Fraccionamiento de una encomienda: una mirada desde el liderazgo indígena. Qaraqara, 1540-1569

La encomienda, merced real que otorgaba al beneficiario el derecho de disfrutar los tributos de un grupo indígena a cambio de ciertas obligaciones, se generalizó rápidamente en el Centro-Surandino luego de la caída del Tawantinsuyu, cimentada en la alianza más o menos forzada con los grandes mallku. El presente trabajo dirige su mirada hacia la jerarquía de autoridades indígenas que viabilizaban una encomienda, mediante la reconstrucción de los vaivenes de un segmento de la encomienda de Gonzalo Pizarro, aquel que contenía la prehispánica Federación Qaraqara – una entidad política que se extendía desde el norte de Potosí hasta el río Pilcomayo, en la frontera con los Chicha (actual Departamento de Tarija, Estado Plurinacional de Bolivia) -, desde su cesión en 1540 hasta fines de la década de 1560. Mediante un estudio de caso concreto, se enfatiza el doble proceso de fraccionamiento de las entidades políticas prehispánicas, por un lado, y de empoderamiento de líderes indígenas de diversa jerarquía, por el otro. The “encomienda”, a royal grant that gave the right to enjoy the tribute of an indigenous group in exchange for certain obligations, spread rapidly in the Andes after the fall of the Tawantinsuyu, based on the more or less forced alliance with mallku. This paper analyses the hierarchy of indigenous authorities of an encomienda, by reconstructing the changes of a segment of the Gonzalo Pizarro´s encomienda, which included the prehispanic Qaraqara Federation - a polity that extended from northern Potosí to the Pilcomayo river, near the Chichas (Tarija Department, Bolivia) - since its concession in 1540 until the late 1560´s. Through this case study, we emphasize the dual process of prehispanic political entities segmentation on the one hand, and of empowerment of indigenous leaders from different levels, on the other.

Trastornos osteomusculares del personal asistencial en hemodiálisis de la unidad renal dialyser Cúcuta

La manifestación de diferente desordenes musculoesqueléticos presentados por los trabajos repetitivos, los cuales generan de manera directa a las personas malestares y en muchas ocasiones incapacidades producidas por la largas jornadas laborales, por las secuelas heredadas que se presentan cuando se realizan actividades secuenciales, que conllevan a esfuerzos innecesarios o cargas innecesarias al cuerpo por la posición continua del cuerpo durante la jornada laboral o las malas posturas, la manera más práctica de identificar los trastornos y establecer mecanismos para reducir las incapacidades laborales y mejorar las prácticas laborales, es con la aplicación de cuestionarios nórdicos al personal que labora en la unidad renal Dialy-Ser B-BraunCúcuta.The manifestation of different musculoskeletal disorders presented by repetitive work, which directly generates discomfort and, in many occasions, incapacities caused by long working hours, due to the inherited sequelae that occur when sequential activities are carried out, leading to unnecessary efforts or unnecessary burdens on the body due to the continuous position of the body during the working day or bad postures, the most practical way to identify disorders and establish mechanisms to reduce work disabilities and improve work practices, is with the application of questionnaires Nordic staff working in the Dialy-Ser B-Braun-Cúcuta renal unit

Thermal desorption-ion mobility spectrometry: A rapid sensor for the detection of cannabinoids and discrimination of Cannabis Sativa L. chemotypes

Existing analytical techniques used for the determination of cannabinoids in Cannabis sativa L. (Cannabis) plants mostly rely on chromatography-based methods. As a rapid alternative for the direct analysis of them, thermal desorption (TD)-ion mobility spectrometry (IMS) was used for obtaining spectral fingerprints of single cannabinoids from Cannabis plant extracts and from plant residues on hands after their manipulation. The ionization source was 63Ni, with automatic switchable polarity. Although in both ionization modes there were signals in the TD-IMS spectra of the plant extracts and residues that could be assigned to concrete cannabinoids and chemotypes, most of them could not be clearly distinguished. Alternatively, the global spectral data of the plant extracts and residues were pre-processed and then, using principal component analysis (PCA)-linear discriminant analysis (LDA), grouped in function of their chemotype in a more feasible way. Using this approach, the possibility of false positive responses was also studied analyzing other non-Cannabis plants and tobacco, which were clustered in a different group to those of Cannabis. Therefore, TD-IMS, as analytical tool, and PCA-LDA, as a strategy for data reduction and pattern recognition, can be applied for on-site chemotaxonomic discrimination of Cannabis varieties and detection of illegal marijuana since the IMS equipment is portable and the analysis time is highly short

Linfoma T cutáneo en paciente con artritis reumatoidea

La artritis reumatoidea incrementa el riesgo de muerte en pacientes que la padecen, ya sea por las comorbilidades como enfermedades cardiovasculares y las infecciones, como así también por una mayor frecuencia de desórdenes linfoproliferativos asociados a la enfermedad de base. Se presenta el caso de un paciente de sexo masculino de 74 años de edad, con artritis reumatoidea poliarticular y nodular de larga data. Tratado con DMARs, etanercept y abatacept con poca eficacia, por lo que inició rituximab con excelente respuesta, recibiendo luego como mantenimiento tofacitinib 5 mg/ día. En abril de este año presenta lesiones nodulares y eritematosas en ambos miembros inferiores que luego se necrotizan y esfacelan. Se suspende tratamiento inmunosupresor. Se indica biopsia de piel que muestra linfoma T cutáneo con compromiso dérmico e hipodérmico. Se inició quimioterapia CHOP pero luego del segundo ciclo el paciente presenta aplasia medular y fallece

Inhibitory Receptor Expression on T Cells as a Marker of Disease Activity and Target to Regulate Effector Cellular Responses in Rheumatoid Arthritis

Objective: Inhibitory receptors are essential for the regulation of effector immune responses and may play critical roles in autoimmune diseases. We evaluated whether inhibitory receptor expression on T cells from patients with rheumatoid arthritis (RA) were correlated with immune activation, disease activity, and response to treatment, as well as whether inhibitory receptor–mediated pathways were functional. Methods: Using flow cytometry, we performed extensive phenotypic and functional evaluation of CD4+ and CD8+ T cells from the blood and synovial fluid (SF) of RA patients ex vivo and after culture. The relationship of each parameter with the Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR) and response to treatment was examined. Results: In RA patients with low levels of T cell activation, inhibitory receptor expression showed an inverse relationship with the DAS28-ESR. The frequency of T cells expressing multiple inhibitory receptors was reduced in untreated RA patients but returned to normal levels in treated patients. RA patients who responded to treatment showed an augmented frequency of inhibitory receptor–expressing T cells that correlated with reduced inflammatory cytokine production in comparison to nonresponders. Higher frequencies of effector and memory T cells that expressed multiple inhibitory receptors were seen in SF than in peripheral blood. Notably, inhibitory pathways were operative in blood and synovial T cells from all RA patients, although cells from nonresponder patients were less sensitive to inhibition. Conclusion: Inhibitory receptor expression on T cells from RA patients is inversely correlated with effector T cell function and disease activity and may predict response to treatment. Furthermore, different inhibitory pathways are functional and cooperatively suppress synovial T cells, providing a rationale for new treatment strategies to regulate acute local inflammation.Fil: Onofrio, Luisina Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentina. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Zacca, Estefanía. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Ferrero, Paola Virginia. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Acosta, Cristina. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Mussano, Eduardo. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Onetti, Laura. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Cadile, Isaac. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Gazzoni, M. Victoria. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Jurado, Raúl. Universidad Nacional de Córdoba. Facultad de Medicina. Hospital Nacional de Clínicas; ArgentinaFil: Tosello Boari, Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Ramello, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Montes, Carolina Lucia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Gruppi, Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Acosta Rodriguez, Eva Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentin

SATISFACCIÓN ESTUDIANTIL SOBRE LA SIMULACIÓN CLÍNICA COMO ESTRATEGIA DIDÁCTICA EN ENFERMARÍA.

Introducción: La importancia de conocer el grado de satisfacción que tienen los estudiantes de enfermería con el uso de la simulación clínica como estrategia didáctica, radica en que permite establecer una diferenciación entre los elementos exitosos de los que no lo son; con el fin de mejorar estos últimos para enriquecer la experiencia educativa de los estudiantes. Objetivo: determinar la satisfacción y calidad que perciben los estudiantes de enfermería de la Universidad de Cundinamarca frente al uso de la simulación clínica como estrategia didáctica. Métodos: Es una investigación cuantitativa, descriptiva y transversal. Muestra de 40 estudiantes. Se aplicó un instrumento con 15 ítems con una validación de instrumento de Alfa de Cronbach 0,95. Resultados: se obtuvieron que las variables que los estudiantes identificaron con menor grado de calidad y satisfacción de la simulación clínica en un 52,5% fueron las relacionas con escenarios realistas, 42,5% con la duración del caso clínico era adecuado, y 37,5% en que la experiencia con el simulador aumenta su seguridad y confianza. Por lo contrario, las de mayor grado de satisfacción identificados por el 82,5 % de los estudiantes fueron que la simulación les ayudada a integrar la teoría y la práctica además fomenta la comunicación. Conclusión: la simulación clínica favorece el proceso de enseñanza-aprendizaje de futuros profesionales de enfermería, convirtiéndose en una estrategia didáctica útil e innovadora, siempre y cuando se aproxime a la realidad.   Palabras clave: aprendizaje, competencia clínica, enseñanza, estudiantes de enfermería, satisfacción personal. ABSTRACT   Introduction: The importance of knowing the degree of satisfaction that nursing students have with the use of clinical simulation as a didactic strategy lies in the fact that it allows establishing a differentiation between successful elements and those that are not; in order to improve the latter to enrich the educational experience of students. Objective: to determine the satisfaction and quality perceived by nursing students at the University of Cundinamarca regarding the use of clinical simulation as a teaching strategy. Methods: It is a quantitative, descriptive and cross-sectional research. Sample of 40 students. An instrument with 15 items was applied with an instrument validation of Cronbach's Alpha 0.95. Results: it was obtained that the variables that the students identified with a lower degree of quality and satisfaction of the clinical simulation in 52.5% were those related to realistic scenarios, 42.5% with the duration of the clinical case was adequate, and 37 .5% that the experience with the simulator increases their security and confidence. On the contrary, the ones with the highest degree of satisfaction identified by 82.5% of the students were that the simulation helped them to integrate theory and practice, and also fosters communication. Conclusion: clinical simulation favors the teaching-learning process of future nursing professionals, becoming a useful and innovative teaching strategy, as long as it is close to reality.   Keywords: learning, clinical competence, teaching, nursing students, personal satisfaction. &nbsp

Interventions in health organisations to reduce the impact of adverse events in second and third victims

Background Adverse events (AE) are also the cause of suffering in health professionals involved. This study was designed to identify and analyse organization-level strategies adopted in both primary care and hospitals in Spain to address the impact of serious AE on second and third victims. Methods A cross-sectional study was conducted in healthcare organizations assessing: safety culture; health organization crisis management plans for serious AE; actions planned to ensure transparency in communication with patients (and relatives) who experience an AE; support for second victims; and protective measures to safeguard the institution’s reputation (the third victim). Results A total of 406 managers and patient safety coordinators replied to the survey. Deficient provision of support for second victims was acknowledged by 71 and 61 % of the participants from hospitals and primary care respectively; these respondents reported there was no support protocol for second victims in place in their organizations. Regarding third victim initiatives, 35 % of hospital and 43 % of primary care professionals indicated no crisis management plan for serious AE existed in their organization, and in the case of primary care, there was no crisis committee in 34 % of cases. The degree of implementation of second and third victim support interventions was perceived to be greater in hospitals (mean 14.1, SD 3.5) than in primary care (mean 11.8, SD 3.1) (p?<?0.001). Conclusions Many Spanish health organizations do not have a second and third victim support or a crisis management plan in place to respond to serious AEs

The aftermath of adverse events in spanish primary care and hospital health professionals

Background Adverse events (AEs) cause harm in patients and disturbance for the professionals involved in the event (second victims). This study assessed the impact of AEs in primary care (PC) and hospitals in Spain on second victims. Methods A cross-sectional study was conducted. We carried out a survey based on a random sample of doctors and nurses from PC and hospital settings in Spain. A total of 1087 health professionals responded, 610 from PC and 477 from hospitals. Results A total of 430 health professionals (39.6%) had informed a patient of an error. Reporting to patients was carried out by those with the strongest safety culture (Odds Ratio –OR- 1.1, 95% Confidence Interval –CI- 1.0-1.2), nurses (OR 1.9, 95% CI 1.5-2.3), those under 50 years of age (OR 0.7, 95% CI 0.6-0.9) and primary care staff (OR 0.6, 95% CI 0.5-0.9). A total of 381 (62.5%, 95% CI 59-66%) and 346 (72.5%, IC95% 69-77%) primary care and hospital health professionals, respectively, reported having gone through the second-victim experience, either directly or through a colleague, in the previous 5 years. The emotional responses were: feelings of guilt (521, 58.8%), anxiety (426, 49.6%), re-living the event (360, 42.2%), tiredness (341, 39.4%), insomnia (317, 38.0%) and persistent feelings of insecurity (284, 32.8%). In doctors, the most common responses were: feelings of guilt (OR 0.7 IC95% 0.6-0.8), re-living the event (OR 0.7, IC95% o.6-0.8), and anxiety (OR 0.8, IC95% 0.6-0.9), while nurses showed greater solidarity in terms of supporting the second victim, in both PC (p?=?0.019) and hospital (p?=?0.019) settings. Conclusions Adverse events cause guilt, anxiety, and loss of confidence in health professionals. Most are involved in such events as second victims at least once in their careers. They rarely receive any training or education on coping strategies for this phenomenon

Análisis de la velocidad de ondas sísmicas en la falla de Alhama de Murcia (SE Península Ibérica) a partir de ensayos Down-Hole y testificación acústica

Reunión Ibérica sobre Fallas Activas y Paleosismología (3ª. 2018. Alicante). - Texto en español con resumen y palabras claves en inglés y españolEl terremoto de Lorca de 2011 generó aceleraciones más altas de las esperadas debido a un fenómeno de directividad, condicionado por la velocidad de propagación de la ruptura cosismica en relación a la velocidad de las ondas de cizalla (Vs). En este trabajo se analizan los datos de dos tipos de ensayos realizados en el sondeo de investigación FAM-1, que atraviesa la fault gouge (FG): (1) testificación geofísica de velocidad de ondas acústicas (onda completa), y (2) ensayo down-hole (DH). La FG muestran valores de velocidades propias de rocas muy blandas o suelos rígidos. Dentro de la FG se observa una marcada anisotropía, con velocidades de propagación Vp más elevadas según la dirección de la zona de cizalla que aquellas según buzamiento. Los valores de Vs se encuentran por debajo de los 1000 m/s. Si además se considera la anisotropía, esto implicaría valores de Vs tan bajas como 680 ±25 m/s para las ondas de cizalla que viajan según buzamiento. = The Lorca earthquake (2011) generated larger ground acceleration than expected because of a directivity phenomenon. Directivity is influenced by the relationship between the velocity of the propagation of the coseismic rupture and the velocity of the shear waves (Vs). In this work, data from two different tests that were carried out inside the research borehole FAM-1 are analysed: (1) full waveform acoustic logging, and (2) Down-hole seismic testing. The FAM-1 borehole was drilled through more than 100 m of the fault gouge of the fault (FG). The FG shows low velocities, typical of a very weak rock or a stiff soil. A remarkable anisotropy in the velocity can be also observed within the FG, with higher velocities for Vp along the fault strike than those along fault dip. Vs values have been calculated below 1000 m/s. If we consider the anisotropy, the FG may have Vs as lower as 680 ±25 m/s propagating along dip.Departamento de Geodinámica, Estratigrafía y Paleontología, Universidad Complutense de Madrid, EspañaInstituto de Geociencias, Consejo Superior de Investigaciones Científicas, EspañaInstituto de Geociencias, Universidad Complutense de Madrid, EspañaInstitut de Ciències de la Terra Jaume Almera, EspañaAnálisis y Gestión del Subsuelo S.L., EspañaDepartamento de Geología y Geoquímica, Universidad Autónoma de Madrid, EspañaInstituto Geológico y Minero de España, Españ

European Journalism Observatory- a platform for training and professional networks in the Faculty of Information Sciences

The launching of a Spanish platform within the Observatory will serve as a training laboratory for undergraduate and graduate students of the Faculty of Information Sciences at the same time as for establishing a professional media network in and outside Spain. The European Journalism Observatory (EJO) is a network of 14 non-profit media research institutes in 11 countries where Spain continue to be the missing element. All researchers in the EJO network actively strive to transfer their knowledge to the media industry as well as interested publics outside the scientific community, as a platform to enable online availability of at least a portion of many publications in several languages