Guía de diseño y mejora continua de procesos asistenciales integrados. 2ª ed

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Consejo dietético en atención primaria

Tiene traducción al inglés: Dietetic counselling in primary care (http://hdl.handle.net/10668/1217). Destinado a personal sanitario de Atención Primaria. Publicado en la página web de la Consejería de Salud y Bienestar social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / profesionales / Salud Pública / Promoción de la Salud / Actividad Física y Alimentación Equilibrada / Materiales) y (Consejería de Salud y Bienestar Social / Ciudadanía / Nuestra Salud / Vida sana)

Consejo dietético en atención primaria

Tiene traducción al inglés: Dietetic counselling in primary care (http://hdl.handle.net/10668/1217). Destinado a personal sanitario de Atención Primaria. Publicado en la página web de la Consejería de Salud y Bienestar social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / profesionales / Salud Pública / Promoción de la Salud / Actividad Física y Alimentación Equilibrada / Materiales) y (Consejería de Salud y Bienestar Social / Ciudadanía / Nuestra Salud / Vida sana)

Atención al paciente pluripatológico : proceso asistencial integrado. 2ª ed

Publicado en la página web de la Consejería de Salud: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Cuidarte : una estrategia para los cuidados en la Andalucía del siglo XXI

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales (Consejería de Igualdad, Salud y Políticas sociales / Ciudadanía / Quiénes Somos / Planes y Estrategias)

Guía para hacer la voluntad vital anticipada

Contiene modelos de los anexos que deben presentarse en el Registro de Voluntades Anticipadas.

Guía de consejo dietético intensivo en atención primaria

Destinado a personal sanitario de Atención Primaria, principalmente personal de enfermería. Publicado en la página web de la Consejería de Salud y Bienestar social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / profesionales / Salud Pública / Promoción de la Salud / Actividad Física y Alimentación Equilibrada / Materiales) y (Consejería de Salud y Bienestar Social / Ciudadanía / Nuestra Salud / Vida sana)

Trastornos sensoriales : proceso asistencial integrado

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Dynamic arterial elastance to predict arterial pressure response to volume loading in preload-dependent patients

INTRODUCTION Hemodynamic resuscitation should be aimed at achieving not only adequate cardiac output but also sufficient mean arterial pressure (MAP) to guarantee adequate tissue perfusion pressure. Since the arterial pressure response to volume expansion (VE) depends on arterial tone, knowing whether a patient is preload-dependent provides only a partial solution to the problem. The objective of this study was to assess the ability of a functional evaluation of arterial tone by dynamic arterial elastance (Ea(dyn)), defined as the pulse pressure variation (PPV) to stroke volume variation (SVV) ratio, to predict the hemodynamic response in MAP to fluid administration in hypotensive, preload-dependent patients with acute circulatory failure. METHODS We performed a prospective clinical study in an adult medical/surgical intensive care unit in a tertiary care teaching hospital, including 25 patients with controlled mechanical ventilation who were monitored with the Vigileo(®) monitor, for whom the decision to give fluids was made because of the presence of acute circulatory failure, including arterial hypotension (MAP ≤65 mmHg or systolic arterial pressure <90 mmHg) and preserved preload responsiveness condition, defined as a SVV value ≥10%. RESULTS Before fluid infusion, Ea(dyn) was significantly different between MAP responders (MAP increase ≥15% after VE) and MAP nonresponders. VE-induced increases in MAP were strongly correlated with baseline Ea(dyn) (r(2) = 0.83; P < 0.0001). The only predictor of MAP increase was Ea(dyn) (area under the curve, 0.986 ± 0.02; 95% confidence interval (CI), 0.84-1). A baseline Ea(dyn) value >0.89 predicted a MAP increase after fluid administration with a sensitivity of 93.75% (95% CI, 69.8%-99.8%) and a specificity of 100% (95% CI, 66.4%-100%). CONCLUSIONS Functional assessment of arterial tone by Ea(dyn), measured as the PVV to SVV ratio, predicted arterial pressure response after volume loading in hypotensive, preload-dependent patients under controlled mechanical ventilation.

Confabulation in schizophrenia: a neuropsychological study.

Confabulation has been documented in schizophrenia, but its neuropsychological correlates appear to be different from those of confabulation in neurological disease states. Forty-five schizophrenic patients and 37 controls were administered a task requiring them to recall fables. They also underwent testing with a range of memory and executive tasks. The patients with schizophrenia produced significantly more confabulations than the controls. After correcting for multiple comparisons, confabulation was not significantly associated with memory impairment, and was associated with impairment on only one of eight executive measures, the Brixton Test. Confabulation scores were also associated with impairment on two semantic memory tests. Confabulation was correlated with intrusion errors in recall, but not false positive errors in a recognition task. The findings suggest that confabulation in schizophrenia is unrelated to the episodic memory impairment seen in the disorder. However, the association with a circumscribed deficit in executive function could be consistent with a defective strategic retrieval account of confabulation similar to that of Moscovitch and co-workers, interacting with defective semantic memory.

Aplicación de la ecografía pediátrica en Atención Primaria; interconexión con la atención hospitalaria

Introduction: The use of ultrasound in pediatric Primary Care improves both the quality and efficiency of care. Material and methods: This study indertook 250 ultrasounds over a 12 moth period from May 2009 to April 2010. Results: Te results found for each anatomical region were 45% abdominal, 25% cranial, 15% of the hip, 10% of parotid and thyroids and 5% of tender areas. From these, the most relevant pathology was Gastroesophageal Reflux, acoounting for 7.2% of all ultrasounds undertaken. Renal pyelectasia accounted for 1.6% cephalhematoma 1.6%, dysplasia of the hip 1.2%, acute parotitis 1.2%, adenopathy 1.2%, cervical angioma 0.4%, and abscessed adenopathy 0.4%. Conclusion: From this analysis, we conclude that ultrasound is a useful tool for the detection of abdominal and cranial pathologies and secondarily, for thyroid, hip and cervical pathologies.

Programa de Atención a Población Inmigrante en Salud Mental (PAPI-SM)

Publicado en la página web del Servicio Andaluz de Salud. http://www.juntadeandalucia.es/servicioandaluzdesalud (Servicio Andaluz de Salud/principal/la organización/publicaciones)

Modelo de estadios de cambio: compatibilidad con relatos biográficos de mujeres que sufren violencia doméstica

This study aims to analyze the adjustment of women, victims of intimate partner violence, by applying the Prochaska and Di Clemente Stages of Change Model. An interpretative qualitative study was made in 35 domestic violence victims women detected in primary care, women who recognized their relationship as abusive (perceived maltreatment). This is a multicentric study, with participation of six health centers of Malaga city. Biographical Narration technique by audio-recorded and transcribed interview was used; about this, thematic analysis adjustment to Transtheoretic Model phases was applied. ATLAS-TI 5.0 program was used for codification. Precontemplative, maintenance and ending stages were more represented while action phases were poorly mentioned. Main phases characteristics were: "blindness" and inexplicability in precontemplative stage; pros / cons analysis in contemplative phase; making decisions difficulty in action phases; suffering and going ahead purpose in maintenance stage, and determination and analysis capacity in the ending stage. Keys for intervention according to the phase of the process were offered.

¿Quién acompaña a los pacientes a la consulta pediátrica? El acompañante de los pacientes pediátricos en Atención Primaria

Introduction: today, cultural changes may have changed the usual pattern of the mother as the accompanying person in the pediatric office. Objetives: descriptive analysis of the current situation in the pediatrics office. Material and methods: Las Delicias Health Center (health district of Malaga). Selected sample of 250 patients between the periods 1-15 July and 15-30 September, 2011. Results: in most cases (54.8%), the mother stands as the main accompanying person, appearing both parents in the consultation in 16.4% of cases. The figure of the grandparents is of special significance when the mother is an active worker. Most consultations were on-demand by appointment (82.4%), for acute symptoms, with symptoms lasting less than 3 days in most cases (59.2%). Discussion: the mother is presented as the main accompanying person in most cases. The father or grandparents will be present in front of social-cultural factors, mainly active employment status of the mother.

Del artículo de revisión a la recomendación profesional: La uniformación y material de protección individual para los equipos del ámbito prehospitalario de urgencias y emergencias

The Spanish Society of Nursing Emergency (SEEUE) has several lines documentaries that can be consulted on its web page and that have been spread through various publications: Statutes, scientific recommendations, professional recommendations, statements and allegations, grounds for nursing emergency, guarantees and rules, documents of interest and legislation. Set this that composed the regulatory environment, legal and recommendations which society poses to the collective nurse from the area of the emergency, as well as the rest of actors associated with urgent assistance (institutional and administratively) and through what has been the work of conceptualization and definition in our area the past few years. Part of this documentation offer possibilities for scientific endorsement and professional and invites to continue building knowledge and evidence. It is in this sense in which this work can and should be defined from a literature review approach and under the scheme of "review article". The working Group in Primary Care (PC) of the SEEUE, decided to build a Professional Recommendation (PR) in one of the areas of "uncertainty/variability" in the employment context and historical demand of nurses and other emergency care team on security issues: "The uniform and personal protective equipment for professional teams on prehospital emergency areas”.