Background A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. Aim To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. Research design Qualitative study with a content analysis according to Elo and Kinglas framework. Participants (...) and research context Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. Methodology The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. Ethical considerations Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. Findings Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. Conclusion All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas. (shrink)

BackgroundThe COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain.MethodThe sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of (...) mental health and well-being indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators.ResultsMental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and unemployed individuals. Positive affect was higher among women, people with a high level of studies, those not co-living with dependent seniors, the self-employed, the employed, and those working outside home. Negative affect was negatively associated with age and number of children and was higher among women, people with basic studies, singles, individuals co-living with dependent seniors, homemakers, and students.ConclusionThe most vulnerable populations were found to be women, younger people, people with basic or medium studies, students and individuals with no remunerated activities, single populations, and those co-living with dependent seniors as well as those with a reduced number of children. (shrink)

Se presenta una aplicación de la paradoja de Newcomb a la disyuntiva evangélica de la elección entre Dios y el Dinero. Se concluye que la elección simultánea de Dios y el Dinero es debida, o bien a la creencia en la predestinación divina, o bien a una falta de fe en el Evangelio.

La relación entre el fenómeno religioso y el marco de la secularidad o la postsecularidad se hace presente en el ámbito de la escuela pública y, en cierta medida, reproduce las tensiones que tiene la sociedad a la hora de situar esa relación. El objetivo de este texto es presentar y valorar esa relación en el caso español, el cual posee un modelo de tipo confesional de la enseñanza de la religión en la escuela pública. La descripción del modelo debe (...) tener en cuenta el contexto histórico particular y su aplicación, que ha tenido variaciones significativas a lo largo del período democrático según los gobiernos de turno. Se trata de una opción muy controvertida que requiere una valoración ponderada, de tal manera que el texto sumaría los aspectos positivos y las dificultades que suscita el modelo en general y, en particular, la concreción española. La controversia tiene aspectos más coyunturales y otros de mayor calado, cuyo tratamiento sugiere una reflexión de tipo antropológico y teológico, la cual se realiza de manera incipiente. (shrink)

Concern about air-quality in urban areas has led to the implementation of Low Emission Zones as one of many other initiatives to control it. Recently in Spain, the enactment of a law made this mandatory for cities with a population larger than 50k inhabitants. The delimitation of these areas is not without controversy because of possible negative economic and social impacts. Therefore, clear assessments of how these initiatives decrease pollutant concentrations are to be provided. Madrid Central is a major initiative (...) of Madrid city council for reducing motor traffic and the associated air pollution in the city centre. This Low Emission Zone starts at the end of 2018, but the first fully-operational period corresponds to the second quarter of 2019. In this work, a methodology based on the Gaussian Process to analyse the evolution of Nitrogen Dioxide inside Madrid Central is undertaken. A Gaussian Process is a stochastic process suitable for interpretable model selection and predictions. Due to its probabilistic nature it provides error estimation at predictions. After the activation of Madrid Central, a relevant reduction of Nitrogen Dioxide has been observed. However, the role of the meteorology during this period must be ascertained to correctly evaluate the role of the activation of the Low Emission Zone against a prone weather. In this work, a model based on the Gaussian Process is trained with meteorological information to predict the concentration of Nitrogen Dioxide at Madrid Central, $[NO_{2}]$. This probabilistic description allows extracting statistical information on the reduction affected by the meteorological scenario and separately by the Madrid Central activation. (shrink)

This work focuses on the application of machine learning techniques to assist the clinicians in the administration of analgesic drug during general anaesthesia. Specifically, the main objective is to propose the basis of an intelligent system capable of making decisions to guide the opioid dose changes based on a new nociception monitor, the analgesia nociception index. Clinical data were obtained from 15 patients undergoing cholecystectomy surgery. By means of an off-line study, machine learning techniques were applied to analyse the possible (...) relationship between the analgesic dose changes performed by the physician due to the hemodynamic activity of the patients and the evolution of the ANI. After training different classifiers and testing the results under cross validation, a preliminary relationship between the evolution of ANI and the dosage of remifentanil was found. These results evidence the potential of the ANI as a promising index to guide the infusion of analgesia. (shrink)

One of the main challenges in medicine is to guarantee an appropriate drug supply according to the real needs of patients. Closed-loop strategies have been widely used to develop automatic solutions based on feedback variables. However, when the variable of interest cannot be directly measured or there is a lack of knowledge behind the process, it turns into a difficult issue to solve. In this research, a novel algorithm to approach this problem is presented. The main objective of this study (...) is to provide a new general algorithm capable of determining the influence of a certain clinical variable in the decision making process for drug supply and then defining an automatic system able to guide the process considering this information. Thus, this new technique will provide a way to validate a given physiological signal as a feedback variable for drug titration. In addition, the result of the algorithm in terms of fuzzy rules and membership functions will define a fuzzy-based decision system for the drug delivery process. The method proposed is based on a Fuzzy Inference System whose structure is obtained through a decision tree algorithm. A four-step methodology is then developed: data collection, preprocessing, Fuzzy Inference System generation, and the validation of results. To test this methodology, the analgesia control scenario was analysed. Specifically, the viability of the Analgesia Nociception Index as a guiding variable for the analgesic process during surgical interventions was studied. Real data was obtained from fifteen patients undergoing cholecystectomy surgery. (shrink)

Closed-loop administration of propofol for the control of hypnosis in anesthesia has evidenced an outperformance when comparing it with manual administration in terms of drug consumption and post-operative recovery of patients. Unlike other systems, the success of this strategy lies on the availability of a feedback variable capable of quantifying the current hypnotic state of the patient. However, the appearance of anomalies during the anesthetic process may result in inaccurate actions of the automatic controller. These anomalies may come from the (...) monitors, the syringe pumps, the actions of the surgeon or even from alterations in patients. This could produce adverse side effects that can affect the patient postoperative and reduce the safety of the patient in the operating room. Then, the use of anomaly detection techniques plays a significant role to avoid this undesirable situations. This work assesses different one-class intelligent techniques to detect anomalies in patients undergoing general anesthesia. Due to the difficulty of obtaining real data from anomaly situations, artificial outliers are generated to check the performance of each classifier. The final model presents successful performance. (shrink)

Automatic control of physiological variables is one of the most active areas in biomedical engineering. This paper is centered in the prediction of the analgesic variables evolution in patients undergoing surgery. The proposal is based on the use of hybrid intelligent modelling methods. The study considers the Analgesia Nociception Index to assess the pain in the patient and remifentanil as intravenous analgesic. The model proposed is able to make a one-step-ahead prediction of the remifentanil dose corresponding to the current state (...) of the patient. The input information is the previous remifentanil dose, the ANI variable and the electromyogram signal. Modelling techniques used are Artificial Neural Networks and Support Vector machines for Regression combined with clustering methods. Both training and validation were done with a real dataset from different patients. Results obtained show the potential of this methodology to calculate the drug dose corresponding to a given analgesic state of the patient. (shrink)

Desde su nacimiento bajo la pluma de Arthur Conan Doyle, Sherlock Holmes ha sabido adaptarse a los nuevos tiempos; en la actualidad, existen series, películas, videojuegos, e incluso, experiencias virtuales basadas en las obras originales. Este artículo lleva a cabo un análisis evolutivo del concepto de interactividad -desde la previrtualidad literaria de Gil González (2020) hasta la cultura participativa de Jenkins et al. (2015), el lectoespectador de Mora (2012), el interactor de Murray (1997) o el operador de Gubern (1996)-, (...) en los medios de la literatura, el cine y el videojuego en el corpus holmesiano. Para ello, se realiza una amplia revisión bibliográfica desde la perspectiva de la literatura comparada y los estudios intermediales, así como un abordaje crítico-analítico de algunas obras del universo del popular detective especialmente significativas en diferentes medios. (shrink)

RESUMEN La problemática del muy bajo peso al nacer ha sido abordada desde hace varios años, sin embargo, las investigaciones están enfocadas desde diferentes perspectivas y contextos, no siempre se ha considerado su repercusión a corto y a largo plazo, así como la interacción de los diferentes factores que se relacionan con este riesgo biológico. Por ello en esta revisión bibliográfica se realiza una valoración de estudios ejecutados a nivel internacional y en Cuba dedicados al desarrollo neuropsicológico de niños con (...) muy bajo peso al nacer. Se concluye que el muy bajo peso al nacer repercute en el desarrollo neuropsicológicos desde edades tempranas, hasta la adolescencia; por ello es necesario una visión integradora que tenga en cuenta el riesgo biológico, las particularidades individuales y el contexto social en que se desenvuelve el niño desde los primeros momentos, lo que posibilitará, perfeccionar la atención a corto y largo plazo al grupo de riesgo. ABSTRACT The problems of very low birth weight have been dealt with for many years, however, research on the matter is approached from different perspectives and contexts, not always have its short and long term repercussions being considered as well as the interaction of different factors related to this biological risk. Therefore, this bibliographical review makes an assessment of international and Cuban studies devoted to very low birth weight children’s neuropsychological development. It was reached the conclusion that very low birth weight affects neuropsychological development from early ages to adolescence; for that reason, it is necessary to have an integrated approach of the problem that takes into account the biologicals risk, individual characteristics and the social context in which the child develops from the beginning, which will make the improvement of short and long term care to this risk group possible. (shrink)

El presente trabajo investiga las tesis sobre el poder civil de Alonso de la Veracruz que buscan incorporar en la comunidad política española a los habitantes autóctonos del Nuevo Mundo, tesis que suelen relacionarse con F. de Vitoria y el tomismo español, y que últimamente son consideradas parte del republicanismo novohispano elaborado desde la periferia americana. Se busca demostrar que su propósito era aplicar una teoría de derechos naturales, sin que ello implique participación política de los indios americanos. Se analiza (...) la postura del fraile frente a la diversidad cultural y la guerra contra los indios. The paper explores Alonso de la Veracruz's theses on civil power, which sought to integrate the native inhabitants of the New World into the Spanish political community. These theses, which have usually been associated with F. de Vitoria and Spanish Thomism, have recently come to be considered part of a Novohispanic republicanism developed in the American periphery. The article seeks to show that the purpose of such theses was to apply a theory of natural rights that did not entail the political participation of the indigenous population, as well as to analyze Veracruz's position regarding cultural diversity and the war against the indigenous peoples. (shrink)

Adaptive optics are techniques used for processing the spatial resolution of astronomical images taken from large ground-based telescopes. In this work, computational results are presented for a modified curvature sensor, the tomographic pupil image wavefront sensor, which measures the turbulence of the atmosphere, expressed in terms of an expansion over Zernike polynomials. Convolutional neural networks are presented as an alternative to the TPI-WFS reconstruction. This technique is a machine learning model of the family of artificial neural networks, which are widely (...) known for its performance as modeling and prediction technique in complex systems. Results obtained from the reconstruction of the networks are compared with the TPI-WFS reconstruction by estimating errors and optical measurements. The reconstructed wavefronts from both techniques are compared for wavefronts of 153 Zernike modes. For this case, a detailed comparison and grid search to find the most suitable neural network is performed, searching between multi-layer perceptron, CNN and recurrent networks topologies. In general, the best network was a CNN trained for TPI-WFS reconstruction, achieving better performance than the reconstruction software from TPI-WFS in most of the turbulent profiles, but the most significant improvements were found for higher turbulent profiles that have the lowest r0 values. (shrink)

SUMARIO Artículos ¿Por qué democracia? Referencia a los derechos humanos y a la ciudadanía. Why democracy? Reference to human rights and citizenship. Bozo de Carmona, Ana Julia Libertad de expresión y "libertad cómica". Free speech and "comical liberty".Calvo González, José La justicia según J. Finnis. Justice according to John Finnis. Hocevar G., Mayda G. El lenguaje sagrado y su escritura. The sacred language and its writing. Lizaola, Julieta Del carácter coactivo de la μετηνεστασζ en Tucídides. On cornening to compelling (...) nature of Thucydides' μετηνεστασζ. Meabe, Joaquín E. Apuntes para una filosofía crítica de la historia regional. Notes for a critical philosophy concern to the regional history. Mora García, José Pascual Competencia política partidista en los textos de Simón Bolívar . The defender political competition in the Simon Bolivar’s writings . Ortiz Palanques, Marco Fundamentación socio-jurídica de los procesos normativos. Social and juridical reasoning about the normatives changes. Pavó Acosta, Rolando Filosofía y psicopatología en Karl Jaspers: los entramados de la existencia. Philosophy and psychopathology in Karl Jaspers: the studworks of the existence. Portuondo Pajón, Gladys L. La doctrina platónica del alma en la «república». The platonic doctrine of the soul in the «republic» dialogue. Suzzarini, Andrés Una aproximación a la concepción romana del derecho. An estimate study to the roman concept of law. Terán Pimentel, Milagros Interdisciplinares Lo dionisíaco y lo apolíneo en Don Juan Tenorio. The dionysiac and the apolline in Don Juan Tenorio. Pérez Lo Presti, Alirio. (shrink)

En este ensayo se revisará el legado de Francisco de Quevedo y Villegas en algunos autores hispanoamericanos cuya característica común es un dominio superlativo del español: Jorge Luis Borges, Octavio Paz, Juan José Arreola y, por último, en un gran escritor de literatura y crítica que abre una veta para valorar la obra de Quevedo, la cual no fue explorada por los anteriores: José Pascual Buxó.

This article examines four characters from the novel Hombres by Eugenio González in order to reveal the identities of those people who were an inspiration for the narrator to shape the fiction in novel. Since Hombres is placed temporarily in Carlos Ibáñez’s dictatorship, the narrator decides to hide the poet Gómez Rojas, the union leader Luis Triviño, Dr. Juan Gandulfo and the lawyer Carlos Vicuña between the pages of the book. This narrative procedure keeps these people’s identities (...) safe; considering that, making these names and activities evident would have represented a problem for the state security apparatus. (shrink)

El objeto de este artículo es doble. Por una parte, examina el uso que Vives hace de la lengua y del lenguaje, y, por otra parte, indica sus aportaciones al campo de la traducción e interpretación. La diversidad temática presente en su obra hace que su persona sea un punto de referencia para diferentes campos científicos, entre ellos la Filología. Para Vives, tanto el acercamiento filológico, como el aprendizaje de la lengua no sólo deben tener en cuenta la lengua desde (...) un punto teórico, sino también sociocultural. Su especial interés por las lenguas le llevó a realizar un considerable esfuerzo filológico haciendo lecturas e introducciones de varios textos clásicos latinos y también griegos, y transmitiendo su opinión acerca de la forma de realizar versiones o interpretaciones. (shrink)

El pensamiento vivo de Juan Luis Vives, por Joaquín Xirau.--Páginas escogidas de Juan Luis Vives: De concordia y discordia. Tratado del alma. Introducción a la sabiduría. Del socorro de los pobres. Tratado de la enseñanza.