Traditional potato tillage systems in the Peruvian Andes impact bacterial diversity, evenness, community composition, and functions in soil microbiomes.

The soil microbiome, a crucial component of agricultural ecosystems, plays a pivotal role in crop production and ecosystem functioning. However, its response to traditional tillage systems in potato cultivation in the Peruvian highlands is still far from understood. Here, ecological and functional aspects of the bacterial community were analyzed based on soil samples from two traditional tillage systems: 'chiwa' (minimal tillage) and 'barbecho' (full tillage), in the Huanuco region of the Peruvian central Andes. Similar soil bacterial community composition was shown for minimal tillage system, but it was heterogeneous for full tillage system. This soil bacterial community composition under full tillage system may be attributed to stochastic, and a more dynamic environment within this tillage system. 'Chiwa' and 'barbecho' soils harbored distinct bacterial genera into their communities, indicating their potential as bioindicators of traditional tillage effects. Functional analysis revealed common metabolic pathways in both tillage systems, with differences in anaerobic pathways in 'chiwa' and more diverse pathways in 'barbecho'. These findings open the possibilities to explore microbial bioindicators for minimal and full tillage systems, which are in relationship with healthy soil, and they can be used to propose adequate tillage systems for the sowing of potatoes in Peru.

Mapping the periapex anatomical pattern of teeth involved in sodium hypochlorite accidents: a cross-sectional quasi-experimental study.

AIM: To determine the anatomical reasons for sodium hypochlorite (NaOCl) accidents by testing whether this mishap is likely to occur in cases where the anatomical apex of the teeth fenestrates the overlying buccal cortical alveolar bone, allowing NaOCl to gain direct access to buccal soft tissues. METHODOLOGY: Following a cross-sectional, nonrandomized design, 13 patients who suffered unintentional NaOCl accidents whilst undergoing root canal treatment were included. After remission of symptoms, the root canals were fully irrigated with an innocuous radiopaque solution (saline diluted Claritrast 300) and subsequently CBCT scanned to create a 3D-map of the periapex and tracking of the irrigant pathway throughout the periapical tissues. An extra group of five control patients, who underwent root canal treatment with no NaOCl accident, was also CBCT-scanned after irrigation with the tracking radiopaque solution. The anatomical relationship of the cortical bone and the root apex, as well as the distribution of irrigation solution in the periapical tissue, was associated with patients undergoing a NaOCl accident or not, using a Fisher's exact test. RESULTS: The frequency of teeth with apical cortical fenestration was significantly higher in the NaOCl accident-positive group, compared to the negative (P < 0.001). All 13 accident-positive patients had an anatomical apex in direct contact with the buccal soft tissue via fenestration of the overlying cortical bone and direct contact of the foramen with the soft tissues. The radiopaque solution was distributed in the soft tissue in these cases. In contrast, accident-negative patients had no fenestration of the buccal cortical bone and the anatomical root apex was within the cancellous bone or within a bone-confined periapical lesion. The radiopaque solution was also found in the cancellous bone or the periapical lesion, but patients had no manifestations of a NaOCl accident. CONCLUSION: This quasi-experimental cross-sectional clinical study suggests that, in addition to the presence of the extruded NaOCl solution, a patent foramen that fenestrates the cortical bone merging into the mucosal tissue might constitute a risk for the clinical manifestation of a NaOCl accident. Preoperative 3D scans aid in anticipating when an accident is likely to occur.

Fire frequency effects on cleistogamy expression and progeny performance in Cologania broussonetii.

Increased fire frequency usually erodes microenvironmental conditions, causing a drastic limitation of edaphic resources. Thus, the production of permanently closed-small flowers (cleistogamous, CL) should increase in sites with high fire frequency as this implies a less expensive reproductive assurance strategy. However, because open, insect-pollinated flowers (chasmogamous, CH) have the potential capacity to outcross via pollinators, CH progeny produced at any site should outperform selfed CL progeny. We evaluate the effect of fire frequency on the relative production of CL/CH flowers and fruits, and their seed set, along with several progeny performance parameters in Cologania broussonetii (Fabaceae), a resprouting herb with dimorphic cleistogamy native to the Chaco Serrano. Fire frequency increased cleistogamy expression, reaching extreme levels in high fire frequency sites. Seed set was similarly high for both CH and CL flowers in the unburned condition, while in burned sites the few developed CH flowers set more seeds than CL flowers. However, progeny performance was similar between CH and CL progeny at each and across all fire frequency conditions. Cleistogamy expression in C. broussonetii is maximized in abiotically degraded frequently burned habitats, although the selfed CL progeny is as successful as potentially outcrossed CH progeny. Fire frequency may decreased floral size and abundance, selecting for autogamous reproduction, which restricts not only the genetic potential of plant populations but also the resources offered to pollinators. At the community level, increased cleistogamy expression may potentially have negative implications for non-cleistogamous, more outcrossing species surviving in frequently burned environments.

Trichodinids (Ciliophora: Trichodinidae) on Rocky-tidal Fishes from the Baja California Peninsula, Mexico.

Information regarding trichodinid ectoparasites on marine fishes of North America is relatively scarce. In this study, 5 ciliate species from the family Trichodinidae were found associated with 8 fish hosts from the rocky intertidal zone of the western coast of the Baja California Peninsula (BCP), Mexico. All of the host-parasite relationships recorded here are new. Furthermore, 3 of the trichodinid species found are recorded for the first time for Mexico. Trichodinids taxa do not show a noticeable distributional gradient along the BCP, which suggests a wide-continuous distribution of the species throughout the study area.

Número de casos COVID-19 en Chile a 120 días con datos al 21/03/2020 y umbral del esfuerzo diario para aplanar la epi-curva / Number of COVID-19 cases in Chile at 120 days with data at 21/03/2020 and threshold of daily effort to flatten the epi-curve

Realizamos una prospectiva básica, con datos al 21/03/2020 de la evolución del número de casos COVID-19 diarios en Chile con datos del Ministerio de Salud. Asumiendo un crecimiento aritmético en la segunda variación de los datos, se presenta un modelo de ajuste cúbico que estima en más de 100 mil casos a 120 días y que es consistente con los datos registrados a la fecha. Además, se interviene un modelo de casos totales exponencial, para representar en él (mediante un parámetro) el esfuerzo diario por rebajar una elevada primera tasa de crecimiento diario. Este modelo se simula con distinto escenarios numéricos de factibilidad y prevalencia futura deseada.

We present a straightforward projection with data up to 21/03/2020 of the evolution of the number of COVID-19 cases per day in Chile using data from the Ministry of Health. Assuming an arithmetical growth in the second variation of the data, we present a cubic adjustment model in which we estimate over 100 000 cases at 120 days consistent with the data recorded to date. Furthermore, we use an exponential total case model to represent (using a parameter) the daily effort to reduce a high initial daily growth rate. We simulate this model with different numerical scenarios of feasibility and desired future prevalence.

A New Species of Ascarophis (Nematoda: Cystidicolidae) Parasitizing Clinocottus analis (Pisces: Cottidae) from Baja California, Mexico.

A new species of nematode, Ascarophis morronei n. sp. (Cystidicolidae), is described from the stomach wall of the woolly sculpin Clinocottus analis (Cottidae) collected in the rocky intertidal from northwestern Baja California, Mexico. Collected nematodes were studied using both light and scanning electron microscopy. Sequence fragments for 18S rDNA molecular markers were obtained from the new nematode species, in order to test its position within the family Cystidicolidae under a phylogenetic context. Main characters distinguishing this new species include the reduced labia and the morphology of the eggs, distances of nerve ring and excretory pore from the anterior end, and left spicule of males. The new species described here is the second for the genus Ascarophis reported as adult in the Southern California Bight, and the first one recorded for the fish genus Clinocottus.

The ERBB2 gene polymorphisms rs2643194, rs2934971, and rs1058808 are associated with increased risk of gastric cancer.

Gastric cancer (GC) is the third most lethal type of cancer worldwide. Single nucleotide polymorphisms (SNPs) in regulatory sites or coding regions can modify the expression of genes involved in gastric carcinogenesis, as ERBB2, which encodes for the tyrosine-kinase receptor HER-2. The aim of this work was to analyze the association of the polymorphisms: rs2643194, rs2517951, rs2643195, rs2934971, and rs1058808 with GC, as they have not yet been analyzed in GC patients, as well as to report their frequency in the general Mexican population (GMP). We studied genomic DNA from subjects with GC (n=74), gastric inflammatory diseases (GID, n=76 control subjects), and GMP (n=102). Genotypes were obtained by means of real-time PCR and DNA-sequencing. The risks for GC were estimated through odds ratio (OR) using the Cochran-Armitage trend test and multinomial logistic regression. Increased risk for GC was observed under the dominant inheritance model for the rs2643194 TT or CT genotypes with an OR of 2.75 (95%CI 1.12-6.75, P=0.023); the rs2934971 TT or GT genotypes with an OR of 2.41 (95%CI 1.01-5.76, P=0.043), and the rs1058808 GG or CG genotypes with an OR of 2.21 (95%CI 1.00-4.87, P=0.046). The SNPs rs2643194, rs2934971, and rs1058808 of the ERBB2 gene were associated with increased risk for GC.

Morphological and molecular characterization of an enigmatic clinostomid trematode (Digenea: Clinostomidae) parasitic as metacercariae in the body cavity of freshwater fishes (Cichlidae) across Middle America.

The family Clinostomidae Lühe, 1901 contains 29 species allocated to seven genera, of which Clinostomum Leidy, 1856 is the most diverse, with c. 14 valid species. The diversity of Clinostomum has been assessed, combining morphological and molecular data. The genetic library for species in this genus has increased steadily, although there is little or no information for the other genera included in the family. Molecular phylogenetic relationships among the genera of clinostomids have not been assessed, and their classification is still based on morphological traits. The monotypic Ithyoclinostomum was described from a fish-eating bird in Brazil, and its metacercariae have been found in several locations in South America, parasitizing erythrinid freshwater fishes. We collected unusually large metacercariae from the body cavity of cichlids in several locations across Middle America. These metacercariae exhibited some resemblance to Ithyoclinostomum, although several differences prevent their inclusion in Ithyoclinostomum dimorphum, casting doubt on their taxonomic identification. The main objective of this paper was to characterize the metacercariae collected in cichlids using both morphology and molecular data from three molecular markers, and to assess the molecular phylogenetic relationships among the genera of Clinostomidae to establish the position of the newly generated sequences. We took a conservative position and tentatively placed the metacercariae as belonging to Ithyoclinostomum.

The ERBB2 gene polymorphisms rs2643194, rs2934971, and rs1058808 are associated with increased risk of gastric cancer

Gastric cancer (GC) is the third most lethal type of cancer worldwide. Single nucleotide polymorphisms (SNPs) in regulatory sites or coding regions can modify the expression of genes involved in gastric carcinogenesis, as ERBB2, which encodes for the tyrosine-kinase receptor HER-2. The aim of this work was to analyze the association of the polymorphisms: rs2643194, rs2517951, rs2643195, rs2934971, and rs1058808 with GC, as they have not yet been analyzed in GC patients, as well as to report their frequency in the general Mexican population (GMP). We studied genomic DNA from subjects with GC (n=74), gastric inflammatory diseases (GID, n=76 control subjects), and GMP (n=102). Genotypes were obtained by means of real-time PCR and DNA-sequencing. The risks for GC were estimated through odds ratio (OR) using the Cochran-Armitage trend test and multinomial logistic regression. Increased risk for GC was observed under the dominant inheritance model for the rs2643194 TT or CT genotypes with an OR of 2.75 (95%CI 1.12−6.75, P=0.023); the rs2934971 TT or GT genotypes with an OR of 2.41 (95%CI 1.01−5.76, P=0.043), and the rs1058808 GG or CG genotypes with an OR of 2.21 (95%CI 1.00−4.87, P=0.046). The SNPs rs2643194, rs2934971, and rs1058808 of the ERBB2 gene were associated with increased risk for GC.

Temáticas y características metodológicas de la investigación de enfermería publicada en revistas mexicanas: 2010-2015 / Topics and methodological characteristics of nursing research published in Mexican journals: 2010-2015 / Temáticas e caraterísticas metodológicas da pesquisa de enfermagem publicada em revistas mexicanas: 2010-2015

Introducción El desarrollo de la investigación en enfermería es mucho más concreto todos los días; sin embargo, las revistas mexicanas no están dentro de los índices requeridos por el Sistema Nacional de Investigadores para ser consideradas como obras con rigor metodológico y sin sesgos. Objetivo Describir las temáticas y características metodológicas de las publicaciones de enfermería en las principales revistas de México, en los últimos cinco años. Método Estudio descriptivo, retrospectivo y transversal. Se analizaron seis revistas nacionales, que fueron publicadas del segundo semestre del año 2010 al segundo semestre del 2015. La muestra correspondió a 244 artículos originales y/o de investigación. El análisis de resultados se realizó con estadística descriptiva, en el que se utilizaron frecuencias y porcentajes. Resultados Grado de primer autor: posgrado (38.2%). Instituciones de educación superior: (66.8%). Tema central: Clínico (45.8%). No utiliza teoría: (84.0%). De los diseños cuantitativos. Análisis: Descriptivo: (49.1%). Transversal: (73.5%). Sin registro ético: (79.6%). De los diseños cualitativos. Instrumento: Entrevista semiestructurada (83.9%). Codificación: Abierta (80.6%). Rapport (3.2%). Conclusiones La investigación en enfermería debe adoptar criterios de investigación que impliquen una mayor calidad en la forma de hacer investigación, con el fin de considerar los resultados de investigación como parte de un cuerpo de evidencia disciplinar claramente confiable, replicable y útil para rediseñar los procesos en la práctica real de la enfermería.

Introduction Although the development of nursing research is every day becoming more concrete, the related Mexican journals do not fulfill the index level of methodological rigor required by the National System of Researchers. Objective To describe the topics and methodological characteristics of nursing publications in the main Mexican journals in the last 5 years. Method This is a descriptive, retrospective, and transversal study. Six national journals published from the 2nd semester of 2010 to the 2nd semester of 2015 were analyzed. The sample included 244 original and/or research articles. Descriptive statistics, including frequencies and percentages, were calculated. Results Education level of the 1st author: master's degree or superior: 38.2%; institutions of higher studies: 66.8%; main topic: clinical 45.8%; does not use theory: 84.0%. From the studies with a quantitative design: descriptive analysis: 49.1%; transversal: 73.5%; without ethics registry: 79.6%. From the studies with qualitative design: semi-structured interview: 83.9%; open coding: 80.6%; rapport: 3.2%. Conclusions Future nursing research should implement and fulfill the corresponding criteria to enhance its quality, so that its products can become part of a trustable, replication-capable, and useful body of evidence which can drive the development of nursing.

Introdução O desenvolvimento da pesquisa em enfermagem é muito mais concreto todos os dias; porém, as revistas mexicanas não estão dentro dos índices requeridos pelo Sistema Nacional de Pesquisadores para ser consideradas como obras com rigor metodológico e sem vieses. Objetivo Descrever as temáticas e características metodológicas das publicações de enfermagem nas principais revistas do México, nos últimos cinco anos. Método Estudo descritivo, retrospectivo e transversal. Analisaram-se seis revistas nacionais, que foram publicadas do segundo semestre do ano 2010 ao segundo semestre de 2015. A amostra correspondeu a 244 artigos originais e/ou de pesquisa. A análise de resultados realizou-se com estatística descritiva, no que utilizaram frequências e porcentagens. Resultados Grau do primeiro autor: pós-graduação (38.2%). Instituições de educação superior: (66.8%). Tema central: Clínico (45.8%). Não utiliza teoria: (84.0%). Dois desenhos quantitativos. Análise: Descritiva: (49.1%). Transversal: (73.5%). Sem registro ético: (79.6%). Dos desenhos qualitativos. Instrumento: Entrevista semiestruturada (83.9%). Codificação: Aberta (80.6%). Rapport (3.2%). Conclusões A pesquisa em enfermagem deve adoptar critérios de pesquisa que envolvam uma maior qualidade na forma de fazer pesquisa, com o fim de considerar os resultados de pesquisa como parte de um corpo de evidencia disciplinar claramente confiável, replicável e útil para redesenhar os processos na prática real da enfermagem.

Link Between the Adult and the Metacercaria of Clinostomum heluans Braun, 1899 (Trematoda: Clinostomidae) Through DNA Sequences, and its Phylogenetic Position Within the Genus Clinostomum Leidy, 1856.

The phylogenetic position of Clinostomum heluans Braun, 1899 within the genus Clinostomum Leidy, 1856 is reported in this study based on sequences of the barcoding region of the mitochondrial cytochrome c oxidase subunit 1 gene ( COX1). Additionally, molecular data are used to link the adult and the metacercariae of the species. The metacercariae of C. heluans were found encysted infecting the cichlid fish Australoheros sp. in Minas Gerais, Brazil, whereas the adults were obtained from the mouth cavity of the Great White Egret, Ardea alba, in Campeche, Mexico. The COX1 sequences obtained for the Mexican clinostomes and the Brazilian metacercaria were almost identical (0.2% molecular divergence), indicating conspecificity. Similar molecular divergence (0.2-0.4%) was found between sequences of C. heluans reported here and Clinostomum sp. 6 previously obtained from a metacercaria recovered from the cichlid Cichlasoma boliviense in Santa Cruz, Bolivia. Both maximum likelihood and Bayesian inference analyses unequivocally showed the conspecificity between C. heluans and Clinostomum sp. 6, which form a monophyletic clade with high nodal support and very low genetic divergence. Moreover, tree topology reveals that C. heluans occupies a basal position with respect to New World species of Clinostomum, although a denser taxon sampling of species within the genus is further required. The metacercaria of C. heluans seems to be specific to cichlid fish because both samples from South America were recovered from species of this fish family, although not closely related.

Update on the distribution of the co-invasive Schyzocotyle acheilognathi (= Bothriocephalus acheilognathi), the Asian fish tapeworm, in freshwater fishes of Mexico.

The Asian fish tapeworm, Schyzocotyle acheilognathi (syn. Bothriocephalus acheilognathi) represents a threat to freshwater fish, mainly cyprinids, across the globe. This tapeworm possesses an extraordinary ability to adapt to different environmental conditions and, because of that, from its natural geographical origin in mainland Asia, it has colonized every continent except Antarctica. It is thought that this pathogenic tapeworm was first co-introduced into Mexico in 1965 from China, with the grass carp Ctenopharyngodon idella, although the first formal record of its presence was published in 1981. Over the past 35 years, the Asian fish tapeworm has invaded about 22% of the freshwater fish in Mexico. Because fish communities in Mexico are characterized by high species richness and levels of endemism, S. acheilognathi is considered as a co-introduced and co-invasive species. In this review, we update the geographic distribution and host spectrum of the Asian fish tapeworm in Mexico. Up until December 2016, the tapeworm had been recorded in 110 freshwater fish species (96 native and 14 introduced), included in 51 genera, 11 families and 4 orders; it was also widely distributed in all types of aquatic environments, and has been found in 214 localities. We present novel data from a survey aimed at establishing the distribution pattern of the tapeworm in native freshwater fishes of two rivers in north-central Mexico, and the genetic variation among individuals of this co-invasive species collected from different host species and localities. We discuss briefly the factors that have determined the remarkable invasive success of this parasite in freshwater systems in Mexico.

Platelet-lymphocyte and neutrophil-lymphocyte ratios are prognostic but not predictive of response to abiraterone acetate in metastatic castration-resistant prostate cancer.

PURPOSE: Recently neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been reported to be inflammatory parameters that confer poorer outcome in metastatic castration-resistant prostate cancer (mCPRPC). However, these ratios have not been analyzed in patients treated with abiraterone acetate. We explored the relationship between different values of PLR and NLR and survival in mCPRCP treated with abiraterone and their possible relation with a prostate specific antigen (PSA) response. METHODS: We retrospectively analyzed 101 patients with mCRPC treated with abiraterone from January of 2012 to November of 2015 in two different hospitals. A cut-off value of 5 for NLR and 150 for PLR were used to compare survival by Kaplan-Meier method. Moreover, an association between these cut-off values and the PSA response was analyzed by a χ 2 test. RESULTS: In the case of NLR, the median DFS were 12, 1 months for NLR <5 and 7 months for NLR ≥5, p = 0.061. The median OS were 23.9 months for NLR <5 and 16.3 months for NLR ≥5, p = 0.046. In the case of PLR, the median DFS were 11.8 months for PLR <150 and 10.6 months for PLR ≥150, p = 0.549. The median OS were 27.4 months for PLR <150 and 15.9 months for PLR ≥150, p = 0.005. It was not observed a correlation between the different cut-off values of PLR or NLR and a PSA response ≥25% (p = 0.31). CONCLUSIONS: It is shown a better prognostic relationship between PLR and NLR low values and OS that is statistically significant in mCPRC patients treated with abiraterone. Furthermore, it was not shown a relation between PLR and NLR values and PSA response.

Adaptable Optical Fiber Displacement-Curvature Sensor Based on a Modal Michelson Interferometer with a Tapered Single Mode Fiber.

A compact, highly sensitive optical fiber displacement and curvature radius sensor is presented. The device consists of an adiabatic bi-conical fused fiber taper spliced to a single-mode fiber (SMF) segment with a flat face end. The bi-conical taper structure acts as a modal coupling device between core and cladding modes for the SMF segment. When the bi-conical taper is bent by an axial displacement, the symmetrical bi-conical shape of the tapered structure is stressed, causing a change in the refractive index profile which becomes asymmetric. As a result, the taper adiabaticity is lost, and interference between modes appears. As the bending increases, a small change in the fringe visibility and a wavelength shift on the periodical reflection spectrum of the in-fiber interferometer is produced. The displacement sensitivity and the spectral periodicity of the device can be adjusted by the proper selection of the SMF length. Sensitivities from around 1.93 to 3.4 nm/mm were obtained for SMF length between 7.5 and 12.5 cm. Both sensor interrogations, wavelength shift and visibility contrast, can be used to measure displacement and curvature radius magnitudes.

Continuidad de cuidados para la adherencia terapéutica en la persona con diabetes tipo 2 / Fostering therapeutical adherence among persons with diabetes type 2 through care continuity / Continuidade de cuidados para a aderência terapêutica na pessoa com diabetes tipo 2

En México existen 8.7 millones de personas con diabetes tipo 2 (DT2), lo que ha generado un costo por sus complicaciones de 834 dólares al año por persona y 70,281 defunciones. En estas cifras quizá influya la falta de adherencia terapéutica. Estudios recientes han encontrado que la continuidad de cuidados puede generar un impacto positivo en la salud de las personas con DT2. Descripción del caso: Los señores M de 40 años y P de 44 años fueron diagnosticados con DT2 hace más de un año; la señora M se encuentra con niveles de glucemia estable; el señor P, a causa del descontrol glucémico, en 2013 fue hospitalizado. Objetivo: Evaluar, en 2 adultos con DT2, la capacidad de adherencia terapéutica, que se fortaleció mediante la continuidad de cuidados realizada en su domicilio con base en intervenciones educativas de enfermería, fundamentadas en el Modelo de Adaptación de Sor Callista Roy. Metodología: Estudio de caso. Se realizó valoración física y control glucémico. Se diseñaron 3 intervenciones educativas de enfermería. Resultados En el pretest de adherencia terapéutica se obtuvieron percentiles bajos del 33% y medios del 66%. Después de las intervenciones se encontró un incremento respecto al ejercicio físico (70 y 75%), valoración de la condición física (23 y 75%) y dieta (86 y 87%), evidenciada por la mejora en sus niveles glucémicos (postest). Conclusiones: El modelo teórico de enfermería permitió comprender y desarrollar de mejor manera la continuidad de cuidados en el contexto familiar, al favorecer la adaptación de la DT2 mediante la adherencia terapéutica, lo que muestra una estrategia adecuada para mejorar la salud de esta población.

In Mexico, approximately 8.7 million persons are living with diabetes type 2 (DT2). This illness caused in a single year 70,281 deaths as well as complications-costs of around 834 dollars per person. A possible factor could be the patient's lack of therapeutical adherence. Recent studies have reported that care continuity can produce a positive impact on the health of persons with DT2. Case description Persons M and P of 40 and 44 year old respectively were diagnosed with DT2 more than a year ago; while person M has been stable, person P was hospitalized in 2013 due to uncontrolled blood glucose levels. Objective: To assess the therapeutical adherence capacity of these 2 adults with DT2 after care continuity nursing educational interventions based on Callista Roy Adaptation Model of Nursing were given at their homes. Metodology: The case study, Physical examination and TA glycemic control were done. Three educational nursing interventions were designed. Results In the therapeutical adherence pre-test, low and medium percentiles of 33% and 66% were obtained. After the interventions, improvements in physical exercise (70% and 75%), physical condition (23% and 75%) and diet (86% and 87%), as well as in glucose indexes were found. Conclusions: By favoring therapeutical adherence, the nursing theoretical model allowed the understanding and development of care continuity within the family-context, suggesting that it is an adequate strategy to improve the health of populations with DT2.

No México existem 8.7 milhões de pessoas com diabetes tipo 2 (DT2), o que tem gerado um custo por suas complicações de 834 dólares no ano por pessoa e 70,281 mortes. O anterior, é possível que influencie a falta de aderência terapêutica. Estudos recentes têm encontrado que a continuidade de cuidados pode gerar um impacto positivo na saúde das pessoas com DT2. Descrição do caso: Os senhores M de 40 anos e P de 44 anos, foram diagnosticados com DT2 há mais de um ano, a senhora M encontra-se com níveis de glicemia estável, o senhor P, a causa do descontrolo glicêmico em 2013 foi hospitalizado. Objetivo: Avaliar, em 2 adultos com DT2, a capacidade de aderência terapêutica, que se fortaleceu mediante a continuidade de cuidados realizada na sua moradia com base em intervenções educativas de enfermagem, fundamentadas no Modelo de Adaptação de Sor Callista Roy. Metodologia: Estudo de caso. Realizou-se uma apreciação física e controle glicémico. Desenharam-se 3 intervenções educativas de enfermagem. Resultados: No pré-teste de AT obtiveram-se percentis baixos de 33% e médios de 66%. Depois das intervenções encontrou-se um incremento no que respeita ao exercício físico (70% e 75%), avaliação da condição física (23% e 75%) e regime (86% e 87%), evidenciado pela melhora nos seus níveis glicêmicos (post-teste). Conclusões: O modelo teórico de enfermagem permitiu compreender e desenvolver de melhor maneira a continuidade de cuidados no contexto familiar, favorecendo a adaptação da DT2 mediante a aderência terapêutica, o que sugere uma estratégia adequada para melhorar a saúde desta população.

Continuidad del cuidado: adulto mayor con diabetes tipo 2 y su cuidador / Continuity of care: Aged with diabetes type 2 and their caregiver / Continuidade do cuidado: Idoso com diabete tipo 2 e o seu cuidador

Objetivo: Aplicar la continuidad del cuidado en la persona con diabetes tipo 2 (DT2) y su cuidador, posterior al egreso hospitalario a través de intervenciones de enfermería domiciliaria que contribuyan a mejorar el estilo de vida. Método: Se trata un proceso de enfermería a un adulto mayor con DT2 y a su cuidador primario, mediante una valoración de enfermería inicial y la medición del conocimiento de la enfermedad a través del Cuestionario de Conocimiento en Diabetes-24 y estilo de vida, con el Instrumento para Medir el Estilo de Vida en Diabéticos. La identificación de necesidades con la taxonomía NANDA permitió intervenciones de tipo informacional, de relación y gestión basadas en la Clasificación de Intervenciones de Enfermería para la continuidad del cuidado. Las intervenciones educativas fueron ejecutadas en sesiones periódicas, bajo consentimiento informado de los participantes, a través de una metodología interactiva. La efectividad fue evaluada con una valoración final de la persona con DT2 y cuidador. Resultados: Se observó un incremento del nivel de conocimientos de la enfermedad y una mejora en el estilo de vida, de la persona con DT2 y su cuidador, en los dominios: nutrición, actividad física, emociones y adherencia terapéutica. Conclusión: La continuidad del cuidado en la persona con DT2 y su cuidador es una herramienta indispensable para mejorar el estilo de vida y nivel de conocimientos, disminuir el riesgo de complicaciones y evitar reingresos hospitalarios.

Objective: To establish the continuity care on persons suffering from diabetes type 2 (DT2) and their caregiver following hospital discharge, through home-visit interventions which can contribute to the improvement of lifestyles. Method: The nursing process was performed on a patient with DT2 and the corresponding primary caregiver through a nursing assessment which included the use of the 24-Diabetes Knowledge Questionnaire and the Instrument to Measure Lifestyles in patients with Diabetes Type 2. The identification of needs through the NANDA taxonomy allowed informational, relational and managerial interventions based on the Nursing Interventions Classification. The educational interventions were performed during periodic sessions under the informed consent of the participants and through an interactive methodology. The effectiveness was assessed through a final evaluation of the patient and corresponding caregiver. Results: An increment in the level of knowledge of the illness and an improvement in the lifestyle of the person with DT2 and the corresponding caregiver, in the nutrition, physical activity, emotions, and therapeutic adherence domains were observed. Conclusion: The continuity care on the person with DT2 is a critical tool to improve the lifestyle and level of knowledge, and to reduce the risk of complications and hospital re-entries.

Objetivo: Aplicar a continuidade de cuidado na pessoa com diabete tipo 2 (DT2) e seu cuidador à saída hospitalar, através de intervenções de enfermagem domiciliar que contribuam a melhorar o estilo de vida. Método: Trata-se de um processo de enfermagem a um idoso com DT2 e a seu cuidador primário, mediante uma valoração de enfermagem inicial e a medição do conhecimento da doença, a través do questionário de conhecimento em diabete-24 (DKQ-24) e estilo de vida com o instrumento para medir o estilo de vida em diabéticos (IMEVID), A identificação de necessidades com a taxonomia NANDA permitiu intervenções de tipo informacional, de relação e gestão baseadas no NIC para a continuidade do cuidado. As intervenções educativas foram executadas em sessões periódicas, sob o consentimento prévio 2 participantes, a través de uma metodologia interativa. A efetividade foi avaliada com uma valorização final da pessoa com DT2 e cuidador. Resultados: Observou-se um incremento do nível de conhecimentos da doença e uma melhoria no estilo de vida, da pessoa com DT2 e seu cuidador, nos domínios: nutrição, atividade física, emoções e aderência terapêutica. Conclusão: A continuidade do cuidado na pessoa com DT2 e seu cuidador é uma ferramenta indispensável para melhorar o estilo de vida e nível de conhecimentos, diminuir o risco de complicações e evitar reingressos hospitalares.

La enseñanza de la enfermería con simuladores, consideraciones teórico-pedagógicas para perfilar un modelo didáctico / Nursing teaching using simulators, theoretical and pedagogical considerations to design a didactic model / O ensino da enfermagem com simuladores, considerações teórico-pedagógicas para perfilar um modelo didático

Introducción: La incorporación de simuladores de alta fidelidad en la enseñanza de la enfermería constituye una práctica educativa que tiende a extenderse en razón de constituir un entorno educativo favorable para el desarrollo de habilidades en los alumnos y paralelamente aportar condiciones éticas de mayor seguridad en el paciente. Desarrollo: La incorporación de estas tecnologías ofrece nuevas posibilidades educativas en la formación de enfermería, pero es preciso revisar las bases teóricas que conforman un modelo pedagógico, así como esclarecer los nuevos roles que adquieren docentes y alumnos en estos nuevos escenarios de enseñanza aprendizaje. La consideración del concepto de aprendizaje experiencial de John Dewey, así como de zona de desarrollo próximo del constructivismo sociocultural de Vygotsky, aportan elementos sugerentes para la construcción de un modelo pedagógico. Estas consideraciones teóricas demandan el desarrollo de nuevas competencias en el docente, como son el diseño de escenarios de enseñanza aprendizaje, su adecuada ejecución y su evaluación, bajo una concepción de aprendizaje que pone en el centro la actividad del alumno. Experiencias educativas que han empleado simuladores de alta fidelidad reportan que si bien en todos los casos se incrementa la habilidad y la seguridad del alumno, pueden resultar poco estimulantes por su falta de realismo. Conclusiones: El uso de simuladores no debe centrarse solamente en la ejercitación de procedimientos manuales, sino generar paralelamente un entorno de aprendizaje en el que se integren el desarrollo de otras habilidades como la comunicación, reflexión, pensamiento crítico, toma de decisiones y la consideración del paciente como un ente humano complejo.

Introduction: The incorporation of high-fidelity simulators in nursing teaching is an educational practice which tends to spread because it promotes the development of skills in students as well as higher ethical conditions of safety for the patient. Development: The incorporation of these technologies offers new educational possibilities for nursing teaching, yet it is necessary to review the theoretical foundations which support pedagogical models, as well as to clarify the new roles which both teachers and students adopt for these new teaching-learning scenarios. The concept of experience learning of John Dewey and the concept of the proximal development zone of Vygotsky contribute to integrate new pedagogical models. These theoretical considerations demand that teachers develop new competences including those related to scenarios design and program execution and assessment, all of these under a learning conception which places the student at the center of the activity. However, some educational programs which have used high-fidelity simulators report that, although there were improvements in student skills and safety, sometimes these practices can be not stimulating enough due to a lack of realism. Conclusions: The use of simulators should not be only centered on manual procedures practices but also on the generation of a learning environment which promotes the development of other skills such as communication, reflection, critical thought, decision taking, and the conception of the patient as a complex human entity.

Introdução: A incorporação de simuladores de alta-fidelidade no ensino da enfermagem constitui uma prática educativa que tende a espalhar-se, com o objetivo de constituir um ambiente educativo favorável para o desenvolvimento de competências nos alunos e paralelamente contribuir às condições éticas de maior segurança no paciente. Desenvolvimento: A incorporação destas tecnologias oferece novas possibilidades educativas de formação da enfermagem, mas é preciso revisar as bases teóricas que conformam um modelo pedagógico, bem como esclarecer os novos papéis que conseguem docentes e alunos nestes novos cenários de ensino-aprendizagem. A consideração do conceito de aprendizagem experiencial de John Dewey, bem como da zona de desenvolvimento próximo do construtivismo de Vygotsky, oferecem elementos provocadores para a construção de um modelo pedagógico. Estas considerações teóricas demandam o desenvolvimento de novas competências no docente, como são o desenho de cenários de ensino-aprendizagem, a sua adequada execução e avaliação, sob uma concepção de aprendizagem que coloca o aluno no centro da atividade. Experiências educativas que têm empregado simuladores de alta-fidelidade reportam que, apesar de aumentarem a competência e a segurança do aluno em todos os casos, podem resultar pouco motivadores pela sua falta de realismo. Conclusões: O uso de simuladores não se deve concentrar somente na exercitação de procedimentos manuais, senão gerar paralelamente um ambiente de aprendizagem no qual se integrem o desenvolvimento de outras competências de comunicação, reflexão, pensamento crítico, tomada de decisões e a consideração do paciente como ser humano complexo.

Desafío diagnóstico

Caso Clínico Neonato de 23 días de vida, hijo de madre de 17 años primigesta, que acude a cuarto de urgencias hospitalario con historia de lesiones en área perineal que iniciaron a la semana de vida, luego de un parto en casa atendido por partera. Luego de la aparición de la lesiones presentó ebre no cuanti cada, tos húmeda, rinorrea hialina y distensión abdominal de 2 semanas de evolución. Examen Físico Positivo: Paciente activo, febril (38.7oC), pulmones con crépitos bilaterales, abdomen timpánico y distendido, en los genitales se evidenciaba el escroto con úlceras de color verdoso de 3 x 2 cm con áreas necróticas y bordes hiperpigmentados. Exámenes de laboratorios: Hemograma con leucocitos en (18300cel/mm3) N: 52%, L: 28%, hemoglobina 13.7g/dl, plaquetas 455,000 cel/mm3, proteína C reactiva: 1.6 mg/dl. Punción lumbar normal.

Evaluación del conocimiento del Proceso de Atención de Enfermería: Estudiantes de licenciatura de Enfermería. Facultad "Lidia Doce". 2013 / Assessment of knowledge of the Nursing Assistive Process: Undergraduate Nursing students. "Lidia Doce" Faculty. 2013 / Avaliação do conhecimento no Processo de Atenção de Enfermagem: Estudantes de Licenciatura de Enfermagem. Faculdade "Lidia Doce". 2013

La aplicación, a partir de 1995, del Proceso de Atención de Enfermería (PAE) como método sistemático de intervención para la implementación de cuidados profesionales provocó, impacto a nivel nacional e internacional. Objetivo: Evaluar conocimientos del Proceso de Atención de Enfermería en un grupo de alumnos que están concluyendo su formación académica. Método: Se realizó un estudio descriptivo, transversal, aplicando encuesta anónima autoadministrada a estudiantes de 5º año Facultad de Enfermería ¨Lidia Doce" en abril 2013. La encuesta fue aplicada a 33 estudiantes de 38 que constituían la matrícula física y que fueron encuestados al mismo tiempo en las diferentes rotaciones, previo consentimiento informado. Se analizaron variables cognoscitivas (valoración, intervención, evaluación) y se identificaron problemas por etapas, se calificó de aprobados y desaprobados. Resultados: La etapa de intervención aportó mayor número de desaprobados, existen errores en las tres etapas estudiadas. Discusión: Las observaciones obtenidas en el presente estudio confirman otras evidencias relacionadas con la dificultad del conocimiento en el Proceso de Atención de Enfermería, sobre todo en la etapa de intervención.

The establishment, in 1995, of the Nursing Assistive Process (NAP) as a systematic method of intervention for the implementation of professional care generated an important impact both nationally and internationally. Objective: To assess the knowledge of the nursing assistive process among students who are finishing their academic training. Method: A descriptive, transversal study using self-administered anonymous interviews with students from the "Lidia Doce" Nursing Faculty in their 5th year during April 2013. The interview was distributed to 33 of a total of 38 students at the same time during several shifts, and who signed the corresponding Informed Consent form. Cognitive variables (assessment, intervention, evaluation) were analyzed, and problems were identified by stages - the results were either approved or not approved. Results: The intervention stage produced a higher number of non-approvals. There were errors in the three studied stages. Discussion: The observations confirm other evidence related to the difficulty of knowledge of the Nursing Assistive Process, particularly at the intervention stage.

A aplicação do Processo de Atenção de Enfermagem (PAE) a partir de 1995 como método sistemático de intervenção para a implementação de cuidados profissionais, originou um impacto a nível nacional e internacional. Objetivo: Avaliar conhecimentos do processo de atenção de enfermagem num grupo de alunos que estão a concluir a sua formação académica. Método: Realizou-se um estudo descritivo, transversal, aplicando uma sondagem anónima auto-administrada a estudantes do quinto ano na faculdade de enfermagem "Lidia Doce" em Abril de 2013. A sondagem foi aplicada a 33 estudantes em 38, que constituíam a matrícula física e de igual forma lhes foi aplicado o questionário nas diferentes rondas, com consentimento prévio e informado. Analisaram-se variáveis cognoscitivas (valorização, intervenção e avaliação) e identificaram-se problemas por etapas, bem como dar nota para aprovação e desaprovação. Resultados: A etapa de intervenção deu um maior número de desaprovados, porém existem erros nas três etapas estudadas. Discussão: As observações obtidas no presente estudo confirmam outras evidências relacionadas com a dificuldade de conhecimento no processo de atenção de enfermagem, sobretudo na etapa da intervenção.