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El presente artículo aborda la profunda relación de Nietzsche con el lenguaje desde la perspectiva de la filosofía, de la filología y de la poesía. Son reflexiones que remiten al interés del filósofo por la retórica, del filólogo por el estilo, y del poeta que hace uso del lenguaje lírico. Se analizarán cuestiones básicas en la escritura de Nietzsche como la musicalidad, el ritmo, el tono, la metáfora y el carácter dialógico de sus textos.

Revolutionen erheben als einschneidende Ereignisse des Umbruchs den Anspruch auf gesellschaftliche, politische und kulturelle Erneuerung einer Gemeinschaft. Das Buch umfasst Reflexionen über „Revolution“ und ihre Wirkung auf die deutschsprachigen Gesellschaften aus philologischer, philosophischer, kultur- und kunstwissenschaftlicher Sicht. Mit Fokus auf die Germanistik werden die Sektionen Literatur, Kunst und Kultur, Linguistik und DaF sowie Philosophie in Beiträge von Experten/Innen aus unterschiedlichen Ländern und Fachkulturen präsentiert. Historisch steht der Zeitraum zwischen der Novemberrevolution 1918/19 und Studentenbewegung 1968 im Mittelpunkt.

El presente artículo aborda la relación entre la angustia y el miedo y el concepto de lo unheimlich en la literatura escrita en lengua alemana durante el decenio expresionista (1910-1923). La profunda crisis del yo desencadenada por la inestabilidad consustancial a esta época hizo especialmente prolífico el tratamiento de la angustia —como muestra la relevancia del texto de Kierkegaard El concepto del miedo— en autores como Alfred Döblin, Georg Heym, Robert Musil o Georg Trakl. Asimismo, se analizará la obra de Kafka en tanto continúa siendo paradigmática de dicha relación, a la que ha de sumarse la noción de culpa. Abstract: This article presents the relationship between anxiety and fear and the unheimlich concept in the German literature of the Expressionist Decade (1910-1923). The deep crisis of the ego brought about by the inherent instability of this period made the treatment of anxiety especially prolific. Its relevance is clearly shown in Kierkegaard’s text The Concept of Fear, but it also had a great impact on such authors as Alfred Döblin, Georg Heym, Robert Musil or Georg Trakl. Furthermore, the paper focuses on Kafka’s literature as it is paradigmatic of this relationship, to which guilt should be added.

espanolA partir de Temor y temblor, de Soren Kierkegaard, el presente articulo supone una muestra de las diferentes representaciones expresionistas de la violencia en funcion de sus tres diferentes significados en aleman (Gewalt: violencia, poder, fuerza), desconocidos en lengua espanola, inglesa o francesa. No obstante, son varios los pensadores que, como Arendt, Benjamin, Derrida o Weber, han reflexionado sobre la violencia, un motivo esencial de la literatura expresionista alemana, por lo que en las siguientes paginas se procedera a reinterpretar las imagenes de la violencia del expresionismo literario aleman (en particular en textos de Georg Heym y de Franz Kafka) por primera vez atendiendo a su relacion con el termino original aleman y a sus diferentes aplicaciones. EnglishThe present article examines Soren Kierkegaard’s Fear and Trembling in order to explore the various expressionist representations of violence (Gewalt) conveyed by the word’s three different meanings in German, which are unknown in Spanish, English and French. Many authors, however, such as Arendt, Benjamin, Derrida or Weber, have reflected on violence, an essential motif in Expressionism, and so in the following pages images of violence in German literary expressionism (specifically, in texts by Georg Heym and Franz Kafka) will be reinterpreted for the first time in consideration of the original German term and its various applications.

Las investigaciones que componen este libro suponen un acercamiento a las diferentes facetas del filosofo Friedrich Nietzsche, que recogen tanto su labor filosofica como artistica en sus manifestaciones poetica y musical. Por una parte, desde su conocida caracterizacion como Dichterphilosoph, los trabajos aqui reunidos abordan la relacion entre filosofia y poesia en la obra de Nietzsche, los desafios que presenta la traduccion de su obra poetica al espanol, asi como su influencia o recepcion, especialmente entre artistas y eruditos espanoles de principios del siglo XX. Por otra, desde la compresion de su faceta poetica, integradora de la riqueza del gesto en la escritura, encontramos aportaciones que estudian el ritmo, la cadencia, la musicalidad y la danza como expresiones textuales del cuerpo, verdadero centro gravitacional del pensamiento nietzscheano. De este modo, hallamos en el presente volumen una mirada interdisciplinar, consecuencia de la estrecha colaboracion entre filosofos, filologos y representantes del mundo artistico de la expresion corporal. Asi se cumple con lo que el filosofo siempre exigia y expreso en un conocido fragmento postumo de 1881 sobre la filosofia de la indiferencia: hay que establecer el mundo desde multiples ojos, aus vielen Augen die Welt setzen, lo que apunta, en ultima instancia, a la fusion entre ciencia (filosofica) y arte (poetica)

In the political system and in public perception, the well-functioning of economy is frequently equalled to the output of the national economic system. However, during the last decades, this narrow conception of economic prosperity started to erode. This paper is based on a rural prosperity conceptual framework that takes into account the systemic nature and dynamics of interactions and impacts within rural systems through the analysis of an organic agriculture cooperative called Camposeven in the south east of Spain. The focus is on rural prosperity, differences in understanding, related parameters and strategies used by the cooperatives farming partners to success without following the traditional conventions of economic growth and farm-efficiency. Experience lessons in this paper demonstrate that the “technical-economic” approach of rural prosperity is not sufficient and results emphasize the important role of individuals’ behaviour as well as the contexts in which they are involved. The findings point to the increasing relevance of expanding both the theory and practice of rural prosperity approaches in sustainable rural development. This is important in order to enrich the connections between rural prosperity and other concepts such as social capital, innovation, social learning and resilience.

PURPOSE: To evaluate the effect of various implant-level impression techniques on the accuracy of definitive casts for a multiple internal connection implant system with different implant angulations and subgingival depths. MATERIAL AND METHODS: Six tapered Screw-Vent implants were placed in a reference model with different angles (0, 15, and 30 degrees) and subgingival positions (0, 1, and 3 mm). Twenty medium-consistency polyether impressions of this model were made with 4 techniques (n = 5 per group): (1) indirect technique, (2) unsplinted direct technique, (3) acrylic resin-splinted direct technique, and (4) metal-splinted direct technique. Impressions were poured with type IV dental stone. The interimplant distances were measured for casts using a coordinate measuring machine and the deviations compared with the reference model were calculated. Data were analyzed using intraclass correlation coefficient, ANOVA and Bonferroni test (α = 0.05). RESULTS: Four impression procedures showed significant differences (P = 0.0001). Only group 4 casts showed no significant differences in comparison with the reference model (P = 0.666) (ANOVA repeated measures). CONCLUSIONS: The impression procedure affected the accuracy of definitive casts. The metal-splinted direct technique produced the most accurate casts, followed by acrylic resin-splinted direct, indirect, and unsplinted direct techniques.

La literatura alemana del siglo XX solo puede entenderse a partir de Nietzsche, cuyos textos experimentaron una extraordinaria difusión desde 1890. Cabe analizar más a fondo, sin embargo, los motivos y consecuencias de su recepción, en absoluto limitados a su pensamiento filosófico. Así lo manifiesta la «guerra de cantores» a la que le conminó Stefan George, poeta y maestro, centro de varios círculos de intelectuales y personaje decisivo para la inteligencia alemana de la primera mitad del siglo XX, quien reprochaba a su rival, entre otras carencias, la falta del «dios plástico». 20th century German literature can only be understood after Nietzsche, whose texts were widely spread from 1890 onwards. However, the reasons and consequences of his reception deserve a deeper analysis, as they are not absolutely constrained to his philosophical views. This is particularly shown in the «minstrel contest» that Stefan George challenged him with. The fact is that George, poet and master writer as well as the epicentre of various intellectual circles and a decisive figure for the German Intelligentsia during the first half of the 20th century, berated his rival as someone lacking in «plastic god», among other deficiencies.

El síndrome coronario agudo es un conjunto de entidades nosológicas que representan distintos estadios de un proceso fisiopatológico único: la isquemia miocárdica aguda, secundaria en general (pero no exclusivamente) a aterosclerosis coronaria complicada con fenómenos trombóticos que provocará distintos grados de obstrucción al flujo coronario y que en dependencia del grado de obstrucción y del estado previo del miocardio se presentará clínicamente como una angina inestable, infarto agudo del miocardio sin elevación del ST, infarto agudo del miocardio con elevación del ST o muerte súbita de causa isquémica. La presente revisión pretende abordar los principales aspectos fisiopatológicos de dicho proceso: desde la aterogénesis hasta el daño por reperfusión.Acute coronary syndrome is a number of disease entities representing different stages of a unique pathophysiologic process: acute myocardial ischemia generally secondary (but no exclusively) to coronary atherosclerosis complicated with thrombotic phenomena provoking different degrees of coronary flow obstruction and that depending of the obstruction degree and the previous status of myocardium clinically will see as a unstable angina, myocardium acute infarction with rise of ST or sudden death of a ischemic cause. Present review tries to approach the main pathophysiologic features of such process: from the atherogenesis to reperfusion damage.

ResumenLa importancia de la detección precoz de la nefropatía diabética radica en que es un marcador de riesgo cardiovascular y nos indica la existencia de una alteración vascular que se asocia a un aumento del riesgo de padecer un evento cardiovascular, tanto en la diabetes Mellitus tipo 1 (DM 1) como en la tipo 2 (DM 2).La microalbuminuria es un factor de riesgo para la mortalidad total, cardiovascular y coronaria, en los pacientes con DM 1.La mortalidad total se encuentra aumentada en pacientes con DM 2 y microalbúmina, con un RR del 1.8 y se relaciona con niveles de microalbúmina incluso por debajo del rango considerado como normal (20μg/minuto y/o 30mg/día). Por ello, la definición de microalbúmina debe ser revisada en los pacientes con DM 2.Se necesitan más trabajos que confirmen el poder predictivo de la microalbuminuria sobre la enfermedad cardiovascular y coronaria.AbstractThe importance of the early detection of diabetic nephropathy is because it is a cardiovascular risk marker and it indicates the existence of vascular changes associated to an increase risk of having a cardiovascular event in diabetes mellitus type 1 (DM 1), as well as in type 2 (DM 2).Microalbuminuria is a risk factor for overall cardiovascular and coronary mortality in the patients with DM 1.Total mortality is increased in patients with DM 2 and microalbuminuria with a RR of 1.8, and it is related to microalbuminuria levels even below the considered normal range (20μg/min and/or 30mg/day). For this reason, the definition of microalbuminuria must be reviewed in the patients with DM 2.More studies are needed to confirm the predictive power of microalbuminuria in cardiovascular and coronary disease.

The importance of the early detection of diabetic nephropathy is because it is a cardiovascular risk marker and it indicates the existence of vascular changes associated to an increase risk of having a cardiovascular event in diabetes mellitus type 1 (DM 1), as well as in type 2 (DM 2). Microalbuminuria is a risk factor for overall cardiovascular and coronary mortality in the patients with DM 1. Total mortality is increased in patients with DM 2 and microalbuminuria with a RR of 1.8, and it is related to microalbuminuria levels even below the considered normal range (20 microg/min and/or 30 mg/day). For this reason, the definition of microalbuminuria must be reviewed in the patients with DM 2. More studies are needed to confirm the predictive power of microalbuminuria in cardiovascular and coronary disease.

After presenting how research on student learning has changed significantly over the years, depending on the quantitative or qualitative viewpoint used, the authors concentrate on three focuses: superficial, profound and high yield, studying which of these focuses dominates in the learning among nursing students at the University School of Nursing in Murcia. As a result, the authors pose the following question: Why from first year to second year courses is there a positive evolution regarding the profound focus which changes to a negative evolution from second to third year courses which favor the superficial focus?

The authors explain in a standardized model of nursing care for children and adolescents durning pre-operative phase, the first part in the global surgical process. This phase commences at the moment a surgical intervention is deemed necessary and finalizes when the child/adolescent is transported to the operating room. The authors perform a systematic and holistic evaluation, using the Gordon Functional Health Patterns. Special emphasis is given to aspects such as the perception-management health pattern, the nutritional-metabolic pattern, the elimination pattern, the exercise-activity pattern, the dream-rest pattern, the self-perception pattern and the adaptation-stress tolerance pattern. They evaluate the perception and responses children of varying ages provide to being separated from parents. They highlight the cultural factors which must be born in mind in order to achieve an adequate evaluation and individualized care. The authors select the Nursing Diagnoses of NANDA, the North American Nursing Diagnosis Association, which most frequently appear in this pre-operative phase: fear/anxiety, risk of aspiration, risk of an alteration in health maintenance, and risk of infection. Finally, the authors describe the nursinginterventions related with these diagnoses.

Actinomyces spp. and mycobacteria are rare, with both microorganisms known to cause infections mimicking carcinoma or appendicitis. Actinomycetes play an important role in the co-pathogenesis of disease, because they are normal inhabitants of the human buccal cavity and gastrointestinal tract, whereas most mycobacteria are not (1). We report a case of co-infection caused by an Actinomyces naeslundii strain and aMycobacterium sp. in a patient who had a gastroesophageal fistula and who, in the preceding 2 months, had been undergoing treatment for advanced esophageal squamous cell carcinoma.

Josep Franch-Nadal,1,2 Elena Labrador Barba,3 M Carmen Gómez-García,4 Pilar Buil-Cosiales,5 José Manuel Millaruelo,6 María Luisa Orera Peña3 1AEP Raval Sud, Barcelona, 2Center for Biomedical Research Network of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, 3Established Pharmaceuticals Division, Mylan EPD, Madrid, 4Centro de Salud Velez Norte, Málaga, 5Centro de Salud Azpilagana, Pamplona, 6Centro de Salud Torrero La Paz, Zaragoza, Spain Objective: Understanding patients’ and physicians’ perceptions of type 2 diabetes mellitus (T2DM) management and treatment has important implications for diabetes care, allowing the identification of clinical practice issues that could be improved, leading to patients’ better understanding of the illness and, consequently, healthier self-management behaviors. The objective of this study was to identify differences between physicians’ and T2DM patients’ perceptions related to health status, patient-reported outcomes assessments, and T2DM management and treatment, in routine clinical practice in Spain.Methods: This was an observational, cross-sectional study including 1,012 T2DM patients and 974 physicians from 47 and 52 Spanish provinces, respectively. An electronic structured self-administered questionnaire containing 17 questions was designed aiming to address both physicians’ and patient’s perceptions on overall T2DM health status and patient-reported outcomes.Results: T2DM patients perceived a worse health status (40% reported having a “good” and 38% a “neither good nor bad” health status) compared with physicians’ perceptions (77% thought patients had a “good” health status). Most patients answered being “satisfied” or “neither satisfied nor unsatisfied” with the given information, while physicians considered that patients were “satisfied” or “very satisfied” with the information for self-monitoring blood glucose and treatment administration. Fifty-seven percent of patients reported that medical recommendations were “important”, while 58% of physicians considered it as “very important”. Fifty-three percent of patients perceived that their current T2DM treatment suited their preferences “quite a lot”, and this was lower than the proportion of physicians (69%) that believed this for their patients. Additionally, a lower percentage of patients (53%) than physicians (79%) believed that their treatment improved their health-related quality of life “quite a lot”. All differences between patients and physicians were statistically significant (P