https://hdl.handle.net/11000/6 2026-08-31T08:12:07Z https://hdl.handle.net/11000/40323 Título : Clinical leadership and coping strategies in times of COVID-19: observational study with health managers in Mendoza Autor : Gil-Hernández, Eva; Falaschi, Andrea; Carrillo, Irene; Rodríguez, Viviana; Peralta Roca, María Belén; García-Elorrio, Ezequiel; Mira, José Joaquín Resumen : Background The outbreak of the COVID-19 pandemic required an immediate response to the healthcare challenges it posed. This study was conducted to identify actions that helped healthcare professionals to overcome the initial impact in Mendoza (Argentina). Methods A cross-sectional study was carried out in a non-random sample of managers and staff of the public health system of Mendoza (Argentina) (n = 134). An ad-hoc and voluntary survey was carried out with 5 multi-response questions that combined questions referring to the management of the pandemic at the organizational level with others referring to coping at the individual level. The survey questions were formulated based on the results of six focus groups that were conducted previously. Descriptive frequency analysis was performed. Results 60 people agreed to participate and 45 answered the full questionnaire. At both the organizational and individual level, there was consensus with at least 50% of votes. The most outstanding at the organizational level was “Prioritize the need according to risk” and at the individual level it was “Support from family or friends”, being also the most voted option in the whole questionnaire. Conclusions The responses that emerged for coping with COVID-19 must be seen as an opportunity to identify strategies that could be effective in addressing future crisis situations that jeopardize the system’s response capacity. Moreover, it is essential to retain both changes at the organizational level (e.g., new protocols, multidisciplinary work, estructuring, etc.) and coping strategies at the individual level (e.g., social support, leisure activities, etc.) that shift r have proven positive outcomes. 2026-08-31T07:48:56Z https://hdl.handle.net/11000/40322 Título : Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents Autor : Carrillo, Irene; Mira, José Joaquín; Vicente, María Asunción; Fernández, César; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora Resumen : Background: Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. Objective: The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. Methods: The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA’s design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. Results: BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). Conclusions: BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use. 2026-08-31T07:28:00Z https://hdl.handle.net/11000/40321 Título : The aftermath of adverse events in Spanish primary care and hospital health professionals Autor : Mira, José Joaquín; Carrillo, Irene; Lorenzo, Susana; Ferrús, Lena; Silvestre, Carmen; Pérez-Pérez, Pastora; Olivera, Guadalupe; Iglesias, Fuencisla; Zavala, Elena; Maderuelo-Fernández, José Ángel; Vitaller, Julián; Nuño-Solinís, Roberto; Astier, Pilar Resumen : Background: Adverse events (AEs) cause harm in patients and disturbance for the professionals involved in the event (second victims). This study assessed the impact of AEs in primary care (PC) and hospitals in Spain on second victims. Methods: A cross-sectional study was conducted. We carried out a survey based on a random sample of doctors and nurses from PC and hospital settings in Spain. A total of 1087 health professionals responded, 610 from PC and 477 from hospitals. Results: A total of 430 health professionals (39.6%) had informed a patient of an error. Reporting to patients was carried out by those with the strongest safety culture (Odds Ratio–OR- 1.1, 95% Confidence Interval–CI- 1.0-1.2), nurses (OR 1.9, 95% CI 1.5-2.3), those under 50 years of age (OR 0.7, 95% CI 0.6-0.9) and primary care staff (OR 0.6, 95% CI 0.5-0.9). A total of 381 (62.5%, 95% CI 59-66%) and 346 (72.5%, IC95% 69-77%) primary care and hospital health professionals, respectively, reported having gone through the second-victim experience, either directly or through a colleague, in the previous 5 years. The emotional responses were: feelings of guilt (521, 58.8%), anxiety (426, 49.6%), re-living the event (360, 42.2%), tiredness (341, 39.4%), insomnia (317, 38.0%) and persistent feelings of insecurity (284, 32.8%). In doctors, the most common responses were: feelings of guilt (OR 0.7 IC95% 0.6-0.8), re-living the event (OR 0.7, IC95% o.6-0.8), and anxiety (OR 0.8, IC95% 0.6-0.9), while nurses showed greater solidarity in terms of supporting the second victim, in both PC (p = 0.019) and hospital (p = 0.019) settings. Conclusions: Adverse events cause guilt, anxiety, and loss of confidence in health professionals. Most are involved in such events as second victims at least once in their careers. They rarely receive any training or education on coping strategies for this phenomenon. 2026-08-31T06:55:12Z https://hdl.handle.net/11000/40320 Título : Development and internal validation of GENADHECAR: a screening instrument for identifying probable statin non-adherence in patients with ischemic heart disease Autor : Quesada, Jose A.; López-Pineda, Adriana; NOUNI GARCÍA, RAUF; Cordero, Alberto; Carbonell Soliva, Álvaro; Esquerdo Arroyo, Amanda; PEREIRA-EXPOSITO, AVELINO; Guillen-García, Silvia; Arrarte, Vicente; Bertomeu-Gonzalez, Vicente; Nolasco, Andreu; Cazorla-Morallon, Diego; Osende, Julio; nalda-molina, Ricardo; Orozco-Beltrán, Domingo; Carratalá-Munuera, Concepción; Gil-Guillén, Vicente F Resumen : Background: No validated and practical tool exists to assess adherence to statins in secondary prevention of cardiovascular disease. Current reference methods for assessing adherence, including plasma drug measurements, are not feasible for routine clinical care or large clinical trials. Objective: To develop and internally validate a predictive screening instrument for identifying patients at risk of statin non-adherence. Methods: This multicenter cross-sectional study reports the results of the second phase of the GENADHECAR project in four Spanish hospitals. An initial set of 42 adherence-related items was refined and evaluated in a sample of patients with ischemic heart disease. Responses were compared against a pharmacokinetic reference method (plasma statin concentrations) to assess recent medication intake. A multivariate predictive model of non-adherence was then developed, selecting the best predictors and covariates to be included in the final screening instrument. Results: A total of 309 patients were included, of whom 49 (15.9%) were classified as non-adherent according to the pharmacokinetic reference method. The final GENADHECAR screening instrument comprised three questionnaire items (use of reminders, forgetfulness, and medication access) and two sociodemographic variables (sex and educational attainment). Internal bootstrap validation yielded an optimism-corrected AUC of 0.694 (95% CI 0.617–0.767), with adequate calibration (Hosmer–Lemeshow p = 0.994). At the selected probability threshold (0.15), sensitivity was 0.73, specificity 0.61, and positive and negative predictive values were 0.26 and 0.92, respectively. Overall, the model showed moderate discrimination and a high capacity to identify patients at low risk of non-adherence. Conclusion: To our knowledge, GENADHECAR is the first screening instrument with internal validation to identify statin non-adherence using a pharmacokinetic reference method. It offers a brief and practical approach for identifying patients at risk of non-adherence and may help overcome some limitations of conventional self-report methods in this population. Further external validation is needed before routine clinical implementation. 2026-07-31T11:05:30Z https://hdl.handle.net/11000/40319 Título : Metodología de Revisión Sistemática Simplificada (MRSS) para estudiantes de Grado y Máster Autor : Pina López, David; Puente Lopez, Esteban; López López, Reyes; Cascales Martinez, Andrea; Fernández Arce, Alejandro; López Ros, Paloma; García Campos, Jonatan; Vázquez Rodríguez, Carolina; Pamies Aubalat, Lidia; Pascual Rodríguez, Roberto 2026-07-31T11:04:00Z https://hdl.handle.net/11000/40316 Título : Desarrollo de nuevos sistemas de liberación de antineoplásicos basados en biopolímeros para el tratamiento de glioblastoma Autor : Badía Hernández, Pedro Valentín; Moll Carrió, Joan; Díaz Puertas, Rocío; Fuentes Baile, María; Rodríguez Cañas, Enrique; Mira Carrió, Amalia; Saceda, Miguel; García Morales, Pilar; Mallavia Marín, Ricardo Resumen : El glioblastoma (GBM) es un tipo de glioma con una baja incidencia, pero una alta tasa de mortalidad debido a su malignidad (1). Los tratamientos actuales del glioblastoma se centran en la cirugía seguida de quimioterapia con fármacos antineoplásicos. Sin embargo, la administración sistémica daña los tejidos no tumorales, por lo que se está investigando su aplicación local y su liberación controlada (2). La síntesis de nanofibras de PMVEMA-Es permitió la encapsulación de BCNU en un 70 % con un tiempo de liberación de 1h, sin modificar sus propiedades sobre la proliferación celular. Se continuará trabajando en su caracterización en modelos celulares 3D. 2026-07-31T08:53:54Z https://hdl.handle.net/11000/40315 Título : Development of new drug delivery systems based on polymeric nanofibers for glioblastoma treatment Autor : Badía Hernández, Pedro Valentín; Moll Carrió, Joan; Fuentes Baile, María; Mira Carrió, Amalia; Díaz Puertas, Rocío; García Morales, Pilar; Mallavia Marín, Ricardo Resumen : Glioblastoma (GBM) is a type of glioma with a low incidence but a high mortality rate due to its malignancy (1). Current treatments for glioblastoma focus on surgery followed by chemotherapy with antineoplastic drugs. However, systemic administration damages non-tumour tissues, so local application and controlled release is being investigated (2). The synthesis of PMVEMA nanofibers allowed the encapsulation of 100% and 70% of drugs with a release time of 1h, without modifying their properties on cell proliferation. Work will continue with their characterization in 3D cellular models. 2026-07-31T08:52:57Z https://hdl.handle.net/11000/40314 Título : Photoactive polymeric biomaterials for local combined therapy against glioblastoma Autor : Badía Hernández, Pedro Valentín 2026-07-31T08:49:34Z https://hdl.handle.net/11000/40313 Título : Desarrollo de nanofibras poliméricas como sistema de liberación de carmustina y doxorrubicina para el tratamiento del glioblastoma Autor : Badía Hernández, Pedro Valentín 2026-07-31T08:48:17Z https://hdl.handle.net/11000/40312 Título : Optimizing the green synthesis of silver nanoparticles with pomegranate extract for antibacterial purposes: an innovative approach Autor : Díaz Puertas, Rocío; Álvarez Martínez, Francisco Javier; Badía Hernández, Pedro Valentín; Rodríguez Cañas, Enrique; Borrás Rocher, Fernando; Falcó, Alberto; Mallavia Marín, Ricardo Resumen : Silver nanoparticles (AgNPs) have attracted significant attention due to their remarkable antimicrobial and biocidal properties. Green synthesis, which utilizes plant extracts as reducing and stabilizing agents, offers an eco-friendly alternative to traditional methods, reducing toxicity and enhancing biocompatibility. Among natural sources, pomegranate (Punica granatum) peel extract (PGE) is particularly rich in antioxidant compounds such as ellagitannins and polyphenols, which not only facilitate nanoparticle synthesis but also enhance their biological activity. This study focuses on optimizing the green synthesis of AgNPs using PGE through a Box–Behnken response surface methodology (BBD-RSM) to refine key parameters for enhanced reproducibility and efficiency. The synthesized AgNPs were fully characterized, and their antimicrobial properties were evaluated. 2026-07-31T08:47:22Z