Long COVID among Brazilian Adults and Elders 12 Months after Hospital Discharge: A Population-Based Cohort Study.

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.

Validation of the Health Protective Sexual Communication Scale Among Young Adults in the United Kingdom and Spain.

Background and Purpose: The transmission of sexual infections is increasing globally. The research aims to validate the Health Protective Sexual Communication Scale (HPSC) in English and Spanish. Methods: The study survey was administered to 1,223 university students from Spain (658) and the United Kingdom (565) during the academic year 2020-2021. Results: Cronbach's alpha values were .80 (Spain) and .86 (United Kingdom). The scale's Exploratory and Confirmatory Factor Analysis displays a one-dimensional structure of eight items in both countries. Conclusions: The HPSC has excellent reliability and validity. Psychometric findings support the use of the HPSC as a screening tool to measure sexual risk in youth.

Causes of Stress among Healthcare Professionals and Successful Hospital Management Approaches to Mitigate It during the COVID-19 Pandemic: A Cross-Sectional Study.

The outbreak of the COVID-19 pandemic posed an immediate challenge to the management of hospitals in Germany and elsewhere. The risk of stress for front-line healthcare professionals forced occupational health and safety units to adopt a variety of protective measures, not all of which have been thoroughly validated. The main objective of the present analysis is to assess what the most important sources of stress were and which of the protective measures applied to counteract stress among healthcare staff had the greatest impact. A better understanding of these factors will improve hospital management and worker safety in a future health crisis situation and may also prove to be beneficial in non-crisis situations. For this purpose, in 2020, an exploratory, cross-sectional and quantitative study using a questionnaire created for this purpose was carried out on a total of 198 professionals-133 nurses and 65 physicians-at the Klinikum Mittelbaden Balg hospital in Baden-Baden, Germany, during the first wave of the pandemic. Statistical analyses showed that nurses suffer more stress than physicians and that stress is higher among professionals in critical care and emergency units than in units that are less exposed to infected patients. It was also found that measures such as salary incentives, encouragement of work in well-integrated teams, and perceived support from hospital management mitigate stress. These findings highlight the importance of support measures from management and superiors. Knowing the actual effectiveness of the measures applied by management and the factors mentioned above could help to protect healthcare professionals in the event of another pandemic or similar situations and may still be of value in dealing with the continuing COVID-19 pandemic.

Diferentes actitudes hacia la sexualidad entre estudiantes de Enfermería de primero y cuarto curso / Sexuality education: Different attitudes among incoming and outgoing Nursing undergraduates

Objective: To evaluate whether attitudes towards sexuality acquired by students during a Spanish nursing degree are sufficient for their performance in professional practice.Methods: This is a descriptive, cross-sectional, and quantitative study based on a self-completion survey composed of standardized scales that compare sexual attitudes among 101 first-year students with 86 fourth-year students. The 187 nursing students, 24 men and 163 women were between 18 and 60 years old (M age=21.21, SD=5.48). The evaluative instrument was an anonymous questionnaire that consisted of sociodemographic questions and two standardized scales: Attitudes Towards Sexuality Scale (ATSS-28) and Double Standard Scale (DSS).Results: Comparison between cohorts using the Mann-Whitney U test proved to be close to being significant in the ATSS, U=3625.50, z=-1.95, p=.052 and significant in DSS, U=3560.50, z=-2.13, p=.034. These findings indicate that fourth-year students have more positive attitudes towards sexuality and less rigid adherence to gender roles. In addition, a medium negative correlation, r s =-.307, p=.001, between ATSS and DSS was obtained, showing a positive association between attitudes and less adherence to gender roles. These results suggest that nursing degree training had a positive impact on sexual attitudes.Conclusion: Healthcare professionals are centrally involved in the care of patients and families. Nurses' attitudes towards sexuality are important in terms of patient comfort and the accessibility and acceptability of care. Implementation of training in sexuality has a positive effect on nursing care and favours the establishment of global health strategies (AU)

Objetivo: Evaluar si las actitudes hacia la sexualidad adquiridas por los alumnos durante el Grado en Enfermería son suficientes para su desempeño profesional.Métodos: Se trata de un estudio descriptivo y transversal basado en una encuesta compuesta por escalas estandarizadas que comparó las predisposiciones sexuales entre 101 alumnos de primer curso con 86 de cuarto. Los 187 estudiantes de enfermería, 24 hombres y 163 mujeres tenían entre 18 y 60 años (M edad =21.21, DT=5.48). El instrumento utilizado para su evaluación fue un cuestionario anónimo que estaba constituido por preguntas sociodemográficas y las dos siguientes escalas, la Escala de Actitudes hacia la Sexualidad (ATSS-28) y la Escala de Doble Estándar (DSS).Resultados: Los resultados obtenidos estuvieron cera de ser significativos por curso en la ATSS, U=3625.50, z=-1.95, p=.052 y significativos en la DSS, U=3560.50, z=-2.13, p=.034. Estos hallazgos indicaron que los alumnos de cuarto tuvieron actitudes más positivas hacia la sexualidad y una menor adherencia a los roles de género. Además, se obtuvo una correlación negativa moderada, r s =-. 307, p=.001, entre la ATSS y la DSS que mostraba asociación entre las actitudes positivas y la menor adhesión a roles de género. Estos resultados sugieren que la formación enfermera tuvo un impacto positivo en sus actitudes.Conclusión: La enfermería está involucrada de manera central en el cuidado de los pacientes y sus familias. Sus actitudes hacia la sexualidad son importantes en términos de comodidad del paciente, accesibilidad y aceptabilidad de su atención (AU)

Combined use of two rapid tests for the conclusive diagnosis of Chagas disease: a systematic scoping review.

OBJECTIVE: The goal of this systematic scoping review is to collect and summarise scientific evidence regarding the validity of two simultaneous immunochromatographic tests for the conclusive diagnosis of Chagas disease. The research was informed by the following review questions: Will the use of two rapid tests be a valid method for the definitive diagnosis of Chagas disease when compared with conventional serological tests? In what type of population has the operation of two rapid tests been tried for the diagnosis of Chagas disease? What are the biomedical and public health advantages of the diagnostic method resulting from the combination of two rapid tests over the conventional serological method? Will it be a cost-benefit strategy for the diagnosis of Chagas with respect to conventional serological tests? DESIGN: Systematic scoping review. SETTING: A search of the published and unpublished literature in five databases was carried out, in order to identify, screen and select the studies included in this review. RESULTS: 468 studies were identified, of which 46 were screened with a full-text reading, and finally, three articles were included in the review. All studies were in endemic countries with adult and paediatric populations (n=1133) and, together, they evaluated four different rapid tests. The rapid tests showed good sensitivity (97.4%-100%) and specificity (96.1%-100%) for the diagnosis of Chagas when used in combination and compared with the reference tests. CONCLUSIONS: The simultaneous use of at least two immunochromatographic rapid tests is a valid option for the definitive diagnosis of chronic Chagas in endemic rural areas, as long as there are studies that previously evaluate their performance on the areas of implementation. Therefore, this could be an alternative to the current diagnostic standard. However, additional studies are still needed in more countries in order to provide further evidence and to investigate the cost-benefit.

La importancia de la Salud Global en Enfermería ¿qué sabemos? / The importance of the Global Health in Nursing. What do you know about it?

Este ensayo pretende contribuir al debate mundial que se ha generado, desde las disciplinas profesionales y en especial desde la Enfermería, ante la creciente complejidad de los cuidados de la salud que deben afrontarse en contextos globalizados. Esta reflexión parte de un proyecto universitario en el que se tradujo y estudió las competencias de Enfermería en Salud Global en su plan de estudios. Debido a la complejidad de la sociedad actual es necesario incorporar variables psicológicas, sociales y culturales en la formación enfermera desde una perspectiva transcultural y holística que permitan a estos profesionales liderar y generar cambios que hagan frente a las problemáticas mundiales. Apoyándose en la experiencia de una investigación previa sobre la formación de Enfermería en Salud Global, propone que se cuestione el modelo biomédico y el cambio en la relación de la enfermera con otros profesionales y con el paciente

This essay aims to contribute to the global debate that has been generated, both from professional disciplines and especially from Nursing, due to the increasing complexity of health care that must be faced in globalized contexts. This reflection started from a university project in which Nursing skills in Global Health were translated and studied in its study plans. Due to the current complexity of society, it is necessary to incorporate psychological, social and cultural variables in nursing education from a cross-cultural and holistic perspective. This will allow these professionals to lead and generate changes able to face global problems. Based on the experience of a previous research on Nursing training in Global Health, it is proposed to question the biomedical model and the change in the nurse's relationship with other professionals and with the patient

El proceso de institucionalización de la enfermera gestora de casos en España. Análisis comparativo entre los sistemas autonómicos de salud / Institutionalisation of the case management nurse in Spain. Comparative analysis of health systems of the Spanish autonomous communities

La atención a la cronicidad es una necesidad acuciante para los sistemas de salud por su elevada prevalencia y los retos organizativos que su atención genera. Diferentes países resuelven la complejidad de la atención a la cronicidad mediante la gestión de casos a través de la profesión enfermera, con buenos resultados. En este trabajo se analiza el estado de institucionalización de la figura profesional de la enfermera gestora de casos en España mediante el diseño de un estándar de referencia para la comparación entre comunidades autónomas del abordaje de la cronicidad. Se pretende de esta manera monitorear el grado de avance de la estructura institucional de las políticas de atención a la cronicidad en nuestro país mediante esta figura asistencial. Entre los resultados encontramos que ninguna comunidad autónoma ha alcanzado el estándar máximo de implantación y que la situación es muy heterogénea, en la que se constata un débil y errático grado de institucionalización de la enfermera gestora de casos en España a pesar del reconocimiento formal a su papel en la atención al paciente crónico

Care of chronicity is a pressing issue for health systems because of its high prevalence and the organisational challenges that it generates. Different countries solve the complexity of the care of chronicity through case management by the nursing profession, obtaining good results. This paper analyses the status of institutionalisation of the case management nurse in Spain through the design of a reference standard to compare between the autonomous communities in their approach to chronicity. Thus, we sought to monitor the degree of progress of the institutional structure of the policies for the care of chronicity in our country through this healthcare professional. Our results showed that no autonomous community has reached the maximum standard of implementation and that the situation is very heterogeneous, confirming a weak and erratic degree of institutionalisation of the case management nurse in Spain despite the formal recognition of their role in patient care

Institutionalisation of the case management nurse in Spain. Comparative analysis of health systems of the Spanish autonomous communities. / El proceso de institucionalización de la enfermera gestora de casos en España. Análisis comparativo entre los sistemas autonómicos de salud.

Care of chronicity is a pressing issue for health systems because of its high prevalence and the organisational challenges that it generates. Different countries solve the complexity of the care of chronicity through case management by the nursing profession, obtaining good results. This paper analyses the status of institutionalisation of the case management nurse in Spain through the design of a reference standard to compare between the autonomous communities in their approach to chronicity. Thus, we sought to monitor the degree of progress of the institutional structure of the policies for the care of chronicity in our country through this healthcare professional. Our results showed that no autonomous community has reached the maximum standard of implementation and that the situation is very heterogeneous, confirming a weak and erratic degree of institutionalisation of the case management nurse in Spain despite the formal recognition of their role in patient care.