Metal Nanoparticle-Based Biosensors for the Early Diagnosis of Infectious Diseases Caused by ESKAPE Pathogens in the Fight against the Antimicrobial-Resistance Crisis.

The species included in the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and the genus Enterobacter) have a high capacity to develop antimicrobial resistance (AMR), a health problem that is already among the leading causes of death and could kill 10 million people a year by 2050. The generation of new potentially therapeutic molecules has been insufficient to combat the AMR "crisis", and the World Health Organization (WHO) has stated that it will seek to promote the development of rapid diagnostic strategies. The physicochemical properties of metallic nanoparticles (MNPs) have made it possible to design biosensors capable of identifying low concentrations of ESKAPE bacteria in the short term; other systems identify antimicrobial susceptibility, and some have been designed with dual activity in situ (bacterial detection and antimicrobial activity), which suggests that, in the near future, multifunctional biosensors could exist based on MNPs capable of quickly identifying bacterial pathogens in clinical niches might become commercially available. This review focuses on the use of MNP-based systems for the rapid and accurate identification of clinically important bacterial pathogens, exhibiting the necessity for exhaustive research to achieve these objectives. This review focuses on the use of metal nanoparticle-based systems for the rapid and accurate identification of clinically important bacterial pathogens.

Identificación de dimensiones del síndrome de burnout en estudiantes de Contaduría y Finanzas / Identification of dimensions of burnout syndrome in Accounting and Finance students / Identificação das dimensões da síndrome de burnout em estudantes de Contabilidade e Finanças

El síndrome de burnout, también conocido como síndrome del desgaste o agotamiento físico y mental, constituye un problema de gran repercusión social en nuestros días. Objetivo. Identificar las dimensiones del síndrome de Burnout en estudiantes universitarios de la Carrera de Contaduría y Finanzas. Materiales y Método. Se desarrolló bajo un diseño observacional de corte transversal. En este sentido, un total de 161 estudiantes participaron en la investigación. Se utilizó el Maslach Burnout Inventory for Educators. Resultados. Los participantes al ser clasificados en las diferentes dimensiones del síndrome burnout mostraron como regularidad diferencias significativas (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) con 74 (46%) y 57 (35%), 85 (53%) y 47 (29%) y 91 (56%) y 39 (24%) para los niveles bajo y alto de las dimensiones agotamiento emocional, cinismo e ineficacia profesional, respectivamente. No se encontraron asociaciones estadísticas entre las dimensiones del síndrome y las variables edad, género y estado civil de los participantes. Conclusión. Existen diferencias significativas entre los valores de las dimensiones del síndrome de burnout en estudiantes de la Carrera de Contaduría y Finanzas; la mayor cantidad de participantes clasifican en los niveles bajo y alto de las tres dimensiones. Por otro lado, no se observaron asociaciones estadísticas al clasificar a los participantes según edad, género y estado civil. Estos hallazgos brindan información relevante sobre la prevalencia de las dimensiones del síndrome de burnout en estudiantes, lo que puede ser útil para el desarrollo de estrategias de prevención y apoyo.

Burnout syndrome, also known as burnout syndrome or physical and mental exhaustion, is a problem of great social repercussion nowadays. Objective. To identify the dimensions of burnout syndrome in university students of Accounting and Finance. Materials and Method. The study was developed under a cross-sectional observational design. In this sense, a total of 161 students participated in the research. The Maslach Burnout Inventory for Educators was used. Results. The participants when classified in the different dimensions of burnout syndrome showed as regularity significant differences (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) with 74 (46%) and 57 (35%), 85 (53%) and 47 (29%) and 91 (56%) and 39 (24%) for the low and high levels of the dimensions emotional exhaustion, cynicism and professional inefficacy, respectively. No statistical associations were found between the dimensions of the syndrome and the variables age, gender and marital status of the participants. Conclusion. There are significant differences between the values of the dimensions of burnout syndrome in Accounting and Finance students; most participants are classified in the low and high levels of the three dimensions. On the other hand, no statistical associations were observed when classifying participants according to age, gender and marital status. These findings provide relevant information on the prevalence of the dimensions of burnout syndrome in students, which may be useful for the development of prevention and support strategies.

A síndrome de burnout, também conhecida como síndrome de esgotamento ou exaustão física e mental, é um problema com grandes repercussões sociais nos dias de hoje. Objetivos. Identificar as dimensões da Síndrome de Burnout em estudantes universitários de Contabilidade e Finanças. Material e Método. O estudo foi realizado através de um desenho observacional transversal. Participaram da pesquisa 161 estudantes. Foi utilizado o Maslach Burnout Inventory for Educators. Resultados. Os participantes quando classificados nas diferentes dimensões da síndrome de burnout apresentaram regularmente diferenças significativas (p<1,056e-06), (p<1,199e-10), (p<1,309e-13) com 74 (46%) e 57 (35%), 85 (53%) e 47 (29%) e 91 (56%) e 39 (24%) para os níveis baixo e alto das dimensões exaustão emocional, cinismo e ineficácia profissional, respetivamente. Não foram encontradas associações estatísticas entre as dimensões da síndrome e as variáveis idade, género e estado civil dos participantes. Conclusões. Existem diferenças significativas entre os valores das dimensões da síndrome de burnout em estudantes de Contabilidade e Finanças; a maioria dos participantes está classificada nos níveis baixo e alto das três dimensões. Por outro lado, não foram observadas associações estatísticas ao classificar os participantes de acordo com a idade, o género e o estado civil. Estes resultados fornecem informações relevantes sobre a prevalência das dimensões da síndrome de burnout em estudantes, o que pode ser útil para o desenvolvimento de estratégias de prevenção e apoio.

Application of artificial intelligence for the optimization of advanced oxidation processes to improve the water quality polluted with pharmaceutical compounds.

Sulfamethoxazole and metronidazole are emerging pollutants commonly found in surface water and wastewater. These compounds have a significant environmental impact, being necessary in the design of technologies for their removal. Recently, the advanced oxidation process has been proven successful in the elimination of this kind of compounds. In this sense, the present work discusses the application of UV/H2O2 and ozonation for the degradation of both molecules in single and binary systems. Experimental kinetic data from O3 and UV/H2O2 process were adequately described by a first and second kinetic model, respectively. From the ANOVA analysis, it was determined that the most statistically significant variables were the initial concentration of the drugs (0.03 mmol L-1) and the pH = 8 for UV/H2O2 system, and only the pH (optimal value of 6) was significant for degradation with O3. Results showed that both molecules were eliminated with high degradation efficiencies (88-94% for UV/H2O2 and 79-98% for O3) in short reaction times (around 30-90 min). The modeling was performed using a quadratic regression model through response surface methodology representing adequately 90 % of the experimental data. On the other hand, an artificial neural network was used to evaluate a non-linear multi-variable system, a 98% of fit between the model and experimental data was obtained. The identification of degradation byproducts was performed by high-performance liquid chromatography coupled to a time mass detector. After each process, at least four to five stable byproducts were found in the treated water, reducing the mineralization percentage to 20% for both molecules.

New trends in modelling of breakthrough curves to remove pollutants using adsorption on advanced monoliths geometries.

This work proposes a rigorous mathematical model capable of reproducing the adsorption process in dynamic regime on advanced monoliths geometries. For this, four bed geometries with axisymmetric distribution of channels and similar solid mass were proposed. In each geometry a different distribution of channels was suggested, maintaining constant the bed dimensions of 15 cm high and 5 cm radius. The mathematical modeling includes mass and momentum transfer phenomena, and it was solved with the COMSOL Multiphysics software using mass transfer parameters published in the literature. The overall performance of the column was evaluated in terms of breakthrough (CA/CA0 = 0.1) and saturation times (CA/CA0 = 0.9). The mass and velocity distributions obtained from the proposed model show good physical consistency with what is expected in real systems. In addition, the model proved to be easy to solve given the short convergence times required (2-4 h). Modifications were made to the bed geometry to achieve a better use of the adsorbent material which reached up to 80%. The proposed bed geometries allow obtaining different mixing distributions, in such a way that inside the bed a thinning of the boundary layer is caused, thus reducing diffusive effects at the adsorbent solid-fluid interface, given dissipation rates of about 323 × 10-11 m2/s3. The bed geometry composed of intersecting rings deployed the best performance in terms of usage of the material adsorbent, and acceptable hydrodynamical behavior inside the channels (maximum fluid velocity = 35.4 × 10-5 m/s and drop pressure = 0.19 Pa). Based on these results, it was found that it is possible to reduce diffusional effects and delimit the mass transfer zone inside the monoliths, thus increasing the efficiency of adsorbent fixed beds.

Vivencias de enfermeras con COVID-19 aisladas en el entorno familiar / Living Experiences of Nurses with COVID-19 and Isolated in the Family Environment

Introducción: La pandemia de COVID-19 afectó a toda la población, incluido el personal de salud, como las enfermeras. Estas, al vivenciar la enfermedad, adquirieron valiosas experiencias que les permitieron resignificar su existencia como seres en el mundo. Objetivo: Comprender las vivencias de las enfermeras con COVID-19 aisladas en el entorno familiar. Métodos: Se realizó un estudio cualitativo-fenomenológico desde la perspectiva existencialista de Heidegger, participaron 13 enfermeras que laboraban en hospitales de Lima-Perú; durante los meses de octubre 2020 a junio de 2021. La muestra fue por "saturación teórica". Se aplicaron entrevistas en profundidad por vía virtual, se utilizaron preguntas orientadoras, los testimonios fueron grabados y transcritos previa autorización. Para el tratamiento de los datos, estos se sometieron al análisis temático de Braun y Clarke. Resultados: Luego de la transcripción, codificación y reducción fenomenológica de los discursos, se obtuvieron dos categorías: 1. El "cuidar de" y el "estar-con" experiencia del aislamiento en el entorno familiar, subcategorías: Reacción frente al diagnóstico y Contagio familiar. Categoría 2: El "ser ahí" y la angustia al vivenciar la enfermedad por COVID-19 Subcategorías: Lecciones de vida y Significado de la pandemia. Conclusiones: Las enfermeras con COVID-19, en aislamiento en su hogar, vivenciaron lecciones que las hicieron revalorar la vida, la salud y el amor de la familia, lo que ha fortalecido su compromiso de brindar un cuidado humanizado; se destacan la fortaleza personal y la esperanza como elementos que les permite enfrentar el temor, la desesperación y el miedo a la muerte. Entre más se conoce el sujeto a sí mismo más grande es su actitud de cuidado, por lo que el cuidado representa un modo de ser esencial de la enfermera(AU)

Introduction: The COVID-19 pandemic affected the entire population, including the health personnel, such as nurses. Nurses, by living through the disease, acquired valuable experiences that allowed them to redefine their existence as beings in the world. Objective: To understand the experiences of nurses with COVID-19 and isolated in the family environment. Methods: A qualitative-phenomenological study was conducted from the existentialist perspective of Heidegger. Thirteen nurses working in hospitals in Lima, Peru, participated during the months from October 2020 to June 2021. The sample was obtained by "theoretical saturation." In-depth interviews were conducted virtually, using guiding questions; and the testimonies were recorded and transcribed with prior authorization. For data processing, they were subjected to Braun and Clarke's thematic analysis. Results: After transcription, coding and phenomenological reduction of the discourses, two categories were obtained: 1. "Taking care of" and "Being with" in related to the isolation experience in the family environment, with the subcategories of reaction to the diagnosis and family contagion; and 2. "Being there" and distress when experiencing the disease by COVID-19, with the subcategories of life lessons and meaning of the pandemic. Conclusions: Nurses with COVID-19 and isolated at home experienced lessons that made them revalue life, health and family love, which has strengthened their commitment to providing humanized care; personal strength and hope stand out as elements that allow them to face fear, despair and fear of death. The more any subject knows themselves, the greater their caring attitude, so that caring represents a nurse's essential way of being(AU)

Anemia y el desarrollo de la psicomotricidad en la primera infancia / Anemia and the development of psychomotor skills in early childhood / Anemia e desenvolvimento psicomotor na primeira infância

Los bajos niveles de hemoglobina se definen como una concentración baja de hemoglobina en la sangre. La activad metabólica cerebral está vinculada con el desarrollo psicomotor. El desarrollo psicomotor durante la infancia se desarrolla a partir de los reflejos innatos, se organizan en esquemas de conducta, se internalizan durante el segundo año de vida como modelos de pensamiento. En Perú, se contabilizan el 50.99% de los niños con bajos niveles de concentración de hemoglobina en menores de 3 años. Objetivo. Identificar la relación entre la anemia y el desarrollo de la psicomotricidad en la primera infancia. Materiales y Métodos. Para evaluar los niveles de hemoglobina se empleó el método de la azidametahemoglobina, con un hemoglobinómetro, y para evaluar el desarrollo psicomotor se empleó la escala del desarrollo psicomotor. En el estudio participaron 32 niños de 6 a 24 meses de edad. Resultados. El 40,6% presenta niveles de hemoglobina entre 14,2 - 17.2 g/dl, el 31,3% presenta niveles de hemoglobina entre 13.2 -14.1 g/dl seguido del 25,0% que presenta niveles de hemoglobina entre 10,2 -13.1 g/dl y el 3.1% presenta niveles de hemoglobina <10.2 g/dl; respecto al desarrollo psicomotor expresados en coeficiente de desarrollo se evidencia que el 59.4% de niños muestran un desarrollo normal seguido del 31.3% de niños que presenta un desarrollo en riesgo y 9.4% en retraso. Conclusiones. El coeficiente de desarrollo del niño(a) se encontró que la mayoría tiene un desarrollo psicomotor normal seguido de riesgo y de retraso, a pesar que mayoría tiene un coeficiente de desarrollo normal

Low hemoglobin levels are defined as a low hemoglobin concentration in the blood. Brain metabolic activity is linked to psychomotor development. Psychomotor development during infancy develops from innate reflexes, which are organized in behavioral schemes and internalized during the second year of life as thought models. In Peru, 50.99% of children under 3 years of age have low hemoglobin concentration levels. Objective. To identify the relationship between anemia and psychomotor development in early childhood. Materials and Methods. To evaluate hemoglobin levels, the azidametahemoglobin method was used, with a hemoglobinmeter, and to evaluate psychomotor development the psychomotor development scale was used. Thirty-two children aged 6 to 24 months participated in the study. Results. 40.6% presented hemoglobin levels between 14.2 - 17.2 g/dl, 31.3% presented hemoglobin levels between 13.2 -14.1 g/dl followed by 25.0% presenting hemoglobin levels between 10.2 -13.1 g/dl and 3.1% presented hemoglobin levels <10. 2 g/dl; with respect to psychomotor development expressed in development coefficient, 59.4% of children show normal development followed by 31.3% of children with development at risk and 9.4% with delayed development. Conclusions. The development coefficient of the child showed that most of the children have a normal psychomotor development followed by at risk and retardation, although most of them have a normal development coefficient.

Níveis baixos de hemoglobina são definidos como uma baixa concentração de hemoglobina no sangue. A atividade metabólica do cérebro está ligada ao desenvolvimento psicomotor. O desenvolvimento psicomotor durante a infância se desenvolve a partir de reflexos inatos, que são organizados em padrões de comportamento e internalizados durante o segundo ano de vida como padrões de pensamento. No Peru, 50,99% das crianças com menos de 3 anos de idade têm baixas concentrações de hemoglobina. Objetivo. Identificar a relação entre a anemia e o desenvolvimento psicomotor na primeira infância. Materiais e métodos. Para avaliar os níveis de hemoglobina, foi usado o método da azidameta-hemoglobina, com um hemoglobinômetro portátil HemoCue® Hb 201+ e, para avaliar o desenvolvimento psicomotor, foi usada a escala de desenvolvimento psicomotor. Trinta e duas crianças com idade entre 6 e 24 meses participaram do estudo. Resultados. 40,6% tinham níveis de hemoglobina entre 14,2 - 17,2 g/dl, 31,3% tinham níveis de hemoglobina entre 13,2 -14,1 g/dl, seguidos por 25,0% com níveis de hemoglobina entre 10,2 -13,1 g/dl e 3,1% com níveis de hemoglobina <10. 2 g/dl; com relação ao desenvolvimento psicomotor expresso em coeficiente de desenvolvimento, é evidente que 59,4% das crianças apresentam um desenvolvimento normal, seguido por 31,3% de crianças que apresentam um desenvolvimento em risco e 9,4% em atraso. Conclusões. O coeficiente de desenvolvimento infantil mostrou que a maioria das crianças tem um desenvolvimento psicomotor normal, seguido por risco e atraso, embora a maioria delas tenha um coeficiente de desenvolvimento normal.

Salud mental y calidad de sueño en los docentes de educación básica regular / Mental health and sleep quality in regular basic education teachers / Saúde mental e qualidade do sono em professores da educação básica regular

La mala calidad de sueño afecta la salud física y mental, por lo que dormir lo suficiente ayuda a activar la mente y prevenir problemas de salud. Objetivo. El propósito de este estudio fue identificar la salud mental y la calidad de sueño durante la pandemia por la COVID-19. Materiales y método. Se aplicaron tres encuestas en línea (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) y PSQI (Pittsburgh Sleep Quality Index) a 203 profesores de la región de Puno entre damas y varones (102 varones y 101 mujeres) con edades de 25 años hasta 58 años (Edad promedio = 39,19 ±5,47 años), los mismos que cumplieron el aislamiento social obligatorio. Resultados. Los niveles de ansiedad identificados en el estudio fueron altos, el 55,88 % de los varones y el 60,40 % de las mujeres presentan trastornos de depresión; el 77,45 % de los varones y el 70,30 % de las mujeres presentan trastornos de ansiedad y el 47, 06 % de los varones y el 44,55 % de las mujeres presentan una pobre calidad de sueño. Conclusiones. Estos factores afectan a la salud mental de la población por lo que es necesario abordar los problemas de salud mental de las personas durante esta pandemia de COVID-19.

Poor sleep quality affects physical and mental health, so getting enough sleep helps to activate the mind and prevent health problems. Objective. The purpose of this study was to identify mental health and sleep quality during the COVID-19 pandemic. Materials and Method. Three online surveys (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) and PSQI (Pittsburgh Sleep Quality Index) were applied to 203 teachers in the Puno region between women and men (102 men and 101 women) aged 25 years to 58 years (mean age = 39.19 ±5.47 years), the same who met the mandatory social isolation. Results. The levels of anxiety identified in the study were high, 55.88 % of the males and 60.40 % of the females presented depressive disorders; 77.45 % of the males and 70.30 % of the females presented anxiety disorders and 47.06 % of the males and 44.55 % of the females presented poor sleep quality. Conclusions. These factors affect the mental health of the population so it is necessary to address the mental health problems of people during this pandemic of COVID-19.

A má qualidade do sono afeta a saúde física e mental, portanto, dormir o suficiente ajuda a ativar a mente e a prevenir problemas de saúde. Objetivo. O objetivo deste estudo foi identificar a saúde mental e a qualidade do sono durante a pandemia da COVID-19. Materiais e método. Três pesquisas on-line (HARS (Hamilton Anxiety Rating Scale), HDRS (Hamilton Depression Rating Scale) e PSQI (Pittsburgh Sleep Quality Index) foram aplicadas a 203 professores e professoras da região de Puno (102 homens e 101 mulheres) com idades entre 25 e 58 anos (idade média = 39,19 ±5,47 anos), que completaram o isolamento social obrigatório. Resultados. Os níveis de ansiedade identificados no estudo eram altos, 55,88% dos homens e 60,40% das mulheres tinham distúrbios depressivos; 77,45% dos homens e 70,30% das mulheres tinham distúrbios de ansiedade e 47,06% dos homens e 44,55% das mulheres tinham má qualidade de sono. Conclusões. Estes fatores afetam a saúde mental da população e é necessário abordar os problemas de saúde mental das pessoas durante esta pandemia da COVID-19.

Proinflammatory dietary pattern and depression risk in older adults: Prospective analyses from the Seniors-ENRICA studies.

BACKGROUND & AIMS: Only a few studies have assessed the association between a proinflammatory diet and the risk of depression in older adults, and they have rendered weak results. The present study analysed the association between the Dietary Inflammatory Index (DII) and incident self-reported diagnosis or symptoms of depression in two cohorts of community-dwelling older adults in Spain. METHODS: We used data from the Seniors-ENRICA-I (SE-I) and Seniors-ENRICA-II (SE-II) cohorts. In both cohorts, the baseline DII was calculated from habitual food consumption estimated with a validated computer-based diet history. The incidence of both physician self-reported diagnosis of depression and mild-to-major depressive symptoms (≥3 on the 10-item Geriatric Depression Scale) was analysed. Logistic regression models were adjusted for the main potential confounders, such as sociodemographics, lifestyles, and comorbidities. The results of both cohorts were pooled using a random effects model. RESULTS: Among the 1627 participants in SE-I (mean age 71.5 ± 5.5 y, 53.1% women) and the 1579 in SE-II (mean age 71.4 ± 4.2, 46.7% women), 86 (5.3%) and 140 (8.9%) incident cases of depression were identified after a mean 3.2-y and 2.3-y follow-up, respectively. The fully adjusted odds ratio (95% confidence interval) of incident depression for the highest (the highest proinflammatory diet) versus the lowest quartile of DII was 2.76 (1.25-6.08, p-for-trend = 0.005) in the SE-I, 1.90 (1.04-3.40, p-for-trend = 0.005) in the SE-II and 2.07 (1.01-3.13) in the pooled cohorts. The results were consistent across strata defined by sex, age, physical activity, loneliness/poor social network, and morbidity. CONCLUSIONS: A proinflammatory dietary pattern is associated with depression risk in older adults. Future research should evaluate whether reducing the inflammatory component of diet leads to reduced depression symptoms in this population.

Hábitos de estudio en la educación médica: cuestión de estimación continua particularmente en situaciones emergentes / Study habits in medical education: a question of continuous estimation particularly in emerging situations

RESUMEN En la educación médica cubana se reconoce la necesidad de desarrollar en los estudiantes hábitos de estudio para con ello reforzar los procesos educativos. El tema adquiere preminencia debido al estado de emergencia decretado por la pandemia de la COVID-19, lo cual exigió la reorganización del proceso enseñanza aprendizaje y motivó replantearse nuevas estrategias para continuar el curso académico utilizando la modalidad de educación a distancia. Es objetivo de los autores reflexionar sobre los hábitos de estudio y su impronta por su implicación en la eficiencia de la formación de los futuros profesionales de la salud. DeCS: aprendizaje; estudiantes; educación a distancia; educación médica.

ABSTRACT In Cuban medical education, the need to develop study habits in students is recognized in order to reinforce educational processes. The topic becomes prominent due to the state of emergency due to the COVID-19 pandemic, which required the reorganization of the teaching-learning process and motivated the rethinking of new strategies to continue the academic year using the distance learning modality. It is the objective of the authors to reflect on study habits and their implication in the efficiency of the training of future health professionals. MeSH: learning; students; education, distance; education, medical.

Práctica pedagógica de un curso como base del aprendizaje del cuidado enfermero / Pedagogical Practice of a Course as a Foundation for Learning Nursing Care Provision

Introducción: Formar para el cuidado implica profundizar en temas relacionados a la práctica pedagógica y en el cuidado de enfermería. Objetivo: Describir la práctica pedagógica del curso Introducción a Enfermería como base para el aprendizaje del cuidado enfermero. Métodos: Estudio cualitativo con perspectiva explicativa, realizado con estudiantes de la Escuela de Enfermería de la Universidad Nacional de Trujillo, Perú; durante el año 2017. Población conformada por 192 estudiantes. Los datos fueron recolectados a través de tres grupos focales y analizados a partir de la codificación, categorización y teorización. Resultados: Para el aprendizaje del cuidado se identificó la categoría Fortalecer el Aprendizaje para el Cuidado con las sub-categorías: Aplicar Estrategias activas de aprendizaje, acompañamiento docente, visualizar la profesión e internalizar el cuidado enfermero. Conclusiones: La práctica pedagógica desarrollada en el curso introducción a enfermería, ofrece al estudiante de enfermería elementos prácticos y conceptuales base para el aprendizaje del cuidado enfermero(AU)

Introduction: Training for care provision implies deepening on issues related to pedagogical practice and nursing care. Objective: To describe the pedagogical practice of the Introduction to Nursing course as a basis for learning nursing care. Methods: Qualitative study with an explanatory perspective, carried out, during the year 2017, with students from the School of Nursing of National University of Trujillo, Peru. Population made up of 192 students. The data were collected through three focus groups and analyzed by means of coding, categorization and theorizing. Results: For the learning of care provision, the category strengthening learning for care was identified, together with the subcategories applying active learning strategies, teacher support, visualizing the profession and internalizing nursing care. Conclusions: The pedagogical practice developed in the Introduction to nursing course offers the nursing student practical and conceptual elements as a basis for learning nursing care provision(AU)

COVID-19 y su asociación con síntomas depresivos en población española / COVID-19 and its association with depressive mood symptoms in the Spanish Population

RESUMEN. Introducción: la emergencia sanitaria por el COVID-19 ha generado una conmoción mundial que conlleva una serie de problemáticas relacionadas con la salud, los factores psicosociales y la situación económica. Objetivo: evaluar el efecto del confinamiento en el ánimo depresivo en población residente en España mayor de 18 años durante el estado de alarma provocada por la pandemia de la COVID-19, analizando, además, la posible incidencia de las variables sexo, edad, tamaño de la vivienda e ingresos económicos. Material y Métodos: diseño transversal, descriptivo y correlacional con metodología de carácter cuantitativo. El acceso a la muestra fue no probabilístico a través de la técnica bola de nieve. Para evaluar la condición de ánimo depresivo se utilizó la escala CES-D. Para recopilar los datos relacionados con el sexo, la edad, el tamaño de vivienda y la situación económica, se crearon preguntas ad hoc en la propia encuesta. Resultados: las mujeres presentan valores de ánimo depresivo superiores a los hombres. Además, los valores de ánimo depresivo son mayores cuanto menor es la edad. Las personas que residen en viviendas con un tamaño menor, presentan valores de ánimo depresivo superiores respecto a las personas que viven en residencias con superficies mayores. A su vez, las personas con peores condiciones económicas perciben mayores niveles de ánimo depresivo. Conclusiones: los resultados indican que los síntomas de ánimo depresivo y las consecuencias psicosociales en la población española durante el confinamiento, se encuentran condicionadas por el sexo, la edad, el tamaño de la vivienda y la situación económica(AU)

ABSTRACT Introduction: Health emergency due to the COVID-19 pandemic has generated a global commotion, leading to a series of problems related to health, psychosocial factors and economic situation. Objective: To evaluate the effect of confinement on depressive mood in Spanish residents who are over 18 years old during the state of emergency which was declared due to the COVID-19 pandemic. Additionally, this paper aims to analyze the possible impact of some variables such as sex, age, size of dwelling and income. Materials and Methods: Cross-sectional, descriptive and correlational design with quantitative methodology. Access to the sample was based on a non-probabilistic sampling through snowball technique. CES-D scale was used to evaluate the state of depressive mood. In order to collect data related to sex, age, size of dwelling and economic situation, ad hoc questions were included in the survey. Results: Women presented higher values of depressive mood than men. Furthermore, depressive mood values are higher in younger individuals. People who live in smaller dwellings showed higher values of depressive mood compared to those who live in larger dwellings. Similarly, individuals with less favorable economic conditions perceive higher levels of depressive mood. Conclusions: The results show that depressive mood symptoms and their psychosocial consequences in the Spanish population during confinement are conditioned by sex, age, dwelling size and economic situation(AU)

Effect of fermentation time and acid casein concentration as nitrogen source on microbial rennet production.

We evaluated the effects of fermentation time and acid casein content on the microbial rennet obtained by solid-state fermentation using wheat bran as the carbon source. The experiments used two fermentation times (72 and 96 h), while acid casein content was 1.5, 2.0, 2.5, and 3.0 g. Rennet strength from eight enzymatic extracts was measured using pasteurized whole milk. Rennet strength of samples from 72 h of fermentation showed an increase when acid casein content increased. The rennet strength increased at 96 h of fermentation with increasing amount of casein (up to 2.5 g), and then decreased with the largest addition (3.0 g) of casein. Coagulation time for the sample with highest rennet strength was 420 s.

Duration and Quality of Sleep and Risk of Physical Function Impairment and Disability in Older Adults: Results from the ENRICA and ELSA Cohorts.

Sleep duration and quality have been associated with poor physical function, but both the temporality of the association and the independence of sleep duration and quality are unclear. We examined the prospective association of sleep duration and quality with physical function impairment and disability in older adults. Data were taken from participants in the Seniors-ENRICA (2012-2015, n= 1,773) and in the ELSA cohort (waves 4 and 6, n=4,885) aged ≥60 years. Sleep duration and quality were self-reported. Physical function impairment and disability was obtained either from self-reports (ENRICA and ELSA) or from performance assessment (ENRICA). Logistic regression models were adjusted for potential confounders. After a follow-up of 2.0-2.8 years, no association was found between changes in sleep duration and physical function impairment or disability. However, in both studies, poor general sleep quality was linked to higher risk of impaired agility [OR: 1.93 (95% CI: 1.30-2.86) in Seniors-ENRICA and 1.65 (1.24-2.18) in ELSA study] and mobility [1.46 (0.98-2.17) in Seniors-ENRICA and 1.59 (1.18-2.15) in ELSA study]. Poor general sleep quality was also associated with decreased physical component summary (PCS) [1.39 (1.05-1.83)], disability in instrumental activities of daily living [1.59 (0.97-2.59)] and in basic activities of daily living [1.73 (1.14-2.64)] in Seniors-ENRICA. In addition, compared to those with no sleep complaints, participants with 2 or more sleep complaints had greater risk of impaired agility, impaired mobility, decreased PCS and impaired lower extremity function in both cohorts. Poor sleep quality was associated with higher risk of physical impairment and disability in older adults from Spain and from England.

Low vitamin intake is associated with risk of frailty in older adults.

Background: the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods: data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008-10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results: during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38-5.67), P-trend: 0.004, for vitamin B6; 1.65 (0.93-2.95), P-trend: 0.007, for vitamin C; 1.93 (0.99-3.83), P-trend: 0.06, for vitamin E and 2.34 (1.21-4.52), P-trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03-4.23); niacin OR: 2.80 (1.46-5.38) and vitamin B6; 2.23 (1.30-3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34-6.03); P-trend: <0.001, compared to those who met >7. Conclusion: a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated.

Agreement between sleep diary and actigraphy in a highly educated Brazilian population.

OBJECTIVE: This study evaluated the agreement between a sleep diary and actigraphy on the assessment of sleep parameters among school teachers from Brazil. METHODS: A total of 163 teachers (66.3% women; aged 45 ± 9 years) filled out a sleep diary and wore a wrist actigraph device for seven consecutive days. Data were collected from August 2014 to March 2015 in Londrina, a large city in southern Brazil. Intraclass correlation coefficients (ICC) and Pearson correlation coefficients (r) were used to compare self-reported and actigraphic data. RESULTS: Self-reported total sleep time (TST), sleep onset latency (SOL), and sleep efficiency were higher than measured by actigraphy (mean difference: 22.6 ± 46.9 min, 2.6 ± 13.3 min, and 7.3± 5.7%, respectively). Subjective total time in bed (TIB) and wake-up time were lower than measured by actigraphy (mean difference: -10.7 ± 37.6 and -19.7 ± 29.6, respectively). Moderate or good agreement and correlation were found between the sleep diary and the actigraphic data for TST (ICC = 0.70; r = 0.60), TIB (ICC = 0.83; r = 0.73), bedtime (ICC = 0.95; r = 0.91), sleep start time (ICC = 0.94; r = 0.88), and wake-up time (ICC = 0.87; r = 0.78). However, SOL (ICC = 0.49; r = 0.38) and sleep efficiency (ICC = 0.16; r = 0.22) showed only fair or poor agreement and correlation. CONCLUSION: In this highly educated population, the sleep diary and the actigraphy showed moderate or good agreement to assess several sleep parameters. However, these methods seemed to measure different dimensions of sleep regarding sleep onset latency and efficiency. These findings moderately varied according to the individual's subjective sleep quality.

Curso virtual sobre la lengua de señas cubana para los estudiantes de Medicina / Virtual course on the Cuban sign language for Medicine students

Fundamento: a las instituciones de salud acuden con frecuencias pacientes y/o familiares sordos, que no siempre van acompañados por intérpretes de lenguajes de señas que puedan explicar su padecimiento. Objetivo: diseñar un curso virtual sobre lengua de señas cubana dirigido a estudiantes de Medicina para favorecer la comunicación con los pacientes y/o familiares con necesidades auditivas. Métodos: se realizó un estudio descriptivo transversal en la Filial de Ciencias Médicas de Sagua la Grande, en el período septiembre 2013 a abril 2014. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo y empíricos: encuesta en forma de cuestionario, grupo nominal y el criterio de especialistas para valorar el producto diseñado. Resultados: predominó desconocimiento en los estudiantes sobre la lengua de señas cubana y la necesidad de conocerla para comunicarse con los pacientes y/o familiares con estas limitaciones. Se diseñó un curso de acuerdo a los requerimientos del entorno virtual. Conclusiones: los especialistas lo consideraron pertinente y factible porque favorece la comunicación con los pacientes y/o familiares sordos con los que interactuarán estos estudiantes durante su profesión médica, en correspondencia con la aplicación del método clínico.

Background: to health institutions frequently attend deaf patient and/or family who aren't always accompanied by sign language interpreters that can explain about their medical problem. Objective: to design a virtual course on Cuban sign language for Medicine students to favor the communication with the patients and/or family with auditory necessities. Methods: it was carried out a cross-sectional descriptive study in Sagua la Grande Medical Sciences university site, from September 2013 to April 2014. Theoretical methods were used: analysis-synthesis and inductive-deductive and empiric ones: an interview in questionnaire form, nominal group and specialists´ criteria to value the designed product. Results: ignorance prevailed in the students about the Cuban sign language and the necessity of knowing it to communicate with the patients and/or family with these limitations. A course was designed according to the requirements of the virtual environment. Conclusions: the specialists considered it pertinent and feasible because it favors the communication with the deaf patients and/or family, whom the medical students could interact in their profession, while applying the clinical method.

Mediterranean Diet and Changes in Sleep Duration and Indicators of Sleep Quality in Older Adults.

Study Objective: To examine the association between adherence to a Mediterranean diet (MD) and changes in sleep duration and sleep quality in older adults. Methods: We used data from 1596 participants in the Seniors-ENRICA cohort aged ≥ 60 years. MD was evaluated in 2012 with the Mediterranean Diet Adherence Screener (MEDAS) score. Sleep duration (h) and indicators of poor sleep quality were assessed both in 2012 and 2015. Analyses were adjusted for sociodemographic, lifestyle and morbidity variables, and for sleep duration and the number of poor sleep indicators at baseline. Results: Over a median follow-up of 2.8 years, 12.2% of individuals increased and 8.8% decreased their sleep duration by ≥2 h/night. Compared with those in the lowest tertile of adherence to the MD in 2012, those in the highest tertile showed both a lower risk of a ≥2 h/night increase in sleep duration (odds ratio [OR]: 0.54, 95% confidence interval [CI] 0.34-0.85, p-trend = .01) and of a ≥2 h/night decrease (OR: 0.58, 95% CI 0.35-0.95, p-trend = 0.02) from 2012 to 2015. Being in the highest tertile of MD in 2012 was also associated with lower risk of poor sleep quality at follow-up, the OR (95% CI) for having 2-3 indicators of poor sleep was 0.70 (0.51-0.97) and for ≥4 indicators was 0.68 (0.47-0.99, p-trend = .04). High adherence to the MD was also associated with 56% lower odds of having large changes in sleep duration and ≥2 indicators of poor sleep quality simultaneously (OR: 0.44, 95% CI 0.29-0.68, p trend < .001). Conclusions: Adherence to a MD pattern was associated with lower risk of changes in sleep duration and with better sleep quality in older adults.

Determinantes sociales de la salud de la OMS en mujeres mexicanas con el virus de papiloma / Social determinants of health WHO Mexican women with papillomavirus

Uno de los temas centrales de la OMS es el análisis de los problemas de salud mediante el modelo de Determinantes Sociales de la Salud (DSS: inadecuadas condiciones económicas, ambientales y de alimentación). El sistema sanitario de la OMS ha asociado algunas enfermedades tal como el Virus de Papiloma Humano (VPH) con los DSS. Desde el punto de vista de investigación cuantitativa, los DSS reportados por la OMS son: 1) edad de inicio de la actividad sexual, 2) múltiples compañeros sexuales, 3) estrato socioeconómico y 4) sistema inmunitario debilitado. En México, hasta el momento las investigaciones cualitativas en población de mujeres mexicanas con VPH son nulas. Objetivos: identificar los DSS en mujeres mexicanas con VPH mediante una investigación cualitativa. Material y Métodos: diseño cualitativo-descriptivo. La población estuvo conformada por 1800 mujeres con VPH atendidas en consulta externa de un hospital de tercer nivel. De este total solo a 9 mujeres se seleccionaron para entrevista a profundidad (Método de Saturación) Minayo. Mediante el método de saturación se obtuvieron las unidades de significado, categorías y subcategorías. Resultados: se identificaron cinco categorías. 1. Determinantes conductuales, 2. Ingreso y situación económica, 3. Educación para la salud, 4. Estilos de vida y 5. Servicios de salud; utilizando el método de saturación. De estas categorías se obtuvieron nueve subcategorías. Las categorías con mayor saturación fueron: determinantes conductuales, (subcategorías: relación de pareja y relación sexual) e ingreso y situación económica (subcategorías: apoyo económico de pareja e ingreso personal)...

One of the central the mês of the WHO is the analysis of health problems through the Social Determinants of Health (SDH). The WHO health system associated with the DSS (inadequate economic, environmental and food) with some diseases. For the Human Papilloma Virus (HPV), the SDH reported by the WHO from the point of view of quantitative research are: 1) age of onset of sexual activity, 2) multiple sexual partners, 3) socioeconomic status and 4) system immune weaken ed. In Mexico, until this study itisnull qualitative research in Mexican women with HPV. Objectives: Identify the DSS in Mexican women with HPV through a qualitative research. Material and Methods: a descriptive qualitative design was carried out. The population consisted of 1800 women with HPV treated in an outpatient tertiary hospital. Of this total only 9 women were selected for in-depth interview using the Minayo saturation method. Method of saturation, units of meaning, categories, and subcategories were obtained. Results: five categories of SDH (1. Behavioral determinants, 2.Income and economic situation, 3.Health education, 4.Lifestyles, and 5. Health services) were identified. Nine subcategories were obtained by the saturation method. The categories with higher saturation were: behavioral determinants (subcategories: relationship and sex) and income and economic situation (subcategories: financial support and personal income couples)...

Chocolate and health-related quality of life: a prospective study.

BACKGROUND: Chocolate consumption has been associated with a short-term reduction in blood pressure and cholesterol, and improvement of insulin sensitivity; however, participants could not be aware of presenting hypertension or hypercholesterolemia. Moreover, the effect of chocolate on mental health is uncertain. This study assessed the association of regular chocolate consumption with the physical (PCS) and mental (MCS) components of health-related quality of life (HRQL). MATERIALS AND METHODS: We analyzed data from a cohort of 4599 individuals recruited in 2008-2010 and followed-up once prospectively to January 2013 (follow-up mean: 3.5 years). Regular chocolate consumption was assessed at baseline with a validated diet history. HRQL was assessed with the SF-12 v.2 at baseline and at follow-up. Analyses were performed with linear regression and adjusted for the main confounders, including HRQL at baseline. RESULTS: At baseline, 72% of the study participants did not consume chocolate, 11% consumed ≤10 g/day and 17% >10 g/day. Chocolate consumption at baseline did not show an association with PCS and MCS of the SF-12 measured three years later. Compared to those who did not consume chocolate, the PCS scores were similar in those who consumed ≤10 g/day (beta: -0.07; 95% confidence interval (95% CI): -0.94 to 0.80) and in those who consumed >10 g/day (beta: 0.02; 95% CI:-0.71 to 0.75); corresponding figures for the MCS were 0.29; 95% CI: -0.67 to 1.26, and -0.57; 95%CI: -1.37 to 0.23. Similar results were found for sex, regardless of obesity, hypertension, hypercholesterolemia, diabetes or depression. CONCLUSIONS: No evidence was found of an association between chocolate intake and the physical or mental components of HRQL.

Nonexercise cardiorespiratory fitness and mortality in older adults.

INTRODUCTION: High cardiorespiratory fitness (CRF) is strongly associated with longer life among older adults. CRF can be assessed by exercise-based methods, which are not feasible in most clinical settings. Thus, nonexercise algorithms to estimate CRF have been developed, but whether they predict mortality in older adults is uncertain. METHODS: A cohort of 1470 men and 1460 women, representative of the Spanish population age ≥60 yr, was established in 2000/2001 and followed up prospectively through 2011. At baseline, nonexercise CRF was estimated with the sex-specific algorithms developed by Jackson et al. Analyses were performed with Cox regression and adjusted for the main confounders. RESULTS: During an average follow-up of 9.4 yr, 570 (38.8%) deaths occurred in men and 295 (20.2%) in women. Among men, no association was observed between nonexercise CRF and all-cause mortality. Compared with women in the lowest quartile of CRF, the hazard ratio (95% confidence interval) for all-cause death was 0.81 (0.62-1.06) in the second quartile, 0.68 (0.48-0.95) in the third quartile, and 0.56 (0.36-0.87) in the highest quartile (P for trend = 0.004). Results held regardless of age, body mass index, waist circumference, HR, subjective health, functional limitations, and disease status. CONCLUSIONS: Higher nonexercise CRF was related to lower risk of death in older women but not in men. Because previous research does not support clear sex-specific association, further research is required to assess whether nonexercise CRF predicts mortality in older adults or new algorithms should be developed for this population, with special attention to older men.