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)

Leverage, CEO Risk–Taking Incentives, and Bank Failure during the 2007–2010 Financial Crisis

Usual measures of the risk-taking incentives of bank CEOs do not capture the risk-shifting incentives that the exposure of a CEO’s wealth to his firm’s stock price (delta) creates in highly levered firms. We find evidence consistent with the importance of these incentives for bank CEOs: In a sample of large U.S. financial firms, a higher pre-crisis delta is associated with a significantly higher probability of failure during the 2007–2010 financial crisis in highly levered firms, but not in less levered firms

Microbiota and host determinants of behavioural phenotype in maternally separated mice

Early-life stress is a determinant of vulnerability to a variety of disorders that include dysfunction of the brain and gut. Here we exploit a model of early-life stress, maternal separation (MS) in mice, to investigate the role of the intestinal microbiota in the development of impaired gut function and altered behaviour later in life. Using germ-free and specific pathogen-free mice, we demonstrate that MS alters the hypothalamic-pituitary-adrenal axis and colonic cholinergic neural regulation in a microbiota-independent fashion. However, microbiota is required for the induction of anxiety-like behaviour and behavioural despair. Colonization of adult germ-free MS and control mice with the same microbiota produces distinct microbial profiles, which are associated with altered behaviour in MS, but not in control mice. These results indicate that MS-induced changes in host physiology lead to intestinal dysbiosis, which is a critical determinant of the abnormal behaviour that characterizes this model of early-life stress

A comparative study on the effect of different reactive compatibilizers on injection-molded pieces of bio-based high-density polyethylene/polylactide blends

This is the peer reviewed version of the following article: Quiles-Carrillo, L., Montanes, N., Jorda-Vilaplana, A., Balart, R. and Torres-Giner, S. (2019), A comparative study on the effect of different reactive compatibilizers on injection-molded pieces of bio-based high-density polyethylene/polylactide blends. J. Appl. Polym. Sci., 136, 47396, which has been published in final form at https://doi.org/10.1002/APP.47396. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.[EN] The present study reports on the development of binary blends consisting of bio-based high-density polyethylene (bio-HDPE) with polylactide (PLA), in the 5¿20 wt % range, prepared by melt compounding and then shaped into pieces by injection molding. In order to enhance the miscibility between the green polyolefin and the biopolyester, different reactive compatibilizers were added during the melt-blending process, namely polyethylene grafted maleic anhydride (PE-g-MA), poly(ethylene-co-glycidyl methacrylate) (PE-co-GMA), maleinized linseed oil (MLO), and a combination of MLO with dicumyl peroxide (DCP). Among the tested compatibilizers, the dual addition of MLO and DCP provided the binary blend pieces with the most balanced mechanical performance in terms of rigidity and impact strength as well as the highest thermal stability. The fracture surface of the binary blend piece processed with MLO and DCP revealed the formation of a continuous structure in which the dispersed PLA phase was nearly no discerned in the bio-HDPE matrix. The resultant miscibility improvement was ascribed to both the high solubility and plasticizing effect of MLO on the PLA phase as well as the crosslinking effect of DCP on both biopolymers. The latter effect was particularly related to the formation of macroradicals of each biopolymer that, thereafter, led to the in situ formation of bio HDPE-co-PLA copolymers and also to the development of a partially crosslinked network in the binary blend. As a result, cost-effective and fully bio-based polymer pieces with improved mechanical strength, high toughness, and enhanced thermal resistance were obtained.This research was funded by the EU H2020 project YPACK (reference number 773872) and by the Ministry of Science, Innovation, and Universities (MICIU, project numbers MAT2017-84909-C2-2-R and AGL2015-63855-C2-1-R). Quiles-Carrillo and Torres-Giner are recipients of a FPU grant (FPU15/03812) from the Spanish Ministry of Education, Culture, and Sports (MECD) and a Juan de la Cierva contract (IJCI-2016-29675) from the MICIU, respectively.Quiles-Carrillo, L.; Montanes, N.; Jorda-Vilaplana, A.; Balart, R.; Torres-Giner, S. (2019). 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Predicting haplogroups using a versatile machine learning program (PredYMaLe) on a new mutationally balanced 32 Y-STR multiplex (CombYplex): Unlocking the full potential of the human STR mutation rate spectrum to estimate forensic parameters

We developed a new mutationally well-balanced 32 Y-STR multiplex (CombYplex) together with a machine learning (ML) program PredYMaLe to assess the impact of STR mutability on haplogourp prediction, while respecting forensic community criteria (high DC/HD). We designed CombYplex around two sub-panels M1 and M2 characterized by average and high-mutation STR panels. Using these two sub-panels, we tested how our program PredYmale reacts to mutability when considering basal branches and, moving down, terminal branches. We tested first the discrimination capacity of CombYplex on 996 human samples using various forensic and statistical parameters and showed that its resolution is sufficient to separate haplogroup classes. In parallel, PredYMaLe was designed and used to test whether a ML approach can predict haplogroup classes from Y-STR profiles. Applied to our kit, SVM and Random Forest classifiers perform very well (average 97 %), better than Neural Network (average 91 %) and Bayesian methods (< 90 %)

Avaliação qualitativa de uma intervenção educativa em melhorias em saúde em estudantes de enfermagem

Objetivo: Explorar el significado de la experiencia y los conocimientos adquiridos por estudiantes de enfermería formados en mejora de cuidados de salud. Material y métodos: se realizó una aproximación fenomenológica basada en el método Giorgi mediante una discusión grupal de 21 estudiantes europeos de cuatro países en julio 2019. Los datos fueron triangulados con los testimonios de informantes clave y con el uso de una herramienta de evaluación específica para este tema. El análisis también se trianguló con tres investigadores experimentados que redujeron los datos por consenso a ocho unidades de significado. Resultados: El empoderamiento de enfermería y las organizaciones sanitarias horizontales fueron dos de las unidades de significado más recurrentes junto a los valores profesionales como el trabajo en equipo y la humanización en los cuidados. Conclusiones: los conocimientos, las actitudes y los valores adquiridos evidencian las carencias de la formación de los futuros profesionales de enfermería en Europa. El enfoque teórico-práctico de las sesiones, así como la mezcla de culturas supusieron fortalezas para el alumnado. Es necesario el seguimiento de más casos que evidencien el retorno de la inversión formativa en mejoras sustanciales en contextos reales y su impacto sobre la calidad asistencial.Objective: To explore the meaning of the experience and knowledge acquired by nursing students trained in healthcare improvement. Material and methods: A phenomenological approach based on the Giorgi method was made through a group discussion of 21 European students from four countries in July 2019. The data was triangulated with the testimonies of key informants and with the use of an evaluation tool specific to this topic. The analysis was also triangulated with three experienced researchers who reduced the data by consensus to eight units of meaning. Results: Nursing empowerment and horizontal health organizations were two of the most recurrent units of meaning along with professional values such as teamwork and humanization of care. Conclusions: The knowledge, attitudes and values acquired are evidence of the shortcomings in the training of future nursing professionals in Europe. The theoretical and practical approach of the sessions, as well as the mixture of cultures, were strengths for the students. It is necessary to follow up on more cases that show the return on the training investment in substantial improvements in real contexts and its impact on the quality of care.Objetivo: explorar o significado da experiência e dos conhecimentos adquiridos por estudantes de enfermagem formados em melhoria de cuidados de saúde. Materiais e métodos: foi realizada uma aproximação fenomenológica baseada no método Giorgi, mediante uma discussão em grupo com 21 estudantes europeus de quatro países, em julho de 2019. Os dados foram triangulados com os depoimentos de informantes-chave e com o uso de uma ferramenta de avaliação específica para o tema. A análise também foi triangulada com três pesquisadores experientes que reduziram os dados por consenso a oito unidades de significado. Resultados: o empoderamento da enfermagem e das organizações sanitárias horizontais foram duas das unidades de significado mais recorrentes junto com os valores profissionais, como o trabalho em equipe e a humanização dos cuidados. Conclusões: os conhecimentos, as atitudes e os valores adquiridos evidenciam as carências na formação dos futuros profissionais de enfermagem na Europa. A abordagem teórico-prática das sessões, bem como a fusão de culturas supuseram fortalezas para os estudantes. É necessário seguir mais casos que evidenciem o retorno do investimento em formação em melhorias substanciais em contextos reais e seu impacto sobre a qualidade assistencial

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