Effect of Polyphenolic Complements on Cognitive Function in the Elderly: A Systematic Review.

Polyphenols have been shown to be effective against many chronic diseases. These compounds could have a beneficial effect at the cognitive level. The exact mechanism by which they provide positive effects at the cognitive level is not well known, but it is believed that they could counteract neuroinflammation. The objective of this study is to review nutritional interventions that include foods or supplements rich in flavanols, flavonols, or stilbenes to the usual diet on cognitive deterioration in people over 50 years of age. Clinical trials published in PubMed and Web of Science from 1 March 2010 to 1 March 2020 were explored, from which 14 studies were selected. All of them showed some improvement after the intervention. In interventions with flavanols and stilbenes, relevant improvements have been observed both in healthy patients and in patients with established cognitive impairment. Most studies agree that the greatest benefits are found with high doses and longer duration treatments. The changes were fundamentally assessed through cognitive tests, and in some of the studies, through magnetic resonance imaging (fMRI). The type of cognitive test used to assess the effect of the intervention was revealed to be critical. Several studies have also shown improvements in analytical parameters and blood pressure.

Multimodal physical exercise and functional rehabilitation program in oncological patients with asthenia. study protocol.

BACKGROUND: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. METHODS: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021).  https://clinicaltrials.gov/ct2/show/ NCT04761289.

Knowledge about Fibromyalgia in Fibromyalgia Patients and Its Relation to HRQoL and Physical Activity.

Introduction: Fibromyalgia (FM) affects 2.40% of the Spanish population. The most widespread treatment has been the combination of patient education, pain coping strategies and exercise. With regard to patient education, there are few previous studies on the efficacy of relating FM education in isolation with an improvement in FM, although there are some studies that report that health education programs could modify the perception of quality of life and improve pain. Objectives: the aim was to find out the level of knowledge about FM among patients in Extremadura, to explore the relationship between knowledge of FM and Health-Related Quality of Life (HRQoL) and to analyze the relationship between knowledge of physical activity in FM and the practice of physical activity. Methods: A single-measure cross-sectional study was carried out with 121 women with a mean age of 55.06 (±9.93) years. The following questionnaires were used: Fibromyalgia Knowledge Questionnaire (FKQ); SF12v2 (Short-Form Health Survey); and EURO-QOL-5D-5L (EQ-5D-5L). Results: regarding the level of knowledge of the participants about FM, it was found that 10% had a low knowledge, 49% medium and 41% high. In relation to the associations between the level of knowledge and HRQoL, a weak correlation between EQ-5D-5L and the FKQ in the domain of physical activity (r = 0.243) were found. Conclusions: it can be concluded that the level of knowledge about FM of the patients from Extremadura was medium-high and that there is a direct weak relationship between knowledge about physical activity in FM and HRQoL. However, no association was found between knowledge of physical activity in FM and the practice of physical activity.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Spanish Translation and Cultural Adaptation of the Fibromyalgia Knowledge Questionnaire.

INTRODUCTION: Fibromyalgia (FM) translates into a reduction in the quality of life of people who suffer from it, being a chronic disease of unknown etiology. One of the most widespread treatments includes the combination of patient education, along with other components. At the educational level, the Fibromyalgia Knowledge Questionnaire (FKQ) is a tool that assesses knowledge of fibromyalgia. OBJECTIVE: To obtain the translation and cultural adaptation of the FKQ questionnaire into Spanish, as well as its readability, in addition to knowing the relationship between knowledge of the disease and the level of disability. METHOD: In phase one, a translation-back translation and an evaluation of the readability of the questionnaire was carried out from INFLESZ, while in phase two, the questionnaire was passed to women with FM to detect their knowledge of the disease. A total of 49 women participated, with a mean age of 54.48 years. RESULTS: The Spanish version of the FKQ questionnaire was rated by the participants in all its items as "clear and understandable". The readability obtained by the questionnaire was similar to its original version, with both totals being in the "normal" range, following the INFLESZ ranges. Regarding the patients' knowledge about FM, the component in which the highest score was obtained was physical activity (80% correct), while the one that obtained the worst score was knowledge about medication (50% correct). In addition, an inverse correlation was obtained between the FKQ and the FIQ (Fibromyalgia Impact Questionnaire) (r = -0.438; p < 0.01). CONCLUSIONS: The FKQ has been translated and culturally adapted, obtaining a correct understanding by the participants, as well as a degree of readability similar to the original questionnaire. Furthermore, it was obtained that, the lower the level of knowledge of the sick person, the greater the disability.

Risk factors for open conversion of lateral transperitoneal laparoscopic adrenalectomy: retrospective cohort study of the Spanish Adrenal Surgery Group (SASG).

BACKGROUND: Laparoscopic adrenalectomy has become the standard of care for treating adrenal tumors. Conversion from laparoscopic adrenalectomy to an open approach during surgery may be necessary in some cases. This study aimed to identify the risk factors for open conversion of laparoscopic adrenalectomy. METHODS: Retrospective analysis of all consecutive patients undergoing lateral transperitoneal laparoscopic adrenalectomy in six endocrine surgery units of the Spanish Adrenal Surgery Group (SASG) between January 2005 and December 2017. Demographic, clinical, surgical, and histopathologic characteristics were recorded. Risk factors for conversion were assessed by logistic regression analysis. RESULTS: Of a total of 865 patients included in the study, 58 (6.7%) required conversion to open surgery. In the univariate analysis, factors associated with conversion from laparoscopic to open adrenalectomy were body mass index (BMI) ≥ 30 kg/m2 (P = 0.002), previous abdominal surgery (P = 0.015), tumor size > 5 cm (P = 0.001), and surgery for pheochromocytoma (P = 0.034). In the multivariate analysis, independent risk factors were BMI ≥ 30 kg/m2 [odds ratio (OR) 4.26, 95% confidence interval (CI) 2.81-8.75; P = 0.001], tumor size > 5 cm (OR 10.15, 95% CI 4.24-28.31; P < 0.001), and surgery for pheochromocytoma (OR 2.96, 95% CI 1.89-11.55; P = 0.015). CONCLUSIONS: Obesity, tumor size, and pheochromocytoma as the type of adrenal tumor were predictive factors for intraoperative conversion from laparoscopic to open adrenalectomy. Preoperative assessment of these characteristics should be valuable to clinicians in discussing conversion risk in patients and for surgical planning.

The human gallbladder microbiome is related to the physiological state and the biliary metabolic profile.

BACKGROUND: The microbial populations of the human intestinal tract and their relationship to specific diseases have been extensively studied during the last decade. However, the characterization of the human bile microbiota as a whole has been hampered by difficulties in accessing biological samples and the lack of adequate methodologies to assess molecular studies. Although a few reports have described the biliary microbiota in some hepatobiliary diseases, the bile microbiota of healthy individuals has not been described. With this in mind, the goal of the present study was to generate fundamental knowledge on the composition and activity of the human bile microbiota, as well as establishing its potential relationship with human bile-related disorders. RESULTS: Human bile samples from the gallbladder of individuals from a control group, without any record of hepatobiliary disorder, were obtained from liver donors during liver transplantation surgery. A bile DNA extraction method was optimized together with a quantitative PCR (qPCR) assay for determining the bacterial load. This allows the selection of samples to perform functional metagenomic analysis. Bile samples from the gallbladder of individuals suffering from lithiasis were collected during gallbladder resection and the microbial profiles assessed, using a 16S rRNA gene-based sequencing analysis, and compared with those of the control group. Additionally, the metabolic profile of the samples was analyzed by nuclear magnetic resonance (NMR). We detected, for the first time, bacterial communities in gallbladder samples of individuals without any hepatobiliary pathology. In the biliary microecosystem, the main bacterial phyla were represented by Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. Significant differences in the relative abundance of different taxa of both groups were found. Sequences belonging to the family Propionibacteriaceae were more abundant in bile samples from control subjects; meanwhile, in patients with cholelithiasis members of the families Bacteroidaceae, Prevotellaceae, Porphyromonadaceae, and Veillonellaceae were more frequently detected. Furthermore, the metabolomics analysis showed that the two study groups have different metabolic profiles. CONCLUSIONS: Our results indicate that the gallbladder of human individuals, without diagnosed hepatobiliary pathology, harbors a microbial ecosystem that is described for the first time in this study. Its bacterial representatives and metabolites are different from those detected in people suffering from cholelithiasis. In this regard, since liver donors have been subjected to the specific conditions of the hospital's intensive care unit, including an antibiotic treatment, we must be cautious in stating that their bile samples contain a physiologically normal biliary microbiome. In any case, our results open up new possibilities to discover bacterial functions in a microbial ecosystem that has not previously been explored.

Limitaciones en los profesores de Ciencias Médicas de Sancti Spirítus en el desarrollo de investigaciones educativas / Limitations of Medical Sciences professors in Sancti Spirítus in the development of educational research

RESUMEN Fundamento: Las Ciencias Médicas se caracterizan por estudios profesionales en relación a la salud pública y al proceso de salud enfermedad, pero presentan debilidades en la formación del profesional de la Medicina, en el conocimiento y desarrollo de sus habilidades investigativas. Objetivo: Determinar las limitaciones del docente de las Ciencias Médicas en la investigación educativa en el colectivo de primer año de la carrera de Medicina. Metodología: Se realizó un estudio descriptivo de corte transversal; la población estuvo conformada por 30 docentes del colectivo de año, 3 directivos de la facultad el resto profesores principales de las asignaturas. Se realizó el análisis de documentos, la entrevista a directivos, docentes y estudiantes, la encuesta a docentes, y la triangulación de datos en la carrera de Medicina durante el curso 2017-2018 de la Universidad de Ciencias Médicas de Sancti Spíritus. Resultados: Reflejan la formación de un docente concentrado en el contenido de la enseñanza del saber disciplinar, en detrimento de su implicación hacia la investigación educativa, donde el colectivo del año académico no evidencia su potencial formativo. Conclusiones: La actuación del docente de las ciencias médicas se concibe desde lo individual y grupal en el ejercicio docente. Reconociendo que la investigación científica forma parte de sus funciones, pero se inclinan a la materia que imparten y el colectivo de año no los estimula hacia la investigación de los problemas educativos.

ABSTRACT Background: Medical Sciences are characterized by professional studies related to public health and the disease health process, but they present weaknesses in the training of the medical professional, also in the knowledge and development of their research skills. Objective: To determine the limitations of the Medical Sciences professors in the educational research in the first academic year group of the Medicine career. Methodology: A descriptive cross-sectional study was carried out; the population consisted of 30 teachers from the teachers´ academic year group, 3 faculty directors, and the rest, some of the main professors of the subjects. The analysis of documents, the interview with managers, teachers and students, the survey of teachers, and the triangulation of data in the Medicine career during the course 2017-2018 at the Sancti Spíritus University of Medical Sciences were used. Results: The performance of teacher of medical sciences is conceived from both, the individual and the group in the teaching practice. Recognizing that the scientific research is part of their functions, but they are mainly interested into the subject they teach and the teachers´ academic year group does not encourage them to research about educational problems.

Diet: Cause or Consequence of the Microbial Profile of Cholelithiasis Disease?

Recent dietary habits and lifestyle could explain the shaping of the gut microbiota composition and, in consequence, the increasing prevalence of certain pathologies. However, little attention has been paid to the influence of diet on microbiotas, other than the gut microbiota. This is important in cholelithiasis, given that changes in the production of bile acids may affect gallbladder microbial communities. Our aim was to assess the association between regular dietary intake and gallbladder microbial composition. Fourteen adults with cholelithiasis and 14 controls, sex‒age-matched and without gastrointestinal pathology, were included. Diet was assessed through a food frequency questionnaire and quantification of gallbladder microbiota sequences by Illumina 16S rRNA gene-based analysis. The cholelithiasic patients showed greater intake of potatoes and lower consumption of vegetables, non-alcoholic drinks, and sauces, which resulted in a lower intake of energy, lipids, digestible polysaccharides, folate, calcium, magnesium, vitamin C, and some phenolic compounds. Regarding the altered bile microorganisms in cholelithiasic patients, dairy product intake was negatively associated with the proportions of Bacteroidaceae and Bacteroides, and several types of fiber, phenolics, and fatty acids were linked to the abundance of Bacteroidaceae, Chitinophagaceae, Propionibacteraceae, Bacteroides, and Escherichia‒Shigella. These results support a link between diet, biliary microbiota, and cholelithiasis.

Ideal Cardiovascular Health and Arterial Stiffness in Spanish Adults-The EVIDENT Study.

BACKGROUND: Studies concerning ideal cardiovascular (CV) health and its relationship with arterial stiffness are lacking. This study examined the association between arterial stiffness with ideal CV health as defined by the American Heart Association, across age groups and gender. METHODS: The cross-sectional study included 1365 adults. Ideal CV health was defined as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity, and Mediterranean diet adherence) and 3 factors (total cholesterol, blood pressure, and glycated hemoglobin). Patients were grouped into 3 categories according to their number of ideal CV health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). We analyzed the pulse wave velocity (PWV), the central and radial augmentation indexes, and the ambulatory arterial stiffness index (AASI). RESULTS: The ideal CV health profile was inversely associated with lower arterial radial augmentation index and AASI in both genders, particularly in middle-aged (45-65 years) and in elderly subjects (>65 years). Also in elderly subjects, adjusted models showed that adults with at least 3 health metrics at ideal levels had significantly lower PWV than those with 2 or fewer ideal health metrics. CONCLUSIONS: An association was found between a favorable level of ideal CV health metrics and lower arterial stiffness across age groups.

Hiperentorno como medio de enseñanza del proceso atención de enfermería a pacientes con afecciones osteomioarticulares / Hypercontext as material aid of the nursing assistance process to patients with osteomioarticular problems

En la enseñanza de las ciencias de la salud los medios informáticos ocupan un lugar fundamental. Objetivo: Determinar la pertinencia de un hiperentorno en la enseñanza-aprendizaje de la atención de enfermería a pacientes con afecciones del sistema osteomioarticular. Metodología: El universo estuvo formado por cuatro profesores y 76 estudiantes del curso 2014-2015 de la carrera Enfermería de la Universidad de Ciencias Médicas de Sancti Spíritus, se utilizaron métodos del nivel teórico: histórico-lógico, inductivo-deductivo, analítico-sintético y sistémico y del nivel empírico: el criterio de expertos, la encuesta y los talleres de socialización. Resultados: Los criterios que aportaron los expertos permitieron valorar su pertinencia, y después de su aplicación parcial la mayoría de los indicadores estaban siempre o algunas veces presentes según criterios de profesores y estudiantes. En los talleres se observó consenso de su relevancia social. Conclusiones: El hiperentorno resultó pertinente para su utilización en la práctica según los expertos y el reconocimiento de estudiantes y profesores de la presencia mayoritaria de indicadores para los medios informáticos en el proceso de enseñanza-aprendizaje de este tema.(AU)

Evolution of target organ damage and haemodynamic parameters over 4†years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study.

OBJECTIVES: We prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease. SETTING: 2 primary care centres in Salamanca, Spain. PARTICIPANTS: We performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Measurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices. RESULTS: In year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2. CONCLUSIONS: This prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group. TRIAL REGISTRATION NUMBER: NCT01065155; Results.

La cultura profesional docente colaborativa. Categorías de análisis / Collaborative professional teaching culture. Analytical category

Fundamentación: el desarrollo de la cultura profesional docente colaborativo se sustenta en los postulados vigotskianos, donde se concibe al profesor como un sujeto comprometido con las demandas y exigencias de la sociedad. Objetivo: socializar las categorías de análisis que se deben tener en cuenta en un colectivo docente para el desarrollo de una cultura profesional colaborativa en el proceso de formación del profesional de la educación superior. Método: se realizó un estudio etnográfico en la Universidad José Martí Pérez, de Sancti Spíritus, apoyada en la metodología cualitativa y un grupo de técnicas posibilitó la recogida de la información. Resultados: se obtuvieron las categorías de análisis que están estrechamente asociadas al deber ser de un docente universitario, portador de esta cultura. Conclusiones: a partir de la coincidencia de criterios sobre los aspectos teóricos y la reflexión colectiva emergieron elementos indispensables en un colectivo para lograr la cultura profesional docente colaborativa a la cual se aspira, elaborados al tener en cuenta su estructura de contenido y forma.

Background: the development of collaborative professional teaching culture is based on Vigotskian statements, where the teacher is seen as an individual compromised with the demanding and needs of the society. Objective: Socialize the analytical categories that should be taken into consideration in a teaching staff for the development of collaborative professional teaching culture in the process formation of the professional of higher education. Method: an ethnographic study was carried out in the University José Marti Pérez, from Sancti Spiritus, based on a qualitative methodology and a group of techniques that make data collection possible. Results: The analytical categories obtained were closely linked to the requirements of a university teacher that has this culture. Conclusions: starting from common criteria about theoretical aspects and group reflection, vital elements emerged in the teaching staff to get the collaborative professional teaching culture that is needed, elaborated taking into account its structure of content and form.

Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study.

BACKGROUND: The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression. METHODS: We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio. RESULTS: The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (ß = -0.006; p = 0.017) and between BMI and glomerular filtration (ß = -0.813; p = 0.014). HbA1c was positively associated with PWV (ß = 0.501; p = 0.014). CONCLUSIONS: This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis. TRIAL REGISTRATION: Clinical Trials.gov Identifier NCT01065155.

Los diseños y estrategias para los estudios cualitativos. Un acercamiento teórico-metodológico / Strategies and designing for quality studies. A methodological-theoretical approach

Fundamento: La discusión epistemológica en torno a los paradigmas que se utilizan como apoyo a la investigación, ya han quedado atrás en los debates de la ciencia y carecen de base suficiente. Se reconoce hoy la necesaria complementariedad científica donde es la naturaleza del objeto de investigación la que traza las pautas para identificar los métodos y técnicas a utilizar, los que no están necesariamente vinculados a ­un paradigma. Objetivo: Valorar las diferentes alternativas a tomar en cuenta en los diseños y estrategias metodológicas para los estudios cualitativos. Conclusiones: El profesional que realiza investigaciones cualitativas debe poseer una profunda preparación teórico-metodológica que le permita, desde una mirada flexible y abierta, identificar el problema y discernir cuáles son las preguntas que lo han de conducir a través de todo el proceso investigativo, tomar en cuenta la creatividad que requiere el proceso que enfrenta, donde la teoría emerge de los datos, no es impuesta a los datos ni siquiera es contrastada con el dato y donde debe quedar claro que lo que no está escrito, no sucedió.

Background: The epistemology discussion regarding the paradigms that are used as a support of the investigations, has been left behind in the science debates and are without a sufficient base. Today is well known the scientific complementary need where the nature of the object of investigation is the one who mark the steps to identify the methods and techniques to use, which are not involved to a paradigm. Objective: To value the different alternatives to follow in the designing and methodological strategies for the qualities studies Conclusions: The professional who makes the quality investigations must have a deep theoretical-methodological preparation which allows him from a flexible and open look to identify the problem and which are the questions which have to guide him throughout the investigative process, to take into account the creativeness that require the facing process, where theory emerges from the data, is not imposed to the data not even compared with the data and where must be clear that what is not written, did not happened.

El trabajo colaborativo y su influencia en el desarrollo de la cultura profesional docente / Collaborative work and its influence on the development of teaching professional culture

Fundamentación: La necesidad de colaborar entre los docentes conduce al desarrollo de iniciativas, proyectos y planificación donde todos los miembros del grupo trabajan para fines comunes. Objetivo: Sistematizar los referentes teórico-metodológicos que sustentan el trabajo colaborativo para el desarrollo de la cultura profesional docente en el proceso de formación del profesional de la educación superior. Resultados: Los fundamentos que sustentan el trabajo colaborativo son consecuentes con los postulados vigotskianos, donde se conciben al profesor como un sujeto comprometido con las demandas y exigencias de la sociedad, a partir de dotarlo de mayores conocimientos y habilidades que tributen al desarrollo de una cultura profesional docente colaborativa. Conclusiones: El desarrollo de la cultura profesional docente se sustenta en su estructura de contenido y forma. El contenido abarca el conocimiento, las actitudes, las habilidades los hábitos y los valores que el profesor tiene sobre la actividad docente. Las formas de relación y asociación que se desarrollan entre los profesores determinan el tipo de cultura profesional docente predominante en un colectivo pedagógico.

Background: The need for collaboration among teachers leads to the development of initiatives, projects and planning where all members work for common goals. Objective: To systemize the theoretical and methodological references that support collaborative work for the development of teaching professional culture in the formation of professional in higher education. Results: The rationale supporting collaborative work are consistent with the Vygotskian principles, where the teacher is seen as an individual committed to the needs and demands of society, providing him with greater knowledge and skills that ascribe to the development of a teaching professionalcollaborative culture. Conclusions: The development of teaching professional culture is based on its content and form. The content covers the knowledge, attitudes, skills, habits and values that the teacher has on teaching. The forms of relationship and association that develop among teachers determine the type of teaching professional culture prevailing in an educational group.

La integración de las influencias educativas de la universidad y la familia en la formación del profesional de la educación superior / The integration of educational influences of the university and the role of the family in the profesional formation of higher education

Fundamento: en el proceso de formación de los profesionales en la educación superior, la integración de las influencias educativas que rodean al estudiante resultan determinantes para ofrecerle los niveles de ayuda que él reclama. Objetivo: sistematizar los referentes teóricos acerca del proceso de formación del profesional de la educación superior desde la integración de influencias educativas de la universidad y la familia. Conclusiones: en el marco del proceso educativo que se desarrolla en la educación superior se deben integrar las influencias de la universidad y la familia desde el colectivo de año, bajo las condiciones de la situación social de desarrollo del joven universitario que tribute al logro de una formación profesional articulada de forma armónica y coherente a través de la cooperación y la comunicación recíprocas, y la identificación de metas proyectadas hacia la mejora en la formación del estudiante.

Background: in the process of professionals training in higher education, the integration of educational influences around the student is crucial to provide the levels of support that he claims. Objective: to systematize the theoretical framework about the process of formation of the professional of higher education since the integration of educational influences of the university and the family. Conclusions: as part of the educational process that is developed in higher education the influences of the university and the family from the group of the year should be integrated, under the conditions of the social situation of development of the young college that tribute to the achievement of professional articulated training in a harmonic and coherent way through mutual cooperation and reciprocal communication, and the identification of projected goals towards improvement in the student's education.

NPPB and ACAN, two novel SHOX2 transcription targets implicated in skeletal development.

SHOX and SHOX2 transcription factors are highly homologous, with even identical homeodomains. Genetic alterations in SHOX result in two skeletal dysplasias; Léri-Weill dyschondrosteosis (LWD) and Langer mesomelic dysplasia (LMD), while no human genetic disease has been linked to date with SHOX2. SHOX2 is, though, involved in skeletal development, as shown by different knockout mice models. Due to the high homology between SHOX and SHOX2, and their functional redundancy during heart development, we postulated that SHOX2 might have the same transcriptional targets and cofactors as SHOX in limb development. We selected two SHOX transcription targets regulated by different mechanisms: 1) the natriuretic peptide precursor B gene (NPPB) involved in the endochondral ossification signalling and directly activated by SHOX; and 2) Aggrecan (ACAN), a major component of cartilage extracellular matrix, regulated by the cooperation of SHOX with the SOX trio (SOX5, SOX6 and SOX9) via the protein interaction between SOX5/SOX6 and SHOX. Using the luciferase assay we have demonstrated that SHOX2, like SHOX, regulates NPPB directly whilst activates ACAN via its cooperation with the SOX trio. Subsequently, we have identified and characterized the protein domains implicated in the SHOX2 dimerization and also its protein interaction with SOX5/SOX6 and SHOX using the yeast-two hybrid and co-immunoprecipitation assays. Immunohistochemistry of human fetal growth plates from different time points demonstrated that SHOX2 is coexpressed with SHOX and the members of the SOX trio. Despite these findings, no mutation was identified in SHOX2 in a cohort of 83 LWD patients with no known molecular defect, suggesting that SHOX2 alterations do not cause LWD. In conclusion, our work has identified the first cofactors and two new transcription targets of SHOX2 in limb development, and we hypothesize a time- and tissue-specific functional redundancy between SHOX and SHOX2.

La sala de clases sí importa: incidencia del clima de aula sobre la percepción de intimidación y victimización entre escolares / Classroom matters: The incidence of classroom climate on perceptions of peer intimidation and victimization

La investigación sobre agresión entre escolares (bullying) tiende a poner énfasis en las características individuales de agresores y víctimas, y no así en las características contextuales. En este artículo presentamos evidencia de que el clima de aula es un factor predictor de la percepción de agresión entre escolares. Se aplicaron instrumentos de autopercepción y heteropercepción de intimidación y victimización de 444 estudiantes chilenos de séptimo y octavo básico, y se analizó el efecto de la percepción del clima de su sala de clases sobre estos indicadores. Para intimidación, el modelo de regresión fue significativo aún después de controlar el nivel socioeconómico y explicó el 40.1 % de la varianza y para victimización, el 33.5 %. Específicamente, fueron las dimensiones de fricción, satisfacción y competencia las que incidieron en la intimidación y victimización entre pares. Estos resultados son discutidos en el marco de la investigación sobre victimización entre pares desde una perspectiva social-ecológica.

Research on peer aggression (bullying) places emphasis on individual characteristics of aggressors and victims, and scarcely on context variables. This article provides evidence of classroom climate acting as predictor of perceived peer aggression. 444 students enrolled in sixth, seventh, and eight grade were administered instruments measuring self-reported and peer-reported intimidation and victimization. We analyzed the effect of classroom climate on these indicators. For intimidation, the regression model proved significant even after controlling for socioeconomic status, and explained 40.1 % of variance; and for victimization, 33.5 % of variance. Specifically, the dimensions of classroom climate associated with peer aggression were friction, satisfaction, and competitiveness. These results are discussed within the framework of research on peer aggression from a social-ecological perspective.

Identification of a Gypsy SHOX mutation (p.A170P) in Léri-Weill dyschondrosteosis and Langer mesomelic dysplasia.

We report the clinical and molecular characteristics of 12 Spanish families with multiple members affected with Léri-Weill dyschondrosteosis (LWD) or Langer mesomelic dysplasia (LMD), who present the SHOX (short stature homeobox gene) mutation p.A170P (c.508G>C) in heterozygosity or homozygosity, respectively. In all studied families, the A170P mutation co-segregated with the fully penetrant phenotype of mesomelic limb shortening and Madelung deformity. A shared haplotype around SHOX was observed by microsatellite analysis, confirming the presence of a common ancestor, probably of Gypsy origin, as 11 of the families were of this ethnic group. Mutation screening in 359 Eastern-European Gypsies failed to identify any carriers. For the first time, we have shown SHOX expression in the human growth plate of a 22-week LMD fetus, homozygous for the A170P mutation. Although the mutant SHOX protein was expressed in all zones of the growth plate, the chondrocyte columns in the proliferative zone were disorganized with the chondrocytes occurring in smaller columnal clusters. We have also identified a novel mutation at the same residue, c. 509C>A (p.A170D), in two unrelated Spanish LWD families, which similar to A170P mutation impedes nuclear localization of SHOX. In conclusion, we have identified A170P as the first frequent SHOX mutation in Gypsy LWD and LMD individuals.