Antonio-Jesús Marín-Paz

A comprehensive analysis of Francisco Herrera Rodríguez’s doctoral thesis is conducted as a starting point to understand his trajectory as a researcher in the history of medicine. The structure, content and methodology of the thesis are examined. A hermeneutic approach is employed to analyze the sources, including the thesis itself and the personal academic record. This doctoral thesis represented a novel line of research in Spain, contributing significant knowledge about medical scientific production in Cádiz during the 19th century through eighteen classified themes. It serves as a model for future studies on the history of scientific production based on doctoral theses. Se realiza un análisis de la tesis doctoral de Francisco Herrera Rodríguez como punto de partida para comprender su trayectoria como investigador de la historia de la medicina y se examina su estructura, contenido y metodología. Se utiliza el método hermenéutico para analizar las fuentes, incluyendo la propia tesis y el expediente académico personal. La tesis doctoral representó una nueva línea de investigaciónen España, al aportar un conocimiento significativo sobre la producción científica médica en Cádiz durante el siglo xix a través de dieciocho temáticas clasificadas. Su tesis sirve de modelo para futuros estudios sobre la historia de la producción científica basada en tesis doctorales.

Objective: To provide practical information regarding needs, preferences of content and format of an app to assist the self-management in patients with multi-morbidity and heart failure (HF). Methods: The three-phase study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. Results: Integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes that captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way. Conclusions: The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development.

BACKGROUND Background: Heart failure (HF) is becoming a global epidemic. To promote healthy behaviors and facilitate the strengthening of the provision of health services in these patients, it is essential to prioritize their opinions and needs. Mobile health applications seem to be an effective tool in the care of these patients. User-centered design and the Information Systems Research (ISR) perspective are well-established approaches to developing mobile applications that are responsive to the needs of these patients. OBJECTIVE Objective: The aim of this study was to provide practical information regarding needs, preferences of content, and format of an App to assist the self-management in patients with multi-morbidity and HF. METHODS Methods: This three phases study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. A total of 20 patients were included in this study. Data collection continued until data saturation was reached. All data were transcribed verbatim and analyzed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. RESULTS Results: The integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes, related to the domains of food and nutrition, medication and treatment, rehabilitation and physical activity, signs and symptoms, self-management, and emotional management. These subthemes captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain: i) components that increase the patient's understanding of HF, ii) self-care, iii) self-efficacy, participation of the family / caregiver, iv) psychosocial well-being, and v) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), in nutritional information (70%), type of exercises in order to improve their physical condition (75%), and information about food and drugs interaction (60%). As a transversal element, in a large part of the user stories, was highlighted the importance of motivation messages (60%). CONCLUSIONS Conclusions: A 3-phases process integrating theoretical basis, evidence from integrative reviews, and research findings from target users has been considered a guide for future App development. CLINICALTRIAL ClinicalTrials.gov NCT04725526 INTERNATIONAL REGISTERED REPORT RR2-10.2196/35945

Background: Patients with multimorbidity and complex health needs are defined as a priority by the World Health Organization (WHO) and the European Union. There is a need to develop appropriate strategies with effective measures to meet the challenge of chronicity, reorienting national health systems. The increasing expansion of mobile health (mHealth) interventions in patient communication, the reduction of health inequalities, improved access to health care resources, adherence to treatment, and self-care of chronic diseases all point to an optimistic outlook. However, only few mobile apps demonstrate their effectiveness in these patients, which is diminished when they are not based on evidence, or when they are not designed by and for users with different levels of health literacy (HL). Objective: This study aims to evaluate the efficacy of an mHealth intervention relative to routine clinical practice in improving HL and self-management in patients with multimorbidity with heart failure (HF) and complex health needs. Methods: This is a randomized, multicenter, blinded clinical trial evaluating 2 groups, namely, a control group (standard clinical practice) and an intervention group (standard clinical practice and an ad hoc designed mHealth intervention previously developed), for 12 months. Results: The contents of the mHealth intervention will address user-perceived needs based on the development of user stories regarding diet, physical exercise, cardiac rehabilitation, therapeutic adherence, warning signs and symptoms, and emotional management. These contents have been validated by expert consensus. The creation and development of the contents of the mHealth intervention (app) took 18 months and was completed during 2021. The mobile app is expected to be developed by the end of 2022, after which it will be applied to the experimental group as an adjunct to standard clinical care during 12 months. Conclusions: The trial will demonstrate whether the mobile app improves HL and self-management in patients with HF and complex health needs, improves therapeutic adherence, and reduces hospital admissions. This study can serve as a starting point for developing other mHealth tools in other pathologies and for their generalization to other contexts. Trial Registration: ClinicalTrials.gov NCT04725526; https://tinyurl.com/bd8va27w International Registered Report Identifier (IRRID): DERR1-10.2196/35945

Information about the paper titled "SIMULATION OF NURSING VIRTUAL CONFERENCE FOR COLLABORATIVE LEARNING ON RESEARCH DISSEMINATION IN HEALTH EDUCATION" at IATED Digital Library

Introduction: Hyperlactatemia occurs during or after extracorporeal circulation in the form of lactic acidosis, increasing the risk of postoperative complications and the mortality rate. The aim of this study was to evaluate whether continuous high-volume hemofiltration with volume replacement through a polyethersulfone filter during the extracorporeal circulation procedure decreases postoperative lactatemia and its consequences.Materials and methods: This was a randomized controlled trial. Patients were randomly divided into two groups of 32: with or without continuous high-volume hemofiltration through a polyethersulfone membrane. Five patients were excluded from each group during the study period. The sociodemographic characteristics, filter effects, and blood lactate levels at different times during the procedure were evaluated. Secondary endpoints were studied, such as the reduction in the intubation time and time spent in ICU.Results: Lactatemia measurements performed during the preoperative and intraoperative phases were not significantly different between the two groups. However, the blood lactate levels in the postoperative period and at 24 hours in the intensive care unit showed a significant reduction and a possible clinical benefit in the hemofiltered group. Following extracorporeal circulation, the mean lactate level was higher (difference: 0.77 mmol/L; CI 0.95: 0.01–1.53) in the nonhemofiltered group than in the hemofiltered group (p<0.05). This effect was greater at 24 hours (p = 0.019) in the nonhemofiltered group (difference: 1.06 mmol/L; CI 0.95: 0.18–1.93) than in the hemofiltered group. The reduction of lactatemia is associated with a reduction of inflammatory mediators and intubation time, with an improvement in liver function.Conclusions: The use and control of continuous high-volume hemofiltration through a polyethersulfone membrane during heart-lung surgery could potencially prevent postoperative complications. The reduction of lactatemia implied a reduction in intubation time, a decrease in morbidity and mortality in the intensive care unit and a shorter hospital stay.