A competency model for nurse executives

[EN] BackgroundNurses capable of adequately developing their competencies in the management field are essential for the sustainability of health-care organizations. Such competencies should be included in a model of specific competencies.AimThe aim of this research is to propose a competency model for nurse executives.MethodsThe Delphi method was applied to reach a consensus on the required competencies, and Principal Component Analysis (PCA) was applied to determine the construct validity and reduce the data set's dimensionality. Consensus was defined based on at least 80% of the experts agreeing with the proposed competencies. For each competency, the development levels were beginner, advanced beginner, competent, highly competent and expert.ResultsFrom among the 51 competencies that were identified to define a model for nurse executives, decision-making, leadership and communication stood out. The PCA indicated the structural validity of the proposed model by saturation of the principal components (Cronbach's α > 0.631).ConclusionNurses wishing to develop their professional careers as nurse executives must first develop the competencies shown in the proposed model. Nurse executives should follow the educational programmes specified in this study, to adapt their knowledge to this role's requirements.S

The pyrolytical fingerprint of nitrogen compounds reflects the content and quality of soil organic carbon

The increasing land degradation is a problem that affects many soils in countries with a Mediterranean climate. In this aspect the soil organic matter (SOM) plays an important role, due to its progressive biodegradation parallels to desertification and the concomitant emissions of CO2 to the atmosphere. These facts make basic research on the structure and composition of SOM important for soil conservation. Organic N-compounds in soil are of particular interest due to their chemical structure and speciation status in the SOM which can play an important role in soil N bioavailability and in the whole biogeochemical activity of the soil. For this reason, studying the possible relationships between the different N-compounds and soil properties, such as SOM content and its chemical characteristics, can provide new information on the stabilization and storage of organic C in soil. For this research, 30 soils from Spanish ecosystems with a wide range of SOM content were selected. The molecular composition of SOM in whole soil samples including N-compounds, was analyzed by analytical pyrolysis (Py-GC/MS). A parallel characterization of SOM quality was carried out using solid state 13C NMR and UV–vis spectroscopy. Based on their chemical structure, the N-compounds identified by Py-GC/MS were classified into seven main groups: indoles, pyridines, pyrazoles, benzonitriles, imidazoles, pyrroles and quinolines. Multivariate statistical analyses were used to explore the relationship between the distribution of the above compounds and the SOM content. A significant predictive model was obtained for the SOM using partial least squares (PLS) regression, which was used to predict SOM content using the pyrolytic N-compounds as descriptors. This would show that there is a relationship between the patterns of N-compounds and the biogeochemical mechanisms involved in the different C storage levels the soils. Also, multidimensional scaling (MDS) and principal components analysis (PCA) showed to what extent the individual N-compounds are informative of status and quality of the humic acid fraction of SOM. As a whole, the results obtained by Py-GC/MS suggest that indoles, alkylindoles, alkylbenzimidazoles and alkylpyridines could be indicators of SOM accumulation while unsubstituted benzonitrile and pyridine are related to SOM qualityThis work was supported by grants CGL2013-43845-P and BES2014-069238 from the Spanish Ministry of Economy and Competitiveness (MINECO

The use of remote sensing to detect the consequences of erosion in gypsiferous soils

Tillage practices on sloping ground often result in unsustainable soil losses impairing soil functions such as crop productivity, water and nutrients storage, and soil organic carbon (SOC) sequestration. A sloping olive grove (10%) was planted in shallow gypsiferous soils in 2004. It was managed by minimum tillage; the most frequent management practice in central Spain. The consequences of erosion were studied in soil samples (at 0–10, 10–20, and 20–30 cm depths) by analyzing SOC, available water and gypsum content, and by detecting spectral signatures using an ASD FieldSpecPro® VIS/NIR-spectroradiometer. The Brightness index (BI), Shape index (FI), and Normalized Difference Vegetation Index (NDVI) were derived from the ASD spectral signatures and from remote sensing (Sentinel-2 image) data. The development of these young olive trees was estimated from the measured diameter of the trunks (17 ± 18 cm diameter). In 20–30 cm of the soil, the carbon stock (38 ± 18 Mg ha−1) as well as the available water content (12 ± 6%) was scarce, affecting the productivity of the olive grove. The above-mentioned indices obtained from the laboratory samples and the pixels of the Sentinel-2 image were significantly (p < 0.01) correlated, with a correlation coefficient of around 0.4. The BI was related to the gypsum content and the slope of the plot. The FI was related to the carbon and water contents. The NDVI derived from the satellite image identified the influence of soil degradation on the trees and the carbon content. The spatial-temporal changes of the indices might help in tracking soil changes over timeThis research was funded by the Project ACCION, and is part of the Operative Group Lenosot, supported by the Rural Development Programme 2014 e 2020 of the Comunidad de Madrid Government (Spain). We thank the cooperation of the Finca La Chimenea staff and the work of undergraduate students from the Autonomous University of Madri

Comparison of CuO oxidation, analytical pyrolysis and IR spectroscopy to study the lignin signature in soil humic acids

2 pages, 1 figure, 4 references.-- Póster presentado al citado congreso en la Sesión II: Soil (S) Nº 496.-- Book of Abstracts of the Communications presented to the 26th International Meeting on Organic Geochemistry (IMOG), held in Costa Adeje, Tenerife – Spain, September 15 – 20, 2013.One of the most common methodologies in the study of lignins in soils is alkaline CuO oxidation [1]. This method allows quantification of the released lignin-derived phenols, however, it is time-consuming and requires previous derivatization before GC. In order to compare the information on lignin composition provided by current routine techniques used on soil humic acids (HA), this research compares molecular assemblages obtained from 16 HA samples by using either CuO degradation, or analytical pyrolysis (Py), as well as a nondestructive technique such as infrared (IR) spectroscopy.Peer reviewe

Nurse managers’ competencies: A scoping review

.Aim : To describe and synthesize scientific literature on nurse managers’ competencies. Background : The key strategy for the success of health organisations currently re-sides in the capacity of the nurse manager to develop advanced competencies in management. However, there is a lack of systematic reviews that synthesize knowl-edge about nurse managers’ competencies. Evaluation : A scoping review was conducted using electronic databases including Web of Science, Scopus, PubMed and Cumulative Index to Nursing and Allied Health Literature. Key issues : After the first analysis, 392 competencies were observed from 76 stud-ies. Finally, 53 competencies were grouped according to their characteristics. The two most- cited competencies were communication and finance. Conclusions : Knowing the competencies required by nurse managers can help or-ganisations create strategies to develop competent managers. In addition, from the results we can infer what might be the core competencies, since 22 main competen-cies from the total number were identified. Implications for Nursing Management : The competencies identified constitute the body of knowledge necessary for nurse managers. In addition, it is possible to gener-ate a pathway for learning and professional development for nurses before they work at the microlevel of management. The starting point for this pathway could be the 22 core competencies.S

Procesos sedimentarios y diagenéticos en el registro arqueológico del yacimiento pleistoceno de la Cueva de El Esquilleu (Picos de Europa, Norte de España)

La cueva de El Esquilleu (Cillórigo de Liébana, Cantabria, N de España) es un gran abrigo rocoso situado en la región de Picos de Europa (Cordillera Cantábrica) que contiene un importante registro sedimentario, arqueológico y paleontológico del Pleistoceno superior, con abundantes evidencias de industrias líticas musterienses y restos óseos de mamíferos y otros vertebrados. La secuencia estratigráfica se compone de 41 niveles agrupados en cuatro unidades litoestratigráficas con diferente significado sedimentario, que han sido estudiadas con metodología geoarqueológica y tafonómica. En la unidad inferior hemos detectado una acumulación de hidroxilapatito de origen diagenético, que hemos estudiado mediante difracción de rayos X (DRX), microscopía electronica de barrido ambiental (MEBA) y termoluminiscencia (TL). Las dataciones radiocarbónicas existentes y su calibración permiten situar este interesante registro durante el OIS 3 en una horquilla temporal comprendida aproximadamente entre 60000 y 37000 BP.El Esquilleu cave (Cillórigo de Liébana, Cantabria, North of Spain) is a rockshelter placed in the Picos de Europa region (Cantabrian Range) that contains an important sedimentary, archaeological and palaeontological record of the Upper Pleistocene (OIS 3) with abundant mousterian lithics industries and bone remains of mammals and others vertebrates. The stratigraphic sequence consists of 41 levels grouped in four litostratigraphic units with different sedimentary meaning studied by geoarchaeological and taphonomical methods. In the low unit we have detected important accumulations of hydroxylapatite of diagenetic origin, studied by X-ray diffraction (XRD), environmetal scanning electron microscopy (ESEM) and thermoluminescence (TL). The radiocarbon dates existing and their calibration allow approximately locate this interesting record during OIS 3 in a temporary bracket between 60000 and 37000 BP

A road to nowhere? The non-transitional sequence at El Esquilleu (Cantabria, Spain)

El Esquilleu cave has one of the most complete Middle Paleolithic stratigraphies of northern Iberia with a complete chronological framework almost continuous from the beginning of MIS3. The complete analysis of the materials including the last section of the sequence corresponding to the last chronological interval of the occupation in the region shows clear evolutionary tendencies by important changes in the composition of the lithic assemblage. Its study confirms a continuous occupation without any gaps during the Mousterian until recent dates but without any Upper Paleolithic presence. This sequence, referenced to the Mousterian settlement of the Picos de Europa mountains, testifies to the existence of a Mousterian presence in northern Iberia with no clear relation to other Cantabrian areas. Consequently, its occupation without a break until the crucial phase of the end of the Middle Paleolithic suggests a non-transitional process in the history of local Neanderthal groups

El análisis de las redes sociales. Un método para la mejora de la seguridad en las organizaciones sanitarias

P. 209-219La seguridad del paciente depende de la cultura de la organización sanitaria y de las relaciones que los profesionales mantienen entre sí. En este artí- culo se propone que el estudio de esas relaciones debería de llevarse a cabo desde una perspectiva de red y mediante una metodología denominada Análisis de Redes Sociales (ARS). Esta incluye un conjunto de constructos matemáticos fundamentados en la Teoría de grafos. Con el ARS podemos conocer aspectos relacionados con la posición del individuo en la red (centralidad) o la cohesión entre los miembros de un equipo. De esta forma se pueden conocer aspectos tan relacionados con la seguridad como por ejemplo saber qué tipo de vínculos pueden aumentar el compromiso entre los profesionales, cómo se construyen, qué nodos tienen más prestigio en el equipo en cuanto a generar confianza o una red colaborativa, qué profesionales sirven de intermediarios entre los subgrupos de un equipo para transmitir información o suavizar conflictos, etcétera, todos ellos aspectos útiles para establecer una cultura de seguridad. El ARS permitiría analizar las relaciones de los profesionales, su nivel de comunicación para manifestar los errores y pedir ayuda de forma espontánea y la coordinación existente entre departamentos para participar en proyectos que mejoren la seguridad. De esta forma, se relacionan en red utilizando un mismo lenguaje, hecho que ayuda a construir una cultura. En conclusión, se propone un abordaje de la cultura de seguridad desde una perspectiva de ARS que complementaría otros métodos habitualmente utilizados.S

Prevalencia, incidencia y factores de riesgo de los trastornos de la conducta alimentaria en la Comunidad de Cantabria.

RESUMEN: Los trastornos de la conducta alimentaria (TCA) se manifiestan como una alteración en la salud mental, que se asocia a un patrón irregular en la ingesta de alimentos con el consecuente deterioro de la salud física y psicológica. En los últimos años estas patologías han suscitados gran interés social debido en parte al número creciente de pacientes y a la población afectada, en su mayoría mujeres jóvenes. Por otro lado, desde el punto de vista médico se consideran trastornos que implican una importante morbilidad física y psicosocial, cuyas complicaciones clínicas conllevan una elevada tasa de cronicidad. El origen de estas enfermedades no está claramente elucidado y se consideran el resultado de la interacción de múltiples factores. La identificación de estos marcadores de riesgo ha permitido desarrollar programas de detección e intervención precoz mejorando los resultados terapéuticos y minimizando los costes personales y sanitarios. En este artículo se revisan los estudios realizados hasta la fecha en distintas localizaciones del mundo y en concreto en la Comunidad Autónoma de Cantabria, con el objetivo de conocer las cifras de prevalencia e incidencia que realmente esconden estas patologías y los factores de riesgo implicados en su desarrollo.ABSTRACT: Eating disorders manifest as a disturbance of the mental health associated with an irregular pattern in food intake, with a detriment in physic and psychological health as consequence. In the latest years, these pathologies have aroused growing interest in the society because of the increasing incidence and the subtype affected population, young women mostly. On the other hand, from the medical point of view eating disorders are considered disturbances that imply a significant physic and psychosocial morbidity, and whose clinical complications lead to a high chronicity rate. The etiology of these diseases is not clear, and is considered as multifactorial. The detection of risk markers has allowed the development of early identification and treatment programs, improving therapeutic outcomes and personal and healthcare costs. This article reviews the studies carried out among the world, specifically in the Spanish autonomous community of Cantabria. The aim is to know the actually hidden incidence and prevalence of these disorders and the risk factors that are implied in their development

An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition

[ENG]Importance Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. OBJECTIVE To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. DESIGN, SETTING, AND PARTICIPANTS The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. INTERVENTION Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. MAIN OUTCOMES AND MEASURES The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). RESULTS A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, −0.94% [95% CI, −1.19 to −0.69]; 3 years, −0.38% [95% CI, −0.64 to −0.12] and visceral fat storage after 1 year, -126 g [95% CI, −179 to −73.3 g]; 3 years, −70.4 g [95% CI, −126 to −15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95%CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. CONCLUSIONS AND RELEVANCE The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points.S