Rasgos psicológicos asociados al ajuste personal y social de estudiantes adolescentes

264 p.

El autoconcepto personal : estructura interna, medida y variabilidad

324 p.

Diseño, aplicación y evaluación de un programa para el desarrollo de la iniciativa personal en la formación profesional inicial

203 p.

Parametric Analysis for Monitoring 2D Kinetics of Receptor-Ligand binding

Thermal fluctuation approach is widely used to monitor association kinetics of surface-bound receptor-ligand interactions. Various protocols such as sliding standard deviation (SD) analysis (SSA) and Page's test analysis (PTA) have been used to estimate two-dimensional (2D) kinetic rates from the time course of displacement of molecular carrier. In the current work, we compared the estimations from both SSA and modified PTA using measured data from an optical trap assay and simulated data from a random number generator. Our results indicated that both SSA and PTA were reliable in estimating 2D kinetic rates. Parametric analysis also demonstrated that such the estimations were sensitive to parameters such as sampling rate, sliding window size, and threshold. These results furthered the understandings in quantifying the biophysics of receptor-ligand interactions.

Ansiedad del personal de enfermería en relación a la muerte de sus pacientes. Comparativa UCI y Oncología.

La muerte y el proceso de morir ha terminado siendo una situación vinculada al mundo hospitalario. La enfermería es una profesión que se enfrenta cada día a la muerte de otras personas. Estas situaciones a menudo resultan difíciles y dolorosas, por lo que no debemos dejar de encontrar una actitud que pueda equilibrar tanto nuestros sentimientos de tensión, como la cobertura de las necesidades del paciente con una enfermedad terminal o en situación crítica. Existen determinados servicios como UCIs, Oncología, etc. que acogen a pacientes en una situación más grave y con menos expectativas de curación que pueden resultar más dolorosos para la enfermería, al estar constantemente enfrentados a la muerte. Con el fin de conocer los niveles de ansiedad de los profesionales de enfermería de las UCIs y Oncología, se realiza este trabajo. Objetivos: Evaluar los grados de ansiedad de profesionales de enfermería de UCI y Oncología ante la muerte. Metodología: Estudio observacional de prevalencia que se realizará a 88 profesionales de enfermería de los hospitales de Cruces y Galdakao (Osakidetza), mediante los cuestionarios STAI y DAI, que corresponden a ansiedad y ansiedad ante la muerte, respectivamente, siendo validados internacionalmente. Conclusión: En función de los resultados obtenidos podría plantearse el hecho de que la ansiedad pudiera aumentar el número de errores en el trabajo, y que el entendimiento y la preparación ante la muerte puede beneficiar a una disciplina como la enfermería y ayudarla en su ejercicio laboral diario reduciendo así sus niveles de ansiedad.

Proyecto de investigación: obstinación terapéutica, una lucha contra la muerte. Estudio cualitativo al personal de enfermería.

[ES] La práctica de obstinación terapéutica se lleva realizando durante muchos años atrás y hoy día, tristemente, también es posible contemplarlo en los medios hospitalarios. Esta mala praxis, en efecto, se realiza en pacientes que por diferentes circunstancias de la salud, se encuentran en el proceso final de la vida, en el proceso de morir. Por ello, el conocimiento sobre si son adecuados o no los cuidados que se les brinda a determinados pacientes y cómo afecta personalmente a los profesionales de enfermería se apodera de mi inquietud. El objetivo principal del proyecto es explorar la visión de los profesionales sanitarios de enfermería que ven o incluso participan en la práctica de obstinación terapéutica. Para ello, se realizará un estudio con la metodología cualitativa y se utilizará la perspectiva teórica fenomenológica. La población a estudio serán enfermeras y enfermeros que trabajen actualmente en el Hospital Universitario de Cruces en las unidades de diversos servicios, tales como Medicina Interna, Digestivo, Neumología, Cardiología y Neurología.

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.

Single cell proteomics microchip to profile immune function, with applications in stem cell biology, translational disease mechanism study and clinical therapeutics monitoring

In response to infection or tissue dysfunction, immune cells develop into highly heterogeneous repertoires with diverse functions. Capturing the full spectrum of these functions requires analysis of large numbers of effector molecules from single cells. However, currently only 3-5 functional proteins can be measured from single cells. We developed a single cell functional proteomics approach that integrates a microchip platform with multiplex cell purification. This approach can quantitate 20 proteins from >5,000 phenotypically pure single cells simultaneously. With a 1-million fold miniaturization, the system can detect down to ~100 molecules and requires only ~104 cells. Single cell functional proteomic analysis finds broad applications in basic, translational and clinical studies. In the three studies conducted, it yielded critical insights for understanding clinical cancer immunotherapy, inflammatory bowel disease (IBD) mechanism and hematopoietic stem cell (HSC) biology.

To study phenotypically defined cell populations, single cell barcode microchips were coupled with upstream multiplex cell purification based on up to 11 parameters. Statistical algorithms were developed to process and model the high dimensional readouts. This analysis evaluates rare cells and is versatile for various cells and proteins. (1) We conducted an immune monitoring study of a phase 2 cancer cellular immunotherapy clinical trial that used T-cell receptor (TCR) transgenic T cells as major therapeutics to treat metastatic melanoma. We evaluated the functional proteome of 4 antigen-specific, phenotypically defined T cell populations from peripheral blood of 3 patients across 8 time points. (2) Natural killer (NK) cells can play a protective role in chronic inflammation and their surface receptor – killer immunoglobulin-like receptor (KIR) – has been identified as a risk factor of IBD. We compared the functional behavior of NK cells that had differential KIR expressions. These NK cells were retrieved from the blood of 12 patients with different genetic backgrounds. (3) HSCs are the progenitors of immune cells and are thought to have no immediate functional capacity against pathogen. However, recent studies identified expression of Toll-like receptors (TLRs) on HSCs. We studied the functional capacity of HSCs upon TLR activation. The comparison of HSCs from wild-type mice against those from genetics knock-out mouse models elucidates the responding signaling pathway.

In all three cases, we observed profound functional heterogeneity within phenotypically defined cells. Polyfunctional cells that conduct multiple functions also produce those proteins in large amounts. They dominate the immune response. In the cancer immunotherapy, the strong cytotoxic and antitumor functions from transgenic TCR T cells contributed to a ~30% tumor reduction immediately after the therapy. However, this infused immune response disappeared within 2-3 weeks. Later on, some patients gained a second antitumor response, consisted of the emergence of endogenous antitumor cytotoxic T cells and their production of multiple antitumor functions. These patients showed more effective long-term tumor control. In the IBD mechanism study, we noticed that, compared with others, NK cells expressing KIR2DL3 receptor secreted a large array of effector proteins, such as TNF-α, CCLs and CXCLs. The functions from these cells regulated disease-contributing cells and protected host tissues. Their existence correlated with IBD disease susceptibility. In the HSC study, the HSCs exhibited functional capacity by producing TNF-α, IL-6 and GM-CSF. TLR stimulation activated the NF-κB signaling in HSCs. Single cell functional proteome contains rich information that is independent from the genome and transcriptome. In all three cases, functional proteomic evaluation uncovered critical biological insights that would not be resolved otherwise. The integrated single cell functional proteomic analysis constructed a detail kinetic picture of the immune response that took place during the clinical cancer immunotherapy. It revealed concrete functional evidence that connected genetics to IBD disease susceptibility. Further, it provided predictors that correlated with clinical responses and pathogenic outcomes.

Cultores de divinidades indígenas en el Conventus Asturum: onomástica personal y condición cívica

Juan Manuel Abascal Palazón, Antonio Caballos Rufino, Santiago Castellanos Garcia y Juan Santos Yanguas (eds.)

Watershed monitoring and the TMDL modeling to assess bacterial loading in estuarine environments to improve management

Shellfish bed closures along the North Carolina coast have increased over the years seemingly concurrent with increases in population (Mallin 2000). More and faster flowing storm water has come to mean more bacteria, and fecal indicator bacterial (FIB) standards for shellfish harvesting are often exceeded when no source of contamination is readily apparent (Kator and Rhodes, 1994). Could management reduce bacterial loads if the source of the bacteria where known? Several potentially useful methods for differentiating human versus animal pollution sources have emerged including Ribotyping and Multiple Antibiotic Resistance (MAR) (US EPA, 2005). Total Maximum Daily Load (TMDL) studies on bacterial sources have been conducted for streams in NC mountain and Piedmont areas (U.S. EPA, 1991 and 2005) and are likely to be mandated for coastal waters. TMDL analysis estimates allowable pollutant loads and allocates them to known sources so management actions may be taken to restore water to its intended uses (U.S. EPA, 1991 and 2005). This project sought first to quantify and compare fecal contamination levels for three different types of land use on the coast, and second, to apply MAR and ribotyping techniques and assess their effectiveness for indentifying bacterial sources. Third, results from these studies would be applied to one watershed to develop a case study coastal TMDL. All three watershed study areas are within Carteret County, North Carolina. Jumping Run Creek and Pettiford Creek are within the White Oak River Basin management unit whereas the South River falls within the Neuse River Basin. Jumping Run Creek watershed encompasses approximately 320 ha. Its watershed was a dense, coastal pocosin on sandy, relic dune ridges, but current land uses are primarily medium density residential. Pettiford Creek is in the Croatan National Forest, is 1133 ha. and is basically undeveloped. The third study area is on Open Grounds Farm in the South River watershed. Half of the 630 ha. watershed is under cultivation with most under active water control (flashboard risers). The remaining portion is forested silviculture.(PDF contains 4 pages)

A bayesian probabilistic approach to structural health monitoring

A Bayesian probabilistic methodology for on-line structural health monitoring which addresses the issue of parameter uncertainty inherent in problem is presented. The method uses modal parameters for a limited number of modes identified from measurements taken at a restricted number of degrees of freedom of a structure as the measured structural data. The application presented uses a linear structural model whose stiffness matrix is parameterized to develop a class of possible models. Within the Bayesian framework, a joint probability density function (PDF) for the model stiffness parameters given the measured modal data is determined. Using this PDF, the marginal PDF of the stiffness parameter for each substructure given the data can be calculated.

Monitoring the health of a structure using these marginal PDFs involves two steps. First, the marginal PDF for each model parameter given modal data from the undamaged structure is found. The structure is then periodically monitored and updated marginal PDFs are determined. A measure of the difference between the calibrated and current marginal PDFs is used as a means to characterize the health of the structure. A procedure for interpreting the measure for use by an expert system in on-line monitoring is also introduced.

The probabilistic framework is developed in order to address the model parameter uncertainty issue inherent in the health monitoring problem. To illustrate this issue, consider a very simplified deterministic structural health monitoring method. In such an approach, the model parameters which minimize an error measure between the measured and model modal values would be used as the "best" model of the structure. Changes between the model parameters identified using modal data from the undamaged structure and subsequent modal data would be used to find the existence, location and degree of damage. Due to measurement noise, limited modal information, and model error, the "best" model parameters might vary from one modal dataset to the next without any damage present in the structure. Thus, difficulties would arise in separating normal variations in the identified model parameters based on limitations of the identification method and variations due to true change in the structure. The Bayesian framework described in this work provides a means to handle this parametric uncertainty.

The probabilistic health monitoring method is applied to simulated data and laboratory data. The results of these tests are presented.