Monfort Vinuesa, Carlos

The landscape of Extended Reality (ER), which includes Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) is rapidly changing. However, despite the promising results from many randomized controlled trials (RCTs) developed on healthcare environments, there is a lack of standardization, specifically to determine their effectiveness in academic settings. To our best knowledge, this is the first systematic review addressing the efficacy of MR to enhance learning and skills acquisition in undergraduate mental health education. The purposes of this study were to review the scientific literature of those studies involving MR and undergraduate mental health education, to answer the two following questions: (1) Is MR useful to enhance the acquisition of knowledge and skill training in undergraduate mental health education, and (2) Which are the advantages and disadvantages that should be addressed to successfully develop MR in undergraduate mental health education? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, and Scopus y WOS (Web of Science), following the PRISMA statements and using “mixed reality + education”, “mixed reality + student”, “mixed reality + undergraduate”, and “mixed reality + mental health”, as keywords. Those studies published between 2012 to present, in English or Spanish language, were reviewed. A total of 2608 records were retrieved, and only 6 publications met the inclusion criteria, and were finally included. MR training used was varied. There were no studies providing specific outcomes regarding the student’s acquired knowledge (theoretical concepts) after using MR. Several strengths and weaknesses of using MR with students were discussed. The results will be useful to develop innovative MR strategies to improve undergraduate mental health education, due to the lack of studies focused on this topic.

Background Immunity of healthcare workers (HCWs) against measles is a particular concern. They are more likely to contract it than the general population due to their occupational exposure which may cause a nosocomial outbreak. Aim To assess the measles immune status of HCWs at five Spanish university hospitals. Patients and methods Serologic testing (IgG) for measles by chemiluminescence indirect immunoassay (CLIA) was carried out prospectively and consecutively in HCWs from five university hospitals. All HCWs were classified into four epidemiological groups: vaccinated individuals, those with a history of measles disease, subjects with no history of measles or vaccination, and those who did not know if they had measles or were vaccinated, and into five professional categories: physicians, nurses, nursing assistants, other clinical workers, and non-clinical workers. A logistic regression model was constructed to identify the factors independently associated with immunity to measles. Results The study group was composed of 2157 HCWs. 89% had protective antibodies against measles. Of the 238 non-immune HCWs, 199 (83.6%) had been vaccinated as compared to 1084 of the 1919 (56.5%) immune individuals (p<0.0001). The parameters significantly predictive of having protective antibodies against measles were: older age (p<0.0001), epidemiological status (p=0.0002, mainly past measles disease), and professional category (p=0.02, particularly nurses). Conclusion This study shows that HCWs, including those previously vaccinated, are currently at risk of measles and suggests that those with a natural history of infection are better protected. Therefore, knowledge and maintenance of immunity to measles are an essential part of infection control among HCWs.

Objectives: The need to incentivize the humanization of healthcare providers coincides with the development of a more technological approach to medicine, which gives rise to depersonalization when treating patients. Currently, there is a culture of humanization that reflects the awareness of health professionals, patients, and policy makers, although it is unknown if there are university curricula incorporating specific skills in humanization, or what these may include. Therefore, the objectives of this study are as follows: (1) to identify what type of education in humanization is provided to university students of Health Sciences using digital technologies; and (2) determine the strengths and weaknesses of this education. The authors propose a curriculum focusing on undergraduate students to strengthen the humanization skills of future health professionals, including digital health strategies. Methods: A systematic review, based on the scientific literature published in EBSCO, Ovid, PubMed, Scopus, andWeb of Science, over the last decade (2012–2022), was carried out in November 2022. The keywords used were “humanization of care” and “humanization of healthcare” combined both with and without “students”. Results: A total of 475 articles were retrieved, of which 6 met the inclusion criteria and were subsequently analyzed, involving a total of 295 students. Three of them (50%) were qualitative studies, while the other three (50%) involved mixed methods. Only one of the studies (16.7%) included digital health strategies to train humanization. Meanwhile, another study (16.7%) measured the level of humanization after training. Conclusions: There is a clear lack of empirically tested university curricula that combine education in humanization and digital technology for future health professionals. Greater focus on the training of future health professionals is needed, in order to guarantee that they begin their professional careers with the precept of medical humanities as a basis.

The use of avatars in the psychological treatment of some chronic diseases is in their infancy, and it represents a growing field of research with many possibilities for innovation. However, there is a lack of studies seeking to determine if avatar-based therapies could improve mental health in chronic care settings. In fact, to the best of our knowledge, this is the first systematic review addressing this research topic. The objectives of this study were to review the scientific literature on those studies involving avatar-based therapies for chronic patients, as well as different ways to develop them and their efficacy on mental health outcomes. Two main questions were addressed: (1) Are avatar-based strategies useful to improve mental health in chronic patients? (2) Which is the best way to develop avatar-based strategies regarding chronic diseases? A systematic review of the peer-reviewed literature was conducted in March 2021. The results were, not only useful for establishing suitable ways to develop avatar-based strategies to improve mental health in chronic care, but also for providing an ad hoc taxonomy regarding this research topic. Five modalities were established according to technological complexity and avatar presentation. Most of the studies were effective (61.1%) in enhancing mental health in chronic care.

There is a lack of studies to determine if avatar-based protocols could be considered an efficient and accurate strategy to improve psychological well-being in oncology patients, even though it represents a growing field of research. To the best of our knowledge, this is the first systematic review addressing the effectiveness of avatar-based treatments to enhance quality of life (QoL) and psychological well-being in breast cancer patients. The purpose of this study was to review the scientific literature of those studies involving avatar-based technology and breast cancer patients in order to answer the following questions. (1) Are avatar-based strategies useful to im-prove QoL and psychological well-being (anxiety and depression symptoms) in breast cancer patients? (2) Which is the best way to develop avatar-based protocols for breast cancer patients? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, Scopus, and Web of Science (WOS), following the PRISMA statements and using “avatar + breast cancer” or “avatar + cancer” as keywords. Studies which were published in either English or Spanish and which addressed QoL and psychological well-being in breast cancer patients were reviewed. The results will contribute to developing innovative avatar-based strategies focused on breast cancer patients.

While there is an increasing awareness regarding the culture of humanization, which is strongly needed in the healthcare environment, little knowledge has been provided in relation to accurate strategies to teach humanization skills to healthcare undergraduate students, as well as to healthcare professionals. Furthermore, the usefulness of new technologies to improve humanization skills has hardly been addressed so far in the scientific literature, including promising strategies such as Metaverse-related technologies. Presumably, this is the first systematic review focused on the efficacy of Metaverse-related technologies to increase the acquisition of humanization skills in the healthcare environment. The purpose of this study was to review the scientific studies published in the last decade to answer the following two questions: (1) are Metaverse-related technologies useful in enhancing humanization skills in the healthcare environment? (2) What are the advantages and disadvantages that should be addressed to successfully develop Metaverserelated technologies in the healthcare sector? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, Scopus, andWeb of Science (WOS), following the PRISMA statements and using the following keywords: “humanization + Metaverse”; “humanization + mixed reality”; “humanization + extended reality”; “humanization + augmented reality”; “humanization + virtual reality”; “humanization + app”; “humanization + telemedicine”; “humanization + digital health”; “humanization + eHealth”; “humanization + telehealth”; “humanization + web-based”; “humanization + website”; “humanization + digital”; “humanization + online”; and “humanization + internet”. Studies published from 2012 to the present, written in the English language, were reviewed. A total of 505 records were obtained, of which three were selected based on the inclusion and exclusion criteria. The results will be helpful in developing new strategies to improve humanization skills in the health sphere.

Las fluoroquinolonas son una de las clases de antibióticos más prescritas. Aunque inicialmente fueron bien toleradas en ensayos clínicos aleatorizados, estudios epidemiológicos posteriores han informado de un mayor riesgo de efectos adversos efectos adversos amenazantes, graves, duraderos, incapacitantes e irreversibles, relacionados con la neurotoxicidad y la degradación del colágeno, como tendinitis, rotura del tendón de Aquiles, aneurisma aórtico y desprendimiento de retina. Este artículo repasa los principales efectos adversos potencialmente amenazadores, las alarmas emitidas por las agencias reguladoras y las alternativas terapéuticas.

Introducción: Las enfermedades infecciosas pueden beneficiarse de la aplicación de la telemedicina (TM). Este estudio realiza una descripción de las enfermedades infecciosas atendidas por el Servicio de Telemedicina del Hospital Central de la Defensa Gómez Ulla (STM-HCDGU). Métodos: Análisis de las e-consultas realizadas por miembros de las Fuerzas Armadas de Espa˜na desplazados a zona de operaciones en el periodo comprendido entre el 1 de enero del 2015 y el 31 de diciembre del 2018 que desarrollaron sintomatología infecciosa. Resultados: Se diagnosticaron 127 enfermedades infecciosas, siendo las más frecuentes las de etiología respiratoria y posteriormente la malaria. Geográficamente, África y los contingentes embarcados fueron los más significados. Fue necesario evacuar a 18 pacientes al HCDGU, siendo el diagnóstico de malaria el motivo de evacuación más frecuente, causa del único caso mortal. Conclusiones: Las enfermedades infecciosas se benefician de la aplicación de la TM, siendo una herramienta importante para el diagnóstico y tratamiento de estas, constituyendo una oportunidad para ampliar a otras poblaciones desplazadas o remotas.

Objetivo: Estudio de rentabilidad económica, terapéutica y diagnóstica de la aplicación de Telemedicina en el ámbito de las Fuerzas Armadas de España (FAS). Análisis de costes y beneficios adaptados a los diferentes casos que se plantean, según el modelo teórico diseñado. Aplicado al personal militar desplazado en zona de operaciones (ZO) que requirió asistencia por el Servicio de Telemedicina (STM) del Hospital Central de la Defensa Gómez Ulla (HCDGU). Metodología: Análisis de las consultas electrónicas realizadas al STM del HCDGU, por miembros de las FAS desplazados a ZO en el período comprendido entre 01/01/2015 y 31/12/2018, y que desarrollaron síntomas que precisaron atención médica. Resultados: Se diagnosticaron 644 patologías. La rentabilidad económica de la aplicación de Telemedicina gracias al STM en términos de productividad y rentabilidad supera ampliamente los costes de la aplicación de Telemedicina. La discordancia diagnóstica/terapéutica entre ZO y especialistas consultados vía STM supera el 60% de las e-consultas planteadas. Las patologías más frecuentes diagnosticadas fueron de etiología traumática, dermatológica e infecciosa. Conclusiones: La aplicación de Telemedicina resulta rentable económicamente en su aplicación a los contingentes desplazados en ZO. El modelo propuesto y aplicado demuestra su rentabilidad y sostenibilidad desde el punto de vista económico. diagnóstico y terapéutico.