Perceived risk of death in older primary care patients

There is a large gap between life expectancy and healthy life years at age 65. To reduce this gap, it is necessary that people with medical concerns perceived at higher risk of adverse outcomes are readily identified and treated. The same goes for the need to implement prevention plans. The main objectives of this study are to, in a first step, (a) estimate the percentage of medical concerns, (b) identify factors associated with this concern; in a second step, (c) estimate the perceived risk of death, and (d) evaluate the ability of medical concerns to predict this risk. Results show that the existence and severity of medical concerns are crucial in the prediction of perceived risk of death. Early identification of severity of medical concerns and the availability and adequacy of informal caregiving should allow healthcare professionals to promptly initiate an appropriate assessment and treatment of older patients.

Alienated Selfhood and Heroism: A Poststructuralist Reading of John le Carré’s Spy Fiction Novels

John le Carré’s novels “The Spy Who Came in From the Cold” (1963), “Tinker, Tailor, Soldier, Spy” (1974), and “The Tailor of Panama” (1997), focus on how the main characters reflect the somber reality of working in the British intelligence service. Through a broad post-structuralist analysis, I will identify the dichotomies - good/evil in “The Spy Who Came in From the Cold,” past/future in “Tinker, Tailor, Soldier, Spy,” and institution/individual in “The Tailor of Panama” - that frame the role of the protagonists. Each character is defined by his ambiguity and swinging moral compass, transforming him into a hybrid creation of morality and adaptability during transitional time periods in history, mainly during the Cold War. Le Carré’s novels reject the notion of spies standing above a group being celebrated. Instead, he portrays spies as characters who trade off individualism and social belonging for a false sense of heroism, loneliness, and even death.

Chironomid-inferred July-air temperature of Lago Piccolo di Avigliana

Chironomid headcapsules were used to reconstruct late glacial and early-Holocene summer temperatures at Lago Piccolo di Avigliana (LPA). Two training sets (northern Sweden, North America) were used to infer temperatures. The reconstructed patterns of temperature change agreed well with the GRIP and NGRIP d18O records. Inferred temperatures were high during the Bølling (ca 19 °C), slowly decreased to ca 17.5 °C during the Allerød, reached lowest temperatures (ca 16 °C) during the Younger Dryas, and increased to ca. 18.5 °C during the Preboreal. The amplitudes of change at climate transitions (i.e. Oldest Dryas/Bølling: 3 °C, Allerød/Younger Dryas: 1.5 °C, and Younger Dryas/Preboreal: 2.5 °C) were smaller than in the northern Alps but similar to those recorded at another site in northeastern Italy. Our results suggest that (1) Allerød temperatures were higher in the southern Alps and (2) higher during the Preboreal (1 °C) than during the Allerød. These differences might provide an explanation for the different responses of terrestrial-vegetation to late glacial and early-Holocene climatic changes in the two regions. Other sites on both sides of the Alps should be studied to confirm these two hypotheses.

Seawater carbonate chemistry and shell length of Mediterranean pteropod Cavolinia inflexa larvae during experiments

Larvae of the Mediterranean pteropod Cavolinia inflexa were maintained at controlled pHT values of 8.1, 7.82 and 7.51, equivalent respectively to pCO2 levels of 380, 857 and 1713 µatm. At pHT 7.82 larvae exhibited malformations and lower shell growth, compared to the control condition. At pHT 7.51 the larvae did not make shells but were viable and showed a normal development. However, smaller shells or no shells will have both ecological (food web) and biogeochemical (export of carbon and carbonate) consequences. These results confirm that 1pteropods, as well as the species dependent upon them as a food resource, will be severely impacted by ocean acidification.

Cooperative or collaborative learning: Is there a difference in university students’ perceptions?

The hypothesis that the same educational objective, raised as cooperative or collaborative learning in university teaching does not affect students’ perceptions of the learning model, leads this study. It analyses the reflections of two students groups of engineering that shared the same educational goals implemented through two different methodological active learning strategies: Simulation as cooperative learning strategy and Problem-based Learning as a collaborative one. The different number of participants per group (eighty-five and sixty-five, respectively) as well as the use of two active learning strategies, either collaborative or cooperative, did not show differences in the results from a qualitative perspective.

Francesco Grimaldi, un mercader-banquero genovés entre Granada, la corte e Inglaterra (siglos xv-xvi)

Los estudios sobre la comunidad genovesa del Reino de Granada suelen centrarse en las actividades desarrolladas en el territorio y rara vez en la reconstrucción de trayectorias individuales, circunstancia determinada por el recurso casi exclusivo a los protocolos notariales. El caso de Francesco Grimaldi es singular por muchas razones: su localización en fuentes de naturaleza muy variada –protocolos notariales de Granada y Málaga, Registro del Sello de Simancas y Granada, Chancillería de Valladolid, el epistolario del comendador Fuensalida y el archivo privado de la familia Grimaldo de Cáceres– ha permitido seguir su presencia y sus actividades en Granada, la Corte e Inglaterra –donde desempeñó un papel fundamental en el matrimonio entre Catalina de Aragón y Enrique VIII–. Así se conoce su interés por los préstamos y el negocio de la renta, las circunstancias de su matrimonio con Francisca de Cáceres y la adquisición de un importante patrimonio en el reino granadino.

El clima intuido en el Madrid medieval a través de sus documentos y del Libro de la Montería (siglos XIV-XVI)

El presente trabajo pretende analizar cuáles eran las características climáticas que se sucedían en Madrid y su Tierra a lo largo del año, fundamentalmente entre los siglos XIV y XVI. Se intentará comprobar, dentro de las limitaciones que impone la documentación de la época, si en aquel tiempo se daba también un clima mediterráneo, o no, y si este ha variado mucho desde entonces. Igualmente se podrá comprobar algo que tal vez podría, aunque no debería, sorprendernos: el hombre medieval tenía muy claros muchos conceptos meteorológicos y climatológicos, aunque siempre aprehendidos con una finalidad práctica, para aplicarlos en su vida cotidiana tan cercana y dependiente de la naturaleza.

The detection of contaminating clonal cells in apheresis products is related to response and outcome in multiple myeloma undergoing autologous peripheral blood stem cell transplantation.

In the present paper, we report on the use of the heteroduplex PCR technique to detect the presence of clonally rearranged VDJ segments of the heavy chain immunoglobulin gene (VDJH) in the apheresis products of patients with multiple myeloma (MM) undergoing autologous peripheral blood stem cell (APBSC) transplantation. Twenty-three out of 31 MM patients undergoing APBSC transplantation with VDJH segments clonally rearranged detected at diagnosis were included in the study. Samples of the apheresis products were PCR amplified using JH and VH (FRIII and FRII) consensus primers and subsequently analyzed with the heteroduplex technique, and compared with those obtained at diagnosis. 52% of cases yielded positive results (presence of clonally rearranged VDJH segments in at least one apheresis). The presence of positive results in the apheresis products was not related to any pretransplant characteristics with the exception of response status at transplant. Thus, while no one patient with positive apheresis products was in complete remission (CR), negative immunofixation, before the transplant, five cases (46%) with negative apheresis were already in CR at transplant (P = 0.01). The remaining six cases with heteroduplex PCR negative apheresis were in partial remission before transplant. Patients with clonally free products were more likely to obtain CR following transplant (64% vs 17%, P= 0.02) and a longer progression-free survival, (40 months in patients transplanted with polyclonal products vs 20 with monoclonal ones, P = 0.03). These results were consistent when the overall survival was considered, since it was better in those patients with negative apheresis than it was in those with positive (83% vs 36% at 5 years from diagnosis, P= 0.01). These findings indicate that the presence of clonality rearranged VDJH segments is related to the response and outcome in MM transplanted patients.

Post tenebras spero lucem : Alquimia y ritos en el Quijote y otras obras cervantinas

This study focuses on two areas: alchemy (Part I) and rituals of initiation (Part II) in the works of Miguel de Cervantes, focusing on Don Quijote de la Mancha as my main case study. The first part analyses the function of alchemy and how it can be interpreted throughout the works and various literary genres of Cervantes. It will demonstrate that the texts of Cervantes contain both explicit and implicit allusions to, as well as different aspects of alchemy, such as operative and spiritual alchemy and how these are ultimately used by Cervantes as a means of expression. The author draws from this rich source and modifies these means of expression in order to achieve various results: sometimes with wit or in relation to fraud; at other times it focuses on inner alchemy relating to chivalry in what I have called spiritual chivalry, which has the aim of self-improvement and ultimately, gnosis. Regarding the chivalric rituals of initiation, according to this investigation chivalry serves as both satire and representation of the alchemical process in the case of Don Quijote, which finds its key moments during the rituals. In this sense alchemy and chivalry are studied as two sides of the same coin, in which the search for something higher, an object (the philosopher stone, the beloved), subjects the protagonist to continuous transmutations and puts him in contact with the transitory, that is, liminal states, people and spaces. From this perspective Don Quixote de la Mancha is built upon liminal poetics. My approach, which follows the tenets of analogical hermeneutics, is included within the framework of the Western Esotericism Studies. The 16th and 17th centuries were a fertile age for alchemy throughout Europe. In Spain, alchemy and other esoteric disciplines co-existed with the Spanish Inquisition and its body for the control of ideas and texts: censorship. By being ambiguous and putting into dialogue different ideas of alchemy, Cervantes not only allowed readers to reach their own conclusions, he also protected his work from censorship.

Una planta sin clásicos. La berenjena en la farmacología medieval y renacentista

La berenjena (Solanum melongena L.) es una planta solanácea de múltiples variedades, cuyos ancestros salvajes se sitúan en Indochina y el este de África. Su cultivo fue muy temprano en zonas de China e India. Aun así, no se extendió al Occidente antiguo ni apenas se conoció, de ahí su ausencia en los textos clásicos de botánica y farmacología. Fueron los árabes quienes llevaron el cultivo de la planta por el Norte de África y Al-Andalus, de donde pasó ya a Europa. Los primeros testimonios occidentales de la berenjena aparecen en traducciones latinas de textos árabes, para incorporarse luego a la literatura farmacológica medieval y, más tarde ya, a la del Renacimiento, que empezó a tratar de ella por su posible parecido con una especie de mandrágora. Pese a que se le reconocían algunas virtudes medicinales, siempre se la tuvo bajo sospecha por ser de sabor poco agradable, indigesta y causante de algunas afecciones. Solo los botánicos de finales del Renacimiento describirían la planta y sus variedades con criterios más «científicos» y botánicos, ya sin apenas intereses farmacológicos.

La traducción al latín de algunos términos griegos y su repercusión en los comentarios a los "Aphthonii Progymnasmata"

En este trabajo hemos examinado comentarios a la traducción al latín del ejercicio de la Fábula de los Progymnasmata de Aftonio para ver cómo afecta la traducción de algunos términos al comentario. Dado que, al traducir de una lengua a otra, difícilmente hay correspondencia exacta, el traductor opta por la solución que estima más adecuada, primando ciertos matices sobre otros y, con frecuencia, llega, incluso, a dotar al término de acepciones en la lengua meta que no existían en la lengua origen. La elección realizada no parece obedecer a otra razón que a preferencias del traductor, pero tiene consecuencias e influye en los comentaristas. Por otra parte, la existencia de un término acuñado no impide que tanto los traductores como los escoliastas creen otros nuevos, tal vez por deseo de mostrar originalidad. Finalmente, la traducción tiene una doble vertiente: de un lado, influye en el entendimiento del concepto y en el comentario, y, de otro, refleja la concepción que de la realidad tiene el traductor.