Síndrome de Down, envejecimiento y lenguaje: consideraciones para elabordaje fonoaudiológico / Down syndrome, aging and language: considerations for the speech-language therapy

El envejecimiento de las personas con Síndrome de Down ha generado un interés creciente para las disciplinas afines al trabajo terapéutico con personas en situación de discapacidad intelectual. La fonoaudiología ha contribuido con un gran cuerpo de investigaciones al establecer procedimientos de evaluación e intervención en las habilidades comunicativas, lingüísticas y cognitivas de las personas con Síndrome de Down principalmente durante etapas tempranas y en la adolescencia. Sin embargo, el progresivo incremento de la esperanza de vida en esta población, por los avances médicos, terapéuticos y en los servicios sociales, supone nuevos desafíos para el ejercicio clínico. En particular, ello se evidencia si se considera que presentan un envejecimiento prematuro, acelerado y donde ciertas condiciones neurobiológicas predisponen la aparición temprana de procesos neurodegenerativos. En este artículo, se revisan las principales características del lenguaje de los adultos con Síndrome de Down, considerando las especificidades durante el proceso de envejecimiento y su relación con la Enfermedad de Alzheimer. Además, se describen las características de instrumentos de evaluación neuropsicológica que contemplan la valorización del lenguaje en la etapa adulta y se señalan estrategias de abordaje fonoaudiológico aplicables al trabajo de las capacidades del lenguaje de adultos con Síndrome de Down. Finalmente, se comenta la escasez de investigaciones sobre la caracterización e intervención de los dominios lingüísticos y comunicativos en la población adulta con Síndrome de Down. Se destaca también la necesidad de realizar estudios locales desde el ámbito fonoaudiológico dado el cambio demográfico de las personas en situación de discapacidad intelectual en Chile

The aging phenomenon of persons with Down Syndrome has gained increasing interest among disciplines related to therapeutic work with people with intellectual disability. Speech and language therapy has contributed with a large research body aimed at establishing evaluation and intervention procedures on communications and linguistic and cognitive skills of persons with Down Syndrome, mainly in early ages and teenagers. However, the life expectancy of people with Down Syndrome has shown a gradual increase, due to the progress made in the medical and therapeutic scope and in social services, which represent new challenges for clinical exercise, considering the course of a premature and accelerated aging, where certain neurobiological conditions influence the early manifestation of neurodegenerative processes. The present paper reviews the main language characteristics of adults with Down Syndrome, considering the specificities in the aging process and its relationship with Alzheimer's disease. Furthermore, it describes the characteristics of instruments of neuropsychological assessment that includes the valorization of the language in the adult stage, and it points out strategies of the speech and language therapy approach that are applicable to the work of language capabilities of adults with Down Syndrome. Finally, the paper addresses a shortage of research dealing with the characterization and intervention of linguistic and communicative fields among the adult population with Down Syndrome, highlighting the need to develop local studies from the speech and language therapy field given the demographic change of people with intellectual disabilities in Chile

Behaviour of fish by-catch in the mouth of a crustacean trawl.

The behaviour of fish by-catch was recorded and characterized by in situ observations in the mouth of a crustacean trawl using an underwater camera system with artificial light, at depths between 106 and 461 m, along the central coast of Chile. The groups or species studied were rattails (family Macrouridae), Chilean hake Merluccius gayi gayi, sharks (orders Carcharhiniformes and Squaliformes), skates (family Rajidae), flatfishes (genus Hippoglossina) and small benthopelagic and demersal fishes (orders Osmeriformes, Stomiiformes, Gadiformes, Ophidiiformes and Perciformes). The fish behaviour was categorized in terms of (1) position in the water column, (2) initial orientation with respect to the trawl, (3) locomotion and (4) swimming speed with respect to the trawl. Rattails, sharks, skates and flatfishes were passive in response to the trawl and showed similar behavioural patterns, with most fishes observed sitting or touching the bottom with no swimming or other activity. Merluccius gayi gayi was the most active species, displaying a wide combination of behavioural responses when the trawl approached. This species showed several behavioural patterns, mainly characterized by swimming forward at variable speed. A fraction of small bentho-pelagic and demersal fishes also showed an active behaviour but always at lower speed than the trawl. The species-specific differences in behaviour in the mouth of the trawl suggest that improvements at the level of the footrope can be made to reduce by-catch, especially of passive species.

[Know well in order to do well]. / Saber bien para hacer bien.

Health care professionals should have comprehensive training, especially in the humanitarian aspects of care. This is essential to enable them to correctly resolve ethical conflicts that arise in professional practice. Starting from this premise, the article discusses some representative situations nurses encounter daily in their contacts with patients. An examination is made of the ethical aspects of the following: ordinary nursing activities; standards with regard to hospital visits by family members; administration of analgesics; schedules for feeding, drug administration, and the like; clinical research; professional secrecy; free professional practice; and death with dignity.

Know well to do good.

Health care should be entrusted to professionals who have received well-rounded training in the humanitarian as well as the technical aspects of such care. Training of this sort is essential for effective resolution of ethical conflicts that arise in professional practice. Starting from that premise, this article examines a number of ethical problems commonly encountered by nurses in the course of their daily work.