Reduction of motion effects in myocardial arterial spin labeling

Purpose To evaluate the accuracy and reproducibility of myocardial blood flow measurements obtained under different breathing strategies and motion correction techniques with arterial spin labeling. Methods A prospective cardiac arterial spin labeling study was performed in 12 volunteers at 3 Tesla. Perfusion images were acquired twice under breath-hold, synchronized-breathing, and free-breathing. Motion detection based on the temporal intensity variation of a myocardial voxel, as well as image registration based on pairwise and groupwise approaches, were applied and evaluated in synthetic and in vivo data. A region of interest was drawn over the mean perfusion-weighted image for quantification. Original breath-hold datasets, analyzed with individual regions of interest for each perfusion-weighted image, were considered as reference values. Results Perfusion measurements in the reference breath-hold datasets were in line with those reported in literature. In original datasets, prior to motion correction, myocardial blood flow quantification was significantly overestimated due to contamination of the myocardial perfusion with the high intensity signal of blood pool. These effects were minimized with motion detection or registration. Synthetic data showed that accuracy of the perfusion measurements was higher with the use of registration, in particular after the pairwise approach, which probed to be more robust to motion. Conclusion Satisfactory results were obtained for the free-breathing strategy after pairwise registration, with higher accuracy and robustness (in synthetic datasets) and higher intrasession reproducibility together with lower myocardial blood flow variability across subjects (in in vivo datasets). Breath-hold and synchronized-breathing after motion correction provided similar results, but these breathing strategies can be difficult to perform by patients

Connections between family assets and positive youth development: the association between parental monitoring and affection with leisure-time activities and substance use

This study aimed to determine the associations between parental monitoring and affection and three adolescent lifestyle aspects: constructive leisure, non-constructive leisure and substance use. A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). Adolescents aged 12¿15 self-completed a multi-purpose questionnaire. Multiple logistic regressions were performed to analyse the association between the parental monitoring and affection variables and the outcomes in terms of the children¿s lifestyles. The results indicate that parental monitoring is conducive to more constructive leisure and less non-constructive leisure and seems to be conducive to the prevention of substance use. Furthermore, parental affection is conducive to constructive leisure and the prevention of substance use. The discussion focuses on the fact that the family can be a protective resource associated with positive adolescent development

A valid and reliable scale to assess cultural sensibility in nursing

Background: Cultural sensibility is an important concept linked to the achievement of cultural competence. Health professionals must first improve their cultural sensibility to become culturally competent and to be able to offer competent care to culturally diverse populations. Aim To develop and psychometrically test the Cultural Sensibility Scale for Nursing (CUSNUR), a cultural sensibility scale that can be used in nursing for the achievement of competencies needed to care for culturally diverse populations. Design and methods: The cross-sectional survey was conducted over two stages. The first stage involved the cross- cultural and discipline-specific adaptation of an existing scale addressing this concept in the field of law using the reverse translation method. Second, validation of the scale was carried out from October 2016–June 2017 by studying the psychometric properties of the questionnaire through an analysis of content acceptability and reliability and through exploratory factor analysis (EFA). Results: The questionnaire was designed to be clear, easy to understand, and of adequate length, and experts involved in content validation agreed that the scale meets these criteria. A total of 253 nursing students participated in the validation stage. Four factors were identified from the EFA: (1) patient and health professional behaviours, (2) self-assessments, (3) self-awareness, and (4) cultural influence. Two items were excluded. Factorial saturation is adequate for all factors (>0.30). The Cronbach alpha was measured as 0.75. Conclusions: This study presents the first version of the CUSNUR and demonstrates that the scale is valid and reliable

Multiparametric renal magnetic resonance imaging: A reproducibility study in renal allografts with stable function

Monitoring renal allograft function after transplantation is key for the early detection of allograft impairment, which in turn can contribute to preventing the loss of the allograft. Multiparametric renal MRI (mpMRI) is a promising noninvasive technique to assess and characterize renal physiopathology; however, few studies have employed mpMRI in renal allografts with stable function (maintained function over a long time period). The purposes of the current study were to evaluate the reproducibility of mpMRI in transplant patients and to characterize normal values of the measured parameters, and to estimate the labeling efficiency of Pseudo-Continuous Arterial Spin Labeling (PCASL) in the infrarenal aorta using numerical simulations considering experimental measurements of aortic blood flow profiles. The subjects were 20 transplant patients with stable kidney function, maintained over 1 year. The MRI protocol consisted of PCASL, intravoxel incoherent motion, and T1 inversion recovery. Phase contrast was used to measure aortic blood flow. Renal blood flow (RBF), diffusion coefficient (D), pseudo-diffusion coefficient (D*), flowing fraction ( f ), and T1 maps were calculated and mean values were measured in the cortex and medulla. The labeling efficiency of PCASL was estimated from simulation of Bloch equations. Reproducibility was assessed with the within-subject coefficient of variation, intraclass correlation coefficient, and Bland-Altman analysis. Correlations were evaluated using the Pearson correlation coefficient. The significance level was p less than 0.05. Cortical reproducibility was very good for T1, D, and RBF, moderate for f , and low for D*, while medullary reproducibility was good for T1 and D. Significant correlations in the cortex between RBF and f (r = 0.66), RBF and eGFR (r = 0.64), and D* and eGFR (r = -0.57) were found. Normal values of the measured parameters employing the mpMRI protocol in kidney transplant patients with stable function were characterized and the results showed good reproducibility of the techniques

Educación interprofesional: una propuesta de la Universidad de Navarra

La asistencia sanitaria centrada en el paciente es la clave para una atención humana a la persona y a su familia. La práctica colaborativa en equipos interprofesionales resulta imprescindible para alcanzar una atención sanitaria de calidad. La universidad tiene la responsabilidad de preparar a sus graduados para trabajar en equipos interprofesionales. Una enseñanza/aprendizaje centrada en la persona, fundamentada en las competencias que definen la educación interprofesional, es clave para que nuestros estudiantes reconozcan la necesidad del trabajo colaborativo. Este artículo detalla un proyecto docente de educación interprofesional de la Universidad de Navarra, donde estudiantes de las facultades de medicina, enfermería y farmacia aprenden juntos y de manera gradual, las claves de cómo trabajar en equipo

La educación interprofesional en la universidad: retos y oportunidades

La educación interprofesional (EIP) es clave para garantizar el aprendizaje integrado de los alumnos de diferentes titulaciones, que ejercerán una labor profesional basada en el cuidado centrado en la persona, de manera conjunta. El proyecto de EIP de la Universidad de Navarra pretende dar a los alumnos de medicina, enfermería y farmacia los conocimientos, habilidades y actitudes necesarias para trabajar de manera interprofesional, centrándonos en trabajo en equipo, conocimiento y respeto de roles, resolución de conflictos y comunicación interprofesional. Para ello, el equipo de docentes implicados en este proyecto ha tenido que trabajar colaborativamente, experimentando las claves de este trabajo interprofesional, centrado en el alumno, constituyendo una experiencia enriquecedora, constructiva, y que ha aportado las claves del trabajo en equipo necesario para llevar a cabo un proyecto docente de EIP.Interprofessional Education is key to guarantee the integrated learning to different students, who will exercise together a professional work based on a person-centred care. The EIP project of the University of Navarra aims to provide to medical, nursing and pharmacy students with the knowledge, skills and attitudes necessary to work interprofessionally focu- sing on teamwork, knowledge and respect for roles, conflict resolution and interprofessional communication. To achieve this aim, the teachers from the different faculties involved in this project has worked collaboratively, experiencing the keys of this interprofessional work focused on the student, constituting an enriching, living a constructive experience and contributing to the cornerstone of the teamwork necessary to undertake an EIP teaching project

Relation of IL28B Gene Polymorphism with Biochemical and Histological Features in Hepatitis C Virus-Induced Liver Disease

BACKGROUND/AIMS: Polymorphism at the IL28B gene may modify the course of hepatitis C virus (HCV) chronic infection. Our aim was to study the influence of IL28B rs12979860 gene polymorphism on the biochemistry and pathology of HCV-induced disease in the clinical course from mild chronic hepatitis C to hepatocellular carcinoma. METHODS: We have determined the rs12979860 single nucleotide polymorphism (SNP) upstream IL28B gene in two groups of patients with HCV-induced chronic liver disease: 1) 268 patients (159 men) with biopsy-proven chronic hepatitis C, to analyse its relation with biochemical, virological and histological features; and 2) 134 patients (97 men) with HCV-related hepatocellular carcinoma. The distribution of the analysed SNP in hepatocellular carcinoma patients was compared with that found in untreated chronic hepatitis C patients. All patients were white and most were Spaniards. RESULTS: In multivariate analysis ALT values were higher (P = 0.001) and GGT values were lower (P<0.001) in chronic hepatitis C patients homozygotes for the major rs12979860C allele as compared with carriers of the mutated rs12979860T allele. Steatosis was more frequent (Odds ratio = 1.764, 95% C.I. 1.053-2.955) and severe (P = 0.026) in carriers of the rs12979860T allele. No relation was found between the analysed SNP and METAVIR scores for necroinflammation and fibrosis, and there were no differences in the distribution of the analysed SNP between hepatocellular carcinoma and untreated chronic hepatitis C patients. CONCLUSION: The IL28B rs12979860 polymorphism correlates with the biochemical activity and the presence and severity of liver steatosis in chronic hepatitis C

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study

Aims: To determine the associations between internal assets (planning and decision- making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs).Design: A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru).Methods: Adolescents aged 12–18 self-completed a multi-purpose questionnaire be-tween 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision- making, interpersonal competence, and commitment to learning) and sub-stance use.Results: The results indicate that planning and decision- making and commitment to learning are conducive to the prevention of substance use. On the contrary, interper-sonal competence was not associated with substance use.Conclusion: The present study shows that planning and decision- making and com-mitment to learning can be relevant factors in explaining substance use during ado-lescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These find-ings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adoles-cents. Furthermore, the Developmental Assets framework has been proved as a suit-able frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study

Aims: To determine the associations between internal assets (planning and decision- making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs).Design: A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru).Methods: Adolescents aged 12–18 self-completed a multi-purpose questionnaire be-tween 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision- making, interpersonal competence, and commitment to learning) and sub-stance use.Results: The results indicate that planning and decision- making and commitment to learning are conducive to the prevention of substance use. On the contrary, interper-sonal competence was not associated with substance use.Conclusion: The present study shows that planning and decision- making and com-mitment to learning can be relevant factors in explaining substance use during ado-lescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These find-ings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adoles-cents. Furthermore, the Developmental Assets framework has been proved as a suit-able frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use

Intervenciones de musicoterapia en pacientes adultos hospitalizados con esquizofrenia. Una revisión crítica para la práctica enfermera

La esquizofrenia es un trastorno neuropsiquiátrico complejo, cuyo tratamiento principal se centra en el abordaje farmacológico con antipsicóticos. Cada vez son más las intervenciones no farmacológicas, como la musicoterapia, las que se propo nen como alternativa para complementar su abordaje y mejorar la calidad de vida de las personas afectadas. El objetivo de esta investigación es examinar las características y efectos de los estudios de intervención basados en la musicoterapia llevados a cabo por enfermeras y que estén dirigidos a personas adultas con esquizofrenia durante el proceso de hospitalización. Se llevó a cabo una búsqueda sistemática de la literatura que aportó 7 estudios de intervención basados en musicoterapia para personas con esquizofrenia en unidades de hospitalización y liderados por enfermería. Todas las intervenciones mostraron efectos beneficiosos de esta terapia en la mejora de la sintomatología psiquiátrica y un incremento de la calidad de vida