Evaluar la calidad de vida de los cuidadores en enfermos de Alzheimer

[ES]Los cambios sociodemográficos y el aumento de la esperanza de vida han dado lugar a un aumento de algunas enfermedades, incluyendo la enfermedad de Alzheimer. La enfermedad de Alzheimer no sólo afecta a la persona que padece dicha enfermedad, sino que también repercute en la familia. Los cuidadores familiares son los que, de manera mayoritaria, se hacen cargo de la atención de estos pacientes con un compromiso de 24 horas, con lo que implica hacer cambios en sus estilos de vida. Los objetivos de este estudio son describir las características socio-demográficas, determinar la sobrecarga de los cuidadores informales y evaluar la calidad de sueño de los cuidadores. Se realizará un estudio transversal que incluirá a 40 cuidadores de enfermos de Alzheimer, seleccionados por un muestreo no probabilístico de selección por cuotas. Los participantes serán los cuidadores informales de pacientes con la enfermedad de Alzheimer que estén en el estadío III o IV de dicha enfermedad. Nuestra variable dependiente será el sueño y como variable independiente la sobrecarga. El estudio se realizará en la asociación de familiares de Alzheimer de Bilbao (A.F.A - Bizkaia), dónde se captará a la muestra de estudio y donde se procederá a aplicar los cuestionarios pertinentes para dicho estudio. Para participar en el estudio es necesario que firmen el consentimiento informado. Los instrumentos que se utilizarán son el cuestionario de Pittsburg que evalúa la calidad de sueño y la escala de carga de Zarit. Para el análisis de datos se utilizará el programa SPSS 15.0. Palabras clave: enfermedad de Alzheimer, cuidadores, cuidadores familiares, demencia, sobrecarga, sueño.

La respuesta del Personal Sanitario de España durante las campañas de vacunación antigripal

La infección vírica causada por el virus gripal o influenza representa una importante carga de enfermedad a nivel mundial y es responsable de una elevada morbilidad y mortalidad especialmente en ciertos grupos de riesgo. La vacunación constituye un elemento fundamental y es la principal medida preventiva para hacer frente a la gripe y sus complicaciones. El personal sanitario puede actuar como agente transmisor de la infección nosocomial, por este motivo se encuentra incluido en los grupos de riesgo en los que la vacunación frente a la gripe está indicada anualmente siempre y cuando no presente contraindicaciones. Dada su relevancia, se realizó una revisión bibliográfica, en las principales bases de datos electrónicas, para conocer la cobertura de vacunación antigripal (estacional y pandémica) del personal sanitario de España así como analizar las estrategias adoptadas con el fin de aumentar la cobertura de vacunación. La cobertura de vacunación de los profesionales sanitarios de España es baja, siendo menor para la gripe A (H1N1) que para la gripe estacional. Entre el colectivo de profesionales, los médicos tienen mayor cobertura seguido del personal de enfermería. El principal motivo para vacunarse es la autoprotección así como evitar el contagio de sus pacientes, y para no vacunarse dudar sobre la seguridad de la vacuna. La falta de información acerca de estrategias para aumentar la cobertura antigripal y la baja cobertura de este colectivo hacen necesario el desarrollo de más estudios para poder determinar el diseño e intervenciones de las campañas de vacunación antigripal.

La estratigrafía analítica: 25 años de ensayo y aprendizaje en el análisis e interpretación del registro arqueológico

Homenaje a Georges Laplace, realizado en Vitoria-Gasteiz el 13,14 y 15 de noviembre de 2012. Edición a cargo de Aitor Calvo, Aitor Sánchez, Maite García-Rojas y Mónica Alonso-Eguíluz.

Manejo de la técnica Western Blot. Determinaciones relacionadas con obesidad y diabetes.

23 p.

Reforma e a compreensão de sentidos de Licenciatura: questão filosófica ou de carga horária?

Esta pesquisa se propõe a observar, a partir da análise das entrevistas realizadas com membros do Colegiado das Licenciaturas da UERJ (CL), modos de constituição de sentidos de Licenciatura no âmbito da Reforma das Licenciaturas da UERJ/2006. Coube ao CL, a partir da publicação das Resoluções CNE/CP n 1 e 2/2002, discutir e estabelecer as bases para a implantação da Reforma das Licenciaturas na Universidade, que culminou com a publicação da Deliberação UERJ n 21/2005. Assim, este estudo se desenvolve a partir das seguintes questões: a partir da fala dos entrevistados do Colegiado de Licenciaturas, que sentidos de Licenciatura, Prática e Estágio, se instituem discursivamente? De que modo múltiplas vozes que atravessam a fala dos entrevistados participam no estabelecimento desses sentidos? Para a construção do roteiro de entrevista, foi assumida a perspectiva de Rocha, Daher, e SantAnna (2004). Para a concretização da pesquisa foram considerados os pressupostos da Análise do Discurso de base enunciativa (MAINGUENEAU,1997; 2002; 2008a; 2008b), as contribuições de Authier-Revuz (1990; 1998) sobre os comentários que os enunciadores realizam sobre seu próprio dizer, de SantAnna (2004), para o entendimento do Discurso Relatado, e de Ducrot (1987), para a análise dos enunciados negativos de caráter polêmico. Os resultados apontam para um embate relativo ao papel do CL na redação da Deliberação UERJ n 21/2005, que ora é apresentada como o resultado das discussões ocorridas no CL, ora como uma canetada de instâncias superiores ao CL. Questão que merece destaque, ainda como resultado das análises, é a problemática da desvalorização da discussão sobre Licenciatura, uma realidade na Universidade na época dos debates para a Reforma. Outro aspecto perceptível, foi a preocupação dos membros do CL em definir os espaços ocupados por cada Unidade a partir da Reforma. Além disso, observaram-se algumas mudanças na organização dos cursos de Licenciatura após a Reforma, com a nova divisão de carga horária entre os Institutos Básicos, a Faculdade de Educação e o CAp, que altera o modelo tradicional (3+1), que ainda vigora em muitas Universidades. Essa mudança, ao distribuir o papel de formação de professor entre várias unidades acadêmicas, relativiza o que anteriormente era exclusivo da Faculdade de Educação e leva os Institutos Básicos a ter um envolvimento e uma preocupação maior com a Licenciatura, o que não era uma realidade antes da Reforma. Some-se a isso a formalização do reconhecimento do CAp como formador de professores, pois esse Instituto passou a ter uma participação efetiva no currículo das Licenciaturas, promovendo o reconhecimento institucional do trabalho de ensino e orientação/supervisão dos alunos/estagiários

Un nuevo método basado en el empleo de radiación microondas aplicado en la etapa de descarboxilación de la síntesis malónica.

.INTRODUCCIÓN. 1.1. COMPUESTOS 1,3 - DICARBONÍLICOS. METILENOS ACTIVOS. Los compuestos 1,3 - dicarbonílicos son uno de los bloques sintéticos más utilizados a lo largo de la historia de la síntesis orgánica. Esto se debe a sus múltiples centros de reactividad: dos centros reactivos electrófilos y hasta cinco centros nucleófilos, como se puede ver en la Figura 1, que permiten r ealizar infinidad de secuencias de reacciones para generar moléculas complejas. 1 R R O O Figura 1 . Centros reactivos de los compuestos 1,3 - dicarbonílicos. Se conoce un gran número de reacciones para esta familia de compuestos pero en este texto nos vamos a centrar en estudiar tres casos especialmente característicos por el potencial sintético que proporcionan, y que están muy relacionados con el hecho de que los hidrógenos de la agrupación metilénica son especialmente ácidos. Por ejemplo, el pKa de estos protones, en el caso del malonato de dietilo es de 13 unidades, mientras que el de su éster simple es de 24. 2 Esta notable diferencia en la acidez se explica fácilmente por la diferente estabilidad de los aniones enolatos correspondientes para los que la deslocalización de carga por resonancia está más extendida en el primer caso (Figura 2). Figura 2 . Representación de las formas resonantes del anión enolato malonato de dietilo. EtO OEt O O - EtO OEt O O EtO OEt O - O Nu Nu Nu Nu Nu E E 2 Las reacciones más conocidas que se aprovechan de esta característica estructural son, probablemente, la reacción de Knoevenagel, la síntesis malónica y acetilacética y un buen número de reacciones multicomponente, para los que haremos unos comentarios particulares en los siguientes apartados

METAMODELO PARA LA SIMULACIÓN Y OPTIMIZACIÓN DE SECUENCIAS DE ATORNILLADO EN UNIONES DE TORRES DE AEROGENERADOR

Esta Tesis Doctoral presenta un metamodelo para la estimaci�n del fen�meno de interacci�n el�stica en las uniones atornilladas de torres de aerogenerador, cuya principal particularidad geom�trica es la existencia de un hueco entre bridas. El metamodelo permite conocer la p�rdida de carga que cada tornillo de la uni�n experimenta durante la secuencia de atornillado a consecuencia de la interacci�n el�stica ocurrida. El metamodelo consta de cuatro par�metros (resortes lineales) que simulan la respuesta de la uni�n durante la secuencia, y cuyos valores se obtienen a partir de dos an�lisis est�tico-lineales. Se ha creado un algoritmo que, a trav�s del metamodelo, permite llevar a cabo la simulaci�n de secuencias de atornillado; dicho proceso consiste en reproducir una determinada secuencia de atornillado a partir de las cargas introducidas en los tornillos, de forma que, a trav�s de la estimaci�n de las interacciones el�sticas ocurridas durante la secuencia, proporciona como resultado las cargas finales en los tornillos. Tambi�n se ha desarrollado una metodolog�a que, mediante su correspondiente algoritmo, permite optimizar secuencias de atornillado. El proceso de optimizaci�n consiste en calcular las cargas a aplicar a los tornillos a lo largo de una determinada secuencia a fin de obtener en ellos una determinada distribuci�n final de cargas, que generalmente se desea uniforme y se denomina precarga. Combinando los procesos de simulaci�n y optimizaci�n, el metamodelo permite definir la secuencia �ptima para una determinada uni�n. Los resultados obtenidos han sido validados mediante modelos param�tricos de elementos finitos. Por �ltimo, debe remarcarse que, adem�s de proporcionar buenos resultados, tanto el proceso de simulaci�n como el de optimizaci�n se llevan a cabo con un coste computacional muy bajo gracias a la simplicidad del metamodelo.

Advanced Reaction Systems for Hydrogen Production

[EN] This PhD work started in March 2010 with the support of the University of the Basque Country (UPV/EHU) under the program named “Formación de Personal Investigador” at the Chemical and Environmental Engineering Department in the Faculty of Engineering of Bilbao. The major part of the Thesis work was carried out in the mentioned department, as a member of the Sustainable Process Engineering (SuPrEn) research group. In addition, this PhD Thesis includes the research work developed during a period of 6 months at the Institut für Mikrotechnik Mainz GmbH, IMM, in Germany. During the four years of the Thesis, conventional and microreactor systems were tested for several feedstocks renewable and non-renewable, gases and liquids through several reforming processes in order to produce hydrogen. For this purpose, new catalytic formulations which showed high activity, selectivity and stability were design. As a consequence, the PhD work performed allowed the publication of seven scientific articles in peer-reviewed journals. This PhD Thesis is divided into the following six chapters described below. The opportunity of this work is established on the basis of the transition period needed for moving from a petroleum based energy system to a renewable based new one. Consequently, the present global energy scenario was detailed in Chapter 1, and the role of hydrogen as a real alternative in the future energy system was justified based on several outlooks. Therefore, renewable and non-renewable hydrogen production routes were presented, explaining the corresponding benefits and drawbacks. Then, the raw materials used in this Thesis work were described and the most important issues regarding the processes and the characteristics of the catalytic formulations were explained. The introduction chapter finishes by introducing the concepts of decentralized production and process intensification with the use of microreactors. In addition, a small description of these innovative reaction systems and the benefits that entailed their use were also mentioned. In Chapter 2 the main objectives of this Thesis work are summarized. The development of advanced reaction systems for hydrogen rich mixtures production is the main objective. In addition, the use and comparison between two different reaction systems, (fixed bed reactor (FBR) and microreactor), the processing of renewable raw materials, the development of new, active, selective and stable catalytic formulations, and the optimization of the operating conditions were also established as additional partial objectives. Methane and natural gas (NG) steam reforming experimental results obtained when operated with microreactor and FBR systems are presented in Chapter 3. For these experiments nickel-based (Ni/Al2O3 and Ni/MgO) and noble metal-based (Pd/Al2O3 and Pt/Al2O3) catalysts were prepared by wet impregnation and their catalytic activity was measured at several temperatures, from 973 to 1073 K, different S/C ratios, from 1.0 to 2.0, and atmospheric pressure. The Weight Hourly Space Velocity (WHSV) was maintained constant in order to compare the catalytic activity in both reaction systems. The results obtained showed a better performance of the catalysts operating in microreactors. The Ni/MgO catalyst reached the highest hydrogen production yield at 1073 K and steam-to-carbon ratio (S/C) of 1.5 under Steam methane Reforming (SMR) conditions. In addition, this catalyst also showed good activity and stability under NG reforming at S/C=1.0 and 2.0. The Ni/Al2O3 catalyst also showed high activity and good stability and it was the catalyst reaching the highest methane conversion (72.9 %) and H2out/CH4in ratio (2.4) under SMR conditions at 1073 K and S/C=1.0. However, this catalyst suffered from deactivation when it was tested under NG reforming conditions. Regarding the activity measurements carried out with the noble metal-based catalysts in the microreactor systems, they suffered a very quick deactivation, probably because of the effects attributed to carbon deposition, which was detected by Scanning Electron Microscope (SEM). When the FBR was used no catalytic activity was measured with the catalysts under investigation, probably because they were operated at the same WHSV than the microreactors and these WHSVs were too high for FBR system. In Chapter 4 biogas reforming processes were studied. This chapter starts with an introduction explaining the properties of the biogas and the main production routes. Then, the experimental procedure carried out is detailed giving concrete information about the experimental set-up, defining the parameters measured, specifying the characteristics of the reactors used and describing the characterization techniques utilized. Each following section describes the results obtained from activity testing with the different catalysts prepared, which is subsequently summarized: Section 4.3: Biogas reforming processes using γ-Al2O3 based catalysts The activity results obtained by several Ni-based catalysts and a bimetallic Rh-Ni catalyst supported on magnesia or alumina modified with oxides like CeO2 and ZrO2 are presented in this section. In addition, an alumina-based commercial catalyst was tested in order to compare the activity results measured. Four different biogas reforming processes were studied using a FBR: dry reforming (DR), biogas steam reforming (BSR), biogas oxidative reforming (BOR) and tri-reforming (TR). For the BSR process different steam to carbon ratios (S/C) from 1.0 to 3.0, were tested. In the case of BOR process the oxygen-to-methane (O2/CH4) ratio was varied from 0.125 to 0.50. Finally, for TR processes different S/C ratios from 1.0 to 3.0, and O2/CH4 ratios of 0.25 and 0.50 were studied. Then, the catalysts which achieved high activity and stability were impregnated in a microreactor to explore the viability of process intensification. The operation with microreactors was carried out under the best experimental conditions measured in the FBR. In addition, the physicochemical characterization of the fresh and spent catalysts was carried out by Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES), N2 physisorption, H2 chemisorption, Temperature Programmed Reduction (TPR), SEM, X-ray Photoelectron Spectroscopy (XPS) and X-ray powder Diffraction (XRD). Operating with the FBR, conversions close to the ones predicted by thermodynamic calculations were obtained by most of the catalysts tested. The Rh-Ni/Ce-Al2O3 catalyst obtained the highest hydrogen production yield in DR. In BSR process, the Ni/Ce-Al2O3 catalyst achieved the best activity results operating at S/C=1.0. In the case of BOR process, the Ni/Ce-Zr-Al2O3 catalyst showed the highest reactants conversion values operating at O2/CH4=0.25. Finally, in the TR process the Rh-Ni/Ce-Al2O3 catalyst obtained the best results operating at S/C=1.0 and O2/CH4=0.25. Therefore, these three catalysts were selected to be coated onto microchannels in order to test its performance under BOR and TR processes conditions. Although the operation using microreactors was carried out under considerably higher WHSV, similar conversions and yields as the ones measured in FBR were measured. Furthermore, attending to other measurements like Turnover Frequency (TOF) and Hydrogen Productivity (PROD), the values calculated for the catalysts tested in microreactors were one order of magnitude higher. Thus, due to the low dispersion degree measured by H2-chemisorption, the Ni/Ce-Al2O3 catalyst reached the highest TOF and PROD values. Section 4.4: Biogas reforming processes using Zeolites L based catalysts In this section three type of L zeolites, with different morphology and size, were synthesized and used as catalyst support. Then, for each type of L zeolite three nickel monometallic and their homologous Rh-Ni bimetallic catalysts were prepared by the wetness impregnation method. These catalysts were tested using the FBR under DR process and different conditions of BSR (S/C ratio of 1.0 and 2.0), BOR (O2/CH4 ratio of 0.25 and 0.50) and TR processes (at S/C=1.0 and O2/CH4=0.25). The characterization of these catalysts was also carried out by using the same techniques mentioned in the previous section. Very high methane and carbon dioxide conversion values were measured for almost all the catalysts under investigation. The experimental results evidenced the better catalytic behavior of the bimetallic catalysts as compared to the monometallic ones. Comparing the catalysts behavior with regards to their morphology, for the BSR process the Disc catalysts were the most active ones at the lowest S/C ratio tested. On the contrary, the Cylindrical (30–60 nm) catalysts were more active under BOR conditions at O2/CH4=0.25 and TR processes. By the contrary, the Cylindrical (1–3 µm) catalysts showed the worst activity results for both processes. Section 4.5: Biogas reforming processes using Na+ and Cs+ doped Zeolites LTL based catalysts A method for the synthesis of Linde Type L (LTL) zeolite under microwave-assisted hydrothermal conditions and its behavior as a support for heterogeneously catalyzed hydrogen production is described in this section. Then, rhodium and nickel-based bimetallic catalysts were prepared in order to be tested by DR process and BOR process at O2/CH4=0.25. Moreover, the characterization of the catalysts under investigation was also carried out. Higher activities were achieved by the catalysts prepared from the non-doped zeolites, Rh-Ni/D and Rh-Ni/N, as compared to the ones supported on Na+ and Cs+ exchanged supports. However, the differences between them were not very significant. In addition, the Na+ and Cs+ incorporation affected mainly to the Disc catalysts. Comparing the results obtained by these catalysts with the ones studied in the section 4.4, in general worst results were achieved under DR conditions and almost the same results when operated under BOR conditions. In Chapter 5 the ethylene glycol (EG) as feed for syngas production by steam reforming (SR) and oxidative steam reforming (OSR) was studied by using microchannel reactors. The product composition was determined at a S/C of 4.0, reaction temperatures between 625°C and 725°C, atmospheric pressure and Volume Hourly Space Velocities (VHSV) between 100 and 300 NL/(gcath). This work was divided in two sections. The first one corresponds to the introduction of the main and most promising EG production routes. Then, the new experimental procedure is detailed and the information about the experimental set-up and the measured parameters is described. The characterization was carried out using the same techniques as for the previous chapter. Then, the next sections correspond to the catalytic activity and catalysts characterization results. Section 5.3: xRh-cm and xRh-np catalysts for ethylene glycol reforming Initially, catalysts with different rhodium loading, from 1.0 to 5.0 wt. %, and supported on α-Al2O3 were prepared by two different preparation methods (conventional impregnation and separate nanoparticle synthesis). Then, the catalysts were compared regarding their measured activity and selectivity, as well as the characterization results obtained before and after the activity tests carried out. The samples prepared by a conventional impregnation method showed generally higher activity compared to catalysts prepared from Rh nanoparticles. By-product formation of species such as acetaldehyde, ethane and ethylene was detected, regardless if oxygen was added to the feed or not. Among the catalysts tested, the 2.5Rh-cm catalyst was considered the best one. Section 5.4: 2.5Rh-cm catalyst support modification with CeO2 and La2O3 In this part of the Chapter 5, the catalyst showing the best performance in the previous section, the 2.5Rh-Al2O3 catalyst, was selected in order to be improved. Therefore, new Rh based catalysts were designed using α-Al2O3 and being modified this support with different contents of CeO2 or La2O3 oxides. All the catalysts containing additives showed complete conversion and selectivities close to the equilibrium in both SR and OSR processes. In addition, for these catalysts the concentrations measured for the C2H4, CH4, CH3CHO and C2H6 by-products were very low. Finally, the 2.5Rh-20Ce catalyst was selected according to its catalytic activity and characterization results in order to run a stability test, which lasted more than 115 hours under stable operation. The last chapter, Chapter 6, summarizes the main conclusions achieved throughout this Thesis work. Although very high reactant conversions and rich hydrogen mixtures were obtained using a fixed bed reaction system, the use of microreactors improves the key issues, heat and mass transfer limitations, through which the reforming reactions are intensified. Therefore, they seem to be a very interesting and promising alternative for process intensification and decentralized production for remote application.

Depresión en la práctica enfermera. Comparativa Urgencias y Cirugía General.

Introducción: La depresión representa una alta carga para la sociedad afectando a 121 millones de personas en el mundo, convirtiéndose en la tercera causa de carga mundial de morbilidad entre todas las enfermedades. En el campo de la enfermería las tasas de depresión son aun menos prometedoras. Diversos estudios a nivel internacional han considerado a la enfermería como una profesión con altas prevalencias en trastornos depresivos dando lugar a un efecto negativo sobre la fuerza de trabajo en el sector sanitario. Factores como los turnos rotatorios, mal ambiente laboral, bajo de nivel de autonomía o estar soltero o divorciado son algunos de los muchos agentes que aumentan el riesgo de padecer depresión. Objetivos: Aunque la depresión ha sido ampliamente estudiada, en la literatura actual los estudios realizados entre la depresión y la enfermería son relativamente escasos. Por lo tanto, el presente estudio será un esfuerzo para abordar esta cuestión y tendrá un doble propósito: determinar los niveles de depresión existentes entre las enfermeras del Servicio de Urgencias y de Cirugía General del Hospital de Galdakao y comparar los niveles de depresión entre las unidades anteriormente citadas. Metodología: Para ello se realizará un estudio descriptivo observacional de prevalencia. La población a estudio estará formada por los profesionales de enfermería que trabajan en las unidades de Urgencias y Cirugía General del Hospital de Galdakao. El instrumento que se utilizara para la recogida de datos será el Inventario de Depresión Beck (BDI) y el análisis estadístico se llevará a cabo mediante el programa informático SPSS.

Diseño y montaje de un identificador y conmutador para carga de baterías en serie

[ES]El objetivo de este proyecto es diseñar y construir un circuito identificador y conmutador para carga de baterías en serie autónomo. La funcionalidad de este dispositivo es determinar cual es la batería menos cargada de un banco de baterías de ácido plomo que alimenta un coche al estándar de 48 voltios(conformado por cuatro baterías de 12 voltios). Una vez determinado cual es la batería menos cargada debe re-­‐ direccionar la corriente dada por una placa solar a dicha batería. Todo esto debe hacerlo de forma autónoma, a través de un programa específico, implementado en un microcontrolador. En las diferentes fases del proyecto se ha diseñado el software, se ha diseñado y montado el hardware y se ha verificado su correcto funcionamiento. Además se presentan los costes y la viabilidad de una propuesta de fabricación estandarizada a partir de los planos resultantes del proyecto. Este proyecto surge como respuesta a la actual necesidad de aumentar la limitada autonomía de los coches eléctricos y hacerlos más eficientes. El proyecto se ha llevado a cabo en el laboratorio de electrónica de la ETSI de Bilbao y pretende promover el uso de los coches eléctricos y energías renovables.

Proteómica dirigida en la cirugía del cáncer gástrico

240 p. + anexos