Estudio comparativo de la recuperación postparto en base a los Patrones de Marjory Gordon

Objective: Analyse if there is any difference in recovery rate according to their puerperium stage depending on perineal lesion.Material and method: Prospective longitudinal descriptive quantitative study, following the Marjory Gordon’s Functional Health Patterns. Data collection will be performed in three phases (immediate, clinical and remote puerperium), through semi-structured interview completed in first instance in a face-to-face interview and phone call interview at 10 and 30 days, respectively. Results: In Spain there is an episiotomy, induction and assisted delivery rate much higher than recommended. Episiotomy technique lead to significant tear (16,7%) in this study. During immediate puerperium, women who were practiced an episiotomy shown mobility difficulties (p=0,0005), elimination (p=0,0007), baby care (p=0,015), rest (p=0,15) and perceived pain (p=0,005), whereas in the clinical puerperium are affected only mobility (p=0,05), elimination (p=0,042) and perceived pain (p=0,006). After 30 days, remote puerperium, there is not statistical significant differences in both groups. More research is needed to confirm these facts as well as provide new knowledge.Conclusions: Episiotomy produce more negative effects than spontaneous tears at the immediate and clinical puerperium of women. Pain produced by this technique as a short, medium and long term limit many daily activities of women.Objetivo: Analizar si existen diferencias en el nivel de recuperación en las distintas fases del puerperio según el tipo de lesión perineal.Material y método: Estudio cuantitativo de tipo descriptivo longitudinal prospectivo, siguiendo los Patrones Funcionales de Salud de Marjory Gordon. La recogida de datos se realiza en tres fases (puerperio inmediato, clínico y tardío), empleando entrevistas semiestructuradas que se completan en un primer momento en una entrevista personal y vía telefónica a los 10 y a los 30 días, respectivamente.Resultados: En España existe un índice de episiotomías, inducciones y partos instrumentales muy superior al recomendado. La técnica de la episiotomía produjo desgarros importantes (16,7%) en este estudio. Durante el puerperio inmediato, las mujeres con episiotomía tienen dificultades en la movilidad (p=0,0005), la eliminación (p=0,007), cuidado del bebé (p=0,015), descanso (p=0,15) y dolor percibido (p=0,005), mientras que en el puerperio clínico están afectados sólo la movilidad (p=0,05), la eliminación (p=0,042) y el dolor percibido (p=0,006). A los 30 días, en el puerperio tardío, no existen diferencias estadísticamente significativas entre ambos grupos. Se necesitan más estudios que reafirmen estos hechos y aporten nuevos conocimientos.Conclusiones: La episiotomía produce más efectos negativos que los desgarros espontáneos en el puerperio inmediato y clínico en la mujer. El dolor que genera esta técnica a corto, medio y largo plazo es el que limita muchas de las actividades cotidianas de estas mujeres

Intracellular virion traffic to the endosome driven by cell type specific sialic acid receptors determines parvovirus tropism

Parvoviruses are promising anticancer and gene therapy agents, but a deep knowledge of the entry process is crucial to exploit their therapeutic potential. We addressed this issue while attempting to retarget the oncolytic parvovirus minute virus of mice (MVMp) to the tumor vasculature. Residues at three functional domains of the icosahedral capsid were substituted by rational design with peptides competing with the vascular endothelial growth factor. Most substitutions impaired virus maturation, though some yielded infectious chimeric virions, and substitutions in a dimple at the twofold axis that allocates sialic acid (SIA) receptors altered viral tropism. One dimple-modified chimeric virion was efficiently attached as MVMp to α2-linked SIA moieties, but the infection was impaired by the binding to some inhibitory α2-3,-6,-8 SIA pseudoreceptors, which hampers intracellular virus traffic to the endosome in a cell type-dependent manner. Infectious from nonproductive traffic could be mechanistically discriminated by an endosomal drastic capsid structural transition comprising the cleavage of some VP2-Nt sequences and its associated VP1-Nt exposure. Correspondingly, neuraminidase removal of inhibitory SIA moieties enhanced the infection quantitatively, correlating to the restored virus traffic to the endosome and the extent of VP2-Nt cleavage/VP1-Nt exposure. This study illustrates (i) structural constraints to retarget parvoviruses with evolutionary adopted narrow grooves allocating small SIA receptors, (ii) the possibility to enhance parvovirus oncolysis by relaxing the glycan network on the cancer cell surface, and (iii) the major role played by the attachment to cell type-specific SIAs in the intracellular virus traffic to the endosome, which may determine parvovirus tropism and host rang

Propiedades mecánicas de carburo de silicio poroso de estructura celular abierta

VIII Congreso de Propiedades Mecánicas de Sólidos. Comunicaciones en: http://www.upv.es/pms2002/Hemos estudiado las propiedades mecánicas y la microestructura de un material de SiC poroso de estructura celular abierta. El tamaño de celda típico es 2.4 mm. Las celdas abiertas ocupan el 80% del volumen y las aristas que conforman la estructura sólida tienen una densidad de 2.53 g/cm3 , es decir un 79% de la densidad teórica del SiC. Se han realizado ensayos de compresión uniaxial hasta rotura a velocidad de compresión constante de 20 mm/min, sobre muestras de 20x20x30 mm aproximadamente, cargando a lo largo de la dimensión mayor. Los ensayos se han realizado a temperatura ambiente y a altas temperaturas, entre 1150ºC y 1400ºC. La resistencia en compresión a rotura se ha encontrado en el rango 369 kPa y 558 kPa. Se comparan estos resultados con los de otros materiales celulares

Um estudo descritivo dos resultados obstétricos e neonatais em dois modelos de assistência ao parto em primíparas

Introduction: In the 20th century, childbirth went from being attended at home to the hospital setting. Inappropriate and unnecessary interventions were uncritically adopted, leading to a dehumanization of childbirth. This is the model that currently exists in most Spanish hospitals, which has been questioned by the World Health Organization as early as 1996. Objective: The aim is to describe the differences in obstetrical and neonatal results across two different models of maternity care (biomedical model and humanised birth). Method: A correlational descriptive and multicenter study was carried out. A convenience sample of 205 primiparous women, 110 biomedical model and 95 humanised model, were recruited. Obstetrical and neonatal results were compared in two hospitals with different models of maternity care in Spain. Results: The humanised model of maternity care produces better obstetrical outcomes (spontaneous beginning of labour, normal vaginal birth, intact perineum and I degree tear and less episiotomies) than the biomedical model. There were no differences in neonatal outcomes. Conclusion: The benefits of implementing a humanised model of delivery care should be considered by health policy makers and reflected in the woman and her baby.Introducción: En el siglo XX el parto pasó de ser atendido en casa al ámbito hospitalario. Se adoptaron de forma acrítica intervenciones inapropiadas e innecesarias que condujeron a una deshumanización del parto. Este es el modelo que existe actualmente en la mayoría de los hospitales españoles y que fue cuestionado por la OMS ya en 1996. Objetivo: Describir las diferencias que existen en los resultados obstétricos y neonatales en primíparas en dos modelos distintos de asistencia al parto (biomédico y humanizado). Método: Se llevó a cabo un estudio descriptivo, de corte transversal. Se obtuvo una muestra por conveniencia de 205 primíparas, 110 del modelo biomédico y 95 del humanizado. Se compararon los resultados obstétricos y neonatales en dos hospitales con modelos diferentes de asistencia al parto en España. Resultados: En el modelo humanizado de asistencia al parto se obtuvieron unos mejores resultados obstétricos (inicio espontáneo, parto eutócico, periné íntegro o desgarro de I grado y menos episiotomías) que en el biomédico. No hubo diferencias en los resultados neonatales. Conclusión: Los beneficios de instaurar un modelo humanizado de asistencia al parto deberían ser considerados por los responsables de políticas sanitarias y reflejados en la mujer y su criatura.Introdução: No século XX, o parto deixou de ser realizado em casa para ser realizado no ambiente hospitalar. Intervenções inadequadas e desnecessárias foram adotadas acriticamente, levando a uma desumanização do parto. Este é o modelo que existe atualmente na maioria dos hospitais espanhóis e que foi questionado pela Organização Mundial da Saúde já em 1996. Objetivo: O objetivo principal desse estudo é descrever as diferenças existentes nos resultados obstétricos e neonatais em primíparas em dois modelos distintos de assistência ao parto (biomédico e humanizado). Método: Foi realizado um estudo descritivo, transversal. Obteve-se uma amostra por conveniência de 205 primíparas, 110 do modelo biomédico e 95 do modelo humanizado. Os resultados obstétricos e neonatais foram comparados em dois hospitais com diferentes modelos de assistência ao parto na Espanha. Resultados: No modelo humanizado de assistência ao parto obtiveram-se melhores resultados obstétricos (início espontâneo, parto eutócico, períneo íntegro ou laceração grau I e menos episiotomias) do que no modelo biomédico. Não houve diferença nos resultados neonatais. Conclusão: Os benefícios da implementação de um modelo humanizado de assistência ao parto devem ser considerados pelos formuladores de políticas de saúde e refletidos na mulher e em seu bebê

Hospital Intervention to Reduce Overweight with Educational Reinforcement after Discharge: A Multicenter Randomized Clinical Trial

Introduction: Obesity and overweight affect more than one-third of the world’s population and pose a major public health problem. Objective: To evaluate the impact of an educational intervention on dietary habits and physical exercise in patients with overweight admitted to departments of internal medicine, comprising a pre-discharge educational session with follow-up and reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight, systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital readmissions, emergency department visits, and death. Method: A randomized experimental study with a control group was performed in hospitalized non-diabetic adults aged 18 years with body mass index (BMI) 25 kg/m2. Results and conclusions: The final sample included 273 patients. At three months post-discharge, the intervention group had lower SBP and DPB and improved dietary habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences in hospital readmissions, emergency department visits, or mortality at any time point. Both groups evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary habits but a worsening of EQ-5D-5L-value-assessed HRQOL. Discussion: The intervention group showed greater improvements over the short term, but between-group differences disappeared at 6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over the follow-up period. Further research is warranted to determine whether a minimum intervention with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy habits, as in the present control group, may be an equally effective strategy without specific individual educational input.Instituto de Salud Carlos IIIEuropean Commission PI17/0041

Smartphones, minors and vulnerability: a literature review

En la última década ha proliferado la literatura académica sobre los riesgos y oportunidades de las actividades en red entre los niños y jóvenes. El crecimiento exponencial del uso de los dispositivos digitales y nuevas aplicaciones está cambiando las condiciones de acceso a Internet de los niños, esto implica la aparición de nuevos desafíos en términos de seguridad en la red. Hoy en día los teléfonos inteligentes acompañan a los menores en cualquier momento y lugar más allá de la supervisión de sus padres, y la vida en línea se convierte en una experiencia más privada. En este documento se realiza una revisión de la literatura a partir de 2011-2017, con el fin de identificar nuevos riesgos y amenazas asociados con la propagación de dispositivos móviles, particularmente teléfonos inteligentes. Al mismo tiempo, se discuten las vulnerabilidades potenciales que se han analizado en la investigación empírica y los hallazgos de estos estudios sobre esta relación. Todos estos aspectos se analizarán para descubrir los cambios en los factores de vulnerabilidad emergentes que están asociados con los dispositivos móviles en comparación con el acceso al ciberespacio a través de los ordenadores.The literature on the risks and opportunities from online activities for children and young people has increased significantly over the last decade. The explosive growth in the use of digital devices and new applications alters children’s conditions of access to the Internet. Hence, new challenges regarding network security are emerging. Currently, smartphones accompany minors anytime, anywhere, outside of their parents’ supervision. Life online has become a more private experience. This literature review, performed between 2011 and 2017, sought to identify the new risks and threats associated with the spread of mobile devices, especially smartphones. In addition, potential vulnerabilities deriving from the empirical research and the findings on this subject were discussed. These points were analysed to identify the changes in the emerging vulnerability factors associated with mobile devices in comparison with access to cyberspace via computers

Combined impact of traditional and non-traditional health behaviors on mortality: A national prospective cohort study in Spanish older adults

Background: Data on the combined effect of lifestyles on mortality in older people have generally been collected from highly selected populations and have been limited to traditional health behaviors. In this study, we examined the combined impact of three traditional (smoking, physical activity and diet) and three non-traditional health behaviors (sleep duration, sedentary time and social interaction) on mortality among older adults. Methods: A cohort of 3,465 individuals, representative of the Spanish population aged ≥60 years, was established in 2000/2001 and followed-up prospectively through 2011. At baseline, the following positive behaviors were selfreported: never smoking or quitting tobacco >15 years, being very or moderately physically active, having a healthy diet score ≥ median in the cohort, sleeping 7 to 8 h/d, spending <8 h/d in sitting time, and seeing friends daily. Analyses were performed with Cox regression and adjusted for the main confounders. Results: During an average nine-year follow-up, 1,244 persons died. Hazard ratios (95% confidence interval) for allcause mortality among participants with two, three, four, five and six compared to those with zero to one positive behaviors were, respectively, 0.63 (0.46 to 0.85), 0.41 (0.31 to 0.55), 0.32 (0.24 to 0.42), 0.26 (0.20 to 0.35) and 0.20 (0.15 to 0.28) (P for trend <0.001). The results were similar regardless of age, sex and health status at baseline. Those with six vs. zero to one positive health behaviors had an all-cause mortality risk equivalent to being 14 years younger. Adding the three non-traditional to the four traditional behaviors improved the model fit (likelihood ratio test, P <0.001) and the accuracy of mortality prediction (c-statistic: + 0.0031, P = 0.040). Conclusions: Adherence to some traditional and non-traditional health behaviors may substantially reduce mortality risk in older adults.This work was funded by grants from the FIS (ref. 12/1166) and the ‘Plan Nacional sobre Drogas’ (ref. 06/2010), and by the ‘Cátedra UAM de Epidemiología y Control del Riesgo Cardiovascular’. DMG had a “Juan de la Cierva” contract from the Spanish Ministry of Scienc

Food-Based Dietary Guidelines around the World: A Comparative Analysis to Update AESAN Scientific Committee Dietary Recommendations

Food-Based Dietary Guidelines (FBDG) include dietary recommendations based on food groups according to the general and accepted nutrition principles and current scientific evidence. Adoption of FBDG contributes to the prevention of malnutrition in all its forms, promotes human health, and reduces environmental impact. The present review aims to perform an international comparative analysis of the FBDG adopted in different countries from three different continents (America, Asia, and Europe), with particular reference to the Spanish Food Safety and Nutrition Agency (AESAN, Agencia Española de Seguridad Alimentaria y Nutrición) Scientific Committee dietary recommendations. A total of twelve countries with the most updated FBDG and/or closest to the traditional and cultural preferences of Spain were finally selected. All the reviewed FBDG provided recommendations for fruits, vegetables, cereals, legumes, nuts, milk and dairy products, meat and derivatives, fish, eggs, water, and oil; however, remarkable differences regarding recommended amounts were found among countries

Composite waste recycling: Predictive simulation of the pyrolysis vapours and gases upgrading process in Aspen plus.

[EN] Waste generation is one of the greatest problems of present times, and the recycling of carbon fibre reinforced composites one big challenge to face. Currently, no resin valorisation is done in thermal fibre recycling methods. However, when pyrolysis is used, additional valuable compounds (syngas or H2-rich gas) could be obtained by upgrading the generated vapours and gases. This work presents the thermodynamic and kinetic multi-reaction modelling of the pyrolysis vapours and gases upgrading process in Aspen Plus software. These models forecast the theoretical and in-between scenario of a thermal upgrading process of an experimentally characterised vapours and gases stream (a blend of thirty-five compounds). Indeed, the influence of temperature (500°C-1200°C) and pressure (DeltaP=0, 1 and 2bar) operating parameters are analysed in the outlet composition, residence time and possible reaction mechanisms occurring. Validation of the kinetic model has been done comparing predicted outlet composition with experimental data (at 700°C and 900°C with DeltaP=0bar) for H2 (g), CO (g), CO2 (g), CH4 (g), H2O (v) and C (s). Kinetic and experimental results show the same tendency with temperature, validating the model for further research. Good kinetic fit is obtained for H2 (g) (absolute error: 0.5wt% at constant temperature and 0.3wt% at variable temperature) and H2O (v) shows the highest error at variable T (8.8wt%). Both simulation and experimental results evolve towards simpler, less toxic and higher generation of hydrogen-rich gas with increasing operating temperature and pressure.The authors want to thank the Ministry of Science and Innovation of Spain (Ref. PID2019-110770RB-I00) and the Basque Government (Ref. KK-2020/00107, ELKARTEK program) for the funding to carry out the investigation. The authors also thank the financing granted to the “Sustainable Process Engineering” research group for the 2016–2021 period (Basque Government, Ref. IT993-16) and are grateful to Iñaki Múgica from Su Medioambiente (SUMA Soluciones Medioambientales, S.L.) for the technical support provided