Recreación educativa en la escuela : desde la actividad física hacia el fortalecimiento de la convivencia escolar

Esta investigación presenta una propuesta para la comprensión de la recreación educativa y su relación con la convivencia en las escuelas. La propuesta se desarrolló a partir de un proceso de evaluación realizada a un programa gubernamental chileno, ejecutado desde el año 2017 en 371 escuelas a lo largo del país. Esta evaluación implicó una revisión bibliográfica, la aplicación de encuestas a sus participantes y una aproximación cualitativa con estudio de casos múltiple en tres escuelas. Si bien el programa comenzó con una orientación que enfatizó la actividad física como espacio de recreación y promotor de salud, los resultados sugieren avanzar hacia una concepción de recreación educativa que tiene implicaciones no sólo sobre la salud integral de los estudiantes sino también en el fortalecimiento de procesos sociales transversales en la comunidad educativa como son los relacionados con el despliegue de una convivencia inclusiva, democrática y pacífica en las escuelas.This study presents a proposal for comprehension of educational recreation and its relationship with school climate. The proposal was developed based on an evaluation carried out in a Chilean government program which is in place since 2017 in 371 schools throughout the country. The evaluation involved a literature review, the administration of surveys to its participants and a qualitative approach with multiple case studies in three schools. Although the program began with an orientation that emphasized physical activity as a recreational space and a promoter of health, findings suggest moving towards a conception of educational recreation that has implications not only about the integral health of the students but also in the strengthening of transversal social processes in the educational community, such as those related to the deployment of an inclusive, democratic and peaceful school climate

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Recreación educativa en la escuela : desde la actividad física hacia el fortalecimiento de la convivencia escolar

Esta investigación presenta una propuesta para la comprensión de la recreación educativa y su relación con la convivencia en las escuelas. La propuesta se desarrolló a partir de un proceso de evaluación realizada a un programa gubernamental chileno, ejecutado desde el año 2017 en 371 escuelas a lo largo del país. Esta evaluación implicó una revisión bibliográfica, la aplicación de encuestas a sus participantes y una aproximación cualitativa con estudio de casos múltiple en tres escuelas. Si bien el programa comenzó con una orientación que enfatizó la actividad física como espacio de recreación y promotor de salud, los resultados sugieren avanzar hacia una concepción de recreación educativa que tiene implicaciones no sólo sobre la salud integral de los estudiantes sino también en el fortalecimiento de procesos sociales transversales en la comunidad educativa como son los relacionados con el despliegue de una convivencia inclusiva, democrática y pacífica en las escuelas.This study presents a proposal for comprehension of educational recreation and its relationship with school climate. The proposal was developed based on an evaluation carried out in a Chilean government program which is in place since 2017 in 371 schools throughout the country. The evaluation involved a literature review, the administration of surveys to its participants and a qualitative approach with multiple case studies in three schools. Although the program began with an orientation that emphasized physical activity as a recreational space and a promoter of health, findings suggest moving towards a conception of educational recreation that has implications not only about the integral health of the students but also in the strengthening of transversal social processes in the educational community, such as those related to the deployment of an inclusive, democratic and peaceful school climate