Effects of Menu Labeling Policies on Transnational Restaurant Chains to Promote a Healthy Diet: A Scoping Review to Inform Policy and Research.

There is insufficient evidence that restaurant menu labeling policies are cost-effective strategies to reduce obesity and diet-related non-communicable diseases (NCDs). Evidence suggests that menu labeling has a modest effect on calories purchased and consumed. No review has been published on the effect of menu labeling policies on transnational restaurant chains globally. This study conducted a two-step scoping review to map and describe the effect of restaurant menu labeling policies on menu reformulation. First, we identified national, state, and municipal menu labeling policies in countries from global databases. Second, we searched four databases (i.e., PubMed, CINHAL/EBSCO, Web of Science, and Google Scholar) for peer-reviewed studies and gray-literature sources in English and Spanish (2000-2020). Step 1 identified three voluntary and eight mandatory menu labeling policies primarily for energy disclosures for 11 upper-middle and high-income countries, but none for low- or middle-income countries. Step 2 identified 15 of 577 studies that met the inclusion criteria. The analysis showed reductions in energy for newly introduced menu items only in the United States. We suggesr actions for governments, civil society organizations, and the restaurant businesses to develop, implement, and evaluate comprehensive menu labeling policies to determine whether these may reduce obesity and NCD risks worldwide.

Immunochemical and Physical Quantitation of Grass and Olive Pollen Allergens: Correlation With Asthma Admissions in Cáceres, Spain.

BACKGROUND AND OBJECTIVES: The association between pollen counts and allergen levels in the air is controversial. Objectives: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods.

Immunochemical and physical quantitation of grass and olive pollen allergens: correlation with asthma admissions in Cáceres, Spain

BACKGROUND: The association between pollen counts and allergen levels in the air is controversial. OBJECTIVES: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods

ANTECEDENTES: La relación entre los niveles de pólenes en el aire y los niveles de alérgenos es controvertida. OBJETIVOS: El objetivo de este estudio fue cuantificar los niveles de alérgenos principales y totales de Phleum pratense y Olea europaea, y analizar su relación con los niveles de pólenes y el número de crisis asmáticas atendidas en el Complejo Hospitalario de Cáceres, España. MATERIAL Y MÉTODOS: Se captaron pólenes y aeroalérgenos durante Abril-Junio de 2011, utilizando un colector de aire volumétrico y una trampa Burkard. Se extrajeron los alérgenos de los filtros y se cuantificaron mediante ELISA. RESULTADOS: Mayo fue el periodo de mayor polinización, (13 de Mayo, pico máximo de 1.362 granos de polen de gramíneas/m3). El mayor periodo de polinización del olivo fue del 30 de Abril al 20 de Mayo, (11 de Mayo, pico máximo: 851 granos de polen de olivo/m3). Se observó una correlación moderada entre los niveles de polen o alérgenos totales y exacerbaciones de asma, que aumentó al introducir un desfase de 3 días (Phleum), y de 1 día (olivo). La máxima correlación se observó a los 4 y 6 días del pico máximo de polen y de Ole e 1, respectivamente. CONCLUSIONES: Este estudio muestra una correlación significativa entre la polinización de gramíneas y olivo y el aumento del número de visitas a urgencias debidas a crisis asmáticas. Los patrones aerobiológicos de los niveles de alérgenos en el aire son comparables a los recuentos de pólenes durante los periodos de polinización de gramíneas y olivo

Effect of triploidy on digestive enzyme activity of early stages of turbot (Scophthalmus maximus).

In the present work, growth and digestive enzyme activities of total acid and alkaline proteases, pepsin, trypsin, lipase, and α-amylase, as well as partial characterization of enzyme activity, were studied in diploid and triploid turbot. Growth was similar between both groups. Acid protease activity increased consistently during the experiment, for both diploid (2n) and triploid (3n) fish. The alkaline protease activity was always higher for triploids throughout the experiment. Proteolytic acid activity (pH 2) was generally higher for diploids, at all temperatures tested. Higher activity was at pH 2 and 3 for 2n and 3n fish, respectively. Regarding temperature, acid and alkaline protease activity was higher at 37 °C and 60 °C, respectively, for both groups. The general increase in pancreatic enzymes (trypsin and amylase) before 35 days after hatching (DAH) and posterior decrease until 60 DAH. There was a marked effect on enzyme activity when changing from live prey to pellets (35 DAH), especially on triploids.

ALPHACAL: A new user-friendly tool for the calibration of alpha-particle sources.

In this work, we present and describe the program ALPHACAL, specifically developed for the calibration of alpha-particle sources. It is therefore more user-friendly and less time-consuming than multipurpose codes developed for a wide range of applications. The program is based on the recently developed code AlfaMC, which simulates specifically the transport of alpha particles. Both cylindrical and point sources mounted on the surface of polished backings can be simulated, as is the convention in experimental measurements of alpha-particle sources. In addition to the efficiency calculation and determination of the backscattering coefficient, some additional tools are available to the user, like the visualization of energy spectrum, use of energy cut-off or low-energy tail corrections. ALPHACAL has been implemented in C++ language using QT library, so it is available for Windows, MacOs and Linux platforms. It is free and can be provided under request to the authors.

Suitability of multiple Mediterranean oak species as a food resource for Reticulitermes grassei Clément (Isoptera: Rhinotermitidae).

The subterranean termite Reticulitermes grassei Clément causes lesions in the trunk of Quercus suber L. by constructing feeding galleries, but no information is available regarding other Quercus species from the Mediterranean region. This work aimed to study the suitability of the other main oak species of Mediterranean forests as a food resource for R. grassei. Two experiments, choice and non-choice feeding, were conducted lasting for 15, 30, and 45 days each. In the non-choice experiment, termites were offered one of the following food types: Quercus suber, Quercus ilex L., Quercus faginea Lam, cork or Pinus pinea L., which was considered the control. The choice feeding experiment used all the same food types listed above, supplied simultaneously in the same container. Food selection was examined by analysing the relationships over time between surviving termites and food consumption. The results indicated that R. grassei could be considered a generalist species, as it consumed the cork and wood of all oak species, as well as displaying a clear preference for soft wood (pine). Correlation analysis indicated that consumption was not dependent on wood density. Survival of R. grassei was influenced by the time of exposure to different oak species, but a high survival rate was maintained over time in the pine treatment (upper 70% in the three experiments). Given these results, it can be concluded that all the oak species are a suitable food source for R. grassei.

Autecology, feeding preferences and reproductive biology of Chorthippus (Glyptobothrus) vagans (Eversmann, 1848) (Orthoptera: Gomphocerinae) in Mediterranean ecosystems.

Chorthippus vagans is a common species of Gomphocerinae (Orthoptera) on the Iberian Peninsula. It is endangered in Central Europe where information about its ecological requirements is available; however, aspects of its biology are almost unknown in Mediterranean ecosystems, where it is widespread and common. The focus of this study was to determine how C. vagans adjusts its biology to environmental features of this ecosystem and to interpret how it may be affected by the ecological changes related to the re-vegetation programme linked to the construction of the Breña dam (SW Spain). The research parameters included the autoecology, feeding response and some aspects of reproduction of this species in the Southern Iberian Peninsula. To determine the local distribution and phenology of C. vagans, monthly samplings were conducted (2007-2010) in 12 sampling plots. For the food selection tests, ten nymphs and ten adults were placed individually in insectaries under controlled conditions. Grasses (Lolium sp.) and shrubs (Cistus sp.) were supplied ad libitum in two types of tests, monospecific and mixed diet. The reproductive biology was analysed by both observations of anatomical structures (integument, bristles, tibial spines, tarsal claws and mandibles) and ovarian dissections of 29 females and in laboratory rearing experiments with 15 pairs of adults. The results indicate that C. vagans shows an extended activity period which peaks at the end of summer. It is a polyphagous grasshopper, although adults show a slight preference for grasses. In addition, it is a univoltine species with spring-summer breeding activity.

Sinusitis maxilar por osteonecrosis asociada a bisfosfonatos en pacientes con cáncer de mama: serie de casos / Maxillary sinusitis associated to bisphosphonate-related osteonecrosis in patients with breast cancer: case series

Los bisfosfonatos (BF) son fármacos ampliamente utilizados como estabilizadores óseos en el tratamiento de metástasis óseas, osteoporosis, enfermedad de Paget, entre otras patologías, debido a sus efectos anti-tumorales y a la característica de inhibir la actividad osteoclástica. La osteonecrosis maxilar asociada a BF, hoy en día osteonecrosis maxilar asociada a fármacos (ONMF) es definida como la presencia de hueso expuesto, no-vascularizado y necrótico en la cavidad oral por un periodo mayor a ocho semanas, con una historia positiva de tratamiento con fármacos anti-reabsorción ósea (BP, inhibidores del ligando RANKL) y/o anti-angiogénicos y sin antecedentes de tratamiento con radiación o metástasis obvia en los maxilares. La frecuencia de ONMF es incierta. La mandíbula es más frecuentemente afectada por ONMF que el maxilar. Pocos casos de ONMF en el maxilar han sido descritos con un diagnostico de sinusitis maxilar simultáneo. Tres casos con sinusitis maxilar asociada a ONMF son presentados en este trabajo. Todos los pacientes fueron mujeres con una historia positiva de cáncer de mama y tratamiento con bisfosfonatos. Los primeros dos casos, desarrollaron ONMF después de una extracción del tercer molar maxilar. El tercer caso con ONMF en el maxilar, sólo tenía antecedentes de curetaje periodontal. Una tomografía computada fue realizada y mostró compromiso del seno maxilar en todos los pacientes. Modalidades diagnósticas para evaluar la extensión de la necrosis y el compromiso del seno, como también alternativas de tratamiento son descritas en este estudio. Finalmente, una revisión actualizada de la literatura es presentada.

Bisphosphonates are widely used as bone-stabilizers in the treatment of osseous metastases, osteoporosis, Paget's disease and others,due to their ability to inhibit osteoclast activity and anti-tumor effects. Bisphosphonate-related osteonecrosis of the jaw, nowadays medication-related osteonecrosis of the jaw (MRONJ), is defined as the presence of exposed, non-vascularized and necrotic bone tissue in the oral cavity over a period of 8 weeks with a current or previous history of treatment with antiresorptive (bisphosphonates, RANKL ligand inhibitor) and/or antiangiogenic agents, and no history of radiation therapy to the jaws or obvious metastatic disease to the jaws. The frequency of MRONJ is unclear. The mandible appears to be more frequently affected by MRONJ than the maxilla. Isolated cases of maxillary MRONJ have been described in wich a simultaneous sinusitis maxillaris was diagnosed. Three cases of MRONJ associated with maxillaris sinusitis are presented. All cases were females with a positive history of breast cancer and bisphosphonate therapy. The first two, developed MRONJ after a third molar upper extraction. The third case with MRONJ, had a history of periodontal curettage. A computed tomography was performed and showed a maxillary sinus compromise in all patients. Imaging modalities to evaluate the extent of the necrosis and the sinus compromise, as also treatment options were described in this study. Finally, an updated literature review is presented.

Competency frameworks for advanced practice nursing: a literature review.

AIM: This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. BACKGROUND: There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. INTRODUCTION: International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. METHODS: A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. RESULTS: The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. CONCLUSIONS: Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes.

Modulation of cosmic microwave background polarization with a warm rapidly rotating half-wave plate on the Atacama B-Mode Search instrument.

We evaluate the modulation of cosmic microwave background polarization using a rapidly rotating, half-wave plate (HWP) on the Atacama B-Mode Search. After demodulating the time-ordered-data (TOD), we find a significant reduction of atmospheric fluctuations. The demodulated TOD is stable on time scales of 500-1000 s, corresponding to frequencies of 1-2 mHz. This facilitates recovery of cosmological information at large angular scales, which are typically available only from balloon-borne or satellite experiments. This technique also achieves a sensitive measurement of celestial polarization without differencing the TOD of paired detectors sensitive to two orthogonal linear polarizations. This is the first demonstration of the ability to remove atmospheric contamination at these levels from a ground-based platform using a rapidly rotating HWP.

Assessment of an educational intervention in the management of non-critical inpatient glycemic control.

In hospitalized diabetic patients, the recommended insulin therapy is basal bolus plus correction-dose regimen instead of sliding-scale insulin. The purpose of this study was to evaluate the effect of the implementation of a new protocol based on basal bolus therapy on managing diabetes in a university hospital setting. We performed a cross-sectional study before and 12 months after a 4-month intervention period to implement a basal bolus regimen in hospitalized patients. Non-critical patients admitted into the hospital for at least 72 h were included. Changes in prescribing habits, glucose control and incidence of hypoglycemia were evaluated. An increase in the use of the new protocol and a decrease in sliding scale were observed after the intervention. In the pre-intervention group, a total of 59.2% glucose readings were between 70 and 180 mg/dL versus 57.1% after the intervention, without observing statistical differences. Significant reductions in hypoglycemia between pre- and post-intervention (13.04 vs. 4.08%, p = 0.0215) were observed. The percentage of hospitalized diabetic patients who had HbA1c was 10.43 and 4.08% in pre- and post-intervention phases, respectively. The protocol showed beneficial outcomes in terms of fewer hypoglycemia episodes and reflected a change in prescription habits, but it did not improve glycemic control. Furthermore, the percentage of patients who had an HbA1c test during their hospitalization remained very low after the intervention. This fact may seriously limit the correct management of hyperglycemia after the hospital discharge.

El dolor del parto preocupa más a los futuros padres que a las madres / Labor pain worries future fathers more than the mothers

Objetivo. Evaluar la preocupación por el dolor de los futuros padres frente a otras variables que pueden afectar al bienestar de sus mujeres durante el parto, y estudiar posibles diferencias de opinión entre padres y madres al respecto. Pacientes y métodos. Estudio transversal descriptivo realizado mediante encuesta anónima y voluntaria a padres y madres en el último mes de gestación de estas. Se solicitaba de ambos por separado, que puntuaran de 0 a 10 las variables expuestas en función del grado de preocupación que suponían para ellos, y su importancia para el bienestar durante el proceso del parto (escala 0: no preocupa y/o mínima importancia a 10: máxima preocupación y/o importancia. Los ítem sobre los que se cuestionó fueron: 1) secuelas estéticas, 2) pudor, 3) información continuada, 4) caminar, 5) beber durante la dilatación, 6) compañía, 7) dolor, 8) guardar la compostura, 9) amabilidad y 10) habitabilidad de la sala. Se registraron también edad, paridad, estudios y nacionalidad. Resultados. Se realizaron 147 encuestas, 99 a madres y 48 a padres. El dolor es la variable que más preocupaba a los futuros padres con una media (DE) de 8,1 (2,0), mientras que para las madres tuvo mayor relevancia la información 7,7 (2,5), amabilidad 7,9 (2,1) y compañía 8,2 (2,3) durante el parto, observándose además diferencias significativas entre padres y madres para las variables: dolor (p=0,001); caminar (p=0,003) y beber (p=0,009). Conclusiones. Los resultados del estudio muestran que la preocupación por el dolor de parto es mayor en los futuros padres que en las madres, y que estas se muestran más preocupadas por la información y la compañía que por el dolor que puedan llegar a experimentar. Mejorar los aspectos asistenciales que más preocupan a ambos: información, participación paterna y analgesia debería redundar en una mayor calidad percibida por el usuario (AU)

Objective. To evaluate the concerns of the future father about labor pain and another 9 items which could be important to the well-being of the mother during delivery. To investigate any possible differences in opinion between the future father and mother. Patients and methods. An anonymous and voluntary questionnaire was offered to the father and the pregnant patient during the last month of pregnancy. They had to answer the questionnaire separately, scoring 10 items in a 0-10 point ordinal scale, according to their concerns and the importance for the good development of the delivery (0= not concerned about/insignificant to 10=concerned about/great importance). The items included were: 1) esthetic aftermath, 2) embarassment, 3) continous information, 4) walking during labor, 5) drinking during labor, 6) companionship, 7) labor pain, 8) keeping composure, 9) kindness, 10) room comfortability. Data on age, education, parity and nationality were recorded. Results. A total of 147 questionnaires were completed, 99 by mothers, and 48 by fathers. Pain was the most important concern for the future fathers scoring a mean (SD) of 8.15 (2), while continuous information 7.71 (2.5), kindness 7.9 (2.1), and companionship 8.21 (2.3) were more important than pain for mothers. A statistically significant difference was found between fathers and mothers regarding labor pain (P=.001), walking during labor (P=.003), and drinking during labor (P=.009). Conclusions. The result of our study suggests that increasing the presence of the father during the delivery process, and taking care of the emotional aspects and the quality of the information given could be very important for the perception of satisfaction (AU)

[Labor pain worries future fathers more than the mothers]. / El dolor del parto preocupa más a los futuros padres que a las madres.

OBJECTIVE: To evaluate the concerns of the future father about labor pain and another 9 items which could be important to the well-being of the mother during delivery. To investigate any possible differences in opinion between the future father and mother. PATIENTS AND METHODS: An anonymous and voluntary questionnaire was offered to the father and the pregnant patient during the last month of pregnancy. They had to answer the questionnaire separately, scoring 10 items in a 0-10 point ordinal scale, according to their concerns and the importance for the good development of the delivery (0= not concerned about/insignificant to 10=concerned about/great importance). The items included were: 1) esthetic aftermath, 2) embarassment, 3) continous information, 4) walking during labor, 5) drinking during labor, 6) companionship, 7) labor pain, 8) keeping composure, 9) kindness, 10) room comfortability. Data on age, education, parity and nationality were recorded. RESULTS: A total of 147 questionnaires were completed, 99 by mothers, and 48 by fathers. Pain was the most important concern for the future fathers scoring a mean (SD) of 8.15 (2), while continuous information 7.71 (2.5), kindness 7.9 (2.1), and companionship 8.21 (2.3) were more important than pain for mothers. A statistically significant difference was found between fathers and mothers regarding labor pain (P=.001), walking during labor (P=.003), and drinking during labor (P=.009). CONCLUSIONS: The result of our study suggests that increasing the presence of the father during the delivery process, and taking care of the emotional aspects and the quality of the information given could be very important for the perception of satisfaction.

Large-aperture wide-bandwidth antireflection-coated silicon lenses for millimeter wavelengths.

The increasing scale of cryogenic detector arrays for submillimeter and millimeter wavelength astrophysics has led to the need for large aperture, high index of refraction, low loss, cryogenic refracting optics. Silicon with n=3.4, low loss, and high thermal conductivity is a nearly optimal material for these purposes but requires an antireflection (AR) coating with broad bandwidth, low loss, low reflectance, and a matched coefficient of thermal expansion. We present an AR coating for curved silicon optics comprised of subwavelength features cut into the lens surface with a custom three-axis silicon dicing saw. These features constitute a metamaterial that behaves as a simple dielectric coating. We have fabricated silicon lenses as large as 33.4 cm in diameter with micromachined layers optimized for use between 125 and 165 GHz. Our design reduces average reflections to a few tenths of a percent for angles of incidence up to 30° with low cross polarization. We describe the design, tolerance, manufacture, and measurements of these coatings and present measurements of the optical properties of silicon at millimeter wavelengths at cryogenic and room temperatures. This coating and lens fabrication approach is applicable from centimeter to submillimeter wavelengths and can be used to fabricate coatings with greater than octave bandwidth.

State-of-the-art in downstream processing of monoclonal antibodies: process trends in design and validation.

Monoclonal antibodies (mAbs) are the most important family of biopharmaceutical compounds in terms of market share. At present, 30 mAbs have been approved and are now commercialized for therapeutic purposes. mAbs are typically produced by mammalian cell culture in bioreactors that range in scale of 1-20 m(3) . Regardless of scale, from laboratory to commercial settings, the recovery and purification of mAbs present important challenges. Depending on the scale, the particular product, and the type of production process (bioreactor operation, process time, complexity of the culture media, cell density, etc.), many possible downstream configurations are possible and have been used. In this contribution, we review each type of unit operation that forms a downstream train for mAb production. We provide information regarding typical operation settings and critical variables for centrifugation, ultrafiltration, affinity chromatography, ion exchange chromatography, and viral removal operations. In addition, we discuss some important considerations required for the formulation of drugs based on mAbs.

Análisis del portafolio como herramienta evaluativa de las prácticas clínicas de enfermería comunitaria en estudiantes de pregrado / Portfolio analysis as evaluation tool of Community Nursing Clinical Practice Learning in undergraduates

Objetivos. Analizar la implementación y la utilidad del portafolio como herramienta evaluativa de las prácticas clínicas en enfermería comunitaria en la Escuela de Enfermería Puerta de Hierro de la Universidad Autónoma de Madrid (UAM) y valorar la influencia de variables sociodemográficas y académicas en el proceso de evaluación continua del portafolio. Sujetos y métodos. Estudio descriptivo en el marco de un proyecto de innovación docente financiado por la UAM. La población objeto de estudio fueron estudiantes de segundo y tercer curso de enfermería de la escuela Puerta de Hierro(UAM), que realizaron sus prácticas clínicas de enfermería comunitaria en el medio de la atención primaria de salud (n = 38). Variables principales: calificaciones intermedias y finales en los trabajos que componían el portafolio (diario reflexivo, caso clínico, análisis de salud de la comunidad),puntualidad en las entregas, dificultad, utilidad y mejora del aprendizaje percibida, horas dedicadas a la semana, autoevaluación de las prácticas clínicas, calificación de la tutora, evaluación final del portafolio. Para el análisis bivariante se usaron pruebas no paramétricas. Se calcularon intervalos de confianza para un 95% de seguridad. Resultados. Se analizaron 38 estudiantes con una edad media 21,5 ± 4,3 años, 81,6% mujeres. Para el 56,7%, la dificultad fue alta. La utilidad se señaló como alta en el 72,9% de los casos. La media en la autoevaluación del estudiante fue de 7,68; la evaluación de la tutora, de 8,31, y la calificación definitiva del portafolio final por parte de las profesoras, de 7,07. Conclusiones. La implementación del portafolio ha puesto de manifiesto la dificultad sentida por los estudiantes en un proceso que requiere escritura reflexiva, trabajo diario y autoevaluación. Ahora bien, estas dificultades se traducen en una alta percepción de utilidad y de mejora para el aprendizaje (AU)

Aim. To analyze the implementation and usefulness of the portfolio as assessment tool for Community Nursing Clinical Practice Learning in the Puerta de Hierro Nursing School of Universidad Autónoma de Madrid (UAM), and to assess the influence of sociodemographic and academic variables in the process of continuous evaluation of the portfolio. Subjects and methods. cross-sectional study in the context of a teaching innovation project funded by the UAM. The target population: students of 2nd and 3rd courses of Puerta de Hierro Nursing School (UAM) that made their Community Nursing Clinical Practice Learning in the setting of the Primary Health Care (n = 38). Main outcomes: intermedium and final scores in the works that includes the portfolio (‘reflectivediary’, ‘clinical case’ and ‘analysis of community health’),timeliness of delivery, difficulty, usefulness and perceived improvement of learning, hours spent/week, student self assessment, qualification of the tutor, final evaluation of the portfolio. Bivariate analysis was done using non parametrictests. Confidence intervals were calculated for 95% confidence. Results. 38 students were studied. The mean age was of 21.5 ± 4.3 years-old, 81.6% women. Difficulty was high in56.7%. The utility was noted as high in 72.9%. The student self-assessment average score was 7.68, the evaluation ofthe tutor: 8.31 and portfolio final score by the teachers: 7,07.Conclusions. The implementation of portfolio has shown the difficulty felt by students in a process requiring reflective writing, daily work and self-evaluation. However, these difficulties translate into a high perception of usefulness and improve learning (AU)

¿Es el cintigrama renal estático diferido mejor predictor de reflujo vesicoureteral que el cintigrama renal estático en etapa aguda en niños con infección urinaria febril? / Is late static renal scintigraphy a better predictor of vesicoureteral reflux than acute renal static scintigraphy? in children whit first episode of febrile urinary infection?

Objetivo: Comparar la utilidad del CRE en etapa aguda versus el CRE diferido para predecir la presencia y/o ausencia de RVU en niños con primer episodio de ITU febril. Material y métodos: Estudio retrospectivo donde se analizaron 95 pacientes con primer episodio deITU febril, a los cuales se les realizó dentro de los primeros 15 días de evolución del cuadro un CRE control y luego un CRE diferido después de 6 meses del primer episodio. Se correlacionó la presencia de alteración cintigráfica en el CRE agudo y en el CRE diferido con la existencia RVU diagnosticado mediante UCG. Resultados: La edad promedio fue de 17 meses, con 72 (75,8 por ciento) pacientes menores de 2 años de edad. Cuarenta y nueve pacientes eran de sexo femenino. Se encontró RVU en 41 de los 95 pacientes (43,2 por ciento). En la etapa aguda 93,7 por ciento de los pacientes tuvo un CRE alterado, 46,1 por ciento de los cuales tenía RVU. Ninguno de los 6 pacientes con CRE normal tuvo RVU (VPN de 100 por ciento). En el CRE diferido persistieron con alteraciones cintigráficas el 40,4 por ciento de los niños, de los cuales la mitad presentaba RVU. De los 59 niños sin alteraciones cintigráficas el 61 por ciento no tenía RVU (VPN 60 por ciento).Conclusión: El CRE diferido no es un buen predictor de RVU en niños con primer episodio de ITU febril, a diferencia del CRE realizado en etapa aguda, el cual tiene un excelente VPN para RVU.

Objective: To compare the usefulness of static renal scintigraphy done in the acute phase of febrile UTI versus late static renal scintigraphy to predicit the presence and/or absence of VUR in children with first episode of febrile UTI. Materials and methods: Retrospective study that analized 95 patients with first episode of febrile UTI, to whom a control static renal scintigraphy was done in the first 15 days of the UTI and then late static renal scintigraphy was performed after 6 months of the first episode of UTI. A correlation was made between the presence of scintigraphic abnormalities in the acute phase static renal scintigraphy and late static renal scintigraphy with the existence of VUR diagnosed by VUG. Results: The mean age was 17 months, with 72 (75.8 percent) patients younger than 2 years. Forty-nine patients were girls. VUR was found in 41 of the 95 patients (43.2 percent). In the acute phase 93.7 percent of the patients had an abnormal static renal scintigraphy, 46.1 percent of which had VUR. None of the 6 patients with a normal static renal scintigraphy had VUR (NVP de 100 percent). In the late static renal scintigraphy 40.4 percent of the patients persisted with scintigraphic alterations, the presence of VUR in this group of patients was of 50 percent. Of the 59 patients without scintigraphic abnormalities 61 percent did not have VUR (PPV 60 percent).Conclusion: The late static renal scintigraphy is not a good predictor of VUR in children with first episode of febrile UTI, unlike the static renal scintigraphy done in the acute phase of the illness, which has an excelent NPV for VUR.

Saving feral horse populations: does it really matter? A case study of wild horses from Doñana National Park in southern Spain.

In the 1980s, a conservation programme involving a feral horse population, the Retuertas horses from the Guadalquivir marshes, was started in the Doñana National Park. The analysis of an extensive genetic survey of this population, which now numbers 100 animals, and 10 additional European and North African breeds using DNA polymorphisms from 22 microsatellites is presented. Highly significant fixation indexes were obtained for all pairwise comparisons between the Retuertas population and other breeds. A population neighbour-joining breed phenogram was built using different distance measures, but the Retuertas population failed to cluster with either of the two major clades of European and North African breeds, highlighting its uniqueness. In fact, the Retuertas population was positioned at the base of the trees, which were rooted using donkey samples. Furthermore, assignment tests and the individual Q-matrices obtained with the structure programme isolated the Retuertas breed from the other breeds with only four K groups. Interestingly, some local semi-feral horses, known as Marismeño, also currently living in the Guadalquivir marshes, have some microsatellite genotypes that fall well within the Retuertas cluster. This raises the possibility of incorporating horses from the Marismeño population in a future conservation programme.

Encefalitis herpética: Serie clínica de 15 casos confirmados por reacción de polimerasa en cadena / Herpetic encephalitis: Case series of 15 patients confirmed by polymerase chain reaction

La encefalitis herpética es la causa más frecuente de encefalitis esporádica en el mundo occidental. Para conocer las principales características clínicas de esta enfermedad en nuestro medio, se efectuó un análisis de casos confirmados por reacción de polimerasa en cadena en dos hospitales universitarios de Santiago. Un total de 15 casos pudo ser identificado con un promedio de edad de 41 años (5-78 años) y 80% ³ 30 años, el primero de ellos el año 1998. La mayor parte se presentó con fiebre y compromiso de conciencia (80% cada uno) o cefalea (67%). Las convulsiones y la focalización fueron infrecuentes (£ 15%) y sólo 2 casos (13%) tuvieron además una manifestación herpética extracerebral. La duración promedio de los síntomas fue de 3,8 días. La mayor parte estuvo asociada al serotipo 1 (86,7%). El 91,7% de los casos evaluados presentó alteraciones electroencefalográficas, 81,8% alteraciones en la resonancia magnética y sólo 13,3% en la tomografía axial computarizada. La totalidad de los pacientes fue tratada con aciclovir y la letalidad fue de 13,3%, aunque el deceso en un paciente con SIDA y linfoma del SNC no pudo ser atribuido a la infección herpética. Seis pacientes (40%) presentaban secuelas neurológicas al momento del egreso. La muerte o alteraciones neurológicas al alta estuvieron asociadas significativamente a un inicio del tratamiento > 3 días desde el inicio de los síntomas. (p = 0,01 prueba bilateral de Fisher).