Padres que cuidan a sus hijos con plurisdiscapacidad: estudio cualitativo sobre el cuidado y sus consecuencias

Las personas con pluridiscapacidad presentan retraso mental severo o profundo además de otros déficits orgánicos, físicos o mentales. Las vidas de las familias de niños con pluridiscapacidad transcurren en un proceso de duelo continuo para adaptarse a las constantes pérdidas del menor y tienen que prestarles cuidados para hacer frente a los síntomas que les producen las distintas discapacidades que padecen. Estudio etnográfico con el objetivo de conocer las características del cuidado que prestan los progenitores a sus hijos con pluridiscapacidad. Técnicas: observación participante y entrevistas. Participantes: progenitores de hijos e hijas entre 3 y 18 años con pluridiscapacidad de Barcelona (España), reclutados a través de las escuelas de educación especial. Los resultados muestran que los padres han aprendido los cuidados que prestan a través de su propia experiencia. Expresan la influencia positiva que les produce el cuidado de sus hijos y su deseo de seguir cuidándoles. Manifiestan su malestar por no disponer de un modelo de atención integral y reclaman un profesional que actúe como su referente.

Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

A systems biology approach identifies molecular networks defining skeletal muscle abnormalities in chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory process of the lung inducing persistent airflow limitation. Extensive systemic effects, such as skeletal muscle dysfunction, often characterize these patients and severely limit life expectancy. Despite considerable research efforts, the molecular basis of muscle degeneration in COPD is still a matter of intense debate. In this study, we have applied a network biology approach to model the relationship between muscle molecular and physiological response to training and systemic inflammatory mediators. Our model shows that failure to co- ordinately activate expression of several tissue remodelling and bioenergetics pathways is a specific landmark of COPD diseased muscles. Our findings also suggest that this phenomenon may be linked to an abnormal expression of a number of histone modifiers, which we discovered correlate with oxygen utilization. These observations raised the interesting possibility that cell hypoxia may be a key factor driving skeletal muscle degeneration in COPD patients.

Cheirolophus intybaceus (Asteraceae, Centaureinae) o la constància del valor 2C

Cheirolophus intybaceus es una especie heliófila propia de los matorrales mediterráneos termófilos que crece en una franja litoral de unos 50 km de anchura que va desde Tolón (Var, Francia) hasta el sur de la península Ibérica, estando también presente en las islas Baleares (excepto en Menorca). Se encuentra también en las zonas elevadas y soleadas de las cuencas fluviales mediterráneas, formando un complejo de táxones estrechamente relacionados entre sí. Los objetivos de este trabajo son: i) contribuir a la aportación de datos de tamaño del genoma para diversas especies de Asteraceae; ii) estudiar la variación de la cantidad de ADN a lo largo del área de distribución de una especie; iii) evaluar la capacidad de discriminación de este parámetro a niveles taxonómicos bajos. Se ha encontrado una correlación positiva y significativa entre la cantidad de ADN y la latitud, es decir, que en hábitats con menor pluviosidad y más cálidos el tamaño del genoma tiende a disminuir en esta especie. La variación en todo el área de distribución de Ch. intybaceus es de 1,15 veces. Nos encontramos, por lo tanto, ante un caso de baja variabilidad que apoya la constancia del valor 2C.

De Vegetatio notulae, I

Petrocoptideto=Antirrhinetum mollis. Los inventarios se efectuaron en el Congost deis Terradets (La Noguera), sobre la carretera, a unos 400 m. de altitud, en las condiciones siguientes: 1. Roca sobreplomada, caliza. Exp. NW. Cobertura 10 %. Superficie estudiada, 50 m2. 2. Al lado del anterior, condiciones análogas. Sup. est., 50 nr. 3. Roca caliza. Exp. WSW. Incl. 8o°. Sup. est., 50 m2.

Neutron skin of 208Pb, nuclear symmetry energy, and the parity radius experiment

A precise determination of the neutron skin thickness of a heavy nucleus sets a basic constraint on the nuclear symmetry energy (the neutron skin thickness is the difference of the neutron and proton rms radii of the nucleus). The parity radius experiment (PREX) may achieve it by electroweak parity-violating electron scattering (PVES) on 208Pb. We investigate PVES in nuclear mean field approach to allow the accurate extraction of the neutron skin thickness of 208Pb from the parity-violating asymmetry probed in the experiment. We demonstrate a high linear correlation between the parity-violating asymmetry and the neutron skin thickness in successful mean field forces as the best means to constrain the neutron skin of 208Pb from PREX, without assumptions on the neutron density shape. Continuation of the experiment with higher precision in the parity-violating asymmetry is motivated since the present method can support it to constrain the density slope of the nuclear symmetry energy to new accuracy.

Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD'

Proteasome inhibition reduces proliferation, collagen expression, and inflammatory cytokine production in nasal mucosa and polyp fibroblasts

Proteasome inhibitors, used in cancer treatment for their proapoptotic effects, have anti-inflammatory and antifibrotic effects on animal models of various inflammatory and fibrotic diseases. Their effects in cells from patients affected by either inflammatory or fibrotic diseases have been poorly investigated. Nasal polyposis is a chronic inflammatory disease of the sinus mucosa characterized by tissue inflammation and remodeling. We tested the hypothesis that proteasome inhibition of nasal polyp fibroblasts might reduce their proliferation and inflammatory and fibrotic response. Accordingly, we investigated the effect of the proteasome inhibitor Z-Leu-Leu-Leu-B(OH)2 (MG262) on cell viability and proliferation and on the production of collagen and inflammatory cytokines in nasal polyp and nasal mucosa fibroblasts obtained from surgery specimens. MG262 reduced the viability of nasal mucosa and polyp fibroblasts concentration- and time-dependently, with marked effects after 48 h of treatment. The proteasome inhibitor bortezomib provoked a similar effect. MG262-induced cell death involved loss of mitochondrial membrane potential, caspase-3 and poly(ADP-ribose) polymerase activation, induction of c-Jun phosphorylation, and mitogen-activated protein kinase phosphatase-1 expression. Low concentrations of MG262 provoked growth arrest, inhibited DNA replication and retinoblastoma phosphorylation, and increased expression of the cell cycle inhibitors p21 and p27. MG262 concentration-dependently inhibited basal and transforming growth factor-β-induced collagen mRNA expression and interleukin (IL)-1β-induced production of IL-6, IL-8, monocyte chemoattractant protein-1, regulated on activation normal T cell expressed and secreted, and granulocyte/macrophage colony-stimulating factor in both fibroblast types. MG262 inhibited IL-1β/tumor necrosis factor-α-induced activation of nuclear factor-κB. We conclude that noncytotoxic treatment with MG262 reduces the proliferative, fibrotic, and inflammatory response of nasal fibroblasts, whereas high MG262 concentrations induce apoptosis.

New features of the layer-by-layer deposition of microcrystalline silicon films revealed by spectroscopic ellipsometry and high resolution transmission electron microscopy

Spectroscopic ellipsometry and high resolution transmission electron microscopy have been used to characterize microcrystalline silicon films. We obtain an excellent agreement between the multilayer model used in the analysis of the optical data and the microscopy measurements. Moreover, thanks to the high resolution achieved in the microscopy measurements and to the improved optical models, two new features of the layer-by-layer deposition of microcrystalline silicon have been detected: i) the microcrystalline films present large crystals extending from the a-Si:H substrate to the film surface, despite the sequential process in the layer-by-layer deposition; and ii) a porous layer exists between the amorphous silicon substrate and the microcrystalline silicon film.

Proteasome inhibition reduces proliferation, collagen expression, and inflammatory cytokine production in nasal mucosa and polyp fibroblasts

Proteasome inhibitors, used in cancer treatment for their proapoptotic effects, have anti-inflammatory and antifibrotic effects on animal models of various inflammatory and fibrotic diseases. Their effects in cells from patients affected by either inflammatory or fibrotic diseases have been poorly investigated. Nasal polyposis is a chronic inflammatory disease of the sinus mucosa characterized by tissue inflammation and remodeling. We tested the hypothesis that proteasome inhibition of nasal polyp fibroblasts might reduce their proliferation and inflammatory and fibrotic response. Accordingly, we investigated the effect of the proteasome inhibitor Z-Leu-Leu-Leu-B(OH)2 (MG262) on cell viability and proliferation and on the production of collagen and inflammatory cytokines in nasal polyp and nasal mucosa fibroblasts obtained from surgery specimens. MG262 reduced the viability of nasal mucosa and polyp fibroblasts concentration- and time-dependently, with marked effects after 48 h of treatment. The proteasome inhibitor bortezomib provoked a similar effect. MG262-induced cell death involved loss of mitochondrial membrane potential, caspase-3 and poly(ADP-ribose) polymerase activation, induction of c-Jun phosphorylation, and mitogen-activated protein kinase phosphatase-1 expression. Low concentrations of MG262 provoked growth arrest, inhibited DNA replication and retinoblastoma phosphorylation, and increased expression of the cell cycle inhibitors p21 and p27. MG262 concentration-dependently inhibited basal and transforming growth factor-β-induced collagen mRNA expression and interleukin (IL)-1β-induced production of IL-6, IL-8, monocyte chemoattractant protein-1, regulated on activation normal T cell expressed and secreted, and granulocyte/macrophage colony-stimulating factor in both fibroblast types. MG262 inhibited IL-1β/tumor necrosis factor-α-induced activation of nuclear factor-κB. We conclude that noncytotoxic treatment with MG262 reduces the proliferative, fibrotic, and inflammatory response of nasal fibroblasts, whereas high MG262 concentrations induce apoptosis.

Prospección sísmica en el Glaciar Johnsons, Isla Livingston (Antártida). (campañas antárticas 1996-1997 y 1997-1998)

Durante las campañas antárticas de 1996-97 y 1997-98, se realizaron en el glaciar Johnsons (Isla Livingston, A n t á rtida) cinco perfiles sísmicos de refracción (con un total de 2.685 m longitud) y dos perfiles de reflexión (2.980 m longitud) con el objetivo de obtener i n f o rmación sobre el grosor del hielo y la topografía del basamento. En cuanto a la sísmica de refracción, se presenta como un método e ficaz para la obtención del espesor y de la velocidad del hielo, mientras que se propone la sísmica de reflexión como la técnica más adecuada para obtener información sobre la morfología de la cubeta glacial y el contacto hielo-roca. Los resultados aportados por los anteriores métodos se han completado con un análisis minucioso de los datos de campo (estudio del frente de ondas) obteniéndose la localización de sectores con fracturas (grietas) y pudiéndose distinguir áreas de distintas características glaciológicas (zonas de acumulación y ablación). Este conocimiento de la estructura interna del glaciar mediante prospección sísmica junto con otros datos glaciológicos permitirá modelizar la dinámica del flujo del glaciar Johnsons.

Electron scattering in isotonic chains as a probe of the proton shell structure of unstable nuclei

Electron scattering on unstable nuclei is planned in future facilities of the GSI and RIKEN upgrades. Motivated by this fact, we study theoretical predictions for elastic electron scattering in the N=82, N=50, and N=14 isotonic chains from very proton-deficient to very proton-rich isotones. We compute the scattering observables by performing Dirac partial-wave calculations. The charge density of the nucleus is obtained with a covariant nuclear mean-field model that accounts for the low-energy electromagnetic structure of the nucleon. For the discussion of the dependence of scattering observables at low-momentum transfer on the gross properties of the charge density, we fit Helm model distributions to the self-consistent mean-field densities. We find that the changes shown by the electric charge form factor along each isotonic chain are strongly correlated with the underlying proton shell structure of the isotones. We conclude that elastic electron scattering experiments on isotones can provide valuable information about the filling order and occupation of the single-particle levels of protons.

Patrón espacial de un ecotono bosque subalpino pastos alpinos (Las Cutas, Ordesa, Pirineos Centrales)

Describimos el patrón espacial de un ecotono bosque subalpino-pastos alpinos, que incluye los límites altitudinales del bosque y del árbol, dominado por Pinus uncinata Ram. y localizado en los Pirineos Centrales. Situamos una parcela rectangular (30 x 140 m) cruzando el ecotono con su lado mayor paralelo a la pendiente. Para cada individuo de R uncinata dentro de la parcela medimos: su localización (coordenadas x, y), y variables estructurales (p. ej. altura) y de forma de crecimiento (número y tipo -vivo o muerto, vertical o arbustivo- de pies por individuo). Los individuos vivos de P. uncinata se clasificaron según su tamaño (adultos, jóvenes, vástagos y plántulas) y forma de crecimiento (krurmnhoIz -individuos arbustivos policórmicos-, krummholz con pies verticales). Describimos cuantitativamente el tipo de sustrato (suelo, materia orgánica, grava, roca) y la cobertura de herbáceas, arbustos y P. uncinata usando transectos paralelos a la pendiente. La estructura del ecotono se describió mediante: (a) los análisis del patrón de puntos (K de Ripley) y (b) del patrón de superficies (correlogramas espaciales de la altura); (c) la detección y descripción de fronteras usando la densidad o variables de tamaño y forma de crecimiento de los indidividos ; (d) la síntesis de las variaciones en la presencia y diversidad de sustratos y de herbáceas y arbustos-, y (e) la ordenación de los cuadrados en que subdividimos la parcela (115 cuadrados de 6 x 6 m), de acuerdo a su posición espacial en el ecotono, al tipo de sustrato, a la cobertura de herbáceas y arbustos y al número, tamaño y forma de crecimiento de los individuos de P. uncinata. La mayoría de los individuos vivos de P. uncinata eran krummhoIz, situándose por encima del límite del bosque. Los individuos krummholz mostraron interacción espacial positiva con las plántulas. En el área inferior del ecotono, los individuos grandes, verticales y unicórmicos...

Landscape Systems and Human Land-Use Interactions in Mediterranean Highlands and Littoral Plains during the Late Holocene: Integrated Analysis from the InterAmbAr Project (North-Eastern Catalonia).

The main goal of the InterAmbAr reseach project is to analyze the relationships between landscape systems and human land-use strategies on mountains and littoral plains from a long-term perspective. The study adopts a high resolution analysis of small-scale study areas located in the Mediterranean region of north-eastern Catalonia. The study areas are distributed along an altitudinal transect from the high mountain (above 2000m a.s.l.) to the littoral plain of Empordà (Fig. 1). High resolution interdisciplinary research has been carried out from 2010, based on the integration of palaeoenvironmental and archaeological data. The micro-scale approach is used to understand human-environmental relationships. It allows better understanding of the local-regional nature of environmental changes and the synergies between catchment-based systems, hydro-sedimentary regimes, human mobility, land-uses, human environments, demography, etc.

Las tecnologías de la información y la comunicación en los sistemas sanitarios. Un nuevo reto para la enfermera

En la actualidad, diversos países están incorporando las Tecnologías de la Información y la Comunicación (TIC) en sus procesos asistenciales, abriendo una nueva perspectiva en la gestión de la información sanitaria. La importancia que adquieren las TIC viene determinada por la posibilidad de poder mejorar la eficiencia de los recursos dedicados al cuidado de la salud de la población. En este proceso de cambio hay que tener en cuenta el factor humano como elemento crucial del sector salud, ya que a pesar de la presión asistencial y el nivel de exigencia de la población, debe garantizar un nivel de excelencia profesional que permita avanzar en la implantación de las TIC. Por todo ello, en este nuevo contexto asistencial, los profesionales enfermeros tienen un papel clave, lo que plantea la necesidad de disponer de una formación específica que les permita dar respuesta a esta nueva situación. La incorporación de las TIC en el ámbito sanitario implica un proceso de adaptación, así como un cambio estructural y social tanto de los profesionales como de los usuarios. El presente artículo tiene como objetivo analizar el proceso de incorporación de las TIC en los sistemas sanitarios y algunas de las implicaciones más destacadas que ello supone para las enfermeras.