Contextualización de la educación ambiental : más que una simple materia en la currícula educativa.

Antonio Esteban Matarranz Rodríguez (biografía): Licenciado en Pedagogía, Mención Desarrollo Agrícola y Rural (Ciencias Agrícolas), de la Universidad Autónoma de Santo Domingo (UASD), Cum Laude. Postgrados en Ciencias Forestales, en la Universidad Nacional Pedro Henríquez Ureña (Unphu), Magna Cum Laude; y en Gestión Ambiental para Países en Vía de Desarrollo, en la Universidad Tecnológica de Dresde, Alemania. Maestría en Administración Pública, de la Pontificia Universidad Católica Madre y Maestra (Pucmm). Labora en el Área Ambiental y de Recursos Naturales del Sector Público desde 1988, y fue merecedor de la “Medalla al Mérito en el Servicio Público 2013”. Ha participado en numerosos eventos nacionales y representó el país en diversos eventos internacionales en la República Popular China, Argentina, Japón, Chile, Colombia, Trinidad y Tobago, Jamaica y Bahamas. Del 2001 al 2015 se desempeñó como coordinador del Módulo de Medio Ambiente en los cursos Comando y Estado Mayor, y Maestría en Seguridad y Defensa Nacional, del Instituto Superior para la Defensa (INSUDE). Actualmente es profesor en las universidades APEC (Unapec) e Iberoamericana (Unibe).La educación ambiental es la toma de conciencia que permite entender la importancia de cuidar el medio ambiente, para así promover en la ciudadanía nuevas actitudes y valores que implica el uso racional de los recursos naturales. Para esto es necesario involucrar a las generaciones presentes y del porvenir, a través de la intervención educativa sistematizada; por eso la necesidad de que la educación ambiental sea integradora. De hecho, en este artículo el autor se propone a partir de varias reflexiones combinar con énfasis claro el notable interés de impactar con la formación en ética y responsabilidad, para poder construir un mejor concepto de desarrollo sostenible en una sociedad cambiante y joven como la de hoy

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Educación superior, medio ambiente y sustentabilidad

Antonio Esteban Matarranz Rodríguez (biografía): Licenciado en Pedagogía, Mención Desarrollo Agrícola y Rural (Ciencias Agrícolas), de la Universidad Autónoma de Santo Domingo (UASD), Cum Laude. Postgrados en Ciencias Forestales, en la Universidad Nacional Pedro Henríquez Ureña (Unphu), Magna Cum Laude; y en Gestión Ambiental para Países en Vía de Desarrollo, en la Universidad Tecnológica de Dresde, Alemania. Maestría en Administración Pública, de la Pontificia Universidad Católica Madre y Maestra (Pucmm). Labora en el Área Ambiental y de Recursos Naturales del Sector Público desde 1988, y fue merecedor de la “Medalla al Mérito en el Servicio Público 2013”. Ha participado en numerosos eventos nacionales y representó el país en diversos eventos internacionales en la República Popular China, Argentina, Japón, Chile, Colombia, Trinidad y Tobago, Jamaica y Bahamas. Del 2001 al 2015 se desempeñó como coordinador del Módulo de Medio Ambiente en los cursos Comando y Estado Mayor, y Maestría en Seguridad y Defensa Nacional, del Instituto Superior para la Defensa (INSUDE). Actualmente es profesor en las universidades APEC (Unapec) e Iberoamericana (Unibe).La educación es el proceso de facilitar el aprendizaje o la adquisición de conocimientos, así como habilidades, valores, creencias y hábitos de un grupo de personas que los transfieren a otras personas. En ese contexto el autor citó el seminario “Universidad y Medio Ambiente en América Latina y el Caribe”, que se realizó en Bogotá, Colombia, en 1985, en dicho evento se analizó el importante papel que desempeñan las universidades en los procesos de desarrollo, y por lo mismo la necesidad de vincular la educación superior con la temática ambiental. Conscientes de esa realidad, en República Dominicana se han dado pasos firmes en la readecuación de la infraestructura de desarrollo y generación de conocimiento, al asociar y considerar las bases legales que sustentan y dan impulso a los planteamientos citados en el seminario de referencia, en el más alto nivel de planificación

Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort : 2004-2013

To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS. Of 7165 new HIV diagnoses, 46.9% (CI:45.7-48.0) were LP, 240 patients died.First-year mortality was the highest (aHR = 10.3[CI:5.5-19.3]); between 1 and 4 years post-diagnosis, aHR = 1.9(1.2-3.0); an

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. Prospective multicenter cohort study. Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ("NAE development"); from alive and NAE-experienced to death ("Death after NAE"); and from alive and NAE-free to death ("Death without NAE"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition "Death after NAE". 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition "Death after NAE" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), ag

Human immunodeficiency virus/hepatitis C virus coinfection in Spain : Prevalence and patient characteristics

The purpose of this study was to assess the prevalence of anti-hepatitis C virus (HCV) antibodies (Abs) and active HCV infection in human immunodeficiency virus (HIV)-infected (HIV+) patients in Spain in 2015. This was a cross-sectional study.Methods. The study was performed in 41 centers in 2015. Sample size was estimated for an accuracy of 2%, the number of patients from each hospital was determined by proportional allocation, and patients were selected using simple random sampling. The reference population was 35 791 patients, and the sample size was 1867 patients. Hepatitis C virus serostatus was known in 1843 patients (98.7%). Hepatitis C virus-Abs were detected in 695 patients (37.7%), in whom the main route of HIV acquisition was injection drug use (75.4%). Of these 695 patients, 402 had HCV RNA, 170 had had a sustained viral response (SVR) after anti-HCV therapy, and 102 cleared HCV spontaneously. Hepatitis C virus-ribonucleic acid results were unknown in 21 cases. Genotype distribution (known in 367 patients) was 1a in 143 patients (39.0%), 4 in 90 (24.5%) patients, 1b in 69 (18.8%) patients, 3 in 57 (15.5%) patients, 2 in 5 (1.4%) patients, and mixed in 3 (0.8%) patients. Liver cirrhosis was present in 93 patients (23.1%) with active HCV infection and in 39 (22.9%) patients with SVR after anti-HCV therapy. The prevalence of HCV-Abs and active HCV infection in HIV+ patients in Spain is 37.7% and 22.1%, respectively; these figures are significantly lower than those recorded in 2002 and 2009. The predominant genotypes in patients with active HCV infection were 1a and 4. A high percentage of patients had cirrhosis. Cirrhosis is also common in patients with SVR after anti-HCV therapy