Medio físico y corredores naturales: notas sobre el poblamiento paleolítico del País Valenciano

Aquest treball pretén ser una reflexió sobre les relacions entre el medi físic i el poblament humà del País Valencia anterior a la implantació del neolític (ca. 500.000 - 7.000 BP). A partir de les seues característiques físiques i estructurals, s'analitzen els eixos regionals, comarcals i locals que han pogut vertebrar la comunicació regional i extraregional dels grups cagadors-recol•lectors prehistòrics. Incorporar a aquesta discussió les característiques dels jaciments i els conjunts faunístics associats, permet de valorar les seues variacions diacròniques en retació amb l'ocupació de diferents entorns.This piece of research is intended to be a reflection on the relations between the physical medium and the human settlement in the Valencian Country, previous to the introduction of Neolithic (circa 500.000-7.000 BP). In accordance with their physical and structural features, we analyze the regional, district area and local axes which have made it possible to link the regional and extraregional communication of the groups of prehistoric hunters and gatherers. The addition of the characteristics of the archaeological sites and their associated faunal whole to the present discussion enable us to value their diachronic variations as related to the ocupation of different environmentsEste trabajo pretende ser una reflexión sobre las relaciones entre el medio físico y el poblamiento humano del País Valenciano anterior a la implantación del Neolítico (ca. 500.000 - 7.000 BP). A partir de sus características físicas y estructurales se analizan aquellos ejes regionales, comarcales y locales que han podido vertebrar la comunicación regional y extraregional de los grupos cazadores-recolectores prehistóricos. La incorporación a esta discusión de las características de los yacimientos y de los conjuntos faunísticos asociados, permiten valorar sus variaciones diacrónicas en relación con la ocupación de diferentes entomos

Social Networking and Science Research. The MIT-UPV and Metal 2.0 Cases

The value of social networking for business isn't so clear but in other areas it has been very advanced, as in the world of collaborative research and business at the international level, can affect joint enterprise (enterprise-level) is displayed as shown in the results of the collaboration project Networking between MIT and the UPV (http://mitupv.mit.edu) and UPV and AIMME1 (http://www.metal20.org/). Most of the measurable benefits such as improved collaboration and multimedia documentation are already in place. In terms of all the components of social networking, being on a single platform, we already have that, too, in the form of unified communications (UC). Many experts conclude that the crowdsourcing can be applied to a wide variety of problems, and that it raises numerous interesting technical and social challenges. Given the success of current CS systems, they expect that this emerging field will grow rapidly. In the near future, they foresee three major directions: more generic platforms, more applications and structure, and more users and complex contributions. The networks have a life. They grow, change, reproduce, survive and die. A social network is a kind of super human, with an anatomy and physiology of their own. Social networks can develop a type of intelligence that increases or supplements individual intelligence.Gil Pechuán, I.; Conesa García, MP.; Peris-Ortiz, M. (2012). Social Networking and Science Research. The MIT-UPV and Metal 2.0 Cases. En Advanced Topics in Multimedia Research. InTech. 53-64. doi:10.5772/36052S536

Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly

Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration—half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach

Innovation, Creativity and Entreprenaeurship Learning Outcomes in Higher Education

A major trend in higher education is the current shift towards improving students’ creativity and individual thinking. The aim of this shift is to bring students closer to the real world and the complex problems they will encounter outside formal education. Competencies describe what training participants should be able to do at the end of such training. This paper defines the learning outcomes associated with the innovation, creativity and entrepreneurship competency. This proposal draws on a review of the innovation and competencies literature and the expertise of selected staff. According to the literature review and the following analysis by the authors, the main indicators (key aspects) associated with the competency are as follows: seek opportunities, generate ideas, execute plans and add value. These indicators vary by educational level to reflect increasing complexity and difficulty in the learning outcomes at each stage of university education. This paper proposes learning outcomes and indicators associated with the competencies of innovation, creativity and entrepreneurship. It corresponds to the first essential step associated with the definition of a competency assessment.This research has been partially supported by: Project for educational improvement B019/14. Integrating teamwork and leadership in class, funded by School of Higher Technical Studies in Engineering and Design and the Vice-Rector of Studies, Quality and Accreditation. Project for educational improvement (PIME/2014/A09). Students' perceptions and motivations in the development and assessment of competencies at the UPV, funded by the Escuela Técnica Superior de Ingeniería Industrial, Escuela Técnica Superior de Ingeniería Informática and the Vice-Rector of Studies, Quality and Accreditation. European Union [FINCODA 554493-EPP-1-2014-1-FI-EPPKA2-KA] and Universitat Politècnica de València [PIME/2014/A/013/A - Barómetro INCODE: Evaluación de Competencias de lnnovación en la Empresa y en la Universidad]. (The European Commission’s support for this publication does not constitute an endorsement of its contents, which reflect the views of the authors only. The European Commission cannot be held responsible for any use of the information contained herein). Project for educational improvement (PIME/2013/A/016/B) RECICRE - Rubric for evaluating competence of innovation and Tempus IDEA Inter Disciplinary Education Agenda.Cuenca, L.; Bonet Espinosa, MP.; Boza García, A.; Fuentes-Durá, P.; Lajara-Camilleri, N.; Marín García, JA.; Peris-Ortiz, M.... (2015). Innovation, Creativity and Entreprenaeurship Learning Outcomes in Higher Education. IATED, International Association of Technology, Education and Development. http://hdl.handle.net/10251/7284

The Spanish society of Parenteral and Enteral Nutrition (SENPE) and its relation with healthcare authorities

Está muy bien documentado en la literatura médica que la desnutrición es un problema común en todos los niveles de atención sanitaria, desde atención primaria a especializada y en centros de atención geriátrica. Este problema no se limita a países con pocos recursos económicos o con limitado desarrollo social y económico. También es un problema universal en Europa. La desnutrición aumenta las cifras de morbilidad, mortalidad, ingresos hospitalarios y duración de la estancia. Estas cifras más elevadas suponen lógicamente un aumento del uso de recursos sanitarios. A pesar de esto, el problema de la desnutrición a menudo puede pasar desapercibido y el paciente no recibir el tratamiento necesario. Este problema requiere la cooperación de múltiples agentes tales como los Gobiernos de los Estados, los profesionales de la salud y los mismos ciudadanos. El VIII Foro de Debate concluye con la necesidad de establecer un claro plan de actuación (a semejanza de la European Alliance for Health Nutrition) y la creación de una plataforma (coalición) que reúna las voces de asociaciones de profesionales sanitarios, instituciones, colegios profesionales, asociaciones de pacientes, industria y entidades aseguradoras. Los fines de esta plataforma consistirán en informar de la extensión del problema, identificar y potenciar líderes que transmitan los fines de esta iniciativa ante las autoridades autonómicas y nacionales, propuesta de soluciones y colaboración en su puesta en marcha y finalmente, evaluación/ control de las acciones desarrolladasIt has been well documented in medical literature that hyponutrition is a common issue at all healthcare levels, from primary to specialized health care, as well as geria - tric healthcare facilities. This problem is not limited to countries with scarce economic resources or limited social development; it is also a universal issue in Europe. Hyponutrition increases the rates of morbidity, mortality, hospital admissions, and hospital stay. These higher figures also represent a higher use of healthcare resources. In spite of this, hyponutrition may often go undetected and the patient may not receive the necessary treatment. This problem requires the cooperation of multiple agents such as the Governments, the healthcare professionals, and the citizens themselves. The VIII Discussion Forum concludes on the need to establish a clear-cut plant for action (similar to the European Alliance for Health Nutrition) and the creation of a platform (coalition) encompassing the voices of healthcare professionals associations, institutions, professional colleges, patients associations, the pharmaceutical companies, and insurance companies. The goals of this platform will be to inform about the extent of this issue, to identity and promote leaders that will convey the aims of this initiative to regional and national healthcare authorities, to present solutions and to collaborate in their implementation, and finally to assess/control the actions take

Returning to work in cancer survivors: a multi-center cross-sectional study in Spain

Objetivo: Analizar la situación laboral, así como variables sociodemográficas (edad, sexo, estado civil y titulación) relacionadas con el cáncer (tipo de cáncer, estrategia de tratamiento primario y fase de supervivencia) en supervivientes españoles de cáncer. Método y procedimiento: Estudio transversal sobre una muestra heterogénea de 772 supervivientes de cáncer de inicio en la edad adulta en edad laboral. Se realizaron análisis correlacionales y de regresión logística para estudiar la capacidad predictiva de las variables sociodemográficas y relacionadas con el cáncer sobre la situación laboral y la posible modulación de los resultados por la CVRS evaluada mediante el QLACS. Resultados: Sólo el 55% de los supervivientes de cáncer estaban empleados. La edad, la cualificación y el tipo de cáncer fueron predictores independientes de la situación laboral, así como de la fase de supervivencia en los supervivientes con una CVRS baja. Conclusiones: Un alto porcentaje de supervivientes en edad laboral no vuelve a trabajar tras la experiencia oncológica. Algunas variables sociodemográficas y relacionadas con la enfermedad pueden ayudar a la identificación precoz de la población de riesgo en la que centrar la atención. Objective: To analyze the employment status as well as sociodemographic (age, gender, marital status, and qualification) and cancer-related variables (cancer type, primary treatment strategy, and survival phase) in Spanish cancer survivors. Method and procedure: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. Correlational and logistic regression analyses were performed to study the predictive ability of sociodemographic and cancer-related variables on employment status and the possible modulation of results by HRQOL assessed by the QLACS. Results: Only 55% of cancer survivors were employed. Age, qualification, and type of cancer were independent predictors of employment status as well as the survival phase in survivors with a low HRQOL. Conclusions: A high percentage of working-age survivors do not return to work after the cancer experience. Some sociodemographic and disease-related variables can help in the early identification of the risk population on which to focus attention

Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7-59 months. A matched case-control study

Estudis de control de casos; Pneumònia; Vacunació i immunitzacióEstudios de casos y controles; Neumonía; Vacunación e inmunizaciónCase-control studies; Pneumonia; Vaccination and immunizationBackground The 13-valent pneumococcal conjugate vaccine (PCV13) was licensed based on the results of immunogenicity studies and correlates of protection derived from randomized clinical trials of the 7-valent conjugate pneumococcal vaccine. We assessed the vaccination effectiveness (VE) of the PCV13 in preventing invasive pneumococcal disease (IPD) in children aged 7–59 months in a population with suboptimal vaccination coverage of 55%. Methods The study was carried out in children with IPD admitted to three hospitals in Barcelona (Spain) and controls matched by hospital, age, sex, date of hospitalization and underlying disease. Information on the vaccination status was obtained from written medical records. Conditional logistic regression was made to estimate the adjusted VE and 95% confidence intervals (CI). Results 169 cases and 645 controls were included. The overall VE of ≥1 doses of PCV13 in preventing IPD due to vaccine serotypes was 75.8% (95% CI, 54.1–87.2) and 90% (95% CI, 63.9–97.2) when ≥2 doses before 12 months, two doses on or after 12 months or one dose on or after 24 months, were administered. The VE of ≥1 doses was 89% (95% CI, 42.7–97.9) against serotype 1 and 86.0% (95% CI, 51.2–99.7) against serotype 19A. Serotype 3 showed a non-statistically significant effectiveness (25.9%; 95% CI, -65.3 to 66.8). Conclusions The effectiveness of ≥1 doses of PCV13 in preventing IPD caused by all PCV13 serotypes in children aged 7–59 months was good and, except for serotype 3, the effectiveness of ≥1 doses against the most frequent PCV13 serotypes causing IPD was high when considered individually.This work was supported by the Plan Nacional I+D+I, ISCIII – Subdirección General de Evaluación y Fomento de la Investigación Sanitaria (Projects PI 11/02081, PI 11/2345) and cofounded by Fondo Europeo de Desarrollo Regional (FEDER) and AGAUR (Grant 2014 SGR 1403)

Failures of 13-Valent Conjugated Pneumococcal Vaccine in Age-Appropriately Vaccinated Children 2-59 Months of Age, Spain

Vaccination with the 13-valent conjugated pneumococcal disease (PCV13) has reduced invasive pneumococcal disease (IPD), but there have been reports of vaccine failures. We performed a prospective study in children aged 2-59 months who received diagnoses of IPD during January 2012-June 2016 in 3 pediatric hospitals in Catalonia, Spain, a region with a PCV13 vaccination coverage of 63%. We analyzed patients who had been age-appropriately vaccinated but who developed IPD caused by PCV13 serotypes. We detected 24 vaccine failure cases. The serotypes involved were 3 (16 cases); 19A (5 cases); and 1, 6B, and 14 (1 case each). Cases were associated with children without underlying conditions, with complicated pneumonia (OR 6.65, 95% CI 1.91-23.21), and with diagnosis by PCR (OR 5.18, 95% CI 1.84-14.59). Vaccination coverage should be increased to reduce the circulation of vaccine serotypes. Continuous surveillance of cases of IPD using both culture and PCR to characterize vaccine failures is necessary

Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7-59 months. A matched case-control study

Background The 13-valent pneumococcal conjugate vaccine (PCV13) was licensed based on the results of immunogenicity studies and correlates of protection derived from randomized clinical trials of the 7-valent conjugate pneumococcal vaccine. We assessed the vaccination effectiveness (VE) of the PCV13 in preventing invasive pneumococcal disease (IPD) in children aged 7-59 months in a population with suboptimal vaccination coverage of 55%. Methods The study was carried out in children with IPD admitted to three hospitals in Barcelona (Spain) and controls matched by hospital, age, sex, date of hospitalization and underlying disease. Information on the vaccination status was obtained from written medical records. Conditional logistic regression was made to estimate the adjusted VE and 95% confidence intervals (CI). Results 169 cases and 645 controls were included. The overall VE of ≥1 doses of PCV13 in preventing IPD due to vaccine serotypes was 75.8% (95% CI, 54.1-87.2) and 90% (95% CI, 63.9-97.2) when ≥2 doses before 12 months, two doses on or after 12 months or one dose on or after 24 months, were administered. The VE of ≥1 doses was 89% (95% CI, 42.7-97.9) against serotype 1 and 86.0% (95% CI, 51.2-99.7) against serotype 19A. Serotype 3 showed a non-statistically significant effectiveness (25.9%; 95% CI, -65.3 to 66.8). Conclusions The effectiveness of ≥1 doses of PCV13 in preventing IPD caused by all PCV13 serotypes in children aged 7-59 months was good and, except for serotype 3, the effectiveness of ≥1 doses against the most frequent PCV13 serotypes causing IPD was high when considered individually

Impact of the 13-valent conjugated pneumococcal vaccine on the direct costs of invasive pneumococcal disease requiring hospital admission in children aged < 5 years. A prospective study

The lack of invasive pneumococcal disease (IPD) cost studies may underestimate the effect of pneumococcal polysaccharide conjugated vaccines (PCV). The objective of this study was to estimate the direct costs of hospitalized IPD cases. A prospective study was made in children aged <5 years diagnosed with IPD in two high-tech hospitals in Catalonia (Spain) between 2007-2009 (PCV7 period) and 2012-2015 (PCV13 period). Costs were calculated according to 2014 Catalan Health Service rates using diagnostic-related groups. In total, 319 and 154 cases were collected, respectively. Pneumonia had the highest cost (65.7% and 62.0%, respectively), followed by meningitis (25.8% and 26.1%, respectively). During 2007-2015, the costs associated with PCV7 serotypes (Pearson coeffcient (Pc) = 0.79; p = 0.036) and additional PCV13 serotypes (Pc = 0.75; p = 0.05) decreased, but those of other serotypes did not (Pc = 0.23 p = 0.62). The total mean cost of IPD increased in the PCV13 period by 31.4% (¿3016.1 vs. ¿3963.9), mainly due to ICU stay (77.4%; ¿1051.4 vs. ¿1865.6). During the PCV13 period, direct IPD costs decreased due to a reduction in the number of cases, but cases were more severe and had a higher mean cost. During 2015, IPD costs increased due to an increase in the costs associated with non-PCV13 serotypes and serotype 3 and this requires further investigation