sobre la aplicación de Big Data en Salud: independencia, privacidad y justicia. La protección de la privacidad y la seguridad de los pacientes se cuestiona en un contexto en el que la ciberseguridad está lejos de ser completa. Además, un desequilibrio en la explotación de estos datos por parte de los sectores público y privado podría generar inequidades que significarían un problema importante de justicia social. Este artículo sigue una metodología cualitativa basada en el análisis documental de los textos legislativos vigentes, especialmente el recientemente aprobado reglamento general de protección de datos (RGPD), así como documentos no legislativos de proyectos y comunicaciones parlamentarias a lo largo de las dos últimas legislaturas, con el objetivo es analizarlas y evaluar cómo se ajustan a los principios esbozados por la UNESCO, especialmente con respecto al principio de justicia social. También se revisan los proyectos nacionales más representativos que han empezado a adoptarse.
Genetic Polymorphisms of Superoxide Dismutase Locus of Pneumocystis jirovecii in Spanish Population
(Frontiers Media, 2019-10-15) Morilla Romero de la Osa, Rubén; González-Magaña, Amaia; Friaza, Vicente; Armas, Yaxsier de; Medrano Ortega, Francisco Javier; Calderón Sandubete, Enrique José; Horra Padilla, Carmen de la; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; The Ibero-American Programme for Science, Technology and Development
Objective: Pneumocystis pneumonia remains a major opportunistic infection in immunocompromised patients worldwide. Colonization with Pneumocystis jirovecii has recently gained attention as an important issue for understanding the complete cycle of human Pneumocystis infection. P. jirovecii Superoxide Dismutase (SOD) gene could be a molecular target with high clinical relevance, but the epidemiological information about SOD genotypes distribution is scarce. The aim of this work was to provide information about the prevalence of genotypes of Pneumocystis SOD among Spanish patients and to describe possible differences between colonized and Pneumocystis pneumonia patients. Methods: we developed a cross-sectional study analyzing broncho-alveolar lavage fluid samples from 30 Pneumocystis pneumonia patients, 30 colonized patients, and 20 controls using a nested PCR protocol designed to amplify the sodA gene of P. jirovecii. The diagnostic yield of SOD Nested PCR was evaluated against the routine practice of mtLSUrRNA Nested PCR, which is considered the gold standard. Results: SOD locus was amplified in 90% of Pneumocystis pneumonia patients, 10% of colonized patients, and none of controls. Genotype SOD1 was observed in 11 cases (52.4%) and genotype SOD2 in 10 cases (47.6%). Genotype SOD2 was observed only in Pneumocystis pneumonia patients while the genotype SOD1 was observed in both colonized and Pneumocystis pneumonia patients. Conclusions: This study provides epidemiological information about SOD genotypes distribution in Spain, showing a low genetic diversity and a predominant presence of genotype SOD1 in colonized patients. SOP Nested PCR was more sensitive and accurate assay in Pneumocystis pneumonia patients than in colonized individuals.
A second update on mapping the human genetic architecture of COVID-19
(Nature Research, 2023-09-06) Romero Gómez, Manuel; Horra Padilla, Carmen de la; Calderón Sandubete, Enrique José; Medrano Ortega, Francisco Javier; Ampuero Herrojo, Javier; Delgado de la Cuesta, Juan; Guerrero Montávez, Juan Miguel; Morilla Romero de la Osa, Rubén; Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología; Universidad de Sevilla. Departamento de Enfermería; Universidad de Sevilla. Departamento de Medicina; NIA NIH HHS
Investigating the role of host genetic factors in COVID-19 severity and susceptibility can inform our understanding of the underlying biological mechanisms that influence adverse outcomes and drug development1,2. Here we present a second updated genome-wide association study (GWAS) on COVID-19 severity and infection susceptibility to SARS-CoV-2 from the COVID-19 Host Genetic Initiative (data release 7). We performed a meta-analysis of up to 219,692 cases and over 3 million controls, identifying 51 distinct genome-wide significant loci—adding 28 loci from the previous data release2. The increased number of candidate genes at the identified loci helped to map three major biological pathways that are involved in susceptibility and severity: viral entry, airway defence in mucus and type I interferon. (extract)

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