Barriers and Facilitators of Communication in the Medication Reconciliation Process during Hospital Discharge: Primary Healthcare Professionals’ Perspectives

The WHO established that medication errors are the most common and preventable errors and represent an expenditure of 42 billion U.S. dollars annually. The risk of medication errors increases in transitions between levels of care, mainly from hospital care to primary healthcare after hospital discharge. In this context, communication is a key element in the safety of the medication reconciliation process. The aim of this paper was to describe the barriers to, and facilitators of, effective communication during the medication reconciliation process at hospital discharge in people over 65 years of age, from the perspective of primary healthcare professionals. A qualitative descriptive study was designed, and in-depth interviews were conducted with 21 individuals, of whom 13 were nurses and 8 were physicians. This study was carried out with healthcare professionals belonging to primary healthcare centres in Huelva (Spain). Following content analysis of the discourses we identified 19 categories, grouped into three areas: interlevel communication, communication between primary healthcare professionals, and communication between healthcare professionals and patients/caregivers. The barriers found mainly relate to the adequacy and use of technological tools, time available, workload and the level of collaboration of patients/caregivers. Facilitating elements for communication in medication reconciliation included technologies, such as computerized medical history, protocolization of clinical sessions, the presence of case management nurse and interdisciplinary teamwork

Communication on Safe Caregiving between Community Nurse Case Managers and Family Caregivers

Dependent elderly individuals are usually cared for at home by untrained family members who are unaware of the risks involved. In this setting, communication on safe caregiving is key. The aim of this study is to describe the factors influencing the process followed by community nurse case managers to provide communication on safe caregiving to family members caring for dependent elderly individuals. A phenomenological study, by focus group, was done in urban healthcare facilities. Key informants were seven community nurses, case managers with more than 12 years’ experience. We did a thematic analysis and we identified the units of meaning to which the most relevant discourses were assigned. The concepts expressed were grouped until subcategories were formed, which were then condensed into categories. Four categories of analysis emerged: communication-related aspects; professional skills of nurse case managers; communication on safety and the caregiving role. To planner interventions, for the prevention of adverse events at home, is essential to consider these aspects: nurses’ professional communication skills, factors inherent to safe caregiving, the characteristics of the home where care is provided, the personal and family circumstances of the caregiver, and whether or not the caregiver’s role has been assumed by the family caregivers

Microstructure, interfaces and properties of 3YTZP ceramic composites with 10 and 20 vol% different graphene-based nanostructures as fillers

The graphene family comprises not only single layer graphene but also graphene-based nanomaterials (GBN), with remarkably different number of layers, lateral dimension and price. In this work, two of these GBN, namely graphene nanoplatelets (GNP) with n~15–30 layers and few-layer graphene (FLG) with n < 3 layers have been evaluated as fillers in 3¿mol% yttria stabilized tetragonal zirconia (3YTZP) ceramic composites. Composites with 10 and 20¿vol% GNP or FLG have been fabricated by wet powder processing and spark plasma sintering (SPS) and the influence of the content and number of layers of the graphene-based filler has been assessed. For both graphene-based fillers, an intermediate zirconia oxycarbide has been detected in the grain boundaries. The lower stacking degree and much more homogeneous distribution of the FLG, revealed by transmission electron microscopy (TEM), can improve load transfer between the GBNs and the ceramic matrix. However, high FLG contents lower densification of the composites, due partly to the larger FLG interplanar spacing also estimated by TEM. The hardness (both Vickers and nanoindentation) and the elastic modulus decrease with increased GBN content and with improved graphene dispersion. The FLG greatly inhibit the crack propagation that occur perpendicular to their preferential orientation plane. The composites with thinner FLG have higher electrical conductivity than those with GNP. The highest electrical conductivity is achieved by composites with 20¿vol% FLG in the direction perpendicular to the compression axis during sintering, s¿¿=¿3400¿±¿500¿Sm-1.Peer ReviewedPostprint (published version

Reemplazo de coronas metal-cerámica por cerámicas libres de metal. Revisión sistemática de la literatura

56 p.La opción rehabilitadora clásica para restaurar dientes que han sufrido pérdida estructural son las coronas dentales, las que restituyen la función del diente, devolviendo su anatomía y estructura. Por esto, los materiales utilizados para fabricar estas prótesis fijas deben otorgar propiedades biomecánicas que garanticen su éxito clínico y supervivencia. Actualmente, gran parte de los tratamientos rehabilitadores realizados en odontología son en base a restauraciones estéticas libres de metal, sin embargo, las restauraciones metal-cerámica (MC) siguen siendo el gold standard. Es por ello que la presente RSL busca determinar si las propiedades biomecánicas evaluadas in vitro de las coronas libres de metal son comparables con las coronas MC, posibilitando una indicación con fundamentos y la selección apropiada según el caso. Se examinaron tres bases de datos: PubMed, Scopus y Web of Science, utilizando criterios de búsqueda predefinidos: P: Estudios in vitro que evaluaron coronas como restauración, I: Estudios donde la intervención fueran coronas cerámicas libres de metal realizadas con distintos materiales cerámicos, C: Coronas metal-cerámica y O: propiedades biomecánicas. Realizamos la selección de artículos y la extracción de datos en duplicado e independientemente. El proceso fue predefinido y piloteado por lineamientos PRISMA. Según la evidencia in vitro, encontramos que los sistemas cerámicos libres de metal mostraron propiedades biomecánicas comparables a los sistemas MC, por lo tanto, las coronas MC sí son comparables con las coronas cerámicas libres de metal, para que sean utilizados, ya sea como núcleo, revestimiento o coronas monolíticas en dientes anteriores y posteriores

Microstructure, interfaces and properties of 3YTZP ceramic composites with 10 and 20 vol% different graphene-based nanostructures as fillers

The graphene family comprises not only single layer graphene but also graphene-based nanomaterials (GBN), with remarkably different number of layers, lateral dimension and price. In this work, two of these GBN, namely graphene nanoplatelets (GNP) with n∼15–30 layers and few-layer graphene (FLG) with n < 3 layers have been evaluated as fillers in 3 mol% yttria stabilized tetragonal zirconia (3YTZP) ceramic composites. Composites with 10 and 20 vol% GNP or FLG have been fabricated by wet powder processing and spark plasma sintering (SPS) and the influence of the content and number of layers of the graphene-based filler has been assessed. For both graphene-based fillers, an intermediate zirconia oxycarbide has been detected in the grain boundaries. The lower stacking degree and much more homogeneous distribution of the FLG, revealed by transmission electron microscopy (TEM), can improve load transfer between the GBNs and the ceramic matrix. However, high FLG contents lower densification of the composites, due partly to the larger FLG interplanar spacing also estimated by TEM. The hardness (both Vickers and nanoindentation) and the elastic modulus decrease with increased GBN content and with improved graphene dispersion. The FLG greatly inhibit the crack propagation that occur perpendicular to their preferential orientation plane. The composites with thinner FLG have higher electrical conductivity than those with GNP. The highest electrical conductivity is achieved by composites with 20 vol% FLG in the direction perpendicular to the compression axis during sintering, σ⊥ = 3400 ± 500 Sm-1.Ministerio de Economía y Competitividad MAT2015-67889-

Solid lubricant behavior of MoS2 and WSe2-based nanocomposite coatings

Tribological coatings made of MoS2 and WSe2 phases and their corresponding combinations with tungsten carbide (WC) were prepared by non-reactive magnetron sputtering of individual targets of similar composition. A comparative tribological analysis of these multiphase coatings was done in both ambient air (30–40% relative humidity, RH) and dry nitrogen (RH<7%) environments using the same tribometer and testing conditions. A nanostructural study using advanced transmission electron microscopy of the initial coatings and examination of the counterfaces after the friction test using different analytical tools helped to elucidate what governs the tribological behavior for each type of environment. This allowed conclusions to be made about the influence of the coating microstructure and composition on the tribological response. The best performance obtained with a WSex film (specific wear rate of 2 × 10−8 mm3 N–1m–1 and a friction coefficient of 0.03–0.05) was compared with that of the well-established MoS2 lubricant material.The Spanish Ministry of Economy, Industry and Competitiveness [projects n° MAT2010-21597-C02-01, MAT2011-29074-C02-01; MAT2015-65539-P; MAT2015-69035-REDC], Junta de Andalucía [P10-TEP-67182] and Spanish National Research Council (CSIC) [201560E013] are acknowledged for their financial support

Plasma assisted deposition of single and multistacked TiO2 hierarchical nanotubes photoanodes

We present herein an evolved methodology for the growth of nanocrystalline hierarchical nanotubes combining physical vapor deposition of organic nanowires (ONWs) and plasma enhanced chemical vacuum deposition of anatase TiO2 layers. The ONWs act as vacuum removable 1D and 3D templates, with the whole process occurring at temperatures ranging from RT to 250 °C. As a result, a high density of hierarchical nanotubes with tunable diameter, length and tailored wall microstructures are formed on a variety of processable substrates as metal and metal oxide films or nanoparticles including transparent conductive oxides. The reiteration of the process leads to the development of an unprecedented 3D nanoarchitecture formed by stacking the layers of hierarchical TiO2 nanotubes. As a proof of concept, we present the superior performance of the 3D nanoarchitecture as a photoanode within an excitonic solar cell with efficiencies as high as 4.69% for a nominal thickness of the anatase layer below 2.75 ¿m. Mechanical stability and straightforward implementation in devices are demonstrated at the same time. The process is extendable to other functional oxides fabricated by plasma-assisted methods with readily available applications in energy harvesting and storage, catalysis and nanosensingJunta de Andalucia(FQM 1851 and FQM-2310)España Mineco 201560E055 MAT2016-79866-R MAT2013-40852-R MAT2013-4MAT2013-47192-C3-3-R2900-

Characterisation of Co@Fe3O4 core@shell nanoparticles using advanced electron microscopy

Cobalt nanoparticles were synthesised via the thermal decomposition of Co2(CO)8 and were coated in iron oxide using Fe(CO)5. While previous work focused on the subsequent thermal alloying of these nanoparticles, this study fully elucidates their composition and core@shell structure. State-of-the-art electron microscopy and statistical data processing enabled chemical mapping of individual particles through the acquisition of energy-filtered transmission electron microscopy (EFTEM) images and detailed electron energy loss spectroscopy (EELS) analysis. Multivariate statistical analysis (MSA) has been used to greatly improve the quality of elemental mapping data from core@shell nanoparticles. Results from a combination of spatially resolved microanalysis reveal the shell as Fe3O4 and show that the core is composed of oxidatively stable metallic Co. For the first time, a region of lower atom density between the particle core and shell has been observed and identified as a trapped carbon residue attributable to the organic capping agents present in the initial Co nanoparticle synthesis.Junta de Andalucía Feder PE2009-FQM-4554 TEP-217EU FP7 AL-NANOFUNC CT-REGPOT2011-1-28589

Patterning and control of the nanostructure in plasma thin films with acoustic waves: mechanical vs. electrical polarization effects

Nanostructuration and 2D patterning of thin films are common strategies to fabricate biomimetic surfaces and components for microfluidic, microelectronic or photonic applications. This work presents the fundamentals of a surface nanotechnology procedure for laterally tailoring the nanostructure and crystalline structure of thin films that are plasma deposited onto acoustically excited piezoelectric substrates. Using magnetron sputtering as plasma technique and TiO2 as case example, it is demonstrated that the deposited films depict a sub-millimetre 2D pattern that, characterized by large lateral differences in nanostructure, density (up to 50%), thickness, and physical properties between porous and dense zones, reproduces the wave features distribution of the generated acoustic waves (AW). Simulation modelling of the AW propagation and deposition experiments carried out without plasma and under alternative experimental conditions reveal that patterning is not driven by the collision of ad-species with mechanically excited lattice atoms of the substrate, but emerges from their interaction with plasma sheath ions locally accelerated by the AW-induced electrical polarization field developed at the substrate surface and growing film. The possibilities of the AW activation as a general approach for the tailored control of nanostructure, pattern size, and properties of thin films are demonstrated through the systematic variation of deposition conditions and the adjustment of AW operating parameters

Magnetic and microstructural analysis of palladium nanoparticles with different capping systems

Palladium nanoparticles capped with different protective systems in a size range between 1.2 and 2.4 nm have been obtained by varying the preparation chemical method. Magnetization curves for all the samples show hysteresis loops, evidencing a ferromagnetic or a permanent magnetism in the nanoparticles. The microstructure of the nanoparticles has been analyzed by x-ray absorption and transmission electron microscopy. The nature of the magnetic behavior found for all these Pd nanoparticles (NPs) is different depending on their sizes and structural features and is explained on the basis of two different suggested mechanisms. The particles protected by means of a surfactant (tetralkylammonium salts), present a ferromagnetic order related to the factors increasing the density of states just below the Fermi level. Whereas, when the nanoparticles are stabilized by covalent bonds with protective species (thiol derivatized alkane chains or surface oxidized Pd NPs), the increase of the 4d density of holes, localized by the bonded atoms (S or O), is giving rise to the observed ferromagneticlike behavio