Sánchez López, María Inmaculada

Objetivos: Describir el apoyo emocional y la competencia profesional percibida por las mujeres que han sufrido una pérdida por muerte intrauterina, y analizar la asociación entre la relación paciente-profesional y la intensidad del duelo y otras variables relacionadas con la pérdida. Por otra parte, se pretende conocer la existencia de variables predictoras del duelo por muerte intrauterina. Metodología: Estudio observacional, descriptivo y retrospectivo, en el que han participado 95 mujeres que tuvieron una o más pérdidas espontáneas del embarazo en los últimos 5 años. Se analizó la intensidad del duelo (adaptación española validada de la escala de duelo Perinatal Grief Scale, con puntuaciones de 16 a 80: a mayor puntuación, mayor intensidad del duelo) y la interacción con los profesionales sanitarios durante la pérdida (encuesta validada de la calidad de la atención en muerte intrauterina, con puntuaciones de 13 a 65: a mayor puntuación, mayor calidad en la atención percibida). Resultados: Un 90,5% de las mujeres presenta un duelo activo, y la media de intensidad de duelo es de 38,8 ± 9,8. La media obtenida en la interacción con los profesionales sanitarios fue de 39,2 ± 10,2. El duelo fue predicho por la interacción con el personal sanitario (R2 ajustado= 0,281), por la semana de la pérdida (R2 ajustado= 0,38) y por el tiempo transcurrido desde la pérdida (R2 ajustado= 0,409). Conclusiones: Existe una relación inversa entre la calidad de la atención percibida por las participantes durante la pérdida y la intensidad del duelo, que es la principal variable predictora del duelo en las mujeres de esta muestra.

Aims and Objectives: To determine the effect of immersive virtual reality (VR) on perceived pain and fear in children during vaccination and parental satisfaction with the procedure. Background: Virtual reality can reduce the perception of pain by children but only three studies have analysed its use during vaccination to date; these had small sample sizes and imperfect methodological designs. Design: A randomised controlled clinical trial. Methods: One hundred and sixty participants from the Tres Forques Health Center were randomly assigned to the intervention group (IG) (n = 82) in which distraction with immersive VR was used during the vaccination, while standard distraction techniques were used for the control group (n = 80). The primary outcome was pain (Wong–Baker FACES). Secondary outcomes included (Children's Fear Scale) and parental satisfaction with the vaccination procedure. Chi-squared tests were used for qualitative variables, relationships between quantitative variables were tested with Spearman correlations, and Mann–Whitney U- or Student t-tests were employed to assess the relationship between quantitative and qualitative variables. Results: Compared to the controls, the children in the IG reported significantly less pain and fear, while parental satisfaction was significantly higher. Reported pain and fear did not differ according to the sex of the patient. Child age was not linked to fear but was related to pain: the younger the patient, the greater the pain they described. Conclusions: Immersive VR effectively controlled pain and fear in children during vaccination and increased parent satisfaction with the vaccination process. Patient sex did not influence the level of pain and fear but age did. Relevance to clinical practice: Improving vaccination experiences can reduce perceived pain and fear in children and increase parent satisfaction, thereby enhancing vaccination schedule adherence and improving group immunity. Reporting Method: The CONSORT Statement for non-pharmacological randomised clinical trials were followed.

The movement restrictions put in place as a result of the COVID-19 pandemic required modification of the population’s usual routines, including those of the most vulnerable groups such as patients with schizophrenia. This was a retrospective observational study. We used an online survey to collect information on patient adherence to the Mediterranean diet (Mediterranean Diet Adherence Screener questionnaire), physical exercise (International Physical Activity Questionnaire Short Form), and tobacco consumption and levels of anxiety and depression (Hospital Anxiety and Depression Scale) before and during the movement restrictions. A total of 102 people with schizophrenia participated in this study. During the COVID-19 pandemic lockdown the participants significantly increased the number of minutes spent sitting per day (z = 􀀀6.73; p < 0.001), decreased the time they spent walking (z = 􀀀6.32; p < 0.001), and increased their tobacco consumption (X2 = 156.90; p < 0.001). These results were also accompanied by a significant increase in their reported levels of anxiety (z = 􀀀7.45; p < 0.001) and depression (z = 􀀀7.03, p < 0.001). No significant differences in patient diets during the pandemic compared to before the movement restrictions were reported. These results suggest the need to implement specific programs to improve lifestyle and reduce anxiety and depression during possible future pandemic situations.

The purpose of this study was to compare the effects of three different physical exercise programs on the symptomatology, body composition, physical activity, physical fitness, and quality of life of individuals with schizophrenia. A total of 432 patients were assessed for eligibility and 86 were randomized into the aerobic (n = 28), strength (n = 29) or mixed (n = 29) groups. Positive, negative, and general symptoms of psychosis, body mass index (BMI), physical activity (IPAQ-SF), physical fitness (6-min walk test [6MWT] and hand-grip strength [HGS]), and quality of life (WHOQUOLBREF) were assessed at baseline, post-intervention (16 weeks), and at 10-months. Our results at 16 weeks showed significant improvements in all three groups in the negative, general, and total symptoms with moderate to large effect sizes (P < 0.01, ηp 2 > 0.11), no change in the BMI, 6MWT or IPAQ-SF, and a significant improvement in the HGS test in the strength and mixed groups (P ≤ 0.05, ηp 2 > 0.08). Nonetheless, all the improvements had disappeared at 10 months. We concluded that 3 weekly sessions of a moderate to vigorous progressive exercise program for 16 weeks improved the symptomatology of individuals with schizophrenia in all three groups, with no differences between them. However, the effects had declined to baseline levels by the 10-month follow-up, suggesting that exercise interventions should be maintained over time.

Introduction Numerous studies support the practice of different physical exercise modalities as an effective treatment to address the problems associated with schizophrenia, reporting that they result in improvements in patient symptoms and quality of life. Given the lack of studies comparing different types of training in controlled environments, the aim of this proposed study will be to compare the effects of three physical exercise programmes (strength, aerobic and mixed) on the symptoms, body composition, level of physical activity and health-related quality of life of patients with schizophrenia. Methods and analysis A multicentre, single-blinded (evaluator), randomised, wait-list controlled (ratio 2:2:2:1) trial will be conducted with 105 patients recruited from different psychosocial care centres. The participants will be randomised into three 16-week training groups comprising 48 sessions lasting 1 hour each, or to the wait-list control group. The training groups will complete aerobic, strength or mixed (aerobic +strength) training. The participants will be assessed before, immediately after and 6 months after the end of the intervention. The patients in the wait-list control group (n=15) will receive one of the three trainings immediately after the intervention. The study variables will include positive, negative and general symptomology (Positive and Negative Syndrome Scale) as the primary outcome; as secondary outcome: body composition (by assessing body mass index, body fat mass and waist circumference), physical activity levels (International Physical Activity Questionnaire-Short Form) and quality of life (abbreviated WHO Quality of Life questionnaire).

Objetivo: analizar la relación entre las variables sociodemográficas y clínicas en pacientes con deterioro cognitivo en función del lugar de residencia (domicilio familiar frente a instituciones), comparándola con la autopercepción del estado de salud de ambos grupos. Material y métodos: estudio comparativo observacional transversal. La muestra estuvo formada por 71 sujetos, de los cuales 44 recibían cuidado informal en su domicilio y asistían a un centro de día (Valencia, España), y 27 que residían en un centro sociosanitario (Teruel, Valencia), ambos situados en zona rural. Los participantes fueron evaluados mediante el índice de comorbilidad de Charlson, Mini-Mental Test de Folstein (MMSE), test de fluidez verbal, autopercepción del estado de salud mediante escala visual analógica del Euro-Qol y variables sociodemográficas que incluyeron: sexo, edad, nivel de estudios, estado civil y número de hijos. Resultados: los principales resultados apuntan a que pese a que los pacientes que residen en sus hogares tienen un peor estado cognitivo en relación con el MMSE (diferencia de 3,09 puntos; p = 0,003) y la fluidez verbal (diferencia de 3,05 puntos 5,32; p = 0,000), su autopercepción del estado de salud es superior frente a aquellos que viven en un centro sociosanitario (diferencia de 21,22 puntos; p = 0,000). Conclusiones: los sujetos que residen en el domicilio presentan una autopercepción de su estado de salud mejor que aquellos que residen en el centro sociosanitario, pese a que su estado cognitivo muestra peores resultados. Este aspecto contribuye a la mejora de la utilización de los recursos necesarios hacia los ámbitos donde los cuidados sean más eficaces. / Objective: analyze the relationship between sociodemographic and clinical variables in patients with cognitive impairment regarding to the place of residence (family home versus institutions), compare their self-perception of health status. Material and Method: observational comparative study. The sample was formed by 71 participants; 44 of them were living in their homes and attended to a day center and 27 of them resided in a Social Health Center. Participants were evaluated using the Charlson comorbidity index, Folstein Mini Mental Test (MMSE), verbal fluency test, self-perception of health status using Euro-Qol visual analogue scale and sociodemographic variables included: sex, age, level of studies, marital status and number of children. Results: the main results suggest that patients residing in their homes have a worse cognitive state compared to those who lived in Social Health Centers in relation to the MMSE (difference of 3,09 points, p=0,003) and verbal fluency (difference of 3,05 points 5,32, p=0,000). However, their self-perception of health status was higher (difference of 21,22 points, p=0,000). Conclusions: patients with cognitive dysfunction who reside in their homes have a better self-perception of their health status compared to those who reside in the Social Health Center. This aspect is of relevance to the improvement of the development of cost-effective strategies that encourage the health of patients with cognitive diseases.

Some studies have been conducted in Ethiopia to analyze the predictive factors associated with recovery or mortality in children with acute malnutrition, but no recent studies carried out in Oromia have analyze nutritional recovery status in this children. we studied the factors affecting nutritional recovery for survival in acutely malnourished children Southern Ethiopia. cohort study that included the children admitted to the (blinded for review) hospital (Oromia, Ethiopia) for acute malnutrition from January 2015 to December 2016 (n = 440). Kaplan–Meier tests and log-rank tests were used to describe the survival. Chi-squared tests and Spearman and Mann–Whitney U correlation tests were also employed. The mean survival time was shorter in children with severe versus moderate malnutrition at admission (49 days vs. 101 days; log-rank p = 0.042). The survival time was shorter in children with severe acute malnutrition at the time of admission. Survival time of children with moderate acute malnutrition was shorter in children who came from rural areas compared to urban areas. Severe acute malnutrition was associated with hospital stays, death rates, or transfer to another hospital. Practical implications: the results of this study may improve the care of children with malnutrition.

Background: Virtual reality (VR) is used as a distraction measure during painful clinical procedures associated with the use of needles. These procedures include vaccinations, blood draws, or the administration of medications, which can cause children to feel increased levels of pain and fear. Objective: The objective of this study was to collect and analyze the current evidence regarding the effectiveness of VR as a tool to distract children from pain and fear during needle procedures as compared to that of standard techniques. Methods: A systematic review and meta-analysis was performed. We included randomized clinical trials (RCTs) or quasi-RCTs with participants younger than 21 years who underwent needle procedures in which the main distraction measure used was VR and where the main outcome measure was pain. The databases searched included the PubMed, Web of Science, Scopus, PsycINFO, CINAHL, and Cochrane libraries. In this systematic review, the studies were analyzed by applying the Critical Appraisal Skills Program guide in Spanish and the Jadad scale. In the meta-analysis, the effect size of the studies was analyzed based on the results for pain and fear in children. Results: From 665 unique search results, 21 studies were included in this systematic review, most of which reported low methodological quality. The study sample cohorts ranged from a minimum of 15 participants to a maximum of 220 participants. Ten studies were included in the meta-analysis. The global effect of using VR as a distraction measure was a significant reduction in pain (inverse variance [IV] –2.37, 95% CI –3.20 to –1.54; Z=5.58; P<.001) and fear (IV –1.26, 95% CI –1.89 to –0.63; Z=3.92; P<.001) in children in the experimental groups. Conclusions: The quality of the studies was mostly low. The main limitations were the impossibility of blinding the participants and health care personnel to the VR intervention. Nonetheless, the use of VR as a distraction measure was effective in reducing pain and fear in children during procedures involving needles.