La investigación científica en ciencias de la salud, la universidad como eje central del proceso

Se expone el papel primordial de la Universidad en la investigación como una de sus funciones sustantivas y se relaciona la participación de los estudiantes junto a los profesores con énfasis en la importancia de los grupos de investigación. Se revisan los diferentes criterios para los tipos de investigación. Se enfatiza en el método científico aplicado a la medicina, como proceso o instrumento de la ciencia adecuado para obtener la expresión de los fenómenos investigados, y de esta forma comprobar si una hipótesis luego de verificarla puede ser verdadera

Consequences of the Covid-19 pandemic on complex multimorbid elderly: Follow-up of a community-based cohort. SAMAC3 Study

©2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Journal of Nursing Scholarship. To access the final edited and published work see https://doi.org/10.1111/jnu.12860Background: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. Purpose: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care pro vided by the nurses, including nursing diagnosis and interventions, use of health ser vices, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. Design: A 1-year longitudinal cohort study was conducted. Methods: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called “SAMAC3 study”. Results: Significant negative changes were observed in the functional and cognitive ca pacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. Conclusions: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was ob served. The nurses detected significant changes in activity-exercise, cognitive perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. Clinical Relevance: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deteriora tion of the physical and cognitive domains

Zoonosis: impacto en la Salud Pública de una parroquia ecuatoriana.

Las zoonosis son aquellas enfermedades que son transmitidas a las personas por medio del contacto directo o indirecto con animales enfermos. Estas entidades nosológicas  son controladas a través de la vigilancia epidemiológica, identificando diferentes grupos de riesgo, entre los más comunes: Trabajadores de los camales, del alcantarillado y agricultores. Uno de los programas que mayor seguimiento recibe desde el punto de vista epidemiológico es el control de la rabia, considerado como prioritario. La rabia está controlada en la provincia de Pichincha, ya que por seis años consecutivos no ha existido ningún caso de rabia en personas u animales. Con el control de vectores se trata de ubicar y eliminar los focos de riesgo como son los vertederos de basura, mercados, quebradas contaminadas, parques y animales capaces de transmitir enfermedades como las ratas y los insectos. Adicionalmente se está desarrollando el control de la calidad de la leche de cabra, y realizando los estudios para identificar posibles enfermedades provocadas por el consumo de leche no pasteurizada. Se propone la atención del problema que las zoonosis representan para la Salud Pública, desde una visión integral, como una alternativa de trascendencia a considerar por parte de las instancias responsables de la organización y planeación de los servicios de Salud Pública

Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain

©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published version of a Published Work that appeared in final form in Atención Primaria. To access the final edited and published work see https://doi.org/10.1016/j.aprim.2021.102050Objetivo: Conocer el nivel de competencia en Práctica Basada en la Evidencia (PBE) de las enfermeras de Atención Primaria (AP) en Espana˜ y analizar los factores asociados. Diseno: ˜ Estudio transversal de carácter nacional, realizado en enero-marzo de 2020. Emplazamiento: AP en Espana. ˜ Participantes: Setecientas ochenta enfermeras de AP en activo en el Sistema Nacional de Salud con experiencia profesional mínima de un ano. ˜ Mediciones principales: 1) Variables sociodemográficas, profesionales y de acceso a infor mación científica, y 2) variable de resultado: competencia en PBE (actitud, conocimientos, habilidades y utilización), evaluada mediante el cuestionario EBP-COQ Prof©. Se realizaron análisis bivariados y multivariados mediante regresión lineal. Resultados: La puntuación media en el nivel de competencia en PBE de las enfermeras de AP fue de 131,5 (desviación típica [DT] 17,0). Por dimensiones: actitud 36,8 (DT 3,6); conocimien tos 38,2 (DT 8,9); habilidades 23,0 (DT 3,5) y utilización 33,3 (DT 6,1). Leer más de 3 artículos en el último mes es la variable que tiene más influencia sobre todas las dimensiones del EBP COQ Prof©, seguida de la formación en PBE (más de 150 h) y la tutorización de alumnos de Enfermería. El nivel educativo (máster, especialista y doctorado) se asocia con las dimensio nes conocimientos y habilidades, mientras que trabajar en un centro BPSO® se asocia con la utilización de la PBE Conclusiones: Estos hallazgos pueden orientar a los gestores en los servicios de AP a planificar estrategias que mejoren el nivel de competencia en PBE de las enfermeras, dirigidas princi palmente a lograr una aplicación real en la práctica clínica. No obstante, se hace necesario considerar el posible impacto del sesgo de selección en los resultados.Objective: To describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors. Design: Cross-sectional, national survey design, carried out between January and March 2020. Setting: PC in Spain. Participants: Seven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience. Main measurements: (1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out. Results: The mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150 h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization. Conclusions: These findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results

Gonadotropin induction of spermiation in Senegalese sole: Effect of temperature and stripping time

11 pages, 7 figures, 1 tableTreatments with homologous recombinant follicle-stimulating and luteinizing hormones (rFsh and rLh, respectively) are known to enhance spermatogenesis and sperm production in sole, but the response can be highly variable depending on the dose, duration and time of the year of the rFsh treatment. To further investigate the physiological effects of rFsh and rLh on sperm production in sole, here we examined the pattern of spermiation of F1 males, of approximately 450 g, treated with rFsh and rLh under controlled temperature. In an initial trial at 12 °C, males were weekly injected intramuscularly with 18 μg kg−1 rFsh over five weeks and subsequently treated with a single injection of 18 μg kg−1 rLh. Histological analysis indicated that the rFsh+rLh treatment increased gonad weight and stimulated spermatogenesis, and also enlarged the size of the seminiferous and efferent duct (ED) tubules, resulting in a doubling of sperm production with respect to the controls. Sperm counts in the ED and sequential stripping of males at 24, 48 and 72 h post rLh injection further revealed that only one batch of spermatids is recruited into spermatozoa (Spz) differentiation after a single rLh induction. A peak of sperm accumulation in the ED occurs at 48 h, coinciding with the upregulation of genes potentially involved in Spz maturation. In a second experiment, we tested the effect of two rFsh doses (10 or 18 μg kg−1) over five weeks as previously, followed by one rLh injection at 12 °C or 17 °C. The results confirmed that spermiation was the highest 48 h after rLh treatment at 12 °C, which was increased in a dose-dependent manner with the dose of rFsh previously supplied (from 0.36 to 0.95 × 109 Spz kg−1). However, sperm production elicited with the low rFsh dose was potentiated by ~3-fold (from 0.36 to 1.06 × 109 Spz kg−1) when the rLh treatment was given at 17 °C. These data suggest that in Senegalese sole sperm collection should be carried out at 48 h after rLh treatment, and that a low dose of rFsh at 12 °C is highly efficient for stimulating sperm production when rLh is administered at a temperature close to that occurring during maximum natural spermiationThis work was supported by the Spanish Ministry of Science and Innovation (MINECO) (AGL2017-84013-R to F.C.), the European Commission Portugal 2020 Program (European Regional Development Fund, 038433_REARLING to I.B.), and the CERCA Programme (Government of Catalonia). Participation of F.C. was funded by a “Ramon y Cajal” contract (RYC-2015-17103, MINECO). Participation of S.R. and W.G. was funded, respectively, by a PhD grant from AGAUR Catalonian Agency for the Management of Universities and Research Grants (Government of Catalonia, Spain) co-financed by the European Social Fund, and a PhD grant from the National Board of Science and Technology (CONACYT, Mexico)Peer reviewe

Renal tubule Cpt1a overexpression protects from kidney fibrosis by restoring mitochondrial homeostasis

Chronic kidney disease (CKD) remains a major epidemiological, clinical, and biomedical challenge. During CKD, renal tubular epithelial cells (TECs) present a persistent inflammatory and profibrotic response. Fatty acid oxidation (FAO), the main source of energy for TECs, is reduced in kidney fibrosis and contributes to its pathogenesis. To determine whether gain of function in FAO (FAO-GOF) could protect from fibrosis, we generated a conditional transgenic mouse model with overexpression of the fatty acid shuttling enzyme carnitine palmitoyl-transferase 1A (CPT1A) in TECs. Cpt1a-knockin (CPT1A-KI) mice subjected to 3 models of renal fibrosis (unilateral ureteral obstruction, folic acid nephropathy [FAN], and adenine-induced nephrotoxicity) exhibited decreased expression of fibrotic markers, a blunted proinflammatory response, and reduced epithelial cell damage and macrophage influx. Protection from fibrosis was also observed when Cpt1a overexpression was induced after FAN. FAO-GOF restored oxidative metabolism and mitochondrial number and enhanced bioenergetics, increasing palmitate oxidation and ATP levels, changes that were also recapitulated in TECs exposed to profibrotic stimuli. Studies in patients showed decreased CPT1 levels and increased accumulation of short- and middle-chain acylcarnitines, reflecting impaired FAO in human CKD. We propose that strategies based on FAO-GOF may constitute powerful alternatives to combat fibrosis inherent to CKD

Impact of the 2021 La Palma volcanic eruption on air quality: Insights from a multidisciplinary approach

The La Palma 2021 volcanic eruption was the first subaerial eruption in a 50-year period in the Canary Islands (Spain), emitting ~1.8 Tg of sulphur dioxide (SO2) into the troposphere over nearly 3 months (19 September-13 December 2021), exceeding the total anthropogenic SO2 emitted from the 27 European Union countries in 2019. We conducted a comprehensive evaluation of the impact of the 2021 volcanic eruption on air quality (SO2, PM10 and PM2.5 concentrations) utilising a multidisciplinary approach, combining ground and satellite-based measurements with height-resolved aerosol and meteorological information. High concentrations of SO2, PM10 and PM2.5 were observed in La Palma (hourly mean SO2 up to ~2600 μg m−3 and also sporadically at ~140 km distance on the island of Tenerife (> 7700 μg m−3) in the free troposphere. PM10 and PM2.5 daily mean concentrations in La Palma peaked at ~380 and 60 μg m−3. Volcanic aerosols and desert dust both impacted the lower troposphere in a similar height range (~ 0–6 km) during the eruption, providing a unique opportunity to study the combined effect of both natural phenomena. The impact of the 2021 volcanic eruption on SO2 and PM concentrations was strongly influenced by the magnitude of the volcanic emissions, the injection height, the vertical stratification of the atmosphere and its seasonal dynamics. Mean daily SO2 concentrations increased during the eruption, from 38 μg m−3 (Phase I) to 92 μg m−3 (Phase II), showing an opposite temporal trend to mean daily SO2 emissions, which decreased from 34 kt (Phase I) to 7 kt (Phase II). The results of this study are relevant for emergency preparedness in all international areas at risk of volcanic eruptions; a multidisciplinary approach is key to understand the processes by which volcanic eruptions affect air quality and to mitigate and minimise impacts on the population.The authors also acknowledge the support from ACTRIS and ACTRIS-Spain, the Spanish Ministry of Science and Innovation and the support from the European Union H2020 program through the following projects (PID2019-104205GB-C21/AEI/10.13039/501100011033, EQC2018-004686-P, PID2019-103886RB-I00/AEI/10.13039/501100011033 and PID2020-521-118793GA-I00) and programs (GA No. 654109, 778349, 871115, 101008004 and 101086690). Research activities of the CSIC staff during the eruption were funded by CSIC through the CSIC-PIE project with ID numbers PIE20223PAL009 and PIE20223PAL013 (Real Decreto 1078/2021, de 7 de diciembre). Part of this study was performed within the framework of the project AERO-EXTREME (PID2021-125669NB-I00) funded by the Spanish State Research Agency (AEI) and ERDF funds

Relationship between olive oil consumption and ankle-brachial pressure index in a population at high cardiovascular risk

Background and aims: The aim of this study was to ascertain the association between the consumption of different categories of edible olive oils (virgin olive oils and olive oil) and olive pomace oil and ankle-brachial pressure index (ABI) in participants in the PREDIMED-Plus study, a trial of lifestyle modification for weight and cardiovascular event reduction in individuals with overweight/obesity harboring the metabolic syndrome. Methods: We performed a cross-sectional analysis of the PREDIMED-Plus trial. Consumption of any category of olive oil and olive pomace oil was assessed through a validated food-frequency questionnaire. Multivariable linear regression models were fitted to assess associations between olive oil consumption and ABI. Additionally, ABI ≤1 was considered as the outcome in logistic models with different categories of olive oil and olive pomace oil as exposure. Results: Among 4330 participants, the highest quintile of total olive oil consumption (sum of all categories of olive oil and olive pomace oil) was associated with higher mean values of ABI (beta coefficient: 0.014, 95% confidence interval [CI]: 0.002, 0.027) (p for trend = 0.010). Logistic models comparing the consumption of different categories of olive oils, olive pomace oil and ABI ≤1 values revealed an inverse association between virgin olive oils consumption and the likelihood of a low ABI (odds ratio [OR] 0.73, 95% CI [0.56, 0.97]), while consumption of olive pomace oil was positively associated with a low ABI (OR 1.22 95% CI [1.00, 1.48]). Conclusions: In a Mediterranean population at high cardiovascular risk, total olive oil consumption was associated with a higher mean ABI. These results suggest that olive oil consumption may be beneficial for peripheral artery disease prevention, but longitudinal studies are needed

Regulación de la actividad económica en el ámbito internacional y libertad de establecimiento. Cuestiones societarias, fiscales de derecho de la competencia, derecho privado y arbitraje

Ponencias presentadas al Seminario Español de Derecho Internacional Privado, que tuvo lugar en Barcelona, del 18 al 20 de octubre de 2017, Universidad Autónoma de Barcelon