Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity.

INTRODUCTION: Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change. METHODS: Nineteen adults with a history of obesity living in the United Kingdom were interviewed through video conferencing between May 2020 and March 2021. Semi-structured interviews and socio-demographic questionnaires were used, and data analysed through hermeneutic phenomenology informed reflexive thematic analysis. RESULTS: Three main themes were created: living with convenience and normalcy: the increased accessibility of unhealthy food, people interacting with digital media for positive practice change, and the need to prioritise prevention in schools, the National Health Service and the food industry. CONCLUSIONS: The food environment was the major barrier, while interactions with social media was the most important opportunity to adopt healthy practices. The National Health Service was considered an obesogenic environment, something relevant since it has been traditionally recognised as an obesity management system. The perceptions from individuals with a history of obesity provide new suggestions on the influence of previously overlooked environments to design more adequate and effective interventions and policies that consider, more than in the past, the environments where people spend their lives.

Photovoice: An active learning tool with community nursing students.

OBJECTIVE: To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community. METHODS: A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data. RESULTS: Seventy eight percent of the students felt that photovoice was an interesting and useful tool for nurses, 89% affirmed it helped stimulate reflection on social and health inequities in times of pandemic, 82% described that it developed many emotions and feelings and 86% would like to disseminate their photographs directly to stakeholders, citizens, and politicians. Three themes were identified in the data: "stimulate critical reflection", "develop emotional skills", and "encourage action". CONCLUSIONS: Photovoice is a successful active learning pedagogical approach that engages nursing students to develop critical awareness while connecting with their communities, with the real world. It fosters students' sensitivity and motivation and encourages them to take action. Teachers need to introduce new scaffolds for active learning, such as photovoice, to provide innovative academic support that nurtures and develops the next generation of nurses appropriately.

Psychometric properties of the living with long term conditions scale in an English-speaking population living with long term conditions in the UK.

OBJECTIVE: To present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs. DESIGN: An observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested. SETTING: The study took place across the UK via primary care surgeries and voluntary organisations, between December 2021 and June 2022. PARTICIPANTS: The study included 577 patients living with different LTCs, as chronic obstructive pulmonary disease, arthritis, chronic heart failure, Parkinson's disease, chronic kidney disease and type 2 diabetes mellitus. Inclusion criteria included: (a) having been diagnosed with one or more of the conditions; (b) being able to read, understand and answer written questionnaires; (c) being fluent in English and (d) being able to provide written informed consent. Patients were involved in the design and pilot study of the scale. RESULTS: A total sample of 577 people with an age range of 37-97 years (98±9.65) were recruited. Internal consistency of the total 26-item LwLTCs scale score was excellent (ordinal alpha=0.90) but confirmatory factor analysis showed better fit indices (Normed Fit Index=0.96; standardised root mean square residual=0.051; Goodness of Fit Index=0.98) for a 20-item LwLTCs scale. CONCLUSIONS: A shorter version of the LwLTCs scale, with just 20 items and with excellent psychometric properties, is recommended. Having a short scale is key when considering the implementation of the scale in clinical practice to develop person-centred pathways and more comprehensive care plans.

First validation study of the living with long term conditions scale (LwLTCs) among English-speaking population living with Parkinson's disease.

INTRODUCTION: Parkinson's disease is the second most prevalent neurodegenerative disease, affecting 10 million people worldwide. Health and social care professionals need to have personalised tools to evaluate the process of living with Parkinson's disease and consequently, plan individualised and targeted interventions. Recently, the English version of the Living with Long term conditions (LwLTCs) scale has been developed filling an important gap related to person-centred tools to evaluate the process of living with long term conditions among English-speaking population. However, no validation studies for testing its psychometric properties have been conducted. AIM: To analyse the psychometric properties of the LwLTCs scale in a wide English-speaking population living with Parkinson's disease. METHODS: Validation study, with an observational and cross-sectional design. The sample was composed of individuals living with Parkinson's disease from non-NHS services in the community. Psychometric properties including feasibility and acceptability, internal consistency, reproducibility, and construct, internal and known-groups validity were tested. RESULTS: A total sample of 241 people living with Parkinson's disease were included. 6 individuals did not complete 1 or 2 items on the scale. Ordinal alpha was 0.89 for the total scale. The intraclass correlation coefficient for the total scale was 0.88. The LwLTCs scale is strongly correlated with scales measuring satisfaction with life (rs=0.67), quality of life (rs=0.54), and moderately correlated with social support (rs=0.45). Statistically significant difference just for therapy and co-morbidity, yet no for gender, employment situation, or lifestyle changes. CONCLUSIONS: The LwLTCs scale is a valid scale to evaluate how the person is living with Parkinson's disease. Future validation studies to prove the repeatability of the total scale and particularly, domains 3-Self-management, and 4-Integration and internal consistency will be needed. Developing further studies on the English version of the LwLTC in people with other long term conditions is also proposed.

El Análisis de Redes Sociales desde la perspectiva Enfermera: una aproximación teórico-empírica / Social Network Analysis from the nurse perspective: A theoretical-empirical approach

El ámbito de la salud es uno de los entornos más relacionales que la ciencia conoce, pero raramente se analizan los contactos entre actores. La Teoría de Redes conceptualiza al individuo como parte de una estructura a la cual nutre y de la cual se nutre. El Análisis de Redes Sociales (ARS) es el método que da soporte a la Teoría de Redes. En el siguiente trabajo se plantean los objetivos de (i) dar a conocer la Teoría de Redes y su justificación en el contexto de salud, (ii) describir el ARS, (iii) mostrar investigación en salud con aplicación del ARS, (iv) presentar la evolución del ARS en la Enfermería Española. Entre las principales conclusiones se resalta que (i) el ARS se centra en la estructura y la entidad social como unidad de análisis, (ii) las redes son causa y efecto de los resultados de salud, (iii) existen investigaciones con ARS aplicadas al cuidado y lideradas por enfermeras, y (iv) para consolidar el conocimiento y el uso del paradigma del ARS es necesario crear redes cohesivas de investigadores y profesionales multidisciplinares.(AU)

The field of health is one of the most relational environments that science knows, but the contacts between actors are rarely analyzed. The Theory of Networks conceptualizes the individual as part of a structure to which he nourishes, and from which he nourishes himself. Social Network Analysis (SNA) is the method that supports Network Theory. In the following work the objectives of (i) to present the Theory of Networks and their justification in the health context are presented, (ii) to describe the SNA, (iii) to showresearch in health with application of the SNA, (iv) present the evolution of SNA in Spanish Nursing. Among the main conclusions it is highlighted that (i) the SNA focuses on the structure and the social entity as the unit of analysis, (ii) the networks are the cause and effect of the health outcomes, (iii) there are SNA investigations applied to the care and led by nurses, and (iv) to consolidate the knowledge and use of the SNA paradigm, it is necessary to create cohesive networks of researchers and multidisciplinary professionals.(AU)

The Impact of COVID-19 Pandemic on Health Inequities: A Photovoice Study With Nursing Students.

INTRODUCTION: The COVID-19 pandemic has an amplified impact on vulnerable populations. Also, aspects related to health inequalities are insufficiently taught in higher education. This study aims to promote reflection in nursing students on the impact of the COVID-19 pandemic on vulnerable populations affected by health inequities. METHODOLOGY: A photovoice method was used. Undergraduate nursing students (Spain and United Kingdom) took and explained photographs using SHOWED models. RESULTS: 108 students participated. Two-domain summary themes were created: The COVID-19 pandemic has impacted ethnic minorities and socioeconomically vulnerable groups, and Proposals to respond to the negative impact on ethnic minorities and socioeconomically vulnerable groups. DISCUSSION: The students identified negative health scenarios by linking COVID-19 with aspects of work, salary, and housing of these two specific populations. Holistic actions were also proposed to protect their health. As future health professionals, they must recognize these communities and work to eliminate inequalities.

The influence of social relationships and activities on the health of adults with obesity: A qualitative study.

BACKGROUND: Obesity in adults is a leading health challenge that causes millions of deaths worldwide and represents a risk factor for developing long-term conditions. Social relationships are one of the multiple drivers shaping obesity and obesity-related practices. However, there is still little evidence as to the processes by which relationships influence the adoption of positive and negative obesity health-related practices-eating, physical activity and alcohol intake. This study aims first to identify the types of relationships relevant to the adoption of practices in adults with obesity and, second, to explore the type of activities these relationships engage with or promote to produce those practices and their potential health consequences. METHODS: Nineteen adults who have or had a history of obesity living in the United Kingdom were interviewed between May 2020 and March 2021. Experiences were explored through semi-structured interviews and network mapping via videoconferencing. Data were analysed using a hermeneutic phenomenology informed thematic analysis. RESULTS: Three main themes were identified: (1) everyday familial routines matter, (2) chasing healthier lifestyles: comparing, modelling and connecting emotionally with friends and (3) healthcare professionals as negative influencers. DISCUSSION AND CONCLUSIONS: Findings show how different types of relationships might shape the risk of developing and losing weight. They uncover the power of informal networks (family and friends) and highlight the potentially negative impact of formal ones (healthcare professionals). Our exploration could add to arguments about the need for stakeholders confronting obesity to be aware of the relevance of everyday social relationships in health and well-being strategies for tackling the issue, in creating collective and individual person-centred long-term sustainable actions. PATIENT AND PUBLIC CONTRIBUTION: Feedback on the tone/content of the interview questions was provided by the two first participants. The results were checked and received feedback from one of the interviewees.

The use of social network analysis in social support and care: a systematic scoping review protocol.

BACKGROUND: In recent decades, the literature on Social Network Analysis and health has experienced a significant increase. Disease transmission, health behavior, organizational networks, social capital, and social support are among the different health areas where Social Network Analysis has been applied. The current epidemiological trend is characterized by a progressive increase in the population's ageing and the incidence of long-term conditions. Thus, it seems relevant to highlight the importance of social support and care systems to guarantee the coverage of health and social needs within the context of acute illness, chronic disease, and disability for patients and their carers. Thus, the main aim is to identify, categorize, summarize, synthesize, and map existing knowledge, literature, and evidence about the use of Social Network Analysis to study social support and care in the context of illness and disability. METHODS: This scoping review will be conducted following Arksey and O'Malley's framework with adaptations from Levac et al. and Joanna Briggs Institute's methodological guidance for conducting scoping reviews. We will search the following databases (from January 2000 onwards): PubMed, MEDLINE, Web of Science Core Collection, SCOPUS, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, PROSPERO, and DARE. Complementary searches will be conducted in selected relevant journals. Only articles related to social support or care in patients or caregivers in the context of acute illnesses, disabilities or long-term conditions will be considered eligible for inclusion. Two reviewers will screen all the citations, full-text articles, and abstract the data independently. A narrative synthesis will be provided with information presented in the main text and tables. DISCUSSION: The knowledge about the scientific evidence available in the literature, the methodological characteristics of the studies identified based on Social Network Analysis, and its main contributions will highlight the importance of health-related research's social and relational dimensions. These results will shed light on the importance of the structure and composition of social networks to provide social support and care and their impact on other health outcomes. It is anticipated that results may guide future research on network-based interventions that might be considered drivers to provide further knowledge in social support and care from a relational approach at the individual and community levels. TRIAL REGISTRATION: Open Science Framework https://osf.io/dqkb5 .

Exploring The Netley British Red Cross Magazine: An example of the development of nursing and patient care during the First World War.

Netley Hospital played a crucial role in caring for the wounded during the nineteenth century and twentieth century, becoming one of the busiest military hospitals of the time. Simultaneously, Florence Nightingale delved into the concept of health and developed the theoretical basis of nursing. This research aims to describe the experiences related to nursing and patient care described in The Netley British Red Cross Magazine during the First World War. The analysis displays different nurses' roles and the influence of environmental factors in the delivery of the soldiers' care. There are indications that Nightingale's ideas would have infiltrated the nursing practices and other aspects of the soldiers' recovery at Netley. The history of the Netley Red Cross Hospital shows the theoretical and practical advancement of nursing care towards a holistic approach.

Analyzing Nursing Leadership at an Academic Historical Event: A Descriptive Study Based on Social Networks.

PURPOSE: To analyze the leadership network structure among nursing leaders in Spain identified through the Grupo40Enfermeras y Universidad event. METHODS: A descriptive cross-sectional study using social network analysis was used. Study sample consisted of 210 individuals, of whom 119 received nominations as referents. Structural analysis of the network was conducted using centrality and cohesion. RESULTS: A network structure was generated in which different leadership strategies were identified through InDegree, Eigenvector, and Betweenness Centrality. Five leaders were identified as bridges to other individuals using Betweenness. The whole network presented little cohesion although two highly cohesive cores were detected by K-core measurements. CONCLUSION: A strategy is needed to support nursing leaders with high degree of Betweenness to serve as bridges to connect other nursing leaders.

Valores, costumbres y estructuras familiares en 1901: una mirada a los cuidados culturales actuales / Values, customs and family structures in 1901: a look at the current cultural care

La actual dinámica social hace que el cuidado de enfermería se convierta en un desafío permanente, pues debe considerar las continuas transformaciones de los aspectos socioculturales de las personas para ofrecer unos cuidados de calidad. Sin embargo, hay personas que mantienen creencias, normas y prácticas familiares tradicionales que pasan de generación en generación. Una forma de explorar estas es a través del análisis de fuentes documentales históricas. Este estudio propone conocer las creencias, tradiciones, prácticas y estructuras familiares de la comarca del Bierzo (León, España) en 1901. Utilizaremos para ello, como referente documental, las respuestas dadas acerca del “Matrimonio” en la “Encuesta del Ateneo de Madrid” de 1901. Esta encuesta recogía las creencias, tradiciones y prácticas de la sociedad de la época en todo el territorio nacional, aunque, en este caso concreto, nos limitemos a la comarca del Bierzo. Esta profundización en el conocimiento holístico ayudaría a que las enfermeras puedan planificar y ejecutar intervenciones donde los pacientes se sientas valorados y tratados como seres únicos y respetados considerando sus características de individualidad y sus contextos particulares

Current social dynamics make nursing care a permanent challenge since it must consider the continuous transformations of the sociocultural aspects of people to offer quality care. However, some people maintain traditional family beliefs, norms and practices that are passed from generation to generation. One way to explore these is through the analysis of historical documentary sources. This study proposes to know the beliefs, traditions, practices and family structures of the Bierzo region (León, Spain) in 1901. We will use, as a documentary reference, the answers given about the "Marriage" in the "Survey of the Ateneo of Madrid" of 1901. This survey collected the beliefs, traditions and practices of the society of that period throughout the national territory. However, in this specific case, we limit the information to the Bierzo region. This deepening of holistic knowledge would help nurses to plan and execute interventions where patients feel valued and treated as unique and respected beings considering their characteristics and their particular contexts

Social network influences and the adoption of obesity-related behaviours in adults: a critical interpretative synthesis review.

BACKGROUND: Obesity is a key risk factor for developing a long-term condition and a leading cause of mortality globally. The limited evidence associated with interventions that currently target obesity-related behaviours demand new approaches to tackle this problem. Given the evidence that social ties are implicated in the gaining and reduction of weight, the use of social networks in interventions is potentially a novel and useful means of tackling this health issue. There is a specific gap in the literature regarding what and how social network properties and processes together with environmental and individual factors influence the adoption of positive and negative obesity-related behaviours in adults. METHODS: To address this gap in developing an integrated and holistic conceptual approach, a critical interpretative synthesis was undertaken following a line of argument synthesis as an analytical strategy. RESULTS: Twenty-four studies were included. The data-driven themes meso-micro network processes, contextual and individual factors, and types of ties and properties were identified individually as components and causes of different health scenarios. Nevertheless, these drivers do not act on their own. As a consequence, developing multi-agent coalitions considering cross-level influences between the data-driven themes are two mechanisms that are created to understand more in-depth how social networks and the environment influence the adoption of obesity-related behaviours. These two new constructs point to a dynamic multilevel set of influences between multiple constructs, developing scenarios where positive and negative health results are identified. CONCLUSIONS: This critical interpretative synthesis offers a new means of exploring the application of social network properties and mechanisms in the 'obesity' field. The synthesizing argument created during the analysis process might be considered by health policy-makers, who might need to contemplate the wider open system of socially connected individuals and harness these forces to design new interventions where social networks and other contextual and individual factors operate together in a complex multilevel environment influencing obesity-related behaviours and practices.

The Importance of External Contacts in Job Performance: A Study in Healthcare Organizations Using Social Network Analysis.

There is evidence that relations between physicians and nurses within healthcare institutions might be shaped by informal aspects of such relations and by links to people external to the organization, with an impact on work performance. Social network analysis is underutilized in exploring such associations. The paper aims to describe physicians’ and nurses’ relationships outside their clinical units and to explore what kind of ties are related to job performance. A network analysis was performed on cross-sectional data. The study population consisted of 196 healthcare employees working in a public hospital and a primary healthcare centre in Spain. Relational data were analysed using the UCINET software package. Measures included: (i) sample characteristics; (ii) social network variables; and (iii) team performance ratings. Descriptive statistics (means, medians, percentages) were used to characterize staff and performance ratings. A correlational analysis was conducted to examine the strength of relationships between four different types of ties. Our findings suggest that external ties only contribute to improving the performance of physicians at both the individual and team level. They are focused on the decision-making process about the therapeutic plan and, therefore, might need to seek advice outside the workplace. In contrast, external ties are not relevant for the work performance of nurses, as they need to find solutions to immediate problems in a short period of time, having strong ties in the workplace. Social network analysis can illuminate relations within healthcare organizations and inform the development of innovative interventions.

Influencia de los espacios verdes urbanos en la salud mental / The influence of urban green areas on mental health

OBJETIVO: describir la incidencia de cesárea en el Hospital Universitario de Burgos (HUBU) de 2004 a 2014; así como explorar la influencia de la edad materna avanzada, teniendo en cuenta dos edades de corte (35 y 40 años), en dicha incidencia. MATERIAL Y MÉTODO: estudio descriptivo longitudinal retrospectivo (2004-2014) sobre los 24.521 partos realizados en el HUBU. Se utilizó el registro informatizado de partos. La variable principal del estudio fue la cesárea, y la variable independiente, la edad de la mujer, teniendo en cuenta dos edades de corte (mayores de 40 vs. iguales o menores de 40 años; mayores de 35 vs. iguales o menores de 35 años). Se utilizó prueba z para el contraste de hipótesis; se calcularon intervalos de confianza (IC) al 95% de seguridad. RESULTADOS: se contó una población de 24.426 partos. La diferencia de incidencia de cesárea entre mayores de 40 igual o menor que 40 años fue de un 11% (IC 95%: 8%-14%; p< 0,001) a favor de una mayor incidencia en la mayores de 40. Atendiendo a la edad de corte de 35 años, esta diferencia fue de un 5% (IC 95%: 3,8%-6,2%; p< 0,001), y en la misma dirección anteriormente señalada. La incidencia acumulada global de cesárea fue del 22,5% (IC 95%: 21,98%-23,02%). CONCLUSIÓN: existen diferencias en la incidencia de cesárea en función de la edad, independientemente del corte de edad a los 35 o a los 40 años, y con una mayor incidencia en las más mayores. Cabe preguntarse el efecto de las técnicas de reproducción asistida y el posible aumento de cesáreas electivas

OBJECTIVE: to describe the incidence of C-sections at the Hospital Universitario de Burgos (HUBU) from 2004 to 2014; as well as to explore the influence of advanced maternal age, considering two cut-off ages (35 and 40 years) for said incidence. MATERIAL AND METHODS: a descriptive longitudinal retrospective study (2004-2014) on the 24,521 labours conducted at the HUBU. The computerized record of labours was used. The primary variable of the study was C-section, and the independent variable was maternal age, considering two cut-off ages (>40-year-old vs. is less than or equal to40 year-old; >35-year old vs. is less than or equal to35-year-old). The z-test was used for hypothesis contrast, and a 95% confidence interval (CI) was estimated. RESULTS: the study included a population of 24,426 labours. The difference in the incidence of C-sections between >40-year old and is less than or equal to40-year-old was 11% (CI 95%: 8%-14%; p< 0.001), showing a higher incidence in >40-year-old women. Regarding the cut-off age of 35 years, the difference was 5% (CI 95%: 3.8%-6.2%; p< 0.001), and in the same direction previously mentioned. There was an overall cumulative incidence of C-sections of 22.5% (CI 95%: 21.98%-23.02%). CONCLUSION: there are differences in the incidence of C-sections based on age, regardless of the cut-off age of 35 or 40 years, showing a higher incidence in older mothers. It is worth considering the effect of assisted reproduction techniques, and the potential increase in elective C-sections