The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis.

BACKGROUND: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses' environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices. AIM: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment. METHODS: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain. RESULTS: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses' environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved. CONCLUSIONS: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research.

Nurses as agents for achieving environmentally sustainable health systems: A bibliometric analysis.

AIM: To analyse the current scientific knowledge and research lines focused on environmentally sustainable health systems, including the role of nurses. BACKGROUND: There seem to be differences between creating interventions focused on environmentally sustainable health systems, including nurses, and the scarcity of research on this topic, framed on the Sustainable Development Goals. METHODS: A bibliometric analysis was carried out, via three databases (Web of Science, Scopus and Pubmed), and the guideline recommendations were followed to select bibliometric data. RESULTS: The search resulted in 159 publications, significantly increasing the trends from 2017 to 2021 (p = .028). The most relevant countries in this area were the United States, the United Kingdom and Sweden. Also, the top articles were from relevant journals, indexed in Journal Citation Report, and the first and the second quartiles linked to the nursing field and citations (p < .001). CONCLUSION: Education is key to achieving environmentally sustainable health systems via institutions and policies. IMPLICATIONS FOR NURSING MANAGEMENT: There is a lack of experimental data and policies on achieving or maintaining environmentally sustainable health care systems, indicating that nurses have an important role and should be consulted and included in decision-making policies regarding sustainability in the health care systems.

Validation of the Spanish Version of the Questionnaire on Environmental Awareness in Nursing (NEAT).

Environmental awareness of the ecological problems caused by this climate crisis and its impact on global health has been growing globally. Nurses are health care agents that usually hurt the environment and contribute to the unsustainability of the care system. Such behavior is perpetuated without the nurses' awareness and is even magnified by the current pandemic, jeopardizing the health systems and the Sustainable Development Goals. However, there is no Spanish version of any survey that measures the awareness of these agents, only the Nurses Environmental Awareness Tool (NEAT) is available. The current research presents a unique investigation based on a mixed method, using the Spanish version of the NEAT, also called NEAT-es. The results of the mixed analysis (N = 376), a cognitive interview, and descriptive analysis indicated perfect consistency (Cronbach's alpha > 0.80), better than the original. The survey validation achieved higher values and can be used to measure environmental awareness in Spain and Spanish-speaking countries.

Impact of the Pandemic on the Teaching and Research Staff at a Technological University in Spain: Deepening the Gender Gap.

The alteration of the educational model caused by the COVID-19 pandemic has not affected all university faculty equally. This work explores the academic, digital and gender inequalities caused by the pandemic on the teaching and research staff of a technological university for STEM (Science, Technology, Engineering and Mathematics) disciplines in Spain, the Universitat Politècnica de Catalunya-BarcelonaTech (UPC). The study considers an anonymous survey with a non-probabilistic voluntary sample (n = 355). The results of the survey reveal that, over these months, the teaching and research staff of the university, regardless of gender, has significantly increased its academic activity due especially to the number of hours devoted to virtual teaching compared to its teaching dedication in a situation of normalcy. This study shows that the lockdown has strongly affected women who are more vulnerable to crisis. In particular, the negative impact on research has been higher in female faculty staff from the UPC, who already face disparities regarding promotion and, during lockdown, stated more difficulties with household work reconciliation. From the results of this study, it is possible to conclude that the COVID-19 pandemic has deepened the gender gap in the academic field.

Equitable mitigation to achieve the 1.5 °C goal in the Mediterranean Basin.

The mitigation required to achieve the 1.5 °C goal of the Paris Agreement entails drastic emissions reductions. The mentioned goal is of special interest for regions like the Mediterranean where the average temperature is rising above the world average with the consequential risk for the future viability of its different ecosystems. The objective of this work is to analyze if the commitments of the Mediterranean Basin countries submitted under the Paris Agreement framework are in line with the 1.5 °C goal. For this analysis, the cumulative emissions of the current Nationally Determined Contributions of these countries until 2030, are compared with the result obtained from distributing the cumulative greenhouse gas emissions compatible with the 1.5 °C global mitigation scenario between 2018 and 2100. This distribution is obtained using the Model of Climate Justice that allocates the global emissions by using equity criteria (equality and responsibility) that take into consideration the historical responsibility for each country, in the period from 1994 to 2017. There are two main conclusions from the analysis of the NDCs. Firstly, it is concluded that the Mediterranean Basin countries, as a whole, are not in line with the 1.5 °C goal, because by 2030, 77% of the emissions budget that should be available until 2100, based on the equity criteria aforementioned, will already have been emitted. And, secondly, when the NDCs for each one of the countries are compared, some significant differences in the degree of ambition can be seen.

Judicialización de medicamentos de alto costo en Argentina / Judicialization of high-cost drugs in Argentina

INTRODUCCIÓN Los medicamentos de alto costo son causa frecuente de recursos de amparo. El objetivo del estudio fue identificar los medicamentos de alto costo judicializados, las patologías involucradas, el impacto económico y los factores contextuales. METODOS Se realizó un estudio descriptivo cuali-cuantitativo. Se incluyó un análisis retrospectivo de amparos por medicamentos de alto costo. Se analizaron notas periodísticas y la relación entre amparos con aprobación regulatoria e inclusión a paquetes de beneficios. RESULTADOS Se analizaron 405 amparos sobre medicamentos de alto costo entre el 01/01/2017 y 31/12/2020. El 53% de los demandantes eran mujeres, el 35% menores y más del 80% con cobertura de salud. El 42% se inició en Buenos Aires. Los medicamentos más judicializados fueron nusinersen (21,73%), palbociclib (5,93%) y agalsidasa alfa (4,69%). El 21,91% fueron en pacientes con atrofia muscular espinal y el 12,09% en cáncer de mama. El 69,35% estaban aprobados por ANMAT y el 45,74% incluido en SUR al momento del amparo El 16,80% de los casos judicializados habían sido evaluados por CONETEC. El objeto del amparo fue el rechazo a la provisión en el 80% y el fallo a favor del demandante en el 90%, con tiempo hasta el acceso de 150 días. El costo por paciente del tratamiento con nusinersen fue de ARS 28.200.000; con palbociclib de ARS 6.028.089 y con agalsidasa alfa hasta ARS 35.582.112. Se observó una relación temporal entre la aparición del nusinersen en prensa nacional y la cantidad de amparos; más de la mitad fueron previos a la aprobación de la comercialización en el país. DISCUSIÓN La judicialización se concentró en medicamentos de altísimo costo para enfermedades poco frecuentes y en medicamentos oncológicos. Casi la totalidad de los fallos son a favor del demandante, siendo los tiempos de acceso al medicamento prolongados. Los medios de comunicación y los informes de evaluación de tecnologías sanitarias podrían afectar estos procesos.

The structure of molten CuCl: Reverse Monte Carlo modeling with high-energy X-ray diffraction data and molecular dynamics of a polarizable ion model.

The results of the structural properties of molten copper chloride are reported from high-energy X-ray diffraction measurements, reverse Monte Carlo modeling method, and molecular dynamics simulations using a polarizable ion model. The simulated X-ray structure factor reproduces all trends observed experimentally, in particular the shoulder at around 1 Å(-1) related to intermediate range ordering, as well as the partial copper-copper correlations from the reverse Monte Carlo modeling, which cannot be reproduced by using a simple rigid ion model. It is shown that the shoulder comes from intermediate range copper-copper correlations caused by the polarized chlorides.

Multicentric study of epidemiological and clinical characteristics of persons injured in motor vehicle accidents in Medellín, Colombia, 2009-2010 / Estudio multicéntrico de las características epidemiológicas y clínicas de las personas lesionadas en accidentes de tránsito en Medellín, Colombia, 2009-2010

Introduction: Traffic accidents (TA) cause 1.23 million deaths each year worldwide while between 20 and 50 million persons are injured each year. In 2011 in Medellin, Colombia, there were 307 traffic deaths and 23,835 injured with 411 accidents for each 10,000 vehicles. Objective: The purpose of the study was to describe the epidemiologic and clinical characteristics, as well as the quality of life and disability outcomes for those injured in traffic accidents in Medellin. Methods: This prospective, descriptive, cross-sectional study collected data from 834 patients that were classified with the New Injury Severity Score (NISS) , the WHO-DAS-II (Disability Assessment) Scale and the SF-36 Health Survey. Results: Three-fourths (75.8%) of the patients were male. Eighty-one percent (81.0%) of patients were involved in motorcycle accidents, with 45.6% suffering moderate trauma, and 32.6% experiencing severe trauma. Of the patients with severe trauma, 8.5% were not wearing helmets. Half of the sample (49.7%) injured their extremities. The WHODAS-II domains most affected were: Activities outside the home (62.0%), Housework (54.3%) and Moving in one's environment (45.2%). Quality of life areas affected were: Physical role (20.3%), Body pain (37.3%), Emotional role (44.1%), Physical functioning (52.6%). Conclusions: Patients with more severe injuries had higher levels of disability and a worse quality of life. Motorcycles made up a large proportion of traffic accidents in this city and mitigation strategies to reduce this public health problem should particularly focus on this high-risk group.

Antecedentes: Los accidentes de tránsito (AT) causan 1.23 millones de muertes en el mundo, y entre 20 y 50 millones sufren lesiones no fatales. En Medellín (Colombia) en el 2011 hubo 307 muertos en AT y 23.835 heridos, con 411 accidentes por cada 10.000 vehículos. Objetivo: Describir las características epidemiológicas, clínicas, de calidad de vida y discapacidad de los pacientes luego de un AT en Medellín. Métodos: Estudio descriptivo trasversal prospectivo del estado inicial de una cohorte de 834 pacientes, clasificados de acuerdo a la gravedad de trauma (NISS) y las escalas WHO-DAS II y SF-36. Resultados: En el 81% de los AT estuvieron involucradas motos, con lesiones moderadas en el 45.6 %, y graves en el 32.6% de ellos. No utilizaban casco el 8.5% de los pacientes con NISS grave. En el 49.7% se afectaron los miembros inferiores. Los dominios del WHO-DAS II más afectados fueron: actividades fuera del hogar (62.0%) actividades domésticas (54.3%) y moverse en el entorno (45.2%). La calidad de vida comprometió los dominios de desempeño físico (20.3%), dolor corporal (37.3%), desempeño emocional (44.1%) y funcionamiento físico (52.6%). Conclusiones: Los pacientes con lesiones más graves tuvieron mayor compromiso en la discapacidad y en la calidad de vida. Esta carga de enfermedad la producen principalmente los AT en los que están involucradas las motos.

Multicentric study of epidemiological and clinical characteristics of persons injured in motor vehicle accidents in Medellín, Colombia, 2009-2010.

INTRODUCTION: Traffic accidents (TA) cause 1.23 million deaths each year worldwide while between 20 and 50 million persons are injured each year. In 2011 in Medellin, Colombia, there were 307 traffic deaths and 23.835 injured with 411 accidents for each 10.000 vehicles. OBJECTIVE: The purpose of the study was to describe the epidemiologic and clinical characteristics, as well as the quality of life and disability outcomes for those injured in traffic accidents in Medellin. METHODS: This prospective, descriptive, cross-sectional study collected data from 834 patients that were classified with the New Injury Severity Score (NISS) , the WHO-DAS-II (Disability Assessment) Scale and the SF-36 Health Survey. RESULTS: Three-fourths (75.8%) of the patients were male. Eighty-one percent (81.0%) of patients were involved in motorcycle accidents, with 45.6% suffering moderate trauma, and 32.6% experiencing severe trauma. Of the patients with severe trauma, 8.5% were not wearing helmets. Half of the sample (49.7%) injured their extremities. The WHODAS-II domains most affected were: Activities outside the home (62.0%), Housework (54.3%) and Moving in one's environment (45.2%). Quality of life areas affected were: Physical role (20.3%), Body pain (37.3%), Emotional role (44.1%), Physical functioning (52.6%). CONCLUSIONS: Patients with more severe injuries had higher levels of disability and a worse quality of life. Motorcycles made up a large proportion of traffic accidents in this city and mitigation strategies to reduce this public health problem should particularly focus on this high-risk group.

ANTECEDENTES: Los accidentes de tránsito (AT) causan 1.23 millones de muertes en el mundo, y entre 20 y 50 millones sufren lesiones no fatales. En Medellín (Colombia) en el 2011 hubo 307 muertos en AT y 23.835 heridos, con 411 accidentes por cada 10.000 vehículos. OBJETIVO: Describir las características epidemiológicas, clínicas, de calidad de vida y discapacidad de los pacientes luego de un AT en Medellín. MÉTODOS: Estudio descriptivo trasversal prospectivo del estado inicial de una cohorte de 834 pacientes, clasificados de acuerdo a la gravedad de trauma (NISS) y las escalas WHO-DAS II y SF-36. RESULTADOS: En el 81% de los AT estuvieron involucradas motos, con lesiones moderadas en el 45.6 %, y graves en el 32.6% de ellos. No utilizaban casco el 8.5% de los pacientes con NISS grave. En el 49.7% se afectaron los miembros inferiores. Los dominios del WHO-DAS II más afectados fueron: actividades fuera del hogar (62.0%) actividades domésticas (54.3%) y moverse en el entorno (45.2%). La calidad de vida comprometió los dominios de desempeño físico (20.3%), dolor corporal (37.3%), desempeño emocional (44.1%) y funcionamiento físico (52.6%). CONCLUSIONES: Los pacientes con lesiones más graves tuvieron mayor compromiso en la discapacidad y en la calidad de vida. Esta carga de enfermedad la producen principalmente los AT en los que están involucradas las motos.

Estudio evaluativo sobre una herramienta informática de gestión enfermera en el periodo 2005-2010 / Assessment of a software application tool for managing nursing care processes in the period 2005-2010

Objetivos. Identificar beneficios y dificultades en la aplicación informática. Método. Estudio evaluativo de la herramienta informática Azahar utilizada en la gestión del proceso enfermero. La población de estudio fueron las enfermeras usuarias del sistema en hospitalización y las beneficiarias del mismo en Atención Primaria; en cada grupo la selección se realizó al azar y el número lo determinó la saturación de los datos. Técnicas de recogida de datos: entrevistas en profundidad y grupo de discusión. Resultados. Las enfermeras consideraron que lo más beneficioso y de utilidad en la herramienta son la valoración inicial y el informe de alta de continuidad de cuidados; así mismo identifican como ventajoso que registre todos los datos del proceso enfermero garantizando la calidad. Los inconvenientes y debilidades los relacionaron con estar sometidas a continuas variabilidades en su cotidianeidad asistencial; un aumento de carga de trabajo impide realizar siempre el registro informático, haciéndolo en papel, lo que supone una duplicidad en los registros; consideraron así mismo que el sistema operativo de la herramienta informática debe mejorar en cuanto a simplicidad y operatividad. Conclusión. La simplicidad en la herramienta y la adecuación en las cargas de trabajo, favorecerían la utilización de la misma y como consecuencia unos cuidados continuados (AU)

Objectives. To identify problems and critical points in the software application. Method. Assessment of the implementation of the software tool "Azahar" used to manage nursing care processes. The monitored population consisted of nurses who were users of the tool, at the Hospital and those who benefited from it in Primary Care. Each group was selected randomly and the number was determined by data saturation. A qualitative approach was employed using in-depth interviews and group discussion as data collection techniques. Results. The nurses considered that the most beneficial and useful application of the tool was the initial assessment and the continuity of care release forms, as well as the recording of all data on the nursing process to ensure quality. The disadvantages and weaknesses identified were associated with the continuous variability in their daily care. The nurses related an increase in workload with the impossibility of entering the records into the computer, making paper records, thus duplicating the recording process. Likewise, they consider that the operating system of the software should be improved in terms of simplicity and functionality. Conclusion. The simplicity of the tool and the adjustment of workloads would favour its use and as a result, continuity of care (AU)

[Assessment of a software application tool for managing nursing care processes in the period 2005-2010]. / Estudio evaluativo sobre una herramienta informática de gestión enfermera en el periodo 2005-2010.

OBJECTIVES: To identify problems and critical points in the software application. METHOD: Assessment of the implementation of the software tool "Azahar" used to manage nursing care processes. The monitored population consisted of nurses who were users of the tool, at the Hospital and those who benefited from it in Primary Care. Each group was selected randomly and the number was determined by data saturation. A qualitative approach was employed using in-depth interviews and group discussion as data collection techniques. RESULTS: The nurses considered that the most beneficial and useful application of the tool was the initial assessment and the continuity of care release forms, as well as the recording of all data on the nursing process to ensure quality. The disadvantages and weaknesses identified were associated with the continuous variability in their daily care. The nurses related an increase in workload with the impossibility of entering the records into the computer, making paper records, thus duplicating the recording process. Likewise, they consider that the operating system of the software should be improved in terms of simplicity and functionality. CONCLUSION: The simplicity of the tool and the adjustment of workloads would favour its use and as a result, continuity of care.

A polarizable ion model for the structure of molten CuI.

The results are reported of the molecular dynamics simulations of the coherent static structure factor of molten CuI at 938 K using a polarizable ion model. This model is based on a rigid ion potential to which the many body interactions due to the anions induced polarization are added. The calculated structure factor reproduces the clear sharp prepeak observed in neutron diffraction data. The corresponding partial structure factors and the related radial distribution functions calculated by molecular dynamics are compared with those found in the literature derived from a combination of neutron and x-ray diffraction data with the aid of the reverse Monte Carlo simulation technique, as well as those calculated by ab initio MD simulations.

The structure of molten AgCl, AgI and their eutectic mixture as studied by molecular dynamics simulations of polarizable ion model potentials.

The structure of molten AgCl, AgI, and their eutectic mixture Ag(Cl(0.43)I(0.57)) is studied by means of molecular dynamics simulations of polarizable ion model potentials. The corresponding static coherent structure factors reproduce quite well the available neutron scattering data. The qualitative behavior of the simulated partial structure factors and radial distribution functions for molten AgCl and AgI is that predicted by the reverse Monte Carlo modeling of the experimental data. The AgI results are also in qualitative agreement with those calculated from ab initio molecular dynamics.

Static dielectric properties of polarizable ion models: molecular dynamics study of molten AgI and NaI.

The fluctuation-dissipation theorem for the static dielectric response function of systems of ions with inducible point dipoles is derived. It is shown that the static longitudinal dielectric function is determined by spatial correlations of both charge and dipole-moment density fluctuations. Moreover, it is deduced that the long-wavelength behavior of the charge structure factor for polarizable ion systems is different from that for systems of rigid ions. Molecular dynamics simulation results of rigid and polarizable ion models for molten AgI and NaI are reported.

Molecular dynamics study of polarizable point dipole models for molten sodium iodide.

The structure, the ionic transport properties, and the dynamics of long-wavelength charge-density fluctuations, for two polarizable point dipole models of molten NaI, have been studied by molecular dynamics simulations. These models are based on a rigid ion potential to which the induced dipole polarization of the anions is added. The polarization is added in such a way that point dipoles are induced on the anions by both local electric field and short-range damping interactions that oppose the electrically induced dipole moments. The two polarizable ion models differ only in the range of the damping polarization interactions. The influence of the induced anion polarization on the different properties of simulated molten NaI is discussed.

Free radical-scavenging activity of indolic compounds in aqueous and ethanolic media.

Indolic compounds are a broad family of substances present in microorganisms, plants and animals. They are mainly related with tryptophan metabolism, and present particularities that depend on their respective chemical structures. The most important members of the family are the plant hormone, indole-3-acetic acid, and the animal hormone, melatonin. An important characteristic of some indolic compounds is that they may be useful as chemical preventive agents against diseases such as cancer, oxidative stress, etc. For this reason, the possible antioxidant activities (free radical-scavenging activity) of several indoles were studied. The2,2'-azino-bis-(3-ethylbenzthiazoline-6-sulfonic acid /H(2)O(2)/HRP decoloration method was applied to determine both hydrophilic (in buffered media) and lipophilic (in organic media) antioxidant properties of the indolic compounds. Also, a study of the hydrophilic antioxidant activities of indoles at different pH values (between 4.5 and 8.5) was made. Finally, their possible role as diet plant antioxidants is discussed.

On-line antioxidant activity determination: comparison of hydrophilic and lipophilic antioxidant activity using the ABTS*+ assay.

The ABTS/H(2)O(2)/HRP decoloration method is capable of determining both hydrophilic (in buffered media) and lipophilic (in organic media) antioxidant properties in complex samples. Now, we have adapted this method for on-line chromatographic determination. The easy, rapid and controlled generation of the ABTS radical and its great stability in buffered and organic media were important characteristics in the measurement of antioxidant activities. The HPLC-ABTS method used two pumps (one for isocratic eluting-phase and the other for preformed ABTS radical) and an UV-VIS diode array detector. The dual analysis of samples -- conventional (with UV-VIS detection) and ABTS-scavenging (at 600 nm) -- provided valuable on-line information about the correspondence between the presence of a determined compound and its possible antioxidant activity, and was applicable to both hydrophilic and lipophilic antioxidants (HAA and LAA). A comparison between HAA and LAA determined by the end-point method and by the on-line HPLC method is presented. The application to juices showed that both methods are suitable, sensitive and selective, gave similar values, and the HPLC-ABTS method contributed additional information about the antioxidant activity profile.