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Abstract Background COVID-19 disease affected the cognitive level of institutionalized patients in nursing homes, especially in the older subjects regardless of gender. This study aims to assess cognitive impairment using the Mini-Mental State Examination (MMSE) before and after COVID-19 infection, and to determine whether these changes varied based on gender. Methods A pre- and post-COVID-19 study was conducted, involving 68 geriatric patients (34 men and 34 women) from two nursing homes. Cognitive impairment was assessed using the MMSE. Results COVID-19 infection had a notable impact on the cognitive health of older adults residing in nursing homes, primarily attributed to the social isolation they experienced. This effect was more pronounced in older individuals. A comparison of the MMSE results by gender before and after contracting COVID-19 revealed significant differences in attention and calculation, with women obtaining the worst score before the virus. However, following their recovery from the virus, men demonstrated significantly lower scores in time and space orientation and evocation. Conclusion COVID-19 has led to a decline in cognitive functioning, significantly worsening the mental state of older individuals, even after recovery from the virus. Consequently, it is crucial to implement proactive measures to prevent isolation and safeguard the cognitive well-being of this vulnerable population.

This paper outlines a description of research carried out at a public university in Colombia where students of the Hospitality and Tourism Management program took four general English levels in 2017 as a requirement to graduate. According to the data collected, these levels were not enough to acquire the necessary knowledge and skills to interact in English. This need, determined through questionnaires, and a CNA report were the starting point of this research study, whose main objective was to enrich students' language learning skills and knowledge through a CLIL curriculum. This participatory action research is framed within a qualitative study. After designing, implementing, and piloting one unit, including four lessons, we determined that not only students' language learning skills can be improved but also their confidence, participation, solidarity, and awareness of their and others' learning process through the activities designed and strategies proposed by this approach.

The aim of the present study was to determine the gender respiratory differences of bilateral diaphragm thickness, respiratory pressures, and pulmonary function in patients with low back pain (LBP). A sample of 90 participants with nonspecific LBP was recruited and matched paired by sex (45 women and 45 men). Respiratory outcomes included bilateral diaphragm thickness by ultrasonography, respiratory muscle strength by maximum inspiratory (MIP) and expiratory (MEP) pressures, and pulmonary function by forced expiratory volume during 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC spirometry parameters. The comparison of respiratory outcomes presented significant differences (p < 0.001), with a large effect size (d = 1.26–1.58) showing means differences (95% CI) for MIP of −32.26 (−42.99, −21.53) cm H2O, MEP of −50.66 (−64.08, −37.25) cm H2O, FEV1 of −0.92 (−1.18, −0.65) L, and FVC of −1.00 (−1.32, −0.69) L, with lower values for females versus males. Gender-based respiratory differences were presented for maximum respiratory pressures and pulmonary function in patients with nonspecific LBP. Women presented greater inspiratory and expiratory muscle weakness as well as worse lung function, although these differences were not linked to diaphragm thickness during normal breathing.

Abstract Background This research evaluated whether the relationships between factors of resilience, self-esteem, depression, and anxiety in dental students with changes in teaching and learning methods. We also studied the psychological impact of face-to-face lectures during the COVID-19 pandemic. Methods This cross-sectional descriptive study used Google Forms to collect data with the Rosenberg Self-Esteem Scale (RSE), Connor-Davidson Risk Resilience Scale (CD-RISC), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI and BDI-II). An open-ended question was also asked about important learning difficulties. Results The analysis revealed very high levels of resilience (30.23 ± 5.84), self-esteem in the normal range (29.08 ± 4.03), minimal depression levels (12.32 ± 8.05), and low anxiety levels (17.20 ± 12.41). There were no significant differences between sociodemographic variables ranges in regard to all psychological questionnaires. No high levels of depression and anxiety were found. Conclusions The levels were low compared to other studies in which online teaching was used, which is explained by the fact that the students retained adequate resilience and self-esteem thanks to being able to contact teachers and, above all, their own peers.

Background Onychocryptosis is a nail deformity that occurs when the side of the nail grows into soft tissue, which causes pain, sepsis and the formation of granulation. The aim of the study was to evaluate and compare different levels of kinesiophobia in subjects with onychocryptosis before and after surgery to eliminate this condition. Methods A descriptive and observational study was conducted with a total sample size of 25 subjects with a mean age of 40.96 ± 18.25 years. The pretest sample was composed of the 25 subjects before the surgical treatment of onychocryptosis and the posttest sample was composed of the same 25 subjects after the surgical treatment of onychocryptosis. Kinesiophobia levels and total scores were self-reported using the Spanish version of the Tampa Scale for Kinesiophobia (TSK-11). Results The Wilcoxon test for related samples and the Mann-Whitney U test for independent samples were used to compare the results before and after the surgical treatment. It was observed that in all the items as well as in the total score, there were significant changes in the levels of kinesiophobia, after the surgical intervention for onychocryptosis (P 0.05). Before surgery, 0% of the subjects with onychocryptosis reported not being afraid of movement, 16% reported mild fear of movement, 8% reported moderate fear of movement and 76% of the subjects with onychocryptosis reported severe and maximum fear of movement. On the other hand, 100% of the subjects did not report kinesiophobia after surgical treatment (P

Background The aging of the population highlights the need to establish empathetic connections with older adults. To achieve this, age simulation suits have been designed, allowing users to experience the physical limitations associated with aging. This study aimed to evaluate the experience of dental students with these devices, using psychometric tools to measure the impact on their understanding and empathy. Methods A pre/post-test study was conducted with the participation of 63 dental students from Rey Juan Carlos University who were fitted with an age simulation suit and asked to perform different tasks. Psychometric tools were used to assess specific parameters. Empathy was measured using the Jefferson Empathy Scale, emotional intelligence was assessed with the Trait Meta-Mood Scale-24 (TMMS-24), and the emotional attention dimension was analyzed using the Positive and Negative Affect Schedule (PANAS). Results The scores on the Jefferson Empathy Scale significantly improved from 88.44 ± 6.8 to 91.06 ± 10.11 after using the simulation suit (P

Introduction: The aim of the present study was to determine the effectiveness of simultaneous bilateral visual diaphragm biofeedback (BFB) from ultrasonography in conjunction with inspiratory muscle training (IMT) on diaphragmatic thickness during normal breathing and respiratory and clinical outcomes in patients with non-specific low back pain (NSLBP) and determine the influence of age and sex.Methods: A single-blind randomized clinical trial was carried out (NCT04582812). A total sample of 96 patients with NSLBP was recruited and randomized by sex-based stratification into IMT (n = 48) and BFB + IMT (n = 48) interventions over 8 weeks. Bilateral diaphragmatic thickness at maximum inspiration (Tins) and expiration (Texp), respiratory pressures, lung function, pain intensity, bilateral pressure pain threshold (PPT), disability, and quality of life were measured at baseline and after 8 weeks.Results: The BFB + IMT group showed significant differences (p < 0.05) with increased left hemidiaphragm thickness at Tins and Tins-exp (d = 0.38–053), and right and left PPT (d = 0.71–0.74) versus the IMT group. The interaction with sex was statistically significant (p = 0.007; F(1,81) = 7.756; ηp2 = 0.087) and higher left hemidiaphragm thickness at Tins was predicted by the BFB + IMT group (R2 = 0.099; β = 0.050; F(1,82) = 8.997; p = 0.004) and male sex (R2 = 0.079; β = 0.045; F(1,81) = 7.756;p = 0.007). Furthermore, greater left hemidiaphragm thickness at Tins-exp was predicted by younger age (R2 = 0.052; β = −0.001; F(1,82) = 4.540; p = 0.036).Discussion: The simultaneous bilateral visual diaphragm biofeedback by ultrasonography in conjunction with IMT was effective in both increasing the left diaphragmatic thickness during inspiration, which was positively influenced and predicted by male sex and younger age, and increasing the bilateral PPT of the paraspinal muscles in patients with NSLBP.

Introduction: The methods used in the diagnosis of pregnancy in rats mostly have disadvantages, such as: the need for a high degree of professional expertise, material costs, the need for anesthesia and the impossibility of diagnosing on the first days. However, the determination of body weight is easily obtained data, supported by a simple and non-invasive technique, which represents an advantage over other methods. Objective: To determine on which day of gestation the increase in body weight reaches sufficient significance to establish the diagnosis of pregnancy in Wistar rats. Material and Methods: It is an observational, prospective, longitudinal study. A total of 37 females were selected and divided into two groups: 24 pregnant rats (RG) and 13 non-pregnant rats (RNG). Both groups were weighed on gestation days 0, 2, 6, 9, 13 and 16. The variation in body weight was analyzed through the days. Results: Despite the body differences between groups on days 2 and 6, the results were inconclusive for this stage. The GR reached a minimum average increase of 27.5 g towards day 9, for this same day the average increase in the GR and RNG was 36.1 g and 9.17 g, respectively. Conclusions: Body weight from day 9 of gestation reaches sufficient relevance for the diagnosis of pregnancy in heterozygous Wistar rats, but not before day 6.

BackgroundAnkylosing spondylitis (AS) is a chronic, inflammatory, and autoimmune disease. This condition primarily affects the axial skeleton and presents direct foot involvement, such as Achilles enthesitis or plantar fascia involvement.ObjectiveThis study aimed to investigate the impact of foot health on the quality of life of individuals with AS compared to a control group without AS.Materials and methodsA sample of 112 subjects was recruited, with a mean age of 46.80 ± 10.49 years, divided into two groups: 56 individuals with AS (cases) and 56 individuals without AS (controls). Demographic data were collected, and the scores obtained in the Foot Health Status Questionnaire domains were recorded.ResultsOf the participants, 27.79% (N = 30) were men and 73.21% (N = 82) were women. The mean age in the group was 46.80 ± 10.49. Significant differences (p

This paper reports an action research study on cooperative learning projects for engineering students at a public university. The research study is aimed at improving reading skills through the use of four cooperative learning projects implemented during the English classes. Data gathered from a survey, four group interviews, and the teacher's journal were collected and analyzed to determine the categories after coding the data. Findings suggest that working cooperatively has a higher effect on students' reading skills. Conclusions also highlight that cooperative learning strengthens English reading skills and fosters leadership, decision making, communication and problem-solving abilities. Additionally, it increases participation, motivation and goal achievement in students' language learning process.

Las comunidades indígenas del norte del Cauca (Colombia) han venido sosteniendo una larga discusión sobre cómo atender el problema de desnutrición de sus miembros de manera autónoma. Esto nos lleva a preguntarnos: ¿Cuál es el camino que las comunidades indígenas Nasa se han propuesto para aportar alimentos nutritivos a su colectividad? Para responder esta pregunta, en la investigación que aquí se presenta se ha usado la investigación-acción participativa, comunitaria y transformadora (IAPCT), con técnicas que recogen conversatorios, talleres, entrevistas, matrices y trabajo en campo. Ello permitió identificar la importancia de las empresas comunitarias en la generación de alimentos nutritivos, destacando que este proceso es un pilar importante en el fortalecimiento de la autonomía económica.

IntroductionKinesiophobia and lymphedema appear to be related conditions, and it is important to understand this relationship, as many of the symptoms and comorbidities presented by individuals with lower limb lymphedema are prevented and treated through movement, thus constituting kinesiophobia as a barrier to intervention. The objective of this study is, therefore, to evaluate and analyze the kinesiophobic beliefs reported by individuals with and without lower limb lymphedema, regarding the agreement, severity and differences found, and to establish levels of kinesiophobia.MethodsA case-control study with a total sample of 80 participants (40 with lower limb lymphedema and 40 without) was performed. Both groups (with and without lymphedema) were characterized anthropologically, sociodemographically, and clinically. In the case group, lymphedema was evaluated. Participants in both groups completed the Tampa Scale for Kinesiophobia - 13 items (TSK-13).ResultsIndividuals with lower limb lymphedema had higher TSK-13 scores than their matched group without lymphedema. The items belonging to the activity avoidance subscale had the highest agreement and score in both groups. Differences between groups were mainly established for items belonging to the somatic focus subscale, showing that individuals with lower limb lymphedema have kinesiophobic beliefs related to the perceived severity of their lymphedema. The prevalence of kinesiophobia was increased in both groups, but the severity was mild.ConclusionsConsidering the apparent tendency of people with lower limb lymphedema to present kinesiophobia and movement-limiting beliefs regarding the condition, greater attention should be paid to its assessment, prevention and treatment from a multidisciplinary and multimodal perspective, which takes into account the multiplicity of factors inherent to kinesiophobia and lymphedema and thus reduce their impact on the management of lymphedema.

The COVID-19 pandemic caused abrupt and profound changes to teaching and learning. The present study seeks to understand adolescents' experiences of the emergency adoption of online school learning (OSL) during the first national lockdown in Italy. Sixty-four students in their final two years of high school were interviewed and content analysis was performed. The findings describe students' views of the changes related to OSL according to structural, individual and relational dimensions. Schools' lack of organization, overwhelming demands, as well as experience of difficulties in concentration, stress and inhibited relationships with teachers and classmates were among the challenges evidenced in the transition. OSL, however, has also made it possible to experience a new flexibility and autonomy in the organization of learning. The study stresses the importance of fostering adaptation of teacher-student relationships and collaborative learning in order to improve schools' preparedness for digital transitions in and out of emergencies., Author(s): Iana Tzankova [sup.1] , Christian Compare [sup.1] , Daniela Marzana [sup.2] [sup.3] , Antonella Guarino [sup.1] , Immacolata Di Napoli [sup.4] , Alessia Rochira [sup.5] , Emanuela Calandri [sup.6] [...]

Abstract Background The coronavirus 2019 (COVID-19) pandemic has prompted several changes in the learning methods of students. The purpose of this study was to establish whether a relationship between levels of resilience, self-esteem, anxiety, depression, and academic stress in both hybrid and virtual learning education exist. Methods A descriptive and observational case-control study was carried out in universities that offer nursing designation. A total sample of 140 freshman nursing students was recruited. Concretely, 70 participants were recruited from an university receiving hybrid education and 70 participants were recruited from another university receiving virtual learning education. Nursing students self-reported the following questionnaires: the Rosenberg Self-Esteem scale, the 10 CD-Risk Connor-Davidson Risk Resilience Scale, the Beck Anxiety Inventory, the Beck Depression Inventory and the Academic Stress Coping Scale. Results Significant differences (P = 0.001) showed higher depression levels for students who received virtual education versus received hybrid education. Differences in Rosenberg test for self-esteem and Beck Anxiety Inventory for anxiety (P > 0.05) were not found. Conclusion Students who received online education presented higher depression levels which could be due to they had not face-to-face relationships with teachers or classmates, whereas the hybrid education group received a different type of direct interaction with teachers and peers.

BackgroundFunctional Hallux Limitus (FHL) is a dynamic foot dysfunction characterized by a limitation of hallux dorsiflexion when the first metatarsal head is under load. FHL plays a role in the development of osteoarthrosis in the first metatarsophalangeal joint (IMTPJ). Forefoot disorders can significantly impact an individual's quality of life, leading to dysfunction and pain. The aim of this project was to evaluate the quality of life of school-aged individuals with and without FHL using the Foot Health Status Questionnaire (FHSQ).MethodsA case-control study was conducted to evaluate the outcomes in paediatric age. A total sample of 116 children between 6 and 12 years old was used to conduct this research. The sample was divided into two groups: (i) the healthy group (n = 58) and the FHL group (n = 58). The FHSQ was completed and the FHL test was performed in a seated position to classify the patients into the selected group.ResultsNon-significant changes were observed when the mean values of the FHSQ domains were compared between the groups with and without FHL, except for the “general foot health” domain (p = 0,024) associated with the specific foot health section (section 1) of the Questionnaire. For the domains linked with the general well-being section (section 2), there was not a statistically difference in the mean of the scores obtained between the two school-aged groups with and without FHL, being slightly lower in the group with the presence of FHL for the overall health and physical function domains. Both the healthy and case groups obtained and identical range of scores (10–100) for the “foot pain” domain. Nevertheless, the mean of the score was lower for the participants with FHL.ConclusionsThe perception of the quality of general foot health was poorer in the school-aged group with FHL. Variables such as foot pain and footwear are likely contributors influencing the perception of foot health quality. The school-aged population with FHL faces a decline in the quality of foot life. Ensuring adequate foot control in children and implementing future foot programs for this population are imperative for enhancing school children's perception of foot health and managing the development of pain and footwear-related issues.

En este trabajo nos proponemos un acercamiento a ciertas representaciones de Mendoza correspondientes a los años inaugurales del siglo XIX, en diferentes formatos: “Descripción de la ciudad de Mendoza, remitida por su Diputado de Comercio don Eusevio [sic] Videla”, publicado en El Telégrafo Mercantil, Rural, Político, económico e historiógrafo del Río de la Plata, de Buenos Aires, más dos obras “literarias” de Francisco de Serra y Canals: El celo del Español y el Indiano instruido (1800), y El Perito incógnito y el Curioso aprovechado, además, un “Plano topográfico de la Ciudad de Mendoza del año 1802”, extraído de la obra de Jorge Ricardo Ponte, Mendoza, aquella ciudad de barro. Historia de una ciudad andina desde el siglo XVI hasta nuestros días (1987) y que, conforme expresa dicho autor, fue publicado por Monseñor José Aníbal Verdaguer en su Historia Eclesiástica de Cuyo en 1931. Nuestro objetivo es la reconstrucción de las representaciones en torno del paisaje/territorio mendocinos en esos textos, y la hipótesis que guía nuestro abordaje es la posibilidad de detectar en ellos una serie de tópicos y términos que darían cuenta de la "modernidad" ilustrada. En dichos estudios esperamos advertir la evolución de las ideas en relación con las representaciones de Mendoza, visibles a través de diferentes estrategias de escritura.

Este artigo apresenta os avanços do projeto de pesquisa internacional "Movimentos socioterritoriais em perspectiva comparativa". O objetivo é analisar como a questão das desigualdades no acesso e controle da terra está incluída nos Objetivos de Desenvolvimento Sustentável, investigando as ações dos movimentos sociais rurais e as ações do Estado nesta área na Argentina. A metodologia é baseada em uma sistematização de notícias. Foram adotados critérios que permitem mapear estas ações e uma metodologia foi desenvolvida e comparada com outros países. Nesta ocasião, discutimos os resultados correspondentes a 2021, um ano marcado pela pandemia e por problemas econômicos como endividamento externo, escassez de moeda estrangeira e inflação. A análise dos dados mostra que os movimentos sociais rurais desenvolvem ações relacionadas à posse da terra e à consolidação de seus direitos, seja por meio de protestos ou de ações judiciais. Por outro lado, predominam ações estatais relacionadas ao fortalecimento do sistema produtivo, capacitação e assistência técnica, mas não há evidências de ações voltadas para a reversão das desigualdades na distribuição de terras em favor de camponeses e comunidades indígenas.

Using the policy narrative framework, this article examines the pathways through which the development of policies (related to rural/small towns young NEETs in various EU countries) are based on evidence. To do this, we consider the Youth Guarantee (YG), an EU program (2014-2020) developed in several member countries with the aim of socioprofessional inclusion of NEETs (young people aged 15-24 that are not in employment, education, or training). It examines how evidence is used for national policy-making and is taken into account by stakeholders. This study involves documentary analysis of YG in three European countries: namely, Romania, Italy, and Portugal. In addition, it involves 27 interviews with policy-makers and NGO leaders. The results show a predominantly statistical use of data exclusively managed by public institutions. Therefore, we emphasize the importance of consulting evidence from academia and NGOs to improve this policy.

Mesenchymal stem/stromal cells (MSCs) are multipotent cells located in different areas of the human body. The oral cavity is considered a potential source of MSCs because they have been identified in several dental tissues (D-MSCs). Clinical trials in which cells from these sources were used have shown that they are effective and safe as treatments for tissue regeneration. Importantly, immunoregulatory capacity has been observed in all of these populations; however, this function may vary among the different types of MSCs. Since this property is of clinical interest for cell therapy protocols, it is relevant to analyze the differences in immunoregulatory capacity, as well as the mechanisms used by each type of MSC. Interestingly, D-MSCs are the most suitable source for regenerating mineralized tissues in the oral region. Furthermore, the clinical potential of D-MSCs is supported due to their adequate capacity for proliferation, migration, and differentiation. There is also evidence for their potential application in protocols against autoimmune diseases and other inflammatory conditions due to their immunosuppressive capacity. Therefore, in this review, the immunoregulatory mechanisms identified at the preclinical level in combination with the different types of MSCs found in dental tissues are described, in addition to a description of the clinical trials in which MSCs from these sources have been applied.

La disminución de las barreras de género, el uso del tiempo diferenciado entre hombres y mujeres que investigan, la infraestructura material necesaria y los recursos humanos en investigacióny docencia, han mejorado gracias al impulso de las propias académicas.

El bienestar animal (BA) del ganado en régimen de manejo extensivo, ha sido muy poco estudiado y dentro del ganado bovino, la raza de lidia, es muy interesante en este aspecto por sus particularidades etológicas y su comportamiento agresivo. Se desarrolla un protocolo de valoración optimizado en base al proyecto Welfare Quality®, con el fin de integrar y evaluar el BA en las instalaciones, en el comportamiento de grupo, en los signos fisiológicos y en el manejo. Para ello se han evaluado 6 explotaciones distintas, 3 de ellas situadas en la región de Extremadura (España) y 3 en la región de Querétaro (México). Se escogieron 10 animales de cada subgrupo, formados en base al momento productivo y a los propios lotes de cada ganadería: vacas madres, sementales y lotes de animales de diferentes edades. Cada indicador de BA recogido en el protocolo se valoró en una escala de 1 a 5. La metodología de toma de datos desarrollada funcionó de forma adecuada. En general, las 6 ganaderías presentan una calificación óptima en todos los parámetros, si bien cabe destacar diferencias en cuanto a la distancia de aproximación, siendo menor en aquellas explotaciones en las que se manejan con mayor frecuencia a los animales, también reflejado en la curiosidad mostrada por los animales. Es importante destacar que el estudio refleja una alimentación adecuada, tanto a largo como a corto plazo (condición corporal y llenado ruminal) en las 6 ganaderías. En cuanto a la salud (respiración y mucosas, estado de pezuñas e índice de cojeras) se obtuvieron unos valores óptimos de BA. Se aprecia cierta diferencia entre las ganaderías de España y México en cuanto a la condición corporal de los animales, siendo sensiblemente menor en México, donde en invierno es la época seca, con menor cantidad de pasto.

ObjectivesDepression is a condition that can be associated with other illnesses, especially chronic illnesses. Lower limb lymphedema is a chronic, disabling condition that can affect the quality of life and be related to psychological and psychosocial factors that interfere with people’s lives. This study aims to characterize and analyze the depressive symptoms and their severity reported by people with lower limb lymphedema and compare them with a matched group without lymphedema.MethodsA case–control study was carried out (n = 80) with participants divided into a case group (40 people with lower limb lymphedema) and a control group (40 people without lower limb lymphedema). Both groups were anthropometrically, sociodemographically, and clinically characterized. In the case group, a characterization of lymphedema was performed. Participants completed the Beck Depression Inventory-II.ResultsIndividuals with lower limb lymphedema have higher BDI-II scores than the matched group without lymphedema. Somatic depressive symptoms were, in general, the most reported and the ones with the highest scores. The depressive symptoms most reported by the case group were tiredness or fatigue, loss of energy, and changes in sleeping. Tiredness or fatigue, loss of energy, and loss of interest in sex were the most severe depressive symptoms reported by individuals with lower limb lymphedema.ConclusionConsidering the apparent tendency to depression, greater attention should be given to the mental health of people with lower limb lymphedema.

Abstract Objective To discuss the results of the KETASER01 trial and the reasons for its failure, particularly in view of future studies. Methods KETASER01 is a multicenter, randomized, controlled, open‐label, sequentially designed, non‐profit Italian study that aimed to assess the efficacy of ketamine compared with conventional anesthetics in the treatment of refractory convulsive status epilepticus (RCSE) in children. Results During the 5‐year recruitment phase, a total of 76 RCSEs treated with third‐line therapy were observed in five of the 10 participating Centers; only 10 individuals (five for each study arm; five females, mean age 6.5 ± 6.3 years) were enrolled in the KETASER01 study. Two of the five patients (40%) in the experimental arm were successfully treated with ketamine and two of the five (40%) children in the control arm, where successfully treated with thiopental. In the remaining six (60%) enrolled patients, RCSE was not controlled by the randomized anesthetic(s). Significance The KETASER01 study was prematurely halted due to low eligibility of patients and no successful recruitment. No conclusions can be drawn regarding the objectives of the study. Here, we discuss the KETASER01 results and critically analyze the reasons for its failure in view of future trials.

El estado epiléptico (EE) es una emergencia médica y se asocia a una alta morbimortalidad. En la unidad de cuidados intensivos (UCI), existen dos grupos de pacientes con EE: pacientes con múltiples episodios de convulsiones que no responden al manejo inicial y aquellos admitidos por otras razones, quienes desarrollan fenómenos ictales subclínicos en el curso de su estancia en la UCI. El EE no convulsivo (EENC) representa entre el 25-50% de los EE; pero en el paciente crítico esta entidad puede tener una mayor incidencia. Se estima que 10 a 40% de los pacientes con EE evolucionan a un estado epiléptico refractario (EER). El EER se define como la falta de respuesta a un medicamento antiepiléptico de primera línea y a uno o dos medicamentos de segunda línea. Para el manejo del EER, se requiere de múltiples fármacos antiepilépticos (FAE), sedantes en dosis elevadas y a veces del uso de soporte ventilatorio y soporte vasopresor. El manejo del EER está basado en reportes de casos o experiencia de centros especializados, se recomienda la eliminación de la actividad ictal electrográfica con la inducción, por medio de sedación, de un patrón estallido-supresión; siendo una segunda alternativa, un manejo menos agresivo, sin sedación usando altas dosis de antiepilépticos, en una forma escalonada. El propósito de esta revisión es presentar las recomendaciones para el enfoque y manejo del EER en el paciente crítico basadas en la literatura actual y en la experiencia de la UCI del Instituto Neurológico de Antioquia (INDEA).

Background One of the measures for controlling the coronavirus disease 2019 (COVID-19) pandemic was the mass closure of gyms. This measure leads us to determine the differences between indoor and outdoor air quality. That is why the objective of this study was to analyse the indoor air quality of a sports centre catering to small groups and rehabilitation. Methods The study was conducted in a single training centre, where 26 measurements were taken in two spaces (indoors and outdoors). The air quality index, temperature, relative humidity, total volatile compounds, carbon monoxide, ozone, formaldehyde, carbon dioxide, and particulate matter were measured indoors and outdoors using the same protocol and equipment. These measurements were taken twice, once in the morning and once in the afternoon, with all measurements made at the same time, 10 am and 6 pm, respectively. Additionally, four determinations of each variable were collected during each shift, and the number of people who had trained in the room and the number of trainers were counted. Results In the different variables analysed, the results show that CO2 and RH levels are higher indoors than outdoors in both measurement shifts. Temperatures are higher outside than inside and, in the evening, than in the morning. TVOC, AQI and PM show less variation, although they are higher outdoors in the morning. CO is highest indoors. HCHO levels are almost negligible and do not vary significantly, except for a slight increase in the afternoon outside. Ozone levels are not significant. All the variables showed practically perfect reliability in all the measurements, except for ozone measured outside in the morning. On the other hand, the variables exhibit variations between indoors and outdoors during the morning and afternoon, except for the three types of PM. Also, the data show that all the main variables measured inside the sports training centre are similar between morning and afternoon. However, outside, temperature, relative humidity and HCHO levels show significant differences between morning and afternoon while no differences are observed for the other variables. Conclusion The indoor air quality of the training centre assessed was good and met current regulations; some of its components even exhibited better levels than fresh air. This article is the first to measure indoor air quality in a sports training centre catering to rehabilitation and small groups.

La violencia escolar en el contexto de la educación inclusiva constituye una problemática con limitado tratamiento teórico-metodológico en la pedagogía actual. En los últimos años han destacado los estudios teóricos sobre la violencia escolar, que apuntan a visibilizar las manifestaciones entre los miembros de la comunidad educativa desde una perspectiva unilateral. Constituye objeto de análisis de este estudio el incremento de las investigaciones teóricas acerca de las insuficiencias del proceso de inclusión en el contexto educativo y su relación con la violencia escolar como fenómeno que genera exclusión, en particular de los educandos con trastornos de conducta; asimismo, se revisa la participación de la comunidad educativa en esta dinámica. En este sentido, se analizan los nexos teóricos y prácticos entre violencia escolar y las insuficiencias en el proceso de educación inclusiva en contextos con educandos con trastornos de conducta. Se toman como referentes los estudios teóricos de Galtung (2003) que permiten abordar la problemática desde su complejidad y se complementan con los resultados de investigaciones realizadas con miembros de la comunidad educativa que participan en la atención a los trastornos de conducta.

Purpose: The association between voice alterations, health-related quality of life (HRQL), and chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), has previously been reported. The aim of this study was to test the hypothesis that HRQL and dysphonia-associated handicap of patients diagnosed with asthma or COPD are worse than healthy controls. Method: A case-control study in which participants were recruited by a consecutive sampling method from a single institution was conducted. Three groups were created: (a) asthma (51 patients), (b) COPD (52 patients), and (c) 50 healthy controls. Self-reported handicap associated with dysphonia was assessed using the 30-item Voice Handicap Index (VHI-30); meanwhile, HRQL was tested via the European Quality of Life (EQ) Questionnaire and the EQ-visual analog scale. Also, aerodynamic assessment applied to phonation was assessed, and maximum phonation time and s/e index were registered. Results: VHI scores were higher for asthma and COPD (7.19 ± 8.31 and 11.80 ± 15.18, respectively) than in the control group (3.72 ± 6.78). The EQ index was lower in asthma and COPD patients than in controls. The EQ-visual analog scale showed lower scores in asthma and COPD than in the controls. Conclusions: HRQL was worse in COPD patients than in asthma patients. Even though the patient groups showed worse VHI and HRQL scores than the healthy controls, the scores fell within the normal variation range. No significant variations in the maximum phonation time index between groups were noted.

La articulación del Poder Judicial en la organización territorial del Estado ha sido fuente de constantes propuestas, reflexiones y discusiones dada la configuración constitucional de un Poder Judicial único y la limitación competencial de las CC. AA. en el ámbito de la Administración de Justicia. Transcurridos más de cuarenta y tres años desde la entrada en vigor de la Constitución, se trata aún de un ámbito no cerrado en el que siguen estando presentes múltiples visiones sobre cómo abordar las relaciones entre Poder Judicial y Estado autonómico. La jurisprudencia del Tribunal Constitucional, la normativa estatal y autonómica sobre dicha materia constituyen el punto de partida para analizar de qué forma las CC. AA. pueden tener incidencia en el ámbito concreto de la selección y formación de jueces y magistrados, así como en lo relativo al conocimiento por jueces y magistrados de la lengua y el derecho propio de las CC. AA. Desde esta perspectiva se pretende en el presente artículo tanto realizar un análisis de la situación actual como plantearse posibles reformas en aras a garantizar que el Estado autonómico tenga un adecuado reflejo en el ámbito concreto de las cuestiones relativas a jueces y magistrados.