Consequences of Amyloid-ß Deficiency for the Liver.

The hepatic content of amyloid beta (Aß) decreases drastically in human and rodent cirrhosis highlighting the importance of understanding the consequences of Aß deficiency in the liver. This is especially relevant in view of recent advances in anti-Aß therapies for Alzheimer's disease (AD). Here, it is shown that partial hepatic loss of Aß in transgenic AD mice immunized with Aß antibody 3D6 and its absence in amyloid precursor protein (APP) knockout mice (APP-KO), as well as in human liver spheroids with APP knockdown upregulates classical hallmarks of fibrosis, smooth muscle alpha-actin, and collagen type I. Aß absence in APP-KO and deficiency in immunized mice lead to strong activation of transforming growth factor-ß (TGFß), alpha secretases, NOTCH pathway, inflammation, decreased permeability of liver sinusoids, and epithelial-mesenchymal transition. Inversely, increased systemic and intrahepatic levels of Aß42 in transgenic AD mice and neprilysin inhibitor LBQ657-treated wild-type mice protect the liver against carbon tetrachloride (CCl4)-induced injury. Transcriptomic analysis of CCl4-treated transgenic AD mouse livers uncovers the regulatory effects of Aß42 on mitochondrial function, lipid metabolism, and its onco-suppressive effects accompanied by reduced synthesis of extracellular matrix proteins. Combined, these data reveal Aß as an indispensable regulator of cell-cell interactions in healthy liver and a powerful protector against liver fibrosis.

Development of Pleiotropic TrkB and 5-HT4 Receptor Ligands as Neuroprotective Agents.

One common event that is the most detrimental in neurodegenerative disorders, even though they have a complex pathogenesis, is the increased rate of neuronal death. Endogenous neurotrophins consist of the major neuroprotective factors, while brain-derived neurotrophic factor (BDNF) and its high-affinity tyrosine kinase receptor TrkB are described in a number of studies for their important neuronal effects. Normal function of this receptor is crucial for neuronal survival, differentiation, and synaptic function. However, studies have shown that besides direct activation, the TrkB receptor can be transactivated via GPCRs. It has been proven that activation of the 5-HT4 receptor and transactivation of the TrkB receptor have a positive influence on neuronal differentiation (total dendritic length, number of primary dendrites, and branching index). Because of that and based on the main structural characteristics of LM22A-4, a known activator of the TrkB receptor, and RS67333, a partial 5-HT4 receptor agonist, we have designed and synthesized a small data set of novel compounds with potential dual activities in order to not only prevent neuronal death, but also to induce neuronal differentiation in neurodegenerative disorders.

Zooplankton vulnerability to glyphosate exacerbated by global change.

Anthropogenic activities generate a severe footprint at a global scale. Intensive agriculture is a global change driver that affects aquatic systems due to the discharge of pollutants. This situation can be modified or aggravated by other aspects, such as the disturbance history and other global change factors. Following our study line, it is necessary to evaluate how the disturbance history combined with temperature changes can affect the functioning of aquatic systems. The objectives of this study were divided into two phases. The objectives of phase 1 were to induce vulnerability in Daphnia magna populations through a disturbance history based on sublethal glyphosate concentration exposure under different temperature conditions (20 °C and 25 °C). In phase 2, vulnerability was assessed through the exposure to subsequent stressors (starvation, increased salinity and paracetamol) combined with changes in temperature. During the glyphosate exposure period in phase 1, differences were observed in the D. magna populations with respect to temperature, with lower abundance at 25 °C than at 20 °C. However, no differences were observed in abundance regarding glyphosate treatment. The results obtained in phase 2 with the new stressors combined with temperature changes in both directions, revealed stronger effects in vulnerable populations than in control populations. In addition, the temperature changes modulated the effects in the starvation and increased salinity tests. Agrochemical sublethal concentrations induce vulnerability in D. magna populations and inflicted temperature changes can act as a modulating factor for this vulnerability, showing the complexity in assessing the responses under the multiple scenarios associated with global change.

Design of an instrument to measure midwives' workloads based on nursing interventions classification / Design de um instrumento para medir a carga de trabalho das parteiras com base nas intervenções de classificação das intervenções de enfermagem / Diseño de un instrumento para medir cargas de trabajo de matronas basado en intervenciones nursing interventions classification

ABSTRACT Objective: to design a qualitative and quantitative scale for measuring specific workloads for obstetric-gynecological nurses (midwives) within the delivery unit and based on the Nursing Interventions Classification (NIC). Method: this is a mixed qualitative study through focus groups and quantitative with real measurements of NIC times, descriptive and cross-sectional. From September 2020 to May 2021, an extensive bibliographic search, mapping, ad hoc scale development and configuration of three focus groups were carried out to agree on scale design. Moreover, a comparison was carried out on the subjective perception of the time spent providing care (NIC) during the delivery process by focus groups with respect to times actually measured between March and April 2021 in a delivery unit. Results: the qualitative data obtained in focus groups were analyzed and related, agreeing on the ad hoc measuring instrument's final structure and the importance of having this measuring instrument representative of their work, with standardized language adapted to real health demands. Furthermore, when comparing the subjective and real execution times of each of the NIC, we found a significant correlation when presenting different mean execution times with a variation of 13 minutes. Conclusion: the midwives in this study determined the measurement instrument construct validity for their workloads.

RESUMO Objetivo: elaborar uma escala qualitativa e quantitativa para mensuração de cargas de trabalho específicas para enfermeiras obstétrico-ginecológicas (parteiras) na unidade de parto e baseada na Classificação das Intervenções de Enfermagem (NIC). Método: trata-se de um estudo qualitativo misto por meio de grupos focais e quantitativo com medidas reais de tempos NIC, descritivo e transversal. De setembro de 2020 a maio de 2021, foi realizada uma extensa pesquisa bibliográfica, mapeamento, desenvolvimento de escala ad hoc e configuração de três grupos focais para chegar a um acordo sobre o desenho da escala. Além disso, foi realizada uma comparação da percepção subjetiva do tempo gasto na prestação de cuidados (NIC) durante o processo de parto pelos grupos focais com os tempos efetivamente medidos entre março e abril de 2021 em uma unidade de parto. Resultados: os dados qualitativos obtidos nos grupos focais foram analisados ​​e relacionados, concordando com a estrutura final do instrumento de medição ad hoc e a importância de ter este instrumento de medição representativo do seu trabalho, com linguagem padronizada e adaptada às reais demandas de saúde. Além disso, ao comparar os tempos de execução subjetivos e reais de cada uma das NIC, encontramos correlação significativa ao apresentar tempos médios de execução diferentes com variação de 13 minutos. Conclusão: as parteiras deste estudo determinaram a validade de construto do instrumento de medida para suas cargas de trabalho.

RESUMEN Objetivo: diseñar cualitativa y cuantitativa, una escala de medición de cargas de trabajo, específica para las enfermeras obstétrico-ginecológicas (matronas), dentro de la unidad de partos y basada en la Clasificación de Intervenciones de Enfermería (NIC). Método: estudio mixto cualitativo mediante grupos focales y cuantitativo con mediciones reales de tiempos NIC, descriptivo y transversal. Durante los meses de septiembre de 2020 a mayo de 2021, se realizó una extensa búsqueda bibliográfica, mapeo, elaboración ad hoc de la escala, y la configuración de tres grupos focales, para consensuar el diseño de la escala. Además, se ejecutó una comparativa sobre la percepción subjetiva del tiempo empleado en la prestación de cuidados (intervenciones NIC) durante el proceso de parto por parte de los grupos focales, con respecto a los tiempos medidos realmente entre marzo y abril del 2021 en una unidad de partos. Resultados: se analizaron y relacionaron los datos cualitativos obtenidos de los grupos focales, coincidiendo en la estructura final del instrumento ad hoc de medida, y en la importancia de tener este instrumento de medida representativo de su trabajo, con un leguaje estandarizado y adaptado a la demanda sanitaria real. Además, al comparar los tiempos subjetivos y reales de ejecución de cada una de las intervenciones NIC, encontramos una correlación significativa, al presentar distintos promedios de tiempos de ejecución con una variación de 13 minutos. Conclusión: las matronas de este estudio determinaron la validez del constructo del instrumento de medición para sus cargas de trabajo.

Validação de escala para mensurar a carga de trabalho das parteiras / Validación de escala para medir la carga de trabajo de las parteras / Validation of a scale to measure the workload of midwives

Resumo Objetivo Validar a elaboração de uma escala para mensurar a carga de trabalho das parteiras com base na Classificação das Intervenções de Enfermagem (NIC) por meio da sua aplicação multicêntrica em diferentes unidades de parto. Métodos Estudo quantitativo, longitudinal, de caráter multicêntrico, realizado em três hospitais universitários gerais da rede pública de saúde. A amostra foi composta por cinquenta parteiras, que examinaram a validade de construto da escala elaborada, com um total de 370 partos. A coleta de dados iniciou-se por meio da escala elaborada ad hoc pela equipe de pesquisa, contabilizando o tempo e o número médio de intervenções NIC, realizadas a cada nascimento. Resultados As parteiras do estudo estão sujeitas a um aumento na sua carga de trabalho quanto ao número e ao tempo médio gasto na realização das NIC em cada parto atendido. Em sua jornada de trabalho (turno de 12 horas), elas destinam 960,61 minutos (16 horas no turno diurno) e 840,29 minutos (14 horas no turno noturno) para executar suas funções na assistência ao parto. Conclusões Os dados indicam a validade da escala elaborada ad hoc, pois esse instrumento reflete a real carga de trabalho vivenciada pelas parteiras do estudo.

Resumen Objetivo Validar la elaboración de una escala para medir la carga de trabajo de las parteras con base en la Clasificación de Intervenciones de Enfermería (NIC) a través de su aplicación multicéntrica en diferentes unidades de parto. Métodos Estudio cuantitativo, longitudinal, de carácter multicéntrico, realizado en tres hospitales universitarios generales del sistema de salud pública. La muestra estuvo compuesta por 50 parteras, que examinaron la validez del constructo de la escala elaborada, con un total de 370 partos. La recopilación de datos comenzó mediante la escala elaborada ad hoc por el equipo de investigación y contabilizó el tiempo y el número de intervenciones NIC realizadas en cada nacimiento. Resultados Las parteras del estudio están sujetas a un aumento de su carga de trabajo con relación al número y al tiempo promedio utilizado en la realización de las NIC en cada parto atendido. En su jornada laboral (turno de 12 horas), destinan 960,61 minutos (16 horas en el turno diurno) y 840,29 minutos (14 horas en el turno nocturno) para ejecutar sus funciones en la atención al parto. Conclusión Los datos indican la validez de la escala elaborada ad hoc, ya que este instrumento refleja la real carga de trabajo que tienen las parteras del estudio.

Abstract Objective To validate the design of a scale to measure the workload of the midwives based on Classification of Nursing Interventions (NIC), through their multicentric application in different delivery units. Methods Quantitative, longitudinal, study multicentric character, conducted in three general university hospitals of the public system of health. The sample consisted of fifty midwives, who examined the validity of the construct of the designed scale, for a total of 370 births. Data collection began through the scale designed ad hoc by the research team, accounting for the time and average number of NIC interventions, performed at each birth. Results The midwives of the study, are subject to an increase in their workload regarding the number and average time spent conducting interventions NIC in each attended delivery. In their working day (12-hour shift) they allocate 960.61 minutes (16 hours in day shift) and 840.29 minutes (14 hours in night shift), to execute their roles in childbirth attendance. Conclusion The data indicate the validity of the scale designed ad hoc, as this instrument reflects the actual workload experienced by the midwives of the study.

Gestión de casos: Análisis de costo eficiencia en continuidad de cuidados de Pacientes crónicos complejos / Case management: cost-effectiveness analysis in continuity of patient care of the Complex Chronic Patients Unit

Objetivo: Evaluar la relación entre los costes asociados al número y días de ingresos previos y posteriores a la inclusión a la Unidad de pacientes crónicos complejos (PCC). Métodos: Se realizó un análisis de coste-efectividad, descriptivo, con cálculo de medias y desviaciones típicas; además de utilizar la t-Student para muestras pareadas, con el software SPSS v20.0, para un nivel de significación alfa <0,05. Los resultados del cómputo se obtuvieron de la Unidad de Codificación de los pacientes captados por la enfermera gestora de casos, y que sobrevivieron un año en seguimiento por la Unidad PCC. Resultados: Se captaron un total de 132 PCC, con un total de 563 ingresos previos, a 204 post inclusión. La media de número de ingresos al año antes fue de 4,27 (DT: 3,35), y se redujo a 1,55 (DT: 1,74). Por otro lado, el número de días de estancia hospitalaria total se redujo de 3.835 a 1.897 días, que equivale una diferencia de coste estimado en 11165.164,36 de euros. La media de días de ingreso antes fue de 29,05, y se redujo a 14,37 días, encontrando una significación estadística (p<0,001) entre días de ingresos previos y posteriores. Conclusiones: La inclusión en la Unidad PCC garantiza, mediante el liderazgo por la enfermera gestora de casos, una mejora coste-efectiva sin gastos añadidos, por optimizar recursos ya existentes interniveles asistenciales, mediante la identificación de PCC y sus necesidades prioritarias, planificación al alta con informes individualizados y garantizando el contacto. (AU)

Objective: Evaluate the relationship between the costs associated with the number and days of admission before and after inclusion in the Complex Chronic Patients Unit (CCP). Methods: A descriptive cost-effectiveness analysis was performed, with calculation of arithmetic averages and standard deviations; in addition to using the t-Student for paired samples, with the SPSS Enfermería GlobalNº 72 Octubre 2023Página 78v20.0 software, for a significance level alpha <0.05. The results of the computation were obtained from the Coding Unit of the patients recruited by the case manager nurse, who survived one year of follow-up by the CCP Unit. Results: A total of 132 CCP were recruited, with a total of 563 previous admissions, which were reduced to 204 post inclusion. The average number of admissions of the previous year was 4.27 (SD: 3.35), and it was reduced to 1.55 (SD: 1.74). On the other hand, the number of days of total hospital stay was reduced from 3,835 to 1,897 days, which is equivalent to a difference in estimated cost of 11,165,164.36 euros. The average number of days of admission before was 29.05, and it was reduced to 14.37 days, finding a statistical significance (p<0.001) between days of admission before and after. Conclusions: Inclusion in the CCP Unit guarantees, through the leadership of the case manager nurse, a cost-effective improvement without added expenses, by optimizing already existing interlevel care resources, through the identification of CCP and their priority needs, discharge planning with reports individualized and guaranteeing contact. (AU)

Sublethal exposure to agrochemicals impairs zooplankton ability to face future global change challenges.

Intensive agriculture is characterized by the application of multiple stressors that damage aquatic systems. Currently, ecotoxicological evaluations are considered insufficient to understand the environmental risks of stressor mixtures and their consequences in ecosystems. In addition, future global change scenarios could alter the predicted effects of agrochemicals in aquatic systems based on single exposures, making it necessary to consider the history of environmental disturbances that may result in vulnerability to subsequent environmental changes. The objectives of this study were to induce disturbance histories by exposure to sublethal glyphosate concentrations in microcosms and to assess whether this disturbance results in vulnerable populations using Daphnia magna as the target species. Populations were considered vulnerable if their sensitivity to new stressors (inanition, temperature and salinity) was higher than that of undisturbed populations. To induce disturbance history, microcosm aquatic communities (two cladocerans and one microalgae) were exposed to two glyphosate sublethal concentrations (below the No Observed Effect Concentration, NOEC values for D. magna, 0.1 and 1 mg L-1) in microcosms under controlled conditions in a culture chamber for 48 days. After this period, no significant differences were observed with respect to the control microcosms in the selected parameters (cladoceran abundance, microalgae cell abundance, microalgae colony formation, pH and dissolved oxygen). To test vulnerability, our target D. magna populations, which were previously exposed to different glyphosate treatments, were subjected to inanition, elevated temperature and salinity. Our results showed that D. magna populations with disturbance history performed worse in all the scenarios compared to the populations from undisturbed conditions. These results underscore the need to study how environmental disturbance history influences population responses to new and future stressors. Moreover, our findings raise concern regarding the sublethal effects of pesticides on aquatic populations.

Design, synthesis and biological characterization of novel activators of the TrkB neurotrophin receptor.

Numerous studies have been published about the implication of the neurotrophin brain-derived neurotrophic factor (BDNF) and its receptor TrkB in the pathogenesis of several neurodegenerative conditions such as Alzheimer's disease, Parkinson's disease, Multiple Sclerosis and motor neuron disease. BDNF activates the TrkB receptor with high potency and specificity, promoting neuronal survival, differentiation and synaptic plasticity. Based on the main structural characteristics of LM22A-4, a previously published small molecule that acts as activator of the TrkB receptor, we have designed and synthesized a small data set of compounds. The lead idea for the design of the new compounds was to modify the third position of the LM22A-4, by introducing different substitutions in order to obtain compounds which will have not only better physicochemical properties but selective activity as well. ADME and toxicity profiles of molecules have been evaluated as well as their biological properties through the TrkB receptor and affinity to promote neurite differentiation.

Validation of a Nursing Workload Measurement Scale, Based on the Classification of Nursing Interventions, for Adult Hospitalization Units.

We conducted validation of a scale to measure nursing workloads, previously designed using NIC interventions within the four nursing functions (patient care, teaching, management, and research). METHODS: This is an analytical, descriptive, prospective, and observational study using qualitative methodology (focus groups and in-depth interviews) with a quantitative and qualitative section (committee of experts and real application of the scale through a validation pilot and with multicentric application, including hospitalization units of internal medicine and surgery of four hospitals). Qualitative analysis was performed with Atlas.ti8 and quantitative analysis with R. RESULTS: Qualitatively, all the participants agreed on the need to measure workloads in all nursing functions with standardized terminology. The expert committee found greater relevance (91.67%) in "prevention" and "health education" as well as consistency with the construct and adequate wording in 99% of the selected items. In the pilot test and multicenter application, the nurses spent more time on the caring dimension, in the morning shift, and on the items "self-care", "medication", "health education", "care of invasive procedures", "wounds care", "comfort", and "fluid therapy". Cronbach's alpha 0.727, composite reliability 0.685, AVE 0.099, and omega coefficient 0.704 were all acceptable. Construct validity: KMO 0.5 and Bartlett's test were significant. CONCLUSIONS: The scale can be considered valid to measure nursing workloads, both qualitatively in obtaining the consensus of experts and health personnel and quantitatively, with acceptable reliability and validity superior to other similar scales.

Analysis of midwives' situation and the need to measure their workloads.

OBJECTIVE: to analyze midwives' employment situation of midwives and detect their workload measurement needs. METHODS: a mixed methodology (quantitative and qualitative), observational, descriptive and cross-sectional study. Two phases were carried out. The first methodological phase consisted of conducting semi-structured individual interviews. The second methodological phase analyzed the Nursing Intervention Classification (NIC) interventions that midwives perform in the labor room during daily practice. RESULTS: 90.3% of midwives have work overload, since for 80.6% the midwife-pregnant mother ratio is not well established, since the mean execution time of a Nursing Intervention Classification (NIC) intervention is 20 minutes. For this reason, 100% of the sample considers the development of workload measurement tools to be highly useful. CONCLUSIONS: the need to generate an instrument that considers the diversity of Nursing Intervention Classification (NIC) interventions that develop within the labor room is ratified.

Multicenter application of a nursing workload measurement scale in adult hospitalization units.

Objectives: The study aimed to the multicenter application of a nursing workload measurement scale in the internal medicine and surgery adults hospitalization units. Methods: The study design was a multicenter, observational, and descriptive study. A multicenter application of the MIDENF® nursing workload measurement scale was carried out, which consists of 21 items, and covers the four nursing functions (patient care items, teaching, manager, and researcher), in units of hospitalization of adults of internal medicine and surgery of four different hospitals. Each item contains one or more of the nursing interventions of Nursing Interventions Classification (NIC) and has an assigned time, after comparing the real time it takes to perform each intervention with the North American Nursing Diagnosis Association (NANDA) standardized time. The study was carried out during nine months of the year 2020, measuring two days each month in the three work shifts (morning, evening, and night) to all patients admitted on the days of measurement in the indicated units. Results: The descriptive and inferential analysis of 11,756 completed scales, 5,695 in general surgery and 6,061 in internal medicine, showed a greater care load for the two units during the morning shift (227,034 min in general surgery, 261,835 min in internal medicine), especially in the items of "self-care", "medication", "common invasive procedures", "fluid therapy", and "patient and family support", while the managerial function was similar during the three work shifts in the two units studied, getting values between 57,348 and 62,901 min. In the analysis by shift and unit, statistical significance was obtained both for the total workload and the four nursing functions(P < 0.001). Conclusions: It is shown that the use of validated scales with the standardized language of nursing functions, adapted to the units, provides objective information to adjust the nursing staff to the real situation of care in any hospital and unit where it is applied, improving quality and patient safety.

Relationship between Job Satisfaction and Workload of Nurses in Adult Inpatient Units.

Among Nursing and Psychology professionals, the job satisfaction of those in Adult Inpatient Units is analyzed, with a new scale to measure nursing workloads validated. Objective: The objective of this study was to relate nursing workloads to professional job satisfaction. Methods: This is an observational, analytical, descriptive, concurrent and quantitative study, which used the Overall Job Satisfaction scale and subscales therein, to identify global satisfaction-intrinsic or related to motivational factors and extrinsic or associated with hygienic factors-in nursing professionals (n = 104) from eight Inpatient Units of Internal Medicine and Surgery, in four hospital centers, to describe job satisfaction in the professionals studied and to find statistically significant associations between job satisfaction and workload (measured with the scale MIDENF®) in the inpatient units where they work. Results: There were higher levels of satisfaction in the variables "relationship with immediate boss" and "relationship with fellow workers", and lower levels in "relationship with senior management" and "organizational system of the unit". In the inferential analysis, the scores were 75.63 for overall satisfaction, 35.28 for intrinsic satisfaction, and 40.36 for extrinsic satisfaction. Conclusions: There is a close relationship between workload and job satisfaction, showing more dissatisfaction regarding organizational aspects and professional recognition.

Correlation between Positive Orientation and Control of Anger, Anxiety and Depression in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic.

(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of 756 nursing students in Poland, Spain and Slovakia. The empirical data were gathered using an original survey questionnaire, the Positive Orientation Scale and the Courtauld Emotional Control Scale. (3) It was shown that the positive orientation level in Polish students was significantly lower than in students in Spain (p < 0.0001) and Slovakia (p < 0.0001). Low results for positive orientation were obtained in nearly half (47.18%) of the respondents in the Polish sample, whereas it was 34.18% and 31.18% in the Spanish and Slovak samples, respectively (p < 0.0001). A positive orientation was the most important predictor of emotional control among the nursing students at all the sites (p < 0.0001). (4) Positive orientation has been shown to have a significant impact on emotional control in nursing students during the pandemic. Therefore, it is important to carefully monitor students' mental health during the pandemic to determine the demand for psychological and emotional support.

Analysis of midwives' situation and the need to measure their workloads / Análise da situação das parteiras e a necessidade de medir suas cargas de trabalho / Análisis de la situación de las matronas y necesidad de medir sus cargas de trabajo

ABSTRACT Objective: to analyze midwives' employment situation of midwives and detect their workload measurement needs. Methods: a mixed methodology (quantitative and qualitative), observational, descriptive and cross-sectional study. Two phases were carried out. The first methodological phase consisted of conducting semi-structured individual interviews. The second methodological phase analyzed the Nursing Intervention Classification (NIC) interventions that midwives perform in the labor room during daily practice. Results: 90.3% of midwives have work overload, since for 80.6% the midwife-pregnant mother ratio is not well established, since the mean execution time of a Nursing Intervention Classification (NIC) intervention is 20 minutes. For this reason, 100% of the sample considers the development of workload measurement tools to be highly useful. Conclusions: the need to generate an instrument that considers the diversity of Nursing Intervention Classification (NIC) interventions that develop within the labor room is ratified.

RESUMO Objetivo: analisar a situação laboral das parteiras e detectar suas necessidades de mensuração da carga de trabalho. Métodos: estudo de metodologia mista (quantitativa e qualitativa), observacional, descritivo e transversal. Duas fases foram realizadas. A primeira fase metodológica consistiu na realização de entrevistas individuais semiestruturadas. A segunda fase metodológica analisou as intervenções da Classificação de Intervenção de Enfermagem (NIC) que as parteiras realizam na sala de parto durante o dia de atendimento. Resultados: 90,3% das parteiras apresentam sobrecarga de trabalho, pois, para 80,6%, a relação obstetriz-gestante não está bem estabelecida, pois o tempo médio de execução de uma intervenção Classificação de Intervenção de Enfermagem (NIC) é de 20 minutos. Por esse motivo, 100% da amostra considera muito útil o desenvolvimento de ferramentas de medição de carga de trabalho. Conclusões: ratifica-se a necessidade de gerar um instrumento que considere a diversidade de intervenções Classificação de Intervenção de Enfermagem (NIC) que se desenvolvem na sala de parto.

RESUMEN Objetivo: Analizar la situación laboral de las matronas y detectar sus necesidades de medición de cargas de trabajo. Métodos: Estudio de metodología mixta (cuantitativo y cualitativo), observacional, descriptivo y transversal. Se realizaron dos fases: La primera fase metodológica, consistió en la realización de entrevistas individuales semiestructuradas. Y en la segunda fase metodológica, se analizaron las intervenciones de enfermería (NIC) que las matronas efectúan en paritorio durante su jornada asistencial. Resultados: El 90,3% de las matronas presentan sobrecarga en el trabajo, pues para el 80,6% el ratio matrona- gestante no se encuentra bien establecido; pues tiempo medio de ejecución de una intervención de enfermería (NIC), es de 20 minutos. Por ello, el 100% de la muestra considera de máxima utilidad el desarrollo de herramientas de medición de cargas de trabajo. Conclusiones: Se ratifica la necesidad de generar un instrumento que considere la diversidad de intervenciones de enfermería (NIC) que desarrollan dentro del paritorio.

Validação qualitativa de uma escala para medir a carga de trabalho de enfermagem em unidades de internação / Validación cualitativa de una escala para medir la carga de trabajo de enfermería en unidades de internación / Qualitative validation of a scale for nursing workloads in hospitalization units

Resumo Objetivo Projetar e validar uma escala para medir a carga de trabalho de enfermagem em Unidades de Internação de Adultos com base na Classificação de Intervenções de Enfermagem (NIC). Métodos Estudo analítico, descritivo, observacional, prospectivo, utilizando principalmente metodologia de pesquisa qualitativa, por meio de grupos focais, comitê de especialistas e entrevistas individuais, para validar uma Escala de Medição da Carga de Trabalho em Unidades de Internação de Adultos, a partir das intervenções selecionadas (NIC), com base nas características inerentes a tais unidades. Foi utilizada seleção aleatória para determinar os participantes (enfermeiros e especialistas) e é representativa das unidades de hospitalização em estudo. O estudo foi realizado de outubro de 2018 a abril de 2019. Resultados Não apenas os grupos focais, mas também as entrevistas individuais e o comitê de especialistas demonstraram concordância sobre a importância de se obter um instrumento para medir a carga de trabalho validado pelos próprios profissionais e representativo de seu trabalho, com linguagem padronizada e adaptada à saúde real. A análise quantitativa conduzida pelo comitê de especialistas mostra uma maior relevância (91,67%) nos itens: "Prevenção" e "Educação para a saúde", bem como a consistência com a construto e a redação apropriada em 99% dos itens selecionados. Os avaliadores mantiveram a ação em todos os itens com uma taxa de aceitação de 75% a 100%. Conclusão O estudo qualitativo realizado fornece os dados necessários para a concepção e validação de uma escala para medir as cargas de trabalho de enfermagem, identificadas a partir das intervenções de enfermagem (NIC), como indicadores da gestão de recursos humanos.

Resumen Objetivo Proyectar y validar una escala para medir la carga de trabajo de enfermería en unidades de internación de adultos con base en la Clasificación de Intervenciones de Enfermería (NIC). Métodos Estudio analítico, descriptivo, observacional, prospectivo, que utilizó principalmente metodología de investigación cualitativa, por medio de grupos focales, comité de especialistas y entrevistas individuales, para validar una Escala de Medición de Carga de Trabajo en Unidades de Internación de Adultos, a partir de las intervenciones seleccionadas (NIC), con base en las características inherentes a tales unidades. Se utilizó selección aleatoria para definir los participantes (enfermeros y especialistas), que es representativa de las unidades de hospitalización en estudio. El estudio fue realizado de octubre de 2018 a abril de 2019. Resultados No solo los grupos focales, como también las entrevistas individuales y el comité de especialistas demostraron concordancia sobre la importancia de obtener un instrumento para medir la carga de trabajo, validado por los propios profesionales y representativo de su trabajo, con un lenguaje estandarizado y adaptado a la salud real. El análisis cuantitativo conducido por el comité de especialistas muestra una mayor relevancia (91,67 %) en los ítems: "Prevención" y "Educación para la salud", así como una consistencia respecto a la elaboración y redacción apropiada en el 99 % de los ítems seleccionados. Los evaluadores mantuvieron la acción en todos los ítems con un índice de aceptación de 75 % a 100 %. Conclusión El estudio cualitativo realizado proporciona los datos necesarios para la elaboración y validación de una escala para medir la carga de trabajo en enfermería, identificada a partir de las intervenciones de enfermería (NIC), como indicadores de la gestión de recursos humanos.

Abstract Objective To design and validate a scale to measure nursing workloads in Adult Hospitalization Units based on Nursing Interventions (NIC). Methods Analytical, descriptive, observational, prospective study, using mainly qualitative research methodology, by means of focus groups, committee of experts and individual interviews, to validate a Workload Measurement Scale in Adult Hospitalization Units, from the selected interventions (NIC) on a basis of the inherent characteristics of such units. A random selection was used to determine the participants (nurses and experts) and it is representative of the hospitalization units under study. It was carried out from October 2018 to April 2019. Results Not only the focus groups but also the individual interviews and the committee of experts conducted agree on the importance of obtaining an instrument to measure workloads validated by the professionals themselves and representative of their work, with standardized language and adapted to actual healthcare. The quantitative analysis conducted by the committee of experts shows a highest relevance (91,67%) in the items: "Prevention" and "Health education", as well as consistency with the construct and appropriate wording in 99% of the items selected. Evaluators maintained the action on all items with a 75% to 100% acceptance rate. Conclusion The qualitative study carried out provides the necessary data for the design and validation of a scale to measure nursing workloads, identified from the nursing interventions (NIC), as indicators of human resources management.

Environmental disturbance history undermines population responses to cope with anthropogenic and environmental stressors.

Since aquatic ecosystems receive runoff of most anthropogenic pollutants, risk assessment tools and protocols have been developed in order to protect them. However, most ecological risk assessments focus on the study of single species exposed to a single chemical, overlooking the environmental reality of multiple chemical exposures and stresses over generations. To advance in realistic predictions of population and community changes, the environmental disturbance history should be considered. The aim of this study was to evaluate how environmental disturbance history (continuous expected sublethal exposure to one chemical for several generations) determines populations' responses to another stressors. The experiments were performed with Daphnia magna as model organisms. To create a disturbance history, dimethoate was used as first stressor at two different concentrations: medium (0.089 mg·L-1) and high (0.89 mg·L-1). The population exposed to medium concentration ("vulnerable population") showed no differences from the control population in the selected parameters (body size and reproductive success). Our interest in the vulnerable population was to determine whether, after a first stressor, the detected non-effect hides a population impairment, which might undermine populations' responses to future stressors. After 4 generations under dimethoate exposure, the vulnerable D. magna population was exposed to a second chemical stressor (glyphosate) and an environmental stressor (food scarcity) as compared to control. The vulnerable population showed both less resistance to glyphosate and less resistance to starvation, corroborating the hypothesis that a disturbance history of continuous expected sublethal chemical exposures undermines populations' responses to further chemical and environmental stressors.

Rescue of degenerating neurons and cells by stem cell released molecules: using a physiological renormalization strategy.

Evidence suggests that adult stem cell types and progenitor cells act collectively in a given tissue to maintain and heal organs, such as muscle, through a release of a multitude of molecules packaged into exosomes from the different cell types. Using this principle for the development of bioinspired therapeutics that induces homeostatic renormalization, here we show that the collection of molecules released from four cell types, including mesenchymal stem cells, fibroblast, neural stem cells, and astrocytes, rescues degenerating neurons and cells. Specifically, oxidative stress induced in a human recombinant TDP-43- or FUS-tGFP U2OS cell line by exposure to sodium arsenite was shown to be significantly reduced by our collection of molecules using in vitro imaging of FUS and TDP-43 stress granules. Furthermore, we also show that the collective secretome rescues cortical neurons from glutamate toxicity as evidenced by increased neurite outgrowth, reduced LDH release, and reduced caspase 3/7 activity. These data are the first in a series supporting the development of stem cell-based exosome systems therapeutics that uses a physiological renormalization strategy to treat neurodegenerative diseases.

Effect of somatostatin on human retinal pigment epithelial cells permeability.

PURPOSE: To assess the effect of somatostatin (SST) on the permeability of human retinal pigment epithelial cells. METHODS: We conducted two experiments, exposing cells from human-fetal retinal pigment epithelium (hfRPE) cultures to vascular endothelial growth factor (VEGF), with or without SST pretreatment, in one, and to hypoxic conditions, again with or without SST pretreatment, in the other. The paracellular permeability of hfRPE was assessed by measuring transepithelial electrical resistance (TER) and fluorescein isothiocyanate-sodium (FITC-sodium) flux. Immunochemistry analysis was used to assess the expression of occludin and Zonula occludens-1(ZO-1). RESULTS: Both VEGF and hypoxia increased permeability of the hfRPE, as measured by TER and tracer flux, and decreased occludin and ZO-1staining, as measured by immunochemistry. Pretreatment of cultures with SST partially counteracted these effects. CONCLUSIONS: Somatostatin may play a role in the regulation of permeability across retinal pigment epithelium. It may act as an anti-permeability factor in the retina through the enhancement of tight junction function.

Synthesis, characterization, theoretical studies and biological (antioxidant, anticancer, toxicity and neuroprotective) determinations of a copper(II) complex with 5-hydroxytryptophan.

5-Hydroxy-L-tryptophan (5-HTP) is a serotonin pathway metabolite of L-tryptophan in the brain. In the knowledge that the biological properties of some compounds can be modified upon metal complexation, a new solid metal complex, [Cu(5-hydroxytryptophan)2].H2O (Cu5HTP), has been synthesized and characterized to analyze the modification of some biological properties. The conformational investigations (optimized in gas phase at B3LYP/6-311G** theory level) suggest the coexistence of two conformers of Cu5HTP with cis- and trans- arrangements of the amino acids in the equatorial plane. The trans- Cu5HTP1 complex is the most stable conformer. The complexation led to an enhancement of the antioxidant properties of the ligand. The metal complex also improved the anticancer behavior of the ligand (tested in cancer cell lines derived from human lung (A549), cervix (HeLa) and colon (HCT-116)). It did not show toxicity against either the non-malignant human lung fibroblast (MRC-5) cell line or Artemia salina and did not behave as mutagenic agent (Ames test). Cellular reactive oxygen species production may be one of the possible mechanisms of action. Besides, the metal complex exerted neuroprotective action on cortical neurons from embryonic 18 days rats exposed to glutamate.

Impulsando las directrices de la Ley de Calidad del SNS: modelos computacionales de guías de práctica clínica / Promoting directives of the Quality Law of the Spanish National Health System: Computer-interpretable clinical practice guidelines

La Ley de cohesión y calidad del Sistema Nacional de Salud promueve la utilización de nuevas tecnologías para hacer posible la aplicación de la evidencia científica por los profesionales sanitarios. En este sentido, existen herramientas tecnológicas, conocidas como modelos computacionales de guías de práctica clínica (computer-interpretable guidelines), que pueden ayudar a la consecución de este objetivo desde un prisma innovador. Su adopción puede llevarse a cabo de forma iterativa, teniendo un gran potencial inicial como herramientas formativas, de calidad y seguridad del paciente, en la toma de decisiones compartidas y, opcionalmente, podrán ser integradas con la historia clínica electrónica una vez sean validadas de forma rigurosa. En este artículo se presentan los avances de dichas herramientas, se revisan proyectos internacionales y experiencias propias en los que han demostrado su valor, y se ponen de manifiesto las ventajas, riesgos y limitaciones que presentan desde un punto de vista clínico

The Cohesion and Quality Act of the National Health System promotes the use of new technologies to make it possible for health professionals put the scientific evidence into practice. In order to do this, there are technological tools, known as of computer-interpretable guidelines, which can help achieve this goal from an innovation perspective. They can be adopted using an iterative process, having a great initial potential as an educational tool, of quality and safety of the patient, in the decision making and, optionally, can be integrated with the electronic medical history, once they are rigorously validated. This article presents updates on these tools, reviews international projects, and personal experiences in which they have demonstrated their value, and highlights the advantages, risks, and limitations they present from a clinical point of view