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El presente proyecto, SENSIVISUAL-UCM-II, supone una continuidad en los procesos de formación y sensibili-zación de la comunidad universitaria en el uso de tecnologías de información y comuni-cación, TICs, accesibles para personas con discapacidad visual, donde debe prevalecer el derecho a la atención equitativa y de calidad, permitiendo su plena inclusión educativa y social, mediante el respeto a sus necesidades específicas. El presente proyecto conti-nua con el trabajo realizado y pretende ahondar en la adecuación de contenidos docen-tes mediante el uso de herramientas concretas que mejoren el proceso de enseñanza-aprendizaje para personas con déficit visual, siguiendo con el objetivo de la plena inclu-sión de estos alumnos en el aula. SENSIVISUAL-UCM-II persigue la mejora de la calidad docente y de los servicios vinculados a procesos de innovación en materia de inclusión y diversidad, centrándose en los alumnos con discapacidad visual, y bajo la referencia del Aprendizaje por Servicio. La propuesta educativa de este proyecto combina proce-sos de aprendizaje y de servicio a la comunidad en un mismo proyecto, en el que los compañeros de las personas con discapacidad visual aprenden, generando los materia-les didácticos y potenciando el trabajo colaborativo en los grupos de clase, a la vez que trabajan en necesidades reales de la comunidad con la finalidad de mejorarla. Bajo este objetivo, las acciones llevadas a cabo harán que la comunidad universitaria, tanto profe-sores, alumnos como personal de administración y servicios, se implique en la mejora de la institución en su conjunto y del servicio que ésta ha de dar a la sociedad, consiguiendo colocarnos como universidad de referencia en accesibilidad e inclusión.

Critically ill patients often require life support measures such as mechanical ventilation or haemodialysis. Despite the essential role of nutrition in patients' recovery, the inappropriate use of medical nutrition therapy can have deleterious effects, as is the case with the use of respiratory, circulatory, or renal support. To increase awareness and to monitor the effects of inappropriate medical nutrition therapy, we propose to introduce the concept of nutritrauma in clinical practice, defined as metabolic adverse events related to the inappropriate administration of medical nutrition therapy or inadequate nutritional monitoring.

To determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.Secondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compared with those without corticosteroid therapy. We use a propensity score (PS) matching analysis to reduce confounding factors. The primary outcome was ICU mortality. Cox proportional hazards and competing risks analysis was performed to assess the impact of corticosteroids on ICU mortality.A total of 1846 patients with primary influenza pneumonia were enrolled. Corticosteroids were administered in 604 (32.7%) patients, with methylprednisolone the most frequently used corticosteroid (578/604 [95.7%]). The median daily dose was equivalent to 80 mg of methylprednisolone (IQR 60-120) for a median duration of 7 days (IQR 5-10). Asthma, COPD, hematological disease, and the need for mechanical ventilation were independently associated with corticosteroid use. Crude ICU mortality was higher in patients who received corticosteroids (27.5%) than in patients who did not receive corticosteroids (18.8%, p < 0.001). After PS matching, corticosteroid use was associated with ICU mortality in the Cox (HR = 1.32 [95% CI 1.08-1.60], p < 0.006) and competing risks analysis (SHR = 1.37 [95% CI 1.12-1.68], p = 0.001).Administration of corticosteroids in patients with severe influenza pneumonia is ass

Background: Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectroscopy (NIRS) might facilitate early detection for patients at risk of serious complications. Our objectives were to determine the relationship between early determination of rSO2 and mortality and to compare discrimination power for mortality of rSO2 and other resuscitation variables in critically ill CAP patients. Methods: This is a prospective observational study. Patients with CAP were enrolled within 6 h to intensive care admission. Demographics and clinical variables were recorded. rSO2 was determined using NIRS in brachioradialis muscle. All variables were determined at baseline and 24 h after admission. Results: Forty patients were enrolled. Fourteen patients (35 %) had a baseline rSO2 < 60 % and 7 of them died (50 %). Only 1 of 26 (3.8 %) patients with rSO2 >= 60 % died (p = 0.007). The area under ROC curve (AUROC) showed consistent mortality discrimination at baseline (0.84, p = 0.03) and at 24 h (0.86, p = 0.006) for rSO2 values. Cox regression analysis showed that low rSO2 at ICU admission (hazard ratio (HR) = 8.99; 95 % confidence interval (CI) 1.05-76.8; p = 0.045) and low rSO2 at 24 h (HR = 13.18; 95 % CI 1.52-113.6; p = 0.019) were variables independently associated with mortality. In contrast, other variables such as Acute Physiology and Chronic Health Evaluation (APACHE II) score (HR = 1.09; 95 % CI 0.99-1.19; p = 0.052) were not associated with mortality. Conclusions: Our findings suggest that forearm skeletal muscle rSO2 differs in patients with severe CAP according to outcome and might be an early prognosis tool.