Resumo: Objetivo Os eventos de inundação associados às planícies de inundação de muitos rios do mundo afetam a composição e estrutura da biota aquática, pois a variação do nível de água pode garantir a integridade ecológica das áreas úmidas associadas. O objetivo do presente é descrever a variação espacial e temporal na composição da assembleia de macrófitas aquáticas em uma área alagável em Santo Tomás durante um período de inundação no rio Magdalena (norte da Colômbia). Métodos Nós avaliamos a composição e abundância da comunidade de macrófitas aquáticas em três estações de coleta no rio Magdalena mensalmente durante 8 meses entre 2017 e 2018. Nós estimamos a variação espaço-temporal da comunidade usando o método Chao e a cobertura vegetal usando os testes de Kruskal-Wallis e U Mann-Whitney. Uma curva de abundância de classificação foi usada para a dominância das espécies entre os meses de amostragem e as estações. Uma escala não métrica multidimensional (nMDS) foi utilizada para analisar a distribuição espacial e temporal e a análise de correspondência canônica (CCA) foi realizada para estudar a relação entre a composição das espécies de macrófitas e as variáveis físico-químicas da água. Resultados Nos transectos foi registrado um total de 24 espécies de plantas aquáticas distribuídas em 23 gêneros e 15 famílias. A espécie mais abundante (% de cobertura vegetal) foi Ipomoea aquatica (19%), seguida por Ludwigia helminthorrhiza (14%) e Eichhornia azurea (13%). Espécies flutuantes e emergentes foram observadas com mais frequência. As mudanças espaço-temporais e os maiores valores de riqueza e cobertura de macrófitas aquáticas nas zonas úmidas de Santo Tomás ocorreram durante a estação das chuvas. As espécies mais dominantes foram L. helminthorrhiza, E. azurea, Pistia stratiotes, Neptunia oleracea, I. aquatica, Salvinia auriculata e Hymenachne amplexicaulis. A qualidade da água apresentou variações espaciais e temporais durante o pulso de inundação, e algumas variáveis como matéria orgânica (DOQ, DBO5), pH, profundidade, amônia e coliformes fecais foram relacionados à composição da comunidade de macrófitas. Conclusões Em suma nós concluímos que o pulso de inundação do rio Magdalena influenciou a composição das plantas aquáticas nas zonas úmidas de Santo Tomás.

Abstract: Aim The associated flood events to floodplain of many rivers in the world affect the composition and structure of aquatic biota due the water levels variation can ensure ecological integrity of associated wetlands. This study describes the spatial and temporal variation in the macrophyte assemblage in the Santo Tomás wetland during seasonally flood-pulsed of the Magdalena River (North of Colombia). Methods For eight months, between 2017 and 2018 samplings were carried out in three stations for composition and abundance of aquatic macrophytes. Spatio-temporal pattern of richness was estimated with Chao methodology and vegetation cover was calculated using Kruskal-Wallis and U Mann-Whitney tests. A range abundance curve was used for species dominance between samplings and stations. A non-metric multidimensional scaling (nMDS) was used to analyze the Spatio-temporal distribution, Canonical Correspondence Analysis (ACC) was performed to relate the physicochemical variables to the species composition. Results A total of 24 species of aquatic plants distributed in 23 genera and 15 families were registered in the transects. The most abundant species (% of vegetation cover) were Ipomoea aquatica (19%), followed by Ludwigia helminthorrhiza (14%) and Eichhornia azurea (13%). The most frequent life form was free-floating, followed by the emergent one. The Spatio-temporal changes and the highest values of richness and vegetation cover in the Santo Tomás wetlands occurred during the filling and high waters period. L. helminthorrhiza, E. azurea, Pistia stratiotes, Neptunia oleracea, I. aquatica, Salvinia auriculata, and Hymenachne amplexicaulis were the most dominant species. The quality water of Santo Tomás Wetlands showed spatial and temporal variations during flooding pulse and some physicochemical variables such as organic matter (COD, BOD5), pH, depth, ammonia, and fecal coliforms were related to macrophyte community composition Conclusions Spatial and temporal changes of aquatic plants in Santo Tomás wetlands were related to the flooding pulse of Magdalena River.

Resumen Objetivo principal: Analizar el grado de acuerdo en relación con una serie de mitos sobre violencia de género en personas jóvenes, y explorar factores asociados. Metodología: Estudio transversal mediante cuestionario voluntario y anónimo a jóvenes < 25 años residentes en Andalucía detectados por el alumnado de enfermería de la Universidad de Granada durante los años 2016 y 2018. Resultados principales: Participaron un total de 3291 jóvenes. Los mitos con mayor grado de acuerdo fueron: “Los maltratadores son violentos por naturaleza” (37%) y “Los maltratadores están locos” (36,3%). En 2018, respecto a 2016, se duplica el riesgo de estar de acuerdo con pensar que los maltratadores tienen problemas con el alcohol o drogas (OR=2,46; IC95%=2,02-3,00), la violencia de género ocurre en familias de bajo nivel económico o académico (OR=2,17; IC95%=1.54-3,04), o que son casos aislados (OR=2,02; IC95%=1.44-2.83). Conclusión principal: Persisten ciertos mitos entre la población juvenil andaluza, y además en los últimos años, algunos se han visto reforzados.

Abstract Objective: Analyze the degree of agreement in relation to a series of myths about gender violence in young people, and explore associated factors. Methods: Cross-sectional study using a voluntary and anonymous questionnaire to young people <25 years of age living in Andalusia detected by the Nursing students of the University of Granada during the years 2016 and 2018. Results: A total of 3,291 young people participated. The myths with the highest degree of agreement were: “Batterers are violent by nature” (37%) and “Batterers are crazy” (36.3%). In 2018, compared to 2016, the risk of agreeing with thinking that abusers have problems with alcohol or drugs is doubled (OR = 2.46; 95% CI = 2.02-3.00), gender violence occurs in families of low economic or academic level (OR = 2.17; 95% CI = 1.54-3.04), or that are isolated cases (OR = 2.02; 95% CI = 1.44-2.83). Conclusions: Certain myths persist among the Andalusian youth population, and also in recent years, some have been reinforced.

Abstract Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated healthcare costs. Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of healthcare professionals. Material and methods: "Design Thinking" techniques were used to address the analysis of the current situation and identify key aspects. Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing and dietetics) participated in the study. Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in 87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases. Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology.

Resumen Introducción: la desnutrición en los pacientes oncológicos puede conllevar una reducción de la calidad de vida del paciente y un aumento de la morbimortalidad y de los costes sanitarios asociados. Objetivos: analizar las intervenciones nutricionales en las diferentes fases del proceso oncológico, integrando las necesidades de los pacientes y las de los profesionales sanitarios. Material y métodos: se utilizaron técnicas de Design Thinking para abordar el análisis de la situación actual e identificar los aspectos clave. Participaron 13 profesionales de 8 centros sanitarios (endocrinología y nutrición, oncología médica y radioterápica, atención primaria (AP), enfermería y dietética) públicos de Andalucía. Resultados: no se realiza cribado nutricional de forma sistemática en las diferentes fases del proceso oncológico, y no existe consenso universal en los protocolos de actuación e intervención nutricional. Existe un cumplimiento generalizado de los circuitos y tiempos de derivación de los procesos seleccionados. En la fase terapéutica se dispone de la posibilidad de consultar a la Unidad de Nutrición Clínica y Dietética (UNCYD) y el 75 % disponen de protocolos específicos de derivación. La enfermera gestora de casos está presente en todos los hospitales y en AP. El acceso del paciente al psicólogo del centro era posible en el 87 % de los hospitales. Escasa participación de la UNCYD en los Comités de Tumores (solo en el 25 % de los centros). En todos los centros existe algún tipo de colaboración y apoyo de las asociaciones de pacientes y de la Escuela de Pacientes, especialmente en las fases terapéuticas y de control y seguimiento. Conclusiones: se observan variaciones entre los diferentes hospitales y territorios de Andalucía, tanto en la disposición de medios y estructuras como en las actividades y procedimientos. Se han seleccionado y priorizado puntos clave para mejorar la atención nutricional en oncología.

Abstract: Introduction: Diabetic ketoacidosis (DKA) is the main cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM) due to clinical and biochemical alterations associated, cerebral edema as one of the most critical because of the high mortality rates and long-term neurological se quelae. Objective: To analyze the clinical characteristics and complications of patients with DKA ad mitted to a pediatric intensive care unit. Patients and Methods: Retrospective study of DKA patients treated at the Hospital Clínico, Pontificia Universidad Católica de Chile (UPCPUC) between 2000 and 2015. Demographic characteristics, clinical manifestations, biochemical alterations, treatment, complications, and prognosis were assessed. Patients with T1DM onset were compared with those patients already diagnosed with diabetes, analyzing variables according to distribution. Results: 46 DKA events were identified, 67% of them were the first episode of DKA. 66% of patients already diagnosed with diabetes were admitted due to poor adherence to treatment. The main symptoms described were: 63% polydipsia, 56% polyuria, 48% vomiting, 39% weight loss and 35% abdominal pain, and mean blood sugar levels of 522 mg/dL, pH 7.17, and plasma osmolality of 305 mOsm/L. 89% of patients received insulin infusion, and 37% presented hypokalemia. No episodes of cerebral edema or deaths were registered. Conclusions: Most of the DKA admissions were due to T1DM onset. In the group of patients already diagnosed with diabetes, the poor adherence to treatment was the main cause of decompensation. There were no serious complications or deaths associated with DKA management during the studied period. Early diagnosis and proper and standardized treatment contributed to reducing morbidity and mortality in children with DKA.

Resumen: Introducción: La cetoacidosis (CAD) es la principal causa de morbimortalidad en niños con diabetes mellitus tipo 1 (DM1) debido a las alteraciones bioquímicas asociadas, siendo el más temido el edema cerebral, con altas tasas de mortalidad y secuelas neurológicas a largo plazo. Objetivo: caracterizar el perfil clínico y las complicaciones de pacientes con CAD ingresados en una unidad de paciente crítico pediátrico. Pacientes y método: Revisión retrospectiva de pacientes con CAD atendidos en el Hospital Clínico de la Pontificia Universidad Católica de Chile (UPCPUC) entre los años 2000 y 2015. Se evaluaron características demográficas, manifestaciones clínicas, alteraciones bioquímicas, tratamiento, complicaciones y pronóstico. Se compararon pacientes con debut de DM1 versus diabé ticos conocidos, analizándose variables según distribución. Resultados: Se identificaron 46 episodios de CAD. El 67% de éstos correspondió a un debut de DM1. El 66% de los diabéticos conocidos in gresaron por mala adherencia al tratamiento. Los principales síntomas de presentación fueron: 63% polidipsia, 56% poliuria, 48% vómitos, 39% pérdida de peso y 35% dolor abdominal, con medias de Glicemia 522 mg/dL, pH 7,17 y osmolaridad plasmática 305 mOsm/L. El 89% recibió insulina en infusión. El 37% presentó hipokalemia. No se registraron episodios de edema cerebral ni muertes. Conclusiones: La mayoría de los ingresos por CAD correspondió a debut de DM1. En el grupo de diabéticos conocidos, la mala adherencia al tratamiento fue la principal causa de descompensación. No se presentaron complicaciones graves ni muertes asociadas al manejo de la CAD durante el perío do estudiado. El diagnóstico precoz y el tratamiento adecuado y estandarizado pudieran contribuir a reducir la morbilidad y mortalidad en niños con CAD.