Currículum enfermero y estrategias pedagógicas en materia de sostenibilidad medioambiental en los procesos de salud y cuidado

Background: Nurses should be knowledgeable about how it affects climate change to health. To acquire this knowledge it is necessary to define competences and educational strategies that tackle environmental sustainability in nursing training. The objective of this paper is to describe the dimensions that should be included in nurse education in the field of environmental sustainability, climate change and health care and determine the most appropriate pedagogical strategies.Methods: A narrative review of publications on environmental sustainability in relation to nursing and health care has been carried out over the last 10 years. Search strategies have been designed for fifteen databases of Nursing and Health Sciences. The results were systematized in various data arrays.Results: Nurse training in environmental sustainability should include contents such as globalization, environmental impact, promotion of health, use of resources and proper management of waste, food and influences of production processes, the effects of smoking and environmental effects on the health of children. Educational approaches, such as the participatory action research and problem-based learning, are more appropriate to include in the nurse training while covering environmental sustainability.Conclusions: Nurse training in environmental sustainability should include competences at different levels: individual, understanding the rationale and scope of the problem as well as acting accordingly in the professional field and with personnel. Finally, at the social level, nursing has a key role in the promotion of environmental health.Fundamentos: Las enfermeras deben ser conocedoras de cómo afecta el cambio climático a la salud. Para la obtención de estos conocimientos es necesario definir las competencias a adquirir y las estrategias pedagógicas que afronten la sostenibilidad medioambiental en la formación de Enfermería. Objetivo: Describir las dimensiones que debe incluir la formación enfermera en materia de sostenibilidad medioambiental, cambio climático y cuidados de salud y determinar las estrategias pedagógicas más adecuadas. Métodos: Se realizó una revisión narrativa de publicaciones sobre sostenibilidad medioambiental en relación a enfermería y cuidados de salud de los últimos 10 años. Se diseñaron estrategias de búsqueda para quince bases de datos de enfermería y ciencias de la salud. Los resultados se sistematizaron en matrices de datos. Resultados: La formación enfermera en sostenibilidad medioambiental debe incluir contenidos sobre globalización, impacto ambiental, promoción de salud, uso de recursos y gestión adecuada de residuos, alimentos e influencias de los procesos de producción, los efectos del tabaquismo y los efectos ambientales en la salud de la infancia. Los enfoques educativos más adecuados para incluir la sostenibilidad medioambiental en la formación enfermera son la Investigación-Acción Participativa y el aprendizaje basado en problemas. Conclusiones: La formación enfermera en materia de sostenibilidad medioambiental debe incluir competencias en diferentes niveles: en lo individual, comprendiendo los fundamentos y el alcance del problema y actuando consecuentemente en el ámbito profesional y en el personal, y en el plano social, Enfermería tiene un papel clave en la promoción de  la salud medioambiental

Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study)

The most appropriate duration of anticoagulant treatment for cancer-associated venous thromboembolism (CAT) remains unclear. We have conducted a prospective multicenter study in CAT patients with more than 6 months of anticoagulant treatment to predict the risk of venous thromboembolism (VTE) recurrence after anticoagulation discontinuation. Blood samples were obtained when patients stopped the anticoagulation, at 21 days and at 90 days. In each sample we assessed different coagulation-related biomarkers: D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP), P-selectin (PS), phospholipids, soluble tissue factor, factor VIII and the thrombin generation test. It was evaluated 325 CAT patients and 166 patients were included in the study, mean age 64 ± 17 years. VTE recurrence until 6 months after stopping anticoagulation treatment was 9.87% [95% confidence interval (CI): 6–15]. The biomarkers sub-distribution hazard ratios were 6.32 for ratio DD basal/DD 21 days > 2 (95% CI: 1.82–21.90), 6.36 for hs-CRP > 4.5 (95% CI: 1.73–23.40) and 5.58 for PS > 40 (95% CI: 1.46–21.30) after 21 days of stopping anticoagulation. This is the first study that has identified the DD ratio, hs-CRP and PS as potential biomarkers of VTE recurrence in cancer patients after the discontinuation of anticoagulation treatment. A risk-adapted strategy may allow the identification of the optimal time to withdraw the anticoagulation in each CAT patientmThis research was funded by Instituto de Salud Carlos III, grant number (PI15/01085; PI18/01640, PI20/00075), Sociedad Española de Trombosis y Hemostasia; Fundación Respira, grant number (140/2013), Fundación Neumosur, grant number (5/2013) and the LEO Pharma Research Foundation. Partial funding for open access charge: Universidad de Málaga

Clinical and Molecular-Genetic Insights into the Role of Oxidative Stress in Diabetic Retinopathy: Antioxidant Strategies and Future Avenues

Reactive oxygen species (ROS) overproduction and ROS-signaling pathways activation attack the eyes. We evaluated the oxidative stress (OS) and the effects of a daily, core nutritional supplement regimen containing antioxidants and omega 3 fatty acids (A/ω3) in type 2 diabetics (T2DM). A case-control study was carried out in 480 participants [287 T2DM patients with (+)/without (−) diabetic retinopathy (DR) and 193 healthy controls (CG)], randomly assigned to a daily pill of A/ω3. Periodic evaluation through 38 months allowed to outline patient characteristics, DR features, and classic/OS blood parameters. Statistics were performed by the SPSS 24.0 program. Diabetics displayed significantly higher circulating pro-oxidants (p = 0.001) and lower antioxidants (p = 0.0001) than the controls. Significantly higher plasma malondialdehyde/thiobarbituric acid reactive substances (MDA/TBARS; p = 0.006) and lower plasma total antioxidant capacity (TAC; p = 0.042) and vitamin C (0.020) was found in T2DM + DR versus T2DM-DR. The differential expression profile of solute carrier family 23 member 2 (SLC23A2) gene was seen in diabetics versus the CG (p = 0.001), and in T2DM + DR versus T2DM − DR (p < 0.05). The A/ω3 regime significantly reduced the pro-oxidants (p < 0.05) and augmented the antioxidants (p < 0.05). This follow-up study supports that a regular A/ω3 supplementation reduces the oxidative load and may serve as a dietary prophylaxis/adjunctive intervention for patients at risk of diabetic blindness

The clinical and molecular cardiometabolic fingerprint of an exploratory psoriatic arthritis cohort is associated with the disease activity and differentially modulated by methotrexate and apremilast

Objectives: (1) To evaluate clinical and molecular cardiovascular disease (CVD) signs and their relationship with psoriatic arthritis (PsA) features and (2) to identify a clinical patient profile susceptible to benefit from methotrexate (MTX) and/or apremilast regarding CVD risk. Methods: This cross-sectional study included 100 patients with PsA and 100 age-matched healthy donors. In addition, an exploratory cohort of 45 biologically naïve patients treated for 6 months with apremilast, MTX or combined therapy according to routine clinical practice was recruited. Extensive clinical and metabolic profiles were obtained. Ninety-nine surrogate CVD-related molecules were analysed in plasma and peripheral blood mononuclear cells (PBMCs). Hard cluster analysis was performed to identify the clinical and molecular phenotypes. Mechanistic studies were performed on adipocytes. Results: Cardiometabolic comorbidities were associated with disease activity and long-term inflammatory status. Thirty-five CVD-related proteins were altered in the plasma and PBMCs of PsA patients and were associated with the key clinical features of the disease. Plasma levels of some of the CVD-related molecules might distinguish insulin-resistant patients (MMP-3, CD163, FABP-4), high disease activity (GAL-3 and FABP-4) and poor therapy outcomes (CD-163, LTBR and CNTN-1). Hard cluster analysis identified two phenotypes of patients according to the rates of cardiometabolic comorbidities with distinctive clinical and molecular responses to each treatment. Conclusions: (1) Novel CVD-related proteins associated with clinical features could be emerging therapeutic targets in the context of PsA and (2) the pleiotropic action of apremilast could make it an excellent choice for the management of PsA patients with high CVD risk, targeting metabolic alterations and CVD-related molecules

re-habitar El Carmen : Un proyecto sobre patrimonio contemporáneo

El proyecto _re-HABITAR suponía para el propio proceder de la institución un avance más allá del reconocimiento, registro, inventario o protección patrimonial de la arquitectura del siglo XX y del Movimiento Moderno para posicionarse en la acción preventiva y conservativa de ese legado contemporáneo. Para ello, la praxis patrimonial se aferraba a un modelo: el de la vivienda social en España en la segunda mitad del siglo XX; a un caso concreto: el de la barriada de Nuestra Señora del Carmen (Recasens Méndez-Queipo de Llano, 1958); y a un requisito fundamental: analizar un objeto vivo y en uso, aún con la presencia de quienes lo vivieron y usaron desde su origen

Çédille, revista de estudios franceses

Presentació

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Sin / Sense

Sexto 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

Currículum enfermero y estrategias pedagógicas en materia de sostenibilidad medioambiental en los procesos de salud y cuidado

Background: Nurses should be knowledgeable about how it affects climate change to health. To acquire this knowledge it is necessary to define competences and educational strategies that tackle environmental sustainability in nursing training. The objective of this paper is to describe the dimensions that should be included in nurse education in the field of environmental sustainability, climate change and health care and determine the most appropriate pedagogical strategies.Methods: A narrative review of publications on environmental sustainability in relation to nursing and health care has been carried out over the last 10 years. Search strategies have been designed for fifteen databases of Nursing and Health Sciences. The results were systematized in various data arrays.Results: Nurse training in environmental sustainability should include contents such as globalization, environmental impact, promotion of health, use of resources and proper management of waste, food and influences of production processes, the effects of smoking and environmental effects on the health of children. Educational approaches, such as the participatory action research and problem-based learning, are more appropriate to include in the nurse training while covering environmental sustainability.Conclusions: Nurse training in environmental sustainability should include competences at different levels: individual, understanding the rationale and scope of the problem as well as acting accordingly in the professional field and with personnel. Finally, at the social level, nursing has a key role in the promotion of environmental health.Fundamentos: Las enfermeras deben ser conocedoras de cómo afecta el cambio climático a la salud. Para la obtención de estos conocimientos es necesario definir las competencias a adquirir y las estrategias pedagógicas que afronten la sostenibilidad medioambiental en la formación de Enfermería. Objetivo: Describir las dimensiones que debe incluir la formación enfermera en materia de sostenibilidad medioambiental, cambio climático y cuidados de salud y determinar las estrategias pedagógicas más adecuadas. Métodos: Se realizó una revisión narrativa de publicaciones sobre sostenibilidad medioambiental en relación a enfermería y cuidados de salud de los últimos 10 años. Se diseñaron estrategias de búsqueda para quince bases de datos de enfermería y ciencias de la salud. Los resultados se sistematizaron en matrices de datos. Resultados: La formación enfermera en sostenibilidad medioambiental debe incluir contenidos sobre globalización, impacto ambiental, promoción de salud, uso de recursos y gestión adecuada de residuos, alimentos e influencias de los procesos de producción, los efectos del tabaquismo y los efectos ambientales en la salud de la infancia. Los enfoques educativos más adecuados para incluir la sostenibilidad medioambiental en la formación enfermera son la Investigación-Acción Participativa y el aprendizaje basado en problemas. Conclusiones: La formación enfermera en materia de sostenibilidad medioambiental debe incluir competencias en diferentes niveles: en lo individual, comprendiendo los fundamentos y el alcance del problema y actuando consecuentemente en el ámbito profesional y en el personal, y en el plano social, Enfermería tiene un papel clave en la promoción de  la salud medioambiental