Evaluation of psychomotor skills acquired for surgery by veterinary students using biological simulators

This study aimed to evaluate the acquisition of psychomotor skills using biological simulators in surgical practices by thirdyear students of Veterinary Medicine at the Autonomous Metropolitan University, Mexico City. The Gibson Spiral Test was applied pre- and post-practice to 171 students (92 women, 79 men) between 18 and 38 years old. The techniques practiced were: ligature, synthetic skin, enterotomy, enterectomy, gastrostomy, cystotomy, endotracheal tube placement, permanent intravenous catheter. Students were classified as fast-accurate (FA), fast- inaccurate (FI), slow-accurate (SA), and slow-inaccurate (SI). The test duration decreased by 7.91s (P0.10). There were differences among the fast (F) and slow (S) students pre-practice (P0.10). Comparing practice time difference (P=0.007) between slow and fast in the pre-practice, men performed more quickly in pre-practice and after practice (P<0.0001), with no differences in mean number of errors pre- (P=0.662) and post-practice (P=0.962). We conclude that students showed progress in acquiring motor skills, by increasing their speed and reducing errors, thus increasing the number of fast and accurate students. Men outperformed women

INVESTIGACIÓN EN QUÍMICA, BIOLOGÍA Y AGRONOMÍA

Este libro es el segundo de una serie de dos dedicado a los avances lo relativo a las mezclas de diesel y biodiesel obtenido a partir del aceite de semillas de jatropha curcas, entre otros temas de ese ombustible verde; es decir algo que está al día en cuanto a las búsqueda de fuentes de energía limpias; otro tema ampliamente tratado es el del nitrógeno como elemento de fertilización -que junto con la densidad poblacional de las plantas- buscan prácticas agronómicas para obtener mayores rendimientos. El objetivo final de este libro es el mismo: incorporar cada vez más bibliografía que enriquezca las opciones de consulta por parte de interesados en aspectos particulares y, desde luego, divulgar nuevos conocimentos y ofrecer los resultados del quehacer universitario

Implementation of a multiprofessional, multicomponent delirium management guideline in two intensive care units, and its effect on patient outcomes and nurse workload: a pre-post design retrospective cohort study.

AIM OF THE STUDY Delirium is a frequent intensive care unit (ICU) complication, affecting 26% to 80% of ICU patients, often with serious consequences. This study aimed to evaluate the effectiveness, costs and benefits of following a standardised multiprofessional, multicomponent delirium guideline on eight outcomes: delirium prevalence and duration, lengths of stay in ICU and hospital, in-hospital mortality, duration of mechanical ventilation, and cost and nursing hours per case. It also aimed to explore the associations of delirium with length of ICU stay, length of hospital stay and duration of mechanical ventilation. METHODS This retrospective cohort study used a pre-post design. ICU patients in an historical control group (n = 1608) who received standard ICU care were compared with a postintervention group (n = 1684) who received standardised delirium management &ndash; delirium risk identification, preventive measures, screening and treatment &ndash; with regard to eight outcomes. The delirium management guideline was developed and implemented in 2012 by a group of experts from the study hospital. As appropriate, descriptive statistics and multivariate, multilevel models were used to compare the two groups and to explore the association between delirium occurrence and the selected outcomes. RESULTS Twelve percent of the 1608 historical controls and 20% of the 1684 postintervention patients were diagnosed with delirium according to the ICD-10 delirium diagnosis codes. Patients being treated for heart disease, and those with septic shock, ARDS, renal insufficiency (acute or chronic), older age and higher numbers of comorbidities were significantly more likely to develop delirium during their stay. Multivariate models comparing the historical controls with the post intervention group indicated significant differences in delirium period prevalence (odds ratio 1.68, 95% confidence interval [CI] 1.38&ndash;2.06; p &lt;0.001), length of stay in the ICU (time ratio [TR] 0.94, CI 0.89&ndash;1.00; p = 0.048), cost per case (median difference 3.83, CI 0.54&ndash;7.11; p = 0.023) and duration of mechanical ventilation (TR 0.84, CI 0.77&ndash;0.92; p &lt;0.001). The observed differences in the other four outcomes &ndash; in-hospital mortality, delirium duration, length of stay in the hospital, and nursing hours per case &ndash; were not significant. Delirium was a significant predictor for prolonged duration of mechanical ventilation and for both ICU and hospital stay. CONCLUSION Standardised delirium management, specifically delirium screening, supports timely detection of delirium in ICU patients. Increased awareness of delirium after the implementation of standardised multiprofessional, multicomponent management leads to increased therapeutic attention, a prolongation of ICU stay and increased costs, but with no influence on mortality

Suicidal ideation and self-injury in LGB youth: a longitudinal study from urban Switzerland

Background: Adolescent suicidality, suicidal ideation (SUI) and self-harming behaviour (SI) are major public health issues. One group of adolescents known to be particularly prone to suicidality and mental health problems is lesbian, gay and bisexual (LGB) youth. Although the social acceptance of the LGB community has increased in recent years, LGB individuals are still at risk of mental health issues and suicidal behaviour. More longitudinal research looking into the associations between sexual orientation (SO) and facets of mental health across adolescence is warranted. Methods: This research examined associations between sexual orientation, suicidal ideation and self-injury at 15, 17 and 20 years of age in a community-based sample of 1108 Swiss adolescents (51.1% females/48.9% males). At the age of 15 years, participants provided information regarding their SUI and SI. At 17 and 20 years of age, participants also reported their SO. Results: Twelve percent of the female participants and 4.4% of the male participants reported identifying as LGB at 17 and 20 years of age. Self-reports of bi- or same-sex attraction increased over time in both genders, with the increase being more pronounced in females. LGB adolescents of both genders showed significantly higher percentages of SUI and SI at the ages of 17 and 20 years than their heterosexual peers. Conclusions: The findings confirm a higher risk of SUI and SI in adolescents who identify as LGB. Future studies should develop interventions targeting mental health from early adolescence with the aim of reducing disparities related to SO. Keywords: Adolescence; Bisexuality; Homosexuality; Minority stress; Self-injury; Sexual orientation; Suicidal ideation

Band gap engineering of Pb1-xCdxSe thin films providing mid-IR photoluminescent based light emitting diodes for use in non-dispersive infrared gas sensors

This work describes band-gap engineering of PbCdSe thin films for their use as light emitters in methane gas sensors. Pb 0.9 Cd 0.1 Se thin films were synthesized by pulsed direct current (DC) magnetron sputtering. Optical characterisation of films demonstrated successful emission of light at 3.32 μm. Post-sensitization (PS) - in highly reactive oxygen and iodine environment - was also analysed. Design of Experiments (DoE) was used to optimize photoluminescence (PL) of PbCdSe films as a function of PS conditions. The studies demonstrated a high influence of PS temperature on PL properties. The thickness of the films was also demonstrated to have a significant effect on the enhancement of PL. The analysis of the morphology revealed that recrystallisation of the material was key for the emission of light, probing its applicability as mid-IR light source in non-dispersive IR gas sensors

A hospital-wide evaluation of delirium prevalence and outcomes in acute care patients : a cohort study

Background: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case. Methods: This cohort study was performed in a Swiss university hospital following implementation of a delirium management guideline. After excluding patients aged < 18 years or with a length of stay (LOS) < 1 day, 29′278 patients hospitalized in the study hospital in 2014 were included. Delirium period prevalence was calculated based on a Delirium Observation Scale (DOS) score ≥ 3 and / or Intensive Care Delirium Screening Checklist (ICDSC) scores ≥4. Results: Of 10′906 patients admitted, DOS / ICDSC scores indicated delirium in 28.4%. Delirium was most prevalent (36.2–40.5%) in cardiac surgery, neurosurgery, trauma, radiotherapy and neurology patients. It was also common in geriatrics, internal medicine, visceral surgery, reconstructive plastic surgery and cranio-maxillo-facial surgery patients (prevalence 21.6–28.6%). In the unadjusted and adjusted models, delirious patients had a significantly higher risk of inpatient mortality, stayed significantly longer in the ICU and hospital, needed significantly more nursing hours and generated significantly higher costs per case. For the seven most common ICD-10 diagnoses, each diagnostic group’s delirious patients had worse outcomes compared to those with no delirium. Conclusions: The results indicate a high number of patients at risk for delirium, with high delirium prevalence across all patient groups. Delirious patients showed significantly worse clinical outcomes and generated higher costs. Subgroup analyses highlighted striking variations in delirium period-prevalence across patient groups. Due to the high prevalence of delirium in patients treated in care centers for radiotherapy, visceral surgery, reconstructive plastic surgery, cranio-maxillofacial surgery and oral surgery, it is recommended to expand the current focus of delirium management to these patient groups

Case report: Alternative approach for management of refractory volume overload in heart failure: usefulness of venous leg compression

BackgroundManagement of patients with refractory congestion, is one of the most important challenges in the field of heart failure (HF). Diuretic therapy remains the most widely used therapy to achieve euvolemia. However, some patients experience fluid overload despite the use of high-dose diuretics and new strategies to overcome diuretic resistance are needed.Case SummaryWe report an 85 years-old male patient admitted for decompensated HF with persistent tissue fluid overload (peripheral edema) for more than two weeks despite high dose of intravenous furosemide with the combination of other diuretics. At this point, we performed leg venous compression using elastic bandages for three days. After 72 h, edema disappeared, and additional weight loss was achieved (1 kg/day). No side effects were observed and the patient was discharged home euvolemic.ConclusionVenous leg compression may be an alternative therapy in patients with persistent tissue fluid overload resistant to diuretics

Respuesta fisiológica y química de clones de Ulmus minor susceptibles y resistentes a la grafiosis tras la inoculación con Ophiostoma novo-ulmi

Los motivos por los que algunos genotipos de Ulmus minor Mill. resisten más que otros a la infección con el hongo patógeno Ophiostoma novo-ulmi son aun desconocida. Con el objetivo de evaluar si la resis- tencia a la enfermedad de la grafiosis está relacionada con la posesión de ciertos rasgos fisiológicos o quí- micos, se compararon clones de U. minor resistentes y susceptibles a la grafiosis, antes y después de la ino- culación con O. novo-ulmi . Se midieron el potencial hídrico, las tasas de respiración y fotosíntesis foliar, y la conductividad hidráulica de ramas terminales y su composición química mediante espectroscopía de infrarrojo (FT-IR). La inoculación con el hongo produjo un aumento en la proporción de vasos emboliza- dos, de modo que a los 21 días la conductividad hidráulica era solo un 20% de la conductividad máxima en los clones susceptibles. Como consecuencia, el potencial hídrico y la fotosíntesis disminuyeron entor- no a un 100-200% en relación a los controles en los clones susceptibles mientras que no hubo reducciones significativas en los resistentes. Además, los clones mostraron una composición química de sus ramas di- ferente. Por ejemplo, en los árboles inoculados con agua utilizados como control, el pico de absorción en la región del espectro infrarrojo relacionado con la suberina fue más alto en los clones resistentes que en los susceptibles.Estos resultados sugieren que el perfil químico más defensivo de los clones resistentes les permite mantener la funcionalidad fisiológica tras la inoculación con O. novo-ulmi prácticamente inalterada, en comparación con los clones más susceptibles

Restauración de las olmedas ibéricas (Ulmus minor y U. laevis) en zonas riparias de la Comunidad de Madrid

El proyecto LIFE+ “Olmos Vivos” (LIFE13 BIO/ES/000556) tiene como objetivo la restauración de unas formaciones vegetales, las olmedas, que por diversos motivos prácticamente han desaparecido del paisaje forestal español, a pesar de haber poseído un alto valor ecológico y cultural. La grafiosis ha constituido una de las enfermedades forestales más devastadoras, y supuso la práctica desaparición de las olmedas ibéricas de Ulmus minor . En el caso de Ulmus laevis , la alteración de su hábitat ligado a zonas temporalmente encharcadas y riberas ha provocado que las poblaciones españolas se encuentren en riesgo de desaparición. Gracias a la obtención de siete clones de U. minor resistentes a la grafiosis como fruto del Programa del Olmo (UPM-MAGRAMA), el presente proyecto permitirá reintroducir la especie en diversas localizaciones de ribera de los ríos Jarama y Tajo. Asimismo, se plantarán brinzales obtenidos de agrupaciones relícticas de U. laevis , con el fin de aumentar sus poblaciones y conservar sus recursos genéticos, en terrenos de naturaleza silícea de las riberas del río Jarama y Arroyo Viñuelas. El desarrollo del proyecto, de cinco años y tres meses de duración 2014-2019), prevé la plantación de unas 16 700 plantas. Al mismo tiempo se recuperará en nuestras ciudades y pueblos la presencia del olmo, mediante plantaciones con fines divulgativos en entornos urbanos y paseos históricos, para devolver así el protagonismo cultural a un árbol que siempre estuvo entre nosotros, presidiendo las reuniones en las plazas y acompañando con su sombra en muchos caminos de nuestra geografía

Proyecto de comida semipreparada foodie box

El presente trabajo de investigación engloba temas para el desarrollo e implementación de la marca, tiene como objetivo adquirir un rendimiento económico y sostenible en el tiempo. Foodie Box, es un proyecto de emprendimiento dedicado a ofrecer kits personalizados, incluyendo alimentos frescos y semi preparados con las cantidades adecuadas, acompañados de un recetario para mejorar la estadía y experiencia en la cocina, con el buen sabor de la comida casera. El estudio de investigación se basa en las entrevistas, ventas realizadas en la fase de experimentación, y las hipótesis planteadas para justificar la viabilidad del negocio. Por otra parte, se definió el tamaño del mercado, teniendo en cuenta el segmento y establecer las estrategias en función al producto. Las proyecciones de ventas fueron realizadas a partir del plan de Concierge, siendo el punto de partida, para una proyección a tres años. Asimismo, se presenta el plan estratégico, plan de recursos humanos, plan de responsabilidad social, plan de marketing y plan de operaciones, de forma detallada y posicionando las propuestas de valor en el mercado. Finalmente, se realizó el plan financiero para acreditar la viabilidad del proyecto, según las ventas mensuales proyectadas, los costos fijos y variables, gastos, y capital de trabajo, cabe resaltar, que los indicadores financieros fueron de ayuda para analizar la rentabilidad del emprendimiento, siendo un producto sostenible a lo largo de los años.This research encompasses issues for the development and implementation of the brand Foodie Box, its objective is to acquire an economic and sustainable performance over time. Foodie Box is an entrepreneurial project dedicated to offering personalized kits, including fresh and semi-prepared food with the right amounts, accompanied by a recipe book to improve the stay and experience in the kitchen, with the good taste of the product being homemade. The research study is based on the interviews, sales made in the experimentation phase, and the hypotheses raised to justify the viability of the business. On the other hand, the market size was defined, taking account of our segment and establishing strategies based on our product. The sales projections were made from the concierge plan, being the starting point for a three-year projection. Likewise, the strategic plan, human resources plan, social responsibility plan, marketing plan, and operations plan are presented in detail and positioning the value proposals in the market. Finally, the financial plan was carried out to prove the viability of our project, according to the projected monthly sales, fixed and variable costs, expenses, and working capital, it should be noted that the financial indicators were helpful to analyze the profitability of our entrepreneurship, I feel that this product should be sustainable over the years to come.Trabajo de investigació