68 research outputs found

    Appraisal of Ancient Quarries and WWII Air Raids as Factors of Subsidence in Rome: A Geomatic Approach

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    Ancient mining and quarrying activities left anthropogenic geomorphologies that have shaped the natural landscape and affected environmental equilibria. The artificial structures and their related effects on the surrounding environment are analyzed here to characterize the quarrying landscape in the southeast area of Rome in terms of its dimensions, typology, state of preservation and interface with the urban environment. The increased occurrence of sinkhole events in urban areas has already been scientifically correlated to ancient cavities under increasing urban pressure. In this scenario, additional interacting anthropogenic factors, such as the aerial bombardments perpetrated during the Second World War, are considered here. These three factors have been investigated by employing a combined geomatic methodology. Information on air raids has been organized in vector archives. A dataset of historical aerial photographs has been processed into Digital Surface Models and orthomosaics to reconstruct the quarry landscape and its evolution, identify typologies of exploitation and forms of collapse and corroborate the discussion concerning the induced historical and recent subsidence phenomena, comparing these outputs with photogrammetric products obtained from recent satellite data. Geological and urbanistic characterization of the study area allowed a better connection between these historical and environmental factors. In light of the information gathered so far, SAR interferometric products allowed a preliminary interpretation of ground instabilities surrounding historical quarries, air raids and recent subsidence events. Various sub-areas of the AOI where the presenceof the considered factors also corresponds to areas in slight subsidence in the SAR velocity maps have been highlighted. Bivariate hotspot analysis allowed substantiating the hypothesis of a spatial correlation between these multiple aspects

    Estresores adolescentes: Desarrollo de la versión española del Adolescent Stress Questionnaire (ASQ-S)

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    El propósito del presente trabajo es estudiar las propiedades psicométricas de la versión española del Adolescent Stress Questionnaire (ASQ-S) para evaluar los estresores contemporáneos que experimenta la población adolescente entre 12 y 18 años.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

    Estilos de aprendizaje en alumnos de enfermería y su modelaje durante módulos prácticos

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    Las metodologías de innovación docente han sido potenciadas con la creación del Espacio Europeo de Educación Superior. Uno de los objetivos que persigue la innovación es conseguir que el aprendizaje sea reflexivo. La experiencia educativa es un fenómeno altamente complejo, implica cuatro elementos y que en la descripción de Schwab (1983) son: el profesor, el que aprende, el curriculum y el medio. Como plantean Ausubel, Novak y Hanesian (1983), en la teorización sobre el aprendizaje significativo, los alumnos partiendo de su estructura cognitiva previa, van integrando y relacionando nuevos aprendizajes, haciendo referencia a la “estructura cognitiva", como el conjunto de conceptos e ideas que un individuo posee en un determinado campo del conocimiento y de su organización. Las competencias que tienen que adquirir las futuras enfermeras, tienen su desarrollo epistemológico en un conocimiento fundamentalmente práctico, y que va ser desarrollado dentro de ámbitos complejos como son los entornos clínicos y comunitarios, donde realizan y se aproximan a esos saberes. El conocimiento práctico tiene que estar fundamentado en un aprendizaje reflexivo, abandonando paradigmas más positivistas, donde impere el razonamiento clínico basado en modelos reflexivos que le sirvan para argumentar los cuidados. El objetivo del presente estudio es analizar los estilos predominantes de aprendizaje del alumnado de primero de grado de Enfermería y su evolución cuando cursan el tercer año después de su incorporación a los módulos prácticos. Métodos: estudio de intervención con diseño de grupo único. Para realizar el estudio se utilizó como instrumento de recogida de datos el cuestionario CHAEA que determina los estilos de aprendizaje en ambos cursos

    Tecnologías de la información y la comunicación como herramienta educativa en pacientes con enfermedades crónicas no transmisibles en una IPS de la ciudad de Manizales

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    ABSTRACT Introduction: chronic noncommunicable  diseases cause high morbidity and mortality worldwide so it requires innovative strategies that impact on self-care, adoption of healthy lifestyles and the diseases treatment. Nowadays, the information and communication technologies compose a resource in order to improve the effectiveness and efficiency of the patient’s programs with chronic diseases, overcome structural limitations and the availability of human resources in the health system. Objective: to evaluate the impact of theinformation and communication technologies to promote healthy lifestyles and adherence to medication, to know the perception of users about the usefulness of the intervention and also their effect on clinical variables. Methods: longitudinal study, in which 90 patients outpatient health institution in Manizales were included to receive text messages, was made. There were chosen over-age-18 men and women, with arterial hypertension diagnosis or diabetes mellitus who owned a cell phone or were with a near carer assistant who would accept receiving text massages in its own mobile. The massages were about their healthy lifestyle, and these were sent between august and december during 29 weeks. 68 subject completed the follow up. At the end of the intervention, acceptance, usefulness and effects on laboratory and clinical parameters were evaluated. Results: it was found that 100% of the patients who confirmed receiving the messages perceived an improvement in self care; showing changes in diet (95.16%) and the amelioration of medication adherence (59%). Besides, the service utility was qualified as excellent. Conclusions: the patient’s perceptions about the use of the information and communication technologies was positive and it could generates changes in areas such as alimentary habits and medication adherence, in promoting healthy lifestyles and management of chronic noncommunicable diseases. However, it requires controlled studies using a standardized long-term monitoring to determine the actual impact on clinical variables and cost-effective. In addition, it should identify the type of population would get greater benefit. MÉD.UIS. 2016;29(2):59-70.Keywords: Diabetes Mellitus. Hypertension. Primary prevention. Text Messaging. Cell Phones. Education. Technology.Introducción: las enfermedades crónicas no transmisibles causan gran morbilidad y mortalidad a nivel mundial por lo que se requiere de estrategias innovadoras que impacten en el autocuidado, adopción de estilos de vida saludables y manejo de ellas. En la actualidad, las Tecnologías de la información y la comunicación constituyen un recurso para mejorar la efectividad y la eicacia de programas dirigidos a pacientes con enfermedades crónicas, superar las limitaciones estructurales y la disponibilidad de recursos humanos existentes en los sistemas de salud. Objetivo: evaluar el impacto de las Tecnologías de la información y la comunicación como herramienta educativa para promover estilos de vida saludables y adherencia a la medicación, conocer la percepción de los usuarios frente a la intervención y observar el efecto sobre variables clínicas. Materiales y Métodos: estudio longitudinal, donde se incluyeron 90 pacientes de la consulta externa de una institución prestadora de salud de Manizales para recibir mensajes de texto. Fueron seleccionados hombres y mujeres mayores de 18 años con diagnóstico de hipertensión arterial o diabetes mellitus con teléfono celular propio o de un cuidador cercano que aceptaran recibir los mensajes de texto en su teléfono móvil. Los mensajes contenían información sobre estilos de vida saludable y fueron enviados entre agosto y diciembre de 2014 durante 29 semanas. 68 sujetos completaron el seguimiento. Al inal de la intervención, se evaluó la aceptación, utilidad y efectos sobre parámetros de laboratorio y clínicos. Resultados: el 100% de los pacientes que conirmaron la recepción de los mensajes percibieron una mejoría en su autocuidado; evidenciándose cambios en la dieta (95,16%) y mejoría en la adherencia a la medicación (59%), además de caliicarse la utilidad del servicio como excelente por el 61,5% de los sujetos. Sin embargo no se encontraron cambios estadísticamente signiicativos en variables clínicas y de laboratorio. Conclusiones: la percepción de los pacientes frente al uso de las Tecnologías de la información y la comunicación es positiva y genera cambios en aspectos como la alimentación y la adherencia a la medicación, por lo que constituye una herramienta en la promoción de estilos de vida saludables y manejo de enfermedades crónicas no transmisibles. Se requiere de estudios controlados estandarizados mediante un seguimiento a largo plazo para determinar el impacto real sobre variables clínicas y su costo-beneicio. Además se deberá individualizar el tipo de población que obtendría mayor beneicio. MÉD. UIS. 2016;29(2):59-70.Palabras clave: Diabetes Mellitus. Hipertensión. Prevención primaria. Mensaje de texto. Teléfonos celulares. Educación. Tecnología.

    Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

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    IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

    Scaffolds for cartilage regeneration: to use or not to use?

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    Joint cartilage has been a significant focus on the field of tissue engineering and regenerative medicine (TERM) since its inception in the 1980s. Represented by only one cell type, cartilage has been a simple tissue that is thought to be straightforward to deal with. After three decades, engineering cartilage has proven to be anything but easy. With the demographic shift in the distribution of world population towards ageing, it is expected that there is a growing need for more effective options for joint restoration and repair. Despite the increasing understanding of the factors governing cartilage development, there is still a lot to do to bridge the gap from bench to bedside. Dedicated methods to regenerate reliable articular cartilage that would be equivalent to the original tissue are still lacking. The use of cells, scaffolds and signalling factors has always been central to the TERM. However, without denying the importance of cells and signalling factors, the question posed in this chapter is whether the answer would come from the methods to use or not to use scaffold for cartilage TERM. This paper presents some efforts in TERM area and proposes a solution that will transpire from the ongoing attempts to understand certain aspects of cartilage development, degeneration and regeneration. While an ideal formulation for cartilage regeneration has yet to be resolved, it is felt that scaffold is still needed for cartilage TERM for years to come
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