El placer de educar en medios de comunicación

El área de Lengua y Literatura debe atender no sólo al estudio de la Gramática y la Literatura, sino a los diversos usos verbales y no verbales que los alumnos desarrollan en sus actos comunicativos. En la era de la información y la tecnología es necesario alfabetizar a nuestro alumnado y educarlos como consumidores críticos y creadores. Queremos presentar una propuesta didáctica que se hace eco de esta necesidad y que, de forma muy original, integra los medios de comunicación en la enseñanza de la Lengua y la Literatura. Dicha propuesta se llevó a cabo, desarrollando un Programa Didáctico de manera experimental, en un centro de Educación Secundaria de Huelva y los resultados fueron muy halagüeños.Not only should the area of Language and Literature attend the study of Grammar and Literature, but also the diverse verbal and non verbal uses that students develop in their communicative acts. In the era of information and technology, it is necessary to literate our students and educate them as critical and creative consumers. We want to present a didactic proposal which echoes this necessity, and, in a very original way, integrates media in the teaching of Language and Literature. This proposal was carried out developing a Didactic Programme on an experimental basis in a Secondary Education centre of Huelva with flattering results

La trata de personas como objeto del Derecho Internacional.

El presente trabajo de tesis contiene imágenes, diagramas y tablas.El presente trabajo se creó por la necesidad que existe en la actualidad de erradicar uno de los peores delitos en la historia de la humanidad, “la esclavitud” mejor conocida en la época actual como “trata de personas, la esclavitud moderna”, gran negocio que deja ganancias extraordinarias para el crimen organizado alrededor de todo el mundo. Como se verá impactante son las cifras dadas por diversas organizaciones internacionales las cuales ya han identificado a este delito y sus múltiples variables como un delito transnacional, lo anterior significa que trasciende las fronteras nacionales pudiendo ser perseguibles por el derecho nacional de cada país, cuestión que se dificulta al existir una multiplicidad de nacionalidades, así como la complejidad del delito en cuestión, lo que convierte como solución inmediata la colaboración internacional, con la única finalidad de tener una más efectiva persecución de los victimarios existiendo o no convenios o tratados internacionales

"Clown nose" as first manifestation of squamous cell carcinoma of the lung

Background: Skin metastases occur in 0.7% to 9% of all patients with cancer and are usually considered a late event in the evolution of most visceral carcinomas. The development of a nodular metastatic lesion on the nasal tip is known as clown nose sign. Main observation: We report a 64-year-old man that developed a nodular lesion on his nasal tip as first manifestation of squamous lung carcinoma. Conclusion: The biopsy of the cutaneous metastasis may be helpful to histopathologically confirm the suspected primary tumour avoiding invasive diagnostic procedures

Towards a set of competencies in palliative care nursing in Spain: what’s getting in the way of consensus?

Background Spain currently lacks a competency framework for palliative care nursing. Having such a framework would help to advance this field in academic, governmental, and health management contexts. In phase I of a mixed-methods sequential study, we collected quantitative data, proposing 98 competencies to a sample of palliative care nurses. They accepted 62 of them and rejected 36.MethodsPhase II is a qualitative phase in which we used consensus techniques with two modified nominal groups to interpret the quantitative findings with the objective of understanding of why the 36 competencies had been rejected. Twenty nurses from different areas of palliative care (direct care, teaching, management, research) participated. We conducted a thematic analysis using NVivo12 to identify meaning units and group them into larger thematic categories.ResultsParticipants attributed the lack of consensus on the 36 competencies to four main reasons: the rejection of standardised nursing language, the context in which nurses carry out palliative care and other factors that are external to the care itself, the degree of specificity of the proposed competency (too little or too great), and the complexity of nursing care related to the end of life and/or death.ConclusionsBased on the results, we propose reparative actions, such as reformulating the competencies expressed in nursing terminology to describe them as specific behaviours and insisting on the participation of nurses in developing institutional policies and strategies so that competencies related to development, leadership and professional commitment can be implemented. It is essential to promote greater consensus on the definition and levels of nursing intervention according to criteria of complexity and to advocate for adequate training, regulation, and accreditation of palliative care expert practice. Locally, understanding why the 36 competencies were rejected can help Spanish palliative care nurses reach a shared competency framework. More broadly, our consensus methodology and our findings regarding the causes for rejection may be useful to other countries that are in the process of formalising or reviewing their palliative care nursing model

Importance of Tetrahydroiso α-acids to the microbiological stability of beer

Producción CientíficaWhile beer provides a very stable microbiological environment, a few niche microorganisms are capable of growth in malt, wort, and beer. The production of off-flavors and development of turbidity in the packaged product are due to the growth and metabolic activity of wild yeast, certain lactic acid bacteria (LAB) and anaerobic Gram-negative bacteria. Beer also contains bitter hop compounds, which are toxic to Gram-positive and Gram-negative bacteria, and contribute to preventing the spoilage of this beverage. In the boiling process, the hop -acids (humulones) are isomerized into iso -acids. These products are responsible for the bitter taste of beer, but they also play an essential role in enhancing foam stability. Antibacterial activity of iso -acids and their hydrogenated derivates (rhoiso -acids and tetrahydroiso -acids) in MRS broth and beer have been evaluated against different LAB (Lactobacillus and Pediococcus) for the determination of their beer-stabilizing capabilities. Besides this, we have determined the minimum inhibitory concentration and the bacteriostatic effect of each compound against Pediococcus. We found that tetrahydroiso-acids (added directly to beer during production processes) are the compounds that present the greatest antibacterial activity against the main agents implicated in beer spoilage

Effectiveness of a multimodal exercise rehabilitation program on walking capacity and functionality after a stroke

The aim of this study was to determine the effectiveness of a 12-week multimodal exercise rehabilitation program on walking speed, walking ability and activities of daily living (ADLs) among people who had suffered a stroke. Thirty-one stroke survivors who had completed a conventional rehabilitation program voluntarily participated in the study. Twenty-six participants completed the multimodal exercise rehabilitation program (2 days/wk, 1 hr/session). Physical outcome measures were: walking speed (10-m walking test), walking ability (6-min walking test and functional ambulation classification) and ADLs (Barthel Index). The program consisted on: aerobic exercise; task oriented exercises; balance and postural tonic activities; and stretching. Participants also followed a program of progressive ambulation at home. They were evaluated at baseline, postintervention and at the end of a 6-month follow-up period. After the intervention there were significant improvements in all outcomes measures that were maintained 6 months later. Comfortable and fast walking speed increased an average of 0.16 and 0.40 m/sec, respectively. The walking distance in the 6-min walking test increased an average of 59.8 m. At the end of the intervention, participants had achieved independent ambulation both indoors and outdoors. In ADLs, 40% were independent at baseline vs. 64% at the end of the intervention. Our study demonstrates that a multimodal exercise rehabilitation program adapted to stroke survivors has benefits on walking speed, walking ability and independence in ADL

Risk of dependence associated with health, social support, and lifestyle

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.OBJETIVO Analizar la prevalencia de personas en riesgo de dependencia y los factores asociados. MÉTODOS El estudio se basó en datos de la Encuesta de Salud de Cataluña, España, realizada de 2010 a 2011. A partir de una muestra aleatoria de 3.842 individuos, de 15 años o más, se llevaron a cabo modelos de regresión logística para clasificar a los individuos según el estado de su autonomía personal. Se plantearon modelos predictivos para identificar las variables susceptibles de intervención que permitieran distinguir a los individuos dependientes de aquellos en riesgo. Se consideraron variables acerca del estado de salud, apoyo social y estilos de vida. RESULTADOS El 18,6% de la población presentó riesgo de dependencia, con efecto más acusado a partir de los 65 años. En comparación con este colectivo, los individuos que se declararon dependientes (11,0%) manifestaron problemas para realizar las actividades cotidianas y obtuvieron apoyo para ello. Estilos de vida, como fumar, consumir alcohol en exceso y ser sedentario se asociaron con mayor probabilidad de dependencia, en particular para las mujeres. CONCLUSIONES Las dificultades para llevar a cabo las actividades cotidianas preceden a la aparición de dependencia. Preservar la propia autonomía y desenvolverse sin recibir apoyo aparecen como factores protectores. La adopción de un estilo de vida activo y saludable contribuye a reducir el riesgo de dependencia

Improved diagnostics and surveillance identify novel reassortant swine influenza A viruses in Chile

Influenza A Virus (IAV) circulates endemically in nature, representing a constant concern to public health and animal production systems worldwide. The emergence of the 2009 H1N1 influenza A pandemic (A(H1N1)pdm09) highlighted the need of conducting systematic surveillance studies, and evidenced the significant gap of knowledge of the swine IAVs (SwIAV) circulating in pigs worldwide at the time of the outbreak. This also highlighted the role of swine as important reservoirs for the generation of endemic strains with zoonotic and pandemic potential. Despite this, comprehensive information of SwIAV circulating in Latin America is still lacking. While Chile has strong ecological barriers and high stringency controls regarding livestock trading, IAV is endemic and has been consistently detected in pigs. This has caused great concerns for the swine industry, because of the on-going clinical and production losses. Nevertheless, few surveillance efforts have been conducted in Chile and there is limited information regarding the genetic diversity and origin of swIAVs. Determining the viral subtypes and genotypes circulating in swine is key for the development of appropriate vaccine approaches and control measures for the swine industry, and it is crucial for identifying novel strains with pandemic potential. We developed improved diagnostic tools to detect endemic viruses and characterized the diversity and origin of SwAIV and its prevalence in Chilean swine production farms. From December 2013 to June 2015, we sampled 27 farms representative of intensive swine production systems located between the Valparaiso and Araucania administrative regions. Animals were mainly found to be susceptible to IAV infection at 50 to 110 days of age. Serological analysis of 718 serum samples obtained from 3 different farms showed 91-59% prevalence to SwIAV, with 18-67% positivity to A(H1N1)pdm09-like strains and 29-58% positivity to a novel SwH1N2 virus. We also obtained a total of 1016 nasal swabs (NS, 85%) and 176 oral fluids (OF, 15%) that were tested by Real-time RT-PCR (qPCR) and virus isolation. Of these, 295 samples (25%) were positive to swIAV (23% of NS and 38% of OF). A large number of farms (21 out of 27, 78%) were positive in at least one visit, and most farms showed temporal co-circulation of at least 2 viruses or mixed infections. We subtyped selected positive samples and sequenced 51 complete viral genomes using the Illumina platform. Nineteen additional hemagglutinins (HA) genes were sequenced by Sanger. We performed Bayesian Evolutionary Analyses to reconstruct the phylogenies of the viral segments. This identified the circulation of 2 predominant swIAV genotypes in Chile, the A(H1N1)pdm09-like (35%) strain and a novel SwH1N2 virus (45%). This H1N2 virus is unique to Chile since it is genetically distinct from the H1 virus clusters seen in North America and is not related to any previously reported IAV. The genome of this swH1N1 virus contains genes from 3 different human contemporary viruses. Its H1 and N2 genes are derived from human H1N1 and H3N2 viruses from the mid 90’s, respectively, suggesting that both of these human viruses were likely introduced into the Chilean swine population during that time. All the internal genes are from the A(H1N1)pdm09 strain, indicating that multiple and recent reassortment events gave rise to this novel reassortant virus. Of interest, we identified additional reassortant viruses that also contain the internal genes derived from the A(H1N1)pdm09 strain. These included an H1N1 containing the novel SwH1 and NA gene derived from the A(H1N1)pdm09-like strain, an H1N2 virus containing an H1 derived from the A(H1N1)pdm09 strain and the novel SwN2, a SwH3N2 virus and a human-like H3N2 virus, among others. Additionally, our analyses also revealed at least 3 independent human-to-swine introductions of the A(H1N1)pdm09 strain within the last 4 years in Chile. Overall this indicates that close human-swine interactions greatly contribute to the genetic diversity and emergence of IAVs in Chilean swine. This is the first comprehensive molecular epidemiological study of swIAV in Chile demonstrating the co-circulation of multiple viral strains in intensive swine production systems. Our data emphasizes the value of conducting long-term SwIAV surveillance in Latin America, a poorly studied region of the world. Acknowledgements: CEIRS program: HHSN266200700010C, HHSN272201400008C from NIH-NIAID, FONDEF IDeA Grant ID14I10201 and Proyecto Anillo de Investigación en Ciencia y Tecnología - PIA ACT1408, both from CONICYT Chile

An Observational Report of Intensive Robotic and Manual Gait Training in Sub-acute Stroke

Background: The use of automated electromechanical devices for gait training in neurological patients is increasing, yet the functional outcomes of well-defined training programs using these devices and the characteristics of patients that would most benefit are seldom reported in the literature. In an observational study of functional outcomes, we aimed to provide a benchmark for expected change in gait function in early stroke patients, from an intensive inpatient rehabilitation program including both robotic and manual gait training. Methods: We followed 103 sub-acute stroke patients who met the clinical inclusion criteria for Body Weight Supported Robotic Gait Training (BWSRGT). Patients completed an intensive 8-week gait-training program comprising robotic gait training (weeks 0-4) followed by manual gait training (weeks 4-8). A change in clinical function was determined by the following assessments taken at 0, 4 and 8 weeks (baseline, mid-point and end-point respectively): Functional Ambulatory Categories (FAC), 10 m Walking Test (10 MWT), and Tinetti Gait and Balance Scales. Results: Over half of the patients made a clinically meaningful improvement on the Tinetti Gait Scale (>3 points) and Tinetti Balance Scale (>5 points), while over 80% of the patients increased at least 1 point on the FAC scale (0-5) and improved walking speed by more than 0.2 m/s. Patients responded positively in gait function regardless of variables gender, age, aetiology (hemorrhagic/ischemic), and affected hemisphere. The most robust and significant change was observed for patients in the FAC categories two and three. The therapy was well tolerated and no patients withdrew for factors related to the type or intensity of training. Conclusions: Eight-weeks of intensive rehabilitation including robotic and manual gait training was well tolerated by early stroke patients, and was associated with significant gains in function. Patients with mid-level gait dysfunction showed the most robust improvement following robotic training