Distrofia muscular de Duchenne. Perspectivas desde la rehabilitación

La Distrofia Muscular de Duchenne (DMD) es una enfermedad hereditaria de tipo neuromuscular progresiva, que se presenta durante la infancia; afecta aproximadamente 1 de cada 3500 a 6000 niños varones nacidos vivos. El gen DMD que codifica para la distrofina, una proteína estructural del músculo, se localiza en el brazo corto del cromosoma X en la región p21, puede sufrir diferentes mutaciones ocasionando la pérdida parcial o total de la proteína lo que origina la DMD y otras enfermedades relacionadas como la Distrofia Muscular de Becker, que es una distrofia de forma más leve. Esta es una enfermedad discapacitante que se caracteriza por un deterioro progresivo de los músculos, y en las etapas avanzadas de la enfermedad se presentan generalmente complicaciones cardiorespiratorias que son las causas principales que ocasionan la muerte al paciente. Desde el punto de vista de la rehabilitación, cuyo objetivo es retrasar la progresión de la enfermedad, se han venido desarrollado una serie de estrategias de tratamiento y manejo que involucran grupos multidisciplinarios; éstas van desde trabajo en gimnasio con terapeutas para estiramientos hasta prescripción de sillas de ruedas y formulación de ventilación mecánica no invasiva, que si bien se sabe no modifican las bases genéticas de la enfermedad, sí mejoran de forma importante la independencia del paciente, facilitan los cuidados por parte de la familia y los cuidadores y permiten una mejor calidad de vida

Seaweed Biodiversity and Temperature Fluctuations of Calatagan Bay, Verde Island Passage

Changes in seaweed biodiversity reflect ecological changes and management of coastal communities. Calatagan Bay is a tourism, agriculture and aquaculture hotspot fronting the Verde Island Passage, touted to be the global center of marine biodiversity. Detection of stressors through monitoring is the key in the proper management of the area. This study surveyed existing seaweed species of the coast, and contrasted it with reported species in the area together with fluctuations in sea surface temperatures for the past two decades, contrasted with the local knowledge and perspectives of local coast-dwellers. Seaweed along the coast were collected from a representative area of 50 km2 with species identification based on morphology and pigment. Ten species that were previously unreported were found while fourteen previously reported species were no longer observed. Caulerpa, Kappaphycus and Sargassum, all with known market demands, were the dominant genera.  Sea surface temperature data from local weather stations and the NOMADs database indicate significant warming events from June 1998 to present, with peak sea surface temperature at 31.9oC. Focused group discussions with local communities indicate increased incidences of ice-ice disease, and issues with the uncontrolled use of fertilizers of neighboring farms contaminating their coastal fronts

Perceptions and experiences on language anxiety on EEGAFI senior high school students’ English speaking classes: SY 2022-2023

English language is one of the most challenging languages to learn, and students often struggle with it, especially in English-speaking Classes. Additionally, English is widely used throughout the world, which has put second language learners on a difficult path to acquiring excellent communication skills (Lababidi, 2015). In fact, not all students can easily achieve their goals of learning English and follow the language learning process well. In this study, researchers aim to investigate and determine the perceptions and experiences on Language Anxiety of EEGAFI Senior High School Students in English speaking classes. The design selected for this study was quantitative research in natures using interviews. Furthermore, the data has been collected from (n=115) respondents of EEGAFI Senior High School Students. Researchers used simple random sampling method in collecting participants. In this study, it was found out that these five factors (i.e., lack of confidence, poor quality teaching, fear of making mistakes, fear of evaluation, and communication apprehension) are causes of Language Anxiety. In addition, the researchers found that students would feel less anxious when they have lack of confidence and positive thinking, since students selected these as their preferred easing techniques in reducing Language anxiety (see bar graph 1.0). However, students also send some tips on how to reduce language anxiety (see table 1.0)

CONSENSO SOBRE O USO DE PROTEÍNA EM PACIENTES CRÍTICOS – ACNC

The critical patient has a significant loss of muscle mass, frequently observing sarcopenia in these patients. Its presence increases adverse outcomes, hospital stays, increased risk of infections, increased time on mechanical ventilatory assistance, greater disability at hospital discharge, less possibility of return to normal life for patients, increased health costs, and higher mortality. Objective: Indicate the opportune and adequate use of the protein in the critically ill patient. Methods: the Colombian Association of Clinical Nutrition (ACNC) and the Colombian Association of Critical Medicine and Intensive Care (AMCI), using a consensus methodology, made recommendations with a group of experts. Results: 46 recommendations were approved with a consensus greater than 80%. Conclusions: Optimal early and progressive protein intervention in critically ill patients is important to obtain the best clinical outcomes, reduce complications, and have an impact on hospital care costs.El paciente crítico tiene una pérdida de masa muscular significativa, observando frecuentemente sarcopenia en estos pacientes. Su presencia aumenta los desenlaces adversos, estancias hospitalarias, mayor riesgo de infecciones, aumento del tiempo de asistencia ventilatoria mecánica, mayor discapacidad al alta hospitalaria, menor posibilidad del retorno normal a la vida habitual de los pacientes, incremento en gastos en salud y mayor mortalidad. Objetivo: Indicar el uso oportuno y adecuado de la proteína en el paciente crítico. Métodos: la Asociación Colombiana De Nutrición Clínica (ACNC) y la Asociación Colombiana de Medicina Critica y Cuidados Intensivos (AMCI) mediante metodología de consenso realizaron unas recomendaciones con un grupo de expertos. Resultados: 46 recomendaciones fueron aprobadas con consenso superior al 80%. Conclusiones: La intervención óptima proteica temprana y progresiva en el paciente crítico, es importante para obtener los mejores desenlaces clínicos, disminuir complicaciones e impactar en costos de atención hospitalaria. O paciente crítico apresenta perda importante de massa muscular, observando-se frequentemente sarcopenia nesses pacientes. Sua presença aumenta os desfechos adversos, internações hospitalares, aumento do risco de infecções, aumento do tempo de assistência ventilatória mecânica, maior incapacidade na alta hospitalar, menor possibilidade de retorno à vida normal dos pacientes, aumento dos custos de saúde e maior mortalidade. Objetivo: Indicar o uso oportuno e adequado da proteína no paciente crítico. Métodos: a Associação Colombiana de Nutrição Clínica (ACNC) e a Associação Colombiana de Medicina Crítica e Terapia Intensiva (AMCI), utilizando uma metodologia de consenso, fizeram recomendações com um grupo de especialistas. Resultados: 46 recomendações foram aprovadas com consenso superior a 80%. Conclusões: A intervenção proteica precoce e progressiva ideal em pacientes críticos é importante para obter os melhores resultados clínicos, reduzir complicações e impactar nos custos hospitalares

CONSENSO SOBRE EL USO DE PROTEÍNA EN EL PACIENTE CRÍTICO – ACNC

El paciente crítico tiene una pérdida de masa muscular significativa, observando frecuentemente sarcopenia en estos pacientes. Su presencia aumenta los desenlaces adversos, estancias hospitalarias, mayor riesgo de infecciones, aumento del tiempo de asistencia ventilatoria mecánica, mayor discapacidad al alta hospitalaria, menor posibilidad del retorno normal a la vida habitual de los pacientes, incremento en gastos en salud y mayor mortalidad. Objetivo: Indicar el uso oportuno y adecuado de la proteína en el paciente crítico. Métodos: la Asociación Colombiana De Nutrición Clínica (ACNC) y la Asociación Colombiana de Medicina Critica y Cuidados Intensivos (AMCI) mediante metodología de consenso realizaron unas recomendaciones con un grupo de expertos. Resultados: 46 recomendaciones fueron aprobadas con consenso superior al 80%. Conclusiones: La intervención óptima proteica temprana y progresiva en el paciente crítico, es importante para obtener los mejores desenlaces clínicos, disminuir complicaciones e impactar en costos de atención hospitalaria.

Are agriculture and nutrition policies and practice coherent? Stakeholder evidence from Afghanistan

Despite recent improvements in the national average, stunting levels in Afghanistan exceed 70% in some Provinces. Agriculture serves as the main source of livelihood for over half of the population and has the potential to be a strong driver of a reduction in under-nutrition. This article reports research conducted through interviews with stakeholders in agriculture and nutrition in the capital, Kabul, and four provinces of Afghanistan, to gain a better understanding of the institutional and political factors surrounding policy making and the nutrition-sensitivity of agriculture. Semi-structured interviews were conducted with a total of 46 stakeholders from central government and four provinces, including staff from international organizations, NGOs and universities. We found evidence of interdisciplinary communication at the central level and within Provinces, but little evidence of vertical coordination in policy formulation and implementation between the centre and Provinces. Policy formulation and decision making were largely sectoral, top-down, and poorly contextualised. The weaknesses identified in policy formulation, focus, knowledge management, and human and financial resources inhibit the orientation of national agricultural development strategies towards nutrition-sensitivity. Integrating agriculture and nutrition policies requires explicit leadership from the centre. However, effectiveness of a food-based approach to reducing nutrition insecurity will depend on decentralising policy ownership to the regions and provinces through stronger subnational governance. Security and humanitarian considerations point to the need to manage and integrate in a deliberate way the acute humanitarian care and long-term development needs, of which malnutrition is just one element

Whole genome sequencing analysis of Mycobacterium tuberculosis reveals circulating strain types and drug-resistance mutations in the Philippines.

The Philippines is a high-incidence country for tuberculosis, with the increasing prevalence of multi- (MDR-TB) and extensively-drug (XDR-TB) resistant Mycobacterium tuberculosis strains posing difficulties to disease control. Understanding the genetic diversity of circulating strains can provide insights into underlying drug resistance mutations and transmission dynamics, thereby assisting the design of diagnostic tools, including those using next generation sequencing (NGS) platforms. By analysing genome sequencing data of 732 isolates from Philippines drug-resistance survey collections spanning from 2011 to 2019, we found that the majority belonged to lineages L1 (531/732; 72.5%) and L4 (European-American; n = 174; 23.8%), with the Manila strain (L1.2.1.2.1) being the most prominent (475/531). Approximately two-thirds of isolates were found to be at least MDR-TB (483/732; 66.0%), and potential XDR-TB genotypic resistance was observed (3/732; 0.4%), highlighting an emerging problem in the country. Genotypic resistance was highly concordant with laboratory drug susceptibility testing. By finding isolates with (near-)identical genomic variation, five major clusters containing a total of 114 isolates were identified: all containing either L1 or L4 isolates with at least MDR-TB resistance and spanning multiple years of collection. Closer inspection of clusters revealed transmission in prisons, some involving isolates with XDR-TB, and mutations linked to third-line drug bedaquiline. We have also identified previously unreported mutations linked to resistance for isoniazid, rifampicin, ethambutol, and fluoroquinolones. Overall, this study provides important insights into the genetic diversity, transmission and circulating drug resistance mutations of M. tuberculosis in the Philippines, thereby informing clinical and surveillance decision-making, which is increasingly using NGS platforms

Brown rice I love it! an integrated marketing communications campaign for the healthier rice

Rice is a unique commodity for Filipinos. Rice provides as much as 70% of Filipinos daily calorie intake. The poorest spend 15% of their total household expenditure on rice alone. The Philippines however, cannot feed itself, and need to import from other countries. In the past 25 years, the Philippines had been marginally self-sufficient in only seven years. International trade figures reveal that the Philippines is the biggest rice importer in the world, with total exports of about 1.8 million tons of rice in 2007 alone. Recent research thrusts in rice variety development according to the UN-Food and Agriculture Organization (FAO) is on increasing the nutrition found in rice as it is the staple food of more than half of the worlds population. Nutritionists in the Philippines also found out in the latest National Nutrition Survey that many Filipinos are at risk for certain non-communicable diseases due to diet and lifestyle. Increasing rice production and the nutrition level of Filipinos are more than ever relevant in todays society. Unknown to most, the solution is quite simple. Because there is no other food quite life rice for a Filipino, only rice can substitute for rice. This rice is brown rice. Brown rice provides superior health benefits. At the same time, post-harvest research shows that brown rice has as much as 10% higher milling recovery than polished white rice. Computed on national yield levels, the instant increase in Philippine rice production is astounding. By marrying fundamental in Integrated Marketing Communications (IMC), social marketing, and enlightened marketing the campaign will communicate to the target adopters the benefits of shifting to brown rice for better health and at the same time address food security in the long term. The goal is to increase awareness of brown rice as the better rice by encouraging the target adopters to incorporate brown rice in their diets. The campaign is the result of a review of related literature on the concept of social marketing and enlightened marketing, as the umbrella under which IMC belongs research on consumer attitudes and insights on brown rice and an analysis of the current situation

From Research to Practice: Considering Context and the Teacher as Theorist

Language pedagogy has drawn on various disciplines to inform it, one of which is Second Language Acquisition (SLA). However, while considerable developments in SLA have generated more confidence in it, there are still those among SLA researchers who have been reticent in applying results of their research to language pedagogy. Perhaps the problematic relationship between theory and practice and between specialists and teachers need not in principle be oppositional, if we have a greater understanding of the complex nature of the language classroom, as Prabhu has suggested in “The Dynamics of the Language Lesson” (TESOL 1992). In this paper, I expound on two central themes earlier explored by Prabhu, namely the interplay between pedagogic and non-pedagogic dimensions that influences much of what happens in the classroom and the theorizing role teachers have to play if any change aimed at productive learning is to be realized, discussing these issues particularly in relation to SLA studies on interaction to promote L2 learning. In the process, I discuss the implications of the aforementioned points for language teaching, with reference to my teaching context