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Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a serious threat to public health. Globally, carbapenemases-producing CRPA isolates mainly belong to ‘high-risk’ clones; however, the molecular epidemiology of CRPA isolates circulating in Chile are scarce, where this pathogen is the main aetiological agent of ventilator-associated pneumonia. Objectives: To characterize the phylogenomics and molecular features of ST654 CRPA isolates collected in Chile between 2016 and 2022. Methods: Eighty-nine CRPA isolates collected in different Chilean hospitals from clinical specimens between 2005 and 2022 were analysed. Antibiotic susceptibility tests and carbapenemases production were carried out on the CRPA ST654 isolates. Also, they were subjected to whole-genome sequencing, from which in silico analyses were performed. Results: Thirty-four strains (38.2%) belonged to the ST654 high-risk clone, being the most predominant lineage of the collection. Most of these isolates belonged to a subclade including KPC producers that also clustered with strains from Argentina and the United States, whereas few VIM and NDM co-producers clustered in two different smaller subclades. The isolates exhibited a broad resistome encompassing genes mediating resistance to several other clinically relevant drugs. Additionally, all the 34 ST654 isolates were ExoS+ as a virulence factor and associated to the O4-serotype. Conclusions: Our report represents the most comprehensive phylogenomic study of a CRPA high-risk clone ST654 to date. Our analyses suggest that this lineage is undergoing a divergent evolutionary path in Chile, because most of the isolates were KPC producers and were O4 serotype, differing from previous descriptions, which underline the relevance of performing molecular surveillance on this pathogen.

This essay uses storytelling as a mode of inquiry to explore how students with languages other than English and with diasporic experiences and identities negotiate a pathway for themselves in a relentlessly Anglophone environment. I share a story that provides a small window into the everyday work of an English teacher in a large, linguistically diverse school with a large Muslim community on the outskirts of Melbourne. I explore the contexts in which they work and the challenges of representing the affective and ethical dimension of English teachers' work. I reflect on my own situatedness as a researcher and how the methodological and theoretical choices I make are influenced by who I am and how I see the world. This reflexivity helps me understand why I see what I see as a researcher.

Objetivo: Desvelar as vivências de cuidadores de idosos que residem em instituições de longa permanência, durante o confinamento no contexto da pandemia de Covid-19. Método: Método: pesquisa qualitativa, descritiva, através de estudo de caso intrínseco. Amostra intencionada por critério e conveniência de seis cuidadores, Região de Los Ríos, Chile, entrevista semiestruturada foi realizada no ano de 2021. Análise através de comparação constante e redução progressiva. A validade foi garantida pelo cumprimento de critérios de rigor, triangulação por especialistas. Resultados: 489 unidades de significado deram origem a quatro grupos temáticos: Significado de ter vivido a experiência, fatores facilitadores, fatores dificultadores e recomendações. Emergiram dois domínios: Contribuição dos cuidadores para o reforço do seu papel durante a pandemia e Contribuição para o reforço da gestão. Conclusões: permite reconhecer e validar o vínculo afetivo, o empenho e a vocação dos prestadores de cuidados, aspectos fundamentais a reforçar através do aconselhamento e da formação para garantir a qualidade dos cuidados.

Objective: Uncover the experiences of caregivers of elderly people living in long-term care institutions, during confinement in the context of the Covid-19 pandemic. Method: Qualitative, descriptive research, through an intrinsic case study. Intentional sample by criteria and convenience of six caregivers, Los Ríos Region, Chile; a semi-structured interview was carried out in 2021. Analysis applying the constant comparative method and progressive focusing approach. Validity was ensured by compliance with the criteria of rigor and researcher triangulation. Results: 489 units of meaning gave rise to four thematic groups: Meaning of having lived the experience, facilitating factors, hindering factors and recommendations. Two domains emerged: Contribution of caregivers to strengthening their role during the pandemic and Contribution to strengthening management. Conclusions: it allows recognizing and validating the emotional bond, commitment and vocation of care providers, key aspects to be reinforced through counseling and training to guarantee the quality of care.

Objetivo: develar las vivencias de cuidadores de personas mayores que residen en instituciones de larga permanencia, durante el confinamiento en contexto de pandemia por Covid-19. Método: investigación cualitativa, descriptiva, mediante estudio intrínseco de casos. Muestra intencionada por criterios y conveniencia de seis cuidadoras, Región de Los Ríos, Chile, se realizó entrevista semiestructurada, en el año 2021. Análisis a través de comparación constante y reducción progresiva. Se cauteló validez cumpliendo criterios de rigor, triangulación por expertos. Resultados: 489 unidades de significado originaron cuatro núcleos temáticos: Significado de haber vivido la experiencia, factores facilitadores del trabajo, factores que lo dificultan y recomendaciones. Emergieron dos dominios: Aportes de las cuidadoras para fortalecer su rol durante la pandemia y Contribución para fortalecer la gestión. Conclusiones: permite reconocer y validar el vínculo afectivo, compromiso y vocación de las cuidadoras, aspectos fundamentales a fortalecer mediante consejería y capacitación para asegurar la calidad de los cuidados.

Convergence of virulence and antibiotic-resistance has been reported in Klebsiella pneumoniae, but not in Klebsiella variicola. We, hereby, report the detection and genomic characterization of hypervirulent and hypermucoviscous K. pneumoniae and K.variicola recovered in Chile from health-care associated infections, which displayed resistance to broad-spectrum cephalosporins. One hundred forty-six K. pneumoniae complex isolates were screened by hypermucoviscosity by the “string test.” Two hypermucoid isolates, one hypermucoviscous K. pneumoniae (hmKp) and one K. variicola (hmKv), were further investigated by whole-genome sequencing. In vivo virulence was analyzed by the Galleria mellonella killing assay. In silico analysis of hmKp UCO-494 and hmKv UCO-495 revealed the presence of multiple antibiotic-resistance genes, such as blaCTX-M-1, blaDHA-1 and blaLEN-25 among others clinically relevant resistance determinants, including mutations in a two-component regulatory system related to colistin resistance. These genetic features confer a multidrug-resistant (MDR) phenotype in both strains. Moreover, virulome in silico analysis confirmed the presence of the aerobactin gene iutA, in addition to yersiniabactin and/or colicin V encoding genes, which are normally associated to high virulence in humans. Furthermore, both isolates were able to kill G. mellonella and displayed higher virulence in comparison with the control strain. In summary, the convergence of virulence and the MDR-phenotype in K. pneumoniae complex members is reported for the first time in Chile, denoting a clinical problem that deserves special attention and continuous surveillance in South America.

ABSTRACT The aim of this study was to investigate the genomic features of an extensively drug-resistant (XDR) Pseudomonas aeruginosa isolate (P-469) emerging in Chile. Antibiotic susceptibility was determined by disk diffusion and “colistin agar” test. Whole-genome sequencing (WGS) was performed by the Illumina NextSeq 2000 platform, and epidemiologically and clinically relevant data (i.e., sequence-type, serotype, mobile genetic elements, virulome, resistome, plasmidome, prophages, and CRISPR-Cas systems) were retrieved using multiple bioinformatic tools. The P-469 strain displayed an XDR profile, remaining susceptible to colistin. Genomic analysis revealed that this isolate belonged to the “high-risk” clone ST654 (CC654), serotype O4, and genotype exoS+. Strikingly, two CRISPR-Cas systems, five intact prophages sequences, and a broad resistome that included blaNDM-1 and the novel blaVIM-80 carbapenemase genes were predicted. Our results revealed the genomic characteristics of P. aeruginosa belonging to the high-risk clone ST654/O4 coproducing NDM-1 and VIM-80 in Chile, supporting that genomic surveillance is necessary to track the emergence and spread of epidemiologically successful WHO’s critical priority pathogens in order to prevent their rapid dissemination.

Background: the training of Occupational Therapists of the Universidad de La Frontera is carried out through innovative curricula; therefore, it is committed to methodological strategies to develop critical and reflective thinking, teamwork with social responsibility, Learning and Service arises. Objective: to know the perception in relation to learning and service, in 5th level students in the psychosocial intervention module of the Occupational Therapy course at the University of La Frontera. Methods: qualitative, descriptive, exploratory study was carried out through an intrinsic case study. The non-probabilistic, intentional sample of cases by criteria and for convenience, made up of 20 students, after signing the informed consent, formed two focus groups. For data analysis, progressive reduction and grouping into descriptive categories was used. Guba's criteria of rigor and Emanuel's ethical aspects were used. Results: from Level I, 332 units of meaning emerged, grouped into 4 descriptive categories coded according to the objective of the study: meaning of the concept, development of generic competences, facilitating factors and impeding factors, conflict resolution and continuous learning for the first as competences; for the second, learning by doing and meaningful learning; for the third teaching aid and community communication; for the fourth personal aspects and interpersonal relationships. Conclusions: the students attribute great value to this Learning and Service methodology; it allows them to develop relevant competencies for essential professional use for the therapeutic bond, visualized generic competences: conflict resolution, continuous learning, and critical and reflective sense. DeCS: COMPETENCY-BASED EDUCATION; OCCUPATIONAL THERAPY; EVALUATION STUDIES AS TOPIC; UNIVERSITIES; LEARNING.

Background: investigating the competences of a subject allows to reflect and to strengthen the training. Objective: to reveal nursing students’ opinion regarding development of acquired competences through first aid subject. Methods: an exploratory qualitative research was undertaken, a deliberated sample by criteria was constituted by 15 nursing students of fifth grade. The study was developed during the second semester of 2016, and a focus group technique was performed (two focus groups of seven and eight students respectively).Also, were conducted a semi-structured interview, it was worked with Guba strict criteria, content analysis technique and categories emerged through Milles and Huberman framework. Results: three categories emerged related to First Aid on the Plan of Study: a) Meaning of the First Aid concept and subcategories, b) First Aid theoretical definition and c) Practical Definition of First Aid. For the second category called Development of Generic Competences, emerged two subcategories: Instrumental Competences, Systemic competences, and for the category of functions and areas of nursing professional practice developed through First Aid, emerged the categories of Educational Role and Assistance Role. Conclusions: nursing students define the concept of First Aid. From the generic competences identified, the instrumental competences were knowledge, communication and decision making. From the systemic competences were identified Motivation and Leadership as critical axes. According to the curriculum, were identified the assistance and educational roles. It is suggested to involve Psychological First Aid. DeCS: FIRST AID/nursing; FIRST AID/psychology; COMPETENCY-BASED EDUCATION; STUDENTS, NURSING; NURSE'S ROLE.

Fundamento: la labor de una enfermera/o es el cuidado, lo cual implica un trato directo con otros seres humanos, según tiempo, necesidades y ambiente en que se encuentren éstos. En este caso, en un campo diferente, como lo es una institución de protección de niños y adolescentes en riesgo. Objetivo: conocer la experiencia de cuidados de enfermería, develando las motivaciones y valores para cuidar niños, niñas y adolescentes en estos centros de la región de la Araucanía. Métodos: se realizó una investigación cualitativa de diseño fenomenológico. La población estuvo conformada por tres enfermeras/os, el tipo de muestra no probabilística, intencionada de casos por criterios y por conveniencia. Criterios de inclusión: enfermera/o que ejerza su labor en centros del SENAME. La técnica utilizada para la obtención de los datos fue una entrevista en profundidad. El análisis se logró, a través de reducción de éstos. La validez fue comprobada con criterios de rigor y, además, triangulada por investigadores. Se contemplaron los principios éticos de Ezequiel Emanuel. Resultados: del foco central, experiencia en cuidados de enfermería en centros de menores surgieron tres categorías: motivaciones para ejercer la Enfermería, cuidados de Enfermería y valores para otorgar cuidados de Enfermería. Para la primera, emergen como subcategoría: incentivo para trabajar en el centro; para la segunda, inicio y evolución de Cuidados de Enfermería, y para la tercera brotan subcategorías: identificación de valores, desempeño de valores institucionales o profesionales y por último, experiencia de valores profesionales en el cuidado. Conclusiones: las motivaciones para ingresar a trabajar en los centros: estabilidad laboral y seguridad económica. En el cuidado de Enfermería, se identificaron actividades asistenciales y administrativas. Los enfermeros/as evidencian valores como la ética, tolerancia, empatía y dedicación con propiedad profesional e institucional. DeCS: ATENCIÓN DE ENFERMERÍA; SERVICIOS DE PROTECCIÓN INFANTIL; SERVICIOS DE SALUD DEL ADOLESCENTE; SERVICIOS DE SALUD DEL NIÑO; BIENESTAR DEL NIÑO.

Background: the cinema in the teaching-learning process allows developing creativity, complementing knowledge, favors critical analysis, thought abstraction, delivers content that the teacher wishes to profile in the film light by offering moments of the educational space with entertainment, favoring understanding. Objective: to reveal the opinion of fifth year students of the Nursing degree regarding cinema as an educational strategy. Methods: qualitative research based on the grounded theory. The sample was not probabilistic, intentional of cases by criteria and convenience, made up of 21 students, after signing an Informed Consent authorized by the School Office. Information gathering was carried out through in-depth interviews and analysis through data reduction. The validity was checked with rigor criteria and was also triangulated by researchers. Results: the theme of Filmography Workshop for Mental Health emerged from which four categories arose: Meaning of educational strategies to learn Mental Health, facilitating factors for learning through cinema, impeding factors for learning through of cinema andfunctions and fields of the professional practice of the Nurse / or in Mental Health identified through cinema. Conclusions: the cinematic workshop is an excellent activity as educational strategy, it strengthens abstract and critical thought, delivers pedagogic tools at the disposal of the formation. Facilitating factors: used methodology and the role of the teacher, it is indicated that the absence of time and the search of the type of format of the movies became obstructing factors; the educational and attendance roles were identified, to allow them to prepare activities linked to the professional role, it is possible to incorporate critical thought, decision making and the discipline role was identified. DeCS: EDUCATION, NURSING; PROFESSIONAL TRAINING; STUDENTS, NURSING; MOTION PICTURES; LEARNING.

This essay focuses on the recent introduction by the Australian Federal Government of standardised literacy testing in all states across Australia (that is, the National Assessment Program--Literacy and Numeracy, or NAPLAN), and explores the way this reform is mediating the work of English literacy educators in primary and secondary schools. We draw on data collected as part of a research project funded by the Australian Research Council, involving interviews with teachers about their experiences of implementing standardised testing. These interviews indicate that the introduction of standardised testing does not merely constitute an additional part of teachers' workloads, but that it is having a significant impact on their identity as language educators, their understanding of curriculum and pedagogy, and the relationships they seek to maintain with their students. By introducing the NAPLAN tests, the Australian Federal Government is going down the path of other neo-liberal governments around the world. No doubt the story we tell will be familiar to readers in other countries. Our aim, however, is more than simply to give yet another account of the tensions experienced by committed language and literacy teachers as they implement neoliberal policy mandates. Key questions for us include: Why is the Australian government persisting with such policies, even when they have had such dubious consequences (teaching to the test, dumbing down, and so on.) in other national settings? How might educators resist these reforms? What intellectual resources might enable us to articulate an alternative vision of language education to that imposed by neoliberal reforms? (Contains 1 footnote.)

Objetivo: Conocer la opinión de estudiantes de la carrera de Enfermería de la Universidad Autónoma de Chile, respecto del rol del supervisor clínico. Metodología: Investigación cualitativa, descriptiva, interpretativa a través de un estudio intrínseco de caso. Muestra intencionada, de casos por criterios y por conveniencia, conformada por 24 estudiantes de quinto año, previa firma del consentimiento informado, año 2015. Recolección de datos mediante tres grupos focales; para el análisis de ellos se utilizó reducción progresiva y agrupación en categorías descriptivas. Se utilizaron los criterios de rigor de Guba, triangulando por investigadores. Aspectos éticos resguardados por el Comité Ético de Universidad de La Frontera. Resultados: En el Nivel 1 emergieron 257 unidades de significado, agrupadas en: “Factores obstaculizadores del supervisor clínico”, “Características del supervisor clínico”, “Factores facilitadores del supervisor clínico” y “significado del supervisor clínico”. En el Nivel 2 surgen tres núcleos temáticos, finalizando en el Nivel 3 con dos dominios cualitativos: “Factores asociados al supervisor clínico que inciden en el proceso enseñanza-aprendizaje” y “Perfil y atributos del supervisor clínico”. Conclusiones: Para los educandos es importante la formación docente y disciplinar de quien realiza la supervisión clínica, destacando las habilidades interpersonales para ejercer el rol.

This essay presents an English teacher's inquiry into her professional practice in an institutional setting that is heavily regulated by standards-based reforms. Rather than something external to her, she sees those reforms as part of an internal conflict that affects her capacity to be fully responsive to her students. In dialogue with a colleague, she writes stories that reaffirm the deeply relational character of her work, both as an ethically responsive stance and as a means to understand the socially mediated character of her everyday world. She attempts to find alternative ways of seeing and accounting for her work than the reified mentality of standards-based reforms, positing a world that is relational, rather than compartmentalised, where our chief responsibility as teachers is to cultivate a sensitivity towards others around us, rather than continually being compelled to classify and judge them.

The following text is a "narrative inquiry" (Clandinin and Connelly, 2000) in which I present an account of my experiences as an English teacher working in an Australian public secondary school. I explore the ways in which my beliefs as an English teacher conflicted with my role as a Literacy Co-ordinator/teacher and how--even though I may have consciously questioned and resisted performing certain ideological work, such as administering standardised tests and sorting students into remedial groups--there was still a sense in which government policies mediated my professional practice, transforming it into something with which I remained deeply at odds. My aim is not just to provide an empirical account of how students and teachers experienced these literacy initiatives, but to capture the dominant ideology that is shaping education at the current moment. I do this by examining the Victorian government school publication, "Education Times," specifically to demonstrate how the rhetoric of this official publication shaped my professional practices and knowledge as an English teacher. Through this narrative I interrogate taken-for-granted understandings about what counts as "knowledge" in an age of increasing accountability.

Introduction The learning process demands appropriate and effective strategies. Furthermore, the service-learning methodology implies significant challenges for both the student and the teacher-tutor. Objective To reveal the experience of community-based teacher-tutors work with nursing students from the Austral University of Chile, using the service-learning methodology. Method Descriptive and exploratory qualitative research through an intrinsic case study. Non-probabilistic and intentional sample of cases by criteria and convenience. Five teachers from the Austral University of Chile Nursing Institute hired by the university were interviewed. They fulfilled the role of teacher-tutor after signing the informed consent. The information was obtained through semi-structured interviews, and the analysis was carried out through the data reduction methodology, which considers the analysis of results at three levels. The Scientific Ethics Committee of the Austral University of Chile School of Medicine approved the study. Results At level 1: One hundred and seven (107) units of meaning were identified, grouped into five descriptive categories. At level 2, three meta-categories were formed: "opinion of the tutor-teachers on working with the service-learning methodology", "factors that influence working with the service-learning methodology" and "generic competencies developed with the service-learning methodology. Finally, at level 3, two qualitative domains were identified: "Teacher-tutors appreciation for the development of the service-learning methodology" and "Contributions of the service-learning methodology for developing generic competencies". Conclusions The efficient implementation of the methodology requires training and motivation of tutors, teachers, students and community partners.

Introducción. La competencia es entendida como la capacidad para responder solicitudes y realizar tareas de forma adecuada. Los estudiantes de todos los programas deben desarrollarla durante el transcurso de su formación para responder a los requerimientos del mercado laboral. Objetivo. Explorar la percepción de estudiantes de enfermería sobre la adquisición de competencias genéricas a través de la metodología aprendizaje-servicio. Materiales y métodos. Se realizó una investigación cualitativa mediante un estudio intrínseco de casos. La muestra fue no probabilística, intencional por criterios y a conveniencia (16 estudiantes de quinto y séptimo semestre de la carrera de enfermería). La información fue obtenida mediante grupos focales, el análisis se hizo a través de reducción de datos y se contó con firma del consentimiento informado. Resultados. Se encontraron 237 unidades de significado relevantes y dos dominios cualitativos: “beneficios de la metodología aprendizaje-servicio en el proceso de formación de los estudiantes de la carrera de enfermería” y “contribuciones del estudiantado en relación a la utilización de la metodología aprendizaje-servicio”. Conclusiones. La metodología aprendizaje-servicio es un aporte a la formación del alumnado de enfermería y una posibilidad cierta de desarrollar competencias genéricas en diferentes ámbitos.

Enterobacteria-producing extended-spectrum β-lactamases (ESBL) play an important role in healthcare infections, increasing hospitalization time, morbidity and mortality rates. Among several ESBLs that emerge from these pathogens, CTX-M-type enzymes had the most successful global spread in different epidemiological settings. Latin America presents high prevalence of CTX-M-2 in ESBL-producing enterobacterial infections with local emergence of the CTX-M-1 group. However, this high prevalence of the CTX-M-1 group has not yet been reported in Chile. The aim of this study was to identify ESBLs among enterobacteria isolated from clinical samples of critically ill patients from southern Chile. One-hundred thirty seven ESBL-producing bacteria were isolated from outpatients from all critical patient units from Hernán Henríquez Aravena Hospital. Phenotype characterization was performed by antibiogram, screening of ESBL, and determination of minimum inhibitory concentration (MIC). PCR was used for genetic confirmation of resistance. Molecular typing was performed by ERIC-PCR. ESBL-producing isolates were identified as Klebsiella pneumoniae (n = 115), Escherichia coli (n = 18), Proteus mirabilis (n = 3), and Enterobacter cloacae (n = 1), presenting multidrug resistance profiles. PCR amplification showed that the strains were positive for blaSHV (n = 111/81%), blaCTX-M-1 (n = 116/84.7%), blaTEM (n = 100/73%), blaCTX-M-2 (n = 28/20.4%), blaCTX-M-9 (0.7%), blaPER-1 (0.7%), and blaGES-10 (0.7%). The multiple production of ESBL was observed in 93% of isolates, suggesting high genetic mobility independent of the clonal relationship. The high frequency of the CTX-M-1 group and a high rate of ESBL co-production are changing the epidemiology of the ESBL profile in Chilean intensive care units. This epidemiology is a constant and increasing challenge, not only in Chile, but worldwide. Keywords: ESBL-producing enterobacteria, Intensive care units, CTX-M-1 group

The impact of dried apples (Malus × domestica Borkh.) addition on improving the antioxidant characteristics of dark chocolate was evaluated. The antioxidant activity was measured through DPPH scavenging activity and showed an increase in the cocoa bar with ‘Nesta’ dry apple (17.3% vs. 46.8%) in comparison to cocoa mass. The 15 polyphenols analyzed by UHPLC-ESI-MS/MS indicated great variability among the apple varieties. Quercetin was detected in the highest concentrations (ranged from 753.3 to 1915.5 µg g−1), while the lowest were for kaempferol 7-O-glucoside, measured only in ‘Mora’ and ‘Nesta’ cocoa bars (from 0.034 to 0.069 µg g−1, respectively). P-coumaric acid, trans-ferulic acid, and chlorogenic acid contribute largely to the antioxidant activity in cocoa bars. Principal component analysis shows that a cocoa bar with the addition of ‘Nesta’ dry apple differ from others due to its higher content of polyphenols (1614 ± 61.8 mg gallic acid equivalents per 100 g). In conclusion, data confirm that cocoa bars with dry apples might be considered as a polyphenol-enriched food.

Objetivo: Conocer el significado que otorga el usuario mapuche, adscrito al Programa Salud Cardiovascular 2016, Consultorio Makewe, Temuco, Chile, a la hipertensión arterial. Metdología: Investigación bajo el paradigma cualitativo, con base en la teoría fundamentada. La muestra fue conformada por veintidós usuarios, no probabilística, intencionada de casos por criterios y conveniencia, de acuerdo con criterios de inclusión. La recolección de información se hizo mediante dos grupos focales y ocho entrevistas en profundidad, hasta llegar al punto de saturación, previa firma de consentimiento informado. El análisis se caracterizó por ser dinámico y creativo, basado en la estrategia de método comparativo constante, realizando codificación y análisis simultáneo. La validez se comprobó con criterios de rigor y fue triangulada por investigadores. La investigación fue autorizada por el Comité Ético Científico de la Universidad de La Frontera. Resultados: Para hipertensión arterial emergieron cuatro categorías: “Significado” (definición del concepto), “Causa” (percepción), “Convivir” (cambios) y “Tratamiento” (farmacológico, herbolaria, machi —curandera o consejera—). Conclusiones: Sin haber definido la patología, los mapuches la asocian a signos, síntomas y causas; confían en tratamientos otorgados por un equipo de salud, pero no en las/los machis, reconociendo algunas de ellas como buenas, las que por alta demanda y costo son inaccesibles. En general, se ha descuidado la Ley Indígena 19253 de 1993, que da lugar a la institucionalización del Programa de Salud con Población Mapuche (promap), dependiente del Servicio de Salud Araucanía.

Introducción. En la última década, la diabetes miellitus ha presentado un aumento exorbitante en el mundo y la úlcera del pie se constituye como la complicación más seria y costosa, con posible amputación e inclusive la muerte. Objetivo. Conocer la percepción de los pacientes diabéticos pertenecientes al CESFAM Belarmina Paredes en Futrono, Chile, en relación con la aparición de úlceras del pie diabético. Materiales y métodos. Investigación cualitativa realizada mediante estudio intrínseco de casos. Muestra no probabilística, intencionada de casos por criterios y conveniencia, conformada por 12 pacientes con previa firma del consentimiento informado. La información se obtuvo por medio de grupos focales y el análisis se realizó a través de reducción de datos. Resultados. De las 495 unidades de significado develadas en el nivel 1 y su consecuente reducción en el nivel 3, se obtuvieron dos dominios cualitativos: “Conceptos y experiencias vividas producto de la enfermedad y rol equipo de salud” y “Aportes para mejorar calidad de atención”. Conclusiones. Los participantes consideran que la úlcera del pie es una herida.Sin consciencia de riesgo, identifican la amputación como secuela; sin embargo, tienen conocimiento etiológico, describen signos, síntomas y develan tratamiento farmacológico. Expresan cambios en la vida diaria, ausencia laboral y grado de dependencia.

Introduction: The importance of clinical supervisors in the training process of future health professionals is evident. Objective: To know the opinion of the Nutrition and Dietetics students from the Autonomous University of Chile-Temuco regarding the role of clinical supervisors from the Internal Medicine Service of the Dr. Dino Stagno Hospital in the professional practice with adults. Materials and methods: Qualitative, descriptive and interpretative research carried out through an intrinsic case study using a nonprobabilistic and intentional sample. An interview was applied for data collection after obtaining a signed informed consent. Data analysis followed a progressive reduction scheme and validation was made using rigor and triangulation criteria according to the researchers. Results: 105 units of analysis allowed obtaining four categories: factors that hinder the development of the practice (31); factors that favor the development of the practice (30); experience acquired during practice (28), and achievement of program objectives during the practice (16). Finally, a qualitative domain was obtained. Conclusions: Developing professional practice in the adult Internal Medicine Service is a positive experience for students since it allows them to develop self-learning skills, acquire other kinds of skills and achieve the objectives of medical internship. Human resources in hospitals are a favoring factor, and the absence and scarce communication with the university supervisor is an impeding factor.

(1) Background: The aim of this research is to study the importance of improving knowledge of old variety apples in terms of phytochemicals, antioxidant capacity and mineral elements. (2) Methods: Fifteen phenolic compounds (UHPLC-MS/MS techniques), eight mineral elements (Ca, K, Cu, Mn, Fe, Zn, Na and Mg), antioxidant capacity (DPPH%) and vitamin C content in four ancient apple varieties of Tuscany (‘Mora’, ‘Nesta’, ‘Panaia’ and ‘Ruggina’), with the ‘Golden Delicious’ cultivar as reference, were analyzed. (3) Results: Ancient cultivars exhibited a superior antioxidant capacity compared to commercial cultivars. ECTC and CGA were the polyphenols that mostly characterized the ancient apples. The contents of the elements of concern, Zn and Mn, were higher in the ancient cultivars ‘Panaia’ and ‘Ruggina’, while Na showed significant low concentration in ‘Nesta’, ‘Panaia’ and ‘Ruggina’ compared to ‘Golden Delicious’. The vitamin C content also indicated that ‘Mora’, ‘Panaia’ and ‘Ruggina’ old variety had an AsA content around 10 times higher than the ‘Golden Delicious’ apple. (4) Conclusions: Underutilized varieties could be an excellent source of bioactive phenolic phytochemicals, mineral nutrients and vitamins that may offer special nutraceutical benefits compared to other fruits.

Abstract Background Eicosapentaenoic acid (EPA, C20:5n-3), docosahexaenoic acid (DHA, C22:6n-3) and arachidonic acid (AA, C20:4n-6) are long-chain polyunsaturated fatty acids (LCPUFAs) with relevant roles in the organism. EPA and DHA are synthesized from the precursor alpha-linolenic acid (ALA, C18:3n-3), whereas AA is produced from linoleic acid (LA, C18:2n-6) through the action of Δ5 and Δ6-desaturases. High-fat diet (HFD) decreases the activity of both desaturases and LCPUFA accretion in liver and other tissues. Hydroxytyrosol (HT), a natural antioxidant, has an important cytoprotective effects in different cells and tissues. Methods Male mice C57BL/6 J were fed a control diet (CD) (10% fat, 20% protein, 70% carbohydrates) or a HFD (60% fat, 20% protein, 20% carbohydrates) for 12 weeks. Animals were daily supplemented with saline (CD) or 5 mg HT (HFD), and blood and the studied tissues were analyzed after the HT intervention. Parameters studied included liver histology (optical microscopy), activity of hepatic desaturases 5 and 6 (gas-liquid chromatography of methyl esters derivatives) and antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase, and glutathione reductase by spectrophotometry), oxidative stress indicators (glutathione, thiobarbituric acid reactants, and the antioxidant capacity of plasma), gene expression assays for sterol regulatory element-binding protein 1c (SREBP-1c) (qPCR and ELISA), and LCPUFA profiles in liver, erythrocyte, brain, heart, and testicle (gas-liquid chromatography). Results HFD led to insulin resistance and liver steatosis associated with SREBP-1c upregulation, with enhancement in plasma and liver oxidative stress status and diminution in the synthesis and storage of n-6 and n-3 LCPUFAs in the studied tissues, compared to animals given control diet. HT supplementation significantly reduced fat accumulation in liver and plasma as well as tissue metabolic alterations induced by HFD. Furthermore, a normalization of desaturase activities, oxidative stress-related parameters, and tissue n-3 LCPUFA content was observed in HT-treated rats over control animals. Conclusions HT supplementation prevents metabolic alterations in desaturase activities, oxidative stress status, and n-3 LCPUFA content in the liver and extrahepatic tissues of mice fed HFD.

La simulación clínica integra la complejidad del aprendizaje práctico-teórico con posibilidad de repetición, retroalimentación, evaluación y reflexión para lograr competencias disciplinares y genéricas del educando. El objetivo es develar la opinión de estudiantes de enfermería acerca del uso de simulación clínica como estrategia de aprendizaje. Se trata de una investigación cualitativa exploratoria y descriptiva, mediante estudio intrínseco de casos, muestra no probabilística, intencionada de casos por criterios y conveniencia, conformada por 15 informantes, 2016, información recogida mediante grupos focales, analizados por reducción de datos en tres niveles, siguiendo el esquema de comparación constante, no agrupándolas en categorías predeterminadas, por proceso de razonamiento inductivo, validados con criterios de rigor y triangulación de investigadores. En cuanto a los resultados, en el primer nivel emergen 320 unidades de significado agrupadas en 6 categorías descriptivas. En el segundo nivel: tres metacategorías y en el tercero, dos dominios cualitativos: aportes de estudiantes para la implementación de Simulación Clínica y contribución de ésta como estrategia de aprendizaje en el desarrollo de competencias disciplinares y genéricas. Se concluye que esta metodología reduce la brecha existente entre la teoría y práctica, fortalece las competencias genéricas y permite que el estudiante asuma la responsabilidad en su formación.

Objective: Obesity induced by high-fat diet (HFD) elicits white adipose tissue dysfunction. In this study, we have hypothesized that the metabolic modulator eicosapentaenoic acid (EPA) combined with the antioxidant hydroxytyrosol (HT) attenuates HFD-induced white adipose tissue (WAT) alterations. Methods: C57BL/6J mice were administered with a HFD (60% fat, 20% protein, 20% carbohydrates) or control diet (CD; 10% fat, 20% protein, 70% carbohydrates), with or without EPA (50 mg/kg/day), HT (5 mg/kg/day), or both for 12 weeks. Determinations in WAT include morphological parameters, EPA and docosahexaenoic acid content in phospholipids (gas chromatography), lipogenesis, oxidative stress (OS) and inflammation markers, and gene expression and activities of transcription factors, such as sterol regulatory element-binding protein-1c (SREBP-1c), peroxisome proliferator-activated receptor-gamma (PPAR-γ), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) (p65 subunit) and nuclear factor erythroid 2-related factor 2 (Nrf2) (quantitative polymerase chain reaction and enzyme linked immunosorbent assay). Results: HFD led to WAT hypertrophy in relation to PPAR-γ downregulation. WAT metabolic dysfunction was characterized by upregulation of lipogenic SREBP-1c system, mitochondrial energy metabolism depression, loss of the antioxidant Nrf2 signaling with OS enhancement, n-3 long-chain polyunsaturated fatty acids depletion and activation of the pro-inflammatory NF-κB system. EPA and HT co-supplementation diminished HFD-dependent effects additively, reaching values close or similar to controls. Conclusion: Data presented strengthen the importance of combined protocols such as EPA plus HT to attenuate metabolic-inflammatory states triggered by obesity.

This article interrogates the dominant ideology that is shaping education in Victoria at the current moment. It does so by analysing the government school publication, "Education Times," focusing on the years 2000-2003. During those years the Victorian Government invested a significant amount of money into improving the literacy outcomes of so-called underperforming students through initiatives such as "Restart" and "Access to Excellence." "Education Times" played an important role in promoting these initiatives, and thus provides a useful vehicle for examining the ideology driving educational reform in Victoria. (Contains 2 notes.)

Gas-Liquid Chromatography (GLC) methods such as AOAC Fat in foods 966.06 (2005), AOCS Official Methods Ce 1h-05 (2005), Ce 1j-07 (2007), allow for analyzing the fatty acids (FAs) in dietary fats using highly polar liquid phase capillary columns. However, there are still difficulties in completely separating butiric acid from solvent, FA critical pairs with similar polarity, conjugated linoleic acid (CLA) isomers, and long chainpolyunsaturated FAs (LC-PUFAs). Therefore, the selection of the temperature program to be employed is important. This work aimed to improve the AOCS Ce 1j-07 Method for the FA composition of a mixture of soybean and sunflower oil, fish oil, and butterfat, using a modified temperature program, tested among five laboratories. It takes more time, but it allows to completely separate butyric acid from the solvent, trans-18:1 from cis-18:1, 20:1 isomers from 18:3 n-3, 22:1 n-9 from 20:4 n-6, 20:5 n-3 from 24:0 and the main CLA isomers, thus permitting FA quantification in fats and oils for different purposes such as nutritional labeling, quality control and research.

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Uncover the experiences of caregivers of elderly people living in long-term care institutions, during confinement in the context of the Covid-19 pandemic. Method: Qualitative, descriptive research, through an intrinsic case study. Intentional sample by criteria and convenience of six caregivers, Los Ríos Region, Chile; a semi-structured interview was carried out in 2021. Analysis applying the constant comparative method and progressive focusing approach. Validity was ensured by compliance with the criteria of rigor and researcher triangulation. Results: 489 units of meaning gave rise to four thematic groups: Meaning of having lived the experience, facilitating factors, hindering factors and recommendations. Two domains emerged: Contribution of caregivers to strengthening their role during the pandemic and Contribution to strengthening management. Conclusions: it allows recognizing and validating the emotional bond, commitment and vocation of care providers, key aspects to be reinforced through counseling and training to guarantee the quality of care. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Obesity-induced by high-fat diet (HFD) is associated with liver steatosis, oxidative stress and mitochondrial dysfunction, which can be eluded by the co-administration of the lipid metabolism modulator docosahexaenoic acid (DHA) and the antioxidant hydroxytyrosol (HT). C57BL/6J mice fed a HFD were orally administered either with vehicle, DHA, HT or DHA+HT for 12 weeks. We measured parameters related to insulin resistance, serum lipid levels, liver fatty acid (FA) content and steatosis score, concomitantly with those associated with mitochondrial energy functions modulated by the transcriptional coactivator PGC-1a. HFD induced insulin resistance, liver steatosis with n −3 FA depletion, and loss of mitochondrial respiratory functions with diminished NAD+/NADH ratio and ATP levels compared with CD, with the parallel decrease in the expression of the components of the PGC-1α cascade, namely, PPAR-α, FGF21 and AMPK, effects that were not observed in mice subjected to DHA and HT co-administration. Data presented indicate that the combination of DHA and HT prevents the development of liver steatosis and the associated mitochondrial dysfunction induced by HFD, thus strengthening the significance of this protocol as a therapeutic strategy avoiding disease evolution into more irreversible forms characterised by the absence of adequate pharmacological therapy in human obesity. [ABSTRACT FROM AUTHOR]