Can we screen for heart disease in children at public health centres? A multicentre observational study of screening for heart disease with a risk of sudden death in children.

Sudden cardiac death in children is a rare event, but of great social significance. Generally, it is related to heart disease with a risk of sudden cardiac death (SCD), which may occur with cardiovascular symptoms and/or electrocardiographic markers; thus, a primary care paediatrician (PCP) could detect them. Therefore, we proposed a study that assesses how to put into practice and conduct a cardiovascular assessment within the routine healthy-child check-ups at six and twelve years of age; that reflects cardiovascular signs and symptoms, as well as the electrocardiographic alterations that children with a risk of SCD in the selected population present; and that assesses the PCP's skill at electrocardiogram (ECG) interpretation. In collaboration with PCPs, primary care nurses, and paediatric cardiologists, an observational, descriptive, multicentre, cross-sectional study was carried out in the Balearic Islands (Spain), from April 2021 to January 2022, inclusive. The PCPs gathered patient data through forms (medical record, electrocardiogram, and physical examination) and sent them to the investigator, together with the informed consent document and electrocardiogram. The investigator passed the electrocardiogram on to the paediatric cardiologists for reading, in an identical form to those the paediatricians had filled in. The variables were collected, and a descriptive analysis performed. Three paediatric cardiologists, twelve PCPs, and nine nurses from seven public health centres took part. They collected the data from 641 patients, but 233 patients did not participate (in 81.11% due to the PCP's workload). Therefore, the study coverage was around 64%, representing the quotient of the total number of patients who participated, divided by the total number of patients who were eligible for the study. We detected 30 patients with electrocardiographic alterations compatible with SCD risk. Nine of these had been examined by a paediatric cardiologist at some time (functional murmur in 8/9), five had reported shortness of breath with exercise, and four had reported a family history of sudden death. The physical examination of all the patients whose ECG was compatible with a risk of SCD was normal. Upon analysing to what extent the ECG results of the PCP and the paediatric cardiologist agreed, the percentage of agreement in the final interpretation (normal/altered) was 91.9%, while Cohen's kappa coefficient was 31.2% (CI 95%: 13.8-48.6%). The sensitivity of the ECG interpretation by the PCP to detect an ECG compatible with a risk of SCD was 29% and the positive predictive value 45%.     Conclusions: This study lays the foundations for future SCD risk screening in children, performed by PCPs. However, previously, it would be important to optimise their training in reading and interpreting paediatric ECGs. What is Known: • In Spain at present, there is a programme in place to detect heart disease with a risk of sudden death [1], but it targets only children who are starting on or are doing a physical activity as a federated sport. Implementing such screening programmes has proven effective in several countries [2]. However, several studies showed that the incidence of sudden cardiac death is no higher in children competing in sport activities than in those who do not do any sport [3]. This poses an ethical conflict, because at present, children who do not do any federated sport are excluded from screening. According to the revised literature, so far, only in two studies did they screen the child population at schools, and in both, they successfully detected patients with heart disease associated to the risk of sudden death [4, 5]. We have found no studies where the screening of these features was included within the routine healthy-child check-ups by primary care paediatricians. What is New: • We did not know whether-in our setting, at present-the primary care paediatrician could perform a screening method within the routine healthy-child check-ups, in order to detect presumably healthy children at risk of sudden cardiac death, as they present one of the SCD risks. In this regard, we proposed our project: to assess how to put into practice and conduct a cardiovascular assessment via SCD risk screening in the healthy child population by primary care paediatricians and appraise primary care paediatricians' skills in identifying the electrocardiographic alterations associated with SCD risk. The ultimate intention of this pilot study was to make it possible, in the future, to design and justify a study aimed at universalising cardiovascular screening and achieving a long-term decrease in sudden cardiac death events in children.

Effectiveness of the contingency plan for social and health care during the COVID-19 pandemic in a health district in northwestern Spain / Efectividad del plan de contingencia sociosanitario durante la pandemia de la COVID-19 en un distrito sanitario del noroeste de España

Introduction During the COVID-19 pandemic, healthcare facilities have implemented contingency plans to minimize the consequences of this pathology however, the deployment and results of these contingency plans are scarcely shared. Objectives To describe the implementation of the contingency plan in the social and health care in the COVID-19 pandemic in the Public Hospital of Monforte (Lugo, Spain) and to evaluate the effectiveness of the measures included in this plan. Method Phenomenological sampling conducted between March 10 and May 15, 2020. Evaluation qualitative assessment by an external quality improvement team of the Galician Health Service (SERGAS), based on the Practicum Direct rapid structured checklist in risk management, organizational management, and evaluation of decision making. As outcome indicators, we assessed the number of hospital admissions, number of PCRs performed, telephone attention to social and health social-healthcare patients, number of hospitalizations avoided and estimation of their direct cost. Results After assessing and managing the risks, an information security plan was developed and solutions to minimize complications in our patients derived from this pandemic. An emergency decision making team was created, as well as an employee communication mechanism for employees through standardized documents and documentation channels. Conclusions The adaptation of the Practicum Direct rapid model to the healthcare setting is a useful and easy-to-apply tool that allows us to identify weak points and areas for improvement in our Service and thus to strengthen patient care in all clinical areas, improving the quality of care (AU)

Introducción Durante la pandemia de la COVID-19 los centros sanitarios han puesto en marcha planes de contingencia para minimizar las consecuencias de esta enfermedad. Sin embargo, el despliegue y los resultados de estos planes de contingencia son escasamente compartidos. Objetivos Describir la implantación del plan de contingencia en la atención sociosanitaria en la pandemia de la COVID-19 en el Hospital Público de Monforte (Lugo, España) y evaluar la efectividad de las medidas incluidas en dicho plan. Método Muestreo fenomenológico realizado entre el 10 de marzo y el 15 de mayo de 2020. Evaluación cualitativa por un equipo externo de mejora de la calidad del Servicio Gallego de Salud, basada en la lista de verificación rápida estructurada Practicum Direct en gestión de riesgos, gestión organizativa y evaluación de la toma de decisiones. Como indicadores de resultado se valoraron el número de ingresos hospitalarios, el número de PCR realizadas, la atención telefónica a pacientes sociosanitarios, el número de hospitalizaciones evitadas y la estimación de su coste directo. Resultados Tras evaluar y gestionar los riesgos se elaboró un plan de seguridad de la información y soluciones para minimizar las complicaciones en nuestros pacientes derivadas de esta pandemia. Se creó un equipo de toma de decisiones de emergencia, así como un mecanismo de comunicación para los empleados a través de documentos y canales de documentación estandarizados. Conclusiones La adaptación del modelo Practicum Direct rapid al ámbito sanitario es una herramienta útil y de fácil aplicación que nos permite identificar puntos débiles y áreas de mejora en nuestro servicio, y así reforzar la atención al paciente en todas las áreas clínicas, mejorando la calidad asistencial (AU)

Effectiveness of the contingency plan for social and health care during the COVID-19 pandemic in a health district in northwestern Spain.

INTRODUCTION: During the COVID-19 pandemic, healthcare facilities have implemented contingency plans to minimize the consequences of this pathology however, the deployment and results of these contingency plans are scarcely shared. OBJECTIVES: To describe the implementation of the contingency plan in the social and health care in the COVID-19 pandemic in the Public Hospital of Monforte (Lugo, Spain) and to evaluate the effectiveness of the measures included in this plan. METHOD: Phenomenological sampling conducted between March 10 and May 15, 2020. Evaluation qualitative assessment by an external quality improvement team of the Galician Health Service (SERGAS), based on the Practicum Direct rapid structured checklist in risk management, organizational management, and evaluation of decision making. As outcome indicators, we assessed the number of hospital admissions, number of PCRs performed, telephone attention to social and health social-healthcare patients, number of hospitalizations avoided and estimation of their direct cost. RESULTS: After assessing and managing the risks, an information security plan was developed and solutions to minimize complications in our patients derived from this pandemic. An emergency decision making team was created, as well as an employee communication mechanism for employees through standardized documents and documentation channels. CONCLUSIONS: The adaptation of the Practicum Direct rapid model to the healthcare setting is a useful and easy-to-apply tool that allows us to identify weak points and areas for improvement in our Service and thus to strengthen patient care in all clinical areas, improving the quality of care.

Lesiones cutáneas en probable relación con calcifilaxis no urémica en paciente octogenaria: caso clínico y revisión de la literatura / Skin lesions in probable relation to non-uremic calciphylaxis in an octogenarian patient: Clinical case and review of the literature

No disponible

Desarrollo de un sistema de indicadores para la evaluación de la calidad en transporte interhospitalario: proyecto multicéntrico / Quality indicators in interhospital transport: multicentre project

Introducción: El traslado interhospitalario se realiza por equipos muy diferentes en las distintas regiones de nuestro país, lo que dificulta la comparación de su calidad asistencial. Objetivo: Seleccionar y definir una lista consensuada de indicadores de calidad aplicable a todas las unidades de transporte, especializadas o no, a nivel nacional. Material y métodos: Realización de una propuesta inicial de indicadores por el comité coordinador con representantes del transporte especializado de nuestro país. Valoración del listado por especialistas en transporte de las unidades participantes y los grupos de trabajo de SECIP y SENeo. Selección de los indicadores mediante el método Delphi según su relevancia y factibilidad. Resultados: El listado inicial incluyó 35 posibles indicadores. Fueron valorados por 22 especialistas pertenecientes a siete unidades de transporte. En una primera fase se eligieron por consenso cuatro indicadores, que pasaron directamente al listado definitivo. Se enviaron a los encuestados los resultados del resto de indicadores y las observaciones realizadas por los participantes, y tras ello se realizó una segunda valoración, en la que alcanzaron un consenso aceptable otros 11 indicadores. Tras la elaboración del listado, se estableció de forma consensuada la definición final de cada indicador elegido. Conclusiones: Utilizando un sistema de búsqueda de consenso, definimos una lista de 15 indicadores comunes, que podría ser utilizada por las unidades especializadas de nuestro país y personal asistencial no especializado que realiza traslados pediátricos. Permitirá evaluar el rendimiento individual y comparar las diferentes unidades para encontrar oportunidades de mejora y asegurar la máxima calidad durante el transporte. (AU)

Introduction: Interhospital transport is carried out by variable teams in different regions of our country, and this makes quality evaluation and benchmarking complicated. Project objective: select and define a consensual list of quality measurement that may be used by national transport units, whether specialised or not. Methods: Initial set of quality indicators was proposed by coordinators (members of representative specialised transport units in Spain). Evaluation by selected transport specialists from participating units and SECIP (Society of Paediatric Intensive Care) and SENeo (Spanish Neonatology Society) work teams. Selection of definitive indicators by Delphi method according to relevance and feasibility. Results: A total of 35 quality indicators were included in the initial set. Evaluation was carried out by 22 specialists from seven transport teams. In a first round, four indicators were consensually included in the definitive list. Results for the rest of metrics and comments were sent to all participants, and after a second assessment, 11 other indicators reached enough consensus. After list accomplishment, a consensual final definition for every indicator was established. Conclusions: Using a consensual research method, a list of 15 common indicators was obtained, which may be used by specialised transport teams in our country, and by non-specialised clinics in charge of interhospital paediatric transport. It will allow individual performance to be assessed, as well as benchmarking, in order to find improvement opportunities and ensure the highest quality during interhospital transport. (AU)

Quality indicators in interhospital transport: Multicentre project.

INTRODUCTION: Interhospital transport is carried out by variable teams in different regions of our country, and this makes quality evaluation and benchmarking complicated. Project objective: Select and define a consensual list of quality measurement that may be used by national transport units, whether specialised or not. METHODS: Initial set of quality indicators was proposed by coordinators (members of representative specialised transport units in Spain). Evaluation by selected transport specialists from participating units and SECIP (Society of Paediatric Intensive Care) and SENeo (Spanish Neonatology Society) work teams. Selection of definitive indicators by Delphi method according to relevance and feasibility. RESULTS: A total of 35 quality indicators were included in the initial set. Evaluation was carried out by 22 specialists from 7 transport teams. In a first round, 4 indicators were consensually included in the definitive list. Results for the rest of metrics and comments were sent to all participants, and after a second assessment, 11 other indicators reached enough consensus. After list accomplishment, a consensual final definition for every indicator was established. CONCLUSIONS: Using a consensual research method, a list of 15 common indicators was obtained, which may be used by specialised transport teams in our country, and by non-specialised clinics in charge of interhospital paediatric transport. It will allow individual performance to be assessed, as well as benchmarking, in order to find improvement opportunities and ensure the highest quality during interhospital transport.

COVID 19 comprehensive management in a regional hospital of Northwestern Spain.

INTRODUCTION: The COVID-19 pandemic has brought about a paradigm shift in healthcare. OBJECTIVE: To evaluate the utility of a strategy to comprehensively address the pandemic in a health area that covers 42,000 people. METHOD: Between March 10 and May 15, 2020, the COVID Unit was created in the corresponding regional hospital, and an independent circuit was established for the diagnosis and management of patients with suspected or confirmed COVID-19; social health centers were monitored with PCR testing. RESULTS: Eighteen COVID-19-positive patients (age 72.9 ± 13.2 years) were admitted, out of which 66% were males. All these patients had pneumonia and 67% had respiratory distress syndrome; no one required mechanical ventilation. Mean hospital stay was 9.4 ± 5.3 days, and mortality, 11%. PCR tests were applied to all hospital residents (n = 827) and workers (n = 519), 1,044 phone calls were made and 36 hospital admissions were avoided. Only 50 patients required close follow-up, out of which four (0.48%) were positive for COVID-19. CONCLUSION: Clinical monitoring at the hospital and social health centers showed that patient profile was like that documented in the literature and that the incidence of COVID-19 was low in social health centers.

INTRODUCCIÓN: La pandemia de COVID-19 provocó un cambio de paradigma en la atención médica. OBJETIVO: Evaluar una estrategia para abordar integralmente la pandemia en un distrito de salud que comprende 42 000 personas. MÉTODO: Entre el 10 de marzo y 15 de mayo de 2020 se creó la Unidad COVID en un hospital regional correspondiente al distrito y se estableció un circuito independiente para el diagnóstico y manejo de pacientes con sospecha o confirmación de COVID-19; los centros de salud social fueron monitoreados mediante PCR. RESULTADOS: Ingresaron 18 pacientes positivos a COVID-19 (edad de 72.9 ± 13.2 años), 66 % eran hombres; todos presentaron neumonía, 67 % desarrolló síndrome de dificultad respiratoria y ninguno requirió ventilación mecánica. La estancia hospitalaria fue de 9.4 ± 5.3 días y la mortalidad, de 11 %. Se realizaron pruebas de PCR a todos los residentes (n = 827) y trabajadores (n = 519) del hospital, se realizaron 1044 llamadas telefónicas y se evitaron 36 hospitalizaciones. Solo 50 pacientes necesitaron seguimiento cercano, cuatro (0.48 %) positivos a COVID-19. CONCLUSIÓN: El monitoreo clínico en el hospital y centros de salud social mostró que el perfil de los pacientes fue similar al documentado en la literatura y que la incidencia de COVID-19 fue baja en los centros sociales de salud.

COVID 19 comprehensive management in a regional hospital of Northwestern Spain / Gestión integral de COVID 19 en un hospital regional en el noroeste de España

Abstract Introduction: The COVID-19 pandemic has brought about a paradigm shift in healthcare. Objective: To evaluate the utility of a strategy to comprehensively address the pandemic in a health area that covers 42,000 people. Method: Between March 10 and May 15, 2020, the COVID Unit was created in the corresponding regional hospital, and an independent circuit was established for the diagnosis and management of patients with suspected or confirmed COVID-19; social health centers were monitored with PCR testing. Results: Eighteen COVID-19-positive patients (age 72.9 ± 13.2 years) were admitted, out of which 66% were males. All these patients had pneumonia and 67% had respiratory distress syndrome; no one required mechanical ventilation. Mean hospital stay was 9.4 ± 5.3 days, and mortality, 11%. PCR tests were applied to all hospital residents (n = 827) and workers (n = 519), 1,044 phone calls were made and 36 hospital admissions were avoided. Only 50 patients required close follow-up, out of which four (0.48%) were positive for COVID-19. Conclusion: Clinical monitoring at the hospital and social health centers showed that patient profile was like that documented in the literature and that the incidence of COVID-19 was low in social health centers.

Resumen Introducción: La pandemia de COVID-19 provocó un cambio de paradigma en la atención médica. Objetivo: Evaluar una estrategia para abordar integralmente la pandemia en un distrito de salud que comprende 42 000 personas. Método: Entre el 10 de marzo y 15 de mayo de 2020 se creó la Unidad COVID en un hospital regional correspondiente al distrito y se estableció un circuito independiente para el diagnóstico y manejo de pacientes con sospecha o confirmación de COVID-19; los centros de salud social fueron monitoreados mediante PCR. Resultados: Ingresaron 18 pacientes positivos a COVID-19 (edad de 72.9 ± 13.2 años), 66 % eran hombres; todos presentaron neumonía, 67 % desarrolló síndrome de dificultad respiratoria y ninguno requirió ventilación mecánica. La estancia hospitalaria fue de 9.4 ± 5.3 días y la mortalidad, de 11 %. Se realizaron pruebas de PCR a todos los residentes (n = 827) y trabajadores (n = 519) del hospital, se realizaron 1044 llamadas telefónicas y se evitaron 36 hospitalizaciones. Solo 50 pacientes necesitaron seguimiento cercano, cuatro (0.48 %) positivos a COVID-19. Conclusión: El monitoreo clínico en el hospital y centros de salud social mostró que el perfil de los pacientes fue similar al documentado en la literatura y que la incidencia de COVID-19 fue baja en los centros sociales de salud.

Contrasted patterns of genetic differentiation across eight bird species in the Lesser Antilles.

Archipelagoes are considered as "natural laboratories" for studying processes that shape the distribution of diversity. The Lesser Antilles provide a favorable geographical context for divergence to occur. However, although morphological subspecies have been described across this archipelago in numerous avian species, the potential for the Lesser Antilles in driving intra-specific genetic divergence in highly mobile organisms such as birds remains understudied. Here, we assessed level of intra-specific genetic diversity and differentiation between three islands of the Lesser Antilles (Guadeloupe, Dominica and Martinique) using a multi-species approach on eight bird species. For each species, we built a set of microsatellite markers from cross-species amplifications. Significant patterns of inter-island and/or within-island genetic differentiation were detected in all species. However, levels of intra-specific genetic differentiation among the eight bird species were not always consistent with the boundaries of subspecies previously described in the sampled islands. These results suggest different histories of colonization/expansion and/or different species-specific ecological traits affecting gene flow, advocating for multi-species studies of historical and contemporary factors shaping the distribution of diversity on islands.

Tissue plasminogen activator for acute ischemic stroke: calculation of dose based on estimated patient weight can increase the risk of cerebral bleeding.

A dose of 0.9 mg/kg of intravenous tissue plasminogen activator (t-PA) has proven to be beneficial in the treatment of acute ischemic stroke (AIS). Dosing of t-PA based on estimated patient weight (PW) increases the likelihood of errors. Our objectives were to evaluate the accuracy of estimated PW and assess the effectiveness and safety of the actual applied dose (AAD) of t-PA. We performed a prospective single-center study of AIS patients treated with t-PA from May 2010 to December 2011. Dose was calculated according to estimated PW. Patients were weighed during the 24 h following treatment with t-PA. Estimation errors and AAD were calculated. Actual PW was measured in 97 of the 108 included patients. PW estimation errors were recorded in 22.7 % and were more frequent when weight was estimated by stroke unit staff (44 %). Only 11 % of patients misreported their own weight. Mean AAD was significantly higher in patients who had intracerebral hemorrhage (ICH) after t-PA than in patients who did not (0.96 vs. 0.92 mg/kg; p = 0.02). Multivariate analysis showed an increased risk of ICH for each 10 % increase in t-PA dose above the optimal dose of 0.90 mg/kg (OR 3.10; 95 % CI 1.14-8.39; p = 0.026). No effects of t-PA misdosing were observed on symptomatic ICH, functional outcome or mortality. Estimated PW is frequently inaccurate and leads to t-PA dosing errors. Increasing doses of t-PA above 0.90 mg/kg may increase the risk of ICH. Standardized weighing methods before t-PA is administered should be considered.

El discurso literario caribeño, baluarte identitario de la cultura latinoamericana / The Caribbean literary discourse, identity bholds of Latin American culture

La literatura caribeña, por filiación histórico - cultural, pertenece a y es fiel exponente de la cultura latinoamericana. Su literariedad se ha construido sobre la base de un discurso identitario de defensa de su cultura única y, a la vez plural, que la distingue de los referentes occidentales preestablecidos por los centros de poder socioeconómico. El siguiente trabajo muestra los momentos y fases fundamentales de la evolución y desarrollo de la expresión identitaria caribeña a través de una selección cuidadosa de ejemplos de su discurso literario, con vistas a promover una cabal comprensión de los valores extra literarios de esta literatura. Puesto que este discurso literario se alza sobre un supuesto ideoestético de profunda raigambre ontológica, aproximarse a él presupone penetrar en la esencia de la historia y del patrimonio cultural de esta área. Por ello, dado el valor de este tema, se recomienda su estudio por la importancia que tiene para la formación sociocultural de los docentes cubanos, especialmente aquellos que laboran en entornos multiculturales.

Due to historical and cultural filiations, the Caribbean literature is part and a true example of the Latin American culture. Its literary particularities are based on an identity discourse, which defends a unique and, at the same time, plural culture that distinguishes it from western referents pre-established by socioeconomic power centers. This paper presents the fundamental evolution and development phases of the Caribbean identity expression. Some examples of this literary discourse were carefully selected to further an accurate understanding of its extra literary values. Since this literary discourse is based on an aesthetic ideal of deeply ontological roots, an approach to it means penetrating the essence of the region’s history and cultural patrimony. The study of the topic is important to form Cuban professors socioculturally, particularly those who work in multicultural environments.

El discurso literario caribe±o, baluarte identitario de la cultura latinoamericana / The Caribbean literary discourse, identity bholds of Latin American culture

La literatura caribeña, por filiación histórico - cultural, pertenece a y es fiel exponente de la cultura latinoamericana. Su literariedad se ha construido sobre la base de un discurso identitario de defensa de su cultura única y, a la vez plural, que la distingue de los referentes occidentales preestablecidos por los centros de poder socioeconómico. El siguiente trabajo muestra los momentos y fases fundamentales de la evolución y desarrollo de la expresión identitaria caribe±a a través de una selección cuidadosa de ejemplos de su discurso literario, con vistas a promover una cabal comprensión de los valores extra literarios de esta literatura. Puesto que este discurso literario se alza sobre un supuesto ideoestético de profunda raigambre ontológica, aproximarse a él presupone penetrar en la esencia de la historia y del patrimonio cultural de esta area. Por ello, dado el valor de este tema, se recomienda su estudio por la importancia que tiene para la formación sociocultural de los docentes cubanos, especialmente aquellos que laboran en entornos multiculturales(AU)

Due to historical and cultural filiations, the Caribbean literature is part and a true example of the Latin American culture. Its literary particularities are based on an identity discourse, which defends a unique and, at the same time, plural culture that distinguishes it from western referents pre-established by socioeconomic power centers. This paper presents the fundamental evolution and development phases of the Caribbean identity expression. Some examples of this literary discourse were carefully selected to further an accurate understanding of its extra literary values. Since this literary discourse is based on an aesthetic ideal of deeply ontological roots, an approach to it means penetrating the essence of the regions history and cultural patrimony. The study of the topic is important to form Cuban professors socioculturally, particularly those who work in multicultural environments(AU)

Competencia Comunicativa: Evolución cronológica del término y sus elementos constitutivos / Communicative Competence: Chronological Evolution of the Term and its Constituents

La competencia comunicativa surge como uno de los elementos constitutivos de la competencia profesional. Su definición ha variado a través de los años, lo que ha traído aparejado el surgimiento de diversas escuelas y tendencias en diferentes países. Disímiles son las áreas del saber que han analizado la competencia comunicativa. El siguiente trabajo presenta un desglose cronológico del surgimiento, evolución y desarrollo de dicho concepto, a partir de algunas de las figuras más representativas dentro de este campo. Dada la importancia que la misma posee, no solo para la enseñanza de idiomas sino para otras disciplinas que se nutren de los postulados y teorías que esta proclama, se hace necesario su estudio y profundización en aras de perfeccionar y enriquecer los contenidos y programas que conforman la carrera de Medicina y, de este modo, dar un paso de avance en los esfuerzos por graduar médicos más capaces y mejor preparados.

Communicative competence appears as a constituent element of professional competence. Its concept has varied through the years, which has brought about the emergence of different schools and trends in various countries. Communicative competence has been analyzed by dissimilar areas of science. This work presents a chronological study of the emergence, evolvement and development of the term from the ideas of the most outstanding personalities in the field. Given the relevance of the topic, not only for the teaching of foreign languages but for many other disciplines that are fuelled by the postulates and theories that it proclaims, it is necessary to study and deepen into the concept as a way to enrich and improve the contents and syllabuses which are part of the Medicine career curriculum so that a step forward is taken in the efforts to educate more capable and better prepared doctors.

The use of shortening in english for specific purposes: A practical review for nurses

Shortening as a word building process has become very productive in present day English. Abbreviations in nursing have also found a way for professional and quick communication. The main goals of this article, based on actual teaching-learning problems, is to provide some practical activities to give the learners opportunities to get acquainted with and practice abbreviations in an effective and communicative way, and to provide a glossary of the most frequently used abbreviations by nurses.

El uso de abreviaturas como proceso de construcción de palabras se ha vuelto muy productivo en el Inglés actual. Las abreviaciones también han encontrado un camino para la comunicación profesional y rápida. Los principales objetivos de este artículo, son proporcionar algunas oportunidades prácticas para brindar a los que aprenden oportunidades de familiarizarse y practicar abreviaturas de una forma eficaz y comunicativa, y proporcionar un glosario de las abreviaturas utilizadas más frecuentemente por las enfermeras.