García Garcés, Laura

Actualmente, la mitad de la población muere en los hospitales, lejos del hogar, en ocasiones, también lejos de familiares y amigos; rodeado de personas con culturas, religiones y valores diferentes. Por otro lado, vivimos en una sociedad que niega y oculta la muerte; no se detiene a reflexionar sobre ella; y cuando llega ese momento, se convierte en un proceso doloroso e insoportable, atenazado por el miedo; lleno de interrogantes sin respuestas. Esta situación conlleva que, frecuentemente en el final de la vida, se generen conflictos éticos cuyas soluciones son difíciles de determinar y provocan dolor en aquellos que intervienen en la toma de decisiones. Garantizar el derecho de autonomía cuando aparece la incapacidad y la muerte es uno de los desafíos de las sociedades modernas. Partiendo del Documento de Voluntades Anticipadas y queriendo avanzar un paso más, surge en los Estados Unidos el proceso de Planificación Anticipada de la Asistencia Sanitaria como medio para preservar el derecho de autodeterminación de toda persona en cualquier circunstancia. El éxito de este proceso se encuentra en que proporciona al paciente, la familia y allegados un tiempo único para aceptar la finitud de la vida y afrontar la muerte en paz.

The present study aimed to investigate the perceived changes in lifestyle behaviors among Spanish university students during COVID-19-related confinement. An observational, descriptive, and cross-sectional survey study was conducted during April 2020. Sociodemographic and anthropometric data were then obtained. The FANTASTIC questionnaire was used to assess the lifestyles of the 488 participants who took part in the study. Of the participants, 76.3% were female. Overall, the lifestyles of university students significantly deteriorated during the period of confinement caused by the COVID-19 pandemic in Spain. University female students were especially affected compared to their male fellows (p = 0.010). For women, social and family relationships (p < 0.001), personality (p < 0.001), interior (p < 0.001), and career (p < 0.001) were the aspects that worsened during confinement. For men, lack of physical exercise (p < 0.001), social and family relationships (p < 0.001), and career (p = 0.002) were affected to a greater extent. In both cases, confinement was a protective factor against the consumption of tobacco, toxins (p < 0.001), and alcohol (p < 0.001). Gender (p = 0.008) and obesity (p = 0.044) were the two factors that most affected the change in the score of the FANTASTIC questionnaire. Spanish university students’ lifestyles worsened during the lockdown caused by the COVID-19 pandemic, especially those of women, who were the most affected. Some aspects, such as those related to social and emotional behaviors, were deeply affected, while confinement could be a protective factor against previous toxic habits.

Clemente de Alejandría fundó la filosofía cristiana demostrando que fe y filosofía son verdaderamente comple-mentarias. Nacido a mediados del siglo II, inauguró la convergencia y alianza entre el cristianismo y la cultura griega. Sus obras poseen un valor inestimable dentro de la literatura eclesiástica y de la filosofía cristiana de los primeros siglos de la Iglesia. El presente estudio aborda desde la antropo-logía filosófica el pensamiento de Clemente de Alejandría sobre el matrimonio cristiano. Es cierto que el matrimonio no constituye uno de los temas centrales en las obras del autor cristiano, no obstante, dedicó gran parte del tercer libro de los Stromata a refutar doctrinas heréticas surgidas en torno al matrimonio. Este trabajo presenta una reflexión de tipo filosófico sobre los textos que se encuentran en las obras de Clemente de Alejandría en las que fundamenta su visión sobre el matrimonio. La finalidad, características, dignidad del matrimonio así como las segundas nupcias son algunas de las cuestiones que se tratan en este estudio desde la antropología filosófica.

Clinical case description: A 55-year-old man came to the hospital emergency service after being bitten in the penis by his dog. The accident caused several lesions on the glans penis and circumferential avulsion of the skin from the balanopreputial sulcus to thebase of the penis. The scrotum, testes, corpora cavernosa, and urethra were intact. Relevance: Genital trauma from an animal bite is a complex lesion, given that it involves a contaminated wound with a high risk of infection and complication because it can compromise the integrity of the urethra and corpora cavernosa of the patient. Due to the rareness of those types of lesions, there are no clinical guidelines establishing their correct management. Conclusion: More studies with greater scientific evidence are needed to aid in the formulation of standardized clinical practice guidelines, enabling improved functional and cosmetic results in those patients. / Descripción del caso clínico: Presentamos el caso de un varón de 55 años que acudió al servicio de urgencias del hospital tras haber sido mordido en el pene por su perro. Este accidente le ocasionó varias lesiones en la superficie del glande y una avulsión circunferencial de la piel desde el surco balanoprepucial hasta la base del pene. El escroto, testículos, cuerpos cavernosos y uretra estaban intactos. Relevancia: El traumatismo genital causado por mordedura animal es una lesión compleja por ser una herida contaminada con un alto riesgo de infección y complicación porque puede comprometerse la integridad uretral y de los cuerpos cavernosos del paciente. Sin embargo, es una entidad tan infrecuente que no existen guías clínicas que establezcan el correcto manejo de este tipo de lesiones. Conclusión: Se requieren más publicaciones de estos casos y elaborar guías de práctica clínica estandarizadas que permitan una mejor recuperación de los pacientes tanto estética como funcional.

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.

Objective: To evaluate the effect on the satisfaction of nursing students and the participants of Service-Learning methodology in the development of Health Education workshops. Materials and methods: Service-Learning project was designed in four stages: 1) students training in knowledge about Community Nursing and Health Education; 2) development of healthy workshops for its implementation in associations; 3) implementation of the workshops; 4) reflection on Service-Learning impact. An ad hoc questionnaire was developed to assess students’ satisfaction. It was also evaluated the workshops’ participant’s satisfaction. Results: students reported having a very high level of satisfaction by increasing their scores after improving Service-Learning methodology in the subject. In addition, participants who received health promotion workshops developed by nursing students reported a positive impact on their health. Conclusion: development of Service-Learning methodology associated with health education implies high level of satisfaction in nursing students and a social impact for the community.

El presente estudio investiga la opción cristiana por la virginidad en el pensamiento de Clemente de Alejandría. En nuestro autor no se encuentra una doctrina organizada sobre la virginidad cristiana, sin embargo, resulta sorprendente que si se estudian estos comentarios aislados de forma conjunta, se puede descubrir de forma clara y certera el pensamiento del maestro de Alejandría sobre la virginidad dentro del cristianismo. En este estudio, las citas textuales de las obras de Clemente de Alejandría servirán de referencia y nos guiarán en el desarrollo de su visión sobre la virginidad cristiana.

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.