Nursery intervention in response to disturbed behaviour in psychologically impaired institutionalized patients

En el presente trabajo se muestran los elementos básicos para el abordaje de un individuo con discapacidad intelectual agitado por parte del personal de enfermería. Todo ello, respaldado por un plan de cuidados de enfermería. Objetivos: Formar e informar a los profesionales de enfermería para valorar e intervenir de forma eficiente en cada caso ante un discapacitado intelectual institucionalizado. Metodología.- Revisión bibliográfica sobre el tema y exposición de las técnicas propias para atender el proceso: primero, con técnicas verbales, y si éstas no son suficientes, medidas de contención química, y por último mediante la restricción de movimientos con elementos adecuados para tal efecto. Resultados.- Presentación de un protocolo de actuación ante el paciente discapacitado intelectual institucionalizado Conclusiones.- Es necesario formar al profesional de enfermería para reconocer y comprender las manifestaciones de impulsos agresivos, a la hora de planificar el cuidado directo más eficiente y que se ajuste mejor a las necesidades del paciente. De igual modo instruirles sobre la motivación, el conflicto y los impulsos básicos de este tipo de pacientes, a fin de entender mejor su conducta y los sentimientos que manifiestan

The Multiplicity of M-Dwarfs in Young Moving Groups

We image 104 newly identified low-mass (mostly M-dwarf) pre-main sequence members of nearby young moving groups with Magellan Adaptive Optics (MagAO) and identify 27 binaries with instantaneous projected separation as small as 40 mas. 15 were previously unknown. The total number of multiple systems in this sample including spectroscopic and visual binaries from the literature is 36, giving a raw multiplicity rate of at least $35^{+5}_{-4}\%$ for this population. In the separation range of roughly 1 - 300 AU in which infrared AO imaging is most sensitive, the raw multiplicity rate is at least $24^{+5}_{-4}\%$ for binaries resolved by the MagAO infrared camera (Clio). The M-star sub-sample of 87 stars yields a raw multiplicity of at least $30^{+5}_{-4}\%$ over all separations, $21^{+5}_{-4}\%$ for secondary companions resolved by Clio from 1 to 300 AU ($23^{+5}_{-4}\%$ for all known binaries in this separation range). A combined analysis with binaries discovered by the Search for Associations Containing Young stars shows that multiplicity fraction as a function of mass and age over the range of 0.2 to 1.2 $M_\odot$ and 10 - 200 Myr appears to be linearly flat in both parameters and across YMGs. This suggests that multiplicity rates are largely set by 100 Myr without appreciable evolution thereafter. After bias corrections are applied, the multiplicity fraction of low-mass YMG members ($< 0.6 M_\odot$) is in excess of the field.Comment: 25 page

Associations between feed efficiency and aspects of lactation curves in primiparous Holstein dairy cattle.

Genetic selection for improved feed efficiency in dairy cattle has received renewed attention over the last decade to address the needs of a growing global population. As milk yield is a critical component of feed efficiency metrics in dairy animals, our objective was to evaluate the associations between feed efficiency in primiparous Holstein cattle and parameters of a mathematical model describing individual lactation curves. The Dijkstra lactation curve model was fit to individual lactation records from 34 Holstein heifers with previously estimated measures of feed efficiency. We found that the optimal fit of the Dijkstra model was achieved using daily milk yield records up to 21 d in milk to capture the rise to peak milk yield and using monthly dairy herd improvement records for the remainder of lactation to accurately characterize lactation persistency. In the period of lactation before peak milk yield, improved feed efficiency was associated with a faster increase in daily milk yield over a shorter period of time at the expense of increased mobilization of body reserves; this serves to reinforce the concept that dairy cattle are primarily capital breeders versus income breeders. Feed efficiency in the period following peak lactation, as measured by gross feed efficiency, return over feed costs, and net energy efficiency of lactation, was positively associated with higher peak milk yield. The findings in early lactation suggest that estimates of feed efficiency could be improved by evaluating feed efficiency relative to conception, rather than parturition and lactation, to better account for the energy stored and released from body reserves in capital breeding

Application of the SWAT model to an AMD-affected river (Meca River, SW Spain). Estimation of transported pollutant load

Keywords: AMD Acid mine drainage Odiel River SWAT Water quality s u m m a r y The Meca River is highly contaminated by acid mine drainage coming from the Tharsis mining district, belonging to the Iberian Pyrite Belt. This river is regulated by the Sancho reservoir (58 hm 3 ), with a pH close to 4.2. In this work, the load transported by the Meca River to the Sancho reservoir has been assessed. Due to the lack of streamflow data, the hydrological behaviour of the Meca River basin has been simulated using the SWAT model. The model has been calibrated against registered daily inflows of the Sancho reservoir (1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000), excluding the hydrological years 2000/2001 and 2001/2002 that were kept for the validation. The results were satisfactory; the evaluation coefficients for monthly calibration were: r = 0.85 (Pearson&apos;s correlation coefficient), NSE = 0.83 (Nash-Sutcliffe coefficient) and DV = 1.08 (runoff volume deviation). The main uncertainty was the calibration during low water because of the poor accuracy in the measurement of the inputs to the reservoir in these conditions. Discharge and dissolved concentration relationships for different elements were obtained from hydrochemical samplings, which allowed us to estimate the element pollutant load transported to the reservoir: 418 ton/year of Al, 8024 ton/year of SO 4 , 121 ton/year of Zn, etc. Based on these loads, concentrations in the reservoir were calculated for some elements. Apart from Mn and Sr, good adjustment between calculated and measured values was observed (±20% for Ca, Co, Li, Mg, Na, Ni, Zn and SO 4 ). Capsule: Hydrological model combined with water quality data show how pollution by AMD can generate huge loads of contaminants acidifying streams and reservoirs

Avaliação do valor de cultivo e uso de genótipos de trigo de sequeiro no estado de Goiás - 2001.

Embora as potencialidades para o cultivo de trigo na Região Centro-oeste tenham sido visualizadas em meados da década de 30, por meio das primeiras pesquisas realizadas com essa cultura, foi com programas governamentais, em escala nacional, de incentivo à cultura e, posteriormente, com o advento do plantio direto que sua inserção competitiva nos sistemas agrícolas da região tornou-se uma realidade, hoje em bases mais sólidas e técnicas como resultado do zoneamento agroclimático para a cultura em quase toda a região

Comparative effect of high pressure processing and traditional thermal treatment on the physicochemical, microbiology, and sensory analysis of olive jam

In the present work the effect of the processing by high hydrostatic pressures (HPP) was assessed as an alternative to the thermal treatment of pasteurization in olive jam. The effects of both treatments on the product after processing were compared and stability during storage under refrigeration was assessed through the characterization of physicochemical, microbiological and sensory aspects. To assess the effect of processing, two HPP treatments (450 and 600MPa) and thermal pasteurization (80 °C for 20 min) were applied, comparing them with the unprocessed product. HPP 600MPa versus the rest of treatments showed a reduction in microorganisms, greater clarity and less browning, and sensory acceptance. The shelf-life of the refrigerated product would indicate the feasibility of the application of the HPP technology for food with similar shelf-life to that obtained with the traditional treatment of pasteurization, but with a better sensory quality.<br><br>En el presente trabajo se valoró el efecto del procesado por altas presiones hidrostáticas (HPP) como método alternativo al tratamiento térmico de pasteurización en la mermelada de aceitunas. Para ello se comparó el efecto de ambos tratamientos sobre el producto procesado y se evaluó su estabilidad durante el almacenamiento en refrigeración, mediante la caracterización de los aspectos físico-químicos, microbiológicos, y sensoriales. Para evaluar el efecto del procesado, se aplicaron dos tratamientos de HPP (450 y 600MPa) y otro de pasteurización térmica (80 °C durante 20 min), comparándose con el producto no procesado. Las muestras tratadas con HPP 600MPa presentaron, frente al resto de tratamientos una reducción en la presencia de microorganismos, mayor claridad y menor pardeamiento, y una mayor aceptación sensorial. El estudio de la vida útil del producto en refrigeración, indicaría la viabilidad de la aplicación de la tecnología de HPP para obtener alimentos con vida útil similar a la obtenida con el tratamiento tradicional de pasteurización, pero con mejor calidad sensorial

Incidence and etiological mechanism of stroke in cardiac surgery

© 2017. Sociedad Española de Neurología. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published version of a Published Work that appeared in final form in Neurología. To access the final edited and published work see https://doi.org/10.1016/j.nrl.2017.10.004Objetivo Estudiar a los pacientes que tuvieron un ictus en el postoperatorio de cirugía cardiaca, para ver la evolución y determinar los factores que influyen en su pronóstico y tratamiento. Métodos Establecimos un protocolo para la detección precoz de ictus en los pacientes tras cirugía cardiaca. Recogimos la aparición de ictus y datos clínicos, quirúrgicos y pronósticos; posteriormente realizamos un análisis descriptivo. Resultados Durante los 15 meses del estudio hubo 16 ictus, un 2,5% de los pacientes operados. Edad media 69 ± 8 años, 63% varones. La incidencia de ictus en pacientes octogenarios fue del 5,1%. Cinco (31%) fueron cirugías urgentes. Por enfermedad cardiaca intervenida: un 7% recibió cirugía mitral, 6,5% cirugía combinada, un 3% cirugía valvular aórtica y un 2,24% cirugía coronaria. La mayoría de los ictus (44%) fueron por embolia, seguida por hipoperfusión (25%). El 69% de los ictus ocurrieron en los 2 primeros días de postoperatorio. La media de la puntuación en la escala NIHSS en el ictus fue 9, se activó código ictus en 10 (62%), y se realizó trombectomía en uno de ellos (14%). La evolución fue favorable en la mayoría, con una escala de Rankin a los 3 meses ≤ 2 en 13 (80%). No hubo muertes hospitalarias entre estos pacientes. Conclusión En nuestro medio, los ictus tras cirugía cardiaca son de pequeño tamaño y tienen una buena evolución a largo plazo. La mayoría ocurren en los primeros 2 días de postoperatorio y su mecanismo es principalmente embólico. La incidencia de ictus en los pacientes octogenarios intervenidos fue del doble que en la población general. -------------------------Objective We studied patients who had experienced a stroke in the postoperative period of cardiac surgery, aiming to analyse their progression and determine the factors that may influence prognosis and treatment. Methods We established a protocol for early detection of stroke after cardiac surgery and collected data on stroke onset and a number of clinical, surgical, and prognostic variables in order to perform a descriptive analysis. Results Over the 15-month study period we recorded 16 strokes, which represent 2.5% of the patients who underwent cardiac surgery. Mean age in our sample was 69 ± 8 years; 63% of patients were men. The incidence of stroke in patients aged 80 and older was 5.1%. Five patients (31%) underwent emergency surgery. By type of cardiac surgery, 7% of patients underwent mitral valve surgery, 6.5% combined surgery, 3% aortic valve surgery, and 2.24% coronary surgery. Most cases of stroke (44%) were due to embolism, followed by hypoperfusion (25%). Stroke occurred within 2 days of surgery in 69% of cases. The mean NIHSS score in our sample of stroke patients was 9; code stroke was activated in 10 cases (62%); one patient (14%) underwent thrombectomy. Most patients progressed favourably: 13 (80%) scored ≤ 2 on the modified Rankin Scale at 3 months. None of the patients died during the postoperative hospital stay. Conclusion In our setting, strokes occurring after cardiac surgery are usually small and have a good long-term prognosis. Most of them occur within 2 days, and they are mostly embolic in origin. The incidence of stroke in patients aged 80 and older and undergoing cardiac surgery is twice as high as that of the general population