Propuesta de intervención educativa (ULL) - Prevención y manejo local de lesiones por presión

Las lesiones por presión conforman uno de los grandes inconvenientes en la práctica enfermera, se trata de una afección denominada dentro de las heridas crónicas, presente tanto en atención primaria, especializada, como en centros sociosanitarios, donde su incidencia suele ser mayor, entre un 12% y un 14% en centros nacionales. Existe cierta dificultad durante el proceso de cicatrización, tanto a nivel de requerimientos ambientales, nutricionales o físicos del propio paciente, como de conocimientos para su prevención y manejo por parte del equipo de enfermería. Por este motivo, este proyecto pretende formar a los alumnos de enfermería de la Universidad de La Laguna en materia de prevención y manejo local de lesiones por presión, orientando en base a los conocimientos actuales sobre la cicatrización, la infección, la limpieza de la herida, el desbridamiento y sus tipos o el control de factores etiológicos, entre otros. Con el fin de evaluar el nivel de conocimientos del alumnado y la eficacia de la intervención educativa, se realizará un cuestionario anónimo al principio y al final de la misma.Pressure injuries conforms one of the biggest inconvenients in the nursing practice, it´s a disease which is involved in the chronic wounds, present not only in primary and specializing care but also in social-sanitary centres, whose incidence is often high, between 12% and 14% in national centres. The process of cicatrization has certain difficulties as the environmental, nutricional and physical requirements of the patient himself, as well as the knowing of their prevalence and control by the nursing staff. Therefore, this project aims to teach the ULL nursing students about prevention and local manage about pressure injuries, oriented to their current knowing about cicatrization, infection, wound cleansing, debridement and their types plus the etiological factors control, among others. In order to evaluate the level of student´s comprehension and the efectivness from the educational intervention, it will be conducted an anonymous questionnaire at the beggining and at the end, thereof

Gender-role identity in adolescence and women fertility in adulthood

In the new era of economics of fertility, the identification of the determinants of fertility has become one of the major challenges. This paper analyzes how the fertility patterns of both female teenagers’ own families and peers’ families (measured as the number of siblings) affect their future fertility choices. Our analysis distinguishes between the extensive (becoming a mother or not) and the intensive (total number of children) margin of fertility. We provide five main results. First, neither own number of siblings nor peers’ number of siblings affect whether a woman becomes a mother or not. Second, women with more siblings and women whose peers had more siblings tend to have more children. Third, the peer effect is stronger for women who reported having a less close relationship with their mothers. Forth, women that were teenagers characterized by high scores and being involved in activities related to popularity experience a negligible peer effect. Further, more communication between teenagers’ parents increases the influence of women’s own family but reduces the peer effect. These results suggest that fertility patterns of both female teenagers’ own families and peers’ families are relevant in shaping women’s identitydefining role in fertility, specially in the intensive margin; and that the relative importance of these two patterns depends on the quality of the relationships between all actors (between teenagers, between teenagers and their parents, and between teenagers’ parents)

Myocardial function in long distance runners: Assessment by echocardiography, tissue Doppler and speckle tracking

Introducción y objetivos: El ejercicio físico provoca respuestas adaptativas y cambios morfológico-funcionales en el corazón del atleta. El objetivo del presente estudio es caracterizar dichos cambios mediante ecocardiografía convencional y las nuevas técnicas de deformación miocárdica mediante speckle tracking. Material y métodos: Se estudiaron prospectivamente a 68 varones, 38 corredores de fondo (42±8 años), y 30 controles (40±7 años). Se les realizó estudio ecocardiográfico convencional modo M, 2D y doppler así como parámetros de deformación miocárdica mediante speckle tracking a nivel de eje corto basal (B), medio (M), apical (Ap) y planos apicales 4 y 2 cámaras de ventrículo izquierdo (VI) y ventrículo derecho (VD). Se midió strain (S) y strain rate (SR) longitudinal, radial y circunferencial así como la rotación (Rot) y el untwisting (UT) a nivel basal y apical. Resultados: Todos los sujetos presentaron función cardíaca dentro de la normalidad. Se observaron mayor fracción de eyección (FE) así como mayores volúmenes ventriculares en el grupo de atletas. No se hallaron diferencias en los parámetros del anillo Mitral. Los niveles de S longitudinal y circunferencial así como la torsión (Tor) de VI fue mayor en el grupo de los deportistas (p=0.02, p=0.005 y p=0.03 respectivamente). Se observó menor S radial en el grupo de atletas. El tamaño, el TAPSE y la deformación longitudinal del VD presentaron diferencias estadísticamente significativas (p=0.01, 0.002 y 0.006 respectivamente). Conclusiones: Los niveles de deformación miocárdica valorados mediante strain longitudinal y circunferencial son mayores en los atletas así como la torsión ventricular. El mayor grado de deformación longitudinal, circunferencial y la mayor torsión puede representar una respuesta adaptativa al ejercicio.Background: Regular intense physical exercise causes cardiovascular adaptations as well as functional and morphological changes in the athlete’s heart. The aim of the present study is to characterize those changes using conventional echocardiography and new speckle tracking techniques to study myocardial deformation. Methods: 68 men were studied. 38 long distance runners (42±8 years), and 30 sedentary controls (40±7 years). Standard transthoracic echocardiography was performed: M mode, 2D, tissue and colour Doppler. Deformation parameters were studied by speckle tracking at short axis view basal (B), medium (M) and apical (Ap) levels and apical 4 and 2 chamber view of the left ventricle (LV) and right ventricle (RV). Longitudinal, radial and circumferential strain (S) and strain rate (SR) were measured as well as rotation (Rot) and untwisting (UT) at basal and apical levels. Results: Left ventricular ejection fraction and volumes were significantly higher in the athlete group. There were no differences in conventional diastolic parameters. Longitudinal and circumferential left ventricular strain and torsion were higher in the athlete group (p=0.02, p=0.005 and p=0.03 respectively). In addition, radial strain was lower in the athlete group. Right ventricular diameters, tricuspid annular plane systolic excursion (TAPSE) and longitudinal deformation were significantly higher in the athlete group (p=0.01, 0.002 y 0.006 respectively). Conclusion: Myocardial deformation parameters, studied by longitudinal and circumferential strain, as well as ventricular torsion are greater in athletes as compared to sedentary individuals. This increased myocardial longitudinal and circumferential deformation and ventricular torsion might represent an adaptive response to regular intense physical exercise

Heart Preservation Techniques for Transplantation

Heart transplant remains the gold standard of end-stage heart failure treatment. The number of heart transplants performed each year has increased and the number of recipient candidates has been increasing even more. As a result, recipients are now matched with donors over longer distances with increasing organ ischemic time. Organ preservation strategies have been evolving to minimize ischemia reperfusion injury following longer ischemic times. This chapter will include updated organ donation and preservation techniques for heart transplant including organ donation after brain death (DBD) and donation after circulatory death (DCD). The expansion of cardiac donation after circulatory death (DCD) and new techniques for heart preservation may increase the use of hearts from extended criteria donors and thus expand the heart donor pool

Finanzas sostenibles en la banca española: progreso, actualidad y comparación internacional con la banca de referencia a nivel mundial

Esta investigación tiene como objetivo realizar un estudio del concepto de finanzas sostenibles, del progreso de las entidades bancarias españolas en esta materia y posteriormente realizar una comparativa a nivel internacional. Ha sido necesario analizar las diferentes metodologías para el cálculo de las emisiones de carbono derivadas de la actividad financiera y también de la normativa al respecto. Para evaluar el avance en la sostenibilidad en las entidades bancarias se ha optado como criterio considerar las emisiones en toneladas de carbono anuales derivadas de manera directa o indirecta, considerando que existen clasificaciones de emisiones de carbono denominadas alcances y diversas metodologías e índices para su cálculo. A su vez, la investigación se ha apoyado en información cuantitativa proveniente de los Informes Anuales de cada entidad bancaria, lo que ha permitido calcular ratios de emisiones por cliente y por capital permitiendo realizar un análisis comparativo entre los principales bancos españoles y los internacionales. Los resultados de este análisis apuntan a un avance en la reducción de emisiones por parte de los bancos españoles, pero todavía en menor cuantía que los bancos internacionales analizados.This research aims to carry out a study of the concept of sustainable finance, the progress of Spanish banking entities in this matter and subsequently carry out a comparison at an international level. It has been necessary to analyze the different methodologies for calculating carbon emissions derived from financial activity and also from the regulations in this regard. In order to evaluate the progress in sustainability in the banking entities, it has been chosen as a criterion to consider emissions in tons of carbon per year derived directly or indirectly, considering that there are classifications of carbon emissions called scopes and various methodologies and indices for their calculation. In turn, the research has been supported by quantitative information from the Annual Reports of each bank, which has made it possible to calculate ratios of emissions per client and per capital, allowing a comparative analysis between the main Spanish and international banks. The results of this analysis point to progress in reducing emissions by Spanish banks, but still to a lesser extent than the international banks analyzed

Moderate-High Disease Activity in Patients with Recent-Onset Psoriatic Arthritis-Multivariable Prediction Model Based on Machine Learning

The aim was to identify patient- and disease-related characteristics predicting moderate-to-high disease activity in recent-onset psoriatic arthritis (PsA). We performed a multicenter observational prospective study (2-year follow-up, regular annual visits) in patients aged ≥18 years who fulfilled the CASPAR criteria and had less than 2 years since the onset of symptoms. The moderate-to-high activity of PsA was defined as DAPSA > 14. We trained a logistic regression model and random forest-type and XGBoost machine learning algorithms to analyze the association between the outcome measure and the variables selected in the bivariate analysis. The sample comprised 158 patients. At the first follow-up visit, 20.8% of the patients who attended the clinic had a moderate-to-severe disease. This percentage rose to 21.2% on the second visit. The variables predicting moderate-high activity were the PsAID score, tender joint count, level of physical activity, and sex. The mean values of the measures of validity of the machine learning algorithms were all high, especially sensitivity (98%; 95% CI: 86.89-100.00). PsAID was the most important variable in the prediction algorithms, reinforcing the convenience of its inclusion in daily clinical practice. Strategies that focus on the needs of women with PsA should be considered

Izaña Atmospheric Research Center. Activity Report 2015-2016

This report is a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume