La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

Eficacia de la melatonina en insomnio primario en el adulto mayor: revisión sistemática de la literatura

Introducción: La melatonina, una sustancia cronobiótica endógena, es cada vez más empleada para el manejo de los problemas del sueño en adultos mayores por su aparente eficacia y buen perfil de eventos adversos. En este sentido, se intentó evaluar la eficacia de la melatonina en el tratamiento del insomnio primario en el adulto mayor (≥55 años) comparado con benzodiacepinas, zopiclona y placebo a la luz de la evidencia disponible en los últimos cinco años. Métodos: Revisión sistemática de la literatura. Resultados: En comparación con placebo, al parecer la melatonina mejora la calidad y los hábitos de sueño, no así la latencia de inicio de sueño en mediciones subjetivas ni objetivas (polisomnografía); a diferencia de otros medicamentos hipnóticos, no altera la arquitectura del sueño ni genera síntomas diurnos. Conclusiones: No se encontró evidencia que soporte el uso de melatonina en adultos mayores de 55 años para la reducción de la latencia de sueño, aumento del tiempo total de sueño, mejoría de la eficiencia del sueño, disminución de despertares nocturnos o mejoría de la calidad de sueño. Es necesario adelantar más estudios en comparación con placebo y otros medicamentos.

Percepción de calidad de vida relacionada con la salud en pacientes con síndrome de apnea e hipoapnea obstructiva del sueño

El objetivo de esta investigación es describir la calidad de vida y la calidad del sueño en los pacientes con diagnóstico de Síndrome de Apnea Hipoapnea del sueño, mediante el uso de un grupo de cuestionarios para obtener datos demográficos, la evaluación del grado de somnolencia diurna percibida, la percepción de la calidad del sueño y la percepción de la calidad de vida relacionada con la salud con encuestas en sus respectivas versiones validadas para Colombia.

Impacto del horario laboral en la capacidad de atención en médicos de urgencias de la Fundación Santa Fe

Introducción: Se ha determinado que las jornadas laborales, generan un deterioro cognoscitivo y funcional en las personas, con la consecuente afectación en los servicios de salud, al ser una de las disciplinas que más se encuentran en riesgo de cometer errores durante sus procesos de atención. Es por esto que en el presente estudio se pretendió evaluar el impacto de la jornada laboral en la capacidad de atención de los médicos de urgencias. Metodología: Se realizó un estudio transversal aplicando el Psychomotor Vigilance Test, el cual evalúa la capacidad de atención de las personas después de realizar diferentes actividades según el tiempo de respuesta en milisegundos. Se tomó una muestra de la población del personal médico de urgencias de la Fundación Santa Fé de Bogotá, estableciendo una comparación del mismo paciente en los diferentes turnos. Resultados: En el presente estudio se documentó un tiempo de respuesta promedio al inicio de la jornada diurna de 436,6 ms (IC95% 401-477) y al final de 443,1 ms (IC95% 388-484). Con respecto a la jornada nocturna se documentó un tiempo de respuesta promedio inicial de 422,8 ms (IC95% 403-457) y al final de 467,44 ms (IC95% 423-501). Discusión: Encontramos diferencias estadísticamente significativas en cuanto al tiempo de respuesta entre la jornada diurna y nocturna. Por lo tanto es recomendable crear políticas de Estado que gestionen el horario laboral del personal de salud para que prime la seguridad y la calidad de atención en el paciente, evitando al máximo cualquier posibilidad de error médico

Las personas con retraso mental y su diagnóstico : traducción, adaptación y valoración de la Escala de Conducta Adaptativa ABS-S: 2 y ABS-RC: 2 del método de Evaluación de las Areas de Habilidades Adaptativas AAA.

Adaptación de las escalas de conducta adaptativa ABS-S: 2; ABS-RC: 2 y el método de evaluación de Ýreas de Habilidades Adaptativas, AAA. Dos muestras de 67 sujetos sin retraso mental y 142 sujetos con retraso mental en el ámbito de aplicación de la escuela con un tipo de muestreo estratificado. Traducción, adaptación directa e inversa, planteamiento de hipótesis, cumplimentación de las escalas por el profesorado y los padres, procedimiento estadístico de análisis e interpretación de los datos, estimación de baremos, discusión del proceso y resultados. Escalas American Association on Mental Retardation (AAMR): ABS-S: 2; ABS-RC: 2; AAA (Areas de Habilidades Adaptativas; ICAP (Inventario de Conducta Adaptativa) y CET (Cuestionario para la Evaluación de los Test). Bases de datos, SPSS versión 10.0 y Office. Las Escalas ABS-S: 2 y AAA sirven para poder ser utilizadas en la población española con y sin retraso mental de 2 a 18 años. La conducta que se mide en estas escalas manifiesta una adecuada validez y fiabilidad. Las conductas desadaptadas correlacionan de forma inversa con la adquisición y uso de las conductas adaptadas. Las escalas que se han manejado se consideran esenciales para el diagnóstico de las personas con retraso mental ya que hasta este momento no se disponía de ningún instrumento que evaluara las áreas de habilidades adaptativas. Sería conveniente sacar baremos más representativos de la población sin retraso mental para una mayor funcionalidad de las escalas de cara al diagnóstico y la intervención educativa de las personas con retraso mental.

Apoyando proyectos de vida inclusivos: claves para transformar las prácticas socioeducativas de personas adultas con discapacidad intelectual

En el marco del modelo social de la discapacidad cobran importancia la autodeterminación y autogestión de las personas con discapacidad intelectual, replanteando la relación de poder entre profesionales y usuarios. Por ello, la transformación de las prácticas socioeducativas en la construcción y logro de proyectos de vida personalizados constituye un reto para los servicios dirigidos a personas adultas con discapacidad. El objetivo del presente artículo es mostrar, a partir de la revisión de literatura y el análisis de buenas prácticas, algunos elementos clave que facilitan esta transformación. En primer lugar, se presentan las líneas principales de la nueva conceptualización de las personas con discapacidad intelectual como protagonistas de sus proyectos de vida. Seguidamente, y después de contextualizar brevemente el escenario formado por los servicios de adultos en España, se presentan algunas estrategias e instrumentos básicos para la transformación de las prácticas educativas. En las conclusiones se incide en los retos que estas claves plantean en nuestro contexto

¿Contribuye a la inclusión laboral la formación que recibe el alumnado con discapacidad intelectual en la ESO?: análisis y propuestas

Las investigaciones centradas en el análisis de buenas prácticas de inclusión laboral de personas con discapacidad demuestran la importancia de la formación previa, y específicamente la recibida en la etapa de secundaria. El objetivo de este artículo es presentar los resultados de una investigación sobre las características básicas de la formación laboral que reciben los jóvenes con discapacidad intelectual en la ESO. En el primer apartado se realiza una aproximación al papel de la educación secundaria en el desarrollo del rol laboral desde una óptica inclusiva. A continuación, se presenta la investigación realizada con el objeto de obtener datos sobre la adecuación de la formación socio-laboral que se realiza en la ESO (objetivos, método y resultados). Por último se plantean las orientaciones dirigidas a mejorar las oportunidades futuras de inclusión laboral desde el sistema educativo

Não sei...intervenção junto de um aluno com disfunção cognitiva em ambiência inclusiva

RESUMO: Neste trabalho pretende-se mostrar o trabalho desenvolvido num ambiente inclusivo numa turma onde se encontra um aluno com défice cognitivo ligeiro. Dele faz parte a pesquisa bibliográfica sobre a inclusão, deficiência mental e perturbações emocionais. Para identificar as diversas problemáticas da turma utilizámos a sociometria, observação naturalista entre outros. Após a recolha da informação definimos objectivos e estratégias sempre com base na inclusão. De seguida procedemos à intervenção junto do grupo nas áreas da socialização, comunicação e académica. No final realizámos a avaliação das diversas actividades de forma a percebermos se os objectivos foram alcançados. ABSTRACT: In this paper we want to show all the work we had trying to include on a regular class a student with mental retardation. To do so, we search for definitions of inclusion, mental retardation and emotional disorders to help us understand the student problem. We used the several techniques that help us find out how the students react with each other. After this we decided which objectives we wanted to achieve which this work and selected different strategies to work based on inclusion and stared working with the group. Finally we evaluated the work to see if it had helped the students or not.

As atitudes dos professores face à inclusão de alunos com deficiência no Ensino Regular

As sociedades actuais caracterizam-se pela mudança, complexidade e diversidade cultural. De dia para dia assistimos cada vez mais à passagem das responsabilidades educativas da comunidade para a escola, assumindo esta, um papel preponderante na formação dos nossos jovens. O professor, é assim, considerado um elemento chave na construção de uma escola inclusiva e para que haja uma efectiva mudança da escola e das estratégias da sala de aula (Costa, 1999). O objectivo deste estudo é investigar as atitudes dos professores, determinando como estes percepcionam as suas Competências e de que forma essas atitudes são influenciadas, ou não, tendo em conta a experiência profissional, o grupo disciplinar a que pertencem, a experiência no ensino de alunos com deficiência e a formação inicial cujas áreas de estudo, estiveram directamente relacionados com a deficiência. A amostra deste estudo foi constituída por um total de 741 professores do ensino regular (534 afectos ao género feminino e 207 afectos ao género masculino). Foi aplicado o questionário APIAD – Atitudes dos Professores face à Inclusão de Alunos com Deficiência (Leitão, 2011), inferido através da resposta a 14 afirmações, em que cada uma delas deverá ser relacionado com 4 condições de deficiência (deficiência visual, deficiência auditiva, deficiência mental e deficiência motora). Concluiu-se então que, relativamente ao Grupo Disciplinar, as diferenças significativas se encontram entre os professores de Educação Física e os professores de Humanidades e de Ciências, sendo que os primeiros têm uma atitude mais positiva relativamente às suas competências. Quanto ao Contacto com a Deficiência, os resultados indicaram que os professores que têm experiência no ensino de alunos com deficiência têm uma atitude mais positiva relativamente às suas competências. No que se refere à Experiência Profissional, os nossos resultados encontram diferenças significativas entre os professores com menos anos de experiência e os professores com mais anos de experiência, sendo que os primeiros têm uma atitude mais positiva relativamente às suas competências Por último, em relação à Formação Inicial, os professores cujas áreas de estudo, na sua formação inicial, estiveram directamente relacionados com deficiência têm uma atitude mais positiva relativamente às suas competências. ABSTRACT: Today, societies are characterized by change, complexity and cultural diversity. Each day, we saw more and more responsibilities passing from the educational community to school, assuming that a major role in the formation of our youth. Teacher is considered a key element in the building of an inclusive school and for that there is a real change of school and classroom strategies (Costa, 1999). The purpose of this study is to investigate teacher´s attitudes, determining how they perceive their skills and how these attitudes are or aren´t influenced taking into account the professional experience, the subject group they belong to, the experience in students with those particular needs teaching and last, the initial training with chairs that had contact with people with needs. The study sample consisted in a total of 741 teachers of the regular education (534 allocated to the female and 207 assigned to the male gender). We used the questionnaire APIAD - Attitudes of teachers towards the Inclusion of Students with Disabilities (Leitão, 2011), inferred by the response to 14 statements, each one of them should be related to four conditions of disability (visual impairment, hearing impairment, mental retardation and physical disabilities). It was concluded then that for the Disciplinary Group, significant differences are found between the physical education teachers and teachers of Humanities and Sciences, and the former have a more positive attitude to their skills. How to contact the Disability, the results indicated that teachers who have experience teaching students with disabilities have a more positive attitude to their skills. With regard to professional experience, significant differences were found between teachers with fewer years of experience and teachers with more years of experience, and the former have a more positive attitude to their skills. Finally, regarding to initial training, teachers in their initial training formation who have contact with people with disabilities have a more positive attitude to their skills.

Diffusion of the synthetic pyrethroid permethrin into bed-sediments

Bed-sediments are a sink for many micro-organic contaminants in aquatic environments. The impact of toxic contaminants on benthic fauna often depends on their spatial distribution, and the fate of the parent compounds and their metabolites. The distribution of a synthetic pyrethroid, permethrin, a compound known to be toxic to aquatic invertebrates, was studied using river bed-sediments in lotic flume channels. trans/cis-Permethrin diagnostic ratios were used to quantify the photoisomerization of the trans isomer in water. Rates were affected by the presence of sediment particles and colloids when compared to distilled water alone. Two experiments in dark/light conditions with replicate channels were undertaken using natural sediment, previously contaminated with permethrin, to examine the effect of the growth of an algal biofilm at the sediment-water interface on diffusive fluxes of permethrin into the sediment. After 42 days, the bulk water was removed, allowing a fine sectioning of the sediment bed (i.e., every mm down to 5 mm and then 5-10 mm, then every 10 mm down to 50 mm). Permethrin was detected in all cases down to a depth of 5-10 mm, in agreement with estimates by the Millington and Quirk model, and measurements of concentrations in pore water produced a distribution coefficient (K-d) for each section, High K-d's were observed for the top layers, mainly as a result of high organic matter and specific surface area. Concentrations in the algal biofilm measured at the end of the experiment under light conditions, and increases in concentration in the top 1 mm of the sediment, demonstrated that algal/bacterial biofilm material was responsible for high K-d's at the sediment surface, and for the retardation of permethrin diffusion. This specific partition of permethrin to fine sediment particles and algae may enhance its threat to benthic invertebrates. In addition,the analysis of trans/cis-permethrin isomer ratios in sediment showed greater losses of trans-permethrin in the experiment under light conditions, which may have also resulted from enhanced biological activity at the sediment surface.

Soil mobility of sewage sludge-derived dissolved organic matter, copper, nickel and zinc

A soil (sandy loam) column leaching study aimed to determine the extent of mobility and co-mobility of Cu, Ni, Zn and dissolved organic matter (DOM) released from a surface-application (equivalent to 50 t ds ha(-1)) of anaerobically-digested sewage sludge. Leaching of DOM through It the soil column was found to be almost un-retarded. Decidedly similar behaviour was exhibited by Ni suggesting that it migrated as organic complexes. Whilst Cu was also found to be leached, significant retardation was evident. However, the importance of DOM in promoting the mobility of both Cu and Ni was evidenced by their lack of mobility when added to the soil column as inorganic forms. The presence of DOM did not prevent Zn from becoming completely adsorbed by the soil solid phase. In relation to WHO drinking water guidelines, only Ni concentrations showed potential environmental significance. due to the relatively poor retention of Ni by the sludge solid phase. (C) 2003 Elsevier Ltd. All rights reserved.

Prediction leaching of potassium using the convective-dispersive and the convective log-normal transfer function models

There is increasing concern about soil enrichment with K+ and subsequent potential losses following long-term application of poor quality water to agricultural land. Different models are increasingly being used for predicting or analyzing water flow and chemical transport in soils and groundwater. The convective-dispersive equation (CDE) and the convective log-normal transfer function (CLT) models were fitted to the potassium (K+) leaching data. The CDE and CLT models produced equivalent goodness of fit. Simulated breakthrough curves for a range of CaCl2 concentration based on parameters of 15 mmol l(-1) CaCl2 were characterised by an early peak position associated with higher K+ concentration as the CaCl2 concentration used in leaching experiments decreased. In another method, the parameters estimated from 15 mmol l(-1) CaCl2 solution were used for all other CaCl2 concentrations, and the best value of retardation factor (R) was optimised for each data set. A better prediction was found. With decreasing CaCl2 concentration the value of R is required to be more than that measured (except for 10 mmol l(-1) CaCl2), if the estimated parameters of 15 mmol l(-1) CaCl2 are used. The two models suffer from the fact that they need to be calibrated against a data set, and some of their parameters are not measurable and cannot be determined independently.

The dynamics of a polar low assessed using potential vorticity inversion

The dynamics of a polar low are examined using a piecewise potential vorticity (PV) inversion method. In previous studies of this and other polar lows, structural evolution has been described in terms of regions of anomalous PV. In this study the relative importance of different PV anomalies and the interactions between them have been quantified using PV diagnostics. The intensification of the polar low occurred in three stages (in contrast to previous studies of polar lows that have only identified two stages). The dynamical characteristics of stages one and two are consistent with the proposed type C cyclogenesis mechanism. A diabatically-generated lower-tropospheric PV anomaly dominated intensification after initial triggering by a positive upper-level PV anomaly. A phase tilt between the upper and lower levels was maintained through retardation of the positive upper-level anomaly by the effects of latent heat release. Stage three was a period of growth dominated by wind-induced surface heat exchange (WISHE), which contributed at least 18% to the amplitude of the mature surface polar low.

Challenge testing the lactoperoxidase system against a range of bacteria using different activation agents

Lactoperoxidase (LP) exerts antimicrobial effects in combination with H2O2 and either thiocyanate (SCN-) or a halide (e. g., I-). Garlic extract in the presence of ethanol has also been used to activate the LP system. This study aimed to determine the effects of 3 LP activation systems (LP+SCN-+H2O2; LP+I-+H2O2; LP + garlic extract + ethanol) on the growth and activity of 3 test organisms (Staphylococcus aureus, Pseudomonas aeruginosa, and Bacillus cereus). Sterilized milk was used as the reaction medium, and the growth pattern of the organisms and a range of keeping quality (KQ) indicators (pH, titratable acidity, ethanol stability, clot on boiling) were monitored during storage at the respective optimum growth temperature for each organism. The LP+I-+H2O2 system reduced bacterial counts below the detection limit shortly after treatment for all 3 organisms, and no bacteria could be detected for the duration of the experiment (35 to 55 h). The KQ data confirmed that the milk remained unspoiled at the end of the experiments. The LP + garlic extract + ethanol system, on the other hand, had no effect on the growth or KQ with P. aeruginosa, but showed a small retardation of growth of the other 2 organisms, accompanied by small increases (5 to 10 h) in KQ. The effects of the LP+SCN-+H2O2 system were intermediate between those of the other 2 systems and differed between organisms. With P. aeruginosa, the system exerted total inhibition within 10 h of incubation, but the bacteria regained viability after a further 5 h, following a logarithmic growth curve. This was reflected in the KQ indicators, which implied an extension of 15 h. With the other 2 bacterial species, LP+SCN-+H2O2 exerted an obvious inhibitory effect, giving a lag phase in the growth curve of 5 to 10 h and KQ extension of 10 to 15 h. When used in combination, I- and SCN- displayed negative synergy.

Effects of hydrocolloid addition and high pressure processing on the rheological properties and microstructure of a commercial ostrich meat product "Yor" (Thai sausage)

"Yor" is a traditional sausage like product widely consumed in Thailand. Its textures are usually set by steaming, in this experiment ultra-high pressure was used to modify the product. Three types of hydrocolloid; carboxymethylcellulose (CMC), locust bean gum (LBG) and xanthan gum, were added to minced ostrich meat batter at concentration of 0-1% and subjected to high pressure 600 Mpa, 50 degrees C, 40 min. The treated samples were analysed for storage (G) and loss (G '') moduli by dynamic oscillatory testing as well as creep compliance for control stress measurement. Their microstructures using confocal microscopy were also examined. Hydrocolloid addition caused a significant (P < 0.05) decrease in both the G' and G '' moduli. However the loss tangent of all samples remained unchanged. Addition of hydrocolloids led to decreases in the gel network formation but appears to function as surfactant materials during the initial mixing stage as shown by the microstructure. Confocal microscopy suggested that the size of the fat droplets decreased with gum addition. The fat droplets were smallest on the addition of xanthan gum and increased in the order CMC, LBG and no added gum, respectively. Creep parameters of ostrich yors with four levels of xanthan gum addition (0.50%, 0.75%, 1.00% and 1.25%) showed an increase in the instantaneous compliance (J(0)), the retarded compliance (J(1)) and retardation time (lambda(1)) but a decrease in the viscosity (eta(0)) with increasing levels of addition. The results also suggested that the larger deformations used during creep testing might be more helpful in assessing the mechanical properties of the product than the small deformations used in oscillatory rheology. (c) 2007 Elsevier Ltd. All rights reserved.