La violencia de género en mujeres mayores de 65 años

La violencia de género (VG) es un problema actual y de gran importancia social que conlleva graves consecuencias tanto para las mujeres como para sus hijos. Es un tipo de violencia dirigida hacia la mujer por el hecho de serlo y cuyo fin es el sometimiento de esta. Existen diferentes formas de violencia siendo la más frecuente la psicológica. El objetivo es conocer la prevalencia de la VG en las mujeres de 65 años o mayores que acuden a las consultas de enfermería de Atención Primaria (AP). Se ha realizado una entrevista personal a una muestra de 135 mujeres reclutadas en AP que incorpora características sociodemográficas y clínicas y preguntas sobre la relación con su pareja (utilizando el cuestionario WAST largo para la detección de VG), la violencia doméstica, antecedentes de maltrato en la infancia y sobre las denuncias interpuestas en caso de haber sufrido maltrato. La prevalencia de VG actual fue de 13,15%, el 11,11% de maltrato pasado y el 11,11% tenía antecedentes de maltrato en la infancia. Se ha encontrado relación entre la exposición a VG, el número de hijos, y los trastornos de salud mental. El 5,18% manifestó haberse sentido alguna vez maltratada por sus cuidadores. Respecto a las denuncias, el 18,9% lo denunció a la policía y el 64% pidió ayuda a sus familiares. La alta prevalencia de VG en mujeres mayores y sus consecuencias sobre la salud hace necesaria una mayor implicación en la detección por parte de los profesionales de AP y en particular por la enfermería.Grado en Enfermerí

Las empresas Fintech: nuevas perspectivas para un negocio financiero digital

Estos últimos años estamos siendo testigos de una transformación, calificada por muchos como revolución, en el sector de las finanzas que es irreversible. La crisis económica del 2008 y la pandemia mundial del año 2020 han favorecido este escenario y junto a la digitalización global han aparecido nuevos modelos de negocio en el sector financiero, las Fintech. Tanto es el atractivo de las opciones digitalizadas en las finanzas que se están introduciendo grandes empresas tecnológicas a competir en el mercado, las Bigtech. Por otro lado, la banca tradicional se decanta por un ambiente colaborativo con las Fintech ante el peligro de quedarse atrás a nivel competitivo. Este trabajo pretende aportar al lector un estudio sobre la evolución del sector financiero hasta el actual ecosistema Fintech, la aparición del nuevo cliente digital y consigo nuevas demandas que deben ser consideradas y concienciar de la necesidad de una regulación adecuada para favorecer al marco competitivo español.In recent years we are witnessing a transformation, described by many as a revolution, in the finance sector that is irreversible. The economic crisis of 2008 and the global pandemic of 2020 have favored this scenario and along with global digitalization, new business models have appeared in the financial sector, Fintech. So much is the attractiveness of digitized options in finance that large technology companies are being introduced to compete in the market, the Bigtech. On the other hand, traditional banking opts for a collaborative environment with Fintech in the face of the danger of being left behind at a competitive level. This work aims to provide the reader with a study on the evolution of the financial sector to the current Fintech ecosystem, the emergence of the new digital customer and with it new demands that must be considered and raise awareness of the need for adequate regulation to favor the Spanish competitive framework.Grado en Comerci

Plan estratégico Amazon.com: período 2014-2018

El presente trabajo investiga, valora y propone soluciones al problema que la empresa Amazon.com (operaciones en Estados Unidos) exhibe en el año 2013 mediante un plan estratégico para el periodo 2014-2018. Del análisis del caso “Reinventando el comercio electrónico: La apuesta de Amazon.com por el reparto de mercancías con vehículos no tripulados” (Walker y Jiwani 2016) se determina que la situación que afrontaba Amazon.com en Estados Unidos al cierre del año 2013 era la dependencia hacia los proveedores que brindan el servicio de distribución de los productos en la última milla, quienes venían incrementando el precio de este servicio a una tasa de 4% anual, limitando la capacidad de negociación de la empresa en cuanto a los costos y calidad de servicio

Epigenetic and phenotypic responses to experimental climate change of native and invasive Carpobrotus edulis

Despite the recent discoveries on how DNA methylation could help plants to adapt to changing environments, the relationship between epigenetics and climate change or invasion in new areas is still poorly known. Here, we investigated, through a field experiment, how the new expected climate scenarios for Southern Europe, i.e., increased temperature and decreased rainfall, might affect global DNA methylation in relation to phenotypic variation in individuals of clonal plant, Carpobrotus edulis, from its native (Southern African) and invaded (northwestern Iberian Peninsula) area. Our results showed that changes in temperature and rainfall induced phenotypic but not global DNA methylation differences among plants, and the climatic effects were similar for plants coming from the native or invaded areas. The individuals from the Iberian Peninsula showed higher levels of global methylation than their native counterparts from South Africa. We also observed differences between natives and invasive phenotypes in traits related to the pattern of biomass partitioning and to the strategies for water uptake and use and found an epigenetic contribution to phenotypic changes in some leaf traits, especially on the nitrogen isotopic composition. We conclude that the increased temperature and decreased rainfall projected for Southern Europe during the course of the twenty-first century may foster phenotypic changes in C. edulis, possibly endowing this species with a higher ability to successful cope the rapid environmental shifts. The epigenetic and phenotypic divergence that we observed between native and invasive plants suggests an intraspecific functional variation during the process of invasion. This result could indicate that phenotypic plasticity and global DNA methylation are related to the colonization of new habitats. Our findings reinforce the importance of epigenetic plasticity on rapid adaptation of invasive clonal plantsFunding for this study was provided by the Spanish Ministry of Economy and Competitiveness and the European Regional Development Fund (ERDF; grant Ref. CGL2013-48885-C2-2-R and Ref. CGL2017-87294-C3-1P awarded to RR) and by the Autonomous Government of Galicia (grant ref. I2CB awarded to MS)S

Modelo prolab: Kusi-Cushuro, un emprendimiento sostenible para la comercialización de cushuro en el sector turismo

En la actualidad, la necesidad de recuperación del sector de alimentos y bebidas posterior a la pandemia obliga a que la innovación sea un eje central en las propuestas de valor de restaurantes y hoteles. En tal sentido, se identificó un problema complejo, que es la búsqueda continua de la renovación de las propuestas gastronómicas en base a las tendencias actuales de consumo saludable y de productos nativos. Para abordar este problema se aplicó design thinking, donde a través de la empatía se pudo identificar claramente las necesidades del cliente, para posteriormente plantear distintos prototipos que fueron testeados para generar un aprendizaje validado a fin de definir un producto mínimo viable. De esta manera, la solución que se propone es Kusi-Cushuro, un producto basado en el procesamiento del Nostoc sphaericum, conocido con el nombre de “Cushuro”, “Murmunta” y “Llullucha”, etc, que es una cianobacteria de agua dulce con alto valor nutricional, para su venta a hoteles de 4 y 5 estrellas de la zona centro y sur del Perú. Kusi Cushuro desarrollará sus actividades con un enfoque de sostenibilidad ambiental y social, en donde se velará por una extracción inteligente y sostenible del recurso, buscando minimizar el impacto al medio ambiente en la operación del negocio, además de tener un impacto positivo en la calidad de vida de las comunidades que extraen la cianobacteria, con miras a la optimización de su productividad. En relación a la viabilidad financiera de Kusi-Cushuro, el proyecto tiene un VAN de USD783,114 lo cual representa una iniciativa de alto valor para los inversionistas. En cuanto al impacto social del negocio, Kusi-Cushuro tiene una influencia directa en el ODS 8, teniendo un IRS de 33.3%, generando un VAN Social de USD835,300. A partir de los antecedentes expuestos, se recomienda su implementación, así como la continua evaluación de la escalabilidad del negocio a otros lugares de Perú y del mundo.Currently, the need for recovery of the food and beverage sector after the pandemic forces innovation to be a central axis in the value propositions of restaurants and hotels. In this sense, a complex problem was identified, which is the continuous search for the renewal of gastronomic proposals based on current trends in healthy consumption and native products. Design Thinking was applied to address this problem, where through empathy it was possible to clearly identify the client's needs, to later propose different prototypes that were tested to generate validated learning in order to define a minimum viable product. The proposed solution is Kusi-Cushuro, a product based on the processing of Cushuro (algae with high nutritional value) for sale to 4 and 5-star hotels in the central and southern areas of Peru. Kusi-Cushuro will develop its activities with a focus on environmental and social sustainability, where it will ensure an intelligent and sustainable extraction of the resource, seeking to minimize the impact on the environment in the operation of the business, in addition to having a positive impact on quality of life of the communities that extract the algae, with a view to optimizing their productivity. Regarding the financial viability of Kusi-Cushuro, the project has a NPV of USD783,114, which represents a high value initiative for investors. Regarding the social impact of the business, Kusi-Cushuro has a direct influence on SDG 8, having an IRS of 33.3%, generating a Social NPV of USD835,300. Based on the exposed background, its implementation is recommended, as well as the continuous evaluation of the scalability of the business to other places in Peru and the world

Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases

[Abstract] Background: The susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. Methods: We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups. Results: Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution. Conclusion: Patients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.Instituto de Salud Carlos III; RD16/0012 RETICS Progra

Shorter telomere length is associated with COVID-19 hospitalization and with persistence of radiographic lung abnormalities

Background Age and comorbidity are the main determinants of COVID-19 outcome. Shorter leukocyte telomere length (TL), a hallmark of biological aging, has been associated with worse COVID-19 outcomes. We sought to determine TL in patients with severe COVID-19 requiring hospitalization to analyze whether clinical outcomes and post-COVID-19 manifestations are associated with shorter TL. Results We analyzed 251 patients with PCR-confirmed COVID-19, hospitalized in the first months of the pandemics. We determined TL in PBL at admission by quantitative-PCR (qPCR) analysis in patients. A healthy cohort from the same area with a similar age range (n = 169) was used to calculate TL Z-scores. After hospital discharge, 144 COVID-19 survivors were followed-up for persistent COVID-19 manifestations. A second TL determination was performed in a smaller group of 63 patients 1 year later and compared with baseline TL. Hospitalized COVID-19 patients had a decreased baseline age-adjusted TL Z-score compared to the reference group. No differences in Z-scores were observed in patients with different COVID-19 outcomes, classified as WHO ordinal scores. In 144 patients, followed for a median of 8 months, post-COVID manifestations were not associated to differences in TL. Persistence of lung radiographic abnormalities was associated with shorter baseline TL. In patients with a second TL determination, further telomere shortening (TS) was observed in 35% and telomere lengthening in 49%. Patients with further TS had suffered a more severe disease. Conclusion Shorter TL is associated with COVID-19 hospitalization but not with hospital clinical outcomes nor with persistent post-COVID-19 manifestations. Delayed resolution of radiographic lung abnormalities was also associated with shorter TL.This work was supported by a research grant from FOREUM Foundation for Research in Rheumatology. Authors also received financial support from Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI19/01129, COV20/00181, and RICOR RD21/0002) co-financed by the European Regional Development Fund (FEDER). MR.Peer reviewe

Abatacept in patients with rheumatoid arthritis and interstitial lung disease: A national multicenter study of 63 patients

OBJECTIVE: Interstitial lung disease (ILD) is one of the most serious complications of rheumatoid arthritis (RA). In the present study, we aimed to assess the efficacy of abatacept (ABA) in patients with ILD associated to RA. METHODS: National multicenter, non-controlled, open-label registry study of RA patients with ILD treated with ABA. RESULTS: 63 patients (36 women) with RA-associated ILD undergoing ABA therapy were studied. The mean ± standard deviation age at the time of the study was 63.2 ± 9.8 years. The median duration of RA and ILD from diagnosis were 6.8 and 1 year, respectively. RA was seropositive in 55 patients (87.3%). In 15 (23.8%) of 63 patients the development of ILD was closely related to the administration of synthetic or biologic disease modifying anti-rheumatic drugs. After a follow-up of 9.4 ± 3.2 months, two-thirds of patients remained stable whereas one-quarter experienced improvement in the Modified Medical Research Council scale. At that time forced vital capacity remained stable in almost two-thirds of patents and improved in one out of five patients assessed. Also, diffusing capacity of the lung for carbon monoxide remained stable in almost two-thirds and showed improvement in a quarter of the patients assessed. At 12 months, 50% of the 22 patients in whom chest HRCT scan was performed due persistence of respiratory symptoms showed stabilization, 8 (36.4%) improvement and 3 worsening of the HRCT scan pattern. Eleven of 63 patients had to discontinue ABA, mainly due to adverse events. CONCLUSION: ABA appears to be an effective in RA-associated ILD.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER) and RD12/0009/0013 from ‘‘Instituto de Salud Carlos III’’ (ISCIII), Spain