Continuidad del cuidado: adulto mayor con diabetes tipo 2 y su cuidador

ResumenObjetivoAplicar la continuidad del cuidado en la persona con diabetes tipo 2 (DT2) y su cuidador, posterior al egreso hospitalario a través de intervenciones de enfermería domiciliaria que contribuyan a mejorar el estilo de vida.MétodoSe trata un proceso de enfermería a un adulto mayor con DT2 y a su cuidador primario, mediante una valoración de enfermería inicial y la medición del conocimiento de la enfermedad a través del Cuestionario de Conocimiento en Diabetes-24 y estilo de vida, con el Instrumento para Medir el Estilo de Vida en Diabéticos. La identificación de necesidades con la taxonomía NANDA permitió intervenciones de tipo informacional, de relación y gestión basadas en la Clasificación de Intervenciones de Enfermería para la continuidad del cuidado. Las intervenciones educativas fueron ejecutadas en sesiones periódicas, bajo consentimiento informado de los participantes, a través de una metodología interactiva. La efectividad fue evaluada con una valoración final de la persona con DT2 y cuidador.ResultadosSe observó un incremento del nivel de conocimientos de la enfermedad y una mejora en el estilo de vida, de la persona con DT2 y su cuidador, en los dominios: nutrición, actividad física, emociones y adherencia terapéutica.ConclusiónLa continuidad del cuidado en la persona con DT2 y su cuidador es una herramienta indispensable para mejorar el estilo de vida y nivel de conocimientos, disminuir el riesgo de complicaciones y evitar reingresos hospitalarios.AbstractObjectiveTo establish the continuity care on persons suffering from diabetes type 2 (DT2) and their caregiver following hospital discharge, through home-visit interventions which can contribute to the improvement of lifestyles.MethodThe nursing process was performed on a patient with DT2 and the corresponding primary caregiver through a nursing assessment which included the use of the 24-Diabetes Knowledge Questionnaire and the Instrument to Measure Lifestyles in patients with Diabetes Type 2. The identification of needs through the NANDA taxonomy allowed informational, relational and managerial interventions based on the Nursing Interventions Classification. The educational interventions were performed during periodic sessions under the informed consent of the participants and through an interactive methodology. The effectiveness was assessed through a final evaluation of the patient and corresponding caregiver.ResultsAn increment in the level of knowledge of the illness and an improvement in the lifestyle of the person with DT2 and the corresponding caregiver, in the nutrition, physical activity, emotions, and therapeutic adherence domains were observed.ConclusionThe continuity care on the person with DT2 is a critical tool to improve the lifestyle and level of knowledge, and to reduce the risk of complications and hospital re-entries

Functional-bandwidth kernel for Support Vector Machine with Functional Data:An alternating optimization algorithm

Functional Data Analysis (FDA) is devoted to the study of data which are functions. Support Vector Ma- chine (SVM) is a benchmark tool for classification, in particular, of functional data. SVM is frequently used with a kernel (e.g.: Gaussian) which involves a scalar bandwidth parameter. In this paper, we pro- pose to use kernels with functional bandwidths. In this way, accuracy may be improved, and the time intervals critical for classification are identified. Tuning the functional parameters of the new kernel is a challenging task expressed as a continuous optimization problem, solved by means of a heuristic. Our experiments with benchmark data sets show the advantages of using functional parameters and the ef- fectiveness of our approach

Classification of red grapes according to their state of ripeness using a low-cost multispectral device

[ES] El objetivo del presente trabajo fue evaluar la idoneidad de un sensor multiespectral de bajo costo para la determinación del estado de maduración de uvas tintas. El dispositivo propuesto se basa en un sensor multiespectral, con 18 bandas de detección en el rango entre los 410 y los 940 nm. La recogida de muestras se llevó a cabo en un viñedo comercial situado en Rociana del Condado, Huelva. El dispositivo propuesto se utilizó para adquirir la respuesta espectral de 80 racimos de uva en condiciones de laboratorio. Tras esto, cada una de las muestras fue analizada mediante métodos estándar de laboratorio para obtener indicadores objetivos de su estado de maduración (sólidos solubles totales y acidez). Los 18 valores de reflectancia ofrecidos por el sensor fueron usados como datos de entrada para entrenar redes neuronales artificiales para la clasificación de las muestras de uva en función de los parámetros objetivo. Los resultados obtenidos fueron prometedores, lo cual allana el camino hacia la implementación de un sistema para la monitorización del estado de maduración de uvas asequible para los vinicultores.[EN] The present work aims to evaluate a low-cost multispectral device for non-destructive grape ripening status assessment. The proposed device is based on a multispectral sensor, with a spectral response of 18 channels in a range from 410 to 940 nm. The experimental validation was carried out in a commercial vineyard in Rociana del Condado, Huelva. The proposed device was used to analyze 80 grape samples under laboratory conditions. After being processed with the proposed device the grape samples were analyzed with standard chemical methods to generate ground truth values of ripening status indicators (solid soluble content, and acidity). The 18-reflectance data corresponding to the spectral channels of the employed sensor, were used as input variables for developing artificial neural network models to classify the berries samples based on the mentioned ripeness indicators. The obtained results were promising, which paves the way for the implementation of a portable grape ripening appraisal system affordable for grape growers

Drop-in analysis of an internal heat exchanger in a vapour compression system using R1234ze(E) and R450A as alternatives for R134a

The IHX (internal heat exchanger) is introduced in some refrigeration systems in order to achieve higher energy performances. Results obtained vary greatly depending on the refrigerant used and working conditions. This paper describes a drop-in analysis of IHX effects on the performance of a vapour compression system using R1234ze(E) and R450A (R134a/R1234ze(E) commercial mixture) as R134a low-GWP replacements. The tests were carried out in a completely monitored vapour compression system varying the condensing and evaporating temperature, with and without a counter-current flow tube-in-tube IHX. Because the cooling capacity rises and the power consumption remains similar, the conclusion is that the IHX has a positive influence on the energy efficiency for all refrigerants tested. The COP (coefficient of performance) gain using R1234ze(E) is the highest observed (overcomes the R134a COP for the same conditions). The R1234ze(E) and R450A discharge temperature increments are lower than those of R134a so does not reach dangerous values and the IHX pressure drops are also below than that of R134a.The authors thankfully acknowledge "Ministerio de Educacion, Cultura y Deporte - Gobierno de Espana" (Grant number FPU12/02841) for supporting this work through "Becas y Contratos de Formacion de Profesorado Universitario del Programa Nacional de Formacion de Recursos Humanos de Investigacion del ejercicio 2012".Mota Babiloni, A.; Navarro Esbrí, J.; Barragán Cervera, Á.; Moles, F.; Peris, B. (2015). Drop-in analysis of an internal heat exchanger in a vapour compression system using R1234ze(E) and R450A as alternatives for R134a. Energy. 90:1636-1644. https://doi.org/10.1016/j.energy.2015.06.133S163616449

Genetic Evidence for a Tacaribe Serocomplex Virus, Mexico

We isolated arenavirus RNA from white-toothed woodrats (Neotoma leucodon) captured in a region of Mexico in which woodrats are food for humans. Analyses of nucleotide and amino acid sequence data indicated that the woodrats were infected with a novel Tacaribe serocomplex virus, proposed name Real de Catorce virus

Reacciones químicas oscilantes: su historia

Se presenta un recuento histórico de los hechos más destacados, relacionados con el estudio de reacciones químicas oscilantes. Se ilustran y discuten algunos de los conceptos más importantes en el campo de estas reacciones

Simulación de mecanismos complejos de reacción.

Se propone un método para la interpretación de mecanismos complejos de reacción, el cual es aplicado a la simulación del mecanismo de Gyórgyi-Field, (GF) desarrollado para la reacción química oscilante de Belousov-Zhabotinsky (BZ). El método basado en la ley de acción de masas y en el principio de independencia y coexistencia de los pasos elementales, reproduce el comportamiento oscilatorio en la concentración de los intermediarios de reacción

Estudio del comportamiento a cortante de vigas de hormigón reforzado con fibras

This study presents a series of tests for characterizing the structural behaviour of fibre reinforced concrete beams subjected to shear loading. The experimental program involves three types of fibres; two steel fibres and a polypropylene fibre. As a reference, plain concrete and conventionally reinforced concrete specimens have also been tested. The ultimate shear capacity of the beams is calculated and these values compared with those predicted by existing formulations. The study confirms that the toughness and shear crack resistance of the material is greatly enhanced by the fibres. However, the incorporation of 1% of fibres yielded lower shear strength than conventionally reinforced beams with the same amount of steel in the form of transversal stirrups. Existing design methods seem sufficiently robust to estimate the maximum shear load, even when using material properties (toughness, tensile strength) extrapolated from code formulae.Este trabajo presenta una serie de ensayos para caracterizar el comportamiento estructural de vigas realizadas con hormigón reforzado con fibras sometidas a cortante. El programa de ensayos incluía tres tipos de fibras, dos de acero y una de polipropileno. Asimismo, se realizó una serie de ensayos con una viga confeccionada con hormigón armado convencional. La resistencia a cortante de las vigas es comparada con los valores que la formulación existente predice. El estudio confirma que la tenacidad y la resistencia a cortante son incrementadas tras la adición de fibras al hormigón. Sin embargo, la incorporación de un 1% en volumen de fibras conduce a valores de resistencia última a cortante inferiores a los obtenidos con vigas de hormigón convencional con la misma cantidad de acero dispuesta en forma de cercos de cortante. Los actuales métodos de cálculo parecen lo suficientemente precisos para evaluar la carga de cortante último, incluso cuando los parámetros mecánicos utilizados en las fórmulas (tenacidad, resistencia a tracción) son deducidos a partir de la formulación propuesta en la normativa

Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: Methodology

Background: The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used. Methods: This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered) between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province. Results: All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work). There were 191 (0.16%) data entry errors. Conclusion: The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health car

Morphology of radio relics I: What causes the substructure of synchrotron emission?

High-resolution radio observations of cluster radio relics often show complex spatial and spectral features. However, it is not clear what these features reveal about the underlying magnetic field properties. We performed three-dimensional magneto-hydrodynamical simulations of merger shock waves propagating through a magnetised, turbulent intracluster medium. Our model includes the diffusive shock acceleration of cosmic-ray electrons, their spatial advection and energy losses at run-time. With this set-up we can investigate the relation between radio substructure and pre-shock plasma conditions in the host cluster. We find that upstream turbulence plays a major role in shaping the properties of radio relics produced downstream. Within the assumption of diffusive shock acceleration, we can reproduce the observed discrepancy between the X-ray derived Mach number of shocks, and the Mach number inferred from radio spectra. Our simulated spectral index maps and profiles across the radio relic also suggest that the standard deviation of the upstream magnetic field must be relatively small ($\sigma_B\leq 1 \, \mu$G) in order to reproduce observations and therefore, radio relics can potentially constrain the distribution of magnetic fields in galaxy clusters outskirts.Comment: Accepted for publication in MNRAS, 22 pages, 25 figure