Search

Resumo Objetivo Validar a elaboração de uma escala para mensurar a carga de trabalho das parteiras com base na Classificação das Intervenções de Enfermagem (NIC) por meio da sua aplicação multicêntrica em diferentes unidades de parto. Métodos Estudo quantitativo, longitudinal, de caráter multicêntrico, realizado em três hospitais universitários gerais da rede pública de saúde. A amostra foi composta por cinquenta parteiras, que examinaram a validade de construto da escala elaborada, com um total de 370 partos. A coleta de dados iniciou-se por meio da escala elaborada ad hoc pela equipe de pesquisa, contabilizando o tempo e o número médio de intervenções NIC, realizadas a cada nascimento. Resultados As parteiras do estudo estão sujeitas a um aumento na sua carga de trabalho quanto ao número e ao tempo médio gasto na realização das NIC em cada parto atendido. Em sua jornada de trabalho (turno de 12 horas), elas destinam 960,61 minutos (16 horas no turno diurno) e 840,29 minutos (14 horas no turno noturno) para executar suas funções na assistência ao parto. Conclusões Os dados indicam a validade da escala elaborada ad hoc, pois esse instrumento reflete a real carga de trabalho vivenciada pelas parteiras do estudo.

Este artículo muestra hallazgos de una investigación cuyo objetivo fue caracterizar la experiencia de directivos de escuelas primarias públicas en Aguascalientes durante el periodo de educación remota de emergencia (ERE) derivada de la COVID-19; la metodología fue cualitativa de enfoque fenomenológico. Se presentan las experiencias de tres directoras de escuelas ubicadas en comunidades con nivel socioeconómico similar. Los hallazgos muestran que el inicio de la ERE se dio en un marco de incertidumbre e improvisación de estrategias, mientras los docentes y directivos se capacitaban en diversas plataformas tecnológicas y, en general, reorganizaban la enseñanza. Por esto, las directoras se acercaron más a su comunidad educativa ya que buscaron ejercer un acompañamiento centrado en la comunicación constante y activa para conocer las necesidades y preocupaciones de cada uno de sus integrantes para apoyarlos, pese a la inexperiencia en escenarios de emergencia y la falta de recursos provistos por las autoridades educativas estatales.

Abstract Background The use of 18F-FDG Positron emission tomography/Computed tomography (PET/CT) in the initial staging of many cancers is clearly established. Most soft tissue sarcoma (STS) has a high affinity for 18F-FDG, which is why 18F-FDG PET/CT has been proposed as a non-invasive method, useful in diagnosis and follow-up. The standardized uptake value values (SUV), the volume-based metabolic parameters MTV (metabolic tumor volume), and TLG (total lesion glycolysis) determine tumor viability and provide its total volume and the total activity of metabolically active tumor cells. The histological grade is the most important predictor of metastases and mortality associated with STS, and a significant relationship between the metabolic parameters of 18F-FDG PET/CT and the histological grade has been described. Methods A retrospective study was conducted on STS patients, who had histological grade according to the FNCLCC (Fédération Nationale des Centres de Lutte Contre Le Cancer) criteria, as well as a baseline PET/CT. SUV (SUVmax, SUVmean, and SUVpeak), MTV, and TLG were quantified. A T-student test was performed to establish the relationship between the metabolic biomarkers and the histological grade. Their usefulness as predictors of the histological grade was verified using receiver operator characteristic (ROC) curves. A survival function study was performed using the Kaplan–Meier method. To assess the prognostic utility of the metabolic biomarkers we use the Log-Rank method. Results The SUV values were useful to discriminate high-grade STS. We found a significant relationship between the histological grade and the SUV values. SUVmax, SUVpeak, MTV, and TLG were predictors of overall survival (OS). There were no significant differences in the OS for the SUVmean, or in the disease-free survival (DFS) for SUVmax, SUVmean, SUVpeak, MTV, and TLG. Conclusions The SUVmax, SUVmean, and SUVpeak values correlate with the HG and are useful to discriminate high-grade from low-grade STS. Patients with high SUVmax, SUVpeak, MTV, and TLG have a significantly lower OS.

Este artículo desarrolla un panorama histórico de las evaluaciones de logro académico, estandarizadas y a gran escala, aplicadas en la educación mexicana. Mediante una investigación documental, se analizan los inicios, expansión, consolidación y situación actual de este tipo de pruebas. Se concluye destacando la relevancia de contar con evaluaciones confiables del logro académico, que contribuyan al desarrollo educativo nacional. logro académico pruebas de aprovechamiento evaluación a gran escala política educativa historia de México

Background and Objectives: The global prevalence of chronic hepatitis C virus (HCV) infection is 0.8%, affecting around 58 million people worldwide. Treatment with DAAs reduces all-cause HCV mortality by 49–68%. This work aims to determine whether there is liver fibrosis regression (LFR) in patients who achieved Sustained Virological Response (SVR) after treatment with DAAs. Materials and Methods: An analytical, observational, single-center, and cohort study was carried out. The final sample consisted of 248 HCV-infected patients. All started treatment with DAAs between January 2015 and December 2017. Five measurements were performed to determine the fibrotic stage in patients (measured in kilopascals (kPa)) using transient elastography (FibroScan®, Echosens, The Netherlands). Results: Taking the baseline fibrotic stage as a reference, the distribution in subgroups was as follows: 77 F4 patients (31.0%); 55 F3 patients (22.2%); 53 F2 patients (21.4%); and 63 F0/F1 patients (25.4%). There were 40 patients (16.1%) with at least one HCV complication and 13 (5.2%) who developed hepatocellular carcinoma. The overall LFR rate was 77.8% (144 of 185 F2/F3/F4 patients, p = 0.01) at the end of the follow-up period. The highest mean FibroScan® values were observed in patients with: “male gender”; “metabolic syndrome”; “subtype 1a”; “NRP DAA”; “at least one HCV complication”; “death from HCV complications”; and “liver transplantation requirement”. Conclusions: Treatment with DAAs achieved high rates of LFR and a decrease in mean FibroScan® values in all subgroups.

Abstract Background COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p

Objective. To determine the reliability of a non-laboratorial questionnaire, the Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico. Methods. Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 – 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden's index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome. Results. From 53.8% – 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 – 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 – 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 – 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, P < 0.001). Conclusion. The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.

Die Berichte amtlicher Wirtschaftsinstitutionen waren in Zeiten der Weltwirtschaftskrise am Anfang des 21. Jahrhunderts sehr relevant für die Gesellschaft, da sie zuverlässige Auskünfte über die wirtschaftliche Lage gaben. Diese Berichte wurden auf Englisch verfasst und beinhalten zahlreiche Metaphern, die in verschiedene Sprachen übersetzt werden mussten. Ziel dieser Arbeit ist die Klassifizierung der Metaphern nach ihrer Typologie, um die Übersetzungsmethoden zu untersuchen und zu optimieren. Das Korpus besteht aus Texten des IWF in der Quellsprache Englisch und ihren Übersetzungen ins Deutsche und Spanische.

Background: Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Corona Virus 2 has generated significant impact on global health worldwide. COVID-19 can cause pneumonia and organ injury. Chronic kidney disease (CKD) has been associated with increased mortality in previous epidemics, but there is a paucity of data regarding actual risks for non-dialysis CKD patients with COVID-19.Methods: Multicenter, observational cohort study including 136 non-dialysis CKD patients and 136 age- and sex-matched controls that required hospitalization due to COVID-19. Patients with end-stage renal disease, a kidney transplant or without registered baseline glomerular filtration rate prior to COVID-19 infection were excluded. CKD and acute kidney injury (AKI) were defined according to KDIGO criteria.Results: CKD patients had higher white blood cell count and D-dimer and lower lymphocyte percentage. No differences were found regarding symptoms on admission. CKD was associated with higher rate of AKI (61 vs. 24.3%) and mortality (40.4 vs. 24.3%). Patients with AKI had the highest hazard for death (AKI/non-CKD HR:7.04, 95% CI:2.87–17.29; AKI/CKD HR:5.25, 95% CI: 2.29–12.02), followed by CKD subjects without AKI (HR:3.39, 95% CI:1.36–8.46). CKD status did not condition ICU admission or length of in-hospital stay.Conclusions: CKD patients that require hospitalization due to COVID-19 are exposed to higher risk of death and AKI.

Introduction: Prognosis of Coronavirus disease 2019 (Covid-19) patients with vascular risk factors, and certain comorbidities is worse. The impact of chronic neurological disorders (CND) on prognosis is unclear. We evaluated if the presence of CND in Covid-19 patients is a predictor of a higher in-hospital mortality. As secondary endpoints, we analyzed the association between CND, Covid-19 severity, and laboratory abnormalities during admission.Methods: Retrospective cohort study that included all the consecutive hospitalized patients with confirmed Covid-19 disease from March 8th to April 11th, 2020. The study setting was Hospital Clínico, tertiary academic hospital from Valladolid. CND was defined as those neurological conditions causing permanent disability. We assessed demography, clinical variables, Covid-19 severity, laboratory parameters and outcome. The primary endpoint was in-hospital all-cause mortality, evaluated by multivariate cox-regression log rank test. We analyzed the association between CND, covid-19 severity and laboratory abnormalities.Results: We included 576 patients, 43.3% female, aged 67.2 years in mean. CND were present in 105 (18.3%) patients. Patients with CND were older, more disabled, had more vascular risk factors and comorbidities and fewer clinical symptoms of Covid-19. They presented 1.43 days earlier to the emergency department. Need of ventilation support was similar. Presence of CND was an independent predictor of death (HR 2.129, 95% CI: 1.382–3.280) but not a severer Covid-19 disease (OR: 1.75, 95% CI: 0.970–3.158). Frequency of laboratory abnormalities was similar, except for procalcitonin and INR.Conclusions: The presence of CND is an independent predictor of mortality in hospitalized Covid-19 patients. That was not explained neither by a worse immune response to Covid-19 nor by differences in the level of care received by patients with CND.

Urinary albumin excretion remains the key biomarker to detect renal complications in type 2 diabetes. As diabetes epidemy increases, particularly in low-income countries, efficient and low-cost methods to measure urinary albumin are needed. In this pilot study, we evaluated the performance of Raman spectroscopy in the assessment of urinary albumin in patients with type 2 diabetes. The spectral Raman analysis of albumin was performed using artificial urine, at five concentrations of albumin and 24 h collection urine samples from ten patients with Type 2 Diabetes. The spectra were obtained after removing the background fluorescence and fitting Gaussian curves to spectral regions containing features of such metabolites. In the samples from patients with type 2 diabetes, we identified the presence of albumin in the peaks of the spectrum located at 663.07, 993.43, 1021.43, 1235.28, 1429.91 and 1633.91 cm−1. In artificial urine, there was an increase in the intensity of the Raman signal at 1450 cm−1, which corresponds to the increment of the concentrations of albumin. The highest concentration of albumin was located at 1630 cm−1. The capability of Raman spectroscopy for detection of small concentrations of urinary albumin suggests the feasibility of this method for the screening of type 2 diabetes renal complications.

I must begin this text by noting that I was very pleased to receive the invitation of Margarita Zorrilla to comment on the work of Javier Murillo, The research on school effectiveness, in the framework of the VIII National Congress of Educational Research. The Congress is a meeting and meeting place for researchers, of course, but also for many educational actors - teachers of all levels, managers, officials - for whom I was - and I am - sure that this work would be of great interest.

Las evaluaciones a gran escala forman parte de los esfuerzos de los sistemas educativos por identificar su situación actual, y, según el caso, aprovechar sus resultados para fines de rendición de cuentas o de mejora pedagógica. Para generar en efecto algún impacto tendiente a la mejora, se requieren procesos de difusión y uso de resultados que aseguren el aprovechamiento de esta información. Este artículo presenta una síntesis de la literatura revisada en el marco de un estudio realizado en Aguascalientes, México, durante 2013, que tuvo como objetivo general, describir los usos que supervisores, directores y docentes hacían de la información derivada de la Evaluación Nacional del Logro Académico en Centros Escolares (ENLACE), vigente en el sistema educativo mexicano precisamente hasta ese año. A partir de esa revisión y habiéndolos utilizado en ese estudio, se proponen cinco ejes que pueden orientar la obtención y análisis de información en investigaciones futuras sobre el tema: difusión de la información producida por las evaluaciones a gran escala; análisis e interpretación de la información; uso de los resultados en tres niveles: prácticas docentes, gestión escolar y supervisión; efectos del uso de resultados y factores asociados al aprovechamiento de la información. Palabras clave: Evaluación educativa; Evaluación del aprendizaje; Evaluaciones estandarizadas; Programa de evaluación; Educación básica; Calidad de la educación. A Proposal of Axes for the Analysis of the Use of Results of Large-Scale Evaluations of Learning by Teachers and PrincipalsLarge-scale assessments are one of the efforts to identify the current situation of the educational systems, and, depending on the case, build on their results for accountability purposes or pedagogical improvement. In order to promote improvement, there is a need to develop and implement specific processes for communicating and using large-scale assessments results. This paper is aimed at presenting a synthesis of the literature reviewed for a study undertaken in Aguascalientes, Mexico, during 2013. The main objective of the study was to describe how the information derived from the Evaluación Nacional del Logro Académico en Centros Escolares (ENLACE) was used by supervisors, headteachers and teachers. ENLACE was a census large-scale in force in the Mexican educational system until 2013. As a result of this literature review, five axes are proposed for guiding the collection and analysis of information in future research: dissemination of information produced by large-scale evaluations; analysis and interpretation of information; use of results in teaching practices, school management and supervision; effects of the use of large-scale assessments results; and, factors associated with the use of information.Keywords: Educational assessment; Learning assessment; Standardized assessment; Program evaluation; Basic education; Quality education.

Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

El análisis e interpretación de los resultados escolares ha sido preocupación de varias generaciones de estudiosos del hecho educativo. El famoso Informe Coleman (Coleman, et.al.,1966) centró su atención en los factores estructurales –origen social, posición económica, aspectos culturales de las familias– para explicar el desempeño escolar de los estudiantes. En América Latina se empezaron a realizar estudios sobre factores asociados al logro escolar y aportaron evidencia empírica acerca del comportamiento de factores externos e internos a la escuela, así como de los procesos al interior de las escuelas. Muñoz Izquierdo (1996) distingue dos tipos de estudios: a) los de naturaleza correlacional y b) los de naturaleza interpretativa cuyo propósito es reconstruir los procesos que permitirán explicar la distribución de las oportunidades de aprendizaje. Dos líneas teóricas han venido estudiando los resultados escolares: la eficacia escolar que se ocupa de conocer las escuelas y su funcionamiento para mejorarlas, y la productividad escolar busca cómo optimizar la eficiencia de las escuelas. En México, en los noventa la investigación educativa llama la atención sobre factores de la demanda educativa y enfatiza la importancia de los factores de la oferta sobre los cuales se puede intervenir.

La evaluación de centros, como otras evaluaciones que se realizan en los sistemas educativos, es un campo que se ha venido desarrollando bajo distintos propósitos, enfoques y metodologías; asimismo, los resultados que las experiencias concretas han arrojado dan lugar a usos diferentes. Aunque la revisión de literatura sobre el tema permite identificar propuestas de diversa amplitud, la revisión de los sistemas o programas de evaluación educativa de varios países lleva a reconocer dos enfoques principales en la evaluación de centros; la que se basa en los resultados en pruebas de aprendizaje de los alumnos a los que atienden, y la evaluación institucional o de las escuelas como entidades. Este artículo describe en forma breve cada uno de estos enfoques señalando sus características más relevantes y concluye en la necesidad de lograr una mayor articulación de ambos enfoques a fin de contribuir, sobre todo, a la mejora de la calidad de la educación.Palabras clave: Evaluación de centros escolares, evaluación institucional, evaluación de resultados de aprendizaje. School evaluation, as is the case with other evaluation of education systems, is a field that has developed under different purposes, focus and methodologies. In much the same way, the results given by experiences are used for different means. Even though a literature revision of the subject allows us to identify several scope amplitudes, the revision of the evaluation systems or programs in several countries, show to great trends on the evaluation of schools. One of them is based on the results of the students on learning tests and the other on the evaluation of the school as an entity. This article describes, briefly, each of these scenarios pointing their characteristics, and concludes on the necessity of a greater articulation of both methods in order to contribute on the improvement of educational quality. Keywords: School evaluation, institutional evaluation, evaluation of learning results.

Editorial

The article presents the main actions of training developing in Mexico to support the implementation of the Comprehensive Reform of Basic Education at the elementary school level. Addresses the challenges that a curricular reform as this one means, and realizes the need to investigate the effect or contribution of the experiences of today, and the need to cover the training of teachers in service as a topic of professional development in a wide sense.

La incompatibilidad sanguínea en el sistema ABO entre el donante y el receptor es un hecho de observación frecuente en el trasplante alogénico de células progenitoras hematopoyéticas debido a la presencia de anticuerpos en el receptor frente a hematíes del donante. Aunque estos pacientes tienen mayor riesgo de complicaciones inmunohematológicas, la incompatibilidad de grupo sanguíneo, no afecta a la incidencia de Enfermedad Injerto Contra Huésped o la supervivencia del trasplante. Lo relevante para el hematólogo es que esta diferencia puede ser anticipada y reducida a su mínima expresión con políticas transfusionales específicas. Se describe un paciente portador de Leucemia Mieloide Crónica sometido a Trasplante Alogénico con Donante emparentado e Incompatibilidad ABO.

Glaucoma is a widespread ocular disease and major cause of blindness characterized by progressive, irreversible damage of the optic nerve. Although the degenerative loss of retinal ganglion cells (RGC) and visual deficits associated with glaucoma have been extensively studied, we hypothesize that glaucoma will also lead to alteration of the circadian timing system. Circadian and non-visual responses to light are mediated by a specialized subset of melanopsin expressing RGCs that provide photic input to mammalian endogenous clock in the suprachiasmatic nucleus (SCN). In order to explore the molecular, anatomical and functional consequences of glaucoma we used a rodent model of chronic ocular hypertension, a primary causal factor of the pathology. Quantitative analysis of retinal projections using sensitive anterograde tracing demonstrates a significant reduction (approximately 50-70%) of RGC axon terminals in all visual and non-visual structures and notably in the SCN. The capacity of glaucomatous rats to entrain to light was challenged by exposure to successive shifts of the light dark (LD) cycle associated with step-wise decreases in light intensity. Although glaucomatous rats are able to entrain their locomotor activity to the LD cycle at all light levels, they require more time to re-adjust to a shifted LD cycle and show significantly greater variability in activity onsets in comparison with normal rats. Quantitative PCR reveals the novel finding that melanopsin as well as rod and cone opsin mRNAs are significantly reduced in glaucomatous retinas. Our findings demonstrate that glaucoma impacts on all these aspects of the circadian timing system. In light of these results, the classical view of glaucoma as pathology unique to the visual system should be extended to include anatomical and functional alterations of the circadian timing system.

El Mieloma Múltiple (Mieloma de células plasmáticas, mielomatosis, o enfermedad de Kahler) constituye el prototipo de gammapatía monoclonal maligna y se caracteriza por la proliferación neoplásica de una clona de células plasmáticas que produce una inmunoglobulina de carácter monoclonal. Si bien no existe cura, hasta hoy, para el mieloma múltiple, existen estrategias para el tratamiento que pueden ayudar a reducir los síntomas y mejorar la calidad de vida del paciente. Desafortunadamente, por lo general, la posibilidad de sobrevivir no ha mejorado significativamente en los últimos 30 años. Se encuentra en curso una gran cantidad de investigaciones para hallar tratamientos más efectivos y menos tóxicos. Bortezomib, el primero de una nueva clase de drogas denominadas inhibidores de proteosoma, ha sido aclamado como un tratamiento avanzado para el cáncer en pacientes con recaída y mieloma múltiple refractario. Los porcentajes de respuesta que se observaron en los ensayos clínicos condujeron a que el Bortezomib sea el primer tratamiento aprobado por la FDA de los EE.UU. para el mieloma múltiple en más de una década.

This study looks at a case study research on a language awareness workshop in a New York public school with a dual language (Spanish/English) program. A learner-centred lesson, taught in Spanish, focused on basic personal information exchanges for in-service teachers who taught only in English and who had some limited knowledge of Spanish. The instructors' charge was to teach participants how to exchange basic personal information in Spanish. Working from a cultural historical activity theory perspective, the interactions that took place in a videotaped session were analysed, using tools from discourse analysis, conversation analysis, and linguistics. The focus was set on the interactions of the instructors with one of the teachers in the workshop to examine how she moved from resisting a new language to embracing an understanding of the role of a new language in learning by paying attention to the dynamics of identity production. By exploring moment-to-moment identity moves and moves across time, the authors identified learning actions leading to the potential of expansive learning and suggesting enhancement of the concept of experiencing (Sannino, 2010) by examining the production of the teacher's identity.