30 research outputs found
The ecology of peace : preparing Colombia for new political and planetary climates
ABSTRACT: Colombia, one of the worldâs most species-rich nations, is currently undergoing a profound social transition: the end of a decadeslong conflict with the Revolutionary Armed Forces of Colombia, known as FARC. The peace agreement process will likely transform the countryâs physical and socioeconomic landscapes at a time when humans are altering Earthâs atmosphere and climate in unprecedented ways. We discuss ways in which these transformative events will act in combination to shape the ecological and environmental future of Colombia. We also highlight the risks of creating perverse development incentives in these critical times, along with the potential benefits â for the country and the world â if Colombia can navigate through the peace process in a way that protects its own environment and ecosystems
Care and preservation of the school environment in the IED Rodrigo Vives de Andréis
El ser humano ha generado a lo largo de su existencia un impacto negativo sobre los ecosistemas a nivel mundial debido a procedimientos en su beneficio que perjudican abismalmente a las otras especies presentes en el planeta; todo esto se ha logrado ver gracias a estudios ecológicos y ambientales, lo que nos permite saber dónde intervenir y aportar una contribución a estos objetivos mundiales que buscan frenar el impacto negativo que recibe nuestro planeta por parte del ser humano. Por tal motivo el estudio buscó realizar una estrategia Pedagógica (IEP) apoyada en TIC aportada por los docentes que son capacitados por el programa Ciclón a fin de hacer que los estudiantes adopten sentido de respeto y cuidado con el entorno de la institución y el medio ambiente. Metodológicamente se orientó bajo un enfoque cualitativo, utilizando el tipo de investigación -acción, desde un diseño descriptivo, donde se utilizaron técnicas como entrevistas y observación participantes. Dicha muestra estuvo conformada por 200 estudiantes de la jornada de la mañana de la Institución Educativo Departamental Rodrigo Vives de Andreis. Al incluir la investigación y las TIC al aula de clase, se obtuvieron resultados positivos y reconfortantes mediante la implementación de dicho programa medioambientalThe human being has generated throughout its existence a negative impact on ecosystems worldwide due to procedures in their benefit that abysmally harm the other species present on the planet; All this has been achieved thanks to ecological and environmental studies, which allows us to know where to intervene and contribute to these global objectives that seek to curb the negative impact of human beings on our planet. For this reason the study sought to implement a pedagogical strategy (IEP) supported by ICT provided by teachers who are trained by the Cyclone program in order to make students adopt a sense of respect and care with the environment of the institution and the environment . Methodologically, it was guided by a qualitative approach, using the type of research -action, from a descriptive design, where techniques such as interviews and participant observation were used. Said sample was conformed by 200 students of the day of the morning of the Departmental Education Institution Rodrigo Vives de Andreis. By including research and ICT in the classroom, positive and comforting results were obtained through the implementation of this environmental program
Biofunctionalization of hydrogel-based scaffolds for vascular tissue regeneration
Congenital and acquired tissular losses due to disease or trauma are a major world health problem. Regenerative therapy aims to fix damaged tissues by directing the natural capacity of a host organism to use biofunctionalized artificial tissue scaffolds. These three-dimensional (3D) scaffolds can be customized with cells and/or bioactive molecules to induce cellular homing and angiogenesis, essential to ensure successful tissue regeneration. Hydrogels (HGs) scaffolds are networks of hydrophilic homopolymers, copolymers, and/or macromers with chemical and biological activities that enhance their cell colonization. The use of HGs in regenerative medicine has shown to be advantageous since HGs can be prepared under clinical-grade conditions and tailored to the specific needs of the replaced tissue. They can be made to emulate native extracellular matrices (ECMs) including physical, mechanical, and chemical cues and resilience properties. These customized HGs can reproduce the natural hygroscopic capacity of the original tissue which improves cellular anchoring, nutrition, and waste disposal. They can enable host molecular and cellular modification conducive to a natural cellular microenvironment, modifying the properties of the scaffold, and improving chemotaxis, cell adhesion, migration, proliferation, differentiation, and angiogenesis; HGs can be created and biofunctionalized with linked growth factors and synthetic peptides tailored to positively influence scaffold colonization and functional biocompatibility. This review aims to collect the most relevant information regarding biofunctionalization of HGs used for vascular tissue regeneration, their biological effects, and their clinical implications. While most biofunctionalized HGs are still under investigation, some of them have been studied in vitro, ex vivo, and in vivo with promising results. In this regard, in vivo studies have shown that biofunctionalized scaffolds with peptides such as chitosan hydrogel with LL-37 promotes angiogenesis and healing of pressure ulcers. Also, the GHK tripeptide is widely used in trials focused on guided tissue remodeling
POR UNA CULTURA DE PAZ: UNA MIRADA DESDE LAS CIENCIAS DE LA CONDUCTA
Enâ© virtudâ© deâ© loâ© anterior,â© losâ© estudiososâ© deâ© lasâ© cienciasâ© deâ© laâ© conductaâ© â©deâ© laâ© Universidadâ©AutĂłnoma â©delâ© Estado â©de â©MĂ©xico,â©â©ante â©laâ©persistenciaâ© y â©proliferaciĂłnâ© deâ© estos â©hechosâ© enâ© diversasâ© partesâ© delâ©Mundoâ© yâ© deâ© nuestro â©paĂs â©en â©particular, seâ© convocĂłâ© aâ© losâ© estudiososâ© interesadosâ© yâ© aâ© laâ© sociedadâ© enâ© generalâ© aâ© presentarâ© trabajosâ© paraâ© analizar,â© debatirâ© yâ© proponerâ© estrategiasâ© deâ© acciĂłnâ© yâ© direcciĂłn,â© queâ©
fortalezcanâ© unaâ© convivencia y bienestar con sentido humanista para una cultura de paz.
Elâ© presenteâ© textoâ© esâ© productoâ© de â©esta convocatoria â©queâ© recoge â©losâ©trabajos â©de â©â©losâ© interesados â©en â©laâ© temĂĄtica,â©â© deâ© diferentes â©paĂsesâ©(España,â©Argentina,â©Cuba,â©Brasil,â©Costaâ© Ricaâ© yâ© MĂ©xico)â© retomandoâ© conâ© elloâ© susâ© experienciasâ© relativasâ© alâ© estudio,â© anĂĄlisis,â© comprensiĂłnâ© eâ© instrumentaciĂłnâ© deâ© laâ© culturaâ© deâ© pazâ© enâ© losâ© distintosâ© ĂĄmbitosâ© institucionalesâ© enâ© losâ© queâ© participan:â© educativo,â© salud,â© penitenciario,â©
social,â©laboral,â©familia,â©alimentario,â©psicolĂłgico,â©por â©mencionar â©algunos.â©
Elâ© presenteâ© libro,â© propiciaâ© unâ© espacioâ© deâ© reflexiĂłn,â© diĂĄlogoâ© yâ© posicionamientoâ© deâ© las â©ciencias â©de â©la â©conductaâ© para â©la â©apropiaciĂłn,â©anĂĄlisis,â©debateâ© y â©propuestas â©queâ© fortalezcan â©unaâ© culturaâ© de â©pazâ© aâ©travĂ©sâ© de â©laâ© convivencia â©yâ© el â©bienestarâ© social â©conâ© sentido â©humanista.â©Elâ© sistema â©econĂłmicoâ© neoliberalâ© y â©el â©procesoâ© de â©globalizaciĂłn â©hanâ© contribuidoâ©alâ© logroâ© deâ© avancesâ© significativosâ© enâ© laâ© cienciaâ© yâ© laâ© tecnologĂa,â© peroâ© tambiĂ©nâ© hanâ© propiciadoâ© laâ© polarizaciĂłnâ© deâ© lasâ© sociedadesâ© loâ© queâ© haâ© impactadoâ© deâ© maneraâ© negativaâ© aâ© laâ© sociedadâ© enâ© suâ© conjunto,â© peroâ© enâ© mayorâ© medidaâ© aâ© los gruposâ© vulnerables. Dichaâ© polarizaciĂłnâ© haâ© traĂdoâ© consigoâ© unâ© desarrolloâ© desigualâ© delâ© mundoâ© queâ© seâ© expresaâ© deâ© diferentesâ© manerasâ© tantoâ© enâ© paĂsesâ© desarrolladosâ© comoâ© enâ© losâ© llamadosâ© delâ© tercerâ© mundo,â© enâ© dondeâ© noâ© estĂĄnâ© satisfechasâ© lasâ© necesidadesâ© humanas â©elementalesâ© deâ© todos â©losâ©sectores â©de â©la â©poblaciĂłn,â©siempre â©falta â©algo. â©Si â©aâ© esto â©leâ© sumamos â©losâ©conflictosâ© internacionales porâ© diferentesâ© motivosâ© queâ© enfrentanâ© algunasâ© naciones,â© unaâ© insuficienteâ© coberturaâ© educativaâ© yâ© deâ© salud,â©â© desempleoâ© yâ© pobreza â©extrema,â© entre â©otrasâ© cosasÍŸ â©estamosâ© frenteâ© aâ©retos â©deâ© granâ© envergaduraâ© paraâ© losâ© gobiernos,â© paraâ© losâ© estudiososâ© yâ© paraâ© laâ© sociedadâ© civilâ© enâ© general. Uno â©de â©losâ© intentosâ© paraâ© frenar â©y prevenir â©laâ© agudizaciĂłnâ© de â©estas â©problemĂĄticasâ© esâ© laâ© cultura â©de â©paz,â©cuyoâ© estudioâ©y propuestas â©han â©ido â©avanzando â©en â©diferentesâ© sentidos â©y â©de â©manera â©favorable,â©el â©tema â©estĂĄ â©presente â©en â©diferentes â©Organismosâ© Internacionalesâ© comoâ© laâ© ONU,â© laâ© UNESCO,â© laâ© OCDE,â© Elâ© Bancoâ© Mundial,â© entreâ© otros.â© Peroâ© falta â©mucho â©por â©hacer.Universidad AutĂłnoma del Estado de MĂ©xic
una mirada desde las Ciencias de la Conducta
Este libro es el resultado de los trabajos presentados en el 1er Congreso Internacional "Convivencia y bienestar con sentido humanista para una cultura de paz"
The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries
DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0â36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8â100·0) for children from high-income countries, 91·2% (89·5â93·0) for children from upper-middle-income countries, 80·3% (78·3â82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76â50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44â18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23â1·56). For children aged 3â7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprungâs disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprungâs disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36â39) and median bodyweight at presentation was 2·8 kg (2·3â3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
pâ€0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88â4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59â2·79], p<0·0001), sepsis at presentation (1·20
[1·04â1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4â5 vs ASA 1â2, 1·82 [1·40â2·35], p<0·0001; ASA 3 vs ASA 1â2, 1·58, [1·30â1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02â1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41â2·71], p=0·0001; parenteral nutrition 1·35, [1·05â1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47â0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50â0·86], p=0·0024) or percutaneous central line (0·69 [0·48â1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9â27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6â16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2â1.8), stage II (OR 1.6; 95% CI 1.4â1.9), and stage III or worse (OR 2.8; 95% CI 2.3â3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat
Recommended from our members
Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9â27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6â16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2â1.8), stage II (OR 1.6; 95% CI 1.4â1.9), and stage III or worse (OR 2.8; 95% CI 2.3â3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat