Mudança climática e estratégia curricular para o desenvolvimento de competências de gestão ambiental em universidades peruanas

Objective: This paper aims at describing a curricular strategy of environmental management that, based on the gaps identified in the perception and knowledge about climate change, contributes to the education of Huaraz students’ environmental management competency.Methods: The documentary review, observation and a surveys were applied to explore Huaraz university students’ perceptions about climate change. Modeling was used to devise a curricular strategy for environmental management education.Results: The main findings were the identification Huaraz university students’ perceptions about climate change and a curricular strategy for the development of environmental management competence.Conclusions. It was determined that for university students in Huaraz climate change is a topic of interest, females have sounder knowledge than males, however both are insufficiently prepared to face climate change professionally. The curricular strategy of environmental management has a transdisciplinary character and its application should support the development of environmental management competencies in the universities of Huaraz.Objetivo: Este artículo describe una estrategia curricular de gestión medioambiental que, partiendo de las brechas identificadas en la percepción y conocimiento sobre el cambio climático favorece la formación de la competencia gestión medio ambiental en los estudiantes universitarios de Huaraz.Métodos: Se desarrolló una investigación aplicada ya que estuvo orientada a visualizar las percepciones que tienen los estudiantes universitarios sobre el cambio climático, posibilitando intervenir con una estrategia de desarrollo de competencias vinculadas a la gestión del medioambiente. Se aplicó la revisión documental, la observación y una encuesta a una muestra seleccionada del universo de estudiantes universitarios de la ciudad de Huaraz. Resultado: El empleo de la revisión documental, la observación y la aplicación de encuestas estuvo dirigido a la identificación de la percepción y conocimiento de los estudiantes universitarios de Huaraz en torno al cambio climático. A través de la modelación se diseñó una estrategia curricular para el desarrollo de la competencia gestión medioambiental.Conclusiones. Se determinó que para los estudiantes universitarios de Huaraz el cambio climático es una temática de interés, que las hembras tienen mayores conocimientos que los varones, pero en términos generales, no están preparados desde sus carreras para influir en este. La estrategia curricular de gestión ambiental posee un carácter transdisciplinar y su aplicación debe compulsar el desarrollo de las competencias gestión ambiental en las universidades de Huaraz.Objetivo: Este artigo tem como objetivo descrever uma estratégia curricular de gestão ambiental que, a partir das lacunas identificadas na percepção e conhecimento sobre a mudança climática, contribua para a formação de competências de gestão ambiental dos alunos de Huaraz.Métodos: A revisão documental, a observação e uma pesquisa foram aplicadas para explorar as percepções dos estudantes universitários de Huaraz sobre a mudança climática. A modelagem foi usada para elaborar uma estratégia curricular para a educação em gestão ambiental.Resultados: Os principais achados foram a identificação das percepções dos estudantes universitários de Huaraz sobre a mudança climática e uma estratégia curricular para o desenvolvimento de competências de gestão ambiental.conclusões. Determinou-se que para os universitários de Huaraz a mudança climática é um tema de interesse, as mulheres têm um conhecimento mais sólido que os homens, porém ambos estão insuficientemente preparados para enfrentar profissionalmente a mudança climática. A estratégia curricular de gestão ambiental tem caráter transdisciplinar e sua aplicação deve apoiar o desenvolvimento de competências de gestão ambiental nas universidades de Huaraz

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes