Designing an ongoing nursing quality management control framework

OBJETIVOS: Uno de los sistemas básicos de trabajo en evaluación y mejora de la calidad asistencial lo constituyen los sistemas de monitorización de la misma, mediante el uso de indicadores de calidad. Sin embargo, los sistemas de mejora o cuadros de mando no informatizados no permiten monitorizar de forma continua las actuaciones de enfermería, sólo de forma puntual o sincrónica. Por ello, el proyecto que se plantea pretende crear un sistema de monitorización CONTINUO de la calidad en la atención de Enfermería, diseñando, definiendo e implementando indicadores adaptados a través de la fórmula matemática al programa informático Green Cube, programa de historia clínica única informatizada del usuario de Clínica Vistahermosa. El proyecto en sí se ha incluido como objetivo de calidad del centro para el año 2014. A través de ellos se identificarán situaciones de mejora potencial o bien desviaciones de la práctica estandarizada con la finalidad de mejorar la calidad en la atención de Enfermería

Ghrelin and Cannabinoid Functional Interactions Mediated by Ghrelin/CB1 Receptor Heteromers That Are Upregulated in the Striatum From Offspring of Mice Under a High-Fat Diet

We have here assessed, using Δ9-tetrahydrocannabinol (Δ9-THC) for comparison, the effect of Δ9-tetrahydrocannabinolic acid (Δ9-THCA) and of Δ9-tetrahydrocannabivarin (Δ9-THCV) that is mediated by human versions of CB1, CB2, and CB1-CB2 receptor functional units, expressed in a heterologous system. Binding to the CB1 and CB2 receptors was addressed in living cells by means of a homogeneous assay. A biphasic competition curve for the binding to the CB2 receptor, was obtained for Δ9-THCV in cells expressing the two receptors. Signaling studies included cAMP level determination, activation of the mitogen-activated protein kinase pathway and ß-arrestin recruitment were performed. The signaling triggered by Δ9-THCA and Δ9-THCV via individual receptors or receptor heteromers disclosed differential bias, i.e. the bias observed using a given phytocannabinoid depended on the receptor (CB1, CB2 or CB1-CB2) and on the compound used as reference to calculate the bias factor (Δ9-THC, a selective agonist or a non-selective agonist). These results are consistent with different binding modes leading to differential functional selectivity depending on the agonist structure, and the state (monomeric or heteromeric) of the cannabinoid receptor. In addition, on studying Gi-coupling we showed that Δ9-THCV and Δ9-THCA and Δ9-THCV were able to revert the effect of a selective CB2 receptor agonist, but only Δ9-THCV, and not Δ9-THCA, reverted the effect of arachidonyl-2'-chloroethylamide (ACEA 100 nM) a selective agonist of the CB1 receptor. Overall, these results indicate that cannabinoids may have a variety of binding modes that results in qualitatively different effects depending on the signaling pathway that is engaged upon cannabinoid receptor activation

Estudio normativo del test de inteligencia no verbal Toni 2 en una muestra de escolares de 5 y 6 años de la provincia de Santiago, Chile

73 p.A continuación, se presenta un resumen del trabajo desarrollado en esta investigación, el proceso de creación de normas locales del Test de Inteligencia No Verbal, segunda edición, TONI 2. El estudio se inicia con una introducción al tema donde se plantea la justificación de la investigación; posteriormente continúa con el marco teórico que la sustenta, el que se centra fundamentalmente en el desarrollo del concepto de inteligencia y su relación con las variables demográficas analizadas en esta investigación. Se aborda además el tema de la medición de habilidades intelectuales, el concepto de inteligencia no verbal, las características más relevantes de los tests de inteligencia no verbal, la presentación del TONI 2, incluyendo un análisis de sus tareas y bases teóricas así como el aporte de datos de validez y confiabilidad del instrumento. Posteriormente, se realiza un paralelo comparativo entre el TONI y otros instrumentos de evaluación no verbal y se plantea el problema que motiva esta investigación. Luego, se definen los objetivos del trabajo y se desarrollan los aspectos metodológicos del mismo, con la descripción de los procedimientos de muestreo y aplicación del instrumento, así como el análisis de los datos y los estadígrafos usados. Finalmente, se presentan las conclusiones, los comentarios y las proyecciones del estudio./ABSTRACT: The aim of this work was to study the psychometric properties of the Test of Non Verbal Intelligence (TONI). First, an introduction to the topic of this project is included. The theoretical underpinnings of the projects are discussed next. The theoretical review includes a revision of the concept of intelligence and its relation to the variables of the study. Other related topics are discussed, including the assessment of intellectual abilities, the concept of non verbal intelligence, and the properties of test for the assessment of non verbal intelligence. Next, the TONI is described extensively. A comparison between the TONI and other test of non verbal intelligence is also included. The proposal of the study is included following the previous review, as well as the aims of the work. According to data, the TONI is a valid and reliable test that can be used confidently in our country. However, some caution is needed because the sample included in the study is restricted to the metropolitan area of Chile

Transforming the Future Healthcare Workforce across Europe through Improvement Science Training: A Qualitative Approach

Healthcare improvement science (HIS) is the generation of knowledge to cultivate change towards improving health systems performance. Our purpose was to evaluate the experience of European nursing students after an intensive one-week summer program conducted in 2019 at the University of Alicante in Spain. The educational intervention combined theoretical and practical HIS contents, with students from different countries, educational programs, and health systems. The intervention was evaluated under a qualitative approach through the open discussion group technique based on the method of participatory action research (PAR), with a total of 25 students who reflected about their experiences and perceptions during the intervention. The responses were used to improve the program’s contents, its didactics, and organization. Nursing empowerment, professional recognition, and healthcare research were some of the seven main categories identified through the systematic content analysis method triangulated by three experienced researchers. According to the students’ replies, values like compassion, respect, or empathy were identified as key elements of care. Promoting international students’ networking emerged as the key to creating a positive provision for change and the generation of improvement initiatives. Building a HIS culture may potentially provide future healthcare professionals with critical thinking skills and the resources needed to improve their future work settings.The research was financed by the European Union-funded ERASMUS Lifelong Learning Project, ISTEW: Improvement Science Training for European Healthcare Workers (Project No. 539194-LLP-1-2013-1-UK-ERASMUS-EQR)

Can empathy affect the attribution of mental states to robots?

This paper presents an experimental study showing that the humanoid robot NAO, in a condition already validated with regards to its capacity to trigger situational empathy in humans, is able to stimulate the attribution of mental states towards itself. Indeed, results show that participants not only experienced empathy towards NAO, when the robot was afraid of losing its memory due to a malfunction, but they also attributed higher scores to the robot emotional intelligence in the Attribution of Mental State Questionnaire, in comparison with the users in the control condition. This result suggests a possible correlation between empathy toward the robot and humans' attribution of mental states to it

Histomorphometric analysis of osseointegrated grade V titanium mini transitional implants inEdentulous mandible by backscattered scanning electron microscopy (BS-SEM)

The purpose of this study is to assess the use of grade V titanium mini transitional implants(MTIs) immediately loaded by a temporary overdenture. For this, a histomorphometric analysisof the bone area fraction occupancy (BAFO) was performed by backscattered scanning electronmicroscopy (BS-SEM). Four female patients were submitted to surgery in which two MTIs wereinstalled and immediately loaded with a temporary acrylic prosthesis. During the same surgery,two regular diameter implants were placed inside the bone and maintained without mechanical load.After 8 months, the MTIs were extracted using a trephine and processed for ultrastructural boneanalysis by BS-SEM, and the regular-diameter implants were loaded with an overdenture device.A total of 243 BAFOs of MTIs were analyzed, of which 94 were mainly filled with cortical bone,while 149 were mainly filled with trabecular bone. Bone tissue analysis considering the total BAFOswith calcified tissues showed 72.13% lamellar bone, 26.04% woven bone, and 1.82% chondroid bonewithout significant differences between the samples. This study revealed that grade V titanium usedin immediately loaded MTI was successfully osseointegrated by a mature and vascularized bonetissue as assessed from the BAFO

Immediate small-diameter implants as abutments for an overdenture in the edentulous atrophic mandible: report of immersion endoscopic bone in vivo, and histologic bone-implant evaluation after 6 months of function

The aim of this report was to endoscopically evaluate bone quality in vivo in the immediate installation of temporary small-diameter implants, and again after 6 months of function, through an attachments system for overdenture, in the atrophic mandible of a patient. We also histologically evaluated bone-implant interaction in these temporary small-diameter implants, once the success of the osseointegration of the submerged implants was guaranteed. A patient received a total of 6 implants in the atrophic mandible, two of which were immediately loaded with a provisional prosthesis, and four were left to heal in a submerged way. Further, an immersion endoscopic evaluation was performed during bone drilling, and this showed a compact bone structure with limited vascularization and predominantly cortical structure.This immediate loading protocol involving an overdenture retained by two small-diameter implants of 2.9 mm in the atrophic mandible proved to be successful after 6 months of loading. Clinical and histologic osseointegration was consistently achieved for both of the retrieved immediately loaded implants. This modality allows the patient to be restored with a stable, functional, and aesthetic prosthesis during the osseointegration period of submerged implants and soft-tissue healing, before the removal of the provisional implants. The histological evaluation of bone-implant contact found that the space between the implant threads closer to the surface was filled with woven bone and lamellar bone, but the tissue in contact with the cervical portion of the implants was compatible with cortical bone organization. Also, the newly formed bone has a regular cell distribution and characteristics of advanced maturation after 6 months of function in the atrophic mandible. Anchored overdentures in 2 to 4 small-diameter implants (2.9 mm) for edentulous patients with severe atrophy of the mandible with cortical bone would be a minimally invasive alternative

Phenomenological Approach to the Meaning and Impact of Organ Donation in the Family

La donación de órganos es un acontecimiento crítico tras la pérdida de un ser querido. España, a pesar de ser el país del mundo con mayor tasa de donantes, todavía mantiene una negativa familiar del 15,56%. Objetivos: conocer y analizar el impacto de la donación de órganos a través de los significados que tiene para la familia en el contexto español. Materiales y método: estudio cualitativo fenomenológico según el marco conceptual y método de Giorgi. Luego de respetar, al menos, tres años de duelo desde la pérdida de un ser querido, se entrevistaron en profundidad a once familias que donaron órganos en el Hospital La Fe en Valencia. Resultados: tras el análisis de los resultados, se describieron veintisiete unidades de significado que fueron clasificadas en relativos a la pérdida y relativos a la donación de órganos y, posteriormente, correlacionadas. Conclusiones: la donación aparece como mecanismo de alivio o compensación del fallecimiento del familiar.Organ donation is a critical event after the loss of a loved one. Spain, despite being the country with the highest donor rate in the world, still maintains a family negative rate of 15.56%. Objective: Know and analyze the impact of organ donation based on its meaning for the family in the Spanish context. Materials and method: This is a phenomenological qualitative study based on Giorgi's conceptual framework and method. Eleven families who had donated organs at the Hospital La Fe in Valencia were interviewed in depth, following at least three years of mourning since the loss of a loved one. Results: After the results were analyzed, twenty-seven units of meaning were described and classified as relative to the loss and relative to the organ donation. They were then correlated. Conclusion: Organ donation appears to be a relief mechanism or a kind of compensation for the death of a family member

A Geochemical and Geophysical Characterization of Sulfide Mine Ponds at the Iberian Pyrite Belt (Spain)

This work presents the results of a geochemical and geophysical characterization of the Monte Romero and La Naya mine ponds, belonging to the Cueva de la Mora and Riotinto mine districts, respectively, based on mineralogical, geochemical and geophysical techniques. In order to obtain a representative environmental characterization, two deposits showing different mineralogies, physico-chemical parameters, chemical compositions of tailings and pond conditions were selected. Monte Romero mine tailings showed an upper level mainly composed of silicates and a deeper level mainly composed of sulfides and barite. The toxic metal content was different in both levels but high enough to exceed the regional legal concentration limits for agricultural soils. An electrical resistivity tomography survey revealed a homogeneous upper unit (3 m thickness), which displayed low resistivity values, corresponding to water-saturated silt and clay materials with an abundance of sulfides which was interpreted as the pond infilling. The La Naya mine pond presented a homogeneous mineralogical composition made up of quartz as the main mineral and chlorite-smectite and jarosite as accessory phases. The absence of sulfide phases and the low contents of metal elements are directly related to the reworking processes of the sludge dumped in this pond. The geophysical survey revealed that the pond infilling did not have a constant thickness, but ranged between 15 and 20 m. An inner groundwater flow in the infilling was recognized. The low resistivity values allowed the presence of acid waters and related subsurface flows to be identified in both mine ponds, but no acid water drainage occurred across their vessels. When compared to the Aznalcóllar tailings spill, the La Naya pond is large enough to release a similar amount of sludge, but of a very low metal content. The Monte Romero sludge displays a similar, potentially toxic metal content to the Aznalcóllar sludge, but its size is significantly smaller

A Geochemical and Geophysical Characterization of Sulfide Mine Ponds at the Iberian Pyrite Belt (Spain)

(The original publication is available at www.springerlink.com)This work presents the results of a geochemical and geophysical characterization of the Monte Romero and La Naya mine ponds, belonging to the Cueva de la Mora and Riotinto mine districts, respectively, based on mineralogical, geochemical and geophysical techniques. In order to obtain a representative environmental characterization, two deposits showing different mineralogies, physico-chemical parameters, chemical compositions of tailings and pond conditions were selected. Monte Romero mine tailings showed an upper level mainly composed of silicates and a deeper level mainly composed of sulfides and barite. The toxic metal content was different in both levels but high enough to exceed the regional legal concentration limits for agricultural soils. An electrical resistivity tomography survey revealed a homogeneous upper unit (3 m thickness), which displayed low resistivity values, corresponding to water-saturated silt and clay materials with an abundance of sulfides which was interpreted as the pond infilling. The La Naya mine pond presented a homogeneous mineralogical composition made up of quartz as the main mineral and chlorite-smectite and jarosite as accessory phases. The absence of sulfide phases and the low contents of metal elements are directly related to the reworking processes of the sludge dumped in this pond. The geophysical survey revealed that the pond infilling did not have a constant thickness, but ranged between 15 and 20 m. An inner groundwater flow in the infilling was recognized. The low resistivity values allowed the presence of acid waters and related subsurface flows to be identified in both mine ponds, but no acid water drainage occurred across their vessels. When compared to the Aznalcóllar tailings spill, the La Naya pond is large enough to release a similar amount of sludge, but of a very low metal content. The Monte Romero sludge displays a similar, potentially toxic metal content to the Aznalcóllar sludge, but its size is significantly smaller.Depto. de Mineralogía y PetrologíaFac. de Ciencias GeológicasTRUEpu