Relações de Poder em hospitais. Enfermeiros e pais e mães imigrantes

La práctica de la enfermería tiene lugar en el marco de las instituciones sanitarias, siendo la relación interpersonal el eje principal de dicha práctica. En el caso de los inmigrados se pretende proporcionar cuidados culturalmente competentes. Sin embargo, el carácter jerárquico y normativo de los hospitales (instituciones totales) dificulta la relación entre enfermeras y pacientes, máxime cuando estos provienen de otros horizontes culturales. El objetivo de este estudio es explorar las relaciones de poder e identificar las barreras en la relación enfermera-padre/madre inmigrado debido a los condicionantes institucionales del hospital. El estudio, de corte etnográfico, recoge datos a través de los testimonios de los profesionales y de los padres y madres de los niños inmigrados y también mediante observación de los entornos de las prácticas en dos hospitales públicos de tamaño medio de la Comunidad de Madrid. Los resultados muestran que las enfermeras a través del ejercicio del poder institucional establecen con las madres y padres inmigrados relaciones asimétricas favorecidas por la barrera idiomática, los prejuicios y los estereotipos. Para proporcionar cuidados culturalmente competentes, es necesario superar las barreras institucionales y personales y establecer relaciones dialógicas, que permitan flexibilizar e individualizar los cuidados, evitando el etnocentrismo.The practice of nursing takes place in the context of healthcare institutions, being the interpersonal relationship the backbone of the practice. In the case of immigrants the goal is to provide culturally competent care. However, the hierarchical and normative hospitals (total institutions) make the relationship between nurses and patients difficult, especially when they come from other cultural backgrounds. The objective of this study is to explore the power relations and to identify barriers in the relationship between nurses- immigrant fathers/mothers due to institutional constraints of the hospital. The ethnographic study collected data through the testimonies of the professionals and the parents of immigrant children and also by observing the practice environments in two public hospitals of average size of the Community of Madrid. The results show that nurses, through the exercise of institutional power, establish with immigrant parents asymmetrical relationships favored by language barriers, prejudice and stereotypes. To provide culturally competent care, you need to overcome institutional and personal barriers and establish dialogic relationships that allow flexible and individualized care, avoiding ethnocentrism.A prática de enfermagem tem lugar no contexto das instituições de saúde, com o relacionamento interpessoal o principal foco da prática. No caso dos imigrantes a meta é a prestação de cuidados culturalmente competente. No entanto, os hospitais hierárquicos e normativos (instituições totais) faz com que a relação entre enfermeiros e pacientes, especialmente quando eles vêm de outras origens culturais. O objetivo deste estudo é explorar as relações de poder e identificar barreiras no relacionamento enfermera-padre/madre imigraram devido a restrições institucionais do hospital. Estudo etnográfico, os dados coletados através do testemunho dos profissionais e os pais de filhos de imigrantes e também observando os ambientes favoráveis à prática em dois hospitais públicos de tamanho médio da Comunidade de Madrid. Os resultados mostram que os enfermeiros, através do exercício do poder institucional, estabelecida com mães imigrantes e pais de relações assimétricas, favorecidos por barreiras linguísticas, preconceitos e estereótipos. Para prover um cuidado culturalmente competente, é preciso superar as barreiras institucionais e pessoais e estabelecer relações dialógicas que permitem atendimento flexível e individualizado, evitando o etnocentrismo

Diseño y desarrollo de un laboratorio virtual de aplicaciones industriales con láser

El objetivo de este trabajo es el diseño y desarrollo de un laboratorio virtual de aplicaciones industriales de los láseres de potencia. La posibilidad de utilizar modelos de simulación con una determinada gestión del conocimiento para facilitar la realización de experimentos prácticos en asignaturas relacionadas con las aplicaciones industriales del láser, así como para el adiestramiento del cuadro técnico de estos sistemas puede ser muy ventajoso con vistas a la reducción del tiempo, recursos y coste del entrenamiento. Si estos modelos son accesibles a través de internet la ventaja se multiplica, ya que esta característica flexibiliza el procedimiento de aprendizaje al eliminar las restricciones espacio-temporales del proceso de instrucción haciendo posible y facilitando su uso tanto en asignaturas de titulaciones oficiales de impartidas en la ETSII-UPM como en la colaboración en la formación técnica entre organizaciones punteras del área de la tecnología láser de diferentes países

Vapor-liquid interfacial properties of rigid-linear Lennard-Jones chains

We have obtained the interfacial properties of short rigid-linear chains formed from tangentially bonded Lennard-Jones monomeric units from direct simulation of the vapour-liquid interface. The full long-range tails of the potential are accounted for by means of an improved version of the inhomogeneous long-range corrections of Janecek [J. Phys. Chem. B 110, 6264–6269 (2006)] proposed recently by MacDowell and Blas [J. Chem. Phys. 131, 074705 (2009)] valid for spherical as well as for rigid and flexible molecular systems. Three different model systems comprising of 3, 4, and 5 monomers per molecule are considered. The simulations are performed in the canonical ensemble, and the vapor-liquid interfacial tension is evaluated using the test-area method. In addition to the sur- face tension, we also obtain density profiles, coexistence densities, critical temperature and density, and interfacial thickness as functions of temperature, paying particular attention to the effect of the chain length and rigidity on these properties. According to our results, the main effect of increasing the chain length (at fixed temperature) is to sharpen the vapor-liquid interface and to increase the width of the biphasic coexistence region. As a result, the interfacial thickness decreases and the sur- face tension increases as the molecular chains get longer. The surface tension has been scaled by critical properties and represented as a function of the difference between coexistence densities relative to the critical density.The authors would like to acknowledge helpful discus- sions with F. J. Martínez-Ruiz, E. de Miguel, C. Vega, and A. Galindo. This work was supported by Ministerio de Ciencia e Innovación (MICINN, Spain) through Grant Nos. FIS2010- 14866 (F.J.B.), FIS2009-07923 (J.M.M. and M.M.P.) and FIS2010-22047-C05-05 (L.G.M.D.). J.M.M. also acknowledges Ministerio de Ciencia e Innovación for the FPU Grant with reference AP2007-02172. Further financial support from Proyecto de Excelencia from Junta de Andalucía (Grant No. P07-FQM02884), Consellería de Educacion e Ordenacion Universitaria (Xunta de Galicia), Comunidad Autónoma de Madrid (Grant No. MODELICO-P2009/EPS-1691), and Universidad de Huelva are also acknowledged

Factors influencing the progression of primary angular closure following Laser peripheral iridotomy

Introducción: los efectos de la iridotomía periférica láser están demostrados, sin embargo, no siempre logra controlar la presión intraocular ni la progresión de la enfermedad por cierre angular primario.Objetivo: analizar los factores que influyen en la progresión de la enfermedad por cierre angular primario de pacientes pinareños tratados con iridotomía periférica láser.Método: se realizó un estudio analítico de cohorte retrospectivo en el servicio de Oftalmología del Hospital General Docente Abel Santamaría, de Pinar del Río, durante el año 2019. El universo estuvo constituido por pacientes con diagnóstico de enfermedad por cierre angular primario tratados con iridotomía periférica láser. La muestra final quedó integrada por 223 ojos de 123 pacientes. El análisis estadístico se realizó con el programa SPSS.Resultados: el 20,6 % de la muestra experimentó progresión de la enfermedad, lo que se relacionó de forma significativa con la forma clínica (p<0,001), la edad (p=0,012), la amplitud de la cámara anterior (p<0,001), el cierre angular residual (p<0,001), la presión intraocular (p<0,001) y la medicación hipotensora (p<0,001). No arrojó diferencias significativas el sexo (p=0,427), el color de la piel (p=0,741) y la longitud axial (p=0,549).Conclusión: los factores que influyen en la progresión de la enfermedad por cierre angular primario de los pacientes pinareños tratados con iridotomía periférica láser estudiados fueron la forma clínica, menor amplitud de la cámara anterior, presencia de cierre angular residual y presión intraocular superior a 18 mmHg con uso de mayor número de colirios hipotensores oculares.ABSTRACTIntroduction: the effects of Laser peripheral iridotomy have been demonstrated; however it does not always manage to control intraocular pressure or the progression of the disease by primary angular closure.Objective: to analyze the factors influencing the disease progression by primary angular closure in Pinar del Rio patients treated with Laser peripheral iridotomy.Methods: a retrospective analytical cohort study was carried out in the Ophthalmology Service at Abel Santamaria Cuadrado General Teaching Hospital in Pinar del Río, during 2019. The target group comprised the patients diagnosed with primary angular closure disease treated with Laser peripheral iridotomy and the final sample consisted of 223 eyes from 123 patients. The statistical analysis was performed with the SPSS program.Results: of the sample (20.6%) experienced disease progression, which was significantly related to the clinical form (p<0.001), age (p=0.012), anterior chamber amplitude (p<0.001), residual angular closure (p<0.001), intraocular pressure (p<0.001) and hypotensive medication (p<0.001). Sex (p=0.427), skin color (p=0.741) and axial length (p=0.549) did not show significant differences.Conclusions: factors influencing on the progression of the disease by primary angular closure in Pinar del Rio patients who were treated with Laser peripheral iridotomy were: the clinical form, lower anterior chamber amplitude, presence of residual angular closure and intraocular pressure higher than 18 mmHg with the use of more ocular hypotensive eye drops.

Epidemiología del cierre angular primario en Pinar del Río

Introduction: the clinic behavior of primary angular closure can range from suspected disease to advanced stages of glaucomatous damage, which can lead to blindness.Objective: to describe the epidemiology of primary angular closure in Pinar del Río patients by identifying the socio-demographic and ocular variables that determine its clinical type.Methods: a cross-sectional descriptive study was performed in Pinar del Río from 2013 to 2017. The target group consisted of 293 new cases with a diagnosis of primary angular closure in any of its clinical types. The statistical analysis was performed with the SPSS program.Results: mean age was 57.69 ± 7.35 years; women predominated (89.5 %) and 77.2 % evidenced a stressful situation. The average values of axial length and anterior chamber width were 21.89 ± 0.49 mm and 2.65 ± 0.27 mm. 87.03 % of the eyes showed a narrow angle. The mean basal intraocular pressure was 23.86 ± 5.81. When analyzing the socio-demographic and ocular variables in relation to the clinical type, it was found that the factors that determine its onset were: age (p<0.001), angular amplitude (p<0.001), peripheral anterior synechia (p<0.001) and intraocular pressure (p<0.001). Linear regression analysis confirmed these results.Conclusion: primary angular closure is common in middle-aged women under stress; with small eyes, camerular angle and narrow anterior chamber. Age, angular amplitude, peripheral anterior synechiae, and basal intraocular pressure determine the clinical type of the disease.Introducción: la clínica del cierre angular primario puede variar desde una sospecha de la enfermedad hasta estadios avanzados del daño glaucomatoso, lo que puede provocar ceguera.Objetivo: describir la epidemiología del cierre angular primario en pacientes pinareños, una vez identificadas las variables sociodemográficas y oculares que determinan su forma clínica.Métodos: se realizó un estudio descriptivo transversal en Pinar del Río, en los años 2013 y 2017, el universo estuvo constituidos por 293 casos nuevos con diagnóstico de cierre angular primario en cualquiera de sus formas clínicas. El análisis estadístico se realizó con el programa SPSS.Resultados: la edad media fue 57,69 ± 7,35 años; predominaron las mujeres (89,5 %) y el 77,2 % evidenció una situación de estrés. Los valores promedio de longitud axial y amplitud de cámara anterior fueron 21,89 ± 0,49 mm y 2,65 ± 0,27 mm. El 87,03 % de los ojos mostró ángulo estrecho. La media de la presión intraocular basal fue de 23,86 ± 5,81. Al analizar las variables sociodemográficas y oculares en relación a la forma clínica, se encontró que los factores que la determinan fueron: edad (p<0,001), amplitud angular (p<0,001), sinequias anteriores periféricas (p<0,001) y presión intraocular (p<0,001). El análisis de regresión lineal confirmó estos resultados.Conclusión: el cierre angular primario es frecuente en mujeres de mediana edad sometidas a estrés; con ojos pequeños, ángulo camerular y cámara anterior estrecha. La edad, amplitud angular, sinequias anteriores periféricas y presión intraocular basal, determinan la forma clínica de la enfermedad

Influence analysis on discriminant coordinates

Discriminant analysis (DA), particularly Discriminant Coordinates (DC), is broadly applied in the scientific literature and included in many statistical software packages. DC is used to analyze biomedical data, especially for differential diagnosis on the basis of laboratory profiles. Papers handling influence analysis in DA can be found in the literature; however this topic has been scarcely touched upon in DC. In this paper the case-deletion approach is followed to introduce a perturbation in the data and influence measures are proposed to assess the effect on three statistics of interest: the transformation matrix, canonical directions and configuration of the sample centroids.Ministerio de Ciencia y Tecnologí

El sesgo condicionado en el análisis de influencia: una revisión

El sesgo condicionado se ha propuesto como diagnóstico de influencia en distintos modelos y tecnicas estadísticas. Tratando de recoger una visión global de la utilidad del concepto, en este trabajo se hace una revisión general del mismo relacionandolo con la curva de sensibilidad y la curva de influencia muestral. Además, se señalan posibles líneas de trabajo que permitiran abordar el análisis de la influencia a través de este enfoque en una gran variedad de tecnicas estadísticas

Soft Tissue Extramedullary Plasmacytoma

We present the uncommon case of a subcutaneous fascia-based extramedullary plasmacytoma in the leg, which was confirmed by the pathology report and followed up until its remission. We report the differential diagnosis with other more common soft tissue masses. Imaging findings are nonspecific but are important to determine the tumour extension and to plan the biopsy

A Review of the Commercial Uses of Sulphate Minerals from the Titanium Dioxide Pigment Industry: The Case of Huelva (Spain)

This study was focused on the historical evolution of the waste management policy carried out by the Spanish industry devoted to titanium dioxide pigments manufacturing for minimising its environmental impact. This challenge was achieved by modifying the original chemical process and converting the originally dissolved sulphate and sulphuric acid present in the final streams of the factory into sulphate minerals (melanterite FeSO4 7H2O, szomolnokite FeSO4 H2O, and gypsum CaSO4 2H2O). These by-products were physicochemically, mineralogically and radiologically characterised in order to gain basic information for its subsequent commercial use. Some of the uses summarised in this study for both ferrous sulphates are as a supplier of iron to prevent chlorosis, animal food, manufacture of cement (to reduce Cr VI), primary flocculants for ferrous sulphates, magnetite nanoparticle and nano-Fe2O3 formation, production of magnetite concentrate, remediation of polluted soils with metals, and treatment of wastewaters. Red gypsum was analysed as a substitute for natural gypsum in the manufacture of cement, construction materials, inhibitor in soil erosion, and the immobilisation of heavy metals in agricultural soils and carbonation processes.This research was partially supported by the Spanish Government Department of Science and Technology (MINECO) through the project "Fluxes of Radionuclides Emitted by the Phosphogypsum Piles Located at Huelva; Assessment of the Dispersion, Radiological Risks and Remediation Proposals" (Ref. CTM, 2015-68628-R)), the Regional Government of Andalusia project called "Basic processes regulating the fractionations and enrichments of natural radionuclides under acid mine drainage conditions" (Ref.: UHU-1255876), and the University of Cadiz project called "New methodogy of radioisotope isolation with environmental interest for its measurement by alpha spectrometry" (Ref: PR2019-024). Documen

Differential action of pateamine A on translation of genomic and subgenomic mRNAs from Sindbis virus

© 2015 Elsevier Inc. Pateamine A (Pat A) is a natural marine product that interacts specifically with the translation initiation factor eIF4A leading to the disruption of the eIF4F complex. In the present study, we have examined the activity of Pat A on the translation of Sindbis virus (SINV) mRNAs. Translation of genomic mRNA is strongly suppressed by Pat A, as shown by the reduction of nsP1 or nsP2 synthesis. Notably, protein synthesis directed by subgenomic mRNA is resistant to Pat A inhibition when the compound is added at late times following infection; however, subgenomic mRNA is sensitive to Pat A in transfected cells or in cell free systems, indicating that this viral mRNA exhibits a dual mechanism of translation. A detailed kinetic analysis of Pat A inhibition in SINV-infected cells demonstrates that a switch occurs approximately 4. h after infection, rendering subgenomic mRNA translation more resistant to Pat A inhibition.DGICYT(Dirección General de Investigación Científica yTécnica.Ministerio de Economía y Competitividad,Spain)grant(BFU2012-31861).The Institutional Grant awarded to theCentro de Biología Molecular “SeveroOchoa” (CSIC-UAM)by The Fundación Ramón ArecesPeer Reviewe