20 research outputs found

    Cansancio del rol de cuidador: Revisión bibliográfica

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    El envejecimiento progresivo de la poblaci√≥n se relaciona con un aumento de la dependencia, y por tanto de los cuidados de larga duraci√≥n. Los proveedores de dichos cuidados son los ‚Äúcuidadores informales‚ÄĚ y debido a la plena dedicaci√≥n, muchos de ellos acaban desarrollando los s√≠ntomas del Diagn√≥stico Enfermero: Cansancio del rol de cuidador. El perfil m√°s com√ļn del cuidador informal, es una mujer casada, de mediana edad, con alg√ļn lazo sangu√≠neo con la persona a la que est√° cuidando, sin estudios o estudios primarios. Manifiesta ciertos sentimientos y emociones derivados de la tarea de cuidar como miedo, tristeza, ansiedad, agotamiento f√≠sico, apat√≠a o aislamiento social. La detecci√≥n precoz de los signos/s√≠ntomas del cuidador (Riesgo de Cansancio del rol de cuidador) y una pronta intervenci√≥n enfermera, pueden hacer que no aparezca el diagn√≥stico real: Cansancio del rol de cuidador. La escala de Zarit (m√°s utilizada) y el Test de Rasch son los m√°s utilizados para medir la sobrecarga. La figura de la Enfermera de Enlace supone un nexo entre diferentes niveles asistenciales, coordina recursos, servicios y formaci√≥n, lo que lleva al cuidador informal a asumir, sin tanta dificultad, la tarea de cuidar. El anteproyecto de Ley de Promoci√≥n de Autonom√≠a y Atenci√≥n a Personas Dependientes Personal y Dependencia aprobado en 2005 contemplaba la figura de la Enfermera de Enlace con cierta controversia, ya que en ese mismo a√Īo se estaba desarrollando la especialidad de E. Familiar y Comunitaria, que capacita a la enfermera para asumir los roles propuestos para esta nueva figura (enfermera de enlace). El objetivo de este trabajo es: analizar la figura del cuidador principal (informal) profundizando en las consecuencias de los cuidados continuados que realiza y la ayuda profesional que recibe. Palabras clave: cansancio, enfermer√≠a, cuidador informal, sobrecarga.Grado en Enfermer√≠

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    Evaluación del perfil competencial del estudiantado UCM por nivel de iniciativa emprendedora y género. Validación del Modelo Entrecomp de competencias emprendedoras

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    Examinar la relación entre las competencias emprendedoras propuestas por el Marco Europeo de Competencias Emprendedoras (Entrecomp) y el nivel de intención emprendedora. Se consideran las siguientes variables: sexo, estudios que realiza, si compagina trabajo y estudio, y Universidad en la que estudia

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74¬∑0%) had emergency surgery and 280 (24¬∑8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26¬∑1%) patients. 30-day mortality was 23¬∑8% (268 of 1128). Pulmonary complications occurred in 577 (51¬∑2%) of 1128 patients; 30-day mortality in these patients was 38¬∑0% (219 of 577), accounting for 81¬∑7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1¬∑75 [95% CI 1¬∑28‚Äď2¬∑40], p\textless0¬∑0001), age 70 years or older versus younger than 70 years (2¬∑30 [1¬∑65‚Äď3¬∑22], p\textless0¬∑0001), American Society of Anesthesiologists grades 3‚Äď5 versus grades 1‚Äď2 (2¬∑35 [1¬∑57‚Äď3¬∑53], p\textless0¬∑0001), malignant versus benign or obstetric diagnosis (1¬∑55 [1¬∑01‚Äď2¬∑39], p=0¬∑046), emergency versus elective surgery (1¬∑67 [1¬∑06‚Äď2¬∑63], p=0¬∑026), and major versus minor surgery (1¬∑52 [1¬∑01‚Äď2¬∑31], p=0¬∑047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Output Substitution in Multi-Species Trawl Fisheries: Implications for Quota Setting

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    Pre-treatment and extraction techniques for recovery of added value compounds from wastes throughout the agri-food chain

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    Pre-treatment and extraction techniques for recovery of added value compounds from wastes throughout the agri-food chain

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    The enormous quantity of food wastes discarded annually force to look for alternatives for this interesting feedstock. Thus, food bio-waste valorisation is one of the imperatives of the nowadays society. This review is the most comprehensive overview of currently existing technologies and processes in this field. It tackles classical and innovative physical, physico-chemical and chemical methods of food waste pre-treatment and extraction for recovery of added value compounds and detection by modern technologies and are an outcome of the COST Action EUBIS, TD1203 Food Waste Valorisation for Sustainable Chemicals, Materials and Fuels
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