Factores asociados a calidad de vida en pacientes de hemodiálisis incidentes y prevalentes

Introducción: la insuficiencia renal crónica IRC ha aumentado su prevalencia en los últimos años pasando de 44.7 pacientes por millón en 1993 a 538.46 pacientes por millón en 2010, los pacientes quienes reciben terapia de remplazo renal hemodiálisis en Colombia cada vez tienen una mayor sobrevida. El incremento de los pacientes y el incremento de la sobrevida nos enfocan a mejorar la calidad de vida de los años de diálisis. Metodología: se comparó la calidad de vida por medio del SF-36 en 154 pacientes con IRC estadio terminal en manejo con hemodiálisis, 77 pacientes incidentes y 77 pacientes prevalentes, pertenecientes a una unidad renal en Bogotá, Colombia. Resultados: se encontró una disminución de la calidad de vida en los componentes físicos (PCS) y metales (MCS) de los pacientes de hemodiálisis en ambos grupos. En el modelo de regresión logística la incapacidad laboral (p=0.05), el uso de catéter (p= 0,000), el bajo índice de masa corporal (p=0.021), la hipoalbuminemia (p=0,033) y la anemia (p=0,001) fueron factores determinantes en un 78,9% de baja calidad de vida de PCS en los pacientes incidentes con respecto a los prevalentes. En el MCS de los pacientes incidentes vs. Prevalentes se encontró la hipoalbuminemia (p=0.007), la anemia (p=0.001) y el acceso por catéter (p=0.001) como factores determinantes en un 70.6% de bajo MCS Conclusiones: la calidad de vida de los pacientes de diálisis se encuentra afectada con mayor repercusión en el grupo de los pacientes incidentes, se debe mejorar los aspectos nutricionales, hematológicos y de acceso vascular en este grupo.

Comparación del efecto de mera exposición y el condicionamiento clásico en la formación de preferencias

El objetivo de este estudio fue comparar la eficacia del condicionamiento clásico (CC) y el efecto de mera exposición (ME), en condiciones supraliminales (2000 milisegundos –ms-), sobre la formación de preferencias hacia marcas publicitarias. Se realizó un experimento con diseño intrasujeto, donde se manipuló la variable tratamiento afectivo representada por los dos procedimientos a comparar y se midió la variable dependiente –preferencia hacia las marcas- a través de una tarea de elección forzosa y un diferencial semántico. En el experimento participaron 70 hombres, estudiantes de medicina de la Universidad del Rosario con edades entre 18 y 22 años. El CC se realizó a través de un procedimiento simultáneo y en ambas condiciones la variable independiente se expuso el estímulo 8 veces con una duración de 2000 ms. Los resultados mostraron que los dos procedimientos generaron preferencias en los sujetos, pero no diferencias significativas entre la efectividad de los procedimientos.

La expresión de la opinión en el discurso escrito : un estudio de la estructura textual de la argumentación en el periodismo de opinión inglés.

Dar a conocer los modelos de organización textual más comunes en los textos de opinión y aportar una descripción discursiva del subgénero del periodismo de opinión inglés. Un grupo de 60 textos argumentativos publicados en la sección de opinión del periódico norteamericano Usa Today. Se lleva a cabo un análisis de 30 editoriales y 30 artículos de opinión con el fin de conocer su estructura argumentativa y el componente estratégico que la motiva. Para ello se sigue el modelo de descripción de la estructura textual argumentativa de S. Tirkkonen-Condit, que recoge propuestas del modelo de organización textual problema-solución de Hoey; las superestructuras y macroestructuras de Van Dijk; las relaciones retóricas de Grimes; y los estudios de los actos de habla en la argumentación, de Aston y Edmonson. Se utiliza el procesador de textos Word y el programa de diseño de bases de datos Access. Análisis textual. Se determinan las distintas estrategias textuales aplicadas por los autores. Además, se aprecian diferencias significativas entre los editoriales y los artículos de opinión en cuanto al desarrollo de la estructura argumentativa global. Estas diferencias se producen en tres planos diferentes: el valor ilocutivo de los actos comunicativos; el valor interaccional; y la composición de los minitextos que conforman el modelo de organización textual problema-solución. Se distinguen varios tipos de estrategias de interacción con el lector, diseñadas por el escritor para la consecución de sus objetivos persuasivos en función del tema escogido y del contexto social. Se ofrecen propuestas para la aplicación de esta investigación al área del análisis del discurso en inglés y a otros campos de interés, como la lingüística contrastiva español-inglés o la enseñanza del inglés como lengua extranjera en la Universidad.

Problem-based learning and legal education : a case study in integrated experiential study

Resumen basado en el de la publicaci??n

Stochastic modelling of rainfall from satellite data

Satellite-based rainfall monitoring is widely used for climatological studies because of its full global coverage but it is also of great importance for operational purposes especially in areas such as Africa where there is a lack of ground-based rainfall data. Satellite rainfall estimates have enormous potential benefits as input to hydrological and agricultural models because of their real time availability, low cost and full spatial coverage. One issue that needs to be addressed is the uncertainty on these estimates. This is particularly important in assessing the likely errors on the output from non-linear models (rainfall-runoff or crop yield) which make use of the rainfall estimates, aggregated over an area, as input. Correct assessment of the uncertainty on the rainfall is non-trivial as it must take account of • the difference in spatial support of the satellite information and independent data used for calibration • uncertainties on the independent calibration data • the non-Gaussian distribution of rainfall amount • the spatial intermittency of rainfall • the spatial correlation of the rainfall field This paper describes a method for estimating the uncertainty on satellite-based rainfall values taking account of these factors. The method involves firstly a stochastic calibration which completely describes the probability of rainfall occurrence and the pdf of rainfall amount for a given satellite value, and secondly the generation of ensemble of rainfall fields based on the stochastic calibration but with the correct spatial correlation structure within each ensemble member. This is achieved by the use of geostatistical sequential simulation. The ensemble generated in this way may be used to estimate uncertainty at larger spatial scales. A case study of daily rainfall monitoring in the Gambia, west Africa for the purpose of crop yield forecasting is presented to illustrate the method.

Evaluation of reanalysis rainfall estimates over Ethiopia

There is a pressing need for good rainfall data for the African continent both for humanitarian and climatological purposes. Given the sparseness of ground-based observations, one source of rainfall information is Numerical Weather Prediction (NWP) model outputs. The aim of this article is to investigate the quality of two NWP products using Ethiopia as a test case. The two products evaluated are the ERA-40 and NCEP reanalysis rainfall products. Spatial, seasonal and interannual variability of rainfall have been evaluated for Kiremt (JJAS) and Belg (FMAM) seasons at a spatial scale that reflects the local variability of the rainfall climate using a method which makes optimum use of sparse gauge validation data. We found that the spatial pattern of the rainfall climatology is captured well by both models especially for the main rainy season Kiremt. However, both models tend to overestimate the mean rainfall in the northwest, west and central regions but underestimate in the south and east. The overestimation is greater for NCEP in Belg season and greater for ERA-40 in Kiremt Season. ERA-40 captures the annual cycle over most of the country better than NCEP, but strongly exaggerates the Kiremt peak in the northwest and west. The overestimation in Kiremt appears to have been reduced since the assimilation of satellite data increased around 1990. For both models the interannual variability is less well captured than the spatial and seasonal variability. Copyright © 2008 Royal Meteorological Society

Geostatistical Tools for Validation of Satellite and NWP Model Rainfall

An ensemble approach to uncertainty estimation for satellite-based rainfall estimates

Teleconnections between Ethiopian summer rainfall and sea surface temperature: part I. Observation and modelling

In this study, the oceanic regions that are associated with anomalous Ethiopian summer rains were identified and the teleconnection mechanisms that give rise to these associations have been investigated. Because of the complexities of rainfall climate in the horn of Africa, Ethiopia has been subdivided into six homogeneous rainfall zones and the influence of SST anomalies was analysed separately for each zone. The investigation made use of composite analysis and modelling experiments. Two sets of composites of atmospheric fields were generated, one based on excess/deficit rainfall anomalies and the other based on warm/cold SST anomalies in specific oceanic regions. The aim of the composite analysis was to determine the link between SST and rainfall in terms of large scale features. The modelling experiments were intended to explore the causality of these linkage. The results show that the equatorial Pacific, the midlatitude northwest Pacific and the Gulf of Guinea all exert an influence on the summer rainfall in various part of the country. The results demonstrate that different mechanisms linked to sea surface temperature control variations in rainfall in different parts of Ethiopia. This has important consequences for seasonal forecasting models which are based on statistical correlations between SST and seasonal rainfall totals. It is clear that such statistical models should take account of the local variations in teleconnections.

Teleconnections between Ethiopian summer rainfall and sea surface temperature: part II. Seasonal forecasting

A seasonal forecasting system that is capable of skilfully predicting rainfall totals on a regional scale would be of great value to Ethiopia. Here, we describe how a statistical model can exploit the teleconnections described in part 1 of this pair of papers to develop such a system. We show that, in most cases, the predictors selected objectively by the statistical model can be interpreted in the light of physical teleconnections with Ethiopian rainfall, and discuss why, in some cases, unexpected regions are chosen as predictors. We show that the forecast has skill in all parts of Ethiopia, and argue that this method could provide the basis of an operational seasonal forecasting system for Ethiopia.

Validation of improved TAMANN neural network for operational satellite-derived rainfall estimation in Africa

Real-time rainfall monitoring in Africa is of great practical importance for operational applications in hydrology and agriculture. Satellite data have been used in this context for many years because of the lack of surface observations. This paper describes an improved artificial neural network algorithm for operational applications. The algorithm combines numerical weather model information with the satellite data. Using this algorithm, daily rainfall estimates were derived for 4 yr of the Ethiopian and Zambian main rainy seasons and were compared with two other algorithms-a multiple linear regression making use of the same information as that of the neural network and a satellite-only method. All algorithms were validated against rain gauge data. Overall, the neural network performs best, but the extent to which it does so depends on the calibration/validation protocol. The advantages of the neural network are most evident when calibration data are numerous and close in space and time to the validation data. This result emphasizes the importance of a real-time calibration system.

African climate change: Taking the shorter route

Numerous factors are associated with poverty and underdevelopment in Africa, including climate variability. Rainfall, and climate more generally, are implicated directly in the United Nations “Millennium Development Goals” to eradicate extreme poverty and hunger, and reduce child mortality and incidence of diseases such as malaria by the target date of 2015. But, Africa is not currently on target to meet these goals. We pose a number of questions from a climate science perspective aimed at understanding this background: Is there a common origin to factors that currently constrain climate science? Why is it that in a continent where human activity is so closely linked to interannual rainfall variability has climate science received little of the benefit that saw commercialization driving meteorology in the developed world? What might be suggested as an effective way for the continent to approach future climate variability and change? We make the case that a route to addressing the challenges of climate change in Africa rests with the improved management of climate variability. We start by discussing the constraints on climate science and how they might be overcome. We explain why the optimal management of activities directly influenced by interannual climate variability (which include the development of scientific capacity) has the potential to serve as a forerunner to engagement in the wider issue of climate change. We show this both from the perspective of the climate system and the institutions that engage with climate issues. We end with a thought experiment that tests the benefits of linking climate variability and climate change in the setting of smallholder farmers in Limpopo Province, South Africa.