Chiroptically active allenes are employed for the construction of surface-confined nanostructures. Morphological complementarity between the homochiral units leads to self-assembly of two ...highly-ordered, upstanding, diastereomeric architectures. The novel, intertwined self-assembled layer structures feature reactive terminal alkynes for further functionalization and carry potential for widespread applications exploiting chiroptical amplification.
Upstanding chiral architectures (UCAs) were fabricated from chiroptically active allenes under surface-confined conditions with morphological complementarity being central to the self-assembly process.
We develop a deep-learning approach to differentiate between the eye movement behavior of people with neurodegenerative diseases during reading compared to healthy control subjects. The subjects with ...and without Alzheimer’s disease read well-defined and previously validated sentences including high- and low-predictable sentences, and proverbs. From these eye-tracking data trial-wise information is derived consisting of descriptors that capture the reading behavior of the subjects. With this information a set of denoising sparse-autoencoders are trained and a deep neural network is built using the trained autoencoders and a softmax classifier that identifies subjects with Alzheimer’s disease with 89.78% accuracy. The results are very encouraging and show that such models promise to be helpful for understanding the dynamics of eye movement behavior and its relation with underlying neuropsychological processes.
La enfermera referente es una pieza clave para ofertar cuidados de calidad. Nuestro objetivo ha sido conocer como evaluan los pacientes la figura de la enfermera referente en nuestra unidad de ...hemodialisis, para revisar y actualizar su rol y sus tareas. Se selecciono una muestra de 51 pacientes cronicos que acuden a hemodialisis en nuestro centro a los que se entrego una encuesta anonima, autoadministrada, disenada y validada por el personal de la unidad. Los resultados obtenidos indican que los pacientes evaluan positivamente a la enfermera referente confirmandose la utilidad y relevancia de la misma. Sus respuestas definen un perfil basico de enfermera referente: una profesional a la que conocen por su nombre, amable y cortes, con la que se comunican frecuentemente, con extensa formacion y experta en su trabajo, capacitada y dispuesta a resolver las dudas y problemas que los pacientes plantean. En definitiva, su enfermera de confianza. Las aportaciones de los encuestados para mejorar los cuidados, nos sugieren proporcionar mas informacion sobre la dieta y proporcionar espacios de intimidad para la comunicacion enfermera-paciente. PALABRAS CLAVE: -- ENFERMERA REFERENTE -- HEMODIALISIS -- SATISFACCION PACIENTE -- CALIDAD CUIDADOS The referring nurse is a key element in offering quality care. Our aim was to find out how patients assess the referring nurse in our haemodialysis unit, in order to review and update her role and tasks. A sample of 51 chronic patients undergoing haemodialysis in our centre was selected and these patients were given an anonymous self-administered questionnaire, designed and validated by staff of the unit. The results obtained show that patients value the referring nurse positively, confirming her usefulness and relevance. Their replies define a basic profile for a referring nurse: a professional they know by name, friendly and polite, with whom they communicate frequently, with extensive training and an expert in her work, capable of and willing to overcome the doubts and problems that patients raise. In short, the nurse they trust. The contributions of the questionnaire respondents for improving care suggest that we provide more information about diet and provide areas of privacy for nurse-patient communication. KEY WORDS: -- REFERRING NURSE -- HAEMODIALYSIS -- PATIENT SATISFACTION -- CARE QUALITY
The aim of this study was to show how a nurses negative evaluation of a blood pressure (BP) reading can cause an increase in BP in the following reading. Twenty-five subjects with normal pressure who ...had been informed that they were to participate in an epidemiological BP study took part and they were divided into two groups. After taking the first BP reading, participants from the experimental group were informed that their pressure was normal but high for their age, whereas those in the control group were told that their pressure was normal for their age. The results showed that this comment caused a significant increase in the diastolic BP of the experimental group. The theoretical and clinical implications of this reaction are discussed in relation to the phenomenon known as White-Coat Hypertension from the perspective of the theory of incubation.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
La enfermera referente es una pieza clave para ofertar cuidados de calidad. Nuestro objetivo ha sido conocer como evalúan los pacientes la figura de la enfermera referente en nuestra unidad de ...hemodiálisis, para revisar y actualizar su rol y sus tareas. Se seleccionó una muestra de 51 pacientes crónicos que acuden a hemodiálisis en nuestro centro a los que se entregó una encuesta anónima, autoadministrada, diseñada y validada por el personal de la unidad. Los resultados obtenidos indican que los pacientes evalúan positivamente a la enfermera referente confirmándose la utilidad y relevancia de la misma. Sus respuestas definen un perfil básico de enfermera referente: una profesional a la que conocen por su nombre, amable y cortés, con la que se comunican frecuentemente, con extensa formación y experta en su trabajo, capacitada y dispuesta a resolver las dudas y problemas que los pacientes plantean. En definitiva, su enfermera de confianza. Las aportaciones de los encuestados para mejorar los cuidados, nos sugieren proporcionar más información sobre la dieta y proporcionar espacios de intimidad para la comunicación enfermera-paciente.
During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on ...individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses.
To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses.
This study uses descriptive, correlational, two-level design with repeated measures.
Wards of two University hospitals.
A random cohort of 113 nurses was studied.
An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships.
Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task.
The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of this study was to evaluate the influence of primary and secondary appraisal, and of coping strategies, on daily stress, taking into account any possible effect of the big five personality ...traits. Over 10 days, a cohort of 122 people filled out an on-line diary in which they recorded the most important stressful event each day, their primary and secondary appraisal of this, and how they coped with it. The results indicate that negative affect is influenced by a high degree of primary appraisal, limited secondary appraisal and a high rate of refusal, with no significant influence of personality traits. Positive affect is mainly influenced by a lower extent of primary appraisal, more secondary appraisal, and by a low rate of refusal and of social support seeking. Moreover, a low level of neuroticism was a predictor of greater positive affect. These data are discussed, highlighting the importance of a situational assessment of stressful episodes at each moment to not only understand the effects of stress on health but also, to develop effective interventions.
El objetivo de este estudio fue evaluar la influencia de la evaluación primaria, secundaria y de las estrategias de afrontamiento sobre el estrés diario, teniendo en cuenta cualquier posible efecto de los cinco grandes rasgos de personalidad. Durante 10 días, una cohorte de 122 personas llenó un diario en línea en el que registraron el evento estresante más importante de cada día, su evaluación primaria y secundaria y cómo lo afrontaron. Los resultados indican que el afecto negativo está influido por una evaluación primaria alta, una evaluación secundaria limitada y una alta tasa de rechazo, sin influencia significativa de los rasgos de personalidad. El afecto positivo está influido principalmente por un menor grado de valoración primaria, una evaluación secundaria alta, por una baja tasa de rechazo y de búsqueda de apoyo social. Además, un nivel bajo de neuroticismo fue el mejor predictor del afecto positivo. Se discuten estos datos, destacando la importancia de una evaluación situacional de episodios estresantes en cada momento para no sólo comprender los efectos del estrés en la salud sino también, para desarrollar intervenciones efectivas.
Work-related stress is a prevalent condition in the nursing profession, and its influence may vary according to changeable individual and situational factors. It is, therefore, important to ...investigate the real-time momentary changes in these factors and their relationship to emotional exhaustion experienced by nurses.
We aim to analyse how their perceptions of demand, control, effort and reward change according to the task performed through real-time assessment and interact with the emotional exhaustion level of ward nurses.
The research design was longitudinal.
A three-level hierarchical model with a repeated measures design was used to assess the momentary self-reports of 96 hospital ward nurses, completed using a smartphone programmed with random alarms.
Findings show that demand, effort, and control appraisals depend on the task performed. The task appraised as most demanding, effortful, and controllable was direct care. Reward appraisal depends on the task performed and personal variables, i.e. emotional exhaustion. The situations perceived as more rewarding were rest and direct care. Momentary hedonic tone can be explained by the task performed, demand, reward, emotional exhaustion and by the interaction between emotional exhaustion and demand appraisal. Momentary fatigue can be explained by the task performed, demand, reward, and the emotional exhaustion.
This study highlights the importance of using momentary measures to understand complex and changeable inter-relationships. While also clarifying the targets of intervention programmes aimed at preventing burnout within the nursing profession.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Hyperkalaemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) as it limits the use of some prognostic-modifying drugs and has a negative ...impact on prognosis. The objective of the present study was to estimate the prevalence of hyperkalaemia in outpatients with HFrEF and its impact on achieving optimal medical treatment. For this purpose, a multicentre, prospective, and observational study was carried out on consecutive HFrEF patients who were monitored as outpatients in heart failure (HF) units and who, in the opinion of their doctor, received optimal medical treatment. A total of 565 HFrEF patients were included from 16 specialised HF units. The mean age was 66 ± 12 years, 78% were male, 45% had an ischemic cause, 39% had atrial fibrillation, 43% were diabetic, 42% had a glomerular filtration rate < 60 mL/min/1.7 m2, and the mean left ventricular ejection fraction was 31 ± 7%. Treatment at the study entry included: 76% on diuretics, 13% on ivabradine, 7% on digoxin, 18.9% on angiotensin-conversing enzyme inhibitors (ACEi), 11.3% on angiotensin receptors blockers (ARBs), 63.8% on angiotensin-neprilysin inhibitors (ARNi), 78.5% on mineralocorticoid receptor antagonists (MRAs), and 92.9% on beta-blockers. Potassium levels in the baseline analysis were: ≤5 mEq/L = 80.5%, 5.1−5.4 mEq/L = 13.8%, 5.5−5.9 mEq/L = 4.6%, and ≥6 mEq/L = 1.06%. Hyperkalaemia was the reason for not prescribing or reaching the target dose of an MRAs in 34.8% and 12.5% of patients, respectively. The impact of hyperkalaemia on not prescribing or dropping below the target dose in relation to ACEi, ARBs, and ARNi was significantly less. In conclusion, hyperkalaemia is a frequent problem in the management of patients with HFrEF and a limiting factor in the optimisation of medical treatment.
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