Experiencia de padres y madres comitentes en la maternidad subrogada: un abordaje cualitativo

Trabajo fin de grado en EnfermeríaIntroducción: La maternidad subrogada se está convirtiendo en una de las técnicas de reproducción humana asistida más elegidas en los últimos tiempos. Esta práctica va acompañada de problemas legales, además de dilemas éticos, económicos y personales, siendo los más sensibles la explotación de la mujer, la mercantilización de los niños y de la maternidad. Sin contar con que existen también complicaciones biológicas y psicológicas derivadas de este tipo de maternidad para las gestantes. Todo esto hace que sea necesario analizar en profundidad el proceso. Objetivo: Conocer la experiencia de las personas que emplean la maternidad subrogada para formar una familia. Metodología: Estudio cualitativo dentro del marco teórico del interaccionismo simbólico. La muestra estará formada por personas que hayan utilizado la subrogación en la Comunidad de Madrid. La recogida de datos se hará mediante historias de vida. Se realizarán entrevistas en profundidad grabadas en sistema de audio y, posteriormente, transcriptas para su análisis. El análisis de los datos se realizará siguiendo las fases propuestas por Taylor y Bogdan. Conclusión: La investigación permitirá conocer en profundidad este fenómeno tan controvertido que es cada vez más empleado. Permitiendo desde el ámbito enfermero un abordaje mucho más individualizado y eficaz de estas familias.Introduction: Surrogate motherhood is an assisted reproductive technology that is becoming one of the most chosen options in the recent years. This practice is accompanied by legal problems, as well as a large number of ethical, financial and personal dilemmas, the most important are the exploitation of women, child trafficking and motherhood, not to mention that there are also biological and psychological complications for surrogates arising from surrogacy. All this makes it necessary to analyze the process in depth. Main objective: Know the experience of people who use surrogacy to start a family. Methodology: Qualitative study within the theorical framework of Symbolic Interactionism. The sample will consist of people who have used surrogacy in the Community of Madrid. Data collection will be done through life stories. In-depth interviews will be recorded by an audio device, and then transcribed for analysis. The data analysis will be carried out following the phases proposed by Taylor and Bogdan. Conclusions: this research will allow us to learn in depth about this controversial phenomenon that is increasingly used. Allowing from the nursing field a much more individualized and effective approach to these families

Incidencia del estado hídrico en el perfil proteico del hollejo de bayas cv. Tempranillo

Comunicaciones a congreso

Influencia de adición de ceniza volante de mazorca de maíz en propiedades físicas y mecánicas del concreto 210 kg/cm2, 2023

La presente investigación tomo como objetivo principal de evaluar de qué manera influye la adición de ceniza volante de mazorca de maíz en propiedades físicas y mecánicas del concreto 210 kg/cm2, 2023. Además, este estudio fue de tipo básico de laboratorio, con un nivel predictivo o experimental, diseño cuasiexperimental, teniendo así un enfoque cuantitativo y un método deductivo. Por otro lado, su población estuvo representada por 45 probetas de concreto para los diferentes ensayos de resistencia y 15 ensayos de trabajabilidad. De igual forma, se empleó los instrumentos, ficha para ensayo de resistencia a la compresión y asentamiento. Ante ello los resultados obtenidos la adición de ceniza volante tiene un muy bajo incremento respecto a la resistencia de igual manera para el asentamiento con 114.3 mm lo que nos indica que la mezcla es trabajable

Evaluation of the Tobbstop Mobile App for Smoking Cessation: Cluster Randomized Controlled Clinical Trial

Mobile application; Primary public health; Tobacco smoking cessationAplicación móvil; Atención primaria de salud pública; Dejar de fumar tabacoAplicació mòbil; Salut pública primària; Cessament del consum de tabacBackground: Mobile apps provide an accessible way to test new health-related methodologies. Tobacco is still the primary preventable cause of death in industrialized countries, constituting an important public health issue. New technologies provide novel opportunities that are effective in the cessation of smoking tobacco. Objective: This paper aims to evaluate the efficacy and usage of a mobile app for assisting adult smokers to quit smoking. Methods: We conducted a cluster randomized clinical trial. We included smokers older than 18 years who were motivated to stop smoking and used a mobile phone compatible with our mobile app. We carried out follow-up visits at 15, 30, and 45 days, and at 2, 3, 6, and 12 months. Participants of the intervention group had access to the Tobbstop mobile app designed by the research team. The primary outcomes were continuous smoking abstinence at 3 and 12 months. Results: A total of 773 participants were included in the trial, of which 602 (77.9%) began the study on their D-Day. Of participants in the intervention group, 34.15% (97/284) did not use the app. The continuous abstention level was significantly larger in the intervention group participants who used the app than in those who did not use the app at both 3 months (72/187, 38.5% vs 13/97, 13.4%; P<.001) and 12 months (39/187, 20.9% vs 8/97, 8.25%; P=.01). Participants in the intervention group who used the app regularly and correctly had a higher probability of not being smokers at 12 months (OR 7.20, 95% CI 2.14-24.20; P=.001) than the participants of the CG. Conclusions: Regular use of an app for smoking cessation is effective in comparison with standard clinical practice

Impact of the “Law on promotion of personal autonomy and care for people dependent” in population with severe mental disorder

Law 39/2006, known as Dependence Law, has generated skepticism since its approval, for being focused on dependancy and barely promoting personal autonomy, treating it as a secondary issue. As it relates to people with severe mental disorder, a major concern to mental health professional organizations and family associations has been the compatibility of the law with the services provided by the National health service and whether the established selection criteria for qualifying for the service fits the needs of this group. This article reflects the work done across several Spanish autonomous regions by different professionals in an attempt to convince the administration to make the necessary adjustment to suit the characteristics of people with serious mental disorders. After discussing its strengths and weaknesses, it outlines three different ways to offset their risks in three different regions, Extremadura, Andalucia and Madrid. Finally it addresses the key aspects of the law which need to be worked on, in order to become a benefit for people with severe mental disorder, and not a barrierLa Ley 39/2006, conocida como Ley de Dependencia, ha generado, desde su aprobación, desconfianza por estar enfocada a la atención a la dependencia, siendo la promoción de la autonomía personal un elemento apenas desarrollado y secundario. En el caso de las personas con trastorno mental grave, lo que mayor preocupación ha causado a las organizaciones de profesionales de la salud mental y a las asociaciones de familiares ha sido la compatibilidad de dicha Ley con las prestaciones del Sistema Nacional de Salud y si el baremo establecido se ajustaba a las necesidades de este colectivo. Este artículo recoge el trabajo realizado desde diferentes comunidades autónomas por diferentes profesionales en un intento de, tras un análisis de la Ley, plantear a la administración responsable de la misma el necesario ajuste para adaptarla a las características de las personas con trastorno mental grave. Se analizan, en primer lugar, sus fortalezas y debilidades. Posteriormente se exponen tres formas diferentes de contrarrestar sus riesgos, en tres comunidades autónomas diferentes, Extremadura, Andalucía y Madrid. Finalmente se dan las claves de los aspectos de la Ley sobre los que hay que seguir trabajando para que sea una oportunidad para las personas con trastorno mental grave, y no una barrer

Antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) implies a more severe disease with more damage accrual and higher mortality

Introduction: Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in systemic lupus erythematosus(SLE) patients. Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS). Materials and methods: Patients from the RELESSER-T registry were included. RELESSER-T is a Spanish multicenter, hospital-based, retrospective, SLE registry. Results: We included 2398 SLE patients, 1372 of whom were positive for aPL. Overall 1026 patients were classified as SLE, 555 as SLE-APS and817 as SLE-aPL. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than those with SLE-aPL and SLE (p < 0.001). SLE-APS patients showed higher rates of neuropsychiatric, cardiac, pulmonary, renal and ophthalmological manifestations than the other groups (p < 0.001). SLE-APS patients presented greater damage accrual with higher SLICC values (1.9 ± 2.2 in SLE-APS, 0.9 ± 1.4 in SLE-aPL and 1.1 ± 1.6 in SLE, p < 0.001) and more severe disease as defined by the Katz index (3 ± 1.8 in SLE-APS, 2.7 ± 1.7 in SLE-aPL and 2.6 ± 1.6 in SLE, p < 0.001). SLE-APS patients showed higher mortality rates (p < 0.001). Conclusions: SLE-APS patients exhibited more severe clinical profiles with higher frequencies of major organ involvement, greater damage accrual and higher mortality than SLE-aPL and SLE patients.Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: FIS Grant PI11/02857 (Instituto Carlos III, Fondos FEDER) has supported this work. The RELESSER Registry was funded by grants from GSK, Roche, UCB, Lilly and Novartis. The board of Doctor Negrın University Hospital of Gran Canaria approved the protocol. RD 1720. Acknowledgements: Spanish Society of Rheumatology for their contribution in manuscript language editing

A Cultural Heritage Application Schema: Achieving Interoperability of Cultural Heritage Data in INSPIRE

Cultural Heritage is a group of resources identified as a reflection of certain val-ues, beliefs, knowledge and tradition by a certain community. These resources are subject to management, preservation and diffusion through legislative and administrative means, which makes cultural heritage fall within the scope of Protected sites, one of the spatial data themes established in Annex I of the INSPIRE Directive. The INSPIRE Data Specification on Protected Sites thus serves as the starting point for modelling cultural heritage information in order to implement, distribute and share it in an interoperable framework based on Spatial Data Infrastructures. Unfortunately, this data specification was primarily conceived for natural protected sites, which makes an extension necessary if it is to be applied to cultural features. This paper proposes an extension composed of three parts: one devoted to administrative information —including legal protection—, another describes the feature itself, and, a third part is dedicated to the inclusion of additional documentation (texts, images, etc.)

Incidence, associated factors and clinical impact of severe infections in a large, multicentric cohort of patients with systemic lupus erythematosus

OBJECTIVES: To estimate the incidence of severe infection and investigate the associated factors and clinical impact in a large systemic lupus erythematosus (SLE) retrospective cohort. METHODS: All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet ?4 ACR-97 SLE criteria were retrospectively investigated for severe infections. Patients with and without infections were compared in terms of SLE severity, damage, comorbidities, and demographic characteristics. A multivariable Cox regression model was built to calculate hazard ratios (HRs) for the first infection. RESULTS: A total of 3658 SLE patients were included: 90% female, median age 32.9 years (DQ 9.7), and mean follow-up (months) 120.2 (±87.6). A total of 705 (19.3%) patients suffered ?1 severe infection. Total severe infections recorded in these patients numbered 1227. The incidence rate was 29.2 (95% CI: 27.6-30.9) infections per 1000 patient years. Time from first infection to second infection was significantly shorter than time from diagnosis to first infection (p < 0.000). Although respiratory infections were the most common (35.5%), bloodstream infections were the most frequent cause of mortality by infection (42.0%). In the Cox regression analysis, the following were all associated with infection: age at diagnosis (HR = 1.016, 95% CI: 1.009-1.023), Latin-American (Amerindian-Mestizo) ethnicity (HR = 2.151, 95% CI: 1.539-3.005), corticosteroids (?10mg/day) (HR = 1.271, 95% CI: 1.034-1.561), immunosuppressors (HR = 1.348, 95% CI: 1.079-1.684), hospitalization by SLE (HR = 2.567, 95% CI: 1.905-3.459), Katz severity index (HR = 1.160, 95% CI: 1.105-1.217), SLICC/ACR damage index (HR = 1.069, 95% CI: 1.031-1.108), and smoking (HR = 1.332, 95% CI: 1.121-1.583). Duration of antimalarial use (months) proved protective (HR = 0.998, 95% CI: 0.997-0.999). CONCLUSIONS: Severe infection constitutes a predictor of poor prognosis in SLE patients, is more common in Latin-Americans and is associated with age, previous infection, and smoking. Antimalarials exerted a protective effect.Spanish Foundation of Rheumatology. FIS/ISCIII (grant number PI11/02857). Dr. Pego-Reigosa is supported by Grant 316265 (BIOCAPS) from the European Union 7th Framework Programme (FP7/REGPOT-2012–2013.1)

Hormonal dependence and cancer in Systemic Lupus Erythematosus

Objective: To estimate the incidence and analyze any cancer-associated factors in patients with systemic lupus erythematosus (SLE), differentiating between hormone-sensitive (HS) and non-HS cancers. Methods: This was a retrospective multicenter study of a patient cohort from the Systemic Lupus Erythematosus Registry of the Spanish Society of Rheumatology. Included were the first cancer post-SLE diagnosis, clinical and sociodemographic information, cumulative damage, severity, comorbidities, treatments, and refractoriness. Cancers were classified as HS (prostate, breast, endometrium, and ovarian) and non-HS (the remainder). The standardized incidence ratio (SIR) was calculated and logistic regression models were built. Results: A total of 3,539 patients (90.4% women) were included, 154 of whom had cancer (91% female), and 44 had HS cancer (100% female). The cancer SIR was 1.37 (95% confidence interval [95% CI] 1.15-1.59), with higher values in women age <65 years (SIR 2.38 [95% CI 1.84-2.91]). The SIR in women with HS versus non-HS cancer was 1.02 (95% CI 0.13-1.91) and 1.93 (95% CI 0.98-2.89). In HS versus non-HS cancers, SLE diagnostic age (odds ratio [OR] 1.04 [P = 0.002] versus 1.04 [P = 0.019]), and period of disease evolution (OR 1.01 [P < 0.001] versus 1.00 [P = 0.029]) were associated with cancer. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (OR 1.27 [P = 0.022]) and angiotensin-converting enzyme (ACE) inhibitor prescriptions (OR 2.87 [P = 0.048]) were associated with non-HS cancers. Conclusion: Cancer incidence in patients with SLE was higher than in the Spanish population, particularly among young women. This increase might be due to non-HS cancers, which would be associated with SLE involving greater cumulative damage where more ACE inhibitors are prescribed.The RELESSER Registry was partially funded by GSK, Roche, UCB, Lilly and Novartis. The sponsors had no role in the study design, data collection, analysis or interpretation, in writing the report, or in the decision to submit the article for publication. Dr. Pego-Reigosa is supported by grant 316265 (BIOCAPS) from the European Union 7th Framework Program (FP7/REGPOT-2012- 2013.1). The FIS Grant PI11/02857 (Instituto Carlos III, Fondos FEDER) supported this study

Coping Strategies and Social Support in a Mobile Phone Chat App Designed to Support Smoking Cessation : Qualitative Analysis

Smoking is one of the most significant factors contributing to low life expectancy, health inequalities, and illness at the worldwide scale. Smoking cessation attempts benefit from social support. Mobile phones have changed the way we communicate through the use of freely available message-oriented apps. Mobile app-based interventions for smoking cessation programs can provide interactive, supportive, and individually tailored interventions. This study aimed to identify emotions, coping strategies, beliefs, values, and cognitive evaluations of smokers who are in the process of quitting, and to analyze online social support provided through the analysis of messages posted to a chat function integrated into a mobile app. In this descriptive qualitative study, informants were smokers who participated in the chat of Tobbstop. The technique to generate information was documentary through messages collected from September 2014 through June 2016, specifically designed to support a smoking cessation intervention. A thematic content analysis of the messages applied 2 conceptual models: the Lazarus and Folkman model to assess participant's experiences and perceptions and the Cutrona model to evaluate online social support. During the study period, 11,788 text messages were posted to the chat by 101 users. The most frequent messages offered information and emotional support, and all the basic emotions were reported in the chat. The 3 most frequent coping strategies identified were physical activity, different types of treatment such as nicotine replacement, and humor. Beliefs about quitting smoking included the inevitability of weight gain and the notion that not using any type of medications is better for smoking cessation. Health and family were the values more frequently described, followed by freedom. A smoke-free environment was perceived as important to successful smoking cessation. The social support group that was developed with the app offered mainly emotional and informational support. Our analysis suggests that a chat integrated into a mobile app focused on supporting smoking cessation provides a useful tool for smokers who are in the process of quitting, by offering social support and a space to share concerns, information, or strategies