Resumen El artículo muestra la relación estructural entre el testimonio y el juicio estético, y cómo la mentira estructural se implica irreductiblemente como la posibilidad de la verdad. Se explica la necesaria imposibilidad del testimonio como condición de su posibilidad, argumento anticipado por J. L. Borges: “No hay una sola hermosa palabra, con la excepción dudosa de testigo, que no sea una abstracción”. La argumentación se apoya en la teoría husserliana del syncategorema (palabras incompletas cuyo sentido depende del contexto) y en los deícticos (palabras esencialmente ocasionales); asimismo, se toma de I. Kant el papel de la imaginación y los efectos del “como si”.

Abstract This essay demonstrates the structural relationship between testimony and aesthetic judgment. The implications of this discovery are several, the most important being the relationship between the lie and truth, implicating that lie indicates the irreducible possibility of truth. The essay explains the necessary impossibility of the testimony as a condition of its possibility, an argument anticipated in Jorge Luis Borges’ beautiful phrase, “There is not a single beautiful word, with the dubious exception of witness, that is not an abstraction”. The argument is based on Husserl’s theory of the syncategorem (“incomplete” words whose meaning depends on the context) and on deictic words (“essentially occasional” words); as well, it takes from Kant, the role of the imagination and the effects of the “as if”.

Resumen Objetivo. Determinar la asociación entre el esfuerzo percibido (VEP) y variables fisiológicas y determinar los factores predictivos de VEP durante el esfuerzo submáximo y máximo en adultos mayores. Método. Adultos mayores de Kansas (n = 100) y Costa Rica (n = 79) realizaron una prueba de esfuerzo submáxima y máxima. Se recopiló la VEP, nivel de educación y una puntuación total de la función cognitiva (PTFC). Se usaron análisis de correlación y regresión múltiple utilizando VEP como variable criterio y el consumo de oxígeno (VO2), tasa de intercambio respiratorio (RER), PTFC y nivel de educación como predictores. Resultados. Se encontró una correlación significativa entre la VEP y la RER (r = 0.22, p = 0.029) en el esfuerzo máximo. Los predictores de VEP para las mujeres fueron VO2, RER y PTFC en diferentes etapas de la prueba. Para los hombres, la VEP fue predicha por RER, nivel de educación y VO2 en diferentes etapas. Conclusión. Las variables metabólicas y fisiológicas predijeron los valores de VEP en adultos mayores. La edad, la cognición y la FC no se relacionaron con la VEP en el esfuerzo máximo y la RER predijo las puntuaciones de la VEP durante el esfuerzo submáximo y máximo.

Abstract Objective. To determine the association between perceived exertion (RPE) and physiological variables and to determine the predictive factors of RPE during submaximal and maximal exertion in older adults. Method. Older adults from Kansas (n = 100) and Costa Rica (n = 79) performed a submaximal and maximal stress test. RPE, education level and a total score of cognitive function (CFTS) were collected. Correlation and multiple regression analyses were computed using RPE as the criterion variable and oxygen consumption (VO2), respiratory exchange ratio (RER), CFTS and education level as predictors. Results. There was a significant correlation between VEP and RER (r = 0.22, p = 0.029) at maximal exertion. The RPE predictors for women were VO2, RER, and CFTS at different stages of the test. For men, VEP was predicted by RER, education level, and VO2 at different stages. Conclusion. Metabolic and physiological variables predicted RPE in older adults. Age, cognition, and heart rate were unrelated to RPE at maximal exertion, and RER predicted RPE scores during submaximal and maximal exertion.

Resumo Escopo. Determinar a associação entre o esforço percebido (VEP) e as variáveis fisiológicas e determinar os fatores preditivos de VEP durante o esforço submáximo e máximo em idosos. Metodologia. Idosos de Kansas (n= 100) e Costa Rica (n= 79) realizaram uma prova de esforço submáxima e máxima. Foi recopilada o VEP, nível de educação e pontuação total da função cognitiva (PTFCO. Foram usadas análises de correlação e regressão múltipla utilizando VEP como variável critério e o consumo de oxigeno (VO2), taxa de intercambio respiratório (RER), PTFC e nível de educação como preditores. Resultados. Foi encontrada uma correlação significativa entre a VEP e a RER (r = 0.22, p = 0.029)) no esforço máximo. Os preditores de VEP para as mulheres foram VO2, RER e PTFC em diferentes etapas da prova. Para os homens, a VEP foi predita por RER, nível de educação e VO2 em diferentes etapas. Conclusão. As variáveis metabólicas e fisiológicas predisseram os valores de VEP em idosos. A idade, a cognição e a FC não estiveram relacionadas com a VEP no esforço máximo e a RER predizia as pontuações da VEP durante o esforço submáximo e máximo.

Resumo As normas para a resolução de disputas se desenvolveram junto com a comunicação humana, literalmente milhares de anos antes da internet. A mediação surgiu como um sistema social que detém normas específicas de cada cultura e regras que as expressam. Até hoje, a mediação opera como um sistema de significados profundamente humano. Este artigo analisa se tais normas específicas para a mediação, testadas e refinadas com o tempo, serão transferidas, relativamente intactas, para o ambiente virtual. Para isso, será analisado como os designers constroem e implementam os ambientes virtuais e sua decorrente automatização tecnológica. Contudo, para realizar isso da melhor maneira os designers devem, em primeiro lugar, identificar, entender e respeitar os valores, a ética e o propósito implícitos nessas normas intergeracionais.

Abstract The norms of dispute resolution began their development alongside human communication, literally thousands of years before the internet. Mediation emerged as a social system possessed of culture-specific norms and rules that express themselves to this day, in how this mediation operates as a profoundly human system of meaning. This article asks whether these thoroughly time-tested and -refined norms specific to mediation will port over, relatively intact, into virtual space. To be sure, the answer will be seen in how designers build and implement the virtual spaces and attendant automation technology. To do that optimally, however, designers first must identify, understand and respect the values, ethics and purpose embedded in these inter-generational norms.

ABSTRACT The Ministry of Health and Environment (MoHE) of the Commonwealth of Dominica identified the need for a knowledge management strategy to advance the country's national health agenda. The Pan American Health Organization and the MoHE conducted a rapid situation analysis of knowledge management in July 2015. The findings, analysis, and recommendations were developed jointly with a core team of the MoHE within the context of the strategic plan for health, “Investing in Health – Building a Safer Future.” The situation analysis described the overall status of the understanding and implementation of information and knowledge management activities, projects, products, and practices. The analysis also aimed to identify what critical knowledge is needed to support overall organizational goals and individual and team activities. The MoHE expects patient outcomes and quality of care to improve as a result of having a knowledge management strategy that boosts the Ministry's efficiency and productivity.

RESUMEN El Ministerio de Salud y Medioambiente del Commonwealth de Dominica determinó la necesidad de definir una estrategia de gestión del conocimiento para impulsar el programa nacional de salud del país. En julio del 2015, la Organización Panamericana de la Salud y el Ministerio de Salud y Medioambiente llevaron adelante un análisis rápido de la situación de la gestión del conocimiento. Los resultados, el análisis y las recomendaciones fueron elaborados conjuntamente con un equipo básico del Ministerio dentro del contexto del plan estratégico de salud Investing in Health: Building a Safer Future [invertir en la salud para forjar un porvenir más seguro]. En el análisis de la situación se describe el estado general del conocimiento y el desarrollo de actividades, la ejecución de proyectos, la elaboración de productos y la aplicación de prácticas de gestión de la información y el conocimiento. Dicho análisis además tuvo como objetivo definir el conocimiento fundamental que se necesita para apoyar la consecución de todas las metas institucionales y la realización de las actividades tanto individuales como grupales. El Ministerio de Salud y Medioambiente espera que mejoren los resultados de los pacientes y la calidad de la atención al contar una estrategia de gestión del conocimiento que le permita impulsar su eficiencia y productividad.

ABSTRACT BACKGROUND: Cardiovascular disease (CVD) is the most frequent cause of death in people with early stages of chronic kidney disease (CKD), for whom the absolute risk of cardiovascular events is similar to people who have existing coronary artery disease. This is an update of a review published in 2009, and includes evidence from 27 new studies (25,068 participants) in addition to the 26 studies (20,324 participants) assessed previously; and excludes three previously included studies (107 participants). This updated review includes 50 studies (45,285 participants); of these 38 (37,274 participants) were meta-analysed. OBJECTIVES: To evaluate the benefits (such as reductions in all-cause and cardiovascular mortality, major cardiovascular events, MI and stroke; and slow progression of CKD to end-stage kidney disease (ESKD)) and harms (muscle and liver dysfunction, withdrawal, and cancer) of statins compared with placebo, no treatment, standard care or another statin in adults with CKD who were not on dialysis. METHODS: Search methods: We searched the Cochrane Renal Group's Specialised Register to 5 June 2012 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Selection criteria: Randomised controlled trials (RCTs) and quasi-RCTs that compared the effects of statins with placebo, no treatment, standard care, or other statins, on mortality, cardiovascular events, kidney function, toxicity, and lipid levels in adults with CKD not on dialysis were the focus of our literature searches. Data collection and analysis: Two or more authors independently extracted data and assessed study risk of bias. Treatment effects were expressed as mean difference (MD) for continuous outcomes (lipids, creatinine clearance and proteinuria) and risk ratio (RR) for dichotomous outcomes (major cardiovascular events, all-cause mortality, cardiovascular mortality, fatal or non-fatal myocardial infarction (MI), fatal or non-fatal stroke, ESKD, elevated liver enzymes, rhabdomyolysis, cancer and withdrawal rates) with 95% confidence intervals (CI). MAIN RESULTS: We included 50 studies (45,285 participants): 47 studies (39,820 participants) compared statins with placebo or no treatment and three studies (5547 participants) compared two different statin regimens in adults with CKD who were not yet on dialysis. We were able to meta-analyse 38 studies (37,274 participants). The risk of bias in the included studies was high. Seven studies comparing statins with placebo or no treatment had lower risk of bias overall; and were conducted according to published protocols, outcomes were adjudicated by a committee, specified outcomes were reported, and analyses were conducted using intention-to-treat methods. In placebo or no treatment controlled studies, adverse events were reported in 32 studies (68%) and systematically evaluated in 16 studies (34%). Compared with placebo, statin therapy consistently prevented major cardiovascular events (13 studies, 36,033 participants; RR 0.72, 95% CI 0.66 to 0.79), all-cause mortality (10 studies, 28,276 participants; RR 0.79, 95% CI 0.69 to 0.91), cardiovascular death (7 studies, 19,059 participants; RR 0.77, 95% CI 0.69 to 0.87) and MI (8 studies, 9018 participants; RR 0.55, 95% CI 0.42 to 0.72). Statins had uncertain effects on stroke (5 studies, 8658 participants; RR 0.62, 95% CI 0.35 to 1.12). Potential harms from statin therapy were limited by lack of systematic reporting and were uncertain in analyses that had few events: elevated creatine kinase (7 studies, 4514 participants; RR 0.84, 95% CI 0.20 to 3.48), liver function abnormalities (7 studies, RR 0.76, 95% CI 0.39 to 1.50), withdrawal due to adverse events (13 studies, 4219 participants; RR 1.16, 95% CI 0.84 to 1.60), and cancer (2 studies, 5581 participants; RR 1.03, 95% CI 0.82 to 130). Statins had uncertain effects on progression of CKD. Data for relative effects of intensive cholesterol lowering in people with early stages of kidney disease were sparse. Statins clearly reduced risks of death, major cardiovascular events, and MI in people with CKD who did not have CVD at baseline (primary prevention). AUTHORS' CONCLUSIONS: Statins consistently lower death and major cardiovascular events by 20% in people with CKD not requiring dialysis. Statin-related effects on stroke and kidney function were found to be uncertain and adverse effects of treatment are incompletely understood. Statins have an important role in primary prevention of cardiovascular events and mortality in people who have CKD.

The 21st century brings four important challenges in which cooperation plays a central role: (1) a rapidly increasing global interdependence that will result in increasing local diversity as well as more frequent and intense conflicts, (2) the increasing number of democracies throughout the world, (3) the need for creative entrepreneurs, and (4) the growing importance of interpersonal relationships that affect the development of personal identity. The tools for meeting these challenges include cooperative learning. In this article the nature of cooperative learning will be reviewed, the underlying theory of social interdependence will be discussed, and the results of the research on cooperative learning will be briefly reviewed. The way in which cooperative learning contributes to meeting the four challenges will then be discussed.

El siglo XXI trae consigo cuatro grandes retos en los que la cooperación juega un papel fundamental: (1) una interdependencia mundial cada vez mayor que se traducirá en el aumento de la diversidad local, así como en conflictos más frecuentes e intensos, (2) el aumento de sistemas democráticos en el mundo, (3) la necesidad de emprendedores creativos y (4) la creciente importancia de las relaciones interpersonales que afectan al desarrollo de la identidad personal. Las herramientas para responder a estos desafíos incluyen el aprendizaje cooperativo. En este artículo se revisara la naturaleza del aprendizaje cooperativo, se discutirá la teoría de la interdependencia social que subyace, y se revisarán, brevemente, los resultados de la investigación sobre el aprendizaje cooperativo.

BACKGROUND:Cardiovascular disease (CVD) is the most frequent cause of death in people with early stages of chronic kidney disease (CKD), for whom the absolute risk of cardiovascular events is similar to people who have existing coronary artery disease. This is an update of a review published in 2009, and includes evidence from 27 new studies (25,068 participants) in addition to the 26 studies (20,324 participants) assessed previously; and excludes three previously included studies (107 participants). This updated review includes 50 studies (45,285 participants); of these 38 (37,274 participants) were meta-analysed.OBJECTIVE:To evaluate the benefits (such as reductions in all-cause and cardiovascular mortality, major cardiovascular events, MI and stroke; and slow progression of CKD to end-stage kidney disease (ESKD)) and harms (muscle and liver dysfunction, withdrawal, and cancer) of statins compared with placebo, no treatment, standard care or another statin in adults with CKD who were not on dialysis. METHODS:Search methods: We searched the Cochrane Renal Group's Specialised Register to 5 June 2012 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Selection criteria: Randomised controlled trials (RCTs) and quasi-RCTs that compared the effects of statins with placebo, no treatment, standard care, or other statins, on mortality, cardiovascular events, kidney function, toxicity, and lipid levels in adults with CKD not on dialysis were the focus of our literature searches. Data collection and analysis: Two or more authors independently extracted data and assessed study risk of bias. Treatment effects were expressed as mean difference (MD) for continuous outcomes (lipids, creatinine clearance and proteinuria) and risk ratio (RR) for dichotomous outcomes (major cardiovascular events, all-cause mortality, cardiovascular mortality, fatal or non-fatal myocardial infarction (MI), fatal or non-fatal stroke, ESKD, elevated liver enzymes, rhabdomyolysis, cancer and withdrawal rates) with 95% confidence intervals (CI).MAIN RESULTS:We included 50 studies (45,285 participants): 47 studies (39,820 participants) compared statins with placebo or no treatment and three studies (5547 participants) compared two different statin regimens in adults with CKD who were not yet on dialysis. We were able to meta-analyse 38 studies (37,274 participants).

Blood eosinophilia and tissue infiltration by eosinophils are frequently observed in allergic inflammation and parasitic infections. This selective accumulation of eosinophils suggested the existence of endogenous eosinophil-selective chemoattractants. We have recently discovered a novel eosinophil-selective chemoattractant which we called eotaxin in an animal model of allergic airways disease. Eotaxin is generated in both allergic and non-allergic bronchopulmonary inflammation. The early increase in eotaxin paralled eosinophil infiltration in the lung tissue in both models. An antibody to IL-5 suppressed lung eosinophilia, correlating with an inhibition of eosinophil release from bone marrow, without affecting eotaxin generation. This suggests that endogenous IL-5 is important for eosinophil migration but does not appear to be a stimulus for eotaxin production. Constitutive levels of eotaxin observed in guinea-pig lung may be responsible for the basal lung eosinophilia observed in this species. Allergen-induced eotaxin was present mainly in the epithelium and alveolar macrophages, as detected by immunostaining. In contrast there was no upregulation of eotaxin by the epithelial cells following the injection of Sephadex beads and the alveolar macrophage and mononuclear cells surrounding the granuloma were the predominant positive staining cells. Eotaxin and related chemokines acting through the CCR3 receptor may play a major role in eosinophil recruitment in allergic inflammation and parasitic diseases and thus offer an attractive target for therapeutic intervention.