Beliefs, attitudes, death anxiety in a multidisciplinary team oncology palliative care

En el ámbito de la salud, se ha puesto en evidencia la necesidad de profundizar en las actitudes y creencias ante la muerte en los propios profesionales ya que pueden influir en la calidad de los cuidados, especialmente las derivadas de procesos de muerte y duelo, por lo que el objetivo de la investigación fue explorar y analizar actitudes y creencias ante la muerte en el personal de salud en Cuidados Paliativos Oncológicos. Fue un estudio, transversal y descriptivo; se utilizó un muestreo intencional, los instrumentos utilizados fueron: Formato de datos personales y profesionales, Escala de Ansiedad ante la muerte de Templer, Creencias con relación al paciente terminal y Cuestionario de Actitudes ante la Muerte (CAM). Se analizaron los datos estadísticamente: análisis de frecuencias y correlación de Spearman, con una alta tendencia en considerar que es mejor que el paciente terminal fallezca en casa, en el uso de la morfina como tratamiento para el dolor en cáncer avanzado y recibir una atención integral. Dentro de las principales actitudes del personal de salud hacia el paciente terminal y la muerte se encontraron: mayor responsabilidad y atención hacia la vida, y promoción del crecimiento personal para aceptar su propia muerte.In the field of health, has highlighted the need to delve into the attitudes and beliefs about death in the professionals because they can influence the quality of care, especially those derived from processes of death and mourning, for what the objective of the research was to explore and analyze attitudes and beliefs about death in health personnel Oncology Palliative Care. The study was a cross-sectional and descriptive, purposive sampling was used, the instruments used were format personal and professional, Anxiety Scale Templer’s death, beliefs regarding the terminal patient and Attitudes Questionnaire Death (CAM ). Data were analyzed statistically: Frequency analysis and Spearman correlation, with a high tendency to consider that is better than the terminal patient dies at home, in the use of morphine as a treatment for pain in advanced cancer and receiving comprehensive care. Among the main attitudes in the health staff towards the patient and death were found: more responsibility and attention to the promotion of life and personal growth to take his own life

Influencia de los procesos ambientales predominantes en la cuenca y el embalse Hanabanilla sobre la composición de su sedimento

The Hanabanilla reservoir was built in 1960 in the center-south of Cuba and is used for human supply and power generation. This research was aimed at identifying the important processes affecting sediment composition, through the analysis of particle size, and organic carbon (OC), nutrients, and major trace elements concentrations in sediment samples taken at the outlet point of the reservoir. The documentary review allowed us to identify how the nature and management of the basin and the operation of the reservoir affected sediment quality. The application of principal components analysis (PCA), and the determination of ionic relationships and correlations between the sediment quality variables, allowed for the identification of influential processes on sediment quality. Anthropic activities in the period 1960-2012 produced residues rich in OC, total phosphorus (TP) and total nitrogen (TN) that were stored in reservoir sediments. During the first years of the reservoir (1964-1976) the highest concentrations of sediment TP were recorded and the sediments functioned as a sink. The OC and TN mean concentrations were higher in the last stage of the study (2006-2012). The main influential processes on sediment composition were the operation of the reservoir, the geochemical cycle of P, the mineralization of the substances in the water column, and the weathering of silicates and the contribution of organic matter from the basin. Sediment quality data indicate that OC and TN were of allochthonous origin and TP was of autochthonous origin. Levels of sediment OC and TN also corresponded with an increase in anthropic activities in the basin.El embalse Hanabanilla fue construido en 1960 en el centro-sur de Cuba y sus usos principales son el abastecimiento humano y la generación de energía eléctrica. Esta investigación tuvo como objetivo identificar los procesos fundamentales que afectan la composición del sedimento, mediante el análisis del tamaño de las partículas, y el contenido de carbono orgánico (OC), nutrientes y elementos traza mayoritarios en muestras de sedimento tomadas en la obra de toma del embalse. La revisión documental permitió identificar cómo afectan la naturaleza y el manejo de la cuenca, y la operación del embalse a la calidad del sedimento. El análisis de componentes principales (PCA), las relaciones iónicas, y las correlaciones entre las variables de calidad del sedimento, permitieron identificar los procesos influyentes en la calidad del sedimento. Las actividades antrópicas en el período 1960-2012 produjeron residuos ricos en OC, fósforo total (TP) y nitrógeno total (TN) que se almacenaron en los sedimentos del embalse. Durante los primeros años del embalse (1964-1976), se registraron las más altas concentraciones de TP en el sedimento que actuó como sumidero. Las concentraciones medias de OC y TN fueron más altas en la última etapa del estudio (2006-2012). Los principales procesos que influyeron en la composición del sedimento fueron: la operación del embalse, el ciclo geoquímico del P, la mineralización de las sustancias en la columna de agua, y el lavado de los silicatos, unido a la contribución de la materia orgánica de la cuenca. Los datos indicaron un origen alóctono para el OC y el TN, y autóctono para el TP. Los niveles de OC y TN en el sedimento también se correspondieron con un incremento en la actividad antrópica en la cuenca.Fil: Labaut Betancourt, Yeny. Centro de Estudios Ambientales de Cienfuegos; Cuba. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Betancourt, Carmen R.. Universidad de Cienfuegos Carlos Rafael Rodriguez; CubaFil: Díaz Asencio, Misael. Centro de Estudios Ambientales de Cienfuegos; CubaFil: Beutel, Marc W.. University of California; Estados Unido

ESTRO IORT Task Force/ACROP recommendations for intraoperative radiation therapy in borderline-resected pancreatic cancer

Radiation therapy (RT) is a valuable component of multimodal treatment for localized pancreatic cancer. Intraoperative radiation therapy (IORT) is a very precise RT modality to intensify the irradiation effect for cancer involving upper abdominal structures and organs, generally delivered with electrons (IOERT). Unresectable, borderline and resectable disease categories benefit from dose-escalated chemoradiation strategies in the context of active systemic therapy and potential radical surgery. Prolonged preoperative treatment may act as a filter for selecting patients with occult resistant metastatic disease. Encouraging survival rates have been documented in patients treated with preoperative chemoradiation followed by radical surgery and IOERT (>20 months median survival, >35% survival at 3 years). Intensive preoperative treatment, including induction chemotherapy followed by chemoradiation and an IOERT boost, appears to prolong long-term survival within the subset of patients who remain relapse-free for>2 years (>30 months median survival; >40% survival at 3 years). Improvement of local control through higher RT doses has an impact on the survival of patients with a lower tendency towards disease spread. IOERT is a well-accepted approach in the clinical scenario (maturity and reproducibility of results), and extremely accurate in terms of dose-deposition characteristics and normal tissue sparing. The technique can be adapted to systemic therapy and surgical progress. International guidelines (National Comprehensive Cancer Network or NCCN guidelines) currently recommend use of IOERT in cases of close surgical margins and residual disease. We hereby report the ESTRO/ACROP recommendations for performing IOERT in borderline-resectable pancreatic cancer

ESTRO IORT Task Force/ACROP recommendations for intraoperative radiation therapy in borderline-resected pancreatic cancer

Radiation therapy (RT) is a valuable component of multimodal treatment for localized pancreatic cancer. Intraoperative radiation therapy (IORT) is a very precise RT modality to intensify the irradiation effect for cancer involving upper abdominal structures and organs, generally delivered with electrons (IOERT). Unresectable, borderline and resectable disease categories benefit from dose-escalated chemoradiation strategies in the context of active systemic therapy and potential radical surgery. Prolonged preoperative treatment may act as a filter for selecting patients with occult resistant metastatic disease. Encouraging survival rates have been documented in patients treated with preoperative chemoradiation followed by radical surgery and IOERT (>20 months median survival, >35% survival at 3 years). Intensive preoperative treatment, including induction chemotherapy followed by chemoradiation and an IOERT boost, appears to prolong long-term survival within the subset of patients who remain relapse-free for>2 years (>30 months median survival; >40% survival at 3 years). Improvement of local control through higher RT doses has an impact on the survival of patients with a lower tendency towards disease spread. IOERT is a well-accepted approach in the clinical scenario (maturity and reproducibility of results), and extremely accurate in terms of dose-deposition characteristics and normal tissue sparing. The technique can be adapted to systemic therapy and surgical progress. International guidelines (National Comprehensive Cancer Network or NCCN guidelines) currently recommend use of IOERT in cases of close surgical margins and residual disease. We hereby report the ESTRO/ACROP recommendations for performing IOERT in borderline-resectable pancreatic cancer

Flipped classroom y didáctica de las matemáticas en la formación online de Maestros de Educación Infantil

This research work has been carried out in the subject Didáctica de las Matemáticas in the training of teachers of Early Childhood Education following the pedagogical model Flipped Learning in a completely online environment. This model commits to reverse the roles of the teacher and students making the latter the protagonists of their own learning process.The objective was to analyse the learning outcomes and student satisfaction after experiencing the flipped classroom model in one of the units of the subject. For this, a quasi-experimental design was used with a non-equivalent control group and a pretest measure of learning outcomes to control possible initial differences between groups.The different phases in the application of the flipped model are explained, both the preparation before the virtual face-to-face session of the teacher and the students, and its development and the final evaluation.The results of this study show that this pedagogical approach increases student performance and even more when they attend live sessions. Likewise, the subjective assessments obtained have as a common axis: the motivation and satisfaction towards the methodology experienced. El presente trabajo de investigación se ha llevado a cabo en la asignatura Didáctica de las Matemáticas en la formación de maestros de Educación Infantil, siguiendo el modelo pedagógico Flipped Learning, en un entorno completamente online. Este modelo compromete a invertir los roles del docente y del alumno, haciendo a este último protagonista de su propio proceso de aprendizaje. El objetivo ha sido analizar los resultados de aprendizaje y la satisfacción del alumnado tras experimentar el modelo flipped classroom en uno de los temas de la asignatura. Para ello, se utilizó un diseño cuasiexperimental con un grupo de control no equivalente y una medida pretest de los resultados de aprendizaje para controlar las posibles diferencias iniciales entre los grupos. Se explicitan las distintas fases en la aplicación del modelo flipped, tanto la preparación previa a la sesión presencial virtual del profesor y los alumnos, como el desarrollo de la misma y la evaluación final. Los resultados de este estudio muestran que este enfoque pedagógico aumenta el rendimiento de los alumnos y más aún cuando se asiste en directo a las sesiones. Igualmente, las valoraciones subjetivas obtenidas tienen como eje común la motivación y satisfacción hacia la metodología experimentada

Coronavirus Optimization Algorithm: A Bioinspired Metaheuristic Based on the COVID-19 Propagation Model

This study proposes a novel bioinspired metaheuristic simulating how the coronavirus spreads and infects healthy people. From a primary infected individual (patient zero), the coronavirus rapidly infects new victims, creating large populations of infected people who will either die or spread infection. Relevant terms such as reinfection probability, super-spreading rate, social distancing measures, or traveling rate are introduced into the model to simulate the coronavirus activity as accurately as possible. The infected population initially grows exponentially over time, but taking into consideration social isolation measures, the mortality rate, and number of recoveries, the infected population gradually decreases. The coronavirus optimization algorithm has two major advantages when compared with other similar strategies. First, the input parameters are already set according to the disease statistics, preventing researchers from initializing them with arbitrary values. Second, the approach has the ability to end after several iterations, without setting this value either. Furthermore, a parallel multivirus version is proposed, where several coronavirus strains evolve over time and explore wider search space areas in less iterations. Finally, the metaheuristic has been combined with deep learning models, to find optimal hyperparameters during the training phase. As application case, the problem of electricity load time series forecasting has been addressed, showing quite remarkable performance.Ministerio de Economía y Competitividad TIN2017-88209-C

Metodología cartográfica submarina orientada a la gestión y conservación del medio litoral: mapa de las comunidades bentónicas del frente litoral norte del estrecho de Gibraltar

La cartografía de las comunidades bentónicas es esencial, actualmente, para promover actuaciones eficientes de uso, gestión y conservación de las zonas litorales, especialmente en el ámbito de grandes espacios litorales protegidos. En cada uno de éstos, la cartografía resulta determinante para la elaboración de un mapa de zonificación de usos, condicionado, en gran medida, por los distintos valores ecológicos que puedan asignarse a las diferentes comunidades bentónicas establecidas y a sus distribuciones geográficas locales. La metodología utilizada en la elaboración del mapa de las comunidades bentónicas del estrecho de Gibraltar (en el intervalo batimétrico 0-30 m y de 40 km de extensión litoral aproximada), dada la complejidad que reviste este tipo de objetivos, supone una aproximación a la cartografía de la biota sésil sumergida, en tramos litorales amplios contenidos en áreas protegidas. Se han combinado, mediante superposición de información, datos físicos de batimetría y tipos de fondo, obtenidos mediante técnicas acústicas y convenientemente cartografiados, con datos biológicos de las comunidades bentónicas, obtenidos en campaña intensiva de buceo científico (con la toma de imágenes en sustrato duro, para su ulterior análisis) y mediante dragado (con registros de granulometría y fauna endobentónica en sustrato blando). La información ha sido georreferenciada adecuadamente para su introducción, como capas independientes, en un sistema de información geográfica (SIG).The cartography of benthic communities is, today, essential to promoting adequate strategies for the use, management and conservation of littoral areas, especially if they are large protected zones. In each zone, cartography is necessary to elaborate a management zoning map, depending on the ecological value of the different benthic communities established and on the local geographical distribution. The methodology used in the elaboration of a map including the benthic communities of the Straits of Gibraltar (0-30 m depth; 40 km of littoral extension), in spite of the complexity of these kinds of objectives, represents an approach to the cartography of the submarine sessile biota of large littoral zones of protected ar- eas. The present study combines physical data (bathymetry and type of substrate), collected using acoustic techniques, and biological data (benthic communities), collected during an intensive sampling programme using scuba (hard bottom: image analysis) and dredging (soft bottom: granulometry and benthic fauna). The information has been geoindexed to be inserted, as different layers, into a Geographic Information System (GIS)

ESTRO/ACROP IORT recommendations for intraoperative radiation therapy in primary locally advanced rectal cancer

Summary: Carcinoma of the rectum is a heterogeneous disease. The clinical spectrum identifies a subset of patients with locally advanced tumours that are close to or involve adjoining structures, such as the sacrum, pelvic sidewalls, prostate or bladder. Within this group of patients categorized as ‘‘locally advanced”, there is also variability in the extent of disease with no uniform definition of resectability. A practice-oriented definition of a locally advanced tumour is a tumour that cannot be resected without leaving microscopic or gross residual disease at the resection site. Since these patients do poorly with surgery alone, irradiation and chemotherapy have been added to improve the outcome. Intraoperative irradiation (IORT) is a component of local treatment intensification with favourable results in this subgroup of patients. International guidelines (National Comprehensive Cancer Network (NCCN) guidelines) currently recommend the use of IORT for rectal cancer resectable with very close or positive margins, especially for T4 and recurrent cancers. We report the ESTRO-ACROP (European Society for Radiotherapy and Oncology - Advisory Committee on Radiation Oncology Practice) recommendations for performing IORT in primary locally advanced rectal cancer