192 research outputs found
Diferencias entre perfiles enfermeros: práctica avanzada, enfermería asistencial y gestión
Este capítulo aborda un tema clave sobre el que hay mucho debate en la
literatura relacionada con la Práctica Avanzada en Enfermería: los diferentes
perfiles enfermeros: práctica avanzada, enfermería asistencial y gestión.
Puede también considerarse de gran relevancia en España donde es ahora
cuando están emergiendo estos temas y con el desarrollo de los programas
de posgrado, comienza a verse la necesidad de desarrollar una enfermería
con una visión más avanzada y con unos atributos que proporcionen las
herramientas para poder cambiar y mejorar la práctica desde la investigación
y la enfermería basada en la evidencia. El reto de diferenciar estos perfiles
enfermeros es difícil por el tipo de evidencia disponible que está relacionada
con el tema pero no lo aborda directamente.Por ello se presenta en este capítulo un análisis de contenido de la literatura
que ayudará a entender mejor las diferencias y las similitudes entre
estos perfiles y las posibles vías de colaboración entre ellos para potenciar
al máximo la disciplina enfermera
Ultrashort pulsed laser conditioning of human enamel: in vitro study of the influence of geometrical processing parameters on shear bond strength of orthodontic brackets
[Abstract] The surfaces of 63 extracted premolar teeth were processed with intense ultrashort laser pulses (λ = 795 nm; pulse duration, 120 fs; repetition rate, 1 kHz) to produce cross patterns with different pitches (s) in the micrometer range in order to evaluate the influence of such microstructures on the shear bond strengths of orthodontic brackets to enamel. The samples were classified in nine groups corresponding to the control group (raw samples) and eight different laser-processed groups (cross patterns with s increasing from 15 to 180 μm). Brackets were luted with TransbondTM XT adhesive resin to all the samples; after 72 h, they all were submitted to strength test in a universal testing machine. Additionally, a third of the samples underwent morphological analysis of the debonded surface by means of scanning electron microscope microscopy and an analysis of the failure mode based on the adhesive remnant index. The results showed that enamel microstructuring with ultrashort laser pulses remarkably increase the bond strength of brackets. Dense cross patterns (s 90 μm) give rise to smaller improvements of the bond strength. A strong correlation of this behavior with the predominant failure mode in both scenarios was found. So far, the best compromise between suitable adhesive efficiency, processing time minimization, and enamel surface preservation suggests the performance of cross patterns with pitches in the order of 90 μm.Ministerio de Economía y Competitividad; CSD2007-00013Ministerio de Economía y Competitividad; FIS2009-0952Castilla y León. Junta; SA086A12-
El automanejo de los pacientes con diabetes tipo 2: una revisión narrativa
Según la Organización Mundial de la Salud para el
año 2030 la cifra de personas con diabetes mellitus alcanzará valores cercanos a 366 millones en el mundo,
ocupando su mayor proporción la diabetes mellitus tipo
2. Las estrategias actuales de Cronicidad y de la Diabetes
presentes en España abogan por un adecuado automanejo del paciente por medio de programas y/o intervenciones apropiadas para ello. Sin embargo, existen unos
conocimientos y actitudes inadecuadas que limitan la
asociación paciente-profesional que las estrategias de automanejo implican. A través de esta revisión bibliográfica
se pretende mostrar las necesidades reales no cubiertas
que los pacientes con diabetes mellitus tipo 2 tienen a la
hora de automanejar la enfermedad. Así, se asentarán las
bases para el desarrollo de futuros programas efectivos
que se implementen ayudando al profesional sanitario
a dirigir su trabajo diario hacía su principal objetivo, la
persona con diabetes mellitus tipo 2 y sus necesidades.According to the World Health Organization in
2030 the number of people with diabetes mellitus
will reach 366 millions in the whole world, having the
diabetes mellitus type 2 the highest prevalence. The
current National Chronicity and Diabetes Strategies
advocate patients’ selfmanagement programmes and /
or interventions. Nevertheless, the lack of knowledge
and inadequate attitudes hinder the associative relationship between patients and professionals that is
required in these programmes. This literature review
aims to show the outstanding needs that type 2 diabetes mellitus patients have when it comes to managing
the illness. Thus, results from this literature review
could set the bases for the development of future
effective programmes, helping professionals approach
patients’ needs
A pilot study on the Spanish version of the Psychosocial Adjustment to Illness Scale (PAIS‐SR) with carers of people with Parkinson's disease
Aim: To report the cross-cultural adaptation and pilot study of the ongoing validation of the Spanish version of the Psychosocial Adjustment to Illness Scale with carers of people with Parkinson's disease.
Design: Cross-cultural adaptation and pilot study with a cross-sectional validation design of the Spanish version of the Psychosocial Adjustment to Illness Scale - Carers.
Methods: Twenty-one carers of people with Parkinson's disease from a Primary Care practice in Spain were recruited and completed the PAIS-Carers, the SF-36 Health Survey, the Brief COPE Inventory and an assessment form. SPSS 23.0 was used to determine viability/acceptability and preliminary aspects of internal consistency of the instrument.
Results: Five of the seven domains presented floor effect (71.42%), and only one presented ceiling effect (14.28%). The internal consistency of the scale and domains showed acceptable values (over 0.7). The content validity of the Spanish version seemed satisfactory with positive comments in general from participants
Identification and validation of common molecular targets of hydroxytyrosol
Hydroxytyrosol (HT) is involved in healthful activities and is beneficial to lipid metabolism. Many investigations focused on finding tissue-specific targets of HT through the use of different omics approaches such as transcriptomics and proteomics. However, it is not clear which (if any) of the potential molecular targets of HT reported in different studies are concurrently affected in various tissues. Following the bioinformatic analyses of publicly available data from a selection of in vivo studies involving HT-supplementation, we selected differentially expressed lipid metabolism-related genes and proteins common to more than one study, for validation in rodent liver samples from the entire selection. Four miRNAs (miR-802-5p, miR-423-3p, miR-30a-5p, and miR-146b-5p) responded to HT supplementation. Of note, miR-802-5p was commonly regulated in the liver and intestine. Our premise was that, in an organ crucial for lipid metabolism such as the liver, consistent modulation should be found for a specific target of HT even if different doses and duration of HT supplementation were used in vivo. Even though our results show inconsistency regarding differentially expressed lipid metabolism-related genes and proteins across studies, we found Fgf21 and Rora as potential novel targets of HT. Omics approaches should be fine-tuned to better exploit the available databases
Voluntary and community groups and health professionals contribution to selfmanagement and wellbeing
Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol
Background: Parkinson’s disease progressively limits patients at different levels and as a result family members play
a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the
difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a
multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment
to Parkinson’s disease and the quality of life in patients and family carers in a Primary Care setting.
Methods: This quasi-experimental study with control group and mixed methods was designed to evaluate a
multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with
Parkinson’s disease and 100 family carers will be recruited and assigned to two groups. The intervention group will
receive the ReNACE psychoeducational intervention. The control group will be given a general educational
programme. The study will be carried out in six community-based health centres. The results obtained from the
two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and
at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the
Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some
patients and family carers who will have received the ReNACE psychoeducational intervention and also with the
healthcare professionals involved in its development.
Discussion: An important gap exists in the knowledge and application of interventions with a psychosocial
approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in
Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for
patients and family carers, and also in other long-term conditions
Elementos clave en el proceso de convivencia con la enfermedad de Parkinson de pacientes y familiares cuidadores
Fundamento. La enfermedad de Parkinson produce un impacto considerable en la vida de las personas. Es necesario
identificar los elementos clave que influyen en el proceso de
convivencia con la enfermedad de Parkinson para que los profesionales de la salud puedan ayudar a los pacientes y sus familias a convivir lo mejor posible con los cambios y limitaciones
producidos por la enfermedad.
Material y método. Se llevó a cabo un estudio cualitativo
descriptivo. Este estudio se corresponde con la primera fase
de un diseño exploratorio secuencial (Mixed-methods) que
incluye a su vez una fase cuantitativa. Se realizó un proyecto
multicéntrico. Para la recogida de datos se aplicó un muestreo
de conveniencia y se utilizó una entrevista semi-estructurada
realizada individualmente a pacientes y familiares cuidadores
y dos cuestionarios para pacientes: la Escala de Hoehn & Yahr
y el Cuestionario PDNMS. Se realizó un análisis de contenido de
las entrevistas y estadístico descriptivo de los cuestionarios.
Resultados. La muestra la constituyeron 46 participantes. Se
identificaron tres elementos clave en el proceso de convivencia
con la enfermedad de Parkinson: aceptación, adaptación y automanejo. Estos elementos condicionaron dos modos de convivencia con la enfermedad de Parkinson: una convivencia positiva, caracterizada por sentimientos de armonía, equilibrio,
y naturalidad; y una convivencia negativa caracterizada por
sentimientos de frustración, pérdida de control y autoestima.
Conclusiones. Es esencial que los profesionales de la salud
conozcan a fondo estos elementos, así como los factores que
los favorecen o dificultan. En la medida que se propicie la investigación en este ámbito y se identifiquen intervenciones
efectivas se mejorará la atención integral de la personas en
consonancia con las nuevas directrices para la cronicidad.Background. Parkinson’s disease has a considerable impact
on people’s lives. It is necessary to identify the key elements
that influence the process of living with Parkinson’s disease so
that health professionals can help patients and their relatives
to live as well as possible with the changes and limitations produced by the disease.
Material and methods. A qualitative descriptive study was realized. This study corresponded to the first phase of a sequential, exploratory design (mixed method) that in turn included a
quantitative phase. A multicentre project was carried out. Convenience sampling was applied to collect data, a semi-structured interview was realized individually with patients and carer-relatives and two questionnaires with patients: the Hoehn
& Yahr scale and the PDNMS questionnaire. Content analysis
of the interviews and a statistical description of the questionnaires were used.
Results. The sample was made up of 46 participants. Three
key elements were identified in the process of living with
Parkinson’s disease: acceptance, adaptation and self-management. These elements conditioned the modes of living
with Parkinson’s disease: positive living, characterized by
feelings of harmony, balance and naturalness; negative living
characterized be feelings of frustration, loss of control and
self-esteem.
Conclusions. It is essential for health professionals to have a
deep understanding of these elements, as well as of the factors
that favor or hinder them. To the extent that research in this
field progresses and effective interventions are identified, comprehensive patient care will be improved in consonance with
the new directives for chronicity
Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships
Background and objective: The spread of self-care holds the promise of containing chronic illness burden. Falling within the framework of a FP7 collaborative research project, this paper reports the views of key informants from six countries regarding who the main stakeholders are at different levels in the support system for self-care for patients with chronic illness (SSSC) and how they accomplish their role and collaborate.
Methods: 90 Interviews with purposefully selected key informants from Bulgaria, Greece, the Netherlands, Norway, Spain and United Kingdom were conducted. Interviews involved government and local authorities, politicians, academics, health professionals and private sector representatives. Interviewers followed an expert opinion-based guide. Analysis involved a cross-country examination with thematic analysis and framework method techniques.
Results
Key informants described the ideal SSSC as inclusive, interdependent and patient-centred. The following main stakeholders in SSSC were identified: patients, governments, health-care professionals, associations, private companies and the media. In the current SSSCs, collaboration among stakeholders within and across different levels was said to be lacking. Patients were seen as playing a passive subordinate role based on the following: their own attitudes; the paternalistic and medicalized attitudes of the health-care professionals; their misrepresentation by patient associations; and their exposure to the damaging influences of media and industries.
Conclusions
Making SSSC patient-centred constitutes the greatest challenge for European authorities. Strategies must be revised for promoting patient participation. They should undergo changes so as to promote industry and media social responsibility and patient association advocacy capacity
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