Hospital de Guadarrama

We present the case of a patient with polyarteritis nodosa who, during her stay in a functional recovery hospital, experienced a deterioration in renal function, with a suspected pharmacological cause within a multifactorial context

Background Person-centred care (PCC) has considerable effects on the clinical practice of health professionals. The purpose of this study was to describe the perspectives and perceived barriers and enablers of individuals with stroke regarding the PCC model in stroke rehabilitation. Methods A qualitative exploratory study was conducted based on an interpretive framework. Participants were recruited using non-probabilistic purposeful sampling and a snowball-technique strategy. The inclusion criteria consisted of: (a) individuals > 18 years, (b) diagnosed with moderate or severe stroke according to the National Institutes of Health Stroke Scale and (c) in the post-acute or chronic stage of the disease. In total, 31 individuals with stroke were included. In-depth interviews and researchers’ field notes were used to collect the data. A thematic analysis was performed. Also, credibility, transferability, dependability and confirmability techniques were followed to establish trustworthiness of the data. Results Thirty-one individuals with stroke (11 women) were included. Three main themes were identified: (a) The person behind the “patient” label, recognizing the person beyond their illness and valuing their identity and individual characteristics, (b) The person at the centre of care, considering themselves as an active agent in their own care and respecting their preferences and expectations for their care process and (c) Training for PCC, providing health professionals with tools to achieve professional skills for the implementation and development of the PCC model. Conclusions and significance This paper describes relevant aspects that health professionals should consider when providing PCC in the context of the rehabilitation of individuals with stroke. Key messages The individuals’ perspective regarding person-centred care (PCC) has considerable effects on the clinical practice of health professionals. Individuals with stroke describe how there is a person behind the "patient" label, with identity, needs and desire to participate in decision making. Training in the PCC model helps healthcare professionals identify the needs of individuals with stroke during rehabilitation.

BACKGROUND The COVID-19 pandemic has changed the usual working of many hospitalization units (or wards). Few studies have used electronic nursing clinical notes (ENCN) and their unstructured text to identify alterations in patients' feelings and therapeutic procedures of interest. OBJECTIVE This study aimed to analyze positive or negative sentiments through inspection of the free text of the ENCN, compare sentiments of ENCN with or without hospitalized patients with COVID-19, carry out temporal analysis of the sentiments of the patients during the start of the first wave of the COVID-19 pandemic, and identify the topics in ENCN. METHODS This is a descriptive study with analysis of the text content of ENCN. All ENCNs between January and June 2020 at Guadarrama Hospital (Madrid, Spain) extracted from the CGM Selene Electronic Health Records System were included. Two groups of ENCNs were analyzed: one from hospitalized patients in post–intensive care units for COVID-19 and a second group from hospitalized patients without COVID-19. A sentiment analysis was performed on the lemmatized text, using the National Research Council of Canada, Affin, and Bing dictionaries. A polarity analysis of the sentences was performed using the Bing dictionary, SO Dictionaries V1.11, and Spa dictionary as amplifiers and decrementators. Machine learning techniques were applied to evaluate the presence of significant differences in the ENCN in groups of patients with and those without COVID-19. Finally, a structural analysis of thematic models was performed to study the abstract topics that occur in the ENCN, using Latent Dirichlet Allocation topic modeling. RESULTS A total of 37,564 electronic health records were analyzed. Sentiment analysis in ENCN showed that patients with subacute COVID-19 have a higher proportion of positive sentiments than those without COVID-19. Also, there are significant differences in polarity between both groups (<i>Z</i>=5.532, <i>P</i><.001) with a polarity of 0.108 (SD 0.299) in patients with COVID-19 versus that of 0.09 (SD 0.301) in those without COVID-19. Machine learning modeling reported that despite all models presenting high values, it is the neural network that presents the best indicators (>0.8) and with significant <i>P</i> values between both groups. Through Structural Topic Modeling analysis, the final model containing 10 topics was selected. High correlations were noted among topics 2, 5, and 8 (pressure ulcer and pharmacotherapy treatment), topics 1, 4, 7, and 9 (incidences related to fever and well-being state, and baseline oxygen saturation) and topics 3 and 10 (blood glucose level and pain). CONCLUSIONS The ENCN may help in the development and implementation of more effective programs, which allows patients with COVID-19 to adopt to their prepandemic lifestyle faster. Topic modeling could help identify specific clinical problems in patients and better target the care they receive.

To assess the efficacy of a prompted voiding programme for restoring urinary continence at discharge in hospitalized older adults who presented with reversible urinary incontinence (UI) on admission to a functional recovery unit (FRU). To assess the maintenance of the outcomes achieved after hospitalization. To identify modifiable and unmodifiable factors associated with the success of the prompted voiding programme. Quasi-experimental, pre-/post-intervention study without a control group. Participants were aged 65 and over with a history of reversible UI in the previous year who had been admitted to a FRU and were on a prompted voiding programme throughout their hospitalization period. The sample consisted of 221 participants. A non-probabilistic sampling method, in order of recruitment after signing the informed consent form, was used. The primary outcomes were UI assessed at discharge and 1month, 3months and 6months after discharge. Funding was granted in July 2019 by the Spain Health Research Fund (PI19/00168, Ministry of Health). The proposal was approved by the Spanish Research Ethics Committee. The prompted voiding programme described can reverse UI or decrease the frequency and amount of urine loss in hospitalized older adults. Urinary incontinence is highly prevalent in hospitalized older adults. There is a need for care aimed at prevention, recovery and symptom control. Prompted voiding is a therapy provided by the nursing team during hospitalization and can also be provided by family caregivers at home after receiving proper training by the nursing team. Prompted voiding will enhance the health, functional ability and quality of life of older adults with UI, resulting in the reduction of associated healthcare costs and the risk of developing complications.

Dating violence is a significant problem among adolescents. It encompasses a variety of violent behavior, from verbal abuse to physical and sexual abuse, from threats to rape and murder. Among young people, idealization of love and romantic myths are very common as a consequence of our culture and society, which lead them to develop dysfunctional relationships that somehow favor and facilitate partner violence and sexist ideas in daily life. Education is the basic tool to eradicate discrimination and violence against women. The objective of this study is to explore the false myths of romantic love in adolescents and their related factors. A cross-sectional study was conducted with 16–19-year-old teenagers (n = 180), through questionnaires and by employing the romantic love myths scale, the ambivalent sexism inventory, and the love attitudes scale. Adolescents accepted to a greater degree the love myths associated with idealization than those related to abuse with scale values of Med = 2.72, SD = 0.55, and Med = 1.34, SD = 0.68, respectively. Designed models predict love idealization on the basis of benevolent sexism (β = 0.03; CI 95% = 0.021–0.039), religion (β = 0.198; CI 95% = 0.047–0.349), passionate love (β = 0.038; CI 95% = 0.015–0.061), practical love (β = 0.024; CI 95% = 0.001–0.047), and friendly love (β = 0.036; CI 95% = 0.014–0.058). Hostile sexism and undergraduate studies were associated with the myths that relate love and abuse (β = 0.19; CI 95% = 0.007–0.031, β = 0.208; CI 95% = 0.001–0.414, respectively).

A population of an unknown Psammothidium species (Bacillariophyta, Achnanthidiaceae) was found in core sediments collected from Cimera Lake, an oligotrophic, undisturbed mountain lake in Central Spain (Gredos mountain range). The morphology and ultrastructure of this taxon is hereby documented in detail by means of light (LM) and scanning electron (SEM) micrographs. Morphologically, the closest taxon is P. levanderi, and the type of this species is analyzed here to provide a differential diagnosis. A comparison with other similar small Psammothidium species with an elliptic outline show that the combination of features exhibited by this taxon is unique and it is thus described here as Psammothidium toroi sp. nov.

Batrachochytrium dendrobatidis (Bd) causes the disease chytridiomycosis associated with amphibian declines. Response and costs of infection varies greatly between species. Bd can induce a stress response in amphibians resulting in elevated corticosterone (CORT). We exposed Bombina variegata and Hyla arborea tadpoles to Bd+ or Bd- Salamandra salamandra larvae and measured CORT release rates, Bd infection loads, and survival through metamorphosis. Tadpoles of both species exposed to Bd+ larvae had elevated CORT release rates compared to tadpoles exposed to Bd- larvae. Bombina variegata appear less resistant to infection than H. arborea, showing higher Bd loads and more infected individuals. Within species, we did not find differences in cost of infection on survival, however more B. variegata tadpoles reached metamorphosis than H. arborea. The differences in resistance may be species specific, owing to higher immunity defenses with H. arborea having higher overall CORT release rates, and differences in antimicrobial peptides, or to differences in Bd strain or other unexplored mechanisms.