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Activity is the basic unit of teaching. Task-based teaching activity is popular because it emphasizes "learning by doing". Based on the activity theory, this paper designs a task-based teaching triangle model for TCM ESP course, and applies it to a TCM ESP course Introducing TCM Culture in English. An empirical study of task-based teaching activity is carried out by analyzing the subject, determining the object, employing tools, setting rules, clarifying the division of labor, constructing the community, focusing on the results, and enriching evaluation methods. It is proved that the application of the model is helpful to improve students' learning initiative, enrich their TCM English knowledge structure, enhance their TCM English application ability, and optimize TCM English teaching effect.
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English for specific purpose (ESP) courses for the postgraduates in medical schools have both physical and social attributes, with emphasis to improve practical language learning of medical specialties. It's an effective way to develop the English language application ability of high-level medical college students by constructing an ESP teaching and learning ecological system with professional and social contextual characteristics. In this study, through design-based implementation research, scenario simulation class was designed and implemented to accomplish task-based language teaching and learning. Further discussions on how to integrate blended and interrelated classes, on how to define combined and interactive teachers' role were explored. Based on the teaching and learning practices, organically combining the innovative curriculum concept with the construction of ESP ecological system effectively directs the practical application of the ESP class under the perspective of learning science, and verifies the feasibility of the ecological construction of ESP curriculum system.
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The phenomenon of "Chinese cultural aphasia" in college English education in China is typically represented by "traditional Chinese medicine (TCM) cultural aphasia" in English learning among students in TCM colleges and universities, which is mainly caused by insufficient driving force for input and production in both teaching and learning. Based on the production-oriented approach, this study designs a teaching model oriented by "TCM culture" production in the ESP course of Introducing TCM Culture in English and conducts a practice research according to the teaching process of driving, facilitating, and evaluating. The practice research shows that the application of this model has effectively integrated "national sentiment" and "national consciousness" into the teaching and learning of the TCM ESP course, improved the TCM culture production ability among students, realized the educational effect of foreign language teaching, and promoted the teaching and research practice of teachers.
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Abstract The aim of this paper is to present the development of a real-time measurement system for glucose in aqueous media. The proposed system incorporates two lines of research: i) design, synthesis, and implementation of a non-enzymatic electrochemical sensor of Multi-Walled Carbon Nanotubes with Copper nanoparticles (MWCNT-Cu) and ii) design and implementation of a machine learning algorithm based on an Artificial Neural Network Multilayer Perceptron (ANN-MLP), which is embedded in an ESP32 SoC (System on Chip). From the current data that is extracted in real-time during the oxidation-reduction process to which an aqueous medium is subjected, it feeds the algorithm embedded in the ESP32 SoC to estimate the glucose value. The experimental results show that the nanostructured sensor improves the resolution in the amperometric response by identifying an ideal place for data collection. For its part, the incorporation of the algorithm based on an ANN embedded in a SoC provides a level of 97.8 % accuracy in the measurements. It is concluded that incorporating machine learning algorithms embedded in low-cost SoC in complex experimental processes improves data manipulation, increases the reliability of results, and adds portability.
Resumen El objetivo de este artículo es presentar el desarrollo de un sistema de medición en tiempo real de glucosa en medios acuosos. El sistema que se implementa incorpora dos lineas de investigación: i) diseño, síntesis e implementación de un sensor electroquímico no enzimático de Nanotubos de Carbono de Pared Múltiple con nanopartículas de Cobre (NTCPM-Cu) y ii) diseño e implementación de un algoritmo de aprendizaje automático basado en una Red Neuronal Perceptrón Multicapa (RN-PM), embebido en un ESP32 SoC (Sistema en Chip). Un dato de corriente que se extrae en tiempo real durante el proceso de oxidación-reducción a la que se somete un medio acuoso, alimenta el algoritmo embebido en el ESP32 para estimar el valor de glucosa. De los resultados experimentales se demuestra que el sensor nanoestructurado mejora la resolución en la respuesta amperométrica al identificar un lugar ideal para la toma de datos. Por su parte, la incorporación del algoritmo basado en una RN embebido en SoC otorga un nivel de 97.8 % de exactitud en la mediciones. Se concluye que incorporar algoritmos de aprendizaje automático embebidos en SoC de bajo costo en procesos experimentales complejos, mejora la manipulación de datos, incrementa la confiabilidad en resultados y adiciona portabilidad.
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This study aimed to investigate the effect of Tibetan medicine Ershiwuwei Songshi Pills(ESP) on the intestinal flora of non-alcoholic steatohepatitis(NASH) mice. Forty-eight male C57 BL/6 mice were randomly divided into the control group, model(methionine-choline-deficient, MCD) group, high-(0.8 g·kg~(-1)), medium-(0.4 g·kg~(-1)), and low-dose(0.2 g·kg~(-1)) ESP groups, and pioglitazone(PGZ, 10 mg·kg~(-1)) group, with eight mice in each group. Mice in the control group were fed with normal diet, while those in the remaining five groups with MCD diet for five weeks for inducing NASH. During modeling, they were gavaged with the corresponding drugs. The changes in body mass, daily water intake, and daily food intake were recorded. At the end of the experiment, the liver tissues were collected and stained with hematoxylin-eosin(HE) for observing the pathological changes, followed by oil red O staining for observing fat accumulation in the liver. The levels of serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) and triglyceride(TG) in liver tissue were measured. The changes in intestinal flora of mice were determined using 16 S rRNA high-throughput sequencing technology. The results showed that compared with the model group, the high-, medium-and low-dose ESP groups and the PGZ group exhibited significantly lowered AST and ALT in serum and TG in liver tissues and alleviated hepatocellular steatosis and fat accumulation in the liver. As demonstrated by 16 S rRNA sequencing, the abundance index and diversity of intestinal flora decreased in the model group, while those increased in the ESP groups. Besides, the Firmicutes to Bacteroidetes ratio decreased at the phylum level. In the alteration of the composition of intestinal flora, ESP reduced the abundance of Erysipelotrichia and Faecalibaculum but increased the abundance of Desulfovibrionaceae, Rikenellaceae, Lachnospiraceae, and Ruminococcaceae. This study has revealed that ESP has a protective effect against NASH induced by MCD diet, which may be related to its regulation of the changes in intestinal flora, alteration of the composition of intestinal flora, and inhibition of the intestinal dysbiosis.
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Animais , Masculino , Camundongos , Modelos Animais de Doenças , Microbioma Gastrointestinal , Fígado , Medicina Tradicional Tibetana , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológicoRESUMO
One of the fundamental pillars for optimal patient recovery after a cesarean section is pain management after a surgical intervention. For years the gold standard for analgesic management the use of intrathecal morphine due to its long-lasting effect, however adverse effects related to the use of opioids are evidenced too, Currently, with the advent of multimodal analgesia, the use of opioids and the effects associated with them have been reduced, optimizing pain management, reducing hospital stay, lower risk of postpartum depression, reducing the presence of nausea and vomiting as well as pruritus and improving mother-child relationship. An essential component of the multimodal analgesia are regional blocks like the transversus abdominis plane block and the ilioinguinal / iliohypogastric block, Quadratus lumborum and erectus spinae plane block demonstrate its usefulness with better pain management compared with TAP block regardless these have a higher level of complexity due to the visceral pain control; but there is no evidence with methodologic quality enough that demonstrate better outcomes compare with intrathecal morphine.
Uno de los pilares fundamentales para la recuperación de la paciente que fue intervenida de cesárea es el manejo del dolor posoperatorio. Por años el estándar de oro ha sido el uso de la morfina intratecal considerando su larga duración como también los efectos adversos, actualmente con el advenimiento de la analgesia multimodal, se ha reducido el uso de opiodes y de los efectos asociados a estos optimizando el manejo del dolor, disminuyendo la estancia hospitalaria, menor riesgo de depresión posparto, disminuye la presencia de náusea y vómitos como también prurito y mejorando la relación madre e hijo. Un componente esencial de la analgesia multimodal son los bloqueos: transverso del abdomen, ilioinguinal/ iliohipogástrico, cuadrado lumbar, erector de la espina; que han aportado eficazmente en el abordaje del dolor posoperatorio. El bloqueo de los planos y demuestra su utilidad con un mejor manejo del dolor en comparación con el bloqueo TAP, a pesar de que estos tienen un mayor nivel de complejidad debido al control del dolor visceral; pero no hay evidencia con suficiente calidad metodológica que demuestre mejores resultados en comparación con la morfina intratecal.
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Humanos , Feminino , Gravidez , Dor Pós-Operatória/prevenção & controle , Cesárea/métodos , Analgesia Obstétrica , Analgésicos/administração & dosagem , Bloqueio Nervoso/métodos , Coluna Vertebral/efeitos dos fármacos , Músculos Abdominais/efeitos dos fármacos , Ultrassonografia de IntervençãoRESUMO
Abstract Pain after liver resection can be difficult to manage. Epidural anesthesia (EA) is an effective technique in pain control in this surgery. However, postoperative coagulopathy and hypotension due to autonomic nervous system block in high-risk patients, may result that the EA is an inadequate analgesic technique in according to enhanced recovery after surgery (ERAS) recommendations for liver surgery. Regional block techniques have been recommended for liver surgery in ERAS guidelines. Erector spinae plane (ESP) block is a recent block described for thoracic and abdominal surgeries and provides both somatic and visceral analgesia. We describe a high-risk patient with cardiac dysfunction and Parkinson's disease who underwent laparoscopic right liver resection for hepatocellular carcinoma. Satisfactory intra and postoperative analgesia was achieved by a combined continuous ESP block, transversus abdominis plane (TAP), and oblique subcostal TAP blocks. Surgery and postoperative period was uneventful. No opioids were administered during hospitalization. A combined of thoracic and abdominal wall blocks can be an effective approach for intra and postoperative analgesia in high-risk patients undergoing laparoscopic liver resection. Further clinical research is recommended to establish the effectiveness of the ESP block as an analgesic technique in this surgery.
Resumen El dolor posterior a una resección hepática puede ser difícil de manejar. La anestesia epidural (AE) es una técnica efectiva para el control del dolor en esta cirugía. Sin embargo, la coagulopatía y la hipotensión postoperatorias debido al bloqueo del sistema nervioso autónomo en pacientes de alto riesgo, puede hacer que la AE sea una técnica analgésica inadecuada, de acuerdo con las recomendaciones de la recuperación mejorada después de cirugía (ERAS, por las iniciales en inglés de Enhanced Recovery After Surgery) para cirugía hepática. Se han recomendado las técnicas de bloqueo regional para cirugía hepática en las guías ERAS. El bloqueo del plano erector de la espina (BEE) (ESP, por las iniciales en inglés de erector spinae plan block) es una técnica reciente, para cirugías torácicas y abdominales, que brinda analgesia tanto somática como visceral. Se describe aquí un paciente de alto riesgo con disfunción cardiaca y enfermedad de Parkinson que se sometió a resección la paroscópica del lóbulo derecho del hígado por carcinoma hepatocelular. Se logró analgesia intra y postoperatoria eficaz mediante una combinación de bloqueo continuo ESP, y bloqueos del plano transverso abdominal (PTA) y del plano transverso abdominal subcostal oblicuo. La cirugía y el periodo postoperatorio transcurrieron sin novedad y no se administraron opioides durante la hospitalización. La combinación de bloqueos combinados torácicos y de la pared abdominal pueden ser un abordaje efectivo para la analgesia intra y postoperatoria en pacientes de alto riesgo que se someten a resección hepática laparoscópica. Se recomienda continuar con la investigación clínica a finde establecer la efectividad del bloqueo ESP como técnica anestésica para esta cirugía.
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Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Torácica , Falência Hepática/cirurgia , Laparoscopia , Anestesia Epidural , Doença de Parkinson , Complicações Pós-OperatóriasRESUMO
Abstract The erector spinae plane block is a safe and effective regional anesthesia technique, which has earned new indications perioperatively since its description. We introduce two pediatric anesthesia cases in which we performed the erector spinae plane block during intermediate/major orthopedic surgeries. The first patient is a 2 year-old girl submitted to surgical treatment of developmental dysplasia of the hip. The second patient is a 14 year-old boy submitted to surgical treatment of bilateral clubfoot. This last patient is potentially the first published case in which the erector spinae plane block was performed for ankle and foot surgery. Both cases experienced excellent analgesia, avoiding opiate requirement completely.
Resumo O bloqueio do plano eretor da espinha guiado por ultrassonografia é uma técnica segura e eficaz de anestesia regional, que apresenta novas indicações no perioperatório. Apresentamos dois casos de bloqueio do plano eretor da espinha realizados para analgesia de cirurgia ortopédica pediátrica de médio/grande porte. O primeiro: menina de 2 anos submetida a tratamento cirúrgico de displasia do desenvolvimento do quadril. O segundo: menino de 14 anos submetido a correção de pé valgo bilateral. Este último, no melhor do nosso conhecimento, é o primeiro caso de bloqueio do plano eretor da espinha em cirurgia de tornozelo/pé descrito na literatura. Os casos tiveram analgesia pós-operatória adequada, sem necessidade de opioides.
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Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Pé Torto Equinovaro/cirurgia , Procedimentos Ortopédicos/métodos , Displasia do Desenvolvimento do Quadril/cirurgia , Bloqueio Nervoso/métodos , Dor Pós-Operatória/prevenção & controle , Músculos ParaespinaisRESUMO
Abstract Introduction and objectives: Blockade of the Erector Spinal Muscle (ESP Block) is a relatively new block, initially described for chronic thoracic pain analgesia, but it has already been described for anesthesia and analgesia in thoracic surgical procedures and, more recently, for high abdominal surgeries. The aim of the study was to compare two techniques, ESP Block and Epidural Block, with morphine and local anesthetic for postoperative analgesia of open cholecystectomy surgeries. Methods: Controlled single-blind randomized clinical trial with 31 patients (ESP Block, n = 15; Epidural, n = 16), of both genders, ages between 27 and 77 years. The ESP block was performed at the T8 level with injection of 20 mL of 0.5% ropivacaine bilaterally. The epidural block was performed at the T8-T9 space with 20 mL of 0.5% ropivacaine and 1 mg of morphine. Results: The ESP Block group presented higher mean Numeric Pain Scale (NPS) values for pain in the up to 2 hour (p = 0.001) and in the 24 hour (p = 0.001) assessments. The ESP Block group had a three-fold increased risk (43.7% vs. 13.3%) of rescue opioid use in the 24 postoperative hours when compared to the epidural group (RR = 3.72, 95% CI: 0.91 to 15.31, p = 0.046). Conclusion: ESP Block did not prove to be an effective technique for postoperative analgesia of open cholecystectomy, at the doses performed in this study, having required more use of rescue opioid, and without differences in NPS. More comprehensive studies are required to assess the efficacy of ESP block for the visceral and abdominal somatic component, considering the specific blockade level.
Resumo Justificativa e objetivo: O Bloqueio do Plano do Músculo Eretor da Espinha (ESP block) é um bloqueio relativamente novo, inicialmente descrito para analgesia de dor torácica crônica, porém já descrito para anestesia e analgesia em procedimentos cirúrgicos torácicos e, mais recentemente, para cirurgias abdominais altas. O estudo objetivou comparar as técnicas de bloqueio ESP e bloqueio Epidural com morfina e anestésico local para analgesia pós-operatória de cirurgias de colecistectomia aberta. Método: Estudo clínico randomizado controlado, unicego com 31 pacientes (ESP block, n = 15; Epidural, n = 16), de ambos os sexos, idades entre 27 e 77 anos. O ESP block foi realizado no nível de T8 com injeção de 20 mL de ropivacaína 0,5% bilateral. O bloqueio Epidural foi realizado no espaço T8-T9 com 20 mL de ropivacaína 0,5% e 1 mg de morfina. Resultados: O grupo ESP block apresentou valores médios de dor pela Escala Visual Numérica (EVN) maiores nas avaliações até 2 horas (p= 0,001) e em 24 horas (p= 0,001). O grupo ESP block apresentou um risco três vezes maior - 43,7%vs.13,3% - de uso de opioide de resgate em 24 horas pós-operatórias do que o grupo epidural (RR = 3,72; 95% IC 0,91 a 15,31; p= 0,046). Conclusão: Nas doses realizadas nesse estudo, o ESP block não se mostrou uma técnica efetiva para analgesia pós-operatória de colecistectomia aberta, com mais uso de opioide de resgate e sem diferenças na escala visual numérica de dor. Necessita-se de estudos mais abrangentes avaliando a eficácia do ESP block para o componente visceral e somático abdominal, considerando o nível do bloqueio específico.
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Humanos , Masculino , Feminino , Adulto , Idoso , Dor Pós-Operatória/terapia , Colecistectomia/métodos , Analgesia/métodos , Bloqueio Nervoso/métodos , Analgesia Epidural , Método Simples-Cego , Músculos do Dorso/inervação , Pessoa de Meia-IdadeRESUMO
Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.
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Dor Aguda , Anestesia por Condução , Dor Crônica , Manejo da Dor , Coluna VertebralRESUMO
English biomedical research paper writing is a key skill for biomedical postgraduates as it directly determines the publicity of their research findings and their international academic influence. It belongs to the field of ESP (English for Specific Purposes), and has the characteristics of diversified students, specialized and complicated teaching content, and a curriculum with time and space constraints. Based on the characteristics, needs analysis of this course as well as years of discipline construction and teaching research, the flipped classroom for English biomedical research paper writing based on collaborative teaching is put forward, which has combined the advantages of both collaborative teaching and flipped classroom: it integrates the knowledge expertise of biomedical teachers and English teachers to meet the requirements for ESP teachers; in the meantime, it has broken the time and space constraints of traditional classroom through "after-class knowledge input and in-class knowledge extension and deepening", blazing new trails for course delivery.
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The practical course of medical English for academic purpose is the academic module of medical English teaching system. Based on the target situation analysis, the course consists of reading and writing of scientific papers, design of academic posters, and oral presentation in academic conferences, all of which focus on the selected key literature. During the course, the genre analysis theory, task-based teaching and situational teaching were applied to help students to improve their practical competence of academic English through accomplishing different kinds of academic communicative activities.
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Clonorchiasis, caused by direct contact with Clonorchis sinensis worms and their excretory-secretory products (ESPs), is associated with chronic inflammation, malignant changes in bile ducts, and even cholangiocarcinogenesis. Our previous report revealed that intracellular free radicals enzymatically generated by C. sinensis ESPs cause NF-κB-mediated inflammation in human cholangiocarcinoma cells (HuCCT1). Therefore, the present study was conducted to examine the role of upstream Toll-like receptors (TLRs) on the initial host innate immune responses to infection. We found that treatment of HuCCT1 cells with native ESPs induced changes in TLR mRNA levels in a time-dependent manner, concomitant with the generation of free radicals. ESP-mediated free radical generation was markedly attenuated by preincubation of the cells with TLR1-4-neutralizing antibodies, indicating that at least TLR1 through 4 participate in stimulation of the host innate immune responses. These findings indicate that free radicals triggered by ESPs are critically involved in TLR signal transduction. Continuous signaling by this pathway may function in initiating C. sinensis infection-associated inflammation cascades, a detrimental event leading to progression to more severe hepatobiliary diseases.
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Humanos , Anticorpos , Ductos Biliares , Colangiocarcinoma , Clonorquíase , Clonorchis sinensis , Radicais Livres , Imunidade Inata , Inflamação , RNA Mensageiro , Transdução de Sinais , Receptores Toll-LikeRESUMO
Clonorchiasis, caused by direct contact with Clonorchis sinensis worms and their excretory-secretory products (ESPs), is associated with chronic inflammation, malignant changes in bile ducts, and even cholangiocarcinogenesis. Our previous report revealed that intracellular free radicals enzymatically generated by C. sinensis ESPs cause NF-κB-mediated inflammation in human cholangiocarcinoma cells (HuCCT1). Therefore, the present study was conducted to examine the role of upstream Toll-like receptors (TLRs) on the initial host innate immune responses to infection. We found that treatment of HuCCT1 cells with native ESPs induced changes in TLR mRNA levels in a time-dependent manner, concomitant with the generation of free radicals. ESP-mediated free radical generation was markedly attenuated by preincubation of the cells with TLR1-4-neutralizing antibodies, indicating that at least TLR1 through 4 participate in stimulation of the host innate immune responses. These findings indicate that free radicals triggered by ESPs are critically involved in TLR signal transduction. Continuous signaling by this pathway may function in initiating C. sinensis infection-associated inflammation cascades, a detrimental event leading to progression to more severe hepatobiliary diseases.
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Humanos , Anticorpos , Ductos Biliares , Colangiocarcinoma , Clonorquíase , Clonorchis sinensis , Radicais Livres , Imunidade Inata , Inflamação , RNA Mensageiro , Transdução de Sinais , Receptores Toll-LikeRESUMO
Objective:To cultivate English talents with expertise. Methods:Based on the poll of 803 medical students in Grade 2013 with different professional questionnaires and the interview of 30 students who have graduated in the past 5 years and are working now, together with the successful experience from others and our own training objectives, English curriculum model has been built whose purpose is to satisfy professional needs in the future. Results: In addition to the regular courses of 2 years of intensive reading and self-studying audio-visual online learning, we also offer 12 optional courses including practical oral medical English and IELTS English Training Course. The students’enthusiasm for learning English is aroused,and 24.7%of all the students at school take an active part in English selective courses. Conclusion:The multi-mode English curriculum setting based on ESP is the key and inevitable trend in English teaching.
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As the global economic integration, the trend of internationalization of medical education, social demand for foreign talents is more and more big, the English teaching, especially the doctor-patient communication in English teaching has become a major focus on the teaching content.Learning is the study of doctor-patient communication be-tween medical workers and patients how to mutual understanding, trust and cooperation, common a discipline, to conquer the disease and emphasize ability oriented ESP teaching concept, closely integrated with professional, promotes the student as the center, apply English teaching as means and tools to study, the two organically unifies in together.Practice shows that guided by the ESP teaching concept, improve medical students English power of expression of doctor-patient commu-nication attempt made substantial results.
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This paper expounds the connotation of doctor-patient communication and its importance in medical prac-tice, and points out the problems existing in the doctor-patient communication in practice. Based on this, advances the ESP teaching ideas, reform mainly from the following several aspects: first, the increase in oral English course arrange-ment class, small class teaching;secondly, on the oral English teaching mode reform, with school, learning, is unified. Once again, to reform on English spoken language teaching material use, both medical professional knowledge and English language skills. Finally, the reform on oral English teaching staff, improve English teachers' team.
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Many college students’ English is not good enough to meet the need of the society. Pairing general English with ESP is proposed so as to solve the problem. Taking college English teaching in schools of traditional Chinese medicine as a case, this paper analyzes the key factors such as teaching materials, language teachers, students, teaching objectives, methods and environment in the teaching process in order to prove that pairing general English with ESP is feasible.
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English curriculum development has been a focus of English teaching in the medical universities in China.Under the background of cultivation of international medical talents,this thesis analyzed the current situation and major problems in this field,and put forward EGP + ESP model in English curriculum development,proposed to provide systematic and continuous English education for the medical students through the combination of public English and Medical English.
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En este artículo presentamos el proceso de adaptación y validación al contextolocal de la Escala Breve de Evaluación Familiar Faces 20 ESP realizada en la ciudad de Chillán,Chile. Los resultados obtenidos nos demostraron una semejanza altamente significativa frente a losencontrados en la versión original, lo que da cuenta de la fiabilidad y validez del instrumento para elestudio del funcionamiento familiar, sentando importantes precedentes académicos para posterioresinvestigaciones.Con base en el análisis comparativo, pudimos observar que en las familias estudiadas no existendiferencias estadísticamente significativas tanto en cohesión como en adaptabilidad, entre lostipos ensambladas y nucleares. Esto evidencia empíricamente que no es posible atribuir un tipo defuncionamiento determinado a una configuración familiar específica, lo que posiblemente contengaimplicancias teóricas futuras.