The perception of nurses and doctors on a care bundle guideline for management of pain in critical care

Objetivo: el objetivo de este estudio fue explorar la percepción de las enfermeras y los médicos sobre el uso de un paquete de aten- ción como una guía para el manejo del dolor en cuidados críticos. A pesar del desarrollo de guías y protocolos para el manejo del dolor en cuidados críticos, basados en la evidencia, el dolor sigue siendo un problema importante. La introducción de un paquete de atención para cuidados críticos ha mejorado el manejo de los pacientes ventilados. Un paquete de atención en el manejo del dolor tiene como objetivo reducir las variaciones en la práctica. Método: el estudio tiene un diseño prospectivo cualitativo desarrollado mediante una entrevista en profundidad y semi-estructurada de 23 enfermeros y médicos en una unidad de cuidado crítico. Resultado: cuatro temas principales surgieron: 1 ) la adecuación al escenario de cuidado crítico, 2) la aplicabilidad al escenario de cuidado crítico, 3 ) la propiedad del Paquete de Atención al Dolor, y 4) la necesidad en la práctica actual. Los resultados mostraron una pobre aceptación del paquete por parte de los profesionales de la salud en el manejo de dolor agudo en los enfermos críticos. Conclusión: el estudio encontró que las enfermeras y los médicos no percibieron el paquete de atención al dolor como una herramienta útil para mejorar el manejo del dolor, con pruebas que apuntan a una brecha entre la práctica del manejo del dolor, tal como se describe por el paquete de atención, y la práctica real.</jats:p

Labor Supply Responses to Adverse Shocks under Credit Constraints: Evidence from Bukidnon, Philippines

The ability of households to insure consumption from adverse shocks is an important aspect of vulnerability to poverty. How is consumption insurance achieved in a low-income setting where formal credit and insurance markets have been observed to be imperfect or missing? Using 2003 data from the Philippine province of Bukidnon, we investigate how labor supply is used to buffer transitory income shocks, in light of credit constraints. We find that the most vulnerable households are those with little education and with few or no able-bodied male members. Appropriate policy responses include counter-cyclical workfare programs targeted to households with high female-to-male ratios, households with high dependency ratios, and households with little or no education, as well as the provision of universal education and health care. These programs are likely to be effective in strengthening the labor endowments of households and improving their ability to cope with adverse shocks in the future.Labor supply, credit constraints, consumption smoothing, coping strategies, idiosyncratic shocks, Philippines

Visió psicològica del dolor : dolor clínic i dolor experimental

El dolor es un fenómeno complejo con dificultades de definición y en el cual, a pesar de la intensa investigación llevada a cabo, todavia quedan aspectos conceptuales, experimentales y prácticos por resolver. El objetivo del presente trabajo trata, en primer lugar, de evidenciar que las reacciones de dolor vienen determinadas en gran parte por variables psicológicas, tratándose de un fenómeno conductual y, por tanto, posible objeto de estudio de la psicología. Y , en segundo lugar, remarcar que a pesar de las diferencias existentes entre el dolor clínico y el dolor experimental son muy necesarios los estudios experimentales en ambos campos para poder llegar a una mejor definición y comprensión de las reacciones de dolor y de los métodos para su control.Pain is a complex phenomena difficult to define. In spite of the wide research it has been subject to there still remain many conceptual, experimental and practical questions unsolved. The aim of this present work is, first of all to show that pain reactions are mainly determined by psychological variables and can therefore be dealt with as behavioural phenomena and be the subject of psychological study. Secondly, to stress the fact that notwithstanding the differences between experimental and clinical pain, experimental studies in bothfields are needed to achieve a better and more accurate definition and understanding of pain reactions and of the methods to control them

Avaliação das diferenças de gênero nas estratégias de enfrentamento da dor lombar

El dolor lumbar puede ser visto como un gran problema de salud pública. Las diferencias de género son importantes factores que influyen en los síntomas y en las respuestas del comportamiento. El objetivo de este estudio fue investigar las diferencias de género en los comportamientos de dolor y en el manejo del dolor lumbar crónico. La muestra estuvo conformada por 158 participantes (66,5% mujeres), con edades entre los 30 y 88 años que fueron diagnosticados con artrosis lumbar. Los instrumentos utilizados fueron: la Escala Visual Analógica, el Cuestionario de Calidad de Vida y un cuestionario para evaluar las actividades de ocio y distracción del dolor. Los resultados del MANOVA demostraron que las mujeres presentaron mayor percepción del dolor que los hombres. También fue posible observar frecuencias más altas de actividades sociales en las mujeres, así como correlaciones significativas entre las actividades sociales y los dominios psicológicos, sociales y medio ambientales. En conclusión, las mujeres presentan un mayor número de estrategias de afrontamiento para el dolor, lo cual puede influir positivamente en su calidad de vida.A dor lombar pode ser vista como um grande problema de saúde pública. As diferenças de gênero são importantes fatores que influenciam nos sintomas e nas respostas do comportamento. O objetivo deste estudo foi pesquisar as diferenças de gênero nos comportamentos de dor e na gestão da dor lombar crônica. A amostra foi conformada por 158 participantes (66,5% mulheres), com idade entre 30 e 88 anos, que foram diagnosticadas com artrose lombar. Os instrumentos utilizados foram: a Escala Visual Analógica, o Questionário de Qualidade de Vida e um questionário para avaliar as atividades de lazer e distração da dor. Os resultados do MANOVA demonstraram que as mulheres apresentaram maior percepção da dor do que os homens. Também foi possível observar frequências mais altas de atividades sociais nas mulheres, bem como correlações significativas entre as atividades sociais e os domínios psicológicos, sociais e meio ambientais. Em conclusão, as mulheres apresentaram um maior número de estratégias de enfrentamento para a dor, o que pode influenciar positivamente em sua qualidade de vida.Low-back pain is considered a serious public health problem. Gender differences are important factors that influence symptoms and behavioral responses. This research aimed to investigate gender differences in pain behaviors and pain management of chronic low back pain. The sample consisted of 158 participants (66.5% female), aged 30-88 who were diagnosed with Lumbar Osteoarthritis. The instruments used were the Visual Analogue Scale, the Quality of Life Questionnaire and a questionnaire to assess leisure and distraction activities from pain. Results of MANOVA showed that women have significant greater pain perception than men. Higher frequencies of social activities were also observed for women as well as significant correlations between social activities and psychological, social and environmental domains. In conclusion, women presented a greater number of coping strategies for pain than men, which probably tend to have a positive influence in their life quality

Matrix modification for enhancing the transport properties of the human cartilage endplate to improve disc nutrition.

Poor solute transport through the cartilage endplate (CEP) impairs disc nutrition and could be a key factor that limits the success of intradiscal biologic therapies. Here we demonstrate that treating the CEP with matrix metalloproteinase-8 (MMP-8) reduces the matrix constituents that impede solute uptake and thereby improves nutrient diffusion. Human CEP tissues harvested from four fresh cadaveric lumbar spines (age range: 38-66 years old) were treated with MMP-8. Treatment caused a dose-dependent reduction in sGAG, localized reductions to the amount of collagen, and alterations to collagen structure. These matrix modifications corresponded with 16-24% increases in the uptake of a small solute (376 Da). Interestingly, the effects of MMP-8 treatment depended on the extent of non-enzymatic glycation: treated CEPs with high concentrations of advanced glycation end products (AGEs) exhibited the lowest uptake compared to treated CEPs with low concentrations of AGEs. Moreover, AGE concentrations were donor-specific, and the donor tissues with the highest AGE concentrations appeared to have lower uptake than would be expected based on the initial amounts of collagen and sGAG. Finally, increasing solute uptake in the CEP improved cell viability inside diffusion chambers, which supports the nutritional relevance of enhancing the transport properties of the CEP. Taken together, our results provide new insights and in vitro proof-of-concept for a treatment approach that could improve disc nutrition for biologic therapy: specifically, matrix reduction by MMP-8 can enhance solute uptake and nutrient diffusion through the CEP, and AGE concentration appears to be an important, patient-specific factor that influences the efficacy of this approach

THE NOTIONS OF ENGLISH LANGUAGE AND RESEARCH INSTRUCTORS ON THE IMPACT OF DIGITAL TECHNOLOGIES ON THE RESEARCH WRITING PROCESS OF THEIR COLLEGE STUDENTS

This is a descriptive study investigating teachers’ view on the impact of digital technologies on the research writing of their students. Using Mishra and Koehler’s (2006) TPCK model as framework, a probe was made on how technology and content are related and how pedagogical strategies in research relates to the use of technology in the classroom. The results reveal that teachers generally viewed the impact of digital technologies as positive but also showed misgivings on some aspects of technology use. The results have significant impact on the ICT policy currently being implemented in most state-run schools in the Philippines.Keywords: digital technologies, teacher perceptions, college research, ICT polic

The Mechanism of Rhenium Fixation in Reducing Sediments

There is a wide range of uses of information related to rhenium's geochemical behavior. Field studies indicate that rhenium is highly enriched in reducing sediments. However the mechanisms by which this high degree of enrichment is achieved are unclear. Perrhenate's (ReO4-) sorption onto a clay mineral, kaolinite, was investigated and found to be weak. This behavior is consistent with rhenium's conservative behavior in the oceans. Sorption was enhanced by the presence of a reducing agent, lithium borohydride. The presence of sulfide, a reducing agent found in nature, enhanced sorption slightly. Sulfide apparently does not reduce ReO4- rapidly as shown by the failure of polysulfide species to appear in solution. Instead, sulfide causes the formation of thioperrhenates. The mechanism of thiolation is the successive replacement of oxygen atoms in ReO4- by sulfur atoms, but ReO3S- and ReS4- are the only thioperrhenates observed by UV-Vis spectroscopy. The di- and tri- thioperrhenates, ReO2S2- and ReOS3- are absent due to their relative instability. Thiolation of ReO4- appears to be general-acid catalyzed. Quantitative yield of ReS4- from ReO4- was never achieved. Thioperrhenates undergo polymerization in solution to yield a colloidal Re-S species, probably related to Re2S7, which contains polysulfide ions in its structure. This Re-S polymer is stable under different experimental conditions and thermodynamic calculations confirm that it is a very stable, insoluble species. Sulfide may play an important role in Re enrichment in sediments by leading to the formation of this solid Re-S species

VIRTUAL LEADERSHIP OF ELEMENTARY AND MIDDLE SCHOOL PRINCIPALS DURING PANDEMIC ERA IN MAKASSAR CITY

In this situation of pandemic, schools have to adjust to the new trends of education wherein most things have to be done online. Different platforms are used to be able to mobilize teachers, parents, students and other stakeholders of the schools in Makassar City. Applications like Zoom, Google-meet, and WhatsApp are just some of the media that so far effective in communicating with those stakeholders. In this research, the researcher aims to determine ways and means on how these principals are able to mobilize and influence all the stakeholders so that goals and objectives of the school will be achieved. Based on the findings, principals have to use various platforms and need to conduct regular meetings to tall these stakeholders to ensure that education is well delivered. This paper applies the descriptive qualitative method wherein data is mainly collected by interviews and observations based on the objective of the research. These data are then reduced and analyzed to come up with a conclusion that is based on the main objective of the researche

Intranasal steroids for acute sinusitis

Acute sinusitis is a common reason for primary care visits. It causes significant symptoms and often results in time off work and school