Calidad de vida relacionada con la salud en pacientes con síndrome metabólico y diabetes mellitus

The rationale for the present project is to enlarge the knowledge about health related quality of life (HRQoL) in patients with metabolic syndrome (MetS) and diabetes mellitus (DM). DM and MetS suppose a global health burden because of their high prevalence but also because of their association with chronic complications. In addition to the evaluation of morbi - mortality, assessing quality of life is an important outcome, especially in chronic illnesses. DM has been associated with impairments in physical, mental health and social functioning. The data about HRQoL in MetS are scarce. For evaluating HRQoL on DM and MetS three independent studies were performed. The first and the second one were based on the population of the [email protected] study that included a wide sample, representative of the Spanish population. It was conducted in Spain between 2009 and 2010, designed to estimate DM prevalence in the country. Considering we had a wide representative sample, firstly we assessed MetS prevalence and then evaluated HRQoL in the group with MetS or DM, comparing them to “healthy” people without them. The third study assesses HRQoL in patients with DM who attend to a monographic Unit for Diabetes attention. It is important to know the most affected areas of HRQoL and the socio demographic factors that can influence on it, in order to create initiatives to implement patients’ care..

Proyecto EmpléaTe: intervención sociolaboral con personas sin hogar en ciudad de Teruel

Este Trabajo de Fin de Grado tiene como propósito diseñar un programa sociolaboral para personas que se encuentran sin hogar en la ciudad de Teruel. El sinhogarismo es un grave problema que sufre una cifra bastante elevada de población en España y que, desafortunadamente, no deja de aumentar. La realización de este proyecto ha sido posible gracias a la ejecución del Prácticum de Intervención en Cáritas Diocesana de Teruel y Albarracín, donde se pudo hacer una observación directa de las personas sin hogar con las que se trabajaba, además de conocer los recursos con los que se cuenta en la cuidad para esta problemática. Tras esto, se llevó a cabo una revisión bibliográfica y se llegó a la conclusión de que hace falta un mayor trabajo con este colectivo por parte del Trabajo Social. A continuación, se describe el programa diseñado cuyo objetivo es, a partir de actuaciones como la formación, la prospección laboral y la intervención en áreas como la salud, el empoderamiento y la mejora de la calidad de vida de los participantes

Social entrepreneurship as a tool for promoting critical, paradoxical learning in the field of business organization and management: An experiment from the University of Zaragoza

There is a growing interest in examining subversive interventions by scholars that may involve the production of new subjectivities, the constitution of new organizational models, and the linking of these models with current social movements. This paper presents the case of the Social Economy Lab (LAB_ES), created in the Faculty of Economics and Business of the University of Zaragoza in 2017. In particular, we discuss the main experiences and interventions made from the LAB_ES around three areas of work: (1) the space of collective work; (2) the space of participation for the university community; and (3) the space of collective research. The study reflects the possibilities of including the study of alternative organizations in the education agenda. These organizations are guided by principles that include democracy, equality, emancipation and environmental sustainability. Likewise, the results and interventions of the LAB_ES are discussed not only to foster critical thinking among the students, but also to provide this group with skills for starting up alternative projects of organization and management outside the university. Finally, some key conclusions are drawn about the role of the LAB_ES as a space for collective research and collective production of critical knowledge about business organization and management, through the involvement of different actors.Bretos, I.; Díaz-Foncea, M.; Sarasa, C.; Lozenko, AK.; Marcuello, C. (2020). Social entrepreneurship as a tool for promoting critical, paradoxical learning in the field of business organization and management: An experiment from the University of Zaragoza. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):123-130. https://doi.org/10.4995/HEAd20.2020.10996OCS12313030-05-202

Casos Prácticos de Organizaciones de Economía Social para la Docencia en Dirección y Gestión de Empresas

Uno de los principales objetivos de la Cátedra Cooperativas y Economía Social Caja Rural de Teruel, de la Universidad de Zaragoza, consiste en el fomento del conocimiento sobre las cooperativas y las organizaciones de la Economía Social en el ámbito de la comunidad universitaria. Sin duda, una de las vías esenciales para lograrlo reside en promover una mayor inclusión y visibilidad de este tipo de organizaciones dentro de la docencia universitaria, con particular incidencia en las materias relacionadas con la economía y con la dirección y gestión de empresas. En este marco, el documento presenta una colección de 32 casos prácticos breves de organizaciones entroncadas en el sector de la Economía Social con un doble objetivo. Por un lado, pretendemos difundir y visibilizar la labor de distintas empresas y organizaciones relevantes del sector que, desde enfoques, trayectorias y actividades diversas, contribuyen a transformar la realidad socio-económica de los territorios donde operan. Como parte de la Economía Social, estas organizaciones llevan a cabo sus actividades desde unas coordinadas alternativas a los modelos tradicionales de empresa, en tanto que se basan en principios como la primacía de las personas y del fin social sobre el capital, la independencia y autonomía en la gestión con respecto a los poderes públicos, la adhesión voluntaria y abierta, la gestión democrática por parte de los miembros, o la defensa y aplicación de los principios de solidaridad y responsabilidad. Por otro lado, esperamos que los casos prácticos presentados puedan servir de referencia para la docencia no sólo en el ámbito específico de la economía social y solidaria, sino en disciplinas científicas más generales como la economía, la sociología y la dirección y gestión de empresas. Cada uno de los casos muestra la información esencial de empresas y organizaciones de la economía social de Aragón, España, Iberoamérica y multinacionales. En concreto, se han recogido datos básicos sobre distintas variables como la fecha de creación, el número de empleos, socios y/o voluntarios, el sector de actividad y los servicios ofrecidos, hitos organizacionales y el número de organizaciones que integran (en el caso de grupos empresariales o de plataformas y redes). También se facilitan recursos electrónicos, como las páginas web institucionales, redes sociales o vídeos corporativos. Finalmente, cabe señalar que esta publicación se ha elaborado en un marco de colaboración entre los miembros de un equipo investigador que formamos parte de una o varias redes de trabajo relacionadas con el ámbito de la Economía Social en la Universidad de Zaragoza, como son la Cátedra Cooperativas y Economía Social Caja Rural de Teruel, el grupo de investigación GESES (Grupo de Estudios Sociales y Económicos del Tercer Sector) y el Laboratorio de Economía Social (LAB_ES) de la Facultad de Economía y Empresa. Nuestra intención es continuar con este proyecto en el futuro, incluyendo cada año un abanico distinto de empresas y entidades de la Economía Social. Para ello, será fundamental la participación de diferentes colaboradores que quieran sumarse al proyecto

Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)

Background Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which the alimentary limb is eliminated, and the common channel is lengthened from 200 to 300 cm. Short-term results have demonstrated that SADI-S is safe and reproducible and that weight loss and comorbidities resolution are comparable to biliopancreatic diversion or DS. Objective To analyze the long-term outcomes of SADI-S. Methods From May 2007 to December 2015, 164 patients were consecutively submitted to a one-step SADI-S. The mean age was 47 years, and the mean body mass index (BMI) was 45.8 kg/m2. A total of 101 patients had type 2 diabetes, 91 arterial hypertension, 81 obstructive apnea, and 118 dyslipidemia. Limb length was 200 cm in 50 cases, 250 cm in 99, and 300 cm in 15. Results There was no mortality. One patient had a gastric leak, and 2 patients had an anastomotic leak. A total of 25% of the patients were lost to follow-up at 10 years. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. A total of 12 patients were submitted to revisional surgery for hypoproteinemia. Preoperatively 41 diabetics were under insulin treatment; at 5 years, 7 remained with insulin and 12 at 10 years. Mean glycemia was 104 mg/dL at 5 years and 118 mg/dL at 10 years. Mean HbA1c was 5.51% at 5 years and 5.86 at 10 years. Conclusion In the long term, SADI-S offers satisfactory weight loss and comorbidities resolution

Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia

Gastric bypass determines an increase in incretin secretion and glucose excursions throughout the day and may sometimes entail the development of severe post-bariatric hypoglycemia (PBH). However, there is no consensus on the gold standard method for its diagnosis. In this study, we evaluated the usefulness of a mixed meal tolerance test (MMTT) and continuous glucose monitoring (CGM) for the diagnosis of PBH, defined as glucose levels <54 mg/dL (3.0 mmol/L). We found that hypoglycemia occurred in 60% of patients after the MMTT and in 75% during CGM, and it was predominantly asymptomatic. The MMTT confirmed the diagnosis of PBH in 88.9%of patients in whom surgery had been performed more than three years ago, in comparison to 36.4% in cases with a shorter postsurgical duration. CGM diagnosed nocturnal asymptomatic hypoglycemia in 70% of patients, and daytime postprandial hypoglycemia in 25% of cases. The mean duration of asymptomatic hypoglycemia was more than 30 min a day. Patients with ≥2% of their CGM readings with hypoglycemia exhibited a higher degree of glucose variability than those with <1% of the time in hypoglycemia. Our results show that the MMTT may be a useful dynamic test to confirm the occurrence of hypoglycemia in a large number of patients with persistent and recurrent PBH during long-term follow-up after gastric bypass. CGM, on its part, helps identify hypoglycemia in the real-world setting, especially nocturnal asymptomatic hypoglycemia, bringing to light that PBH is not always postprandial.Fundación de Investigación en Nutrición y MetabolismoFundación de Estudios MetabólicosDepto. de MedicinaFac. de MedicinaTRUEpubDescuento UC

Role of Kras status in patients with metastatic colorectal cancer receiving first-line chemotherapy plus bevacizumab: a TTD group cooperative study.

In the MACRO study, patients with metastatic colorectal cancer (mCRC) were randomised to first-line treatment with 6 cycles of capecitabine and oxaliplatin (XELOX) plus bevacizumab followed by either single-agent bevacizumab or XELOX plus bevacizumab until disease progression. An additional retrospective analysis was performed to define the prognostic value of tumour KRAS status on progression-free survival (PFS), overall survival (OS) and response rates.KRAS data (tumour KRAS status and type of mutation) were collected by questionnaire from participating centres that performed KRAS analyses. These data were then cross-referenced with efficacy data for relevant patients in the MACRO study database. KRAS status was analysed in 394 of the 480 patients (82.1%) in the MACRO study. Wild-type (WT) KRAS tumours were found in 219 patients (56%) and mutant (MT) KRAS in 175 patients (44%). Median PFS was 10.9 months for patients with WT KRAS and 9.4 months for patients with MT KRAS tumours (p=0.0038; HR: 1.40; 95% CI:1.12-1.77). The difference in OS was also significant: 26.7 months versus 18.0 months for WT versus MT KRAS, respectively (p=0.0002; HR: 1.55; 95% CI: 1.23-1.96). Univariate and multivariate analyses showed that KRAS was an independent variable for both PFS and OS. Responses were observed in 126 patients (57.5%) with WT KRAS tumours and 76 patients (43.4%) with MT KRAS tumours (p=0.0054; OR: 1.77; 95% CI: 1.18-2.64).This analysis of the MACRO study suggests a prognostic role for tumour KRAS status in patients with mCRC treated with XELOX plus bevacizumab. For both PFS and OS, KRAS status was an independent factor in univariate and multivariate analyses