Heparan sulfate proteoglycans undergo differential expression alterations in left sided colorectal cancer, depending on their metastatic character

Abstract Background Heparan sulfate proteoglycans (HSPGs) are complex molecules which play a role in the invasion and growth and metastatic properties of cancerous cells. In this work we analyze changes in the patterns of expression of HSPGs in left sided colorectal cancer (LSCRC), both metastatic and non-metastatic, and the results are also compared with those previously obtained for right sided tumors (RSCRCs). Methods Eighteen LSCRCs were studied using qPCR to analyze the expression of both the proteoglycan core proteins and the enzymes involved in heparan sulfate chain biosynthesis. Certain HSPGs also carry chondroitin sulfate chains and so we also studied the genes involved in its biosynthesis. The expression of certain genes that showed significant expression differences were also analysed using immunohistochemical techniques. Results Changes in proteoglycan core proteins were dependent on their location, and the main differences between metastatic and non-metastatic tumors affected cell-surface glypicans, while other molecules were quite similar. Glypicans were also responsible for the main differences between RS- and LS- malignances. Regarding the biosynthesis of heparan sulfate chains, differential alterations in transcription depending on the presence or not of metastasis affected genes involved in the modification of uronic acid (epimerization and 2-O sulfation), and some isoforms responsible for sulfation of glucosamine (NDST1, HS6ST1). Moreover, in RSCRCs differences were preferentially found in the expression of genes involved in C6 and C3 sulfation of glucosamine, but not in NDSTs or SULFs. Finally, synthesis of chondroitin sulfate showed some alterations, which affected various steps, including polimerization and the modification of chains, but the main variations dependent on the presence of metastases were epimerization and 6C sulfation; however, when compared with RSCRCs, the essential divergences affected polymerization of the chains and the 6C sulfation of the galactosamine residue. Conclusions We evidenced alterations in the expression of HSPGs, including the expression of cell surface core proteins, many glycosiltransferases and some enzymes that modify the GAG chains in LSCRCs, but this was dependent on the metastatic nature of the tumor. Some of these alterations are shared with RSCRCs, while others, focused on specific gene groups, are dependent on tumor localization

Työ- ja päivätoiminnan vaikutukset mielenterveyskuntoutujan vuorokausirytmiin Hoitokoti Reimarissa

Opinnäytetyön tarkoituksena oli selvittää työ- ja päivätoiminnan vaikutuksia asukkaiden vuorokausirytmiin Hoitokoti Reimarissa. Opinnäytetyön ongelmina oli selvittää, minkälaisia vaikutuksia työ- ja päivätoiminnalla on asukkaan nukkumiseen ja valvetilaan, minkälaiseksi asukkaat kokevat oman vuorokausirytminsä ja miten työ- ja päivätoimintaa voitaisiin kehittää, jotta asukkaiden vuorokausirytmi olisi parempi. Opinnäytetyön tavoitteena oli selvittää Hoitokoti Reimarissa tapahtuvan toiminnan vaikutuksia asukkaiden elämään, saada perusteita toiminnalle ja mahdollisuuksia kehittää toimintaa. Valitsimme aiheen yhteistyöllä, koska hoitokoti halusi selvittää työ- ja päivätoiminnan vaikutuksia asukkaiden elämään, ja itseäni kiinnosti vuorokausirytmi. Opinnäytetyön menetelmäksi valittiin määrällinen menetelmä, koska haluttiin saada tietoa suuremmalta joukolta. Aineiston keruu toteutettiin paperisella kyselylomakkeella. Kyselylomakkeella oli yhteensä 12 kysymystä, jotka sisälsivät monivalintakysymyksiä ja muutaman avoimen kysymyksen. Kyselylomakkeen kysymykset laadittiin opinnäytetyön ongelmien perusteella, jotta kysely tuottaisi opinnäytetyön tarkoituksen kannalta haluttuja tuloksia. Opinnäytetyön kohderyhmän muodostivat Hoitokoti Reimarin asukkaat, joita osallistui kyselyyn yhteensä 18. Tulosten mukaan asukkaat osallistuivat aktiivisesti järjestettyyn työ- ja päivätoimintaan, ja sillä koettiin olevan positiivisia vaikutuksia nukkumiseen, valveillaoloon ja vuoro-kausirytmiin. Asukkaat kokivat nukkuvansa työ- ja päivätoimintapäivinä riittävästi, unen laatu oli hyvää ja nukahtaminen helppoa. Työ- ja päivätoimintaan osallistuminen auttoi asukasta pitämään vireystilaa yllä koko loppupäivän. Sen koettiin myös lisäävän liikunnan määrää, säännöllistävän ruokailua ja muuttavan vuorokausirytmiä tasaisemmaksi. Tulosten mukaan asukkaat olivat tyytyväisiä järjestettyyn toimintaan. Kehittämisehdotuksissa mainittiin esimerkiksi, että työtunteja voisi olla enemmänkin, toiminta voisi kohdistua useammin Hoitokoti Reimarin ulkopuolelle ja erilaista liikuntaa toivottiin olevan nykyistä enemmän. Jatkotutkimusehdotus tälle opinnäytetyölle voisi olla opinnäytetyön tekeminen laadullisella eli kvalitatiivisella menetelmällä. Toinen jatkotutkimusehdotus voisi olla saman aiheen tarkasteleminen hoitokodin henkilökunnan näkökulmasta. Jatkotutkimusehdotuksena voisi olla vielä saman kyselyn tekeminen hoitokodin asukkaille esimerkiksi viiden vuoden kuluttua.The purpose of this study was to collect information on how the work and day activity arranged by Hoitokoti Reimari affects the service users’ diurnal rhythm. The problems of this thesis were to find out what kind of effects the work and day activity has on the sleeping and wakefulness of the service users, what kind of the service users regard as their own diurnal rhythm and how the work and day activity could be developed so that the service users’ diurnal rhythm would be better. The objective of this study was to gather information about what kind of impacts the activities arranged by Hoitokoti Reimari have on service users’ living. The topic of this thesis was chosen in cooperation with Hoitokoti Reimari. A quantitative method was chosen as the method of this study to obtain information from a larger group. The data were collected by a paper questionnaire. It included 12 questions, most of them being multiple choice questions but also a few open questions. The questionnaire was made on the basis of the problems of this study so that it would give suitable information relative to the purpose of this study. The target group was those service users who participated in the work and day activity in Hoitokoti Reimari. Altogether 18 service users responded to the questionnaire. According to the results, the service users actively participated in the work and day activities, and it was seen to have positive effects on sleeping, wakefulness and diurnal rhythm. On the days the service users had work and day activities they also slept sufficiently, the quality of the sleep was good and they fell asleep easily. The participation in work and day activities also helped the service users maintain the vitality. It was considered also to increase the amount of exercise, regularize eating habits and balance the diurnal rhythm. The results show that the respondents were content with the work and day activities arranged in Hoitokoti Reimari. To develop the work and day activity the service users suggested for example that there could be even more working hours and exercising than before and the activity could take place outside of Hoitokoti Reimari more often. One suggestion for the further study could be carrying out this same thesis employing qualitative method. It would also be interesting to approach the same topic from the perspective of the nursing home staff. One suggestion for the further study could be carrying out the same thesis for example after five years

Approaching Grief And Death In Family Members Of Patients With Covid-19: Narrative Review

Revisión Narrativa para realizar una síntesis de evidencias y establecer recomendaciones para el acompañamiento y duelo al familiar del paciente COVIDObjetivo: Realizar una síntesis de la evidencia disponible para establecer recomendaciones sobre el abordaje del duelo y la muerte en familiares de pacientes Covid19 así como ofrecer recursos sustitutivos de los rituales y procedimientos necesarios con el fin de favorecer duelos funcionales y prevenir duelos complicados. Método: Se realizó búsqueda bibliográfica en bases de datos MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL y CUIDEN, utilizando términos MeSH, (family, patient, isolation hospitals, grief, death, ceremonial behavior, self care, affects y social networking) con su ecuación boleana correspondiente. Los artículos seleccionados se sometieron a una lectura crítica a través del Critical Apraisal Skill Programme en español (CASPe). Resultados: Se encontraron 560 artículos atingentes, tras aplicar los criterios de selección, 13 estudios se incluyeron en el análisis, de los cuales 8 eran revisiones sistemáticas, 3 estudios cualitativos,1 estudio piloto prospectivo transversal y 1 guía clínica, que permitieron identificar estrategias para el abordaje del duelo y la muerte atendiendo a este momento de excepcionalidad covid19, incidiendo en el manejo competencial de los profesionales sanitarios en apoyo emocional y el acompañamiento así como el seguimiento durante todo el proceso, así como en la comunicación con la familia. Conclusión: En el proceso final de la vida en tiempos de COVID19, los profesionales sanitarios deben trabajar despedidas, los ritos fúnebres alternativos, la atención espiritual y el afrontamiento precoz que permitirán a su vez la prevención del duelo complicad

De la opresión al bienestar. Explorando poder, opresión y bienestar entre inmigrantes marroquíes en España

Durante las últimas décadas, millones de personas han llegado a países de la Unión Europea para mejorar su calidad de vida y la de sus familiares. Las diferentes culturas, mercados y servicios que encuentran en Europa, fomentan en estos nuevos ciudadanos de la Unión Europea expectativas de satisfacción de sus necesidades, reconocimiento justo de sus aportaciones. Sin embargo, frecuentemente los inmigrantes se incorporan a un mercado laboral precario, que les obliga a asentarse en barrios sin acceso a servicios y recursos sociales, fomentando actitudes de rechazo en los vecinos nativos. La incorporación de los inmigrantes se realiza, por tanto, en condiciones asimétricas, que dificultan sus posibilidades para desarrollar su proyecto migratorio. En este contexto, la adaptación de la comunidad inmigrante se configura como uno de los principales desafíos para el presente y futuro de la Unión Europea

Voices as Cues to Children’s Needs for Caregiving

The aim of this study was to explore the role of voices as cues to adults of children’s needs for potential caregiving during early childhood. To this purpose, 74 college students listened to pairs of 5-year-old versus 10-year-old children verbalizing neutral-content sentences and indicated which voice was better associated with each of 14 traits, potentially meaningful in interactions between young children and adults. Results indicated that children with immature voices were perceived more positively and as being more helpless than children with mature voices. Children’s voices, regardless of the content of speech, seem to be a powerful source of information about children’s need for caregiving for parents and others during the frst six years of life.Funding for open access charge: CRUE-Universitat Jaume

Infective endocarditis and cancer in the elderly

Little is known about the magnitude of the association between infective endocarditis and cancer, and about the natural history of cancer patients with concomitant diagnosis of infective endocarditis. We used the SEER-Medicare linked database to identify individuals aged 65 years or more diagnosed with colorectal, lung, breast, or prostate cancer, and without any cancer diagnosis (5 % random Medicare sample from SEER areas) between 1992 and 2009. We identified infective endocarditis from the ICD-9 diagnosis of each admission recorded in the Medpar file and its incidence rate 90 days around cancer diagnosis. We also estimated the overall survival and CRC-specific survival after a concomitant diagnosis of infective endocarditis. The peri-diagnostic incidence of infective endocarditis was 19.8 cases per 100,000 person-months for CRC, 5.7 cases per 100,000 person-months for lung cancer, 1.9 cases per 100,000 person-months for breast cancer, 4.1 cases per 100,000 person-months for prostate cancer and 2.4 cases per 100,000 person-months for individuals without cancer. Two-year overall survival was 46.4 % (95 % CI 39.5, 54.5 %) for stage I–III CRC patients with concomitant endocarditis and 73.1 % (95 % CI 72.9, 73.3 %) for those without it. In this elderly population, the incidence of infective endocarditis around CRC diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers. A concomitant diagnosis of infective endocarditis in patients with CRC diagnosis is associated with shorter survival

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals

The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. Methods. This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient–health professional communication, and the use of Information and Communication Technologies (ICT). Conclusion. The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicin

Evaluation of the DigiCraft program for the development of children’s digital literacy skills

[ES] Mejorar la competencia digital de niños y niñas para fomentar su e-inclusión en la sociedad es el objetivo de diversos programas puestos en marcha en España. El objetivo de esta investigación es evaluar los resultados del programa educativo DigiCraft, dirigido al desarrollo de la competencia digital en la infancia. Para evaluar el nivel de competencia digital se han utilizado dos pruebas diferentes, una para cada uno de los rangos de edad diferenciados (6 a 8 y de 9 a 12 años). Las pruebas han sido aplicadas al inicio del curso académico y al finalizar el mismo, utilizando un diseño experimental pre-pos-test. Los resultados evidencian un avance significativo en el nivel de competencia digital, destacando el área relacionada con la información y alfabetización informacional en los niños y niñas de 6-8 años y el área de resolución de problemas en el periodo de 9-12 años.[EN] Improve children’s digital competence to foster their e-inclusion in the Society is the objective of several programs implemented in Spain. The aim of this research is to evaluate the results of the DigiCraft educational program, aimed the development of children digital competence. To evaluate the level of digital competence acquired by students, two different assessment tests have been used, one for each of the established age ranges (from 6 to 8 and from 9 to 12 years old.). The tests have been carried out at two different times: one at the beginning of the academic year and the other one at the end of it, using a pre-post-test experimental design The results show the progress achieved in the level of digital competence, highlighting the area related to information and information literacy in 6-8 year old and in the area of problem solving in the period of 9-1

Un rapprochement à la réalité des plates-formes virtuelles des universités espagnoles: le premier défi pour un enseignement personnalisé pour les personnes ayant un handicap moteur ou visuel

The starting point to provide a university education-based custom environments online education to people with functional diversity must focus on ensuring the optimal accessibility to your web content and learning resources. At present, most of the universities now have virtual platforms of education, with an important weight for the correct development of their studies and for the optimization of learning of its students. On the other hand, the virtual environments pose a major access point to the possible enrolment in these university students with disabilities. This paper has two objectives. The first of them is to define which are the optimal conditions for web accessibility in the virtual platforms of education and the web sites of universities for people who have visual impairment or motor disabilities, according to international standards. The second objective of this work aims to deliver a brief approximation on the degree of accessibility of the web sites of the Spanish universities for students with these two disabilities. The work follows a descriptive design based on two elements of analysis. On the one hand, the review of studies of accessibility and functional diversity; and on the other hand, the analysis of web accessibility of the web sites of the 78 Spanish universities. It is concluded that there are difficulties of web accessibility and navigation in the virtual environments of the Spanish universities, a situation that, therefore, leads to limitations in the learning from the collective of students with disabilities.El punto de partida para ofrecer una educación universitaria personalizada basada en entornos de educación online a personas con diversidad funcional debe centrarse en garantizar la óptima accesibilidad a su contenido web y a los recursos de aprendizaje. En la actualidad, la mayoría de las universidades disponen de plataformas virtuales de educación, con un importante peso para el correcto desarrollo de sus estudios y para la optimización del aprendizaje de su alumnado. Por otro lado, los entornos virtuales suponen un importante punto de acceso a la posible matriculación en dichas universidades del alumnado con discapacidad. Este trabajo tiene dos objetivos. El primero de ellos consiste en definir cuáles son las condiciones óptimas de accesibilidad web de las plataformas virtuales de educación y de los sitios web de las universidades para personas que presentan discapacidad visual o discapacidad motórica, de acuerdo a los estándares internacionales. El segundo objetivo del trabajo persigue ofrecer una breve aproximación al grado de accesibilidad de los sitios web de las universidades españolas para el alumnado con esas dos discapacidades. El trabajo sigue un diseño descriptivo basado en dos elementos de análisis. Por un lado, la revisión de estudios de accesibilidad y diversidad funcional y, por otro, el análisis de la accesibilidad web de los sitios web de las 78 universidades españolas. Se concluye que existen dificultades de accesibilidad web y navegación en los entornos virtuales de las universidades españolas, situación que, por lo tanto, redunda en limitaciones en el aprendizaje de los colectivos de estudiantes con limitaciones.Le point de départ pour offrir une éducation universitaire personnalisée fondée dans des environnements de l’éducation online à personnes avec diversité fonctionnelle doit viser à assurer l’optimale accessibilité à son contenu Web et aux ressources d’apprentissage. Actuellement, la plupart des universités disposent de plates-formes virtuelles de l’éducation, avec un poids important pour le bon déroulement de leurs études et pour l’optimisation de l’apprentissage des élèves. D’autre part, les environnements virtuels représentent un important point d’accès à l’éventuelle inscription dans ces universités des élèves handicapés. Ce travail a deux objectifs. Le premier d’entre eux est à définir quels sont les conditions optimales d’accessibilité Web des plates-formes virtuels de l’éducation et des sites Web des universités de personnes qui présentent incapacité visuelle ou d’invalidité motrice, conformément aux normes internationales. Le deuxième objectif du travail poursuit offrir un bref rapprochement au degré d’accessibilité des sites Web des universités espagnoles pour les élèves avec ces deux handicaps. Le travail est une conception descriptive fondée sur deux éléments d’analyse. D’une part, la révision des études d’accessibilité et la diversité fonctionnelle; et d’autre part, l’analyse de l’accessibilité Web des sites Web des 78 universités espagnoles. Il est conclu qu’il existe des difficultés d’accessibilité Web et de la navigation dans les environnements virtuels des universités espagnoles, situation qui, par conséquent, sert limitations à l’apprentissage des collectifs d’étudiants handicapés