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(1) Background: Bullying is one of the most common forms of aggressive behavior during childhood and adolescence. Some decades ago, researchers began exploring the basis of peer victimization from a biological perspective. Specifically, the Hypothalamic-Pituitary-Adrenal (HPA) and Hypothalamic-Pituitary-Gonadal (HPG) axes have been studied in relation to status-relevant behaviors, such as bullying. (2) Methods: We conducted a systematic review following the PRISMA guide and registered the review protocol at PROSPERO (CRD42023494738). We searched for relevant studies in PubMed, Psycinfo, Scopus, and Web of Science, and assessed them using the Robins E-tool. (3) Results: Our search yielded 152 studies, of which 33 were included in the review. These studies explored the association between testosterone and cortisol levels with bullying behavior, finding diverse results. Most of the studies were rated as having a low risk of bias. (4) Conclusions: This study not only enhances our understanding of bullying, but also provides guidance for the development of prevention and management programs for it. In the future, researchers should continue exploring the joint effects of different hormones on the HPA and HPG axis, using a broader set of biomarkers.

Objectives This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH). Methods A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS). Results Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either. Conclusions As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.

Introducción: La ingesta de alimentos puede determinar el estado individual de salud y bienestar de la persona. El abordaje de contenido relevante sobre nutrición en el curriculum de enfermería resulta clave a la hora de proporcionar conocimientos, actitudes y habilidades sobre prevención, tratamiento y promoción de la salud. Objetivo: Revisar el tipo de evidencia en relación a la enseñanza y aprendizaje sobre nutrición en estudiantes de grado en enfermería. Método: Se llevó a cabo una búsqueda en MEDLINE (PubMed/Ovid), Web of Science (WOS), EMBASE (a través de OvidSP), CINAHL (a través de EBSCO Publishing), ERIC (Educational Resource Information Center) y Scopus. La búsqueda incluyó publicaciones en inglés y español desde el lanzamiento de las bases de datos hasta enero de 2021. En esta revisión se incluyeron estudios empíricos primarios y que contuvieran en la muestra estudiantes de enfermería, y estudios cuyos resultados informaran sobre la enseñanza y aprendizaje en nutrición. Resultados: 22 trabajos cumplieron los criterios de inclusión, identificándose cuatro temas relevantes; 1) Revisión de programas y curriculum; 2) Diseños de enseñanza; 3) Evaluación del aprendizaje; 4) Percepción de los estudiantes sobre la metodología de enseñanza. Conclusiones: Las publicaciones incluidas presentan una gran heterogeneidad entre los programas implementados, los resultados de aprendizaje explicitados y los métodos de evaluación, lo que imposibilitó la comparación. Sin embargo, todos destacaron los beneficios de la enseñanza de la nutrición en estudiantes de enfermería. Estos resultados sugieren la necesidad de seguir investigando sobre el diseño, implementación y evaluación de las secuencias de aprendizaje.

[EN]Abstract The aim of the study was to measure the associations between and the evolution of gender awareness, gender-related health knowledge and patient pain legitimation among nursing students. Background Evidence indicates that gender equity skills are still lacking among nurses. Indeed, several studies report gender-biased patient assessment and care, arguing that greater attention should be paid to the gender perspective at university, in order to train nurses who are sensitive to this issue. Recently, certain gender perspective measurement scales have been adapted to the nursing population, offering new opportunities for the educational field. Design A quasi-experimental study was used for this study. Methods This study was conducted in the second semester of the first year of the Nursing Degree run by the University of the Basque Country. A sample of 103 students enrolled in the Anthropology, Ethics and Legislation module completed the Nijmegen Gender Awareness in Medicine Scale, the Pain Legitimation Scale and the Gender Perspective Health Knowledge Scale before and after the second semester, during which part of the syllabus focused on developing gender equity skills. Data were collected between January - April 2022. Results We found positive correlations between gender-related health knowledge and pain legitimation at post-test, and between said knowledge and gender sensitivity at both pre- and post-test (p < 0.05). The repeated measures indicated that traditional expositive teaching did not increase overall scores for gender awareness, gender-related health knowledge or pain legitimation. Conclusions The results suggest that gender-related health knowledge may be a key modifiable factor that leads to enhanced gender awareness in dealings with patients. However, traditional expositive lectures were not enough to produce a robust increase in gender awareness, pain legitimation or gender-related health knowledge levels. The effectiveness of active teachin

[EN] Aim: Identify priorities and reach a consensus on student nurses´ learning requirements and the best-suited teaching strategies in dementia care. Background: Dementia has become a global health priority. Nurses are primary service providers for people with dementia, but they may fall short on professional training. Nursing curricula still lacks a clear educational framework for dementia, meaning that nurse educators must make decisions amidst uncertainty. Design: Nominal group technique based on the conceptual framework proposed by Van de Ven & Delbecq (1972). Methods: A structured face-to-face meeting convened in November 2021 involved nine participants who were directly involved in dementia care. The steps in the technique were (a) idea generation, (b) round-robin recording, (c) discussion, (d) voting and ranking, (e) discussion on the vote, and (f) re-ranking. Participants answered two nominal questions. Consent, anonymity, feedback and iteration were guaranteed throughout the process. Results: The nominal group prioritized theoretical understanding of dementia, communication, caregivers´ needs, comprehensive assessment and ethical practice as learning requirements for nursing students. The outstanding teaching strategy discussed included various approaches to experiential learning. Conclusions: The nominal group technique process explored learning requirement priorities for student nurses within a specific context. Participants discussed experiential learning as the best-suited teaching strategy. Findings could support nurse educators to design and deliver better dementia education. Keywords: dementia; curriculum design; nurse education research; nursing care; nursing students; nominal group technique.

Given the increasing prevalence of frailty and its implications for public health, the identification of biomarkers to detect frailty is essential. Sestrin-1 is a protein with a protective role in muscle function. This study aimed to determine whether the serum sestrin-1 concentration differed between frail and non-frail populations and to investigate its association with frailty-related variables in 225 older women and men living in nursing homes (Gipuzkoa, Spain). Serum sestrin-1 concentration was measured by ELISA. Frailty, dependence, anthropometry, physical function, and physical activity were determined by validated tests and tools. The associations between sestrin-1 concentration and the other variables were determined using generalized linear models. The differences between frail and non-frail individuals were analyzed by the Mann–Whitney U-test, and receiver operating characteristic (ROC) curves were constructed to calculate the capability of sestrin-1 to detect frailty. Unexpectedly, frail individuals - according to the Fried Frailty Phenotype or the Clinical Frailty Scale - had higher serum sestrin-1 concentrations than non-frail individuals. Furthermore, the higher serum sestrin-1 concentration was associated with the increased frailty scores and dependence as well as the poorer physical function and the less physical activity. Given the contradictory results regarding serum sestrin-1 and frailty, further investigation is required to propose it as a molecular biomarker of frailty.

Salutogenesis focuses on factors that generate health and is a useful construct for identifying factors that promote health and for guiding activities to this end. This article describes health assets identified in a community diagnosis and how to leverage them with actions for improvement to deepen the understanding of this concept and its impact on health promotion. An intervention strategy was designed following the principles of participatory action research (PAR). The study was carried out in Mañaria (Basque Country, Spain) using semi-structured and in-depth interviews, participant observation, desk review, and photographs, alongside different participatory strategies. Twenty-six women were interviewed, 21 of whom were community inhabitants, and five were key informants who worked in public or private institutions. Participant recruitment stopped when data saturation was reached. Data were analysed through discourse analysis, progressive coding, and categorisation. Six meta-categories emerged, and for each of these categories, health assets were identified together with actions to improve the community’s health. The latter were presented by the community to the authorities to trigger specific actions towards improving the health of the community. Identification of health assets led to different actions to improve the health of the community including improving the existing physical and social environments, personal and group skills, and the promotion of physical, social, emotional and cultural well-being.

PURPOSE: To perform a systematic review and meta-analysis on the presence of inflammatory polymorphisms in patients with peri-implantitis (PI). PI is the main complication associated to dental implant therapy. Although its main risk factors are history of periodontitis, poor plaque control and lack of regular maintenance, genetic susceptibility could also be a determinant factor for its appearance. Single nucleotide polymorphisms (SNP) are small mutations of the DNA that alter the osseointegration of implants. Inflammatory proteins participate in both destruction of the extracellular matrix and reabsorption of the alveolar bone. METHODS: A bibliographical research was made in PubMed, Scopus and Web of Science (keywords: "single nucleotide polymorphism", "polymorphism", "periimplantitis", "SNP" and "implant failure"). RESULTS: There is a statistically significant association of peri-implant bone loss with the homozygotic model of IL-1beta (-511) (OR: 2.255; IC: 1.040-4.889). CONCLUSIONS: Associations between inflammatory polymorphisms and PI must be taken with caution due to the heterogeneous methodological design, sample size and diagnostic criteria of the studies. Thus, more well-designed studies are needed that analyze the relationship between these and more SNP and PI.

[EN]Angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) are two of the main components of the renin-angiotensin system (RAS). Imbalanced RAS showing lower ACE2 has been associated with increased cardiovascular risk, muscular pathologies, sarcopenia, frailty, other age-related pathologies and a poorer health status. However, its role in aging remains unclear. Thus, the aim of this work was to analyze the serum enzymatic activity of ACE and ACE2, the ACE/ACE2 ratio and its association with anthropometric parameters, blood pressure, physical function, dependence and frailty in older people living in nursing homes. This study is a secondary analysis of baseline data from two randomized clinical trials in a population of 228 older individuals living in nursing homes (Spain). Serum ACE and ACE2 enzymatic activities were measured by fluorimetry. Variables linked to cardiovascular risk, physical function, dependence and frailty were measured using validated tests, indexes and scales. Association between ACE, ACE2 serum activities, the ACE/ACE2 ratio and the rest of the quantitative variables were assessed by Pearson's correlations and by partial correlations controlled by age and sex. The association between serum ACE and ACE2 activities, the ACE/ACE2 ratio and frailty scores was analyzed by generalized linear models with and without controlling for sex and age. Differences in enzymatic activities between sexes and between frail and non-frail individuals were analyzed using Student's t-test and general linear models to control analysis by age and sex. We found that higher serum ACE2 activity was associated with a higher body mass index, worse physical function, greater dependence and increased frailty. This association is consistent with the elevation of circulating ACE2 in certain pathological conditions and in line with RAS deregulation in muscular dystrophies. Serum ACE2 activity, in combination with other molecules, could be proposed as a biom

[EN] This study analyzed the effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents. This was a single-blind, multicenter, randomized controlled trial performed in 10 long-term care settings and involved 112 participants. Participants were randomly assigned to a control group or an intervention group. The control group participated in routine activities; the intervention group participated in a six-month individualized and progressive multicomponent exercise program focused on strength, balance, and walking recommendations. The intervention group maintained peak VO2, oxygen saturation, and resting heart rate, while the control group showed a significant decrease in peak VO2 and oxygen saturation and an increase in resting heart rate throughout the six-month period. Individualized and progressive multicomponent exercise programs comprising strength, balance, and walking recommendations appear to be effective in preventing cardiorespiratory fitness decline in older adults living in long-term care settings.

[EN] Aim To design, implement and evaluate a nurse-led capacity building intervention (PromoGOB) for intersectoral action for health at local governments. Design The programme was based on theories of the policy process and organizational change and facilitated by a nurse developing a health broker role. A complex intervention perspective was adopted in carrying out the study. The intervention was evaluated using a mixed method embedded design. Methods Quantitative component relied on a specific questionnaire. This tool, designed and piloted ad hoc, measured the capacity in terms of knowledge, awareness, resources, skills, and commitment, both at sectoral and government levels. For the qualitative component, semi-structured interviews were conducted. These explored the perceived capacity and feasibility and acceptability issues. The programme was initiated at the end of October 2019, and it lasted a total of 5 weeks. Nineteen individuals representing various sectors at a local government in northern Spain participated in the study. The data analysis was concluded by the end of March 2020. Findings PromoGOB positively influenced participants' capacity for addressing health promotion. Awareness component, intersectoral work and the nurse as health broker were essential in the programme. The necessity of political participation was identified as an issue to be prioritized in future studies. Conclusion This study highlights the relevance of capacity building at local governments and the role that nurses can play in it. Further work should be undertaken to continue developing Health in All Policies approach at local level. Impact This study offers a starting point for nurses to get involved in the policy process of health promotion, performing a specific role as health brokers, building capacity at local governments for addressing social determinants of health, and delving into theories and concepts of the Health in All Policies field.

El objetivo de este estudio fue conocer la efectividad de la higiene con clorhexidina para prevenir infecciones nosoco- miales en pacientes adultos ingresados en unidades de cui- dados intensivos (UCI). Se realizó una revisión sistemática de los ensayos clínicos aleatorizados publicados en los últimos 10 años en diferentes bases de datos. Se extrajo información sobre distintos tipos de infecciones, mortalidad, microorga- nismos implicados y microorganismos multirresistentes. Se incluyeron cinco estudios. La intervención no fue efec- tiva en dos estudios debido a una baja frecuencia de infec- ciones y a una alta prevalencia de bacterias gramnegativas, frente a las que la clorhexidina no es tan eficaz. La interven- ción tampoco redujo las tasas de mortalidad. La interven- ción fue efectiva principalmente para prevenir bacteriemias e infecciones por bacterias grampositivas, por lo que podría ser útil en las UCI con altas prevalencias de infecciones de esas características.

BACKGROUND: Low back pain is the worldwide leading cause of disability and, even though women's pain experience is more severe, frequent, and enduring, female patients are often underdiagnosed and undertreated. Health professionals' gender stereotypes and social norms may underlie the downgrading of pain. AIM: This pilot study aimed to examine the legitimation of low back pain by health professionals in relation to the sex of the patient as well as their gender awareness and the relationship between them. METHOD: This study had a cross-sectional design. Eighty health professionals and students selected by convenience answered a 4-part online questionnaire. The eligibility criteria for participants were: aged >18 years, students in the last course of nursing/medicine or a physician/nurse, and Spanish-speaking. The questionnaire comprises: (1) a between-subjects virtual clinical low back pain case with four random versions (female/male patient and evidence/non-evidence of pathology); (2) the Spanish version of Nijmegen Gender Awareness Scale (S-NGAMS); (3) Ambivalent Sexism Inventory (ASI); and (4) Ambivalence toward Men Inventory (AMI). RESULTS: The total score of legitimation of low back pain correlated negatively with gender role ideology and sexism scales (when the virtual patient was female), as well as the subscales of willingness to offer support and credibility. CONCLUSIONS: Both sexism and gender role ideology could undermine the legitimation of low back pain, the willingness to offer support, and credibility only in female patients. The results showed a possible gender bias in low back pain assessment in health professionals. Low gender sensitivity and high sexism must be treated as modifiable risk factors for health inequities in pain care.

Background & Aims: Inflammation, particularly that mediated by bacterial components translocating from the gut to the liver and binding to toll-like receptors (TLRs), is central to cholestatic liver injury. The triggering receptor expressed on myeloid cells-2 (TREM-2) inhibits TLR-mediated signaling and exerts a protective role in hepatocellular injury and carcinogenesis. This study aims to evaluate the role of TREM-2 in cholestasis.Methods: TREM-2 expression was analyzed in the livers of pa-tients with primary biliary cholangitis (PBC) or primary scle-rosing cholangitis (PSC), and in mouse models of cholestasis. Wild-type (WT) and Trem-2 deficient (Trem-2-/-) mice were subjected to experimental cholestasis and gut sterilization. Pri-mary cultured Kupffer cells were incubated with lipopolysac-charide and/or ursodeoxycholic acid (UDCA) and inflammatory responses were analyzed.Results: TREM-2 expression was upregulated in the livers of patients with PBC or PSC, and in murine models of cholestasis. Compared to WT, the response to bile duct ligation (BDL)-induced obstructive cholestasis or alpha-naphtylisothiocyanate (ANIT)-induced cholestasis was exacerbated in Trem-2-/-mice. This was characterized by enhanced necroptotic cell death, in-flammatory responses and biliary expansion. Antibiotic treat-ment partially abrogated the effects observed in Trem-2-/-mice after BDL. Experimental overexpression of TREM-2 in the liver of WT mice downregulated ANIT-induced IL-33 expression and neutrophil recruitment. UDCA regulated Trem-1 and Trem-2 expression in primary cultured mouse Kupffer cells and damp-ened inflammatory gene transcription via a TREM-2-dependent mechanism.Conclusions: TREM-2 acts as a negative regulator of inflamma-tion during cholestasis, representing a novel potential thera-peutic target.Lay summary: Cholestasis (the reduction or cessation of bile flow) causes liver injury. This injury is exacerbated when gut-derived bacterial components interact with receptors

Background: Patient safety is a relevant subject in the nursing curriculum. Each university programs patient safety teaching and practical training differently. However, few studies have sought to explore the relationship between patient safety as perceived by nursing students and other important psychosocial competencies in the nursing curriculum, such as self-efficacy, competence, and resilience. Objectives: To analyze differential patient safety integration into three nursing education programs, and to assess agreement levels regarding patient safety climate, students' knowledge of patient safety and correlations with specific self-efficacy, competence and resilience. Methods: Participants were 647 undergraduate students from three universities. Patient safety climate and knowledge of patient safety (good praxis) were measured using the Hospital Survey on Patient Safety Culture for nursing students, and other psychosocial variables were also analyzed using other instruments: specific self-efficacy, perceived competence and resilience. Nursing education programs and patient safety climate were analyzed using the Rwg(j) and ICC measures of inter-rater agreement across different academic levels. Results: The ICC and Rwg indexes revealed high inter-rate agreement in all three universities. Differences were observed between Univ-2 and Univ-3 in patient safety climate scores and agreement values between academic levels. Differences in good praxis were found when academic levels were compared in Univ1-and Univ-2. Patient safety climate was found to correlate significantly with the psychosocial variables studied, but only in Univ-1. Conclusions: Perceived patient safety climate differs between universities and academic levels. This competency is related to self-efficacy, competence and resilience, which endorses the assessment of patient safety integration from a broader perspective.

Extensive literature has reported a link between stress and tumor progression, and between both of these factors and mental health. Despite the higher incidence of affective disorders in females and the neurochemical dif-ferences according to sex, female populations have been understudied. The aim of this study was therefore to analyze the effect of stress on tumor development in female OF1 mice. For this purpose, subjects were inoculated with B16F10 melanoma cells and exposed to the Chronic Social Instability Stress (CSIS) model. Behavioral, neurochemical and neuroendocrine parameters were analyzed. Female mice exposed to CSIS exhibited reduced body weight and increased arousal, but there was no evidence of depressive behavior or anxiety. Exposure to CSIS did not affect either corticosterone levels or tumor development, although it did provoke an imbalance in cerebral inflammatory cytokines, decreasing IL-10 expression (IL-6/IL-10 and TNF-alpha/IL-10); chemokines, increasing CX3CR1 expression (CX3CL1/CX3CR1); and glucocorticoid receptors, decreasing GR expression (MR/ GR). In contrast, tumor development did not alter body weight and, although it did alter behavior, it did so to a much lesser extent. Tumor inoculation did not affect corticosterone levels, but increased the MR/GR ratio in the hippocampus and provoked an imbalance in cerebral inflammatory cytokines and chemokines, although differently from stress. These results underscore the need for experimental approaches that allow us to take sex differences into account when exploring this issue, since these results appear to indicate that the female response to stress is mediated by mechanisms different from those often proposed in relation to male mice.

Frailty is a phenomenon that precedes adverse health events in older people. However, there is currently no consensus for how to best measure frailty. Several studies report that women have a higher prevalence of frailty than men, but there is a gap in studies of the high rates of frailty in older people living in long-term nursing homes (LTNHs) stratified by sex. Therefore, we analyzed health parameters related to frailty and measured their capacity to identify frailty stratified by sex in older people living in LTNHs. According to the Fried Frailty Phenotype (FFP), anxiety increased the risk of frailty in women, while for men functionality protected against the risk of frailty. Regarding the Tilburg Frailty Indicator (TFI), functionality had a protective effect in men, while for women worse dynamic balance indicated a higher risk of frailty. The analyzed parameters had a similar capacity for detecting frailty measured by the TFI in both sexes, while the parameters differed in frailty measured by the FFP. Our study suggests that assessment of frailty in older adults should incorporate a broad definition of frailty that includes not only physical parameters but also psycho-affective aspects as measured by instruments such as the TFI.

Aim:This study aims to validate the Nijmegen Gender Awareness in Medicine Scale,which assesses gender sensitivity and gender-role ideology towards patients in theSpanish language for use among physicians and nurses.Background:Women are more likely to suffer pain, delays and health consequencesrelated to low therapeutic effort. Health professionals’gender awareness may mini-mize such bias; however, the only instrument to assess such awareness is limited tophysicians and lacks a Spanish version.Methods:After using the back-translation method, a sample of 167 Spanish nursesand nursing students completed the instrument. In order to obtain additional validityevidence, 98 health professionals filled in gender sensitivity and gender-role ideologytowards patients’subscales and the short versions of the Ambivalent SexismInventory.Results:Gender-role ideology towards patients correlated strongly with sexist atti-tudes, demonstrating convergent validity, and Cronbach’s alpha coefficients showedan adequate internal consistency.Conclusions:Nijmegen Gender Awareness in Medicine Scale perfectly applies tonurse population, and this adaptation also broadens its use for Spanish professionals.Implications for Nursing Management:Nurse managers and educators can use thisapplicable tool to treat low gender awareness levels as a modifiable risk factor andpromote a gender-sensitive caring culture.

Aim To describe the protocol for the pilot phase of a complex intervention, designed to address primary care nurses' role confusion in health promotion. Design A pilot clustered randomized controlled trial, with control and intervention groups. Methods The study will be conducted in a primary care setting. Participants will be nurses from the primary care health service working in a primary care team (PCT, 15 control group; 15 intervention group). Nurses in the experimental group will receive the ROLE-AP programme over a 3-week period. The control group will continue with the normal routine. The pilot will help determine the intervention's feasibility, acceptability, fidelity and quality of the programme components. Data collected preintervention, postintervention and 3 months after intervention will provide estimates of the intervention's preliminary effects on the main variable, nurses' degree of agreement concerning their expected role in health promotion. The study received funding from the local government in December 2019. Discussion Role confusion is promoting primary care nurses' omissions in their health-promoting practice, which is far from the ideal portrayed by the Ottawa Charter. Interventions are needed that reveal the most appropriate mechanisms for addressing role confusion, which requires reaching an intraprofessional agreement about the expectations for role activities. Healthcare organisations could benefit from the incorporation of a programme of these characteristics into standard practice. Impact This study will produce a novel and comprehensive complex intervention that is expected to build nurses' capacity in primary healthcare organizations for health promotion, which is key to increasing the quality, efficiency and sustainability of the National Health System. The programme evaluation and feasibility study will reveal how to better use existing resources in a full-scale clinical trial.

The perception and interpretation of childbirth are changing as values change. This requires women and professionals to adapt to new circumstances. The objective of this study was to analyze the perspectives of women and professionals on hospital birth and to identify improvement areas in order to achieve a positive perinatal experience. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with women, two and eight months after childbirth, participant observation, and professional focus groups. The analysis of the transcribed texts involved a thematic inductive approach. Four improvement areas emerged from the analysis: (a) strengthening communication and the therapeutic relationship; (b) unifying criteria between hospitals and primary care centers to provide coordinated and coherent information; (c) involvement of the partner in the whole process of pregnancy-childbirth-puerperium; (d) improvement of the spaces used in prenatal care and births. The need for a continuity of care from the beginning of pregnancy to the postpartum period is emphasized, which requires an improvement in information, participation, and the promotion of shared decision-making. To this end, coordinated interdisciplinary work, involvement of the partner and the improvement of the spaces used in prenatal care and births are essential.

In primary health care, a community diagnosis is necessary to provide a detailed description of the community as well as an evaluation of the community’s health, including the main factors responsible for it and the needs felt by the population. This article presents a community health diagnosis following a participatory design, taking the perspective of women living in the community, to identify proposals for action. An ethnographic study was carried out in the community of Mañaria (Spain), using semi-structured interviews, in-depth interviews, key informants, participant observation, desk review, and photography. A sample of 21 women were interviewed until reaching saturation of the information. This information was complemented by that provided by five key informants. Data analysis included text analysis, coding, and categorization. Preliminary results were presented to the informants for validation and further refinement, and proposals for action were identified and followed up. Six categories were identified, representing different areas of intervention: population, jobs and economy, public and private spaces, lifestyles, processes of socialization, and health care assets. For each of these areas, the main problems were identified, as were the health care assets and proposals for action. The community diagnosis has been shown to be useful not only to identify health needs but also as an efficacious instrument to trigger social and public health actions that may be undertaken at the institutional level.

[EN] Objective Hepatocellular carcinoma (HCC) is a prevalent and aggressive cancer usually arising on a background of chronic liver injury involving inflammatory and hepatic regenerative processes. The triggering receptor expressed on myeloid cells 2 (TREM-2) is predominantly expressed in hepatic non-parenchymal cells and inhibits Toll-like receptor signalling, protecting the liver from various hepatotoxic injuries, yet its role in liver cancer is poorly defined. Here, we investigated the impact of TREM-2 on liver regeneration and hepatocarcinogenesis. Design TREM-2 expression was analysed in liver tissues of two independent cohorts of patients with HCC and compared with control liver samples. Experimental HCC and liver regeneration models in wild type and Trem-2-/- mice, and in vitro studies with hepatic stellate cells (HSCs) and HCC spheroids were conducted. Results TREM-2 expression was upregulated in human HCC tissue, in mouse models of liver regeneration and HCC. Trem-2-/- mice developed more liver tumours irrespective of size after diethylnitrosamine (DEN) administration, displayed exacerbated liver damage, inflammation, oxidative stress and hepatocyte proliferation. Administering an antioxidant diet blocked DEN-induced hepatocarcinogenesis in both genotypes. Similarly, Trem-2-/- animals developed more and larger tumours in fibrosis-associated HCC models. Trem-2-/- livers showed increased hepatocyte proliferation and inflammation after partial hepatectomy. Conditioned media from human HSCs overexpressing TREM-2 inhibited human HCC spheroid growth in vitro through attenuated Wnt ligand secretion. Conclusion TREM-2 plays a protective role in hepatocarcinogenesis via different pleiotropic effects, suggesting that TREM-2 agonism should be investigated as it might beneficially impact HCC pathogenesis in a multifactorial manner.

Serum alpha-klotho (s-klotho) protein has been linked with lifespan, and low concentrations of s-klotho have been associated with worse physical and cognitive outcomes. Although its significance in aging remains unclear, s-klotho has been proposed as a molecular biomarker of frailty and dependence. This study is a secondary analysis of data from a clinical trial performed in a population of 103 older individuals living in 10 nursing homes in Gipuzkoa (Spain). We aimed to elucidate associations between s-klotho (as measured by enzyme-linked immunosorbent assay) and body composition, physical fitness, and cognition, as well as frailty and dependence (determined using validated tests and scales). In addition, we investigated the association of s-klotho concentration with falls in the six months following the initial assessment. Low s-klotho levels were associated with a lower score in the psychological component of the Tilburg Frailty Indicator, a worse score in the Coding Wechsler Adult Intelligence Scale, and a greater dependence in activities of daily living. Moreover, participants with lower s-klotho concentrations suffered more falls during the 6 months after the assessment. Future translational research should aim to validate klotho's putative role as a biomarker that could identify the risk of aging-related adverse events in clinical practice.

Visible nursing work is usually associated with formal work and physician-delegated tasks which are protocolised and usually well documented. Nevertheless, nurses carry out many actions and display specific attitudes and behaviours which, despite contributing to the well-being, recovery of patients and satisfaction with the attention received, are not as visible. Previous studies have been conducted in order to define 'invisible nursing interventions', but no quantitative instruments focused on measuring invisible nursing interventions have been found in the literature. PURPOSE: To test the psychometric properties of the Perception of Invisible Nursing Care-Hospitalisation (PINC-H) questionnaire. METHODS: Cross-sectional survey design. A self-administered questionnaire was completed by 381 participants recruited consecutively after discharge from a Spanish hospital. Data were collected from 2012 to 2020. RESULTS: Three factors were identified from exploratory factor analysis,namely'Caring for the person','Caring for the environment and the family'and'Caring presence'. Criterion Validity Coefficient was highly significant (p<0.001) with values ranging between 0.63 and 0.71. Cronbach's alpha was 0.96. Test-retest reliability was estimated in a subsample of 187 participants; in all the items, correlation coefficients were highly significant (p<0.001) and within range (0.532-0.811) with a mean value of 0.680. Also, correlations between each dimension and the complete questionnaire indicated good temporal stability between measurements. CONCLUSIONS: The instrument had satisfactory validity and reliability. PINC-H can contribute to highlight nursing interventions and behaviours which are often unseen and, thus, less valued. We argue that PINC-H will also be useful to evaluate the quality of invisible nursing care to oncology inpatients

Positive parenting programs are a key strategy to promote the development of parental competence. We designed a pilot study based on parental self-efficacy to promote healthy lifestyles in their children aged between 2 to 5 years old. In this pilot study, we aimed to assess the effects of a parenting program on parental self-efficacy and parenting styles. Twenty-five parents were allocated into intervention (N = 15) and control group (N = 10). Parents from the intervention group received four group sessions (120 mi per session) to develop a positive parenting, parenting styles and parenting skills regarding to children’s diet, exercise, and screen time, and two additional sessions about child development and family games. Parents from the control group received these two latter sessions. Parental self-efficacy, parenting styles, and meal-related parenting practices were measured before and after the intervention and at 3-month follow-up. Acceptability and feasibility of the program was also measured. Quantitative data were analyzed using the repeat measures ANOVA and ANCOVA tests and the effect size calculation. Content analysis was used to analyse open questions. Positive trends were found regarding parental self-efficacy and the use of authoritative parenting style. Parents also reported a great acceptability of the program getting high satisfaction. According to the feasibility barriers and facilitators aspects were identified. The positive trends founded in this study support the development of parenting programs to promote healthy lifestyle in children.

Background: Nurse educators are required to prepare graduates for the increasing complexities of the practice environment. Debate is a teaching strategy long recognised in many disciplines to promote active learning. Objectives: The aim of this study was to evaluate how debating has been applied in nursing education and the outcomes associated with this educational strategy. Design: A systematic review of the literature. Data sources: Publications in English identified in multiple databases (PubMed, CINAHL, Web of Science, Medline and ERIC) from the launch of the database until 26th November 2019. Review method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review. Results: We identified 14 relevant studies describing structured implementation of debate. Heterogeneity was found across the papers regarding topics, timing schedules, group formation and positioning. Most of the studies evaluated implementation using satisfaction questionnaires or subjective observations. Three quasi-experimental studies reported that implementation of debating improved declarative capacity, argumentative capacity, idealistic moral judgment, and realistic moral judgment. Conclusions: Current studies do not provide enough evidence to understand the scope of debating as an instrument to develop nursing care skills. However, based on the evidence reviewed, we have identified elements to establish a debate-based learning format that might enhance student’s learning and future studies.

Physical activity (PA) during pregnancy has positive health implications for both mother and child. However, current literature indicates that not all pregnant women meet the international recommendations for PA (at least 150 min/week of moderate-to-vigorous PA). The main objective of this study was to assess PA levels among pregnant women in the city of Donostia-San Sebastian and identify their main sociodemographic predictors. We recruited 441 women in the 12th week of pregnancy from the local public obstetric health services. Women wore an accelerometer for one week during two separate time points (1st and 2nd trimesters of pregnancy) and completed a questionnaire assessing several sociodemographic variables as well as self-reported PA. With this information, we estimated women’s overall PA levels during both time points. The fulfillment of PA recommendations raised up to 77% and 85% during the first and second trimesters, respectively. We found that a higher number of children and a greater preference for exercise positively predicted light-to-moderate PA, being the most consistent predictors. The availability of a greater number of cars negatively predicted moderate-to-vigorous PA.

Sarrera: Mugako Nortasunaren Nahasmenduak, pertsonen pentsatzeko, hautemateko, erantzuteko eta besteekin erlazionatzeko orduan eragiten du. Nahaste hau pairatzen duen pertsonak bereizgarri hauek modu iraunkor eta zurrunean erasanak ditu. Kausak konplexu eta zehaztugabeak dira. Gaixotasun kronikoa da, beraz, sendatzeko kontzeptua bizitzako hainbat arlotan eragin dezaketen sintomen intentsitatea gutxitzea da, egonkortasun eta autonomia maila handituz. Gipuzkoan, ez dago nahaste honi zuzenduriko berariazko programa bat eta eremu ez ospitalarioan hutsune bat ikusten denez, Mugako Nortasunaren Nahasmendua diagnostikoa duten pertsonei zuzendutako Osasun Hezkuntza Programa bat egitea ezinbestekoa dela igartzen da. Helburuak: Gradu Amaierako Lanaren helburu nagusia, Mugako Nortasunaren Nahasmendua diagnostikoa duten pertsonentzat Osasun Hezkuntza Programa bat diseinatzea da. Helburu nagusia lortzeko asmoz, helburu zehatzak planteatu dira. Metodologia: proiektuaren helburu nagusiari erantzuteko, hainbat datu iturri erabili dira. Batetik, bilaketa bibliografikoa burutu da, osasun arloko hainbat datu-base kontsultatuz: Dialnet, Medes eta Cuiden. Horiez gain, Biblioteca Virtual en Salud eta WorldCat Discovery (Euskal Herriko Unibertsitatea) metabilatzaileak erabili dira. Euskal Autonomia Erkidegoan zentratutako lana denez, Euskadi eta Espainia mailako web-gune ofizialetan, aldizkarietan eta buru osasuneko elkarteetan informazio gehigarria bilatu da. Gainera, Donostiako Medikuntza eta Erizaintza Fakultateko liburutegia ere kontsultatu da. Garapena: Mugako Nortasunaren Nahasmendua duten pertsonei zuzenduriko Osasun Hezkuntza Programak, pairatzen duten gaixotasuna eta euren burua ezagutzea, beste pertsonekin esperientziak partekatzea eta familiarekin harremana estutzea helburu du. Programa, Tolosako Osasun Zentroan gauzatuko da eta hiru aste iraungo du. Jarduera ezberdinez osaturiko sei gai landuko dira, bi erizainek gidatuta. Ebaluazioa: Osasun Hezkuntza Programaren ebaluazioa eg

Sarrera: XXI. mendeko biztanleriak legezkotzat hartzen du zerbitzu asistentzialak segurua eta pazientearentzat ondorio negatiborik gabekoa izan behar duela. Pazienteentzat ahalik eta segurtasun-mailarik handiena lortzeko helburuarekin, Osakidetzak urteetan zehar lan egin du pazientea babesteko; erorketen intzidentzia eta prebalentzia murriztera bideratutako estrategia eta jarduera ugari egin ditu besteak beste. Donostialdeko ESIri dagokionez, duela bost urte BPSO proiektuan sartu zen eta, geroztik, erorketak eta horietatik eratorritako lesioak saihesteko gomendioak ezartzen aritu da unitateetan. Helburua: Donostia Unibertsitate Ospitaleko (DUO) erorketak saihesteko eta horiek eragindako lesioak gutxitzeko BPSO proiektuan parte hartzea, taldeko bileretan, difusio-jardueretan eta ebaluazio-jardueretan parte hartuz. Jarduerak eta emaitzak: proiektu hau burutzeko jarduera ezberdinetan parte hartu da. Taldeko bilerei dagokionez, erorketa gaia landu duen sustatzailea DUOko erorketa batzordearekin elkartu da. Bertan, gestio lanak egin dira eta DUOko erorketa kopurua gutxitzeko estrategiak pentsatu dira. Osasun profesionalek erorketak eta horiek eragindako lesioak saihesteko estrategien eta erizaintzako jardunbide onen berri izan dezaten, sustatzaileak difusio-jardueretan parte hartu du. Azkenik, ebaluazio-jarduerak egin dira estrategien eraginkortasuna ziurtatzeko. Gogoetako jarduna: horrelako proiektu handia aurrera eramatea oso zaila da, izan ere, kanpotik erraza ematen duen arren, barrutik begiratuz gero, konplexutasun handia du. Proiektu honetan parte hartzeak ezagutzak zabaltzeko aukera handia eskaintzen du. Horrez gain, osasun-erakundearen antolamenduaren eta funtzionamenduaren alderdi bat ezagutzeko aukera ematen du.

Sarrera: Fibrosi Kistikoa (FK) sortzetiko endekapenezko gaixotasun genetikoa da eta gorputzeko sistema asko kaltetzen ditu. Hala ere, galera handienak arnas sisteman eragiten ditu. Kaukasoar populazioan gaixotasun genetiko hilgarri ohikoena da eta arraza zuriko haurren biriketako arazo kronikoen eragile nagusiena ere bada. Azken urteetan, FK duten pertsonen bizi kalitatea asko hobetu da, eta horrekin batera, bizi itxaropena luzatu ere. Horretan, diagnostiko goiztiarrak, tratamendu berritzaileek eta FK unitateetako diziplina anitzeko lantaldeak eragina izan dute. Azken horretan, erizainak, bereziki, paper garrantzitsua du. Izan ere, gaixotasunak haurren eta horien familiarren (zaintzaile informalak) bizitzan sekulako inpaktua eragin dezake. Prozesu luze eta konplexu horri aurre egiteko, erizainak, osasun-hezkuntzaren bidez, familiarrei haurrei eman beharreko zainketak aurkeztuko die baita gaixotasunari aurre egiteko estrategiak garatzeko pauta ezberdinak ere. Helburua: lan honen helburu nagusia da FK berriki diagnostikatu dieten haurren zaintzaile informalei zuzenduriko osasun-hezkuntza programa diseinatzea. Metodologia: gaiari buruzko ebidentzia zientifiko berriena lortzeko bilaketa bibliografikoa egin da. Deskriptoreak (DeCS eta MeSH) eta hitz gakoak definitu dira. Bilaketa bibliografikoa 5 datu-baseetan egin da: Biblioteca Virtual en Salud (BVS), Medes, Dialnet plus, Pubmed eta Cuiden plus. Bertan, hainbat iragazki erabili dira emaitzak murrizteko. Artikuluak aukeratzeko barneratze- eta baztertze-irizpideak aplikatu dira. Irizpideak betetzen dituzten artikuluen laburpena irakurri da. Azkenik, lana egiteko baliagarriak diren artikuluak aukeratu dira. Datu-baseez gain, hainbat web orrialde ere erabili dira informazioa lortzeko. Plangintza: osasun-hezkuntza programa honek zaintzaile informalek FKren inguruko ezagutzak lortzea eta jokabideak eta gaitasunak garatzea du helburu. Horretarako, 4 saiotan banatuta dauden 5 gai multzo landuko dira. Horiek garatzeko hainbat j

Sarrera: Txantxarra haurren artean ohiko gaixotasun kronikoa da, munduan prebalentzia handienetarikoa duena. Honen formakuntza erreakzio kimiko eta mikrobiologikoaren ondorioz ematen da, pixkanaka hortza suntsituz. Gaixotasun prebenigarria eta multifaktoriala kontsideratzen da. Bestalde, esneko hortzak ezinbestekoak dira haurren garapenerako eta haietan asalduraren bat emanez gero, haurretan osasun arazo larriak sor daitezke. Ahoko osasuna sustatzeko, elikadura eta ahoko higienean esku-hartzea garrantzitsua da, ekintza hauek txantxarraren garapenean prebentzio neurri bezala joka baitezakete. Helburua: Helburu orokorra esneko hortzak dituzten haurretan zainketa higieniko-dietetikoek etorkizuneko txantxarrak ekidin ditzaketen aztertzea da. Metodologia: Berrikuspen bibliografikorako, PIO estrukturan oinarrituz, Osasun Zientzietako deskriptore eta hitz gako desberdinak erabiliz, Biblioteca Virtual en Salud (BVS) eta Trip Database metabilatzaileetan eta Dialnet zein Pubmed datu-baseetan bilaketak egin dira. Bestalde, erabilitako beste informazio iturriak liburu zein web-orriak izan dira. Hala, guztira 23 informazio iturri lortu dira. Gainera, erreferentzia bibliografikoak ebidentzia-mailaren arabera antolatu dira. Emaitzak: Ahoko higieneari dagokionez, hortzen garbiketan maiztasunak, denborak, fluorrak, hastapenak eta gainbegiratzeak duen eragina argi geratzeaz gain, ahoko garbitzaileen eta hortzetako hariaren erabilpenak duen eragina ere ikusi da. Zainketa dietetikoetan, bestalde, bularra emateak, azukredun edari eta jakiak, lo aurreko ahorakinak, txikleak zein sendagaiek txantxarren agerpenarekiko duten erlazioa ikusi da. Eztabaida: Autoreen emaitzak gehienetan elkarren artean bat datozen arren, zenbait aztergaitan aurkako emaitzak jaso dira, eztabaida sortuz. Horretaz gain, lanaren garapenean aurkitutako oztopo, egindako ikasketak zein etorkizunari begira aldarrikatu beharreko alderdiak aipatzen dira. Ondorioak: Lan honen bitartez, zainketa higieniko zein dietetikoe

Sarrera: Osasun sailak Eusko Jaurlaritzan aurkeztu zituen Legegintzaldirako Ildo Nagusi orokorretan, osasun sistemaren jardueraren ardatz nagusia pertsonak direla adierazten du. Gainera, pazientearen segurtasuna osasun asistentzialaren elementu garrantzitsua da. Alor horretan, 2013-2016ko Osakidetzako Pazientearen Segurtasunaren zazpigarren lerro estrategikoan presioak eragindako ultzerak segurtasun arazo garrantzitsua direla azpimarratzen da, horien % 95 prebenitu daitezkelarik. Gainera, kostu handia suposatzen dute. Horregatik, Osakidetza BPSO, Zainketen Bikaintasunarekin Konprometitutako Zentroen, programara batu da, presioak eragindako ultzeren prebentzio eta arriskuaren balorazio gidak, helduengan presioak eragindako ultzeren arriskua identifikatzen lagunduko baitie erizainei esparru guztietan. Helburuak: Osakidetzak, Donostia Unibertsitate Ospitalean, presioak eragindako ultzeren prebentzioan gauzatzen duen proiektuan parte hartzea da. Jarduerak eta emaitzak: programan zehar hainbat jarduera gauzatu dira. Hasiera batean, taldeko bilerak egin dira sustatzaileak gaian kokatzeko. Gero, difusio jardueretan parte hartu da erorketen inguruan hauen prebentzioa sustatzeko eta presioak eragindako ultzeren inguruan kontzientzia sortu eta BPSO proiektuaren berri emateko. Bukatzeko, ebaluazio jardueren barruan, aurreko urteetan egin diren dokumentuen azterketa sakon bat egin da. Gogoetako jarduna: BPSO proiektuaren parte izateak ospitalean dauden beste eremuak ezagutzeko eta ezagutza desberdinak garatzeko aukera ematen du, erizaintzako graduan eskuratzen ez direnak. Horrez gain, suertatu daitezkeen oztopoei aurre egiten ikasten ere laguntzen du. Era berean, erizainen lana ezinbestekoa dela ebidentzian jartzen du.

Correction added on 18 November 2019, after first online publication: The first name of Andrea Izagirre Otaegi was previously incorrect and has been updated in this version., Aim To propose a predictive model of procedural and emotional stress in clinical placements while testing self-efficacy as a possible mediator factor. Design The study used an exploratory correlational design. Method A total of 334 nursing students completed the KEZKAK-stress in clinical practice, AG-general self-efficacy and CEA-academic overload questionnaires, along with one about leadership. Sociodemographic information was also included. Results Confirmatory factor analyses and internal consistency reliabilities were satisfactory in all questionnaires. Procedural stress and emotional stress were confirmed by KEZKAK [chi(2) (674) = 1,555.58, p = .001; chi(2)/df = 2.308, CFI = .90, IFI = 91, RMSEA = .06]. The structural equation method for procedural stress and emotional stress had an acceptable fit. They revealed that academic level influenced the perception of leadership and academic overload in both procedural stress and emotional stress. General self-efficacy only mediated emotional stress. Hospital unit acted independently as a predictor of procedural stress.

Phenolic compounds are among the most investigated herbal remedies, as is especially the case for resveratrol. Many reports have shown its anti-aging properties and the ability to reduce obesity and diabetes induced by high-fat diet in mice. However, such beneficial effects hardly translate from animal models to humans. The scientific community has therefore tested whether other plant phenolic compounds may surpass the effects of resveratrol. In this regard, it has been reported that piceatannol reproduces in rodents the anti-obesity actions of its parent polyphenol. However, the capacity of piceatannol to inhibit adipocyte differentiation in humans has not been characterized so far. Here, we investigated whether piceatannol was antiadipogenic and antilipogenic in human preadipocytes. Human mesenchymal stem cells (hMSC), isolated from adipose tissues of lean and obese individuals, were differentiated into mature adipocytes with or without piceatannol, and their functions were explored. Fifty mu M of piceatannol deeply limited synthesis/accumulation of lipids in both murine and hMSC-derived adipocytes. Interestingly, this phenomenon occurred irrespective of being added at the earlier or later stages of adipocyte differentiation. Moreover, piceatannol lowered glucose transport into adipocytes and decreased the expression of key elements of the lipogenic pathway (PPAR gamma, FAS, and GLUT4). Thus, the confirmation of the antiadipogenic properties of piceatanol in vitro warrants the realization of clinical studies for the application of this compound in the treatment of the metabolic complications associated with obesity.

Objective: To determine whether obesity, physical fitness, and physical activity parameters are associated with the enzymatic activity of serum dipeptidyl peptidase IV (sDPPIV) in a sample of healthy women and men. Design and methods: We have correlated parameters of obesity, physical fitness, and physical activity with sDPPIV activity in 374 healthy subjects (age: 60.7 +/- 6.9 years, body mass index: 26.1 +/- 4.1 kg/m(2)). Enzymatic activity was analyzed using spectrofluorimetry, body composition was assessed by impedanciometry, physical fitness data were obtained using the Senior Fitness Test, and physical activity data were collected by accelerometer. Pearson' s partial correlation analysis was applied to determine the relationship between DPPIV activity and the rest of parameters and significantly correlated variables were introduced into linear regression models to predict DPPIV. Results: Serum DPPIV activity was negatively associated with obesity parameters such as body mass (r = -0.112), body mass index (BMI) (r = -0.147), waist circumference (r = -0.164), waist-to-hip ratio (-0.104), and percentage of fat mass (r = -0.185). Serum DPPIV activity was positively associated with cardiovascular fitness (r = 0.138), total amount of physical activity (r = 0.153), and time spent doing light exercise (r = 0.184). Regression models revealed sex differences in enzyme activity with overall activity higher in women than in men (beta = 0.437, p < 0.001). Further, percent fat mass was an independent negative predictor of DPPIV activity (beta = -0.184, p = 0.001). Serum DPPIV activity was positively predicted based on the amount of time spent doing light physical activity (beta = 0.167, p = 0.001). Conclusion: Our results demonstrate that sDPPIV activity is positively associated with healthier parameters regarding fatness, fitness and physical activity.

Introduction: Everybody, throughout their life, must adapt to countless situations in which they are involved; that is why it is necessary to understand each of them in order to advance properly. It has been observed that psychological therapies, among which bibliotherapy is, are effective to understand the changes that people face. Objective: To analyze and highlight the most relevant effects of the use of literature on the child's health-disease process at different times and contexts. Method: A review of the literature was performed through the bibliographic research in the databases Dialnet, Cuiden Plus, LILACS, Medline, Proquest, Pubmed, Scielo, Scopus, TDR, Trip and Virtual Health Library. Results: After the bibliographic research, 2018 articles were identified, out of which 71 articles were obtained after applying filters and inclusion criteria. Finally, 26 articles were selected. Conclusions: Bibliotherapy is beneficial in various areas related to the health-disease process during childhood, improving among other things self-esteem and acceptance of reality, promoting psychological well-being and serving as a bridge in communication between the individual and the health professional.

Introducción Todas las personas, a lo largo de la vida deben adecuarse a innumerables situaciones en las que se ven involucradas; es por ello que resulta necesario comprender cada una de ellas para poder avanzar adecuadamente. Se ha observado que las terapias psicológicas, entre las que se encuentra la biblioterapia, son efectivas para comprender los cambios a los que se enfrentan las personas. Objetivo Analizar y destacar los efectos más relevantes de la utilización de la literatura en el proceso salud-enfermedad del niño en diferentes momentos y contextos. Método Se ha realizado una revisión de la literatura mediante la búsqueda bibliográfica en las bases de datos Dialnet, Cuiden Plus, LILACS, Medline, Proquest, Pubmed, Scielo, Scopus, TDR, Trip y Biblioteca Virtual de la Salud. Resultados Tras la búsqueda bibliográfica se identificaron 2018 artículos de los cuales, tras la aplicación de filtros y criterios de inclusión, se obtuvieron 71 artículos. Finalmente se seleccionaron 26 artículos. Conclusiones La biblioterapia resulta beneficiosa en diversos ámbitos relacionados con el proceso salud-enfermedad durante la infancia, mejorando entre otras cosas la autoestima y la aceptación de la realidad, promoviendo el bienestar psicológico y sirviendo de puente en la comunicación entre el individuo y el profesional de la salud.

El fenómeno del rechazo de manuscritos en las revistas científicas es un hecho que preocupa a autores y a editores. El informe desfavorable del editor produce frustración al romper las expectativas de los autores, que casi nunca están de acuerdo con el parecer de los evaluadores; mientras que los procesos de arbitraje son tan laboriosos y poco reconocidos que un rechazo siempre produce la sensación de haber trabajado para un resultado infructuoso. Por ello las revistas científicas adoptan estrategias para acortar los tiempos y procedimientos de evaluación cuando se presume que un manuscrito no tiene potencial para obtener una valoración positiva en los procedimientos habituales de revisión por pares.

Background: There is increasing evidence suggesting that cognition and physical frailty interact within a cycle of decline associated with aging which has been called cognitive frailty. Exercise programs have demonstrated to be an effective tool to prevent functional and cognitive decline during aging, but little is known about their potential to restore or maintain functionality in individuals that require long-term nursing care. Besides, WHO has recently highlighted the importance of introducing systematic musculoskeletal health programs for older people living in residential care, as they represent a particularly vulnerable group for the development of noncommunicable diseases. Methods: This is a multicentre randomized controlled trial. 114 participants will be randomly allocated to a usual care group or to an intervention group. Inclusion criteria are as follows: >= 70 years, >= 50 on the Barthel Index, >= 20 on MEC-35 who are capable to stand up and walk independently for 10 m. Subjects in the intervention group will add to the activities scheduled for the control group the participation in a 6 months long multicomponent exercise program designed to improve strength, balance and walking retraining. Study assessments will be conducted at baseline and at 3 and 6 months. The primary outcome is change in function assessed by Short Physical Performance Battery and secondary outcomes include other measurements to assess all together the condition of frailty, which includes functionality, sedentary behaviors, cognitive and emotional status and biological markers. The present study has been approved by the Committee on Ethics in Research of the University of the Basque Country (Humans Committee Code M10/2016/105; Biological Samples Committee Code M30/2016/106). Discussion: Results from this research will show if ageing related functional and cognitive deterioration can be effectively prevented by physical exercise in institutionalized elders. It is expected that the re

Las sociedades son dinámicas, han ido evolucionando y adaptándose a las circunstancia. Pero, a lo largo del camino, no siempre los cambios han sonreído de la misma manera a todos los individuos. Los Programas Intergeneracionales surgieron como herramienta para rescatar algo tan vital como son las relaciones interpersonales entre las distintas generaciones, recuperar a ese sector demográfico que tanto ha aumentado en las últimas décadas y que casi ha quedado relegado al olvido, como son los mayores y la aportación tan valiosa que realizan dentro del núcleo familiar y del ámbito social al compartir su experiencia, sabiduría y valores morales. El objetivo de este trabajo es, por un lado, identificar los beneficios psicosociales que se obtienen en las personas mayores con la implementación de los Programas Intergeneracionales, y por otro, conocer la labor que llevan desarrollando los profesionales de Enfermería en la práctica de los mismos. Se ha realizado una revisión narrativa de la literatura existente al respecto, así como de la existencia de guías o manuales en los que se recogen los fundamentos y pautas de actuación para su implementación. En la discusión, de los artículos analizados, destacan los beneficios que aportan las experiencias intergeneracionales en las personas mayores, con o sin discapacidad y con la ayuda de distinta metodología. Como conclusiones, reseñar la mejora moderada de los mayores en aspectos como la autoestima, la soledad, sentimientos de valía o pertenencia a una comunidad, cambios positivos en el humor o aumento de la vitalidad y la alegría; la falta de presencia, en la actualidad, del profesional de enfermería en el desarrollo de Programas Intergeneracionales, la necesidad de crear unas bases rigurosas basadas en la evidencia científica y evitar la variabilidad en cuanto a los mecanismos de actuación, en especial de los sistemas de evaluación de estos programas.

Sarrera: XX. mendetik hona, baldintza ekonomikoek, teknologikoek eta osasun arlokoek izandako aurrerapenek biztanleen bizi kalitatea hobetzea, bizi itxaropena luzatzea eta biztanleria zahartzea eragin dute. Horiekin batera, adinarekin lotura duten gaitzak areagotu dira, adibidez, dementzia. Europan dementzia ohikoena Alzheimerra da. Dementziak menpekotasun handia sortzen du eta inguruarengan ere eragiten du. Helburuak: Alzheimerra duen pertsonaren beharrei erantzuteko eskaini beharreko zainketa integralak proposatzea. Hori lortzeko, gaixotasunaren patologia, zeinuak eta pertsonaren komunikazio arazoak deskribatzea; komunikatzeko estrategia eraginkorrak azaltzea; terapia ez farmakologikoen eraginkortasuna aztertzea; erizaintzako zainketa plan estandarizatua eta indibidualizatua garatzea. Metodologia: alde batetik, berrikuspen narratiboa egin da eta bestetik, erizaintza prozesua aplikatuz, zainketa planak aurkeztu dira. Bilaketa bibliografikoa datu base eta web orri ezberdinetan egin da. Horietan DeCs eta MeSH deskriptoreak, iragazkiak eta aukeratze/baztertze irizpideak erabili dira. Liburuak eta NNNConsult online plataforma ere erabili dira. Emaitzak: Alzheimer gaixotasunak eragiten dituen beharrei erantzuteko, zainketa plan estandarizatua eta indibidualizatua garatu dira. Horietan, bilaketa bibliografikoan aurkitu diren eta ebidentzia erakutsi duten neurriak txertatu dira. Ondorioak: Alzheimerra duen pertsonaren osasun egoera baldintzatzen duten faktore psikikoak eta sozialak kontuan hartzea oso garrantzitsua da. Pertsonari arreta integrala, diziplina anitzekoa eta kalitatezkoa eman behar zaizkio. Zainketak indibidualizatu egin behar dira eta prozesua egonkortzera, auto-zainketa indartzera nahiz kalitatezko bizitza mantentzera bideratuko dira. Enpatiak, komunikazioak eta terapia ez farmakologikoek zainketa horiek hobetzen laguntzen dute. Erizainak, zaintzaile den aldetik, zeregin horietan rol garrantzitsua betetzen du. Ekarpen pertsonala: Alzheimerra duen pertsona z

Objetivo principal: Elaborar y validar un cuestionario para medir el aprendizaje de los cuidados enfermeros durante las prácticas en el grado de enfermería. Metodología: Elaboración de la escala inicial de 45 ítems, pilotaje de la herramienta con alumnado de la Universidad de Zaragoza y Universidad del País Vasco, mediante análisis de la fiabilidad y de estructura. Posterior consulta a expertos para validación de contenido. Resultados principales: El resultado del pilotaje reportó que el global de la herramienta presentaba buena fiabilidad (alfa=0,888), con una estructura unidimensional que explica el 66% de la varianza. El grupo de expertos confirmó la estructura unidimensional de la escala, y propuso la eliminación de 17 ítems por considerarlos redundantes. Conclusión principal: La herramienta presentada resulta útil para la evaluación del aprendizaje del alumnado. Resultaría necesario ampliar el estudio con muestras de otras universidades, e incluir herramientas que aporten validez convergente o divergente. Palabras clave: Educación en Enfermería. Autoevaluación. Aprendizaje.

Se presenta un caso extraído de la práctica asistencial hospitalaria en el que se analizan las acciones que realizan y omiten las enfermeras, lo cual contribuye a fomentar la visibilidad o invisibilidad de las mismas. Tras el mencionado análisis se proponen mejoras relacionadas con distintas habilidades, conocimientos y actitudes en las enfermeras que van a redundar en la mejora de los niveles de bienestar, autocuidado y seguridad de la paciente.

Conocer el estilo de vida de pacientes crónicos hipertensos y diabéticos, determinar los fenómenos que influyen en su autocuidado y analizar su percepción del cuidado profesional. Metodología: Estudio cualitativo de tipo biográfico, entrevistas semiestructuradas. Los relatos fueron analizados desde el marco propuesto por el grupo de investigación “Aurora Mas”. Resultados: Los informantes tienen asumidas sus enfermedades y autocuidados. Adoptan un estilo de vida saludable, valoran positivamente el apoyo de sus redes sociales y familiares. Muestran confianza y seguridad hacia los profesionales. Conclusiones: Las entrevistas son útiles para conocer los estilos de vida de pacientes crónicos, permiten analizar la percepción personal sobre los factores que influyen en su autocuidado. Los profesionales sanitarios deben controlar los indicadores fisiológicos de las enfermedades crónicas y las dimensiones emocionales y sociales de los pacientes, ya que inciden en la percepción de la Calidad de Vida.

429 p. -- Tesis doctoral original leida en la Universidad Pública de Navarra (UPNA, Dpto. Ciencias de la Salud, El planteamiento de la investigación se realiza desde una perspectiva biográfica, entendida ésta un tipo de investigación empírica, basada en el trabajo de campo, valiéndose del método etnográfico, mediante la selección de informantes, trascripción de textos, elaboración de un diario de campo, y el establecimiento de relaciones. El paradigma utilizado es el de la etnografía interpretativa de Geertz. Para la consecución de la investigación se ha trabajado desde el relato de vida, considerado como un estilo particular de entrevista narrativa en el que se le pide a la mujer que, de manera oral y espontánea, narre un aspecto puntual o parte de su experiencia vital, vivida en primera persona, al someterse a una interrupción voluntaria del embarazo, y en el contexto en que esta experiencia. Junto con el relato se combinan dos elementos como son la formulación de preguntas y la observación, y todo ello enmarcado en una relación de intersubjetividad, y dialogo con la informante. Las recogida de narrativas se realizaron desde abril de 2011 a marzo del 2012, consiguiendo entrevistar a un total de veinte mujeres, de las cuales trece fueron de la comunidad Autónoma Vasca (CAV) y siete de países Latinoamericanas Los objetivos planteados, dando voz a la mujer han sido: 1) Conocer y analizar cómo fue la experiencia vital y las consecuencias que dichas práctica ha producido en el cuerpo de la mujer; 2) Averiguar si existe un apoyo social para la mujer, así como el marco adecuado para afrontar sus consecuencias, o si por el contrario ésta se ve sometida al silencio social; 3) Conocer de qué maneras están manipulados los conceptos emocionales y las propias emociones relacionadas con el aborto y cómo inciden en la mujer Los dos grandes ejes de resultados han sido: 1) Los silencios provenientes tanto desde el proceso ginecológico, como el silencio que se impone la propia mujer o aquellos que se crean en la sociedad. 1.1. Desde el proceso ginecológico se ha detectado cierta arbitrarieda

Tesis leída en Facultda de Enfermería, Fisioterapia y Podología de la Universidad Complutense de Madrid. 503 p., Se trata del Diagnóstico de la salud de la comunidad de Mañaria contada desde las mujeres que viven, trabajan o conocen dicha comunidad. Se ha utilizado una metodología cualitativa, con perspectiva etnográfica y trabajo de campo.El estudio expone los problemas de salud, los activos para la salud y las soluciones para mejorar la calidad de vida existentes en la comunidad.

Objective: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). Method: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. Results: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. Conclusion: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures.

En el presente trabajo se expone un caso en el que una enfermera novel establece una interacción con una paciente ingresada debido a un dolor abdominal agudo. Tras la asistencia a las necesidades físicas, la enfermera decide indagar en las dimensiones emocional y social para detectar aspectos que requieren atención y aplicar conocimientos teóricos para el abordaje de una Relación de Cuidado eficiente, entendiendo ésta como un proceso de atención enfermero verdaderamente integral que contribuye a la construcción de una relación de confianza que transmite seguridad y fomenta el bienestar.

La Relación de Cuidado es considerada como un proceso de atención integral que incluye los aspectos físicos, emocionales, comunicativos y espirituales que se sustenta en la individualización de los cuidados cuyos ejes principales son la construcción de una relación de confianza y seguridad y el fomento de la autonomía de la persona. El Estudio de casos es un método útil para analizar diferentes situaciones clínicas, identificar pun-tos fuertes y débiles de la Relación de Cuidado establecida por la enfermera y plantear soluciones y estrategias para mejorarla. Con este trabajo pretendemos mostrar las poten-cialidades del Estudio de casos como instrumento para aprender y visibilizar la Relación de Cuidado, de manera que pueda ser utilizado tanto para comunicar experiencias obte-nidas en la práctica clínica, como para el adiestramiento del estudiante en ciclos de grado y posgrado.