Proyecto GINKGO: Isla de aprendizaje para el espacio público

[ES] El proyecto desarrolla en detalle el diseño de una isla de aprendizaje modular y permeable, con posibilidad de trabajar de forma individualizada, pero que también permite el trabajo colectivo y las puestas en común en un pequeño foro. Un espacio multifuncional, concebido inicialmente para la investigación y el aprendizaje, pero que también pueda ofrecer un punto de reunión y descanso a las personas que transitan por la ciudad, de modo que pueda ser utilizado tanto por grupos escolares, como por colectivos ciudadanos o por grupos de amigos. Un equipamiento, energéticamente autosuficiente, que busca la cohesión social, intercambiando conocimientos y experiencias, e incluso colaborando en proyectos colectivos. Se enmarca en el contexto de la Smart City, analizando las diferentes áreas de interés en el desarrollo de productos y recogiendo las necesidades espaciales que plantean las nuevas metodologías educativas.[EN] The Project develops in detail the design of a public outdoors learning space, modular and permeable, that makes possible working individually as well as allowing collective work or presentations in a small forum. A multifunctional space, initially conceived for research and learning, but providing as well a meeting and resting point for citizens. This way, it can be used by school teams, citizen collectives or just by friends. An urban equipment, energetically self-supplied, that seeks social cohesion, exchanging knowledge and experiences, or even collaborating with collective projects. It is framed in the context of the Smart City, analyzing the different areas of interest in the development of products and collecting the spatial needs of the new educational methodologies.[CA] El projecte desenvolupa, detalladament, el disseny d’una illa d’aprenentatge modular i permeable, amb possibilitat de treballar de forma individualitzada, però que també permet el treball col·lectiu i les posades en comú en un xicotet fòrum. Un espai multifuncional, concebut inicialment per a la investigació i l’aprenentatge, però que també puga oferir un punt de reunió i descans a les persones que transiten per la ciutat, de manera que puga ser utilitzat tant per grups escolars, com per col·lectius ciutadans o per grups d’amics. Un equipament, energèticament autosuficient, que busca la cohesió social, intercanviant coneixements i experiències, i fins i tot col·laborant en projectes col·lectius. S’emmarca en el context de la Smart City, analitzant les diferents àrees d’interés en el desenvolupament de productes i recollint les necessitats espacials que plantegen les noves metodologies educatives.Cotillo Contri, ED. (2019). Proyecto GINKGO: Isla de aprendizaje para el espacio público. Universitat Politècnica de València. http://hdl.handle.net/10251/127251TFG

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] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). 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 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). 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

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

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] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). 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 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). 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

Revisión de los criterios de exclusión en un ensayo clínico sobre funcionalidad de catéteres arteriales

Regarding a clinical trial designed to compare the functionality of arterial catheters kept with heparin vs saline solution, a slow rate of case recruiting was detected. In order to improve this rate an analysis of the reasons for non-inclusion was set up. According to the results, amendments to the protocol had to be proposed to improve case inclusion without reducing the quality of the study. Methodology: All not included catheter insertions were registered and analysed regarding the reason of non-inclusion. Results: The more frequent reasons for non including a case in the study were the insertion of the catheter in other ward or department, the issues related with the informed consent (IC) and the need of more than 5 attempts to insert the catheter. The remaining reasons were related to hematological issues as well as competition with other trials. Conclusions: The main reasons for not including cases in the trial were subject to be changed by including amendments to the protocol, without affecting neither the trial quality nor the proposed goals. So, four amendments were proposed to the local ethical commission, two of which were accepted and subsequently notified to the Spanish Drug Agency. The phase of cases inclusion is now ending with less delay had the amendments not been presented.En el contexto de un ensayo clínico que se diseñó para comparar la funcionalidad de los catéteres arteriales mantenidos con suero heparinizado vs salino se detectó una tasa de reclutamiento de casos muy lenta. En un intento de buscar posibles soluciones para mejorar la tasa de inclusión de sujetos en el estudio se planteó analizar las posibles causas relacionadas. En función de los resultados obtenidos, se debían plantear enmiendas al protocolo que permitieran facilitar una más rápida selección de casos sin mermar la calidad del estudio. Metodología: De cada catéter insertado no incluido en el ensayo se recogía, de manera prospectiva, el motivo de no inclusión para su posterior análisis. Resultados: Los motivos más frecuentes para no incluir un caso en el estudio fueron la inserción del catéter arterial fuera de la UCI, incidencias relacionadas con el consentimiento informado (CI) y más de 5 intentos para canalizar la arteria. El resto se relacionaba con causas hematológicas o competición con otros ensayos. Conclusiones: Las causas de no inclusión de pacientes más importantes fueron susceptibles de corregirse mediante la presentación de enmiendas al protocolo sin que éste se resintiese en su calidad o en la consecución de sus objetivos. Así, se presentaron cuatro enmiendas al Comité Ético de Investigación Clínica (CEIC) del centro, dos de las cuales fueron aceptadas y posteriormente comunicadas a la Agencia Española del Medicamento. Actualmente se está acabando la fase de inclusión de casos con menor retraso que si no se hubieran presentado las enmiendas