Estrategias para el control microclimático del espacio entre edificaciones en clima cálido – húmedo

La presente investigación parte del problema en las zonas de clima cálido - húmedo en las cuales se producen impactos asociados a la incomodidad térmica producto de la intensa radiación solar, altas temperaturas y elevada humedad. Estos factores reducen la calidad de los espacios abiertos y desarrollan en la población una actitud de rechazo hacia el uso del microespacio urbano entre edificaciones en los desarrollos urbanos - conjuntos urbanos - , los mismos frecuentemente admiten soluciones que al parecer no contribuyen a la realización de las actividades comunes de esparcimiento de la población residente. Por lo tanto, el objetivo de la investigación es profundizar en la temática urbano - ambiental - social y el diseño urbano vinculada a la particularidad morfológica local, las condiciones microclimáticas, el uso del microespacio y los requerimientos de los usuarios. La finalidad de desarrollar estrategias de control microclimático del microespacio entre edificios en clima cálido - húmedo en búsqueda de soluciones óptimas que satisfagan las necesidades de los usuarios de los espacios exteriores en estas áreas residenciales. La investigación se centra en el estudio de las particularidades contextuales relacionadas con el microclima y las características urbanas - morfotipológicas, básicamente los factores microclimáticos (soleamiento y ventilación), los morfológicos y edificatorios y las características de las superficies (pavimentos). En coherencia con el objetivo propuesto el trabajo se desarrolla en cuatro fases: la primera aborda la revisión documental, literatura relevante e investigaciones relativas a la calidad ambiental, medio social, medio físico, el microespacio urbano, control y diseño sostenible, modelización proyectual y estrategias sostenibles; la segunda fase se refiere al marco contextual, características urbanas, datos climáticos locales, planes y procesos urbanos, tipologías y conformación urbana. En esta fase se describe el proceso de selección, análisis y evaluación urbano - ambiental de los casos de estudio (conjuntos residenciales). En la tercera fase se aborda el marco evaluativo y estudio de casos, consideraciones físicas, climáticas y valoración térmico - ambiental de los conjuntos residenciales seleccionados. En esta fase se aplican Técnicas Estadísticas y de Simulación Computacional y se analizan los resultados obtenidos. Finalmente, la cuarta fase propositiva incluye el establecimiento de Estrategias, Principios y Lineamientos de optimación térmica y se exponen las Conclusiones parciales de la tesis, alcances y perspectivas futuras. Finalmente, los resultados obtenidos en la investigación demuestran que el análisis en las experiencias de la realidad permiten comprobar que las situaciones y alteraciones ambientales sustanciales, los niveles de afectación térmica y las condiciones de confortabilidad e impacto derivan de las características urbanas, los componentes del microespacio y de las condiciones climáticas las cuales afectan el desarrollo de las actividades y el uso efectivo del microespacio entre edificios. El análisis de los factores morfo - climáticos incidentes y el estudio de los efectos de interacción contribuyen al establecimiento de Principios y Lineamientos para la evaluación y diseño sostenible del microespacio entre edificios y el uso correcto de los elementos del clima en estas áreas urbanas destinadas a la actividad social y al esparcimiento de la población residente. ABSTRACT This research starts from the problem of hot - humid climate zones where impacts related to thermal discomfort are produced as a result from the intense solar radiation and high temperatures and humidity. These factors reduce the quality of open spaces and people develop an attitude of rejection towards the use of urban microspace among buildings within urban developments - urban complexes - . Usually, these complexes admit solutions that apparently do not contribute to the achievement of common leisure activities in the resident dwellers. Therefore, the main purpose of this research is to deepen in the urban - environmental - social issue and urban design linked to the local morphological particularity, microclimate conditions, use of microspace and users’ requirements. In order to develop microclimate control strategies of microspace among buildings in hot - humid climate to look for optimal solutions that satisfy users’ needs of outdoors spaces in these residential areas. The research focuses in the study of contextual particularities related to microclimate and urban - morphotypological characteristics. Basically, microclimate (sunlight and ventilation), morphological and building factors as well as road surface characteristics. According to the proposed objective, this research is developed in four phases: the first one considers documentary review, relevant literature and researches related to environmental quality, social environment, physical environment, urban microspace, control and sustainable design, project modelling and sustainable strategies; while the second phase refers to contextual framework, urban characteristics, local climate data, plans and urban processes, typologies and urban structure. In this phase, the process of selection, analysis and urban - environmental evaluation of case studies (residential complexes) is described. The third phase approaches the assessment framework and case studies, physical and climate considerations as well as environmental - thermal evaluation of selected residential complexes. In this phase, statistical techniques and computational simulations are applied. Likewise, results obtained are analysed. Similarly, fourth and proposing phase includes the establishment of strategies, principles and guidelines of thermal optimization and partial conclusions of the thesis, scopes and future perspectives are exposed. Finally, from the results obtained, it is demonstrated that the analysis on reality experiences allow proving that situations and substantial environmental changes, levels of thermal affectations, comfort conditions and impact derive from urban characteristics, microspace components and from climate conditions which affect the development of activities and the effective use of microspace among buildings. The analysis of incidental morpho - climate factors and the study of interaction effects contribute to the establishment of principles and guidelines for the assessment and sustainable design of microspace among buildings as well as the correct use of climate elements in these urban areas oriented to social and leisure activities of resident population.

Sistema de control borroso en lazo cerrado para terapias con insulina en diabetes tipo I

La diabetes mellitus es un trastorno del metabolismo de los carbohidratos producido por la insuficiente o nula producción de insulina o la reducida sensibilidad a esta hormona. Es una enfermedad crónica con una mayor prevalencia en los países desarrollados debido principalmente a la obesidad, la vida sedentaria y disfunciones en el sistema endocrino relacionado con el páncreas. La diabetes Tipo 1 es una enfermedad autoinmune en la que son destruidas las células beta del páncreas, que producen la insulina, y es necesaria la administración de insulina exógena. Un enfermo de diabetes Tipo 1 debe seguir una terapia con insulina administrada por la vía subcutánea que debe estar adaptada a sus necesidades metabólicas y a sus hábitos de vida, esta terapia intenta imitar el perfil insulínico de un páncreas no patológico. La tecnología actual permite abordar el desarrollo del denominado “páncreas endocrino artificial”, que aportaría precisión, eficacia y seguridad para los pacientes, en cuanto a la normalización del control glucémico y reducción del riesgo de hipoglucemias. Permitiría que el paciente no estuviera tan pendiente de su enfermedad. El páncreas artificial consta de un sensor continuo de glucosa, una bomba de infusión de insulina y un algoritmo de control, que calcula la insulina a infusionar usando la glucosa como información principal. Este trabajo presenta un método de control en lazo semi-cerrado mediante un sistema borroso experto basado en reglas. La regulación borrosa se fundamenta en la ambigüedad del lenguaje del ser humano. Esta incertidumbre sirve para la formación de una serie de reglas que representan el pensamiento humano, pero a la vez es el sistema que controla un proceso, en este caso el sistema glucorregulatorio. Este proyecto está enfocado en el diseño de un controlador borroso que haciendo uso de variables como la glucosa, insulina y dieta, sea capaz de restaurar la función endocrina del páncreas de forma tecnológica. La validación del algoritmo se ha realizado principalmente mediante experimentos en simulación utilizando una población de pacientes sintéticos, evaluando los resultados con estadísticos de primer orden y algunos más específicos como el índice de riesgo de Kovatchev, para después comparar estos resultados con los obtenidos por otros métodos de control anteriores. Los resultados demuestran que el control borroso (FBPC) mejora el control glucémico con respecto a un sistema predictivo experto basado en reglas booleanas (pBRES). El FBPC consigue reducir siempre la glucosa máxima y aumentar la mínima respecto del pBRES pero es en terapias desajustadas, donde el FBPC es especialmente robusto, hace descender la glucosa máxima 8,64 mg/dl, el uso de insulina es 3,92 UI menor, aumenta la glucosa mínima 3,32 mg/dl y lleva al rango de glucosa 80 – 110 mg/dl 15,33 muestras más. Por lo tanto se puede concluir que el FBPC realiza un mejor control glucémico que el controlador pBRES haciéndole especialmente efectivo, robusto y seguro en condiciones de desajustes de terapia basal y con gran capacidad de mejora futura. SUMMARY The diabetes mellitus is a metabolic disorder caused by a poor or null insulin secretion or a reduced sensibility to insulin. Diabetes is a chronic disease with a higher prevalence in the industrialized countries, mainly due to obesity, the sedentary life and endocrine disfunctions connected with the pancreas. Type 1 diabetes is a self-immune disease where the beta cells of the pancreas, which are the responsible of secreting insulin, are damaged. Hence, it is necessary an exogenous delivery of insulin. The Type 1 diabetic patient has to follow a therapy with subcutaneous insulin administration which should be adjusted to his/her metabolic needs and life style. This therapy tries to mimic the insulin profile of a non-pathological pancreas. Current technology lets the development of the so-called endocrine artificial pancreas that would provide accuracy, efficiency and safety to patients, in regards to the glycemic control normalization and reduction of the risk of hypoglycemic. In addition, it would help the patient not to be so concerned about his disease. The artificial pancreas has a continuous glucose sensor, an insulin infusion pump and a control algorithm, that calculates the insulin infusion using the glucose as main information. This project presents a method of control in semi-closed-loop, through an expert fuzzy system based on rules. The fuzzy regulation is based on the human language ambiguity. This uncertainty serves for construction of some rules that represent the human language besides it is the system that controls a process, in this case the glucoregulatory system. This project is focus on the design of a fuzzy controller that, using variables like glucose insulin and diet, will be able to restore the pancreas endocrine function with technology. The algorithm assessment has mainly been done through experiments in simulation using a population of synthetic patients, evaluating the results with first order statistical parameters and some other more specific such as the Kovatchev risk index, to compare later these results with the ones obtained in others previous methods of control. The results demonstrate that the fuzzy control (FBPC) improves the glycemic control connected with a predictive expert system based on Booleans rules (pBRES). The FBPC is always able to reduce the maximum level of glucose and increase the minimum level as compared with pBRES but it is in unadjusted therapies where FBPC is especially strong, it manages to decrease the maximum level of glucose and insulin used by 8,64 mg/dl and 3,92 UI respectively, also increases the value of minimum glucose by 3,32 mg/dl, getting 15,33 samples more inside the 80-110 mg/dl glucose rank. Therefore we can conclude that FBPC achieves a better glycemic control than the controller pBRES doing it especially effective, robust and safe in conditions of mismatch basal therapy and with a great capacity for future improvements.

Climatic factors control rodent seed predation in Pinus pinea L. stands in Central Spain

- Context: Pinus pinea L. presents serious problems of natural regeneration in managed forest of Central Spain. The species exhibits specific traits linked to frugivore activity. Therefore, information on plant–animal interactions may be crucial to understand regeneration failure. - Aims: Determining the spatio-temporal pattern of P. pinea seed predation by Apodemus sylvaticus L. and the factors involved. Exploring the importance of A. sylvaticus L. as a disperser of P. pinea. Identifying other frugivores and their seasonal patterns. - Methods: An intensive 24-month seed predation trial was carried out. The probability of seeds escaping predation was modelled through a zero-inflated binomial mixed model. Experiments on seed dispersal by A. sylvaticus were conducted. Cameras were set up to identify other potential frugivores. - Results: Decreasing rodent population in summer and masting enhances seed survival. Seeds were exploited more rapidly nearby parent trees and shelters. A. sylvaticus dispersal activity was found to be scarce. Corvids marginally preyed upon P. pinea seeds. - Conclusions: Survival of P. pinea seeds is climate-controlled through the timing of the dry period together with masting occurrence. Should germination not take place during the survival period, establishment may be limited. A. sylvaticus mediated dispersal does not modify the seed shadow. Seasonality of corvid activity points to a role of corvids in dispersal.

A negative regulator mediates quorum-sensing control of exopolysaccharide production in Pantoea stewartii subsp. stewartii

Classical quorum-sensing (autoinduction) regulation, as exemplified by the lux system of Vibrio fischeri, requires N-acyl homoserine lactone (AHL) signals to stimulate cognate transcriptional activators for the cell density-dependent expression of specific target gene systems. For Pantoea stewartii subsp. stewartii, a bacterial pathogen of sweet corn and maize, the extracellular polysaccharide (EPS) stewartan is a major virulence factor, and its production is controlled by quorum sensing in a population density-dependent manner. Two genes, esaI and esaR, encode essential regulatory proteins for quorum sensing. EsaI is the AHL signal synthase, and EsaR is the cognate gene regulator. esaI, ΔesaR, and ΔesaI-esaR mutations were constructed to establish the regulatory role of EsaR. We report here that strains containing an esaR mutation produce high levels of EPS independently of cell density and in the absence of the AHL signal. Our data indicate that quorum-sensing regulation in P. s. subsp. stewartii, in contrast to most other described systems, uses EsaR to repress EPS synthesis at low cell density, and that derepression requires micromolar amounts of AHL. In addition, derepressed esaR strains, which synthesize EPS constitutively at low cell densities, were significantly less virulent than the wild-type parent. This finding suggests that quorum sensing in P. s. subsp. stewartii may be a mechanism to delay the expression of EPS during the early stages of infection so that it does not interfere with other mechanisms of pathogenesis.

A homeobox gene with potential developmental control function in the meristem of the conifer Picea abies

Many homeobox genes control essential developmental processes in animals and plants. In this report, we describe the first cDNA corresponding to a homeobox gene isolated from a gymnosperm, the HBK1 gene from the conifer Picea abies (L.) Karst (Norway spruce). The sequence shows distinct similarities specifically to the KNOX (knotted-like homeobox) class of homeobox genes known from different angiosperm plants. The deduced amino acid sequence of HBK1 is strikingly similar within the homeodomain (84% identical) to the maize gene Knotted1 (Kn1), which acts to regulate cell differentiation in the shoot meristem. This similarity suggested that the phylogenetic association of HBK1 with the KNOX genes might be coupled to a conservation of gene function. In support of this suggestion, we have found HBK1 to be expressed in the apical meristem in the central population of nondifferentiated stem cells, but not in organ primordia developing at the flanks of the meristem. This pattern of expression is similar to that of Kn1 in the maize meristem. We show further that HBK1, when expressed ectopically in transgenic Arabidopsis plants, causes aberrations in leaf development that are similar to the effects of ectopic expression of angiosperm KNOX genes on Arabidopsis development. Taken together, these data suggest that HBK1 has a role, similar to the KNOX genes in angiosperms, in the control of cellular differentiation in the apical meristem of spruce. The data also indicate that KNOX-gene regulation of vegetative development is an ancient feature of seed plants that was present in the last common ancestor of conifers and angiosperms.

Population regulation in snowshoe hare and Canadian lynx: Asymmetric food web configurations between hare and lynx

The snowshoe hare and the Canadian lynx in the boreal forests of North America show 9- to 11-year density cycles. These are generally assumed to be linked to each other because lynx are specialist predators on hares. Based on time series data for hare and lynx, we show that the dominant dimensional structure of the hare series appears to be three whereas that of the lynx is two. The three-dimensional structure of the hare time series is hypothesized to be due to a three-trophic level model in which the hare may be seen as simultaneously regulated from below and above. The plant species in the hare diet appear compensatory to one another, and the predator species may, likewise, be seen as an internally compensatory guild. The lynx time series are, in contrast, consistent with a model of donor control in which their populations are regulated from below by prey availability. Thus our analysis suggests that the classic view of a symmetric hare–lynx interaction is too simplistic. Specifically, we argue that the classic food chain structure is inappropriate: the hare is influenced by many predators other than the lynx, and the lynx is primarily influenced by the snowshoe hare.

Characteristics of virus-specific CD8+ T cells in the liver during the control and resolution phases of influenza pneumonia

Dissection of the primary and secondary response to an influenza A virus established that the liver contains a substantial population of CD8+ T cells specific for the immunodominant epitope formed by H-2Db and the influenza virus nucleoprotein peptide fragment NP366–374 (DbNP366). The numbers of CD8+ DbNP366+ cells in the liver reflected the magnitude of the inflammatory process in the pneumonic lung, though replication of this influenza virus is limited to the respiratory tract. Analysis of surface phenotypes indicated that the liver CD8+ DbNP366+ cells tended to be more “activated” than the set recovered from lymphoid tissue but generally less so than those from the lung. The distinguishing characteristic of the lymphocytes from the liver was that the prevalence of the CD8+ DbNP366+ set was always much higher than the percentage of CD8+ T cells that could be induced to synthesize interferon γ after short-term, in vitro stimulation with the NP366–374 peptide, whereas these values were generally comparable for virus-specific CD8+ T cells recovered from other tissue sites. Also, the numbers of apoptotic CD8+ T cells were higher in the liver. The results overall are consistent with the idea that antigen-specific CD8+ T cells are destroyed in the liver during the control and resolution phases of this viral infection, though this destruction is not necessarily an immediate process.

Suppressor T cells regulate the nonanergic cell population that remains after peripheral tolerance is induced to the Mls-1 antigen in T cell receptor Vβ8.1 transgenic mice

We have found suppressor T cells that inhibit the proliferative response of naive CD4+ T cells in T cell receptor (TCR) Vβ8.1 transgenic mice rendered tolerant in vivo by inoculation of Mls-1a-positive cells. This suppression was mediated by CD4+ T cells but not by CD8+ T cells or double-negative (DN) cells, and splenic CD4+ T cells from tolerant mice displayed a greater suppression than lymph node CD4+ T cells. Cell contact was required for efficient suppression, and known inhibitory cytokines such as IL-4, IL-10, and transforming growth factor β were not involved. Suppressor T cells inhibited IL-2 production by naive CD4+ T cells, and the addition of exogenous IL-2 diminished the suppressed activity while having little activity on tolerant T cells. Suppression was abolished by the elimination of CD25+ T cells in the tolerant CD4+ T cell subset. CD25+CD4+ T cells suppressed the proliferative response of the residual fraction of the nonanergic population, namely, 6C10+CD4+ T cells still present in the tolerant mice. However, 6C10−CD4+ T cells still had reduced reactivity to Mls-1a even after CD25+CD4+ T cells were removed and exogenous IL-2 was added. Suppressor cells appear to affect only residual nonanergic cells in situ, thereby facilitating the maintenance of the unresponsive state in vivo. These data provide a framework for understanding suppressor T cells and explain the difficulties and variables in defining their activity in other systems, because suppressor T cells apparently control only a small population of nonanergic cells in the periphery and may be viewed as a homeostatic mechanism.

Paternal and maternal DNA lineages reveal a bottleneck in the founding of the Finnish population.

An analysis of Y-chromosomal haplotypes in several European populations reveals an almost monomorphic pattern in the Finns, whereas Y-chromosomal diversity is significantly higher in other populations. Furthermore, analyses of nucleotide positions in the mitochondrial control region that evolve slowly show a decrease in genetic diversity in Finns. Thus, relatively few men and women have contributed the genetic lineages that today survive in the Finnish population. This is likely to have caused the so-called "Finnish disease heritage"-i.e., the occurrence of several genetic diseases in the Finnish population that are rare elsewhere. A preliminary analysis of the mitochondrial mutations that have accumulated subsequent to the bottleneck suggests that it occurred about 4000 years ago, presumably when populations using agriculture and animal husbandry arrived in Finland.

Neoplastic development: paradoxical relation between impaired cell growth at low population density and excessive growth at high density.

The role of heritable, population-wide cell damage in neoplastic development was studied in the 28 L subline of NIH 3T3 cells. These cells differ from the 17(3c) subline used previously for such studies in their lower frequency of "spontaneous" transformation at high population density and their greater capacity to produce large, dense transformed foci. Three cultures of the 28 L subline of NIH 3T3 cells were held under the constraint of confluence for 5 wk (5 wk 1 degree assay) and then assayed twice in succession (2 degrees and 3 degrees assays) for transformed foci and saturation density. After the 2 degrees assay, the cells were also passaged at low density to determine their exponential growth rates and cloned to determine the size and morphological features of the colonies. Concurrent measurements were made in each case with control cells that had been kept only in frequent low-density passages and cells that had been kept at confluence for only 2 wk (2 wk 1 degree). Two of the three cultures transferred from the 2 degrees assay of the 5 wk 1 degree cultures produced light transformed foci, and the third produced dense foci. The light focus-forming cultures grew to twice the control saturation density in their 2 degrees assay and 6-8 times the control density in the 3 degrees assay; saturation densities for the dense focus formers were about 10 times the control values in both assays. All three of the cultures transferred from the 2 degrees assay of the 5 wk 1 degree cultures multiplied at lower rates than controls at low densities, but the dense focus formers multiplied faster than the light focus formers. The reduced rates of multiplication of the light focus formers persisted for > 50 generations of exponential multiplication at low densities. Isolated colonies formed from single cells of the light focus formers were of a lower population density than controls; colonies formed by the dense focus formers were slightly denser than the controls but occupied only half the area. A much higher proportion of the colonies from the 5 wk 1 degree cultures than the controls consisted of giant cells or mixtures of giant and normal-appearing cells. The results reinforce the previous conclusion that the early increases in saturation density and light focus formation are associated with, and perhaps caused by, heritable, population-wide damage to cells that is essentially epigenetic in nature. The more advanced transformation characterized by large increases in saturation density and dense focus formation could have originated from rare genetic changes, such as chromosome rearrangements, known to occur at an elevated frequency in cells destabilized by antecedent cellular damage.

Abundancia y distribución de especies depredadoras sometidas a control en gestión cinegética: estudio de caso representativo de la urraca (Pica pica) en la comarca de la Marina Baja

El presente estudio tiene como objeto analizar la abundancia y distribución de la urraca en función de las diferentes matrices de usos del suelo y gradientes ambientales. Este trabajo se ha centrado en la Comarca de la Marina Baja (Alicante), una región con 578,8 Km² de superficie. La zona cuenta con una vegetación climática de carrascal de termotipo mesomediterráneo y ombrotipo seco y subhúmedo. Se han realizado un total de 396 transectos para estimar la abundancia de la urraca durante los años 2006-2008, en diferentes matrices del paisaje: natural, abandono, regadío y secano. Las abundancias relativas, la evolución de la especie, el efecto sobre otras especies de caza y el efecto que tiene el control poblacional de las urracas se ha obtenido de 21 encuestas realizadas a los gestores de los terrenos cinegéticos. El análisis de los resultados, muestra una mayor abundancia de los individuos en zonas de cultivo de secano (IKA=0.76 aves/km) y cultivos abandonados (IKA=0.73 aves/km), siendo los valores medios anuales cada vez mayores desde el inicio del muestreo. El análisis múltiple de regresión lineal de la abundancia de urraca con la matriz de usos del suelo muestra una relación significativa y positiva con el abandono antiguo (p<0.01), el frutal de secano y las zonas húmedas (p<0.05), mientras que no hay relación significativa (p>0.05) con los índices del paisaje. El análisis ANOVA muestra que las variables significativas influyentes sobre el número de urracas son: matriz de usos del suelo, latitud/ombroclima, continentalidad y la interacción usos del suelo:continentalidad (p<0.05). La urraca ha experimentado un aumento en sus poblaciones desde principios de la primera década del actual siglo. Los cotos que realizan un control sobre la población de urracas tienen un efecto positivo que se ve reflejado en la menor afección sobre otras especies cinegéticas.

Control glucémico a través del ejercicio físico en pacientes con diabetes mellitus tipo 2; revisión sistemática

Introducción: En España, cerca del 14% de la población es diabética y el 95% corresponde a DM2. Un pobre control glucémico provoca un aumento de la morbilidad y mortalidad. Tres son los pilares en el tratamiento de la DM2: la dieta, la medicación y el ejercicio físico, sin embargo, el potencial de la prescripción de entrenamiento físico no ha sido totalmente explotado. Objetivo: Analizar el efecto de las distintas modalidades de ejercicio físico (AE, RT, Combo, INT) en el control glucémico en pacientes con diabetes mellitus tipo 2. Métodos: La búsqueda bibliográfica se realizó en 3 bases de datos electrónicas (Pubmed, Scopus y Proquest), incluyendo publicaciones desde enero de 2011 hasta mayo de 2014, que realizaran la intervención con AE, RT, Combo o INT, y que midieran la glucemia a través de la glucosa capilar, CGMS o HbA1c. Resultados: Del total de 386 artículos encontrados, 14 cumplieron los criterios de inclusión. Estos artículos fueron clasificados atendiendo a la modalidad de ejercicio físico de la intervención (AE, RT, Combo, INT), y en función de si analizaban el control glucémico como consecuencia del entrenamiento a largo plazo o tras una sesión de entrenamiento. Conclusiones: El AE, RT, Combo e INT muestran eficacia en el control glucémico tanto en el entrenamiento prolongado como en las 24-48h post-entrenamiento. Es necesaria la prescripción de un entrenamiento estructurado con una frecuencia, volumen e intensidad determinados para lograr beneficios en el control glucémico. El combo es la modalidad que obtiene mejores resultados a través del entrenamiento a largo plazo.

Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain

Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.

New Florencia : a case study for the 1970 censuses of population and housing.

" ... Through the financial assistance of the AID" (U.S. Agency for International Development) ISP (International Statistical Programs) of the Bureau of the Census.

Contemporary Mexican attitudes toward population, poverty, and public opinion.

Bibliography: p. 53-54.