Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study.

BACKGROUND: The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. METHODS: This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. RESULTS: Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. CONCLUSION: According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.

Single-Step Functionalization Strategy of Graphene Microtransistor Array with Chemically Modified Aptamers for Biosensing Applications.

Graphene solution-gated field-effect transistors (gSGFETs) offer high potential for chemical and biochemical sensing applications. Among the current trends to improve this technology, the functionalization processes are gaining relevance for its crucial impact on biosensing performance. Previous efforts are focused on simplifying the attachment procedure from standard multi-step to single-step strategies, but they still suffer from overreaction, and impurity issues and are limited to a particular ligand. Herein, a novel strategy for single-step immobilization of chemically modified aptamers with fluorenylmethyl and acridine moieties, based on a straightforward synthetic route to overcome the aforementioned limitations is presented. This approach is benchmarked versus a standard multi-step strategy using thrombin as detection model. In order to assess the reliability of the functionalization strategies 48-gSGFETs arrays are employed to acquire large datasets with multiple replicas. Graphene surface characterization demonstrates robust and higher efficiency in the chemical coupling of the aptamers with the single-step strategy, while the electrical response evaluation validates the sensing capability, allowing to implement different alternatives for data analysis and reduce the sensing variability. In this work, a new tool capable of overcome the functionalization challenges of graphene surfaces is provided, paving the way toward the standardization of gSGFETs for biosensing purposes.

Validating a measure for eco-anxiety in Portuguese young adults and exploring its associations with environmental action.

BACKGROUND: Worsening environmental conditions may amplify people's emotional responses to an environmental crisis (eco-anxiety). In Portugal, young people seem to be especially concerned about climate change. However, this phenomenon needs to be interpreted using accurate instruments. Thus, this study aimed to validate the Portuguese version of the Hogg Eco-Anxiety Scale (HEAS) in young adults and examine the associations among eco-anxiety, sociodemographic characteristics, and pro-environmental behaviours. METHODS: A survey was administered to 623 Portuguese university students aged between 18 and 25 years. The survey included our Portuguese translation of the HEAS (obtained through a back-translation and pretesting process), a sociodemographic assessment, and questions related to pro-environmental behaviours. Confirmatory factor analysis was conducted to assess the construct validity of the Portuguese version of the HEAS, and global fit indices were used to assess whether the original four-dimensional structure of the scale was reproduced. The reliability of the Portuguese version of the HEAS was evaluated by Cronbach's alpha and the intraclass correlation coefficient. Measurement invariance examined sex differences in scale interpretation. Linear regressions were used to detect whether sociodemographic variables predict eco-anxiety and whether eco-anxiety predicts pro-environmental behaviours. RESULTS: The factorial structure of the original scale was replicated in the Portuguese version of the HEAS, showing good internal consistency, reliability over time and strict invariance between men and women. A higher paternal education level predicted greater eco-anxiety in children. Two dimensions of eco-anxiety-namely, rumination and anxiety about personal impacts on the environment-predicted higher engagement in pro-environmental behaviours. CONCLUSIONS: The translated scale is an appropriate tool to measure eco-anxiety in the Portuguese context and should be used to collect evidence to drive environmental and health policies. An individual's education level should be considered a determinant of their emotional response to environmental conditions. Importantly, eco-anxiety can act as a protective emotional response to preserving the planet.

A systematic review on the use of action research methods in mental health nursing care.

AIMS: To identify and synthesize evidence on the use of action research methods in mental health nursing care. DESIGN: Systematic review. DATA SOURCES: CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021. REVIEW METHODS: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures. RESULTS: Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person-centred approach to care and improving decision-making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment. CONCLUSION: This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels. IMPACT: This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person-centred approach to care and decision-making procedures.

Transcultural adaptation and psychometric properties of the spanish version of the therapeutic relationship Assessment Scale-Nurse.

BACKGROUND: The nurse-patient therapeutic relationship is considered a pillar of mental health nursing, contributing to improved person-centered care and shared decision making with the patient. Given the importance of the nurse-patient therapeutic relationship, appropriate evaluation instruments are required to assess its quality. The aim of this study was to adapt and validate the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse. METHODS: A translation and back-translation of the scale was carried out. To analyze the psychometric properties, the scale was administered to 213 nurses working in the field of mental health care. Temporal stability or test-retest was examined by means of the intraclass correlation coefficient (ICC) in a sample of 100 nurses. RESULTS: Confirmatory Factor Analysis revealed a four-factor structure identical to the original version, with some poor model fit indices. The ordinal alpha values for the total scale and the four factors were 0.939, 0.654, 0.798, 0.801, and 0.866, respectively. The intraclass correlation coefficient was 0.928 (95% CI: 0.893-0.952). CONCLUSIONS: The results show that the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse is reliable for determining the quality of the therapeutic relationship that mental health nurses can establish with their patients. However, more studies are needed to analyse the model fit of the instrument's factor structure in the Spanish population.

Evaluating the influence of air pollution on solar radiation observations over the coastal region of Alicante (Southeastern Spain).

The present study evaluates ground-based downward surface shortwave radiation (Rs) over the coastal region of Alicante (Southeastern Spain). Hourly measurements collected over the eleven-year period 2010-2020 are used. Two weather stations located over the region capital, Alicante, have been selected as representative of urban and suburban typologies. Two additional weather stations far from the city have been selected representing rural typologies. Rs is significantly reduced over the urban station during the morning hours within the winter season compared to the observations recorded over the suburban and rural stations, with a global mean difference of -81 and -120 W/m2 at 10 LT, respectively. However, no significant differences are obtained during the midday sun, with a global mean difference of -20 W/m2 between the urban and rural stations. With the aim of explaining these differences, the current paper investigates the relationship between Rs and different air pollutants: NOx, SO2, and fine particulate matter (PM2.5 and PM10) as well as the wind field measured at the urban and suburban stations. The results found in this work point towards a close relationship between Rs and NOx concentrations annual cycles, which are also influenced by the prevailing wind circulations observed over the study area. A global mean NOx concentration of 107 µg/m3 is observed over the urban station at 10 LT during the winter season. In contrast, these high concentrations are significantly reduced over the suburban station, with global mean value of 40 µg/m3 at 10 LT, for this period of the year.

Molecular-Level Insights on Reactive Arrangement in On-Surface Photocatalytic Coupling Reactions Using Tip-Enhanced Raman Spectroscopy.

Plasmon-enhanced photocatalytic coupling reactions have been used as model systems in surface-enhanced Raman spectroscopy and tip-enhanced Raman spectroscopy (TERS) research for decades. However, the role of reactive arrangement on efficiency of these model reactions has remained largely unknown to date often leading to conflicting interpretations of experimental results. Herein, we use an interdisciplinary toolbox of nanoscale TERS imaging in combination with molecular-resolution ambient scanning tunnelling microscopy (STM) and density functional theory (DFT) modeling to investigate the role of reactive arrangement in photocatalytic coupling of 4-nitrobenzenethiol (4-NTP) to p,p'-dimercaptoazobisbenzene on single-crystal and polycrystalline Au surfaces for the first time. TERS imaging with 3 nm resolution clearly revealed a significantly higher catalytic efficiency inside a kinetically driven disordered phase of the 4-NTP adlayer on Au compared to the thermodynamically stable ordered phase. Furthermore, molecular level details of the self-assembled structures in the disordered and ordered phases obtained using ambient high-resolution STM enabled an unambiguous structure-reactivity correlation of photocatalytic coupling. Finally, quantitative mechanistic insights obtained from DFT modeling based on the accurate parameters determined from STM imaging emphatically confirmed that a combination of steric hindrance effect and energetic barrier leads to a lower reaction efficiency in the ordered phase of the 4-NTP adlayer. This fundamental study establishes the first direct structure-reactivity correlation in photocatalytic coupling and highlights the critical role of reactive arrangement in the efficiency of on-surface coupling reactions in heterogeneous catalysis at large.

Autophagy is activated in human spermatozoa subjected to oxidative stress and its inhibition impairs sperm quality and promotes cell death.

STUDY QUESTION: Does oxidative stress (OS) activate autophagy in human sperm? SUMMARY ANSWER: Human spermatozoa subjected to OS activate an autophagic response. WHAT IS KNOWN ALREADY: Autophagy is a regulated pathway of lysosomal degradation which helps eukaryotic cells to maintain or restore homeostasis, being a cellular stress response mechanism. OS is a main cause of impaired sperm function and is linked to male infertility; however, whether OS activates autophagy in human spermatozoa is unknown. STUDY DESIGN, SIZE, DURATION: Human spermatozoa were exposed separately to ionomycin and hydrogen peroxide in order to induce OS. An untreated control group was included. Sperm cells under OS were then exposed to chloroquine in order to block autophagy. An untreated control and a control incubated only with the OS inducer were included in each experimental setting. PARTICIPANTS/MATERIALS, SETTING, METHODS: For this study, semen samples from normozoospermic donors were used and motile sperm cells were selected by the swim up technique. First, the generation of OS under our experimental conditions was demonstrated by analyzing sperm parameters including viability, reactive oxygen species (ROS) production, mitochondrial membrane potential (ΔΨm) motility and thiol oxidation. Then, proteins involved in autophagy, including the microtubule-associated protein light chain 3 (LC3), particularly LC3-I and LC3-II, autophagy-related 5 (ATG5) and autophagy-related 16 (ATG16) proteins as well as the phosphorylated form of AMP-activated protein kinase (pAMPK) were evaluated in spermatozoa exposed to OS and compared to the untreated control. Finally, the impact of autophagy blocking by chloroquine treatment on sperm quality, metabolic parameters, including glycolysis and oxidative phosphorylation, as well as the cell death markers phosphatidylserine externalization and caspase activation was analyzed. Sperm quality parameters, cell death markers and autophagy-related proteins were analyzed by flow cytometry. Motility was evaluated by the computer-assisted sperm analysis system and metabolic parameters were analyzed using an extracellular flux analyzer. MAIN RESULTS AND THE ROLE OF CHANCE: Exposure to ionomycin and hydrogen peroxide promotes OS resulting in increased ROS production and decreased viability, ΔΨm and motility, while increasing thiol oxidation. These alterations were accompanied by a decrease in LC3-I, indicating that autophagy was activated upon OS exposure. Ionomycin also caused an increase in LC3-II, ATG5, ATG16 and pAMPK content. Autophagy blocking of sperm exposed to OS caused deterioration in sperm quality and metabolic parameters as well as an increase in cell death markers. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: The study was carried out in vitro using motile sperm from normozoospermic donors; tests on sperm from infertile patients were not carried out. The autophagy blocking plus OS might generate a non-specific response to a highly stressful situation leading to the induction of cell death. WIDER IMPLICATIONS OF THE FINDINGS: Human spermatozoa subjected to OS activate an autophagic response and its blockage results in increased oxidative damage and commits spermatozoa to cell death. These results suggest a crucial role of autophagy as a stress response by male gametes, which contributes to maintaining the functionality and lifespan of ejaculated sperm cells. Detection of autophagy activation in sperm cells ex vivo could be included in semen analysis as a marker of OS, especially in men displaying high levels of seminal ROS. Novel strategies that aim to activate this cellular stress response could improve sperm quality/functionality under natural ejaculate conditions in which increased ROS levels are expected. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the Fondo Nacional de Investigación Científica y Tecnológica, Chile (ANID/FONDECYT, Grant number 11170758 to P.U.); the Comisión Nacional de Investigación Científica y Tecnológica, Chile (ANID/CONICYT, Grant number PAI79160030 to P.U.) and the Dirección de Investigación, Universidad de La Frontera. The authors disclose no potential conflicts of interest.

Industrial Needs in the Fields of Artificial Intelligence, Internet of Things and Edge Computing.

Industry 4.0 corresponds to the Fourth Industrial Revolution, resulting from technological innovation and research multidisciplinary advances. Researchers aim to contribute to the digital transformation of the manufacturing ecosystem both in theory and mainly in practice by identifying the real problems that the industry faces. Researchers focus on providing practical solutions using technologies such as the Industrial Internet of Things (IoT), Artificial Intelligence (AI), and Edge Computing (EC). On the other hand, universities educate young engineers and researchers by formulating a curriculum that prepares graduates for the industrial market. This research aimed to investigate and identify the industry's current problems and needs from an educational perspective. The research methodology is based on preparing a focused questionnaire resulting from an extensive recent literature review used to interview representatives from 70 enterprises operating in 25 countries. The produced empirical data revealed (1) the kind of data and business management systems that companies have implemented to advance the digitalization of their processes, (2) the industries' main problems and what technologies (could be) implemented to address them, and (3) what are the primary industrial needs and how they can be met to facilitate their digitization. The main conclusion is that there is a need to develop a taxonomy that shall include industrial problems and their technological solutions. Moreover, the educational needs of engineers and researchers with current knowledge and advanced skills were underlined.

Design and Implementation of a Wireless Recorder System for Seismic Noise Array Measurements.

In this work, a wireless data acquisition system for seismic noise array measurements is presented. The developed system is composed of a series of nodes and a central server arranged in a point-to-multipoint topology. The nodes consist of a CC3200 microcontroller, an analog-to-digital converter, and a low-noise conditioning circuit designed specifically to register seismic noise, and which is connected to the seismic sensor. As a server, a Raspberry Pi 4B has been used that will receive the samples from the nodes via Wi-Fi and will save them in files. It also incorporates a Web interface developed with JavaScript node.js technology that allows to configure the number of nodes as well as different options, to start and stop the records, and to view in real time the different signals received from the nodes. The system can be deployed anywhere since each of the nodes use independent batteries as a power supply. In addition, it is possible to operate the system remotely if internet connectivity is available. The prototype has been tested in four different locations in the Alicante province (southeast Spain), demonstrating its suitability for seismic noise array measurements.

Analysis of Radon Measurements in Relation to Daily Seismic Activity Rates in the Vrancea Region, Romania.

Many previous research studies have shown how local and even regional earthquakes can significantly affect the release of radon in the soil. The aim of this work is to investigate the relationship between radon measurements and the daily seismic activity rate and develop a methodology that allows estimating the seismic activity rate using only radon measurements. To carry out this study, the earthquake catalogue of the Vrancea region (Romania) has been used to estimate the daily seismic activity rate during a given time period, in which radon measurements were also recorded, from January 2016 to September 2020. The Vrancea zone represents the most active seismic zone in Europe and is located on the eastern edge of the strongly bent Carpathian arc. In the case of the radon measurements, seasonal behaviours and linear trends due to non-seismic factors have been identified and subsequently removed. The discrete wavelet transform has been used to analyse the radon signal at two different scales: long and short periods. From the analysis carried out on a long-period scale, an approximate linear relationship has been obtained between the radon series and the daily seismic activity rate, which provides insights into the behaviour of the seismic activity in the study region with only the radon information. In addition, the study reveals certain characteristics that could be used as precursors of earthquakes at different scales: weeks in the case of the estimated daily seismic activity rate, and days in the case of the short-period signal obtained by the wavelet analysis. The results obtained for this region allow us to hope that the analysis of the radon time series can become an effective complement to the conventional seismic analysis used in operational earthquake forecasting.

Raspberry Shake-Based Rapid Structural Identification of Existing Buildings Subject to Earthquake Ground Motion: The Case Study of Bucharest.

The Internet of things concept empowered by low-cost sensor technologies and headless computers has upscaled the applicability of vibration monitoring systems in recent years. Raspberry Shake devices are among those systems, constituting a crowdsourcing framework and forming a worldwide seismic network of over a thousand nodes. While Raspberry Shake devices have been proven to densify seismograph arrays efficiently, their potential for structural health monitoring (SHM) is still unknown and is open to discovery. This paper presents recent findings from existing buildings located in Bucharest (Romania) equipped with Raspberry Shake 4D (RS4D) devices, whose signal recorded under multiple seismic events has been analyzed using different modal identification algorithms. The obtained results show that RS4D modules can capture the building vibration behavior despite the short-duration and low-amplitude excitation sources. Based on 15 RS4D device readings from five different multistorey buildings, the results do not indicate damage in terms of modal frequency decay. The findings of this research propose a baseline for future seismic events that can track the changes in vibration characteristics as a consequence of future strong earthquakes. In summary, this research presents multi-device, multi-testbed, and multi-algorithm evidence on the feasibility of RS4D modules as SHM instruments, which are yet to be explored in earthquake engineering.

Spanish adaptation of the quality in psychiatric care-outpatient (QPC-OP) instrument community mental health patients' version: psychometric properties and factor structure.

BACKGROUND: Health systems in the field of mental health are strongly committed to community models that allow patients to be attended in their own environment. This helps them to maintain their family and social ties while trying to avoid costly hospital admissions. The patients' perspective is a key component in the assessment of the quality of psychiatric care and can even determine their adherence to the devices where they are treated. However, there are few instruments with adequate psychometric properties for the evaluation of the quality of psychiatric care in community mental health. The Quality in Psychiatric Care - Outpatient (QPC-OP) instrument has adequate psychometric properties to assess the quality of psychiatric care from the patients' perspective. The aim of this study was to adapt and validate the Spanish version of the QPC-OP instrument. METHODS: A translation and back-translation of the instrument was carried out. To examine its psychometric properties, the instrument was administered to 200 patients attending various community mental health services. To assess test-retest reliability, the instrument was readministered after 7-14 days (n = 98). RESULTS: The Confirmatory Factor Analysis revealed a structure of 8 factors identical to the original version, with an adequate model fit. The internal consistency coefficient (Cronbach's alpha) was 0.951. The intraclass correlation coefficient was 0.764 (95% IC: 0.649 - 0.842), and higher than 0.70 in 5 of the 8 factors. Additionally, an EFA was performed and revealed that the instrument could behave in a unifactorial or four factor manner in the sample analyzed. CONCLUSIONS: Results show that the Spanish version of the QPC-OP instrument is valid and reliable for the assessment of quality of psychiatric care in the community setting.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study.

AIM: We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. BACKGROUND: The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. METHODS: A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. RESULTS: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). CONCLUSION: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

The Effects of a Participatory Intervention in Mental Health Units on Nurses' Perceptions of the Practice Environment: A Mixed Methods Study.

BACKGROUND: The practice environment influences the quality of care and the nursing outcomes achieved in their workplaces. OBJECTIVE: To examine the perception of the clinical practice environment among nurses working in mental health units in the context of their participation in an action research study aimed at improving the nurse-patient relationship. METHOD: An explanatory sequential mixed methods study was designed. The data were collected in three phases in 18 mental health units (n = 95 nurses). Quantitative data were collected through the Practice Environment Scale of the Nursing Work Index, and qualitative data were collected through reflective diaries and focus groups in the context of participatory action research. RESULTS: The nurses' assessment of their practice environment shifted from positive to negative. Nurse manager leadership was the aspect that worsened the most. In addition, the perception of their participation in the affairs of the center and nursing foundations for quality of care decreased. The nurses considered it essential to be able to influence decision-making bodies and that the institution should promote a model of care that upholds the therapeutic relationship in actual clinical practice. CONCLUSIONS: Nurses perceived that they should be involved in organizational decisions and required more presence and understanding from managers. Furthermore, nurses stated that institutions should promote nursing foundations for quality of care. This study contributes to understanding how nurses in mental health units perceive their work environment and how it affects the improvement of the nurse-patient relationship in clinical practice.

Examining the association between evidence-based practice and the nurse-patient therapeutic relationship in mental health units: A cross-sectional study.

AIMS: To examine the relationship between the dimensions of evidence-based practice and the therapeutic relationship and to predict the quality of the therapeutic relationship from these dimensions among nurses working in mental health units. DESIGN: A cross-sectional design. METHODS: Data were collected between February-April 2018 via an online form completed by nurses working at 18 mental health units. Multiple linear regressions were used to examine the relationship between the dimensions of evidence-based practice and therapeutic relationship. Questionnaires were completed by 198 nurses. RESULTS: Higher levels of evidence-based practice were a significant predictor of a higher-quality therapeutic relationship (ß: 2.276; 95% CI: 1.30-3.25). The evidence-based practice factor which most influenced an improved therapeutic relationship was the nurses' attitude (ß: 2.047; 95% CI: 0.88-3.21). The therapeutic relationship dimension which was most conditioned by evidence-based practice dimensions was agreement on tasks, which was most favourable with a better attitude (ß: 0.625; 95% CI: 0.09-1.16) and greater knowledge and skills for evidence-based practice (ß: 0.500; 95% CI: 0.08-0.93). CONCLUSION: In mental health settings, the therapeutic nurse-patient relationship is positively enhanced by evidenced-based practice and the nurse's level of experience, with a great influence on shared decision-making. IMPACT: This research sought to examine the relationship between the evidence-based practice and the therapeutic relationship in mental health nursing. This study demonstrates that an improved attitude and knowledge of evidence-based practices of mental health nurses increases shared decision-making with patients, which is a basic requirement for person-centred care. Because the therapeutic relationship is considered the backbone of nursing practice in mental health units, this research will have an impact on both mental health nurses and mental health unit managers.

The impact of a participatory intervention on the therapeutic relationship in mental health nurses: A multicentre study.

AIMS: To evaluate the effects of an intervention aimed at improving the therapeutic relationship, using the participatory-action research method, in terms of improving the quality of the nurse-patient therapeutic relationship. DESIGN: A single-group pre-post research design. METHODS: Quantitative data were collected between January 2018 and June 2019 using an online form completed by nurses from 18 mental health units (N = 95). Data were collected before and after the intervention, which consisted of the design, implementation and evaluation of strategies to improve the therapeutic relationship through participatory-action research involving nurses. The Working Alliance Inventory-Short, Interpersonal Reactivity Index, Evidence-Based Practice Questionnaire and Practice Environment Scale of the Nursing Work Index were used. The Wilcoxon rank-sum test was used together with the Spearman's correlation coefficient. Two multiple linear regressions models were constructed. RESULTS: Overall, the intervention improved the nurse-patient therapeutic relationship. In addition, the results revealed that, above all, the improvement in evidence-based practice along with a decrease in nurses' personal distress were the factors associated with the improvement of the nurse-patient therapeutic relationship. CONCLUSION: In mental health units, the therapeutic nurse-patient relationship can be improved through participatory interventions that include the implementation of evidence-based practices. IMPACT: This research examined the effects of an intervention aimed at improving the therapeutic relationship among nurses working at mental health units using participatory action research. The results show that the therapeutic relationship can be improved through participatory methods where evidence-based practice is implemented and enhanced among nurses, since a better therapeutic relationship along with reduced staff discomfort are determining factors that influence the quality of the therapeutic relationship. Institutional managers should promote participatory group interventions to enable nurses to develop evidence-based aspects of the therapeutic relationship together with expanding personal aspects and self-knowledge.

Design and Implementation of a Wireless Sensor Network for Seismic Monitoring of Buildings.

This article presents a new wireless seismic sensor network system, especially design for building monitoring. The designed prototype allows remote control, and remote and real-time monitoring of the recorded signals by any internet browser. The system is formed by several Nodes (based on the CC3200 microcontroller of Texas Instruments), which are in charge of digitizing the ambient vibrations registered by three-component seismic sensors and transmitting them to a central server. This server records all the received signals, but also allows their real-time visualization in several remote client browsers thanks to the JavaScript's Node.js technology. The data transmission uses not only Wi-Fi technology, but also the existing network resources that nowadays can be found usually in any official or residential building (lowering deployment costs). A data synchronization scheme was also implemented to correct the time differences between the Nodes, but also the long-term drifts found in the internal clock of the microcontrollers (improving the quality of records). The completed system is a low-cost, open-hardware and open-software design. The prototype was tested in a real building, recording ambient vibrations in several floors and observing the differences due to the building structure.

Multiparameter Flow Cytometry Assay for Analysis of Nitrosative Stress Status in Human Spermatozoa.

Male infertility is an increasing health problem, and oxidative/nitrosative stress plays an important role in the etiology of this condition. Nitrosative stress due to excessive levels of reactive nitrogen species (RNS) is associated with impaired male fertility. Flow cytometry may be a useful tool for semen evaluation, but the availability of multiparameter assays for analysis of sperm quality is limited. The present study standardized a multiparameter flow cytometry analysis for nitrosative stress status in human spermatozoa in a single assay. A suitable multicolor fluorochrome panel was designed and consisted of fluorescein-boronate to detect peroxynitrite, a highly RNS, propidium iodide to analyze viability, tetramethylrhodamine methyl ester perchlorate to detect mitochondrial membrane potential (MMP) and monobromobimane to analyze thiol oxidation. Proper positive and negative controls for each fluorochrome were used to establish the technique, and sperm cells of different qualities and spermatozoa subjected to cryopreservation were analyzed. The results showed that the controls clearly discriminated between the high and low fluorescence intensities for each fluorochrome. The analysis of sperm cells of different quality demonstrated that the assay properly detected differences in all parameters analyzed according to sperm quality. The results may be reported as the mean fluorescence intensity of each fluorochrome and the percentage of cells exhibiting different characteristics. In conclusion, a protocol was standardized to analyze nitrosative stress status, including peroxynitrite production, viability, MMP, and thiol oxidation, in a single analysis using flow cytometry. This protocol may be applied to research approaches and clinical andrology to improve the evaluation of sperm quality and provide a promising tool to increase the use of clinical flow cytometry. © 2020 International Society for Advancement of Cytometry.

Antioxidant effects of penicillamine against in vitro-induced oxidative stress in human spermatozoa.

Oxidative stress contributes importantly to the aetiology of male infertility, impairing sperm function. The protective effect of antioxidants on seminal parameters has been established, and the antioxidant penicillamine has shown beneficial effects; however, its protective effect on human spermatozoa exposed to oxidative stress has not been reported. The objective of this work was to evaluate the effect of penicillamine on human spermatozoa exposed in vitro to oxidative stress. First, the effect of penicillamine on spermatozoa from normozoospermic donors was evaluated. Then, the effect of penicillamine on spermatozoa exposed to oxidative stress induced separately by ionomycin and hydrogen peroxide (H2 O2 ) was analysed. An untreated control and a control treated only with the oxidative stress inducer were included. Reactive oxygen species (ROS) levels, viability, mitochondrial membrane potential (MMP) and motility were analysed. The results showed that penicillamine, added to the incubation medium, decreased the ROS levels induced by ionomycin and H2 O2 , and this effect was associated with better preservation of MMP, motility, and ATP levels. These results highlight the potential advantages of penicillamine supplementation of sperm culture medium, especially for semen samples with high ROS levels and also in circumstances where laboratory handling can cause an increase in ROS production.