Actividades de percepción en entornos virtuales para la enseñanza de pronunciación.

En el contexto de la educación superior y, específicamente, de acuerdo con nuestra experiencia formal en las carreras de Profesorado, Licenciatura y Traductorado de Inglés en la Facultad de Lenguas (Universidad Nacional de Córdoba), los estudiantes que aprueban el Ciclo de Nivelación encuentran dificultades en adquirir las habilidades para la pronunciación inglesa durante su primer año de cursado. Si partimos de que la enseñanza de la pronunciación involucra dos aspectos, el desarrollo de las habilidades perceptivas y el de las habilidades productivas (Kelly, 2000), debemos considerar que el Ciclo de Nivelación se enfoca en el entrenamiento de las primeras, mientras que el primer año se centra en la adquisición de las segundas. Luego, continuar con el entrenamiento de las habilidades receptivas en primer año como una estrategia de andamiaje (del inglés scaffolding, en Wood, Bruner & Ross, 1976) contribuiría no solo a disminuir la brecha que existe entre ambas etapas sino también a integrar los dos tipos de habilidades durante el proceso de aprendizaje en esta área. Para tal efecto, en el presente trabajo describimos secuencias de actividades prácticas del tipo receptivas en un entorno virtual de aprendizaje, pensadas para su posterior integración con habilidades de producción. El objetivo de nuestra propuesta didáctica es ofrecer práctica extra de contenido específico a nivel segmental y ha sido diseñada teniendo en cuenta la naturaleza heterogénea de las clases para adultos, a saber, distintos estilos de aprendizaje y las necesidades particulares del grupo de aprendices en cuestión. Con respecto a los beneficios de utilizar una plataforma virtual para poner en práctica actividades en el ámbito de la enseñanza de una segunda lengua, nuestro trabajo toma como punto de partida el concepto de blended learning (Barret & Sharma, 2007), que combina la enseñanza presencial con la metodología basada en la utilización de la web

Cardiovascular involvement in psoriatic arthritis

Psoriasis is a chronic, genetically determined and immunomediated inflammatory skin disease that affects 2-3% of the Caucasian population. A considerable proportion of these patients develop a form of inflammatory arthritis known as psoriatic arthritis (PsA), although the prevalence of this has not been well defined. Patients with PsA have a higher mortality rate than the general population and the risk of mortality is related to disease severity at the time of presentation. Endothelial dysfunction and early atherosclerosis have been found in patients with PsA without any cardiovascular disease (CVD) risk factors, and experts believe that CVD is one of the leading causes of death, as it is in patients with rheumatoid arthritis (RA). Various disease-related mechanisms may be involved in the development of premature vascular damage in both cases, including an increased synthesis of proinflammatory mediators (such as cytokines, chemokines and adhesion molecules), autoantibodies against endothelial cell components, perturbations in T-cell subsets, genetic polymorphisms, hyperhomocysteinemia, oxidative stress, abnormal vascular repair, and iatrogenic factors. In a recent study of 22 patients with PsA without any signs of CVD, we found that the plasma concentration of asymmetric dimethylarginine (ADMA) levels were significantly high and coronary flow reserve (CFR) was significantly reduced. Moreover, there was a significant correlation between CFR and plasma ADMA levels in the PsA group. The significant correlation between the reduced CRF and increased ADMA levels suggests that, like patients with early RA, PsA patients suffer from endothelial dysfunction and impaired coronary microcirculation. Active PsA is a risk factor for CVD, and so PsA patients should be screened for subclinical forms of the disease and its risk factors, and an early treatment approach should be adopted

Performance capacity evaluated using the 6-minute walk test: 5-year results in patients with diffuse systemic sclerosis and initial interstitial lung disease

Objective. To identify factors indicating exercise-induced oxygen desaturation during the 6-minute walk test (6MWT) in patients with diffuse systemic sclerosis (SSc) and initial interstitial lung disease (ILD). Methods. The study involved 121 consecutive adult anti-Scl 70 autoantibody-positive SSc patients with initial ILD, 93 of whom were followed up for five years. Before enrolment and then annually, the patients underwent high-resolution computed tomography (HRCT), functional lung tests, with carbon monoxide diffusion capacity of the lung (DLCO) and its components (alveolar-capillary membrane [Dm] and pulmonary blood volume [Vc]), the evaluation of dyspnea before and after the 6MWT using the Borg scale, and transthoracic echocardiography. A decrease in peripheral capillary oxygen saturation (SpO(2)) of >= 4% during the 6MWT was used to define desaturation, the appearance of which led to the patient being withdrawn from follow-up. Results. There were no significant differences in HRCT score during the follow-up, but 32 patients (35%) desaturated during the 6MWT, including 12 (37%) who experienced a severe decrease SpO(2), to = 4% showed that, at baseline, the former had lower minimum SpO(2)% levels during 6MWT (p<0.001), lower DLCO (p=0.01), a lower DLCO/VA ratio (p=0.05), lower Dm (p<0.005) and Vc values (p<0.5), and. higher RVsystP (p=0.01). At the time of desaturation, the desaturators minimum SpO(2), levels during the 6MWT correlated with their DLCO (r=0.78; p<0.001), Dm (r=0.65; p<0.01), Vc (r=0.52;p<0.05) and RV-systP values (r = -0.53; p<0.05). Conclusion. Our data seem to confirm the close interdependence between pulmonary diffusion and oxygen desaturation during exercise. In SSc combined 6MWT, DLCO and its components may indicate patients at increased risk of developing pulmonary hypertension

HICCups and inappropriate ADH secretion syndrome as presentations of tick-borne disease

Tick-borne diseases (Lyme disease and tick-borne encephalitis) are becoming a major public health concern. Rapid and correct diagnosis is crucial for complicated cases but is often delayed because of low suspicion or unusual clinical presentation. In this paper the authors describe two atypical presentations of Lyme disease and tick-borne encephalitis in order to help clinicians resolve diagnostic challenges