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Articles publicats en revistes (Infermeria Fonamental i Clínica)

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    Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocol
    (John Wiley & Sons, 2010-07-02) Abad-Corpa, Eva; Meseguer-Liza, Cristobal; Martínez-Corbalán, José Tomás; Zárate-Riscal, Lourdes; Caravaca-Hernández, Amor; Paredes-Sidrach de Cardona, Antonio; Carrillo-Alcaraz, Andrés; Delgado-Hito, Pilar; Cabrero-García, Julio
    Aim. To generate changes in nursing practice introducing an evidence-based clinical practice (EBCP) model through a participatory process. To evaluate the effectiveness of the changes in terms of nurse-sensitive outcome (NSO). Background. For international nursing science, it is necessary to explore the reasons for supporting EBCP and evaluate the real repercussions and effectiveness. Methods. A mixed methods study with a sequential transformative design will be conducted in the bone marrow transplant unit of a tertiary-level Spanish hospital, in two time periods >12 months (date of approval of the protocol: 2006). To evaluate the effectiveness of the intervention, we will use a prospective quasi-experimental design with two non-equivalent and non-concurrent groups. NSO and patient health data will be collected: (a) impact of psycho-social adjustment; (b) patient satisfaction; (c) symptom control; (d) adverse effects. All patients admitted during the period of time will be included, and all staff working on the unit during a participatory action research (PAR). The PAR design will be adopted from a constructivist paradigm perspective, following Checkland’s ‘‘Soft Systems’’ theoretical model. Qualitative techniques will be used: 2-hour group meetings with nursing professionals, to be recorded and transcribed. Field diaries (participants and researchers) will be drawn up and data analysis will be carried out by content analysis. Discussion. PAR is a rigorous research method for introducing changes into practice to improve NSO.
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    Development and initial validation of a theory of planned behaviour questionnaire to assess critical care nurses' intention to use physical restraints
    (John Wiley & Sons, 2019-06-17) Via-Clavero, Gemma; Guàrdia-Olmos, Joan, 1958-; Gallart-Vivé, Elisabeth; Arias-Rivera, Susana; Castanera-Duro, Aaron; Delgado-Hito, Pilar
    Aims: To develop and psychometrically test a Theory of Planned Behaviour questionnaire to assess nurses' intention to use physical restraints in intubated patients. Design: A psychometric instrument validation study conducted in three phases. Methods: A theory‐driven questionnaire was developed. Eight experts validated the content of the preliminary 58‐item questionnaire. A pilot study was conducted including 101 critical care nurses to test the reliability of the items. Construct validity and reliability were tested in a cross‐sectional study of 12 units from eight hospitals in Spain (N=354) from October‐December 2017. Participants completed the questions based on the Theory of Planned Behaviour, as well as socio‐demographic and professional variables. Results: The instrument comprised 48 items. All the direct and indirect constructs exhibited acceptable reliability. Confirmatory factor analysis indicated satisfactory fit indices for factorial structure according to the Theory of Planned Behaviour. Nurses showed favourable attitudes, low perception of social pressure and modest perception of behaviour control. Perceived behavioural control and attitude were moderately positively correlated to the intention to use restraints, whereas subjective norm revealed the lowest correlation. Overall, the model explained 33% of the variance in intention. Conclusions: The Physical Restraint Theory of Planned Behaviour questionnaire is a 48‐item self‐reporting theoretically based instrument with acceptable reliability and construct validity to identify nurses' intentions to use physical restraints in intubated patients. Impact: Unravelling the key determinants of nurses' intentions to use physical restraints should be examined to tailor quality improvement projects aimed at de‐implementing restraints use in practice and to promote safer care.
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    Education on vaccination competence: an intensive course for skillful health science students
    (Academy of Medical Sciences of Bosnia and Herzegovina, 2023-12-15) Machajova, Michaela; Romero Mas, Montserrat; Mecugni, Daniela; Palomar Aumatell, Xavier; Prnova, Janka; Roure Pujol, Carme; Thomander, Heli; Sakellari, Evanthia; Perifanou, Dimitra; Konstantinou, Eleni; Nyman, Sari; Nikula, Anne; Ahokas, Aija; Casas Baroy, Joan Carles; Cavani, Daniela; Ferri, Paola; Galbany Estragués, Paola; Gradellini, Cinzia; Grendova, Kristina
    Background: Vaccination is one of the most successful and cost-effective interventions for public health. Studies have shown that health professionals who have good knowledge and positive attitudes towards vaccination are more likely to provide effective vaccination protection to people, including themselves. Therefore, health science students must acquire evidencebased knowledge during their education to meet the challenges of healthcare. Objective: The aim of this study was to investigate the knowledge, attitudes and feedback of health science students who participated in the Educating Vaccination Competence (EDUVAC) Intensive Course. Methods: A five-day Intensive Course was implemented for health science students, which included a pre-assignment. The EDUVAC Intensive Course used different teaching methods (lectures, workshops, interactive games, discussions), group work, study visits, and cultural programs to encourage students’ motivation. For the purpose of the study, students filled out an online questionnaire after giving informed consent. Results: Sample consisted of 31 health science students from five European Higher Institutions. They had very good knowledge on most knowledge questions. In the post measurement it was significantly greater and equal to 81%, p<0.001. Almost all students (93.5%) totally agreed that “It is important for adults to receive all recommended vaccines according to national guidelines”. The statement “I have had an active attitude and participation in the Intensive Course” received 80.6% total agreement. Over 90.3% rated the Intensive Course as “excellent” or “above average”. Conclusions: After completing the EDUVAC Intensive Course, students felt confident in their vaccination knowledge and skills, which benefited their professional development.
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    Positive mental health questionnaire-short form (PMHQ-SF18): Psychometric properties of the spanish version
    (MDPI, 2025-11-07) Lluch Canut, Ma. Teresa; Puig Llobet, Montserrat; Sanchez-Ortega, M. Aurelia; Moreno Arroyo, M. Carmen; Moreno Poyato, Antonio Rafael; Roldán Merino, Juan Francisco; Hidalgo Blanco, Miguel Ángel; Ferré Grau, Carmen; Albacar Riobóo, Núria; Sequeira, Carlos; Sanchez-Balcells, Sara; Mantas Jiménez, Susana; Prats Arimon, Marta; Agüera, Zaida
    Background: The construct of positive mental health (PMH) is defined as the basis of individuals' psychological well-being and their ability to function effectively and cope with life's challenges. The Positive Mental Health Questionnaire (PMHQ) is a reliable tool for assessing the PMH factors, but its length (39 items) can pose challenges in certain contexts and populations. This highlights the need for an abridged version of the questionnaire that requires less time to administer. Therefore, the main aim was to validate the Spanish 18 item-shortened version of the PMHQ (PMHQ-SF18). Methods: The sample consisted of 574 nursing students. Psychometric analyses were carried out based on construct validity, criterion validity, and internal consistency. A confirmatory factor analysis was conducted to ascertain whether the internal structure was consistent with the model of the previously validated Portuguese brief version. Results: The results supported the good psychometric properties of the instrument, with adequate validity and reliability. Confirmatory factor analysis revealed optimal goodness-of-fit values, supporting the six-factor structure. The overall Cronbach's alpha was 0.83. Conclusions: The findings suggest that the PMHQ-SF18 is a valid and reliable instrument, comparable to the original version, but with the added benefits of being shorter, quicker, and easier to administer. Consequently, it may be particularly useful for population-based screening studies and for monitoring change following positive mental health promotion interventions. Its abridged format makes it particularly suitable for assessing individuals with specific characteristics or in contexts where time is limited, and more concise instruments are required, for example, in primary care or critical care.
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    Participatory learning to enhance leadership competence in nursing students: a feasibility study
    (BioMed Central, 2025-10-29) Jiménez-Herrera, María F.; Gallart Fernández-Puebla, Albert; Martín-Ferreres, Maria Luisa; Rodriguez Higueras, Encarnación; Fuster-Linares, Pilar; Wennberg-Capellades, Laia; Llauradó Serra, Mireia; Martin-Delgado, Leandra; Alfonso-Arias, Cristina; Agudo Ugena, José Pablo; Casas-Güdel, Maria Jose; Pilar-Caballo, Silvia; Navarro-Gil, Noelia
    Background: Clinical leadership is an important skill for nurses to acquire. This process should begin during undergraduate nurse training. The purpose of this study was to evaluate whether the intervention of enhancing the self-perceived leadership competence of nursing students by incorporating a series of participatory learning activities is implementable into a nursing degree programme. Methodology: Feasibility study, with undergraduate nurse training programme in two Spanish universities, were conducted between autumn 2015 and July 2021 in three phases: design, acceptability and implementation, and expansion. Pre-post intervention study with control groups to examine change in self-perceived leadership skills and satisfaction in both the implementation and expansion phases. The two intervention groups (implementation and expansion phases, respectively) comprised nursing students from two consecutive cohorts at our university (n = 136). The two control groups (n = 132) were also students from two consecutive cohorts, one enrolled in our university, the other from the nursing degree programme offered by another university. Data were analyzed using: chi-square test for comparisons of dichotomous qualitative variables; Student's t test for unpaired data or the Mann-Whitney U test (depending on the normality); The general linear model with calculation of p values for within- and between-groups differences, with post-hoc Bonferroni correction, to evaluate the effect of the intervention. Results: In general, the results suggest the feasibility of the intervention due to the participatory learning activities were well-received by both students and academic tutors (satisfaction ratings above 80%), and importantly, they enhanced the self-perceived leadership skills of students who received the intervention (increase of 18% compared with 11% and 7% in the two control groups). Conclusions: The results support the feasibility of enhancing the self-perceived leadership competence of nursing students through participatory learning initiatives of this kind, but do not establish the effectiveness of the intervention, because further studies are required to corroborate these findings both within similar contexts and across diverse educational and cultural settings. Incorporating leadership training into nursing degree programmes could help to provide the foundational skills that students will need if they are to show clinical leadership in their professional careers. This is important as clinical leadership by nurses can have a positive impact on patient care and is also associated with greater professional satisfaction and resilience to workplace pressures.
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    Meropenem and piperacillin/tazobactam optimised dosing regimens for critically ill patients receiving renal replacement therapy
    (Springer Verlag, 2025-08-13) Sinnollareddy, Mahipal; Sousa, Eduardo; Soy Muner, Dolors; Spring, Anna; Starr, Therese; Stephens, Dianne; Taccone, Fabio Silvio; Thomas, Jane; Turnidge, John; Valkonen, Miia; De Waele, Jan J.; Varghese, Julie M.; Deans, Renae; Wallis, Steven C.; Donnellan, Sine; Walker, Robert J.; Eastwood, Glenn M.; Williams, Tricia; Frey, Otto R.; Wilson, Luke C.; Goutelle, Sylvain; Wittebole, Xavier; Gresham, Rebecca; Ain Jamal, Janattul; Joynt, Gavin M.; Kanji, Salmaan; Roberts, Jason A.; Ulldemolins, Marta; Liu, Xin; Baptista, João P.; Bilgrami, Irma; Boidin, Clement; Brinkmann, Alexander; Castro, Pedro; Choi, Gordon; Cole, Louise; Wright, Daniel F.B.; Zikou, Xanthi T.; Bellomo, Rinaldo; Lipman, Jeffrey; Kluge, Stefan; König, Christina; Koulouras, Vasilios P.; Lassig-Smith, Melissa; Laterre, Pierre-Francois; Lee, Anna; Lefrant, Jean-Yves; Lei, Katie; Leung, Patricia; Llauradó Serra, Mireia; Martín Loeches, Ignacio; Mat Nor, Mohd Basri; Mudaliar, Yugan; Ostermann, Marlies; Paul, Sanjoy K.; Peake, Sandra L.; Rello, Jordi; Roberts, Darren M.; Roberts, Michael S.; Richards, Brent; Rodríguez, Alejandro; Roehr, Anka C.; Roger, Claire; Seoane, Leonardo
    Purpose: Optimal dosing of meropenem and piperacillin/tazobactam in critically ill patients receiving renal replacement therapy (RRT) is uncertain due to variable pharmacokinetics. We aimed to develop generalisable optimised dosing recommendations for these antibiotics. Methods: Prospective, multinational pharmacokinetic study including patients requiring various forms of RRT. Independent population PK models were developed, externally validated and applied to perform Monte Carlo dosing simulations using Monolix and Simulx. We calculated the probability that these dosing regimens achieved standard and high therapeutic unbound antibiotic concentrations over 100% of the dosing interval for the treatment of Enterobacterales and Pseudomonas aeruginosa. Results: We enrolled 300 patients from 22 intensive care units across 12 countries receiving continuous veno-venous haemodialysis (13.0%), haemofiltration (23.3%), haemodiafiltration (48.4%) or sustained low-efficiency dialysis (15.3%). Models were developed using data from 234 patients (8322 samples) and validated with 66 additional patients (560 samples). Predictive performance was high, with mean prediction errors of - 5.2% for meropenem and - 16.9% for piperacillin. Dosing simulations showed that meropenem and piperacillin/tazobactam dosing requirements were dependent on urine output and RRT intensity and duration (p < 0.05). In all scenarios, extended/continuous infusions led to a better achievement of effective concentrations with lower daily doses compared to short infusion. Dosing nomograms were developed to inform dosing for different RRT settings, urine outputs, and target concentrations. Conclusion: RRT intensity and duration and urine output determine meropenem and piperacillin/tazobactam dosing requirements in critically ill patients receiving RRT. Extended/continuous infusions facilitate the attainment of effective concentrations.
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    Building nursing students’ professional identity through the ‘Design process’ methodology: A Qualitative Study
    (Sciedu Press Sciedu Press Sciedu Press, 2025-01-08) Tejero Vidal, Lorena L.; Pedregosa, Sara; Majó i Rossell, Anna; Garcia-Díaz, Fernando; Martinez Rodriguez, Laura
    To explore the elements of nursing identity recognized by nursing students in models developed through the ‘Design process’ methodology. The construction of nursing professional identity is a complex process involving identification, group belonging, partial assessments and social representations. Nursing identity is one of the most stereotyped and its formation during the nursing degree has a significant impact on professional development. Design can transform society and communicate a positive nursing identity. The ‘Design process’ connects conceptual content with real-world contexts, particularly with students’ future professional roles.
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    Nursing students' perceptions about the use of clinical simulation to teach safe medication administration: a focus group study
    (BioMed Central, 2025-08-18) Alfonso-Arias, Cristina; Llauradó Serra, Mireia; Rodriguez Higueras, Encarnación; Goni Fuste, Blanca; Brichs-Masnou, Laura; Wennberg-Capellades, Laia; De Juan Pardo, M. Angeles
    Background: Safe medication administration is a core competence that nursing students need to acquire during their training. Clinical simulation facilitates the integration of theoretical and practical knowledge in a safe environment, facilitating engagement and greater confidence. However, it is important to integrate students' perceptions to optimize their learning experience to achieve the desired learning outcomes. The purpose of this study was to explore nursing students' perceptions about the use of clinical simulation to teach safe medication administration. Methods: Descriptive qualitative study through focus groups with nursing students who had participated in simulation-based training on safe medication administration where they had been split into two groups that differed only on the degree of fidelity (low fidelity mannequin or standardized patient). Four focus groups were conducted with 24 nursing students who had participated in simulation-based training on safe medication administration. Group discussions were transcribed and subjected to thematic analysis. Results: Two themes with four subthemes emerged. Theme (1) Usefulness of the clinical simulation for acquiring competence in safe medication administration; included three subthemes. Students reported that simulation-based training helped them link theory and practice, increasing self-awareness of their medication competence and highlighting the importance of training in safe medication administration. Theme (2) "Elements of simulation design that foster learning"; included one subtheme. Students highlighted that having to work individually heightened their sense of responsibility and enabled them to identify their current strengths and weaknesses. The opportunity to observe classmates was seen as useful for learning from mistakes. Conclusions: The results of this study support the use of clinical simulation to teach nursing students the process of safe medication administration, although it is important that learning scenarios are adapted to students' level of experience and competence.
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    Survival improvement of patients with FLT3 mutated acute myeloid leukemia: results from a prospective 9 years cohort
    (Springer Nature, 2023-05-05) Sampol, Antonia; Garcia, Antoni; Cervera, Marta; Garcia Avila, Sara; Bargay, Joan; Ortín, Xavier; Nomdedéu Guinot, Josep Francesc; Esteve, Jordi; Sierra Gil, Jorge; Oñate, Guadalupe; Pratcorona, Marta; Garrido, Ana; Artigas-Baleri, Alicia; Bataller Torralba, Alex; Tormo, Mar; Arnan, Montserrat; Vives, Susana; Coll, Rosa; Salamero, Olga; Vall Llovera, Ferran
    Midostaurin added to intensive chemotherapy is the standard of care for acute myeloid leukemia (AML) with FLT3 mutations (FLT3mut). We analyzed the impact of midostaurin in 227 FLT3mut-AML patients included in the AML-12 prospective trial for fit patients ≤70 years (#NCT04687098). Patients were divided into an early (2012-2015) and late (2016-2020) cohorts. They were uniformly treated except for the addition of midostaurin in 71% of late group patients. No differences were observed in response rates or the number of allotransplants between groups. Outcome was improved in the late period: 2-year relapse incidence decreased from 42% vs 29% in early vs late group (p = 0.024) and 2-year overall survival (OS) improved from 47% vs 61% (p = 0.042), respectively. The effect of midostaurin was evident in NPM1mut patients (n = 151), with 2-yr OS of 72% (exposed) vs 50% (naive) patients (p = 0.011) and mitigated FLT3-ITD allelic ratio prognostic value: 2-yr OS with midostaurin was 85% and 58% in low and high ratio patients (p = 0.049) vs 67% and 39% in naive patients (p = 0.005). In the wild-type NPM1 subset (n = 75), we did not observe significant differences between both study periods. In conclusion, this study highlights the improved outcome of FLT3mut AML fit patients with the incorporation of midostaurin.
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    Análisis de las visitas en la unidad de urgencias hospitalaria y de los conocimientos de la población sobre atención primaria
    (Elsevier España, 2025-10-01) Balsells-Roig, Anna; Llauradó Serra, Mireia
    Objetivos: Analizar las características de las visitas menos urgentes y no urgentes en un servicio de urgencias hospitalario (SUH) y determinar los conocimientos de la población catalana sobre los servicios y uso de la atención primaria (AP). Diseño: El presente estudio está dividido en 2 partes: 1) estudio descriptivo, transversal, en el que se investigaron las visitas de un SUH, y 2) estudio observacional, transversal, a través de una encuesta ad hoc anónima y voluntaria. Emplazamiento: Las visitas analizadas fueron de un SUH de un hospital de tercer nivel de referencia de Cataluña (España). La encuesta fue distribuida electrónicamente a la población catalana. Participantes: 1) Visitas al SUH realizadas en 2018 y 2021 que fueran categorizadas a un nivel de triaje, y 2) residentes en Cataluña excluyendo a los que únicamente disponían de mutua privada de salud y menores de edad. Mediciones principales: 1) Nivel de triaje y variables asociadas a las visitas al SUH, y 2) conocimiento sobre su área de AP y 4 escenarios en los que debían determinar si irían al SUH o a AP. Resultados: 1) Se analizaron 219.454 visitas y el 50% fueron menos urgentes o no urgentes, y 2) 270 personas participaron en la encuesta. A pesar de conocer el área de AP, en caso de estar cerrado, el 67% afirmaban ir al SUH. En los escenarios las respuestas correctas variaron entre un 46,7 y un 86,3%. Conclusiones: Se demuestra la necesidad de abrir futuras líneas de investigación para mejorar el uso que la población hace de los recursos sanitarios en caso de situaciones de salud poco urgentes.
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    Critical care nurses' intention to leave and related factors: Survey results from 5 European countries
    (Elsevier Ltd., 2025-03-09) Llauradó Serra, Mireia; Curado Santos, Estel; Perpiñán Grogues, Marina; Constantinescu-Dobra, Anca; Cotiu, Madalina-Alexandra; Dobrowolska, Beata; Friganovic, Adriano; Gutysz-Wojnicka, Aleksandra; Hadjibalassi, Maria; Ozga, Dorota; Rezic, Sladana; Sabou, Adrian; Slijepcevic, Jelena; Georgiou, Evanthia
    Objectives: To determine the nursing intention to leave in critical care units and explore related factors along with work environment and sociodemographic variables. Design and setting: Quantitative cross-sectional study in five European countries (Spain, Poland, Croatia, Cyprus and Romania) through a self-administered survey in 2021. Methods: The "AACN Critical elements of a healthy work environment scale. National Survey of Critical-Care Nurse Work Environments" by the American Association of Critical Care Nurses was distributed to all nurses working in intensive care units through a convenience sampling method. The questionnaire included questions about healthy work environment, burnout, violence, intention to leave and sociodemographics. Results: 1033 responses were analysed. Participants from each country varied between 75 and 275 nurses. Mean age was 37.3 years old (SD 9.9) with a mean nursing experience in critical care of 10.8 (9.2) years. Despite 83.1 % of the nurses were satisfied with their current job, 22.8 % planned to leave their position. Intention to leave was independently associated with the country, gender, age, satisfaction with current job and frequency of moral distress (p < 0.05) along with several work-related variables, such as lower perception of a healthy work environment. Among the reasons to reconsider leaving the job, the most rated were higher salary and benefits (87.2 %), better staffing (85.3 %) and meaningful recognition (82 %). Conversely, the most relevant reasons that kept nurses working in their organisation, were salary and benefits and the people they work with. Conclusion: Almost one out of three critical care nurses are considering leaving their job. Many aspects of the work environment that influence the intention to leave are modifiable. Implications for clinical practice: Managers need to prioritise the retention of registered nurses, not only recruiting new personnel. Many aspects of the working environment need to be addressed in other to retain critical care nurses.
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    Emotions and feelings in critical and emergency caring situations: A qualitative study
    (BioMed Central, 2020-07-01) Llauradó Serra, Mireia; Acevedo Urdiales, María Sagrario; Bazo-Hernández, Leticia; Font-Jiménez, Isabel; Axelsson, Christer; Jiménez-Herrera, María F.
    Background: Moral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals. Methods: The study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants. Results: The emerging category "emotions and feelings in caring" has been analysed according to Haidt, considering that moral emotions include the subcategories of "Condemning emotions", "Self-conscious emotions", "Suffering emotions" and "Praising emotions". Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient's own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs. Conclusions: Moral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.
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    Optimizing dose conversion from IR-Tac to LCP-Tac formulations in renal transplant recipients: A population pharmacokinetic modeling study
    (MDPI, 2025-09-12) Mohammed Ali, Zeyar; Fernández Alarcón, Beatriz; Fontova, Pere; Vidal Alabró, Anna; Rigo Bonnin, Raúl; Melilli, Edoardo; Montero Pérez, Núria; Manonelles, Anna; Coloma, Ana; Favà, Àlex; Grinyó Boira, Josep M.; Cruzado, Josep Ma.; Colom Codina, Helena; Lloberas Blanch, Núria
    Background/Objectives: Tacrolimus dosing remains challenging due to its narrow therapeutic index and high inter- and intra-patient variability. The extended-release once-daily tacrolimus (LCP-Tac) formulation provides enhanced bioavailability and a sustained pharmacokinetic profile compared to the immediate-release twice-daily tacrolimus (IR-Tac) formulation. Although a general conversion ratio of 1:0.7 is widely recommended when switching between formulations, current guidelines do not account for pharmacogenetic variability. This study aimed to determine whether CYP3A5 genotype influences the conversion ratio in Caucasian renal transplant recipients using population pharmacokinetic (PopPK) modeling. Methods: A PopPK model was developed in NONMEM using full PK profiles (10-18 samples per patient) from 30 stable renal transplant patients treated with both IR-Tac and LCP-Tac. Results: Tacrolimus pharmacokinetics were best described by a two-compartment model with first-order absorption and linear elimination with distinct absorption rate constants and lag times for each formulation. Including circadian rhythm in the apparent clearance (CL/F) and Ka of IR-Tac significantly improved the model. CYP3A5 polymorphism was the most powerful covariate explaining variability on CL/F. CYP3A5*1 expressers showed higher clearance and lower exposure requiring a more pronounced dose reduction upon conversion to LCP-Tac. Simulations indicated optimal conversion ratios of 1:0.6 for CYP3A5*1 expressers and 1:0.7 for non-expressers. Conclusions: These findings highlight the need to move beyond a one-size-fits-all conversion ratio and adopt genotype-informed strategies. LCP-Tac's enhanced bioavailability requires dose reduction, greater in expressers when switching from IR-Tac. These genotype-specific recommendations provide clinically actionable guidance to complement therapeutic drug monitoring and support more individualized conversion protocols in renal transplantation.
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    Effectiveness of a Web-Based Course on Vaccination Competence in Higher Education: The Eduvac Erasmus+ Project.
    (Canadian Center of Science and Education, 2024-02-23) Perifanou, Dimitra; Konstantinou, Eleni; Nikula, Anne; Grendova, Kristina; Ahokas, Aija; Casas Baroy, Joan Carles; Cavani, Daniel; Ferri, Paola; Galbany Estragués, Paola; Gradellini, Cinzia; Machajova, Michaela; Mecugni, Daniela; Nyman, Sari; Palomar Aumatell, Xavier; Prnova, Janka; Romero Mas, Montserrat; Roure Pujol, Carme; Thomander, Heli; Sakellari, Evanthia
    Immunization is a highly cost-effective investment in health, proven to be an effective tool in controlling and eliminating dangerous infectious diseases. Health science students require evidence-based knowledge to tackle challenges in healthcare, particularly in the field of vaccination. The aim of the current study is to asses students’ knowledge on vaccinations and further explore their feedback after attending Educating Vaccination Competence web-based course (EDUVAC web-based course). Students from five Higher Educational Institutes voluntarily participated in the EDUVAC web-based course. The course provided various study materials, including PowerPoint presentations, videos, quizzes, texts, and references to reputable websites. It also offered small assignments and self-tests for self-evaluation. An online questionnaire was available to students before and after they completed the EDUVAC web-based course. The mean knowledge score on vaccines increased significantly after the EDUVAC web-based course (p<0.001). The majority of the students (95%) felt that the web-based course has benefitted them for their future career and 96.4% would encourage other students to attend the EDUVAC web-based course. Overall, our findings suggest that EDUVAC is a valuable resource for those seeking to enhance their understanding of vaccination.
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    The best environment for childbirth in the (post)pandemic: a qualitative study
    (Universitat de Barcelona, 2025-05-30) Biurrun Garrido, Ainoa; Perelló-Iñiguez, Carme; Rodríguez-Garrido, Pía; Costa Abós, Silvia; Goberna Tricas, Josefina
    Objective. This study aims to explore women's experiences with their chosen place of birth in Spain during the pandemic and the immediate (post)pandemic period, as well as the factors influencing their decisions. Material and Method. A qualitative design approach was used, and 14 interviews were conducted with Spanish women who gave birth. Content analysis was employed to extract key themes, resulting in three central categories and six subcategories. Results. Three central categories (accommodating strategies, protective strategies and action-participation strategies) and six analysis subcategories emerged from the two profiles of women interviewed: those who gave birth in a hospital and those who opted for a home birth. Conclusions. The study concludes that it is essential for the chosen place of childbirth to provide women with a sense of safety and peace of mind, whether it occurs in a hospital, home, or birthing centre. Moreover, feeling well-treated by healthcare staff is fundamental for ensuring a positive and dignified childbirth experience.
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    CPT 1C is localized in endoplasmic reticulum of neurons and has carnitine palmitoyltransferase activity
    (American Society for Biochemistry and Molecular Biology, 2008-03-14) Sierra, Adriana Y.; Gratacós, Esther; Carrasco, Patricia; Clotet, Josep; Ureña, Jesús; Serra i Cucurull, Dolors; Asins Muñoz, Guillermina; Hegardt, Fausto; Casals i Farré, Núria
    CPT1c is a carnitine palmitoyltransferase 1 (CPT1) isoform that is expressed only in the brain. The enzyme has recently been localized in neuron mitochondria. Although it has high sequence identity with the other two CPT1 isoenzymes (a and b), no CPT activity has been detected to date. Our results indicate that CPT1c is expressed in neurons but not in astrocytes of mouse brain sections. Overexpression of CPT1c fused to the green fluorescent protein in cultured cells demonstrates that CPT1c is localized in the endoplasmic reticulum rather than mitochondria and that the N-terminal region of CPT1c is responsible for endoplasmic reticulum protein localization. Western blot experiments with cell fractions from adult mouse brain corroborate these results. In addition, overexpression studies demonstrate that CPT1c does not participate in mitochondrial fatty acid oxidation, as would be expected from its subcellular localization. To identify the substrate of CPT1c enzyme, rat cDNA was overexpressed in neuronal PC-12 cells, and the levels of acylcarnitines were measured by high-performance liquid chromatography-mass spectrometry. Palmitoylcarnitine was the only acylcarnitine to increase in transfected cells, which indicates that palmitoyl-CoA is the enzyme substrate and that CPT1c has CPT1 activity. Microsomal fractions of PC-12 and HEK293T cells overexpressing CPT1c protein showed a significant increase in CPT1 activity of 0.57 and 0.13 nmol.mg(-1).min(-1), respectively, which is approximately 50% higher than endogenous CPT1 activity. Kinetic studies demonstrate that CPT1c has similar affinity to CPT1a for both substrates but 20-300 times lower catalytic efficiency.
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    Daily walnut consumption increases 6-sulfatoxymelatonin urinary levels and can improve sleep quality: a randomized crossover trial
    (Royal Society of Chemistry, 2025-09-15) Zerón-Rugerio, María Fernanda; Ibarra-Picón, Aradeisy; Diez Hernández, María; Comas Basté, Oriol; Pérez-Cano, Francisco J.; Cambras Riu, Trinitat; Izquierdo Pulido, Maria
    We aimed to study the potential impact of daily consumption of walnuts on urinary 6-sulphatoxymelatonin (6-SMT) levels and sleep quality parameters. We conducted an open-label randomized crossover trial (NCT04799821) in 76 young adults (24.1 ± 3.4 years; 85.5% women) who either ingested 40 g of walnuts daily during dinner (intervention) or refrained from eating walnuts or any other nuts (control) for 8 weeks, with a 2-week washout period. Outcome variables included the determination of 6-SMT in urine samples collected in two consecutive periods: evening (from 20:00 to 23:00) and nighttime (from 23:00 to 07:00), the measurement of sleep quality parameters (latency, wake after sleep onset, awakenings, and efficiency) and daytime sleepiness (Epworth Sleepiness Scale). Tryptophan and melatonin contents of the walnuts used for the intervention were quantified by high-performance liquid chromatography. The 8-week walnut intervention significantly increased evening urinary 6-SMT concentrations (p = 0.029) and improved sleep latency (p = 0.001), while no differences were found between the baseline and control conditions. Likewise, the walnut intervention resulted in increased global sleep quality (p = 0.002) and lower daytime sleepiness (p = 0.002). Partial correlation analyses indicated that during the intervention, evening urinary 6-SMT concentrations were significantly associated with higher sleep efficiency (p = 0.026) and an improved global sleep quality (p = 0.006). Our findings highlight the potential of walnuts as sleep-promoting foods among young adults. Specifically, we demonstrated that a daily serving of 40 g of walnuts increases urinary 6-SMT levels, reduces sleep latency, and improves global sleep quality. Further research is needed to fully understand the underlying mechanisms involved in the diet-sleep association.
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    Association between pediatric simulation-based education and anxiety, stress, self-confidence in learning, and satisfaction in master nursing students
    (Elsevier, 2025-08-30) Saz Roy, Mª Ángeles; Herranz-Rubia, Núria; Tamame-San Antonio, Marta; García Carulla, Elvira; Hidalgo Blanco, Miguel Ángel; Sarria Guerrero, José Antonio; Crespo Mirasol, Esther; Bosch Alcaraz, Alejandro
    Aim: To analyze the relationship between high-fidelity clinical simulation and levels of anxiety, stress and self-perceived competence in masters level nursing students. Methods: We conducted a quasi-experimental pre–post study from June 2021 to December 2022 at the Faculty of Nursing. 190 Masters students took part in the study. Students were alphabetically divided into four sections of about 20 students and these sections were in turn divided into subgroups of three to four people. Seven clinical scenarios were designed, coinciding with frequent problems in critically ill children and each group of students was assigned one of them. Before and after resolving clinical scenarios students assessed their level of anxiety using the State-Trait Anxiety Inventory (STAI), the Self-Confidence in Learning Scale (SCLS), stress and the Nursing Student Satisfaction. Results: The overall median score for anxiety was 8 (5–10) pre-CS versus 5 (3–7) post-CS, with a statistically significant relationship (p < 0.001). As for stress, we observed scores of 3.0 (2–4) points pre-CS vs. 2.0 (1–3) post-CS, also with statistical significance (p < 0.001). An overall self-confidence in learning score of 25.0 (22–28) points was obtained. Previous experience in CS was independently related to a lower level of stress after performing the CS, and the older the age, the higher the level of self-confidence in learning. Conclusion: When designing scenarios that focus on the attention of critically ill pediatric patients, professionals should consider the relevant sociodemographic and professional variables in order to reduce anxiety and stress.
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    Simulated clinical cases to identify and intervene in intimate partner violence among undergraduate nursing students
    (Elsevier B.V., 2025-08-19) Crespo Mirasol, Esther; Saz Roy, Mª Ángeles; Moreno Poyato, Antonio Rafael; González Vaca, Julia; Rodríguez-Martín, Dolors; Maestre, Elena; García Carulla, Elvira; Isidro Albadalejo, Mónica; Melendo Azuela, Eva Maria; Rodríguez Chaves, Maria del Carmen; Vázquez Garreta, Griselda; Ventosa Ruiz, Ana; Viñas Llebot, Helena
    Background: Training in gender-based violence is necessary to develop identification and intervention skills among nursing students. Aim: To determine the impact of an educational intervention on intimate partner violence in terms of perceptions of violence and empathic responses among nursing students at a Spanish university. Methods: Pre-post quasiexperimental study. Fourth-year students at the Faculty of Nursing at University of Barcelona participated in 2022-23. The Perception of Intimate Partner Violence in Nursing Students questionnaire, the Interpersonal Reactivity Index and an ad hoc satisfaction survey were used. Results: At baseline, 299 students participated, mean age 23.31 years, 88.6% female. After the training, 184 students. 65.5% reported personal experience of intimate partner violence. Women scored higher on empathic response (empathic concern 28.07). After the training, there were improvements in most of the dimensions assessed. The methodology used received a mean score 8.19. Conclusion: Active learning methods in intimate partner violence training have a positive effect on nursing students' learning in terms of perceiving violence and responding empathically. Significant differences were observed in all dimensions except fantasy and personal discomfort.
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    Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts
    (BMJ Publishing Group, 2016-08-05) Ortiz-Tudela, Elisabeth; Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa; Alonso-Poncelas, Emma; Baños-Otalora, Beatriz; Bonmati, Mª de los Ángeles; Esteban-Sepúlveda, Silvia; García-Fraguela, Berta; González-María, Esther; Heredia-Reina, Mª del Pilar; López-Iborra, Mª Lidón; Lúcas Sánchez, Alejandro; Madrid-Pérez, Juan Antonio; Martínez-Nicolás, Antonio; Pérez-Sánchez, M. Pilar
    Objective: The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods: This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results: 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions: Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers.