Conectar
by Cecilia Aguilar-Vega, Jaime Bosch, Satoshi Ito, Benjamin Ivorra, Hyunkyu Jeong, José Manuel Sánchez-Vizcaíno
African swine fever (ASF) is a lethal disease of swine that has spread across Asia since its introduction in 2018. South Korea first reported the disease in September 2019 in domestic pigs, and since then, more than 4,000 cases have been reported in wild boars during its expansion up to August 2024. Due to the high number of ASF notifications in wild boars in South Korea, contrasted with their scarcity in most Asian countries, analyzing the spatiotemporal spread of the disease in a setting with active surveillance provides valuable insights. In this study, we performed a trend-surface analysis on temporally gridded case data to characterize the overall geographic spread and direction of ASF in wild boars across South Korea, from its emergence to August 2022. Additionally, we propose a novel approach distinct from previous studies, to estimate spread velocity by incorporating an upper threshold to avoid unrealistic values. The model described the spread of ASF in the study area. The disease showed greater expansion in the east of the country. Initially, a south and eastward direction was estimated. The estimated median velocity was 19.53 km/month, with cell-level velocities ranging from 2.45 to 69.99 km/month. Velocity increased notably from autumn 2021 onward and varied substantially across years. Our results show the dynamics of ASF in wild boars of South Korea, providing new evidence of their role in the epidemiology of the disease.Chronic heat stress and recurrent dehydration from strenuous labour in hot environments are recognised drivers of acute kidney injury among agricultural workers in Mesoamerica and may contribute to Chronic Kidney Disease of Unknown Aetiology (CKDu). This study explored how members of a long-term community-based cohort in northwest Nicaragua perceive, experience and adapt to extreme heat, within the broader context of environmental and labour changes.
This qualitative study used focus group discussions with participants from a community-based cohort followed for over a decade and community members. Transcripts were analysed thematically using an interpretative approach, with trustworthiness ensured through peer debriefing, audit trails, triangulation and achievement of thematic saturation.
Rural agricultural communities in northwest Nicaragua participating in a long-term community-based cohort.
Participants were purposively sampled from a prospective community-based cohort and community members were invited to participate. Men and women across different age groups were invited. In total, 91 adults aged ≥18 years participated in 11 face-to-face focus groups, each comprising 8–11 men or women.
Themes describing experiences of heat stress, occupational risk and adaptive responses among agricultural workers.
Participants described worsening heat linked to deforestation, unsafe and inadequate water access and unrealistic production targets that prioritised output over health. In response, workers reported adaptive practices including self-paced labour, hydration routines and peer monitoring. Community solidarity and mutual aid emerged as key sources of resilience despite structural constraints.
Heat stress amplifies occupational hazards and exacerbates health inequities among marginalised agricultural workers. Integrating climate adaptation and equity into labour protections—ensuring access to clean water, adequate shade and fair workloads—can strengthen resilience in agricultural communities facing rising heat-related health risks.
by Jimmy Andreyvan Cainamarks-Alejandro, Liliana Cruz-Ausejo, Miguel Angel Burgos-Flores, Jaime Rosales-Rimache, Jonh Astete-Cornejo, David Villarreal-Zegarra
BackgroundThe COVID-19 pandemic marked an increase in depressive, anxiety, and post-traumatic stress disorder symptoms, more specifically among healthcare workers, teachers, and police officers. These workers face external and occupational factors which had a significant impact on mental health, significant increase in workload and direct exposure to the virus, shortage of personnel protective equipment, and instances of abuse, including discrimination. Mental health care in primary care requires a process of early identification and timely referral of complex cases. Telehealth emerges as an effective alternative for addressing challenges in mental health care, although its implementation encounters obstacles.
ObjectiveTo design a telehealth service that facilitates screening, initial management, and timely referral for mental health diagnoses in workers with prior SARS-CoV-2 infection, and to evaluate usability, acceptability, and user satisfaction.
MethodsMixed-method study with a user-centered design approach involving key external and internal service users in three sequential stages (pre-design, co-design, and post-design). The study phases lasted 6 months, involving a total of 23 participants in the pre-design phase (contextual inquiry and preparation and training), 12 participants in the co-design phase (framing the issue, generative design, and sharing design), and in the post-design phase, 4 participants were involved in service implementation, and 81 participants—drawn from the subgroup of 134 users who received psychoeducation—were included in the efficacy assessment.
ResultsThe proposal included the development and evaluation of a service model guide and a telehealth software platform. First, the participants took part in a series of workshops (Pre-design, Co-design) where they provided ideas for meeting the product requirements, based on the Design Thinking methodology framework. The telehealth service model was named TelePsico CENSOPAS. It comprised four processes: a) Service promotion; b) User pre-identification; c) Appointment management; d) Psychoeducation counseling and referral. The Telehealth platform was designed through three cycles of an iterative process and integrated a proprietary development platform with third-party service technologies for communication support and information exchange. During post-design, the pilot test involved 698 screened patients; 193 were identified with mental health risks, and 134 of them received psychoeducation sessions. In addition to user acceptance, the usability score of the platform was 86.1 ± 16.9 SD, satisfaction dimensions of the service was 45.1 ± 7.2 SD for satisfaction with care processes, and 36.7 ± 5.2 SD satisfaction with psychological care.
ConclusionThe proposal for mental health telehealth services and its supporting platform was successfully developed and accepted by both internal and external users, particularly within well-structured occupational health services in workplaces serving vulnerable occupational groups. In addition, it achieved higher satisfaction and usability scores than Peru’s outpatient care services. These findings support the replicability of user-centered design frameworks—such as design thinking—within the occupational health sphere.
To explore the roles and training of advanced practice nurses specialised in acute pain management, as reported in the current literature.
Scoping review.
We searched PubMed, Scopus and CINAHL in December 2023 to identify relevant studies published from 1996.
Relevant literature was identified, screened, and analysed using a structured scoping review process. Two reviewers independently selected and extracted data from eligible studies, with a third reviewer resolving any disagreements.
A total of 1682 records were screened, and 36 studies met the inclusion criteria. Four main themes emerged: job titles, roles, training, and barriers. The review revealed substantial variation in job titles and role descriptions across clinical settings and geographic regions, with more comprehensive role definitions found in countries like the United States and the United Kingdom. Training pathways, including postgraduate qualifications and certification, varied significantly and many low- and middle-income countries lacked structured training frameworks. Barriers identified included regulatory limitations, insufficient educational infrastructure and lack of legal authority to practice.
This review highlights significant international variation in the definition, training and regulation of advanced practice nurses in acute pain management. There is an urgent need to develop global standards, including unified competencies and certification pathways, to ensure consistent and effective care.
Standardising competencies and training will support role recognition, improve consistency in clinical practice and promote high-quality care for individuals experiencing acute pain.
This review addresses the global inconsistency in role definition and training of advanced practice nurses in acute pain management. Findings may inform educators, health professionals, policymakers and regulators, particularly in resource-limited settings.
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
by María-Angélica Calderón-Peláez, Myriam L. Velandia-Romero, Jaime E. Castellanos
Zika virus (ZIKV) poses a significant threat to neural tissue, causing substantial damage to unborn children exposed to the virus in utero, with consequences that can manifest even after birth, despite being born with a normal head circumference. Regardless of the extensive research, the interactions between ZIKV and the nervous system cells remain insufficiently understood, particularly regarding how neuronal responses influence broader inflammatory and viral dynamics especially in postnatal stages of development. This study evaluated the susceptibility to ZIKV infection, viral replication, immune response, and survival of neurons, astrocytes and microglial cells during postnatal developmental stages, using both in vivo and in vitro mice models. In vivo, a non-lethal but extensive infection of neurons and microglia was shown. The infection caused a robust but controlled immune response with elevated levels of MCP-1, TNF-α, and IL-6, that prevented severe neuronal damage. In vitro, neurons exhibited high susceptibility to ZIKV, with elevated levels of pro-inflammatory cytokines and IFN-β, indicating a strong inflammatory response. In contrast, astrocytes and microglia displayed varied responses, contributing to a pro-inflammatory feedback loop. These findings offer critical insights into the cellular dynamics of ZIKV infection, enhancing our understanding of its effects during postnatal nervous system development. By clarifying the interactions between ZIKV and neuronal cell types, this study deepens the comprehension of the virus’s pathophysiology and its broader implications for neurodevelopmental outcomes, extending beyond the well-documented association with microcephaly.by Claire A. MacGeorge, Matthew Henry, Hannah A. Ford, Lacy Malloch, Emily Fratesi, Shannon Cabaniss, Jaime Baldner, Melody Greer, Kristin Gaffney, Milan Bimali, Preetha Abraham, Linda Y. Fu, P. Songthip Ounpraseuth, Christine B. Turley
BackgroundAttention-deficit/hyperactivity Disorder (ADHD) is the most common neurobehavioral condition of childhood and can be controlled with stimulant medication. Evidence-based guidelines endorse use of standardized ADHD symptom reports to facilitate medication titration to therapeutic dosage. Children living in under-resourced areas experience barriers to receiving this recommended evidence-based care. The Remote ADHD Monitoring Program (RAMP) uses a text-based platform to relay symptom reports from caregivers and teachers to healthcare providers. This pilot study is a feasibility study examining intervention uptake. It compares the submission of structured symptom reports in those children enrolled in RAMP compared to usual care as well as utilization of the RAMP platform by providers.
MethodsThis paper describes the protocol to evaluate the feasibility of deploying RAMP in practices serving rural or underserved children. We will recruit 36 dyads from 4 practices in 2 separate states. Each dyad will include a caregiver and their child aged 5–11 years with a diagnosis of ADHD who is starting or reinitiating stimulants. Dyads will be randomized 1:1 to receive the RAMP intervention or usual care with attention controls. Our primary outcome is number of symptom reports (paper assessments in control arm and RAMP reports in intervention arm) per participant that are completed by caregivers and teachers and returned to providers. Our secondary outcome is proportion of submitted RAMP reports that are reviewed by providers.
DiscussionAs telehealth use increases, it is critical that we improve access to high quality care for children with chronic conditions. Leveraging technology may be a meaningful approach to improve efficiency in optimizing medication management. This pilot study tests a text-based platform designed to improve communication between the caregivers and teachers of children with ADHD and health care providers. If successful, a future trial will examine the effectiveness of the RAMP intervention on improvement in symptoms.
Trial registrationClinicalTrials.gov NCT06743425.
Introducción: La Inseguridad Alimentaria (IA), vinculada a la pobreza, favorece el consumo de alimentos poco nutritivos y aumenta el riesgo de enfermedades crónicas. Su comprensión es clave en enfermería comunitaria y escolar para fomentar hábitos saludables desde edades tempranas. Objetivo: Analizar la relación entre el Nivel Socioeconómico (NSE) e IA en Estudiantes de Una Universidad Pública del Norte de Sinaloa, México. Metodología: Estudio cuantitativo, descriptivo, correlacional y transversal en estudiantes de 18 a 25 años inscritos en un programa de Licenciatura. Los participantes fueron seleccionados a partir de un muestreo aleatorio simple. La muestra fue de 311 estudiantes. Se aplicó una cédula de datos sociodemográficos, el cuestionario AMAI y la Escala Latinoamericana y Caribeña de Inseguridad Alimentaria. Resultados: En los hogares sin presencia de menores, la IA severa presenta mayor prevalencia en NSE medio (29,6%) y alto (32,5%). Se observó una correlación positiva y significativa entre el NSE y la IA, tanto en hogares sin integrantes menores de edad (rs = 0,263, p < 0,01), como en aquellos con menores (rs = 0,231, p < 0,01). Conclusiones: En esta población de estudiantes universitarios, se observó que a medida que aumenta el NSE, también lo hace la IA, lo que sugiere que esta no es exclusiva de los sectores socioeconómicos bajos, sino que también afecta de forma considerable a los niveles medio y alto. La persistencia de esta problemática en todos los niveles sugiere que factores estructurales, más allá del ingreso, como el acceso a alimentos nutritivos, educación alimentaria y estabilidad laboral, podrían influir significativamente.
ABSTRACT
Introduction: Food insecurity (FI), linked to poverty, promotes the consumption of unhealthy foods and increases the risk of chronic diseases. Understanding it is key in community and school nursing to foster healthy habits from an early age. Objective: To analyze the relationship between socioeconomic status (SES) and FI in students at a public university in Northern Sinaloa, Mexico. Methodology: A quantitative, descriptive, correlational, and cross-sectional study was conducted with students aged 18 to 25 years enrolled in an undergraduate program. Participants were selected using simple random sampling. The sample consisted of 311 students. A sociodemographic data form, the AMAI questionnaire, and the Latin American and Caribbean Food Insecurity Scale were administered. Results: In households without children, severe FI was more prevalent in middle (29.6%) and high (32.5%) SES groups. A positive and significant correlation was observed between socioeconomic status (SES) and food insecurity (FI), both in households without minor members (rs = 0.263, p < 0.01) and in those with minors (rs = 0.231, p < 0.01). Conclusions: In this population of university students, it was observed that as SES increases, so does FI, suggesting that it is not exclusive to low socioeconomic sectors, but also significantly affects middle and high levels. The persistence of this problem at all levels suggests that structural factors, beyond income, such as access to nutritious food, nutrition education, and job stability, could have a significant influence.
by Jaime Carballedo-Pulido, Mariona Farrés-Tarafa, Juan Roldán-Merino, Marta Berenguer-Poblet, Montserrat Girabent-Farrés, Carla Otero-Arús, Susana Santos-Ruiz
BackgroundAlthough the SBAR framework is widely used in clinical and educational settings, there is a lack of validated Spanish-language tools that objectively assess its use by students in simulation. The adaptation and validation of the SBAR-LA rubric address this gap and provide a resource for training and evaluating structured communication.
ObjectiveTo conduct the cross-cultural adaptation and psychometric validation of the SBAR-LA rubric in Spanish for assessing structured communication skills in undergraduate nursing students during clinical simulation.
MethodsA two-phase cross-sectional psychometric validation study was conducted. Phase one involved cross-cultural adaptation, including forward and backward translation, expert panel review, and cognitive debriefing with nursing students. Phase two assessed inter-rater reliability using Krippendorff’s alpha based on 97 performance evaluations obtained in different simulation scenarios. The SBAR-LA-Sp rubric contains 10 dichotomous items across the four SBAR dimensions.
ResultsThe Spanish version of the SBAR-LA rubric demonstrated excellent inter-rater reliability, with a Krippendorff’s alpha of 0.933 (95% CI: 0.905–0.956). Internal consistency and agreement between raters were also high, confirming the instrument’s robustness.
ConclusionsThe Spanish version of the SBAR-LA rubric provides an objective measure of structured communication in nursing simulation. The findings support its use in academic training. Further research is needed to examine its effect on learning outcomes.
La salud de los indígenas es una prioridad mundial, especialmente, en países de bajos y medianos ingresos suele ser un asunto crítico por la exacerbación de desigualdades sociales. Estudio cualitativo en el que se aplicaron herramientas de investigación acción participación. Con el objetivo de diseñar un modelo de atención intercultural del parto con la comunidad Emberá Chamí de Riosucio Colombia. Las experiencias y significados de la comunidad indígena alrededor de la atención del parto están enmarcadas en la percepción de barreras e injusticias epistémicas y sociales, un modelo de atención intercultural implica superar estas barreras y generar procesos de adaptación y modificación de prácticas y saberes institucionalizados. Para la atención intercultural del parto es fundamental contar con una infraestructura que cuente con las áreas, ambientes en las cuales se respeten, en donde se permita la práctica de la medicina ancestral y occidental de manera sincrónica, puesto que al conocer las necesidades específicas de la comunidad sobre las creencias y practicas relacionadas con el parto, podemos mejorar la experiencia de las gestantes
Objetivo principal: Describir la prevalencia de sarcopenia y analizar la influencia de las conductas asociadas del estilo de vida en la sarcopenia en personas mayores residentes de Mexicali, México. Metodología: Se consideró un diseño descriptivo inferencial. Participaron 105 personas mayores de 60 años o más. El muestreo fue no probabilístico. Se evaluaron los criterios diagnósticos para sarcopenia y las conductas asociadas al estilo de vida. La investigación se realizó acorde a la reglamentación ética. Resultados principales: El 24,8% y el 59% presentaron uno de los tres estadios de la sarcopenia acorde a los puntos de corte para la población mexicana y EWGSOP respectivamente. Se encontró asociación con el IMC (p <,01) y sexo (p <,05). Conclusión principal: Se identificó que la prevalencia es menor cuando se consideran los puntos de corte regionales para México. El IMC y el sexo se asociaron con la sarcopenia.
Objetivo principal: analizar si tomar la dosis de acenocumarol en ayunas favorece lograr un porcentaje de tiempo en rango terapéutico (TRT) valo-rado como óptimo. Metodología: estudio observacional, analítico. Se enseñó a 122 pacientes anticoagulados con acenocumarol una recomenda-ción del prospecto del medicamento (revisión, 2017): “tomar la dosis diaria lo más alejada de las comidas”. Seguimiento desde abril a octubre de 2018. Para cada paciente, en el control de INR, se registró su valor y si tomaba la dosis en ayunas. Finalizado el seguimiento se calculó su TRT. Resultados principales: en aquellos pacientes con una valoración del TRT igual o mayor al 60 %, la diferencia de proporciones entre los que toma-ban la dosis en ayunas y los que la tomaban con alimentos fue de 0,28 (IC 95 %: 0,09 a 0,44). Estadísticamente significativo, p = 0,004. Conclusión principal: tomar acenocumarol en ayunas favorece obtener un tratamiento anticoagulante valorado como óptimo.
En los accidentes, cuando hay una disrupción súbita en la relación estable entre el individuo y su medio, las fuerzas violentas que intervienen originan un trauma grave, definido como lesión orgánica por alteración del entorno del individuo. La coordinación y toma de decisiones en el tándem Rescate-Asistencia in situ condiciona toda la intervención y esfuerzo de la asistencia. El resultado depende del buen funcionamiento y coordinación del grupo en toda la cadena asistencial [Fragmento de texto].
FreshRSS 