“The team needs to feel cared for”: staff perceptions of compassionate care, aids and barriers in adolescent mental health wards

BackgroundCompassion is vital in healthcare. Current understandings of the nature of compassionate care, its aids and barriers, are more theoretically developed than grounded in staff experience. This study explores staff perceptions of compassionate care in child and adolescent mental health wards.MethodsThree focus groups were conducted with a total of 35 staff from adolescent mental health wards (10–12 people in each group), on the nature of compassionate care, aids and barriers. Transcripts were analysed using thematic analysis. A follow-up survey with 36 workers from other UK child and adolescent mental health wards was completed and means and standard deviations of responses were analysed to confirm wider resonance of themes.ResultsElements of compassionate care fell into six themes relating to individual, team and organisational factors: emotional connection, sense of being valued, attention to the whole person, understanding, good communication, and practical help/resources. Aids and barriers mirrored each other, and showed that what staff think is key to the nature of compassionate care for patients is also what they feel they need to receive to be able to show compassionate care.ConclusionsThis study suggests that staff need the same elements of compassion as those which they seek to provide. A greater emphasis needs to be placed on providing staff with individual, team and organisational level resources which help them to feel compassionately held within the interconnected systems in which they work, in order to be able to continue to provide high level compassionate care. Staff need to be nourished, valued and compassionately cared for in order to be able to care compassionately for the patients they look after

Análisis de impacto presupuestal para Octeotride, Lanreotide y Pasiotide en el tratamiento de la Acromegalia y Gigantismo en Colombia

60 páginas : gráficasIn Colombia a disease orphan is recognized by law 1392 of 2010 and is defined as that chronically debilitating, serious, that threatens the life and with a lower prevalence of 1 per 5,000. One of the diseases that are facing this problem is the acromegaly and gigantism due to their complexity in the diagnosis, with an annual incidence of three to four new cases per million inhabitants and prevalence between 40 and 90 cases per million and given its lines of treatment is considered of high cost. The development of new health technologies today allows to generate good resource management and strengthen the system. To carry out a budget impact analysis of some technology of interest it is necessary To manage the economic evaluations which will allow to support in the decision making in health worldwide. In Colombia, 1483 people are reported to be diagnosed with the pathologies of acromegaly and gigantism. Somatostatin analogues have been studied in the treatment of acromegaly and gigantism, it has been shown that they are highly effective in inhibiting growth hormone production. According to the guides consulted their effect and the duration of their action is much greater compared to the dopamine agonists as evidenced in the ranges and periods of dosage described above, as it requires a much greater amount of Bromocriptine in shorter periods of time. For the costs of Pasireotide is evidence that there is a maximum price or minimum standardized as the average of the data obtained through the institutional channel in the database of the SISMED, shows that the price of all suppliers this averaging and there is no overrun by any manufacturer. The use of these technologies allows an approach of cases where acromegaly is highly active and cannot be controlled and which in turn can be used in the treatment where the alteration of the growth hormone secretion is minimal. For the FOSYGA the result obtained makes it clear that if scenario 1 is applied to the deterministic level there will be a saving of about $10 million COP, in scenario number 2, the investment must be of about$600,000 COP, but it is necessary by the state Keep in mind that the effectiveness of the treatment in implementing the use of the three new technologies will be much greater. It is suggested that the technologies called (Octeotride, lanreotide and pasireotide) are included in the comprehensive plan of health, given that the cost makes it accessible to the populationEn Colombia una enfermedad huérfana es reconocida por la ley 1392 de 2010 y se define como aquella crónicamente debilitante, grave, que amenaza la vida y con una prevalencia menor de 1 por cada 5.000. Una de las enfermedades que se enfrentan a esta problemática es la Acromegalia y el Gigantismo debido a su complejidad en el diagnóstico, con una incidencia anual de tres a cuatro casos nuevos por millón de habitantes y prevalencia entre 40 y 90 casos por millón y dadas sus líneas de tratamiento se considera de alto costo. El desarrollo de nuevas tecnologías de salud en la actualidad permite generar una buena administración de recursos y fortalecer el sistema. Para realizar un análisis de impacto en presupuesto de alguna tecnología de interés es preciso gestionar las evaluaciones económicas las cuales permitirán apoyar en la toma de decisiones en salud a nivel mundial. En Colombia se encuentran reportadas 1483 personas que son diagnosticados con las patologías de acromegalia y gigantismo. Los análogos de somatostatina han sido estudiados en el tratamiento de la acromegalia y gigantismo, se ha evidenciado que son altamente eficaces en la inhibición de producción de la hormona de crecimiento. De acuerdo con las guías consultadas su efecto y la duración de su acción es mucho mayor en comparación a los agonistas dopaminérgicos como se evidencia en los rangos y periodos de dosificación anteriormente descritos, ya que se requiere una cantidad mucho mayor de Bromocriptina en periodos más cortos de tiempo. Para los costos del Pasireotide se evidencia que no hay un precio máximo o mínimo estandarizado ya que el promedio de los datos obtenidos a través del canal institucional en la base de datos del SISMED, muestra que el precio de todos los proveedores esta promediado y no hay un sobrecosto por parte de algún fabricante. El uso de estas tecnologías permite un abordaje de casos donde la acromegalia es altamente activa y no se puede controlar y que a su vez puedan ser utilizados en el tratamiento donde la alteración de la secreción de hormona de crecimiento es mínima. Para el FOSYGA el resultado obtenido permite evidenciar que si se aplica el escenario 1 a nivel determinístico habrá un ahorro de cerca de $10.000.000 COP, en un escenario número 2, la inversión debe ser de alrededor de$600.000 COP, pero es necesario por parte del estado tener en cuenta que la efectividad del tratamiento al implementar el uso de las tres nuevas tecnologías será mucho mayor. Se sugiere que las tecnologías denominadas (Octreotide, Lanreotide y Pasireotide) sean incluidas en el plan integral de salud, dado que el costo hace que sea accesible a la población.Incluye bibliografíaPregradoQuímico(a) Farmacéutic

Aprendizaje significativo y atención en niños y niñas del grado primero del colegio Rodrigo Lara Bonilla

El siguiente proyecto se titula ‘‘Aprendizaje significativo y atención en niños y niñas de primero del colegio Rodrigo Lara Bonilla’’. Es por ello que se realizó una intervención teniendo en cuenta la problemática que se evidenció en este colegio; sede B, localizado en ciudad bolívar, en el curso primero A, el cual se conformaba por 36 estudiantes, de los cuales un gran porcentaje presentaba dificultades atencionales; por consiguiente se propuso realizar una intervención basada en estrategias de aprendizaje significativo, las cuales permitieran mejorar sus niveles de atención y su rendimiento académico

SELF-EFFICACY AND COMPLEX THINKING IN HIGHER EDUCATION STUDENTS IN PERU

The objective of the study was to determine the relationship and predictability between self-efficacy and complex thinking in higher education students in Peru, making comparisons by gender, in 543 students aged 18 to 25 years, from four public universities to whom the scales of Self-Efficacy (EAPESA; Palenzuela, 1983) and Complex Thinking created by CIFE (2017) were applied. The results show a moderate positive relationship and complex thinking is a predictor of self-efficacy in 17.6% of the cases observed, and there are no significant differences according to gender, and most were located at medium and high levels in both variables

Lipólisis de queso fresco y quesos madurados: factores que afectan y consecuencias

Introduction: of the lipolysis process in cheeses is one of the major biochemical changes especially in the mature type, this process is generated by the degradation of fat, enzymatically that influences the sensory characteristics of cheeses, since the free fatty acids (GLA) produced during lipolysis contribute together with volatile compounds to the flavor of cheese.  The objective in the present work is to evaluate the characteristics, factors and consequences that affect the process of lipolysis to both fresh and matured type cheeses. Methodology this bibliographic review was carried out through the PRISMA statement, which consists of a systematic review that is carried out in 4 steps: Identification, Screening, Choice, and Inclusion.  Results factors such as poor pasteurization in cheeses, the way of elaboration and the milk enzymes themselves (lipases) affect the biochemical process of lipolysis, because of this there is an oxidation in fresh cheeses generating low quality in the product. In matured cheeses, lipolysis is presented by some factors among which the quality of the milk, homogenization, pH, pasteurization, temperature, concentration, and degree of agitation stand out, on the other hand, the AGL in this type of cheeses are responsible for enhancing the flavor and characteristic aroma.  Conclusion the factors involved in the lipolysis process makes it easier for cheese producers to have stricter control during the production processes.  Area of study: Engineering, industry, food production.Introducción el proceso de lipólisis en quesos es uno de los mayores cambios bioquímicos especialmente en los de tipo maduro, este proceso se genera por la degradación de la grasa, por vía enzimática que influye sobre las características sensoriales de los quesos, ya que los ácidos grasos libres (AGL) producidos durante la lipólisis contribuyen junto con los compuestos volátiles al sabor del queso. El objetivo en el presente trabajo es evaluar las características, factores y consecuencias que afectan el proceso de lipólisis tanto a los quesos tipo frescos como madurados. Metodología esta revisión bibliográfica se realizó por medio de la declaración PRISMA, que consiste en una revisión sistemática que se lleva a cabo en 4 pasos; Identificación, Cribado, Elección e Inclusión. Resultados factores como una mala pasteurización en los quesos, la forma de elaboración y las propias enzimas de la leche (lipasas) afectan al proceso bioquímico de la lipólisis, como resultado de esto se da una oxidación en los quesos frescos generando baja calidad en el producto. En los quesos madurados la lipólisis se presenta por algunos factores entre los que se resalta la calidad de la leche, la homogenización, pH, pasteurización, temperatura, la concentración y el grado de agitación, por otra parte, los AGL en este tipo de quesos son encargados de potenciar el sabor y aroma característico. Conclusión conocer los factores que intervienen en el proceso de lipólisis facilita a los productores queseros a tener un control más estricto durante los procesos de elaboración. Área de estudio: Ingeniería, industria, producción de alimentos

Remote sensing of lunar aureole with a sky camera: Adding information in the nocturnal retrieval of aerosol properties with GRASP code

The use of sky cameras for nocturnal aerosol characterization is discussed in this study. Two sky cameras are configured to take High Dynamic Range (HDR) images at Granada and Valladolid (Spain). Some properties of the cameras, like effective wavelengths, sky coordinates of each pixel and pixel sensitivity, are characterized. After that, normalized camera radiances at lunar almucantar points (up to 20° in azimuth from the Moon) are obtained at three effective wavelengths from the HDR images. These normalized radiances are compared in different case studies to simulations fed with AERONET aerosol information, giving satisfactory results. The obtained uncertainty of normalized camera radiances is around 10% at 533 nm and 608 nm and 14% for 469 nm. Normalized camera radiances and six spectral aerosol optical depth values (obtained from lunar photometry) are used as input in GRASP code (Generalized Retrieval of Aerosol and Surface Properties) to retrieve aerosol properties for a dust episode over Valladolid. The retrieved aerosol properties (refractive indices, fraction of spherical particles and size distribution parameters) are in agreement with the nearest diurnal AERONET products. The calculated GRASP retrieval at night time shows an increase in coarse mode concentration along the night, while fine mode properties remained constant.This work was supported by the Andalusia Regional Government (project P12-RNM-2409) and by the “Consejería de Educación, Junta de Castilla y León” (project VA100U14).Spanish Ministry of Economy and Competitiveness and FEDER funds under the projects CGL2013-45410-R, CMT2015-66742-R, CGL2016-81092-R.“Juan de la Cierva-Formación” program (FJCI-2014-22052).European Union's Horizon 2020 research and innovation programme through project ACTRIS-2 (grant agreement No 654109)

Objectively measured physical activity, sedentary time and subclinical vascular disease: Cross-sectional study in older British men.

Low physical activity (PA) and high levels of sedentary time (ST) are associated with higher cardiovascular disease (CVD) risk among older people. However, their independent contribution and importance of duration of PA and ST bouts remain unclear. We investigated associations between objectively measured PA, ST and non-invasive vascular measures, markers of CVD risk. Cross-sectional study of 1216 men from the British Regional Heart Study, mean age 78.5years, measured in 2010-2012. Carotid intima thickness (CIMT), distensibility coefficient (DC) and plaque presence were measured using ultrasound; pulse wave velocity (cfPWV) and augmentation index (AIx) using a Vicorder. PA and ST were measured using hip-worn ActiGraph GT3X accelerometers. After adjusting for covariates, each additional 1000 steps per day was associated with a 0.038m/s lower cfPWV (95% CI=-0.076, 0.0003), 0.095 10(-3) kPa(-1) higher DC (95% CI=0.006, 0.185), 0.26% lower AIx (95% CI=-0.40, -0.12) and a 0.005mm lower CIMT (95% CI=-0.008, -0.001). Moderate and vigorous PA (MVPA) was associated with lower AIx and CIMT, light PA (LPA) with lower cfPWV and CIMT and ST with higher cfPWV, AIx and CIMT and lower DC. LPA and ST were highly correlated (r=-0.62). The independence of MVPA and ST or MVPA and LPA was inconsistent across vascular measures. Bout lengths for both PA and ST were not associated with vascular measures. In our cross-sectional study of older men, all PA regardless of intensity or bout duration was beneficially associated with vascular measures, as was lower ST. LPA was particularly relevant for cfPWV and CIMT