The time between Palaeolithic hearths.

Resolving the timescale of human activity in the Palaeolithic Age is one of the most challenging problems in prehistoric archaeology. The duration and frequency of hunter-gatherer camps reflect key aspects of social life and human-environment interactions. However, the time dimension of Palaeolithic contexts is generally inaccurately reconstructed because of the limitations of dating techniques1, the impact of disturbing agents on sedimentary deposits2 and the palimpsest effect3,4. Here we report high-resolution time differences between six Middle Palaeolithic hearths from El Salt Unit X (Spain) obtained through archaeomagnetic and archaeostratigraphic analyses. The set of hearths covers at least around 200-240 years with 99% probability, having decade- and century-long intervals between the different hearths. Our results provide a quantitative estimate of the time framework for the human occupation events included in the studied sequence. This is a step forward in Palaeolithic archaeology, a discipline in which human behaviour is usually approached from a temporal scale typical of geological processes, whereas significant change may happen at the smaller scales of human generations. Here we reach a timescale close to a human lifespan.

Multidisciplinary evidence of an isolated Neanderthal occupation in Abric del Pastor (Alcoi, Iberian Peninsula).

Testing Neanderthal behavioural hypotheses requires a spatial-temporal resolution to the level of a human single occupation episode. Yet, most of the behavioural data on Neanderthals has been obtained from coarsely dated, time-averaged contexts affected by the archaeological palimpsest effect and a diversity of postdepositional processes. This implies that time-resolved Neanderthal behaviour remains largely unknown. In this study, we performed archaeostratigraphic analysis on stratigraphic units IVe, IVf, IVg, Va, Vb and Vc from Abric del Pastor (Alcoi, Iberian Peninsula). Further, we isolated the archaeological remains associated with the resulting archaeostratigraphic unit and applied raw material, technological, use-wear, archaeozoological and spatial analyses. Our results show a low-density accumulation of remains from flintknapping, flint tool-use and animal processing around a hearth. These data provide a time-resolved human dimension to previous high-resolution environmental and pyrotechnological data on the same hearth, representing the first comprehensive characterisation of a Neanderthal single occupation episode. Our integrated, multidisciplinary method also contributes to advance our understanding of archaeological record formation processes.

Assessing high risk of suicide amongst physicians and nurses in treatment.

Little is known about the suicidal behaviour of health professionals admitted to specialised programmes. This study aims to describe the factors associated with high risk of suicide (HRS) of physicians and nurses in treatment at the Galatea Care Programme. We conducted a retrospective naturalistic study with data from 1,214 electronic medical records of physicians and nurses working in Catalonia and in treatment at the Galatea Clinic during 2017 and 2018. HRS was registered in the medical record according to the screening criteria of the Catalonia Risk Suicide Code; 62.4% (n = 757) were physicians and 37.6% (n = 457) were nurses. HRS was identified in 5% physicians and 5.2% nurses. Patients who were in a relationship or were not on a sick leave were less likely to have HRS, whereas those with affective disorders were more likely to have HRS compared with those with anxiety disorders or substance use disorders. Patients with HRS were more likely to have concurrent mental disorders. Specialised treatment programmes for health professionals should regularly screen for suicide risk, especially amongst those having affective disorders, comorbid mental disorders or when their working and interpersonal life areas are impaired.

Insights into the timing, intensity and natural setting of Neanderthal occupation from the geoarchaeological study of combustion structures: A micromorphological and biomarker investigation of El Salt, unit Xb, Alcoy, Spain.

Middle Paleolithic lithic and faunal assemblages throughout Eurasia reflect short-term Neanderthal occupations, which suggest high group mobility. However, the timing of these short-term occupations, a key factor to assess group mobility and territorial range, remains unresolved. Anthropogenic combustion structures are prominent in the Middle Paleolithic record and conceal information on the timing and intensity and natural setting of their associated human occupations. This paper examines a concentration of eleven combustion structures from unit Xb of El Salt, a Middle Paleolithic site in Spain through a geoarchaeological approach, in search of temporal, human impact and paleoenvironmental indicators to assess the timing, intensity and natural setting of the associated human occupations. The study was conducted using micromorphology, lipid biomarker analysis and compound specific isotope analysis. Results show in situ hearths built on different diachronic topsoils rich in herbivore excrements and angiosperm plant residues with rare anthropogenic remains. These data are suggestive of low impact, short-term human occupations separated by relatively long periods of time, with possible indicators of seasonality. Results also show an absence of conifer biomarkers in the mentioned topsoils and presence of conifer charcoal among the fuel residues (ash), indicating that fire wood was brought to the site from elsewhere. A microscopic and molecular approach in the study of combustion structures allows us to narrow down the timescale of archaeological analysis and contributes valuable information towards an understanding of Neanderthal group mobility and settlement patterns.

Neanderthals from El Salt (Alcoy, Spain) in the context of the latest Middle Palaeolithic populations from the southeast of the Iberian Peninsula.

We present a bioanthropological study of dental remains recovered from El Salt Middle Palaeolithic site (Alcoy, Alicante, Spain). The dental remains were found in a sedimentary layer representing a calm depositional environment within a freshwater spring system. The corresponding archaeological context comprises a Middle Palaeolithic faunal and lithic assemblage that represents the last documented evidence of human occupation at the site, dating to between 47.2 ± 4.4 and 45.2 ± 3.4 ka (thousands of years ago). This evidence is overlain by an archaeologically sterile deposit dated to 44.7 ± 3.2 ka. Results show that the teeth belong to a single juvenile or young adult individual with morphological and metric features falling within the Neanderthal range of variability, although the considered traits are not taxonomically highly discriminant. The reported fossils are representative of the latest Middle Palaeolithic groups in the region and may be considered in the ongoing debate on the disappearance of Neanderthals and the end of the Middle Palaeolithic.

New evidence of early Neanderthal disappearance in the Iberian Peninsula.

The timing of the end of the Middle Palaeolithic and the disappearance of Neanderthals continue to be strongly debated. Current chronometric evidence from different European sites pushes the end of the Middle Palaeolithic throughout the continent back to around 42 thousand years ago (ka). This has called into question some of the dates from the Iberian Peninsula, previously considered as one of the last refuge zones of the Neanderthals. Evidence of Neanderthal occupation in Iberia after 42 ka is now very scarce and open to debate on chronological and technological grounds. Here we report thermoluminescence (TL) and optically stimulated luminescence (OSL) dates from El Salt, a Middle Palaeolithic site in Alicante, Spain, the archaeological sequence of which shows a transition from recurrent to sporadic human occupation culminating in the abandonment of the site. The new dates place this sequence within MIS 3, between ca. 60 and 45 ka. An abrupt sedimentary change towards the top of the sequence suggests a strong aridification episode coinciding with the last Neanderthal occupation of the site. These results are in agreement with current chronometric data from other sites in the Iberian Peninsula and point towards possible breakdown and disappearance of the Neanderthal local population around the time of the Heinrich 5 event. Iberian sites with recent dates (<40 ka) attributed to the Middle Palaeolithic should be revised in the light of these data.

Kangaroo Mother Care, home environment and father involvement in the first year of life: a randomized controlled study.

AIMS: This study tested the hypothesis that Kangaroo Mother Care creates a climate in the family, which enhances infants' performance on the developmental quotient scale. SETTING: The largest social security hospital in Colombia with a neonatal intensive care unit. SUBJECTS: At 12 months of corrected age, 194 families in the Kangaroo Mother Care group and 144 families in the Traditional Care group were available for analysis. INTERVENTIONS: Infants were kept 24 h/day in an upright position, in skin-to-skin contact until it was no longer tolerated by the infants. Babies in the Traditional Care were kept in incubators on the Minimal Care Unit until they satisfied the usual discharge criteria. OUTCOME MEASURES: The Home Observation for Measurement of the Environment (HOME), Father Involvement and Developmental Quotient (Griffiths) scores. RESULTS: 1) Kangaroo mothers created a more stimulating context and a better caregiving environment than mothers in the Traditional Care group; 2) this environment was positively correlated to father involvement and 3) the family environment of male infants was most improved by Kangaroo Mother Care. CONCLUSION: Kangaroo Mother Care has a positive impact on home environment. The results also suggest, first, that both parents should be involved as direct caregivers in the Kangaroo Mother Care procedure and secondly, that this intervention should be directed more specifically at infants who are more at risk at birth. The Kangaroo Mother Care intervention could be an excellent means to ensure parents' mature involvement in the future of their children.

Ameloblastoma o adamantinoma / Ameloblastoma or adamantinoma

Se relata el caso de un paciente de 26 años de edad, con deformidad facial, que presenta un tumor gingivoyugal posterior derecho con imágenes oteolíticas en los estudios radiológicos simples y en la resonancia magnética, con histopatología e inmunohistoquímica de ameloblastoma. La terapéutica fue quirúrgica con amplio margen. Motiva la presentación la escasa frecuencia de presentación de este tumor.

It is present a ameloblastoma case, tumour of rare case on a patient of 26 years old in who development the process on the maxilla. It is realized a revision of the neoplastic characteristic and it is comment the result of the surgical treatment realized at the patient.

Derivación aorta torácica descendente bifemoral para salvamento de extremidades inferiores / Descending thoracic aortabifemoral bypass to save lower extremities

Cuando la aorta abdominal no es un sitio con flujo adecuado o es técnicamente inaccesible para derivar el flujo a las extremidades inferiores por representar un alto riesgo secundario a múltiples situaciones complejas, se justifica el recurso de las derivaciones extraanatómicas en pacientes apropiadamente seleccionados con resultados de baja morbilidad y mortalidad, mejor calidad de vida y menores costos en comparación con la amputación de extremidades inferiores.Presentamos el caso de un paciente sometido a derivación aorta torácica descendente bifemoral (DATDB) como una alternativa satisfactoria de manejo diferente a las derivaciones extraanatómicas convencionales utilizadas en nuestro medio, con mayor permeabilidad reportada por tener flujo directo de la aorta y sin incremento de la morbilidad y de la mortalidad.

Kangaroo mother care and the bonding hypothesis.

BACKGROUND: Based on the general bonding hypothesis, it is suggested that kangaroo mother care (KMC) creates a climate in the family whereby parents become prone to sensitive caregiving. The general hypothesis is that skin-to-skin contact in the KMC group will build up a positive perception in the mothers and a state of readiness to detect and respond to infant's cues. METHOD: The randomized controlled trial was conducted on a set of 488 infants weighing <2001 g, with 246 in the KMC group and 242 in the traditional care (TC) group. The design allows precise observation of the timing and duration of mother-infant contact, and takes into account the infant's health status at birth and the socioeconomic status of the parents. BONDING ASSESSMENT: Two series of outcomes are assessed as manifestations of a mother's attachment behavior. The first is the mother's feelings and perceptions of her premature birth experience, including her sense of competence, feelings of worry and stress, and perception of social support. The second outcome is derived from observations of the mother and child's responsivity to each other during breastfeeding at 41 weeks of gestational age. INTERVENTIONS: KMC has three components. The first is the kangaroo position. Once the premature infant has adapted to extrauterine life and is able to breastfeed, he is positioned on the mother's chest, in a upright position, with direct skin-to-skin contact. The second component is kangaroo nutrition. Although breastfeeding is the prime source of nutrition, infants also may receive preterm formula whenever necessary and vitamin supplements. The third component is the clinical control; infants are monitored on a regular basis, daily until they are gaining at least 20 g per day. Afterward, weekly clinic visits are scheduled until term, which constitutes the ambulatory minimal neonatal care. In the TC group, infants are kept in incubators until they are able to self-regulate their temperature and are thriving (ie, have an appropriate weight gain). Infants are discharged according to current hospital practice, usually not before their weight is approximately 1700 g. Afterward, as with the KMC group, weekly clinic visits are scheduled until term. RESULTS: We observed a change in the mothers' perception of her child, attributable to the skin-to-skin contact in the kangaroo-carrying position. This effect is related to a subjective "bonding effect" that may be understood readily by the empowering nature of the KMC intervention. Moreover, in stressful situations when the infant has to remain in the hospital longer, mothers practicing KMC feel more competent than do mothers in the TC group. This is what we call a resilience effect. In these stressful situations we also found a negative effect on the feelings of received support of mothers practicing KMC. We interpret this as an isolation effect. To thwart this deleterious effect, we would suggest adding social support as an integral component of KMC. The observations of the mothers' sensitive behavior did not show a definite bonding effect, but rather a resilience effect. This is attributable to the KMC intervention; mothers practicing KMC were more responsive to an at-risk infant whose development has been threatened by a longer hospital stay. Otherwise, we observed that the mothers (in both the KMC group and the TC group) had behavioral patterns that were adapted to the child's at-risk health status and to the precarious condition of some premature infants requiring intensive care. We conclude that the infant's health status may be a more prominent factor in explaining a mother's more sensitive behavior, which overshadows the kangaroo-carrying effect. CONCLUSION: These results suggest that KMC should be promoted actively and that mothers should be encouraged to use it as soon as possible during the intensive care period up to the 40 weeks of gestational age. Thus, KMC should be viewed as a means of humanizing the process of g

Estrogen improves psychological function in asymptomatic postmenopausal women.

Estrogen treatment of postmenopausal women has been suggested to improve mood and psychological function. However, this remains controversial because previous studies involved heterogeneous groups, were not double blind, and included women who were also experiencing somatic symptoms that were relieved by estrogen. A randomized double-blind study was carried out comparing the effects of placebo and conjugated equine estrogens (0.625 and 1.25 mg) on psychological function over 3 months in 36 asymptomatic women, aged 45-60. The tests included the Minnesota Multiphasic Personality Inventory-168, the Profile of Adaptation to Life, and the Beck Depression Inventory. Memory was assessed directly by the Wechsler Adult Intelligence Scales, measuring both digit span and digit symbol. All women were well-adjusted psychologically. The income management scale of the Profile of Adaptation to Life improved (P less than .05) with estrogen, as did the Beck Depression Inventory (P less than .05), but these results were not dose-related. Memory assessed prospectively by the Wechsler Adult Intelligence Scales was not affected significantly. These results suggest that estrogen use may improve the overall quality of life in postmenopausal women.