During the Middle Ages and the Renaissance, ink was commonly manufactured by mixing tannin with iron sulphates. The anoxic environment inside ancient books favours the reduction of the sulphate in ...the ink and allows spherical aggregates (framboids) of submicrometre-sized pyrite crystals (iron sulphide) to be formed.
Spanish Natural History Museum Garcia-Guinea, Javier; Martinez-Frias, Jesus
Science (American Association for the Advancement of Science),
01/1999, Volume:
283, Issue:
5400
Journal Article
Spanish Natural History Museum Garcia-Guinea, Javier; Martinez-Frias, Jesus
Science (American Association for the Advancement of Science),
01/1999, Volume:
283, Issue:
5400
Journal Article
Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the ...fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial.
We conducted a mixed-method fidelity evaluation study of the PVS-PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions, documented modifications to the planned implementation strategy, and a structured group interview with centers' leaders were all used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals' responsiveness and program differentiation.
Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed, the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies' perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers.
The PVS-PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals' exposure to the implementation strategy was high in both groups. The centers' organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions.
Clinicaltrials.gov identifier: NCT03254979 . Registered 16 August 2017.
At international level, there is abundant evidence of the positive impact that the Advanced Practice Nurse (APN) has on patients, health care organizations and nursing professionals. At national ...level, such evidence is incipient and should be developed in order to justify investments in the introduction of APN roles. The present study provides evidence on the impact of the APN in the professional development of nurses in one outpatient clinic of a hospital in Northern Spain.
The advanced practice nursing student (APNS) developed a change project aimed at improving knowledge of evidence based practice (EBP) among nurses in the cited outpatient clinic. To that end, the APNS followed the steps of the PEPPA (participatory, evidence-based, patient-focused process, for guiding the development, implementation, and evaluation of advanced practice nursing) framework and conducted unstructured observations, literature reviews, personal interviews and group discussions with 8 patients, 2 nurses and 4 cardiologists. The evaluation of the change project included personal interviews with nurses in the outpatient clinic before and after the intervention.
Nurses notably increased their knowledge on formulating clinical questions, developing and executing bibliographic searches, synthesizing and criticizing evidence, and applying and evaluating research results.
The results suggest that the positive impact of the integration of APNs into the Spanish clinical setting is not restricted to just patients and the hospital setting, but extends to the professional development of nurses and the outpatient clinic setting.
La psicopatía es un concepto antiguo que sigue teniendo gran repercusión en la sociedad actual. Así, los medios de comunicación nos muestran con relativa frecuencia brutales crímenes que se atribuyen ...a hipotéticos “psicópatas”. Debido a su falta de inclusión como categoría diagnósticas en las clasificaciones internacionales de enfermedades mentales resulta necesario esclarecer su término y delimitar sus características definitorias.
Se presenta una revisión de las evidencias que relacionan la posible afectación de los lóbulos frontales, ya sea estructural o funcionalmente, y la conducta del psicópata. Los datos revelan aparentes alteraciones en las técnicas de neuroimagen, actividad eléctrica cerebral, funcionamiento bioquímico y actividad del sistema nervioso autónomo. Asimismo se ha demostrado el déficit que presentan los psicópatas en el procesamiento emocional y en las funciones ejecutivas. A pesar de estas evidencias, hoy en día el psicópata no es considerado legalmente como un enfermo con afectación orgánica.
Psychopathy is an ancient concept that is still commonly used in modern society. Mass media frequently present brutal crimes attributed to hypothetical "psychopaths." As this term is not included as a diagnostic category in the international classifications of mental diseases, its characteristics must be clarified and defined. We present a review of the most significant evidence of a possible dysfunction of the frontal lobes, either structural or functional, related to psychopaths’ behavior. The findings reveal apparent alterations in neuroimaging techniques, cerebral electrical activity, biochemical and autonomic nervous system functioning. These individuals have been shown to have difficulty processing emotional information and deficits in executive functions. Despite these data, psychopathy is not currently considered a mental disease in the legal context.
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