Acciones Cooperativas que Contribuyan a la Valoración Ambiental del Entorno Educativo

The present research has as general objective to promote cooperative actions that contribute to the environmental valuation of the educational environment in the Center of Initial Education Bolivariano "Cinqueña III" of the municipality Barinas state Barinas. The research model was qualitative, the method is action research. The key informants are five (5) teachers, twenty-two (22) parents and representatives; As well as twenty-six (26) boys and girls of the mentioned educational center, who were selected because they belong to the same context of study. The techniques that will be used to compile the information will be direct observation and for that reason an observation guide will be built for parents and representatives, for the teachers the interview will be used, for that reason an interview script will be designed to be Applied to them. In addition, the triangulation process will be taken as validity and reliability of the instruments, which implies that the data are collected from various points of view, allowing diverse comparisons to the same phenomenon, of a group at several moments; In this way increases the degree of validation of the results obtained.La presente investigación tiene como objetivo general promover acciones cooperativas que contribuyan a la valoración ambiental del entorno educativo en el Centro de Educación Inicial Bolivariano “Cinqueña III” del municipio Barinas estado Barinas. El modelo de la investigación fue cualitativo, el método es investigación acción. Los informantes claves son cinco (5) docentes, veintidós (22) padres y representantes; así como veintiséis (26) niños y niñas del mencionado centro educativo, los cuales fueron seleccionados porque pertenecen al mismo contexto de estudio. Las técnicas que se utilizarán para la recopilación de la información serán la observación directa y por ello se construirán una guía de observación dirigida a los padres y representantes, para los docentes se utilizará la entrevista, por tal razón se diseñará un guión de entrevista a ser aplicados a los mismos. Además, se tomará como validez y fiabilidad de los instrumentos el proceso de triangulación, el cual, implica que los datos se recojan desde variados puntos de vistas, que permitan comparaciones diversas a un mismo fenómeno, de un grupo en varios momentos; de esta manera aumenta el grado de validación de los resultados obtenidos, permitiendo llevar a la práctica los valores que amplían la conciencia ambiental en los infantes. Debido a esto se afirma que las acciones cooperativas es una estrategia de gran cuantía para fortalecer los valores ambientales

Calidad y sostenibilidad : una propuesta metodológica interdisciplinar para la innovación competitiva de los municipios turísticos maduros

En el contexto de las primeras manifestaciones de una fase recesiva relacionada con la falta de competitividad de los destinos de sol y playa convencionales en países desarrollados en comparación con los análogos de países emergentes, se esgrimen como alternativa la evolución hacia un modelo de excelencia, identificado con calidad ambiental y calidad en el servicio. En el artículo se presenta una propuesta metodológica que tiene como objetivo fundamental reorientar la actitud de los agentes sociales de los municipios correspondientes a estos destinos hacia aquella que facilite la asunción por éstos de los criterios de calidad y sostenibilidad en sus prácticas económicas y territoriales. Esta metodología tiene un carácter interdisciplinar desde dos dimensiones. Una definida por la combinación de metodologías procedentes de dos áreas temáticas: los estudios turísticos y los estudios sobre procesos de innovación en el marco del desarrollo local. Otra, aportada por la composición del equipo, integrado por geógrafos, antropólogos y economistas.Environmental quality (sustainability) and service quality are being argued as a way to do more competitive the mature sun and beach destination, that are living the competition of young destinations. This paper presents a methodologic proposal whose main aim is helping to the local stakeholders in these destination to modify their behaviour in order to take on their economic and environmental skills these issues of sustainability and quality. This methodology is interdisciplinary in two ways: On the one hand, it arranges the methodologies belonging to tourist studies with that of the local development studies. On the other hand, it arranges the methodologies belonging to the study workteam: geographers, anthropologists and economists

Social Stress Increases Cortisol and Hampers Attention in Adolescents with Excess Weight

Objective: To experimentally examine if adolescents with excess weight are more sensitive to social stress and hence more sensitive to harmful effects of stress in cognition.Design and Methods: We conducted an experimental study in 84 adolescents aged 12 to 18 years old classified in two groups based on age adjusted Body Mass Index percentile: Normal weight (n=42) and Excess weight (n=42). Both groups were exposed to social stress as induced by the virtual reality version of the Trier Social Stress Task --participants were requested to give a public speech about positive and negative aspects of their personalities in front of a virtual audience. The outcome measures were salivary cortisol levels and performance in cognitive tests before and after the social stressor. Cognitive tests included the CANTAB Rapid Visual Processing Test (measuring attention response latency and discriminability) and the Iowa Gambling Task (measuring decision-making).Results: Adolescents with excess weight compared to healthy weight controls displayed increased cortisol response and less improvement of attentional performance after the social stressor. Decision-making performance decreased after the social stressor in both groups.Conclusion: Adolescents who are overweight or obese have increased sensitivity to social stress, which detrimentally impacts attentional skills.This study has been funded by grants PSI2010-17290 (INTEROBE) from the Ministry of Innovation and Science (MICINN), and P-10-HUM-6635 (NEUROECOBE)

Recomendaciones dietéticas en la artritis reumatoide

Rheumatoid arthritis (RA) is a chronic autoimmune disease that has a significant effect on patients’ physical, emotional, and social functioning. For decades, patients have used different diets to try to improve the symptoms of RA. The possible benefits of dietary therapy for rheumatoid arthritis are reviewed in this article. Nutritional objectives for RA, are to halt the loss of bone mass, promote healing of bone fractures and improving bone-associated inflammatory disorders and joints. In general, diets low in saturated fat, rich in polyunsaturated fats: omega 3 and omega 6, rich in complex carbohydrates and fiber are recommended.La artritis reumatoide es una enfermedad sistémica crónica, con gran impacto en la vida social, emocional y física de los pacientes. Desde hace décadas, se han utilizado distintas dietas para tratar de mejorar los síntomas de las personas que la padecen. En este artículo se revisan los posibles beneficios de la terapia dietética en la artritis reumatoide. Los objetivos nutricionales en esta patología son frenar la pérdida de masa ósea, favorecer la recuperación de fracturas óseas y mejorar los trastornos inflamatorios asociadas al hueso y a las articulaciones.  En general, se recomiendan dietas bajas en grasas saturadas, ricas en grasas polinsaturadas: omega 3 y omega 6, en hidratos de carbono complejos y fibra

Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem Resistant Gram-Negative Bacilli: An Interrupted Time-Series Analysis

This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship.Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a critical public health threat, and carbapenem use contributes to their spread. Antimicrobial stewardship programs (ASPs) have proven successful in reducing antimicrobial use. However, evidence on the impact of carbapenem resistance remains unclear. We evaluated the impact of a multifaceted ASP on carbapenem use and incidence of CR-GNB in a high-endemic hospital. An interrupted time-series analysis was conducted one year before and two years after starting the ASP to assess carbapenem consumption, CR-GNB incidence, death rates of sentinel events, and other variables potentially related to CR-GNB incidence. An intense reduction in carbapenem consumption occurred after starting the intervention and was sustained two years later (relative effect −83.51%; 95% CI −87.23 to −79.79). The incidence density of CR-GNB decreased by −0.915 cases per 1000 occupied bed days (95% CI −1.743 to −0.087). This effect was especially marked in CR-Klebsiella pneumoniae and CR-Escherichia coli, reversing the pre-intervention upward trend and leading to a relative reduction of −91.15% (95% CI −105.53 to −76.76) and −89.93% (95% CI −107.03 to −72.83), respectively, two years after starting the program. Death rates did not change. This ASP contributed to decreasing CR-GNB incidence through a sustained reduction in antibiotic use without increasing mortality rates.This research was funded by the Plan Nacional de I + D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0008; RD16/0016/0009) co-financed by European Development Regional Fund ‘A way to achieve Europe’ and Operative program intelligent Growth 2014–2020, which did not participate in the development of the program or the analysis of its results

La figura de Cajal: Vacuna contra la neurofobia y estímulo de vocaciones investigadoras para los estudiantes de medicina

Proponemos actividades centradas en D. Santiago Ramón y Cajal dirigidas a prevenir la neurofobia (miedo a las neurociencias y a la neurología clínica) entre los estudiantes de Medicina y fomentar su interés por la investigación biomédica traslacional

Identification of CRF66_BF, a New HIV-1 Circulating Recombinant Form of South American Origin

Circulating recombinant forms (CRFs) are important components of the HIV-1 pandemic. Among 110 reported in the literature, 17 are BF1 intersubtype recombinant, most of which are of South American origin. Among these, all 5 identified in the Southern Cone and neighboring countries, except Brazil, derive from a common recombinant ancestor related to CRF12_BF, which circulates widely in Argentina, as deduced from coincident breakpoints and clustering in phylogenetic trees. In a HIV-1 molecular epidemiological study in Spain, we identified a phylogenetic cluster of 20 samples from 3 separate regions which were of F1 subsubtype, related to the Brazilian strain, in protease-reverse transcriptase (Pr-RT) and of subtype B in integrase. Remarkably, 14 individuals from this cluster (designated BF9) were Paraguayans and only 4 were native Spaniards. HIV-1 transmission was predominantly heterosexual, except for a subcluster of 6 individuals, 5 of which were men who have sex with men. Ten additional database sequences, from Argentina (n = 4), Spain (n = 3), Paraguay (n = 1), Brazil (n = 1), and Italy (n = 1), branched within the BF9 cluster. To determine whether it represents a new CRF, near full-length genome (NFLG) sequences were obtained for 6 viruses from 3 Spanish regions. Bootscan analyses showed a coincident BF1 recombinant structure, with 5 breakpoints, located in p17 gag , integrase, gp120, gp41-rev overlap, and nef, which was identical to that of two BF1 recombinant viruses from Paraguay previously sequenced in NFLGs. Interestingly, none of the breakpoints coincided with those of CRF12_BF. In a maximum likelihood phylogenetic tree, all 8 NFLG sequences grouped in a strongly supported clade segregating from previously identified CRFs and from the CRF12_BF "family" clade. These results allow us to identify a new HIV-1 CRF, designated CRF66_BF. Through a Bayesian coalescent analysis, the most recent common ancestor of CRF66_BF was estimated around 1984 in South America, either in Paraguay or Argentina. Among Pr-RT sequences obtained by us from HIV-1-infected Paraguayans living in Spain, 14 (20.9%) of 67 were of CRF66_BF, suggesting that CRF66_BF may be one of the major HIV-1 genetic forms circulating in Paraguay. CRF66_BF is the first reported non-Brazilian South American HIV-1 CRF_BF unrelated to CRF12_BF.This work was funded through Acción Estratégica en Salud Intramural (AESI), Instituto de Salud Carlos III, projects PI16CIII/00033 and PI19CIII/00042; Red de Investigación en SIDA (RIS), Instituto de Salud Carlos III, Subdirección General de Evaluación y Fondo Europeo de Desarrollo Regional (FEDER), Plan Nacional I+D+I, project RD16ISCIII/0002/0004; and scientific agreements with Consellería de Sanidade, Government of Galicia (MVI 1004/16) and Osakidetza-Servicio Vasco de Salud, Government of Basque Country (MVI 1001/16).S

Risk factors, clinical features, and outcomes of listeriosis in solid-organ transplant recipients: a matched case-control study

BACKGROUND: Solid-organ transplant (SOT) recipients are classically considered to be at increased risk for listeriosis. However, risk factors for this infection have not been assessed. METHODS: We carried out a multicenter, matched case-control study (1:2 ratio) from January 1995 through December 2007. Control subjects were matched for center, transplant type, and timing. Conditional logistic regression was performed to identify independent risk factors. Clinical features and outcomes for all case patients were reviewed. RESULTS: Thirty patients (0.12%) with cases of listeriosis were identified among 25,997 SOT recipients at 15 Spanish transplant centers. In a comparison of case patients with 60 matched control subjects, the following independent risk factors for listeriosis were identified: diabetes mellitus (odds ratio [OR], 5.6; 95% confidence interval [CI], 1.6-19.6; ), P = .007 history of cytomegalovirus infection or disease within the preceding 6 months (OR, 35.9; 95% CI, 2.1-620; P = .014), receipt of high-dose prednisone within the preceding 6 months (OR, 6.2; 95% CI, 1.8-21.1; P = .003), and trimethoprim-sulfamethoxazole (TMP-SMZ) prophylaxis (OR, 0.07; 95% CI, 0.006-0.76; P = .029). Twenty-six patients (86.7%) had bacteremia, and 7 had shock at presentation. Other manifestations included meningoencephalitis (10 cases), spontaneous peritonitis (2), pleural empyema (1), brain abscesses (1), and liver abscesses (1). The 30-day mortality rate was 26.7% (8 of 30 patients died). CONCLUSIONS: Listeriosis in SOT recipients is uncommon but causes high mortality. Diabetes mellitus, cytomegalovirus infection or disease, and receipt of high-dose steroids are independent risk factors for this infection, whereas TMP-SMZ prophylaxis is a protective factor