The Primary Care Visit: What Else Could Be Happening?

The Institute of Medicine Report called for a greater role for nurses within the context of oral health in two recent publications, Advancing Oral Health in America (2011) and Improving Access to Oral Health Care for Vulnerable and Underserved Populations (2011). Nurses provide care for many vulnerable persons, including frail and functionally dependent older adults, persons with disabilities, and persons with intellectual and developmental disabilities. These persons are the least likely to receive necessary, health-sustaining dental care (which is distinct from mouth care). The mouth, or more accurately, plaque, serves as a reservoir for bacteria and pathogens. The link between mouth care, oral health, and systemic health is well-documented; infections such as pneumonia have been linked to poor oral health. Nurses, therefore, need to reframe mouth care as oral infection control and infection control more broadly. The can provide the preventive measure that are crucial to minimizing systemic infections. Nurses in all settings can potentially provide mouth care, conduct oral health assessments, educate patients about best mouth care practices, and make dental referrals. Yet, nurses are often hesitant to do anything beyond basic oral hygiene—and even in this area, often fail to provide mouth care based on best practices

Neural signatures of predictive language processing in parkinson’s disease with and without mild cognitive impairment

This study was funded by grants from the Fundació la Marató de TV3 2014/U/477 and 20142910, and by financial support from the Center for Biomedical Research and Neurodegenerative Resources (CIBERNED). PLC was funded with a pre-doctoral grant FPU15/05554 (FPU "Ayudas para la Formación de Profesorado Universitario") of the Spanish Ministry of Education, Culture and Sport. JP was funded by PERIS (expedient number: SLT008/18/00088) of Generalitat de Catalunya. JK and HB-K were funded by FIS PI18/01717. HB -K was funded by Río Hortega CM17/00209 of Instituto de Salud Carlos III (ISCIII) (Spain). JM was funded by Río Hortega CM15/00071 of Instituto de Salud Carlos III (ISCIII) (Spain). None of these funding sources had any involvement in the conduct of the research or the preparation of the article.Cognitive deficits are common in Parkinson’s disease (PD), with some PD patients meeting criteria for mild cognitive impairment (MCI). An unaddressed question is whether linguistic prediction is preserved in PD. This ability is nowadays deemed crucial in achieving fast and efficient comprehension, and it may be negatively impacted by cognitive deterioration. To fill this gap of knowledge, we used event-related potentials (ERPs) to evaluate mechanisms of linguistic prediction in a sample of PD patients (on dopamine compensation) with and without MCI. To this end, participants read sentence contexts that were predictive or not about a sentence-final word. The final word appeared after 1 second, matching or mismatching the prediction. The introduction of the interval allowed to capture neural responses both before and after sentence-final words, reflecting semantic anticipation and processing. PD patients with normal cognition (N = 58) showed ERP responses comparable to those of matched controls. Specifically, in predictive contexts, a slow negative potential developed prior to sentence-final words, reflecting semantic anticipation. Later, expected words elicited reduced N400 responses (compared to unexpected words), indicating facilitated semantic processing. Besides, PD patients with MCI (N = 20) showed a prolongation of the N400 congruency effect (compared to matched PD patients without MCI), indicating that further cognitive decline impacts semantic processing. Finally, lower verbal fluency scores correlated with prolonged N400 congruency effects and with reduced pre-word differences in all PD patients (N = 78). This relevantly points to a role of deficits in temporal-dependent mechanisms in PD, besides prototypical frontal dysfunction, in altered semantic anticipation and semantic processing during sentence comprehension.Fundació la Marató de TV3 2014/U/477 and 20142910Center for Biomedical Research and Neurodegenerative Resources (CIBERNED)FPU15/05554 (FPU "Ayudas para la Formación de Profesorado Universitario") of the Spanish Ministry of Education, Culture and SportPERIS (expedient number: SLT008/18/00088) of Generalitat de CatalunyaRío Hortega CM17/00209 of Instituto de Salud Carlos III (ISCIII) (Spain)FIS PI18/01717. HB -KRío Hortega CM15/00071 of Instituto de Salud Carlos III (ISCIII) (Spain

Alpha power decreases associated with prediction in written and spoken sentence comprehension

Alpha and beta power decreases have been associated with prediction in a variety of cognitive domains. Recent studies in sentence comprehension have also reported alpha and/or beta power decreases preceding contextually predictable words, albeit with remarkable spatiotemporal variability across reports. To contribute to the understanding of the mechanisms underlying this phenomenon, and the sources of variability, the present study explored to what extent these prediction-related alpha and beta power decreases might be common across different modalities of comprehension. To address this, we re-analysed the data of two EEG experiments that employed the same materials in written and in spoken comprehension. Sentence contexts were weakly or strongly constraining about a sentence-final word, which was presented after a 1 s delay, either matching or mismatching the expectation. In written comprehension, alpha power (8–12 Hz) decreased before final words appearing in strongly (relative to weakly) constraining contexts, in line with previous reports. Furthermore, a similar oscillatory phenomenon was evidenced in spoken comprehension, although with relevant spatiotemporal differences. Altogether, the findings agree with the involvement of both modality-specific and general-domain mechanisms in the elicitation of prediction-related alpha power decreases in sentence comprehension. Specifically, we propose that this phenomenon might partly reflect richer and more precise information representation when linguistic contexts afford prediction.pre-doctoral grant (FPU "Ayudas para la Formacion de Profesorado Universitario") of the Spanish Ministry of Education, Culture and Sport FPU15/0555

Adipocinas en la osteopatía del paciente alcohólico

El consumo de alcohol a dosis tóxicas produce pérdida de masa ósea, fundamentalmente por un efecto directo sobre el osteoblasto, ocasionando un incremento del riesgo de fracturas. Además del efecto tóxico directo del etanol sobre el hueso, otros factores contribuyen a la enfermedad ósea como la miopatía, niveles elevados de citoquinas proinflamatorias o la malnutrición. El deficiente estado nutricional del alcohólico, reflejado en parte por ingestas escasas o nulas, malabsorción y descenso de la síntesis de proteínas a nivel hepático, conlleva una disminución de los niveles de vitamina D y a alterar su metabolismo lo que contribuye a alterar aún más la masa ósea. Cada vez está más establecida la existencia de una situación proinflamatoria “basal” en el alcohólico. Se ha descrito que en la regulación del metabolismo óseo en estos pacientes median citoquinas proinflamatorias, como el TNFα y la IL-6, las cuales incrementan los niveles de osteoprotegerina, que a su vez induce la síntesis de osteoclastos favoreciendo así la destrucción ósea. El objetivo de este estudio es evaluar la relación existente entre la presencia de osteopenia u osteoporosis en un grupo de 118 alcohólicos ingresados en nuestro centro y los diferentes parámetros de composición corporal, como la masa magra y la masa grasa. Asimismo, se evaluaron niveles de adipocinas, como la adiponectina, resistina y leptina y se estudió la relación de éstas con la osteopatía del paciente alcohólico

Trascendencia del suplemento “La Cultura en México"

Ilustración: "Pulgas de París con máscaras para turistas", GuttiEl presente trabajo revisa sucintamente la importante inluencia de "La Cultura en México",suplemento del semanario Siempre!, ya que se trató de la primera publicación cultural-literaria que satisfizo las necesidades de libertad de opinión y de interacción con el campo político desde el campo literario, tal como la reclamaba la nueva generación de intelectuales de los años sesenta en el país. This paper checks succinctly the important inluence of “La Cultura en México”, supplement of the weekly Siempre!, since it was the first cultural-literary publication that it satisfied the needs of freedom of opinion and of interaction with the political field by the literary ield, as the new intellectual generation of the sixties was claiming it in the country

OPTIMIZACIÓN DE LA ACEPTABILIDAD DE UN POSTRE LÁCTEO CON CARÁCTER PREBIÓTICO

La investigación llevada a cabo en esta tesis, ha tenido como objetivo la optimización de la formulación de un postre lácteo con bajo contenido en grasa (<0,1%) y con características prebióticas, utilizando una mezcla de inulinas de cadena corta y larga. Se estudiaron los efectos de la concentración de inulina, de azúcar y de aroma a limón en las propiedades reológicas y sensoriales del producto. Para el diseño experimental y el análisis de datos se utilizó el Método de Superficie de Respuesta (MSR). El comportamiento de flujo y la viscoelasticidad de las muestras variaron con la concentración de inulina y azúcar. La aceptabilidad varió principalmente con las concentraciones de inulina y azúcar y en menor medida con la de aroma a limón. De acuerdo al modelo obtenido se estableció para cada ingrediente el intervalo de concentraciones de máxima aceptabilidad y se seleccionó, como representativa, la formulación con 5,5% de inulina, 10% de azúcar y 60 ppm de aroma. Finalmente, las propiedades sensoriales de esta muestra se compararon con las de una muestra con el contenido en grasa habitual (2,8%), previamente seleccionada con un contenido en azúcar del 11,4% y 146 ppm de aroma. Entre estas dos muestras no hubo diferencias en cuanto a la aceptabilidad, aunque la de bajo contenido en grasa e inulina presentó mayor sabor a limón, consistencia y cremosidad.Arcia Cabrera, P. (2010). OPTIMIZACIÓN DE LA ACEPTABILIDAD DE UN POSTRE LÁCTEO CON CARÁCTER PREBIÓTICO. http://hdl.handle.net/10251/13733Archivo delegad

Neural Evidence of Hierarchical Cognitive Control during Haptic Processing: An fMRI Study

Interacting with our immediate surroundings requires constant manipulation of objects. Dexterous manipulation depends on comparison between actual and predicted sensory input, with these predictions calculated by means of lower- and higher-order corollary discharge signals. However, there is still scarce knowledge about the hierarchy in the neural architecture supporting haptic monitoring during manipulation. The present study aimed to assess this issue focusing on the cross talk between lower- order sensory and higher-order associative regions. We used functional magnetic resonance imaging in humans during a haptic discrimination task in which participants had to judge whether a touched shape or texture corresponded to an expected stimulus whose name was previously presented. Specialized haptic regions identified with an independent localizer task did not differ between expected and unexpected conditions, suggesting their lack of involvement in tactile monitoring. When presented stimuli did not match previous expectations, the left supramarginal gyrus (SMG), middle temporal, and medial prefrontal cortices were activated regardless of the nature of the haptic mismatch (shape/texture). The left primary somatosensory area (SI) responded differently to unexpected shapes and textures in line with a specialized detection of haptic mismatch. Importantly, connectivity analyses revealed that the left SMG and SI were more functionally coupled during unexpected trials, emphasizing their interaction. The results point for the first time to a hierarchical organization in the neural substrates underlying haptic monitoring during manipulation with the SMG as a higher-order hub comparing actual and predicted somatosensory input, and SI as a lower- order site involved in the detection of more specialized haptic mismatch

EL IMAGINARIO DEL 68 MEXICANO EN LA NARRATIVA LITERARIA: DEBATE FIGURATIVO Y POLÍTICO

The purpose of the study to analyze briefly some left-wing novels about the student movement of 1968 (M-68) of Mexico, and set the terms of the literary and political debates intertextual. The reporting period covers from 1971 to 2006. The hypothesis is that this narrative contributed substantially to shape the social imaginary of the M-68 and managed to prevent detractors versions omit or distort the event, also revived the tradition of conceiving the social mission of the literature was the aesthetic legacy of the literature of the Mexican Revolution. This achievement was made possible by the social nature of the protagonists of the M-68, were graduate students and intellectuals. Over 35 years, was displaying the competition between writers, both the literary and the political interpretations of the M-68. Realistic strategies, mimetic and witnesses, subjects and collective action, the stories started to focus political subjectivities affected by the M-68. The basic principles of architectural analysis of the text notes and arguments. Please note that the purpose of the first stories was to rescue the testimonies and memories build a utopian horizon, the second group it is important to report the effects of repression on individuals. In this century there is only one novel, Armablanca, contained the thinker and writer Jos&eacute; Revueltas as a prophet of political changes in Mexico that would come as a result of M-68.El prop&oacute;sito del estudio en analizar someramente algunas novelas de izquierdas sobre el movimiento estudiantil de 1968 (M-68) de M&eacute;xico, y establecer los t&eacute;rminos de los debates literarios y pol&iacute;ticos intertextuales. El periodo examinado abarca de 1971 a 2006. La hip&oacute;tesis es que tal narrativa contribuy&oacute; sustancialmente a configurar el imaginario social del M-68 y logr&oacute;&nbsp; impedir que las versiones detractoras omitieran o distorsionaran el acontecimiento; asimismo resucit&oacute; la tradici&oacute;n de concebir la misi&oacute;n social de la literatura que hab&iacute;a sido el legado est&eacute;tico de la literatura de la Revoluci&oacute;n Mexicana. Este logro fue posible por la naturaleza social de los protagonistas del M-68: eran estudiantes de nivel superior e intelectuales. A lo largo de 35 a&ntilde;os se fue desplegando la concurrencia entre los escritores, tanto en el plano literario como en el de las interpretaciones pol&iacute;ticas del M-68. De las estrategias realistas, mim&eacute;ticas y testimoniales, con sujetos y acciones colectivos, las narraciones pasaron a focalizar subjetividades pol&iacute;ticas afectadas por el M-68. Los principios b&aacute;sicos del an&aacute;lisis observan la arquitectura del texto y los argumentos. Se advierte que la finalidad de las primeras narraciones fue rescatar los testimonios y construir las memorias en un horizonte ut&oacute;pico; en el segundo grupo lo importante es denunciar los efectos de la represi&oacute;n en los individuos. En el presente siglo s&oacute;lo hay una novela, Armablanca, que figura al escritor y pensador Jos&eacute; Revueltas como profeta de los cambios pol&iacute;ticos que sobrevendr&iacute;an en M&eacute;xico a resultas del M-68.&nbsp;&nbsp; &nbsp

Planificación de un sistema de comunicación para la digitalización de procesos electorales mediante el acceso biométrico de usuarios

La tecnología cada día forma más parte de nuestra vida, el ocio, el trabajo, la educación, la medicina, la relación entre personas está en constante cambio debido a la tecnología, por ello se ve conveniente una modificación en el sistema de elección del gobierno, es decir, una modernización en el sistema de votación actual que esté a la altura de las exigencias de una población cada vez más acostumbrada a la rapidez y exactitud de la tecnología. En este Trabajo Fin de Grado se pretende hacer un análisis, estudio y descripción de los elementos necesarios para llevar a cabo la red de comunicaciones necesaria para la implementación de la votación electrónica. Esta red se realizará mediante fibra óptica, el medio de transmisión físico con más ventajas en la actualidad, que proporciona grandes velocidades de subida y bajada, fiabilidad de la red, gran durabilidad y fácil escalabilidad. La red implementada está ideada para ser usada en procesos electorales pero podrá aprovecharse su instalación durante el período docente y ser usada como una red de acceso a internet común para los colegios. El proyecto se divide en dos partes: Diseño de la red exterior. En este apartado se realiza un análisis del cableado de fibra óptica y los diferentes componentes de la red a lo largo del municipio, que interconecta los diferentes colegios con el nodo de acceso a la fibra óptica y los CPD que tendrán almacenada la información de identificación de usuarios y a su vez almacenarán también el voto de los ciudadanos. Diseño de la red interior de un colegio. Se propone el diseño de red en el edificio de un colegio modelo con los correspondientes planos. Debido a las similitudes arquitectónicas entre los colegios, la estructura de red puede ser implementada en cualquiera de ellos. La arquitectura que se propone es un cableado estructurado. Aunque el proyecto requiere un gran esfuerzo económico por parte de la administración pública, son claros los beneficios que esta red proporciona frente a la votación electoral actual. Debido a las vulnerabilidades de las redes informáticas la votación electrónica estará combinada con un sistema de impresión del voto e inserción en urna para poder realizar auditorías.Technology is increasingly part of our life, leisure, work, education, medicine, the relationships are constantly changing due to technology, for this reason it is convenient to change the system of government election, such a modernization in the current voting system that is up to the demands of a population increasingly accustomed to the speed and accuracy of technology. In this Final Project the aim is to analyze, study and describe the necessary elements to carry out the communications network for the implementation of electronic voting. This network will be carried out by optical fiber, the physical transmission medium with more advantages at present, it provides great upload and download speeds, network reliability, great durability and easy scalability. The implemented network is designed to be used in electoral processes but its installation can be used during the teaching period and used as a common Internet access network for schools. The project is divided into two parts: Exterior network design. In this section it is made an analysis of the fiber optic cabling and the different network components throughout the municipality is carried out, which interconnects the different schools with the fiber optic access node and the CPDs that will have stored the users identification information stored and the vote of the citizens. Design of the internal network of a school. It is proposed the network design in the building of a model school with the corresponding plans. Due to the architectural similarities between the schools, the network structure can be implemented in any of them. The proposed architecture is structured cabling. Although the project requires a great economic effort on the part of the public administration, the benefits that this network provides against the current electoral vote are clear. Due to the vulnerabilities of the computer networks, electronic voting will be combined with a system for printing the vote and inserting it into an urn to carry out audits.Ingeniería en Tecnologías de Telecomunicació