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Introduction Evidence shows that gender has a substantial impact on health behaviours, access to and use of health systems and health system responses. This study aims to assess gender bias in patients subjected to low-value practices in the primary care setting and to develop recommendations for reducing adverse events that women experience for this reason.Methods and analysis A Delphi study will be performed to reach a consensus on the ‘Do Not Do’ recommendations with a possible gender bias. A retrospective cohort study in a random selection of medical records will then be carried out to identify the frequency of adverse events that occur when the selected ‘Do Not Do’ recommendations are ignored. Qualitative research techniques (consensus conference and nominal group) will be carried out to develop recommendations to address any gender bias detected, considering barriers and facilitators in clinical practice.Ethics and dissemination The study was approved by the ethics committee of San Juan de Alicante Hospital (San Juan de Alicante, Spain) Reference N. 21/061. We will disseminate the research findings via peer-reviewed articles, presentations at national and international scientific forums and webinars.Trial registration number The study was registered at ClinicalTrials.gov (NCT05233852) on 10 February 2022.

Key Clinical Message The presence of more than one genetic/genomic disorder is not uncommon. It is therefore essential to continuously consider new signs and symptoms over time. Administration of gene therapy could be extremely difficult in particular situations. Abstract A 9‐month‐old boy presented to our department for evaluation of developmental delay. We found that he was affected by intermediate junctional epidermolysis bullosa (COL17A1, c.3766 + 1G > A, homozygous), Angelman syndrome (5,5 Mb deletion of 15q11.2‐q13.1), and autosomal recessive deafness type 57 (PDZD7, c.883C > T, homozygous).

Objectives: This study aimed to evaluate gender-based disparities in preventable adverse events due to low-value practices (LVPs) in primary care.Methods: A retrospective cohort study in Alicante, Spain.Results: A total of 1,516 patient records were examined, finding that older individuals and women experienced more LVP-related events. Female patients faced a higher volume of such events than males with the same health issue. Interaction analysis revealed patients treated by male physicians had more severe events, while those attended by females experienced milder ones. Adverse events were more frequent in LVPs associated with gender-based reasons.Conclusion: These results highlight the need for tailored healthcare professional awareness programs on overuse’s impact on safety. Addressing outcome differences between male and female patients should inform awareness campaigns.

Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.

BackgroundThe COVID-19 pandemic has generated immense health care pressure, forcing critical decisions to be made in a socially alarmed environment. Adverse conditions have led to acute stress reactions, affective pathologies, and psychosomatic reactions among health personnel, which have been exacerbated by the successive waves of the pandemic. The recovery of the entire health system and its professionals has been hindered, making it essential to increase their resilience. ObjectiveThis study aimed to achieve 2 primary objectives. First, it sought to identify coping strategies, both individual and organizational, used by health care workers in Ecuador to navigate the acute stress during the early waves of the pandemic. Second, it aimed to develop training materials to enhance team leaders' capabilities in effectively managing high-stress situations. MethodsThe study used qualitative research techniques to collect information on institutional and personal coping strategies, as well as consensus-building techniques to develop a multimedia psychological tool that reinforces the resilience of professionals and teams in facing future crises. ResultsThe findings from the actions taken by health care workers in Ecuador were categorized into 4 types of coping strategies based on Lazarus' theories on coping strategies. As a result of this study, a new audiovisual tool was created, comprising a series of podcasts, designed to disseminate these strategies globally within the Spanish-speaking world. The tool features testimonials from health care professionals in Ecuador, narrating their experiences under the pressures of providing care during the pandemic, with a particular emphasis on the coping strategies used. ConclusionsEnsuring the preparedness of health professionals for potential future outbreaks is imperative to maintain quality and patient safety. Interventions such as this one offer valuable insights and generate new tools for health professionals, serving as a case study approach to train leaders and improve the resilience capacity and skills of their teams.

Introducción: El catéter venoso central es necesario en los cuidados pediátricos, sin embargo, es una causa importante de bacteriemia nosocomial con 25% de mortandad. El profesional de enfermería es responsable del mantenimiento del catéter venoso central con el propósito de evitar complicaciones locales y sistémicas como la endocarditis y la bacteriemia relacionadas al tratamiento endovenoso.Objetivo: Describir las intervenciones de enfermería para el mantenimiento del catéter venoso central en pacientes pediátricos de un hospital especializado.Metodología: Diseño observacional, descriptivo, transversal, muestra conformada por 85 profesionales de enfermería que otorgaron cuidados directos a niños hospitalizados y recibieron capacitación, muestreo no probabilístico, el instrumento utilizado fue una lista de verificación de mantenimiento del catéter venoso central. Se recolectaron datos con la técnica de observación. El estudio cumple con los aspectos éticos de la ley general de salud en materia de investigación.Resultados: Las intervenciones de enfermería se realizaron con un cumplimiento global de 90.1%, se enfatiza que 70.6% efectuaron lavado de manos antes de manipular el dispositivo. La limpieza y mantenimiento del sitio de inserción la realizaron 98.8%, desinfectaron puertos y conexiones, identificaron lúmenes 92.9%.Conclusión: Los profesionales de enfermería realizan las intervenciones para el mantenimiento del catéter venoso central con un cumplimiento bueno. Sin embargo, las intervenciones con menor cumplimiento que requieren mejora son la higiene de manos, los tiempos para cambios de equipo y soluciones, la desinfección de puertos y conexiones; esenciales para disminuir las infecciones del torrente sanguíneo. Además de estudios futuros acerca de los factores profesionales e institucionales asociados al cumplimiento.

Abstract This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann–Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome ‘acute stress’. Finally, the Kruskal–Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p

Introducción: El proceso de morir se ha desplazado a lo largo de la historia desde la familia y el hogar hasta los profesionales de salud y los hospitales. Cuidar demanda actitudes, conocimientos y destrezas que se deben adquirir y perfeccionarse durante la formación disciplinar. Objetivo: Explorar las actitudes que muestra el personal de enfermería que labora en áreas hospitalarias críticas ante el proceso de la muerte de pacientes. Materiales y métodos: Estudio descriptivo de corte transversal, bajo un muestreo no probabilístico por conveniencia se obtuvo una muestra final de 71 enfermeras profesionales que laboran en áreas críticas de dos hospitales de alta especialidad en Tabasco, México. El instrumento utilizado fue “Actitudes ante la muerte” (CAM-2), traducido del original de Martin y Salovely. Resultados: Los profesionales de enfermería que participaron en el estudio tienen una edad promedio de 32.5 años (DE=7), donde el 71.8% de los participantes pertenecen al sexo femenino. El 67.6% del personal de enfermería muestra una actitud de indiferencia ante la muerte, solo un 9.9% muestra una actitud positiva. Con relación a la perspectiva de actitud de temor el 46.5% manifiesta que pensar en la muerte les genera ansiedad, mientras que el 39.4% ve la muerte de los pacientes como algo natural. Conclusiones: El personal de enfermería posee sentimientos de indiferencia ante el cuidado del paciente ante la muerte, sin embargo, consideran que aceptar su propia muerte los lleva a cuidar con más libertad. Como citar este artículo: Morales Ramón Fabiola, Ramírez López Fabiola, Cruz León Aralucy, Arriaga Zamora Rosa Ma, Vicente Ruíz María Asunción, De la Cruz García Carmen, García Hernández Nallely. Actitudes del personal de enfermería ante la muerte de sus pacientes. Revista Cuidarte. 2021; 12(1): e1081. http://dx.doi.org/10.15649/cuidarte.1081

Objetivo: Evaluar el nivel de implementación de las medidas de seguridad del paciente quirúrgico en el cumplimiento de la lista de verificación de cirugía segura en pacientes pediátricos. Materiales y métodos: El tipo de estudio descriptivo, observacional y de corte transversal, en el periodo comprendido de abril 2014– diciembre 2015. Se trabajó con una muestra de 72 profesionales de salud que integran el equipo quirúrgico. Resultados: Predominó el femenino 56.4% (n=44), estado civil de los encuestados fue casados 71.8% (n=56), el tipo de profesión de los participantes fueron médicos cirujanos 24.4% (n=19), licenciados en enfermería e instrumentistas 14.1% (n=11).El tipo de plaza fueron de adscripción estatal 42.3% (n=33); el turno en el que laboran fueron del matutino 62.8% (n=29), la antigüedad de los trabajadores con más de 20 años de servicio 38.5% (n=30). Discusión. El dominio del conocimiento sobre la lista de verificación de cirugía segura en el personal quirúrgico de un Hospital de tercer nivel de la Secretaría de Salud Tabasco México, en relación a los hallazgos se muestra favorable con un 98% en el nivel de conocimiento, coincidiendo con Aledo 2013. Investigación realizada en Colombia sobre el conocimiento de la lista de verificación de Chequeo para la seguridad en cirugía desde la perspectiva del personal. La implementación de la asepsia y el marcado de sitio quirúrgico obtuvo un 72.8% de cumplimiento, similar con estudios previos. 2011 Constanza y Col. por la Sociedad Colombiana de Anestesiología y Reanimación donde la puntuación fue de 82%, quienes afirman que no todas las cirugías tienen esta indicación.

Las enfermedades crónicas como diabetes, hipertensión, enfermedad cardiovascular, cáncer, pueden limitar la habilidad de los adultos mayores para ejecutar actividades de la vida diaria, generando cansancio o sobrecarga en los cuidadores. Objetivo: Determinar la relación que existe entre el cansancio, el cuidado y los efectos a la salud del cuidador. Metodología: Estudio cuantitativo y analítico. La muestra se conformó con 123 cuidadores familiares y 123 personas adultas con enfermedad crónico degenerativa. El tipo de muestreo fue no probabilístico. Resultados y Discusión: Se encontró asociación entre el cansancio y las repercusiones del cuidado (r=.438, p

A learning-based approach to autonomous robot grasping is presented. Pattern recognition techniques are used to measure the similarity between a set of previously stored example grasps and all the possible candidate grasps for a new object. Two sets of features are defined in order to characterize grasps: point attributes describe the surroundings of a contact point; point-set attributes describe the relationship between the set of n contact points (assuming an n -fingered robot gripper is used). In the experiments performed, the nearest neighbour classifier outperforms other approaches like multilayer perceptrons, radial basis functions or decision trees, in terms of classification accuracy, while computational load is not excessive for a real time application (a grasp is fully synthesized in 0.2 seconds). The results obtained on a synthetic database show that the proposed system is able to imitate the grasping behaviour of the user (e.g. the system learns to grasp a mug by its handle). All the code has been made available for testing purposes.