Humanización en la asistencia clínica oncológica

Sin resume

El sistema de los Tiempos y el Epos de la historia: Schelling y la historicidad del absoluto

The question regarding the Historicity (Geschichtlichkeit) of the Absolute, of Time and of the course of history causes Schelling to turn every scientific presentation on the Absolute into a story in which the Past, Present and the Future come together in reverberations of a process-oriented, Historical Totality that should be epically narrated. These reverberations outline an understanding of Time that, far from being understood as a succession of "now-points", present the Past (Vergangenheit) as that which never ceased to be: to ti en einai (quod quid erat esse); the Present (Gegenwart) as "Gegen-wart", that is, like a "being vigilant" (warten) "against" (gegen); and the Future (Zukunft) as that which the Present achieves, once nurtured by the Past itself: the 'what's to come' (Zu-kunft). The dynamic of this system of time is the intended explanation; a dynamic in which the Absolute shows itself as pure Historicity (Geschichlichkeit).EI problema de la historicidad (Geschichtlichkeit) del Absoluto, del tiempo y del devenir de la historia, convierten en Schelling toda exposición científica sobre el Absoluto en un relato en el que Pasado, Presente y Futuro conforman las reverberaciones de una totalidad procesual, histórica que ha de ser narrada épicamente. Estas reverberaciones apuntan a una comprensión del tiempo que, lejos de ser entendido éste como una sucesión de "puntos-ahora", presenta al Pasado (Vergangenheit) como aquello que nunca ha dejado de ser: to ti en einai (quod quid erat esse), esto es, el pasado que nunca ha sido presente pero solo para el cual es posible el "era", el "es" y el "será"; el Presente (Gegenwart) por su parte se muestra literalmente como "Gegen-wart", esto es, como un "estar vigilante" (warten) "contra" (gegen), de modo que ha de ser entendido en su oposición con un pasado del que saca su propia fuerza y que permanece como aquello oculto en el fondo, pero en el modo de una latencia, de una potencia absoluta; y el Futuro (ZukunJt) es aquello que el presente alcanza al tomar fuerza del propio pasado: es lo por-venir (Zu-kunJt). Ningún tiempo, ninguna potencia se borra en cada Edad: sigue existiendo pero subordinándose a la prevaleciente en este tiempo. La dinámica de este sistema de los tiempos es la que se tratará de explicar, una dinámica en la que el absoluto se muestra como pura historicidad ( Geschichlichkeit)

Nanofabrication, simulation and optical characterization of plasmonic nanostructures

[eng] This thesis is devoted to the nanofabrication, simulation and optical characterization of different plasmonic nanostructures. When an electromagnetic wave reaches a metallic nanostructure, it can give rise to collective oscillations of the free electrons in the metal. These oscillations reach a maximum at the so-called surface plasmon resonance, whose intensity and frequency depend in the material, geometry, embedding medium, interparticle interactions, etc. Based on the tunability of core-shell nanoparticles, hollow cylindrical gold nanostructures (nanocups) have been fabricating using a combination of nanoimprint lithography (NIL) and non-directional metallization. Besides, to overcome the high-aspect ratio limitations of NIL, a trilayer stack (resist-oxide­resist) has been used in such a way that the bottom resist layer, which controls the height of the nanostructure, is not affected by the lithography, which takes place only in the top resist layer. Also, the fabrication method allows for easy changes in the geometry: the height can be changed by changing the thickness of the bottom resist layer, the thickness by modifying the amount of deposited material and the diameter by changing the etching time. By hanging the geometric parameters of the nanostructures, the plasmonic properties can be easily tuned. Besides, for certain dimensions (400 nm in diameter and height and 30 nm of Wall and base thickness), these structures present a peak in the extinction spectra in the visible range that corresponds to a concentration of the electric field within the cavity. This excitation mode has also been reported for other nanostructures with semispherical symmetry. However, the fact of being cylindrical enables a homogeneous enhancement of the electric field along the cavity while in the other case this is not possible due to the lack of symmetry. Also, based on geometrically frustrated magnetic systems, three particular cases of hexagonal lattices of plasmonic nanoelements have been studied. All of them have been designed so that the pitch is of the order of the resonance wavelength and the gaps between elements small enough to enable near-field coupling. Besides, a metal-insulator-metal configuration has been implemented, designed to have constructive interference, which leads to high absorption peaks. The samples have been fabricated by electron beam lithography to be able to change easily the design and study the optical response as a function of the geometries. Both simulation and spectroscopy results show that all these systems present high absorption peaks in the visible and/or near infrared. Also, they present a broad absorption peak in the NIR due to the dipolar excitation of the gaps between neighboring elements and sharper peaks in the visible that are assigned to collective modes. Moreover, these systems present an extended time response where the system fluctuates between collective and localized modes. This behavior, characteristic from magnetic frustrated systems, is induced by the frustration of the dipolar excitation of the gaps due to the geometry of the lattice. Besides, the collective modes give rise to enhancements of the electric field in large areas, making these systems of interest for enhanced spectroscopies.[spa] Esta tesis está dedicada a la nanofabricación, simulación y caracterización de las propiedades ópticas de diferentes nanoestructuras de oro. Por un lado, inspirados por las nanopartículas tipo core-shell, se han fabricado nanoestructuras de oro cilíndricas en forma de taza, combinando litografía por nanoimpresión (NIL) con metalización por pulverización catódica. Para tener la posibilidad de fabricar estructuras de una elevada altura frente a su anchura, se ha utilizado una tricapa de resina-óxido-resina, de manera que la capa inferior de resina controla la altura de las estructuras mientras que la litografía se realiza en la capa superior y por tanto se sobreponen las típicas dificultades que aparecen en NIL para estructuras de elevada relación de aspecto. Estas nanoestructuras, al igual que las nanoparticulas core-shell, presentan tambien gran capacidad de ajuste de sus propiedades como función de su geometria. Por otro lado, basados en los sistemas magnéticos con frustración geometrica, se han estudiado diferentes redes hexagonales de nanoelementos de oro. Todos los sistemas se han diseñado de modo que el periodo es del orden de la longitud de onda de resonancia y los espacios entre estructuras suficientemente pequeños para tener acoplo de campo cercano. Se ha utilizado una configuración metal-aislante­metal para obtener interferencia constructiva y, en consecuencia, picos de alta absorción. Las muestras se han fabricado utilizando litografía por haces de electrones para poder estudiar los cambios en la respuesta óptica en función de la geometría. Estos sistemas presentan un pico de absorción ancho en el infrarrojo ligado a la excitación dipolar de los huecos entre nanoestructuras y picos más estrechos en el visible que corresponden a modos donde predomina el comportamiento colectivo del sistema. Además, el estudio de la evolución temporal del sistema muestra que este tipo de redes presentan una respuesta extendida en el tiempo inducida por la frustración geométrica del sistema, característica de los sistemas magnéticos frustrados, durante la cual el sistema oscila entre modos localizados y modos colectivos. Por todo ello, consideramos que estas estructuras pueden ser de interés para aplicaciones relacionadas con la absorción de luz

Ansiedade na gravidez : implicações para a saúde e desenvolvimento do bebé e mecanismos neurofisiológicos envolvidos

O presente artigo é uma revisão da investigação mais relevante no domínio das implicações da ansiedade materna para a saúde e desenvolvimento do recém-nascido. Atende, particularmente, aos mecanismos neurofisiológicos possivelmente responsáveis pelo impacto adverso da ansiedade materna durante a gravidez na saúde e bom desenvolvimento do bebé, tanto durante a gestação, como a médio e longo prazo. Finaliza, alertando para a necessidade de implementar medidas de prevenção e intervenção em situações de alta ansiedade, as quais são fundamentais para garantir uma diminuição da morbilidade associada e dos efeitos adversos que se verificam no desenvolvimento da criança.The present article is a review of the more recent and relevant research in the field of maternal anxiety implications to the infant’s health and development. It mainly discusses neurophysiologic mechanisms probably responsible for the adverse impact of maternal anxiety during pregnancy in infant’s health and development, during childbearing and also in postpartum and later in life. This article ends alerting to the necessity of prevention and intervention measures for reducing anxiety levels during pregnancy, in order to diminishing the morbidity associated with and the main adverse effects in child’s development.Fundação para a Ciência e Tecnologia (FCT) - SFRH/BD/13768/2003

Sobredentadura inferior en el paciente anciano : ¿Existe evidencia científica que apoye su carga inmediata?

En la actualidad, cada vez más pacientes ancianos edéntulos reclaman tratamientos con implantes en la mandíbula, como son las sobredentaduras, puesto que buscan mayor comodidad y estabilidad de las prótesis, pero los tiempo de cargas convencionales retardan el uso de estas prótesis lo que es un inconveniente para el paciente, por eso cada vez se apuesta más por la carga inmediata de los implantes, ya que nos ofrece múltiples ventajas. En este trabajo se pretende revisar la literatura publicada hasta el momento para comprobar si existe evidencia científica que apoye la carga inmediata de implantes con una sobredentadura mandibular. Se llega a la conclusión de que sí existe evidencia científica que apruebe el éxito de la carga inmediata con sobredentaduras inferiores, no obstante muchos autores recomiendan la realización de más estudios con una muestra de pacientes mayor y durante periodos de tiempo más largos para que esta cuestión sea más apoyada.Universidad de Sevilla. Grado en Odontologí

Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: parity differences and effects

This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. Methods: A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. Results: A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. Limitations: The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Conclusions: Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum.This work was supported by the Operational Program Science and Innovation 2010 (POCI 2010) of the Community Support Board III and by the European Community Fund FEDER (POCI/SAU-ESP/56397/2004; anxiety and depression in women and men during the transition to parenthood: effects on fetal and neo-natal behavior and development)

Dor cervical e alterações da função muscular e postura em estudantes do ensino secundário com idade igual ou superior a 16 anos

Mestrado em FisioterapiaEnquadramento: A prevalência de dor cervical em adolescentes é elevada e um fator de risco para dor cervical na idade adulta. Contudo, os estudos sobre as alterações da função associadas à dor cervical nesta faixa etária, em particular, da função muscular e da postura são reduzidos. Objetivos: Comparar a postura da cabeça, a resistência dos músculos flexores e extensores profundos da cervical em adolescentes com e sem dor cervical. Métodos:Um total de 70 adolescentes (35 com dor cervical e 35 sem dor cervical) com idade igual ou superior a 16 anos da Escola Secundária de Estarreja participaram neste estudo. Foi avaliada a anteriorização da cabeça através do ângulo entre a sétima vertebra cervical, o trágus da orelha e a horizontal, e a resistência dos músculos flexores profundos e dos extensores profundos através do teste dos flexores profundos e do teste dos extensores profundos, respetivamente. Foram, também, avaliadas a intensidade, duração e frequência da dor cervical e incapacidade associada. Resultados: Dos 35 participantes com dor cervical, 51,4% tem dor há pelo menos 1 ano, 74,3% referem ter dor pelo menos 2 a 3 vezes por semana e 48,6% refere que a dor afeta as atividades do dia-a-dia. O grupo com dor cervical apresenta menor anteriorização da cabeça do que o grupo sem dor (com dor=46,62º ± 4,91º; sem dor =44,18º ± 3,64º, p<0,05) e menor resistência muscular dos flexores profundos (com dor= 25,50 ± 23,03s; sem dor= 35,89 ± 21,53s, p<0,05) e dos extensores profundos (com dor= 126,64 ± 77, 94s; sem dor= 168,66 ± 74,77s, p<0.05). Conclusão: Os adolescentes com dor cervical têm menor anteriorização da cabeça e menor resistência dos músculos flexores e extensores profundos da cervical comparativamente aos adolescentes sem dor cervical.Background: Neck pain is highly prevalent in adolescence and a risk factor for having neck pain while adult. However, changes in function associated with pain, in particular, muscle function and head posture, have not been investigated. Aim: To compare forward head posture and endurance of the deep neck flexors and deep neck extensors in adolescents with and without neck pain. Methods: A total of 70 participants (35 with neck pain and 35 without neck pain) aged 16 years old or more from Escola Secundária de Estarreja entered the study. They had their forward head posture assessed through the angle between C7, the tragus of the ear and the horizontal and their deep flexors and deep extensors’ endurance assessed through the deep flexors test and deep extensors test, respectively. Results: Of the 35 participants with neck pain, 51,4% reported having pain for at least 1 year, 74,3% reported having pain 2 to 3 times a week and 48,6% reported that their neck pain affected daily activities. Participants with neck pain showed less forward head posture (pain=46,62º ± 4,91º; no pain =44,18º ± 3,64º, p<0,05) and less endurance of both the deep neck flexors (pain= 25,50 ± 23,03s; no pain= 35,89 ± 21,53s, p<0,05) and the deep neck extensor muscles (pain= 126,64 ± 77, 94s; no pain= 168,66 ± 74,77s, p<0.05). Conclusion: Adolescents with neck pain seem to have less forward head posture and less endurance of both deep neck flexors and extensors when compared to asymptomatic participants