La mejora de la calidad de vida de las personas con lesión medular: la transición del centro rehabilitador a la vida cotidiana desde la perspectiva de los usuarios

El retorno a la vida cotidiana para una persona con lesión medular después del periodo de rehabilitación en régimen hospitalario, es un proceso difícil no exento de dificultades y nuevos retos personales. En este trabajo nos planteamos identificar aquellos factores más relevantes que contribuyen a mejorar su calidad de vida, desde la perspectiva de las propias personas afectadas. Hemos realizado dos grupos de discusión: uno formado por 12 personas con paraplejia y otro formado por 6 personas con tetraplejia. El análisis de contenido realizado indica que, para los participantes existen dos dimensiones relacionadas con su percepción de calidad de vida una vez salen del centro de rehabilitación: a) necesidad de atención al entorno más próximo y b) preparación para el mundo real. Concluimos señalando la importancia de realizar programas de rehabilitación integral, que incluyan, rehabilitación física, aprendizaje de habilidades que posibiliten el máximo de independencia y autonomía personal y trabajo de apoyo a la familia

Comportamientos de riesgo en la adolescencia: paralelismos entre el uso del casco y el uso del preservativo

Un gran quantitat de problemàtiques associades a la mortalitat i morbiditat dels adolescents és poden prevenir (per exemple els accidents de circulació i el VIH). Aquests problemes de salut tenen a veure amb factors ambientals i comportamentals, i no amb factors biològics. La conducció arriscada i la pràctica de relacions sexuals sense protecció contribueixen a incrementar les taxes de malaltia en aquest col·lectiu. L'ús del preservatiu i l'ús del casc són dues conductes que salven vides. Existeix molta evidència sobre la seva efectivitat d'aquestes mesures preventives per minimitzar i/o evitar les conseqüències negatives en situacions de risc. Els resultats d'aquesta investigació posen de manifest que no tots adolescents utilitzen el casc quan circulen en ciclomotor, i el preservatiu quan mantenen relacions sexuals amb penetració. L'ús del casc i l'ús del preservatiu són conductes independents.

Improvement of strategies for the management of fire blight (Erwinia amylovora). Evaluation and optimization of physical and chemical control methods, and use of decision support systems

El foc bacterià és una malaltia que afecta a plantes de la família de la rosàcies, causada pel bacteri Erwinia amylovora. El seu rang d'hostes inclou arbres fruiters, com la perera, la pomera o el codonyer, i plantes ornamentals de gran interès comercial i econòmic. Actualment, la malaltia s'ha dispersat i es troba àmpliament distribuïda en totes les zones de clima temperat del món. A Espanya, on la malaltia no és endèmica, el foc bacterià es va detectar per primer cop al 1995 al nord del país (Euskadi) i posteriorment, han aparegut varis focus en altres localitzacions, que han estat convenientment eradicats. El control del foc bacterià, és molt poc efectiu en plantes afectades per la malaltia, de manera que es basa en mesures encaminades a evitar la dispersió del patogen, i la introducció de la malaltia en regions no endèmiques. En aquest treball, la termoteràpia ha estat avaluada com a mètode d'eradicació d'E. amylovora de material vegetal de propagació asimptomàtic. S'ha demostrat que la termoteràpia és un mètode viable d'eradicar E. amylovora de material de propagació. Gairebé totes les espècies i varietats de rosàcies mantingudes en condicions d'humitat sobrevivien 7 hores a 45 ºC i més de 3 hores a 50 ºC, mentre que més d'1 hora d'exposició a 50 ºC amb calor seca produïa danys en el material vegetal i reduïa la brotació. Tractaments de 60 min a 45 ºC o 30 min a 50 ºC van ser suficients per reduir la població epífita d'E. amylovora a nivells no detectables (5 x 102 ufc g-1 p.f.) en branques de perera. Els derivats dels fosfonats i el benzotiadiazol són efectius en el control del foc bacterià en perera i pomera, tant en condicions de laboratori, com d'hivernacle i camp. Els inductors de defensa de les plantes redueixen els nivells de malaltia fins al 40-60%. Els intervals de temps mínims per aconseguir el millor control de la malaltia van ser 5 dies pel fosetil-Al, i 7 dies per l'etefon i el benzotiadiazol, i les dosis òptimes pel fosetil-Al i el benzotiadiazol van ser 3.72 g HPO32- L-1 i 150 mg i.a. L-1, respectivament. Es millora l'eficàcia del fosetil-Al i del benzotiadiazol en el control del foc bacterià, quan es combinen amb els antibiòtics a la meitat de la dosi d'aquests últims. Tot i que l'estratègia de barrejar productes és més pràctica i fàcil de dur a terme a camp, que l'estratègia de combinar productes, el millor nivell de control de la malaltia s'aconsegueix amb l'estratègia de combinar productes. Es va analitzar a nivell histològic i ultrastructural l'efecte del benzotiadiazol i dels fosfonats en la interacció Erwinia amylovora-perera. Ni el benzotiadiazol, ni el fosetil-Al, ni l'etefon van induir canvis estructurals en els teixits de perera 7 dies després de la seva aplicació. No obstant, després de la inoculació d'E. amylovora es va observar en plantes tractades amb fosetil-Al i etefon una desorganització estructural cel·lular, mentre que en les plantes tractades amb benzotiadiazol aquestes alteracions tissulars van ser retardades. S'han avaluat dos models (Maryblyt, Cougarblight) en un camp a Espanya afectat per la malaltia, per determinar la precisió de les prediccions. Es van utilitzar dos models per elaborar el mapa de risc, el BRS-Powell combinat i el BIS95 modificat. Els resultats van mostrar dos zones amb elevat i baix risc de la malaltia. Maryblyt i Cougarblight són dos models de fàcil ús, tot i que la seva implementació en programes de maneig de la malaltia requereix que siguin avaluats i validats per un període de temps més llarg i en àrees on la malaltia hi estigui present.

Desmite dos Ligamentos Colaterais da Articulação Interfalângica Distal em Equinos

Os objectivos deste estudo basearam-se na análise dos aspectos clínicos de cavalos de desporto, aos quais foi diagnosticado através de ecografia, desmite dos Ligamentos Colaterais (LCs) da articulação Interfalângica Distal (IFD). Os cavalos incluídos na amostra foram examinados entre Setembro de 2011 e Junho de 2012 tendo sido selecionados aqueles que apresentaram os critérios de inclusão requeridos, nomeadamente o diagnóstico de desmite em pelo menos um dos LCs da articulação IFD. Foram incluídos 8 animais no estudo, sendo que o diagnóstico foi feito através de um cuidadoso exame ortopédico e de ecografia, tendo-se verificado as lesões nos membros anteriores. O LC Lateral foi o mais afectado (5 cavalos) seguido do Medial (2 cavalos). Apenas em 1 dos casos as lesões eram bilaterais. A maioria dos animais apresentavam distensão da articulação IFD confirmada ecograficamente. A claudicação foi invariavelmente exacerbada em círculo no piso duro, sendo que 7 dos 8 (87.5%) animais aumentaram o grau de claudicação quando o membro afectado estava no interior do círculo. Após o bloqueio digital palmar a claudicação foi atenuada em 7 dos 8 animais (87.5%) sendo totalmente abolida em 3 (37.5%) deles. O bloqueio da articulação IFD foi positivo em todos os animais, e o bloqueio da bursa podotroclear negativa em 7 dos 8 cavalos. Metade dos animais (50%) apresentaram alterações radiográficas como osteoartrite da articulação IFD, remodelação óssea da origem/inserção do LC afectado e um deles apresentava ossificação de uma cartilagem ungular. Todos os animais apresentaram sinais evidentes de lesão na ecografia, sendo que alguns demostraram sinais de desmite crónica e outros aguda. Os tratamentos instituídos variaram de acordo com a história, sinais clínicos, sinais radiográficos e severidade das lesões ecográficas. A desmite dos LC da articulação IFD deve ser considerada como uma causa de claudicação que afecta a performance dos cavalos de desporto. Mais estudos são necessários, de modo a caraterizar melhor estas lesões e avaliar as melhorias após a terapia por forma a determinar os factores que mais influenciam o prognóstico. Palavras-Chave: Equinos, Ligamentos colaterais, Desmite, articulação Interfalângica distal

Las negociaciones para el Tratado de Libre Comercio entre los países andinos y los Estados Unidos: reflexiones para el debate (Tema Central)

Este artículo presenta un análisis de las ventajas y desventajas que traería consigo la firma de un TLC andino con Estados Unidos. A partir del acercamiento a diferentes sectores de la economía andina, el autor determina quienes podrían ser los posibles perdedores y ganadores con la firma de un Tratado de este tipo. La inexistencia de una agenda productiva interna en cada uno de los países, es señalada como una de las principales desventajas que tienen los andinos para poder aprovechar las ventajas que representaría la firma de un TLC y para poder convertir en oportunidades las exigencias que el mismo plantea. El desarrollo de un debate sustentado en criterios técnicos y políticos, más allá de fundamentos ideológicos, es para el autor el elemento central del cual se debe partir para determinar la conveniencia del TLC.

Spatial Aggregation of Forest Songbird Territories and Possible Implications for Area Sensitivity

Habitat area requirements of forest songbirds vary greatly among species, but the causes of this variation are not well understood. Large area requirements could result from advantages for certain species when settling their territories near those of conspecifics. This phenomenon would result in spatial aggregations much larger than single territories. Species that aggregate their territories could show reduced population viability in highly fragmented forests, since remnant patches may remain unoccupied if they are too small to accommodate several territories. The objectives of this study were twofold: (1) to seek evidence of territory clusters of forest birds at various spatial scales, lags of 250-550 m, before and after controlling for habitat spatial patterns; and (2) to measure the relationship between spatial autocorrelation and apparent landscape sensitivity for these species. In analyses that ignored spatial variation of vegetation within remnant forest patches, nine of the 17 species studied significantly aggregated their territories within patches. After controlling for forest vegetation, the locations of eight out of 17 species remained significantly clustered. The aggregative pattern that we observed may, thus, be indicative of a widespread phenomenon in songbird populations. Furthermore, there was a tendency for species associated with higher forest cover to be more spatially aggregated [ERRATUM].

Understanding Demographic and Behavioral Mechanisms that Guide Responses of Neotropical Migratory Birds to Urbanization: a Simulation Approach

Although studies often report that densities of many forest birds are negatively related to urbanization, the mechanisms guiding this pattern are poorly understood. Our objective was to use a population simulation to examine the relative influence of six demographic and behavioral processes on patterns of avian abundance in urbanizing landscapes. We constructed an individual-based population simulation model representing the annual cycle of a Neotropical migratory songbird. Each simulation was performed under two landscape scenarios. The first scenario had similar proportions of high- and low-quality habitat across the urban to rural gradient. Under the first scenario, avian density was negatively related to urbanization only when rural habitats were perceived to be of higher quality than they actually were. The second landscape scenario had declining proportions of high-quality habitat as urbanization increased. Under the second scenario, each mechanism generated a negative relationship between density and urbanization. The strongest effect on density resulted when birds preferentially selected habitats in landscapes from which they fledged or were constrained from dispersing. The next strongest patterns occurred when birds directly evaluated habitat quality and accurately selected the highest-quality available territories. When birds selected habitats based on the presence of conspecifics, the density–urbanization relationship was only one-third the strength of other habitat selection mechanisms and only occurred under certain levels of population survival. Although differences in adult or nest survival in the face of random habitat selection still elicited reduced densities in urban landscapes, the relationships between urbanization and density were weaker than those produced by the conspecific attraction mechanism. Results from our study identify key predictions and areas for future research, including assessing habitat quality in urban and rural areas in order to determine if habitats in urban areas are underutilized.

Ovenbird (Seiurus aurocapilla) Territory Placement Near Seismic Lines is Influenced by Forest Regeneration and Conspecific Density

The boreal forest of western Canada is being dissected by seismic lines used for oil and gas exploration. The vast amount of edge being created is leading to concerns that core habitat will be reduced for forest interior species for extended periods of time. The Ovenbird (Seiurus aurocapilla) is a boreal songbird known to be sensitive to newly created seismic lines because it does not include newly cut lines within its territory. We examined multiple hypotheses to explain potential mechanisms causing this behavior by mapping Ovenbird territories near lines with varying states of vegetation regeneration. The best model to explain line exclusion behavior included the number of neighboring conspecifics, the amount of bare ground, leaf-litter depth, and canopy closure. Ovenbirds exclude recently cut seismic lines from their territories because of lack of protective cover (lower tree and shrub cover) and because of reduced food resources due to large areas of bare ground. Food reduction and perceived predation risk effects seem to be mitigated once leaf litter (depth and extent of cover) and woody vegetation cover are restored to forest interior levels. However, as conspecific density increases, lines are more likely to be used as landmarks to demarcate territorial boundaries, even when woody vegetation cover and leaf litter are restored. This behavior can reduce territory density near seismic lines by changing the spatial distribution of territories. Landmark effects are longer lasting than the effects from reduced food or perceived predation risk because canopy height and tree density take >40 years to recover to forest interior levels. Mitigation of seismic line impacts on Ovenbirds should focus on restoring forest cover as quickly as possible after line cutting.

Plant species and functional group effects on abiotic and microbial soil properties and plant-soil feedback responses in two grasslands

1 Plant species differ in their capacity to influence soil organic matter, soil nutrient availability and the composition of soil microbial communities. Their influences on soil properties result in net positive or negative feedback effects, which influence plant performance and plant community composition. 2 For two grassland systems, one on a sandy soil in the Netherlands and one on a chalk soil in the United Kingdom, we investigated how individual plant species grown in monocultures changed abiotic and biotic soil conditions. Then, we determined feedback effects of these soils to plants of the same or different species. Feedback effects were analysed at the level of plant species and plant taxonomic groups (grasses vs. forbs). 3 In the sandy soils, plant species differed in their effects on soil chemical properties, in particular potassium levels, but PLFA (phospholipid fatty acid) signatures of the soil microbial community did not differ between plant species. The effects of soil chemical properties were even greater when grasses and forbs were compared, especially because potassium levels were lower in grass monocultures. 4 In the chalk soil, there were no effects of plant species on soil chemical properties, but PLFA profiles differed significantly between soils from different monocultures. PLFA profiles differed between species, rather than between grasses and forbs. 5 In the feedback experiment, all plant species in sandy soils grew less vigorously in soils conditioned by grasses than in soils conditioned by forbs. These effects correlated significantly with soil chemical properties. None of the seven plant species showed significant differences between performance in soil conditioned by the same vs. other plant species. 6 In the chalk soil, Sanguisorba minor and in particular Briza media performed best in soil collected from conspecifics, while Bromus erectus performed best in soil from heterospecifics. There was no distinctive pattern between soils collected from forb and grass monocultures, and plant performance could not be related to soil chemical properties or PLFA signatures. 7 Our study shows that mechanisms of plant-soil feedback can depend on plant species, plant taxonomic (or functional) groups and site-specific differences in abiotic and biotic soil properties. Understanding how plant species can influence their rhizosphere, and how other plant species respond to these changes, will greatly enhance our understanding of the functioning and stability of ecosystems.

A role for parasites in stabilising the fig-pollinator mutualism

Mutualisms are interspecific interactions in which both players benefit. Explaining their maintenance is problematic, because cheaters should outcompete cooperative conspecifics, leading to mutualism instability. Monoecious figs (Ficus) are pollinated by host-specific wasps (Agaonidae), whose larvae gall ovules in their "fruits'' (syconia). Female pollinating wasps oviposit directly into Ficus ovules from inside the receptive syconium. Across Ficus species, there is a widely documented segregation of pollinator galls in inner ovules and seeds in outer ovules. This pattern suggests that wasps avoid, or are prevented from ovipositing into, outer ovules, and this results in mutualism stability. However, the mechanisms preventing wasps from exploiting outer ovules remain unknown. We report that in Ficus rubiginosa, offspring in outer ovules are vulnerable to attack by parasitic wasps that oviposit from outside the syconium. Parasitism risk decreases towards the centre of the syconium, where inner ovules provide enemy-free space for pollinator offspring. We suggest that the resulting gradient in offspring viability is likely to contribute to selection on pollinators to avoid outer ovules, and by forcing wasps to focus on a subset of ovules, reduces their galling rates. This previously unidentified mechanism may therefore contribute to mutualism persistence independent of additional factors that invoke plant defences against pollinator oviposition, or physiological constraints on pollinators that prevent oviposition in all available ovules.

Relationship between sublethal injury and microbial inactivation by the combination of high hydrostatic pressure and citral or tert-butyl hydroquinone

The aim was to investigate (i) the occurrence of sublethal injury in Listeria monocytogenes, Escherichia coli, and Saccharomyces cerevisiae after high hydrostatic pressure (HHP) treatment as a function of the treatment medium pH and composition and (ii) the relationship between the occurrence of sublethal injury and the inactivating effect of a combination of HHP and two antimicrobial compounds, tert-butyl hydroquinone (TBHQ) and citral. The three microorganisms showed a high proportion of sublethally injured cells (up to 99.99% of the surviving population) after HHP. In E. coli and L. monocytogenes, the extent of inactivation and sublethal injury depended on the pH and the composition of the treatment medium, whereas in S. cerevisiae, inactivation and sublethal injury were independent of medium pH or composition under the conditions tested. TBHQ alone was not lethal to E. coli or L. monocytogenes but acted synergistically with HHP and 24-h refrigeration, resulting in a viability decrease of >5 log(10) cycles of both organisms. The antimicrobial effect of citral depended on the microorganism and the treatment medium pH. Acting alone for 24 h under refrigeration, 1,000 ppm of citral caused a reduction of 5 log(10) cycles of E. coli at pH 7.0 and almost 3 log(10) cycles of L. monocytogenes at pH 4.0. The combination of citral and HHP also showed a synergistic effect. Our results have confirmed that the detection of sublethal injury after HHP may contribute to the identification of those treatment conditions under which HHP may act synergistically with other preserving processes.

Rat neurosphere cells protect axotomized rat retinal ganglion cells and facilitate their regeneration

We investigated the ability of a population of rat neural stem and precursor cells derived from rat embryonic spinal cord to protect injured neurons in the rat central nervous system (CNS). The neonatal rat optic pathway was used as a model of CNS injury, whereby retinal ganglion cells (RGCs) were axotomized by lesion of the lateral geniculate nucleus one day after birth. Neural stem and precursor cells derived from expanded neurospheres (NS) were transplanted into the lesion site at the time of injury. Application of Fast Blue tracer dye to the lesion site demonstrated that significant numbers of RGCs survived at 4 and 8 weeks in animals that received a transplant, with an average of 28% survival, though in some individual cases survival was greater than 50%. No RGCs survived in animals that received a lesion alone. Furthermore, labeled RGCs were also observed when Fast Blue was applied to the superior colliculus (SC) at 4 weeks, suggesting that neurosphere cells also facilitated RGC to regenerate to their normal target. Transplanted cells did not migrate or express neural markers after transplantation, and secreted several neurotrophic factors in vitro. We conclude that NS cells can protect injured CNS neurons and promote their regeneration. These effects are not attributable to cell replacement, and may be mediated via secretion of neurotrophic factors. Thus, neuroprotection by stem cell populations may be a more viable approach for treatment of CNS disorders than cell replacement therapy.

Case studies to demonstrate the range of applications of the Southampton Hand Assessment Procedure

The Southampton Hand Assessment Procedure (SHAP) was devised to assess quantitatively the functional range of injured and healthy adult hands. It was designed to be a practical tool for use in a busy clinical setting; thus, it was made simple to use and easy to interpret. This paper describes four examples of its use: before and after a surgical procedure, to observe the impact of an injury, use with prostheses, and during recovery following a fracture. The cases show that the SHAP is capable of monitoring progress and recovery, identifying functional abilities in prosthetic hands and comparing the capabilities of different groups of injuries.

Development and experimental identification of a biomechanical model of the trunk for functional electrical stimulation control in paraplegia

Objectives. Theoretic modeling and experimental studies suggest that functional electrical stimulation (FES) can improve trunk balance in spinal cord injured subjects. This can have a positive impact on daily life, increasing the volume of bimanual workspace, improving sitting posture, and wheelchair propulsion. A closed loop controller for the stimulation is desirable, as it can potentially decrease muscle fatigue and offer better rejection to disturbances. This paper proposes a biomechanical model of the human trunk, and a procedure for its identification, to be used for the future development of FES controllers. The advantage over previous models resides in the simplicity of the solution proposed, which makes it possible to identify the model just before a stimulation session ( taking into account the variability of the muscle response to the FES). Materials and Methods. The structure of the model is based on previous research on FES and muscle physiology. Some details could not be inferred from previous studies, and were determined from experimental data. Experiments with a paraplegic volunteer were conducted in order to measure the moments exerted by the trunk-passive tissues and artificially stimulated muscles. Data for model identification and validation also were collected. Results. Using the proposed structure and identification procedure, the model could adequately reproduce the moments exerted during the experiments. The study reveals that the stimulated trunk extensors can exert maximal moment when the trunk is in the upright position. In contrast, previous studies show that able-bodied subjects can exert maximal trunk extension when flexed forward. Conclusions. The proposed model and identification procedure are a successful first step toward the development of a model-based controller for trunk FES. The model also gives information on the trunk in unique conditions, normally not observable in able-bodied subjects (ie, subject only to extensor muscles contraction).

Inactivation of Escherichia coli by citral

Aims: The aim was to evaluate (i) the resistance of Escherichia coli BJ4 to citral in a buffer system as a function of citral concentration, treatment medium pH, storage time and initial inoculum size, (ii) the role of the sigma factor RpoS on citral resistance of E. coli, (iii) the role of the cell envelope damage in the mechanism of microbial inactivation by citral, and (iii) possible synergistic effects of mild heat treatment and pulsed-electric fields (PEF) treatment combined with citral. Methods and Results: The initial inoculum size greatly affected the efficacy of citral against E. coli cells. Exposure to 200 µl l-1of citral at pH 4.0 for 24 h at 20 ºC caused the inactivation of more than 5 log10 cycles of cells starting at an inoculum size of 106 or 107 CFU ml-1, whereas increasing the cell concentration to 109 CFU ml-1 caused less than 1 log10 cycle of inactivation. E. coli showed higher resistance to citral at pH 4.0 than pH 7.0. The rpoS null mutant strain E. coli BJ4L1 was less resistant to citral than the wild-type strain. Occurrence of sublethal injury to both, the cytoplasmic and outer membranes was demonstrated by adding sodium chloride or bile salts to the recovery media. The majority of sublethally-injured cells by citral required energy and lipid synthesis for repair. A strongly synergistic lethal effect was shown by mild heat treatment combined with citral but the presence of citral during the application of a PEF treatment did not show any advantage. Conclusions: This work confirms that cell envelope damage is an important event in citral inactivation of bacteria, and it describes the key factors on the inactivation of E. coli cells by citral. Significance and Impact of Study: Knowledge about the mechanism of microbial inactivation by citral helps establish successful combined preservation treatments.