Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals

BackgroundPediatric Early Warning Systems (PEWS) aid in identification of deterioration in hospitalized children with cancer but are underutilized in resource-limited settings. Proyecto EVAT is a multicenter quality improvement (QI) collaborative in Latin America to implement PEWS. This study investigates the relationship between hospital characteristics and time required for PEWS implementation.MethodsThis convergent mixed-methods study included 23 Proyecto EVAT childhood cancer centers; 5 hospitals representing quick and slow implementers were selected for qualitative analysis. Semi-structured interviews were conducted with 71 stakeholders involved in PEWS implementation. Interviews were recorded, transcribed and translated to English, then coded using a priori and novel codes. Thematic content analysis explored the impact of hospital characteristics and QI experience on time required for PEWS implementation and was supplemented by quantitative analysis exploring the relationship between hospital characteristics and implementation time.ResultsIn both quantitative and qualitative analysis, material and human resources to support PEWS significantly impacted time to implementation. Lack of resources produced various obstacles that extended time necessary for centers to achieve successful implementation. Hospital characteristics, such as funding structure and type, influenced PEWS implementation time by determining their resource-availability. Prior hospital or implementation leader experience with QI, however, helped facilitate implementation by assisting implementers predict and overcome resource-related challenges.ConclusionsHospital characteristics impact time required to implement PEWS in resource-limited childhood cancer centers; however, prior QI experience helps anticipate and adapt to resource challenges and more quickly implement PEWS. QI training should be a component of strategies to scale-up use of evidence-based interventions like PEWS in resource-limited settings

Investigation of the properties influencing the deactivation of iron electrodes in iron-air batteries

Iron-air batteries hold the potential to be a key technology for energy storage, thanks to their energy density, low cost, safety and abundance of their materials. In order to scale the technology up and optimize the cell formulations, it is key to obtain a clear understanding of how the physical-chemical properties of the electrode influence their electrochemical behaviour, in particular, the capacity loss. In this work, we propose for the first time mathematical correlations between textural and crystallographic properties of iron electrodes and their electrochemical stability. By adjusting synthesis parameters, we were able to tune pore size and volume, surface area and crystal size of iron oxides, and found that stability is highly correlated to both surface area and pore size. Large surface area and small average pore size provide electrodes with enhanced stability. We hypothesize that the cause for deactivation is the passivation of the electrodes ascribed to the formation of a non-conductive, non-reactive iron (II) hydroxide layer during discharge, which then cannot be reduced to iron again. We validate this hypothesis with electrochemical impedance spectroscopy studies, which show that, in the more stable electrodes, the charge transfer resistance in the Fe(OH)2 to Fe reduction does not significantly change after cycling, contrary to the behaviour of the less stable electrodes, corroborating our hypothesis. Furthermore, the electrode with the best properties was cycled 100 times, retaining almost 75% of its initial capacity at the end of the 100 cycles. These results are highly relevant for the future design and operation of iron-air batteries

Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review.

BackgroundDigital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user's uptake and sustained interactions with these interventions.ObjectiveThis systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs.MethodsA systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included.ResultsA total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one's own health.ConclusionsAlthough previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions

Understanding Mental Health App Use Among Community College Students: Web-Based Survey Study

BackgroundMental health concerns are a significant issue among community college students, who often have less access to resources than traditional university college students. Mobile apps have the potential to increase access to mental health care, but there has been little research investigating factors associated with mental health app use within the community college population. ObjectiveThis study aimed to understand facilitators of and barriers to mental health app use among community college students. MethodsA web-based survey was administered to a randomly selected sample of 500 community college students from April 16 to June 30, 2020. Structural equation modeling was used to test the relationships between the use of mental health apps, perceived stress, perceived need to seek help for mental health concerns, perceived stigma, past use of professional mental health services, privacy concerns, and social influence of other people in using mental health apps. ResultsOf the 500 participants, 106 (21.2%) reported use of mental health apps. Perceived stress, perceived need to seek help, past use of professional services, and social influence were positively associated with mental health app use. Furthermore, the effect of stress was mediated by a perceived need to seek help. Privacy concerns were negatively associated with mental health app use. Stigma, age, and gender did not have a statistically significant effect. ConclusionsThese findings can inform development of new digital interventions and appropriate outreach strategies to engage community college students in using mental health apps

Understanding the Role of Support in Digital Mental Health Programs With Older Adults: Users’ Perspective and Mixed Methods Study

BackgroundDigital mental health interventions have the potential to increase mental health support among isolated older adults. However, the older adult population can experience several barriers to accessing and using digital health resources and may need extra support to experience its benefits. ObjectiveThis paper aimed to understand what older adults experience as an important aspect of support during engagement in a digital mental health program. The program entailed 3 months of staff support to participate in digital literacy training and engage with the digital mental health platform myStrength, which offers support for a range of mental health challenges, including depression and anxiety. MethodsA total of 30 older adults participated in surveys and interviews to assess their experience of participating in a digital mental health program provided by county mental health services. As part of the program, participants attended 4 classes of digital literacy training, had access to the digital mental health platform myStrength for 2 months with staff support (and 10 months after the program without support), and received support from program staff during the entire 3-month program. Survey data were analyzed using descriptive statistics, and interview data were analyzed using thematic analysis. ResultsA thematic analysis of the interview data revealed that participants valued ongoing support in 3 main areas: technical support to assist them in using technology, guided support to remind them to use myStrength and practice skills they had learned, and social support to enable them to connect with others through the program. Furthermore, participants reported that social connections was the most important aspect of the program and that they were mainly motivated to participate in the program because it was recommended to them by trusted others such as a community partner or because they believed it could potentially help others. ConclusionsOur findings can be used to inform the design of future digital mental health programs for older adults who may have unique support needs in terms of dedicated technical support and ongoing guided support to use technology and social support to increase social connectedness

Understanding the Potential of Mental Health Apps to Address Mental Health Needs of the Deaf and Hard of Hearing Community: Mixed Methods Study

BackgroundMental health concerns are a significant issue among the deaf and hard of hearing (D/HH) community, but community members can face several unique challenges to accessing appropriate resources. ObjectiveThe aim of this study was to investigate the mental health needs of the D/HH community and how mental health apps may be able to support these needs. MethodsA total of 10 members of the D/HH community participated in a focus group and survey to provide their perspectives and experiences. Participants were members of the Center on Deafness Inland Empire team, which comprises people with lived experience as members of and advocates for the D/HH community. ResultsFindings identified a spectrum of needs for mental health apps, including offering American Sign Language and English support, increased education of mental health to reduce stigma around mental health, direct communication with a Deaf worker, and apps that are accessible to a range of community members in terms of culture, resources required, and location. ConclusionsThese findings can inform the development of digital mental health resources and outreach strategies that are appropriate for the D/HH community

Oxygen-functionalized highly mesoporous carbon xerogel based catalysts for direct methanol fuel cell anodes

14 páginas.- 8 figuras en color.- 6 tablas.PtRu catalysts were prepared using a highly mesoporous carbon xerogel submitted to different oxygen functionalization treatments: diluted and concentrated nitric acid as well as gas-phase 5% O2−N2 oxidation. Catalysts with 20 wt % loading and equimolar Pt:Ru metallic phase were prepared using an impregnation procedure involving chemical reduction with formic acid. The so-obtained carbon materials, as well as the different catalysts synthesized, were characterized by means of N2 physisorption, temperature-programmed desorption (TPD), X-ray diffraction (XRD), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). Cyclic voltammetry and chronoamperometry were performed to study their activity toward carbon monoxide and methanol oxidation. Functionalization of the carbon support was found to play a definitive role in the interaction between carbon material and the active phase, determining metallic dispersion, alloying degree, and reduction extent. The activity of the catalysts in methanol electro-oxidation was directly related to the metal oxidation state and alloying degree.The authors gratefully acknowledge the financial support by the Spanish Ministry of Science and Innovation (MICINN) and FEDER through Project MAT2008-06631-C03-01 and -02. The authors also want to thank the Spanish Ministry of Economy and Competitiveness (Secretaríade Estado de I+D+I, previously MICINN) and FEDER for financial support under the project CTQ2011-28913-C02-01. M.E. Gálvez is indebted to the Spanish Ministry of Economy and Competitiveness (Secretaria de Estado de I+D+i) for her “Ramón y Cajal” contract.Peer reviewe

Ética y ciudadanía - HU316 201801

Descripción: Ética y Ciudadanía es un curso de formación general, de carácter teórico-práctico, dirigido a estudiantes de ciclos iniciales de distintas carreras; que busca contribuir al desarrollo una de las competencias generales de nuestro modelo educativo: Ciudadanía en el nivel 1. Propósito: El curso pretende contribuir con el aprendizaje ético y ciudadano de los estudiantes invitándolos a conocer y explicar problemas éticos y de su vida cotidiana. Teniendo en cuenta que este curso se realiza bajo la modalidad semipresencial, se proponen diversas actividades educativas de tipo individual y grupal, tanto en las sesiones presenciales como en las sesiones virtuales, lo que supone una participación activa, organizada y permanente por parte de los estudiantes. Las estrategias a utilizarse incluyen: lectura y discusión de textos, análisis y evaluación de películas y documentales, resolución de casos, debates y exposiciones, foros virtuales. Siendo el docente la pieza clave para este proceso de aprendizaje, cumple con el rol de promover un ambiente colaborativo a través del diálogo, el respeto y la reflexión, partiendo del conocimiento previo y las fortalezas de los estudiantes para generar nuevas capacidades y desarrollar la competencia asociada al curso