156 research outputs found
Quality of life of survivors from severe sepsis and septic shock may be similar to that of others who survive critical illness
INTRODUCTION: The objective of the present study was to compare the health-related quality of life (HR-QoL) of survivors from severe sepsis and septic shock with HR-QoL in others who survived critical illness not involving sepsis. METHODS: From March 1997 to March 2001, adult patients in an eight-bed medical/surgical intensive care unit (ICU) of a tertiary care hospital admitted with severe sepsis or septic shock (sepsis group; n = 305) were enrolled and compared with patients admitted without sepsis (control group; n = 392). Patients younger than 18 years (n = 48) and those whose ICU stay was 1 day or less (n = 453) were excluded. In addition, patients exhibiting nonsevere sepsis on admission were excluded (n = 87). Finally, patients who developed nonsevere sepsis or severe sepsis/septic shock after admission were also excluded (n = 88). RESULTS: In-hospital mortality rates were 34% in the sepsis group and 26% in the control group. There were no differences in sex, age, main activity (work status), and previous health state between groups. Survivors in the sepsis group had a significantly higher Acute Physiology and Chronic Health Evaluation II score on admission (17 versus 12) and stayed significantly longer in the ICU. A follow-up appointment was held 6 months after ICU discharge, and an EQ-5D (EuroQol five-dimension) questionnaire was administered. A total of 104 sepsis survivors and 133 survivors in the control group answered the EQ-5D questionnaire. Sepsis survivors reported significantly fewer problems only in the anxiety/depression dimension. Although there were no significant differences in the other dimensions of the EQ-5D, there was a trend towards fewer problems being reported by sepsis survivors. CONCLUSION: Evaluation using the EQ-5D at 6 months after ICU discharge indicated that survivors from severe sepsis and septic shock have a similar HR-QoL to that of survivors from critical illness admitted without sepsis
An analysis of the dynamics of two high-value export chains: smallholder participation, standards and trust
Neurological outcome after cardiac arrest: cold and dark issues
Prognostication after cardiac arrest is important for patients, families
and health providers. It also has ethical and social implications. With the
introduction of therapeutic hypothermia after recovery from cardiac arrest in
comatose patients,(1,2) prognostication has become more complex and concerns
have been raised, particularly about the amount of time and the number of
tools required for this treatment.info:eu-repo/semantics/publishedVersio
Resposta para: Desfecho neurologico apos parada cardiaca: problemas frios e sombrios [editorial].
We are thankful for the interest in our editorial.(1) We agree that the study population in Kim et al.(2) is different from that of Leão et al.(3), insofar as the first consisted of patients who had pre-hospital cardiorespiratory arrest, and the second consisted of patients with out-of-hospital and in-hospital cardiorespiratory arrest. However, neither study showed benefits to achieving the target hypothermia more quickly. In addition, the study by Leão et al. suggested a worse prognosis in patients who reached hypothermia more quickly.(3) As mentioned in the editorial, although the study had several limitations, there is a pathophysiological rationale for this finding.(4,5
Elaboración de sidra carbonatada de manzana ana y estudio de factibilidad para la instalación de una planta procesadora en la ciudad de quito
Cider is a naturally fermented wine made from apple. For its unique characteristics, this beverage has remained in the european culture for centuries. Trying to maintain the tradition, we offer “ASTURIAL”. This product combines all the history, representing finesse and apple freshness.
This Thesis involves the necessary stages for the production of “Asturial”, a carbonated apple cider, as well as the viability of constructing a cider factory in Quito. This project began with a market study, which led to determining the demand in order to develop the product and its technological production.
The marketing study determined the niche of apparent market for the cider consumption. Because of the innovating characteristics of the product, a 10% of the demand was taken into account.
The product was evaluated by the niche in terms of sensory tests and consumer testing.
The process and suitable machinery for obtaining “Asturial”, was designed attending the final recipe and established demand. A HACCP study was created in order to maintain the product’s quality.
Also an economic study was created attending to the product’s demand and production. This study concluded that producing by rent is the best option in order to produce “Asturial”, and it shows the next financial indicators: NPV (255,943.44) TIR (78%) ROI (2.92) y PRI (1.47)
Improved Survival with Therapeutic Hypothermia after Cardiac Arrest with Cold Saline and Surfacing Cooling: Keep It Simple
Aim. To evaluate whether the introduction of a therapeutic hypothermia (TH) protocol consisting of cold saline infusion and surface cooling would be effective in targeting mild therapeutic hypothermia (32–34°C). Additionally, to evaluate if TH would improve survival after cardiac arrest.
Design. Before-after design.
Setting. General Intensive Care Unit (ICU) at an urban general hospital with 470 beds.
Patients and Methods. Patients admitted in the ICU after cardiac arrest between 2004 and 2009 were included. Effectiveness of the TH protocol to achieve the targeted temperature was evaluated. Hospital mortality was compared before (October 2004–March 2006) and after (April 2006–September 2009) the protocol implementation.
Results. Hundred and thirty patients were included, 75 patients were not submitted to TH (before TH group), and 55 were submitted to TH (TH group). There were no significant differences concerning baseline, ICU, and cardiac arrest characteristics between both groups. There was a significant reduction in hospital mortality from 61% (n = 46) in the before TH group to 40% (n = 22) in the TH group.
Conclusion. Our protocol consisting of cold saline infusion and surface cooling might be effective in inducing and maintaining mild therapeutic hypothermia. TH achieved with this protocol was associated with a significant reduction in hospital mortality
Responsabilidad social empresarial en el Ecuador enfocado en la erradicación del trabajo infantil, ejecutado por la Empresa Multinacional Telefónica
La inclusión de la Responsabilidad Social Empresarial dentro de las empresas es cada vez más importante, no solo como apoyo al crecimiento social sino también ayuda a mejorar la imagen de la marca de la sociedad, lo que representa una ventaja frente a la competencia. El objetivo principal de la RSE es llegar a una gestión sustentable en los aspectos sociales y ambientales. Hoy en día se busca cambiar la imagen que se tiene de la empresa privada, como una institución que se preocupa tan solo por el objetivo económico y la generación de utilidades. El trabajo infantil es un problema de preocupación mundial, que afecta especialmente a los países de la región de América del Sur. Organizaciones tanto nacionales como internacionales han propuesto medidas para su erradicación. Telefónica es una empresa multinacional, quien dentro de sus iniciativas de RSE, ha implementado el programa PRONIÑO, el que se encarga de apoyar la erradicación del trabajo infantil y fomentar la escolarización en todos los países donde opera, por lo que Ecuador también ha sido beneficiario de esta iniciativa consiguiendo resultados positivos. Este trabajo se basa en la teoría del Socialismo del Siglo XXI, debido a que esta teoría busca el progreso social, su objetivo principal es obtener el mejor resultado para el mayor número de personas, al igual que la RSE, el socialismo del Siglo XXI, busca el crecimiento social evitando al máximo las consecuencias negativas para la sociedad y el entorno
Maltrato Psicológico
Child abuse has existed since time ago, when the parents considered that the children were their property and that any way punishment was accepted as normal in society. Over the years and after much research, researchers have determined that the types of punishment are framed within child abuse; one of the ways is psychological abuse, this one affects to children emotionally and cognitively. In Ecuador the statistics made by UNICEF indicate that children and adolescents have been subjected to violent treatment and the Ministerio de Inclusión Económica y Social in its study shows that only a quarter of people psychologically abused denounce the abuses, most of them due to lack of knowledge or fear, thus they decide to keep in silent and continue being psychologically abused with the risk of falling into another type of abuse that can be physical and sexual and finally trigger a social problem. This research study on the psychological abuse applied the methods and the research instruments that allowed to obtain information of the students and teachers of República de Colombia school....El maltrato a menores ha existido desde el inicio de los tiempos, cuando los padres consideraban que los hijos eran de su propiedad y que cualquier forma de castigo se aceptaba como normal en la sociedad. Con el transcurso de los años y luego de muchas investigaciones, los estudiosos en el tema determinaron que esos tipos de castigo se enmarcan dentro del maltrato infantil; una las formas de ese maltrato es el maltrato psicológico que está demostrado que afecta a la parte emocional y cognitiva del niño. En el Ecuador las estadísticas realizadas por UNICEF indican los niños, niñas y adolescentes han sido objeto de trato violento y el Ministerio de Inclusión Económica y Social en su estudio manifiesta que solo una cuarta parte de agredidos psicológicamente denuncian los abusos sufridos, la mayoría por desconocimiento o miedo decide callar y continuar siendo agredido psicológicamente con el riesgo de caer en otro tipo de abuso que puede ser físico o sexual y que al final desencadena un problema social. El presente estudio sobre el maltrato psicológico aplicó métodos técnicas e instrumentos de investigación que permitieron obtener información de los alumnos y docentes de la Escuela República de Colombia...
El pase del Niño “Rey de Reyes” de la ciudad de Riobamba: las prácticas sociales en la gestión del patrimonio y las disputas de poder
El pase del Niño “Rey de Reyes” de la ciudad de Riobamba genera una importante presencia cultural en el imaginario de los habitantes de este lugar, manifestación religiosa que enfatiza su pertenencia y permanencia a través de las prácticas sociales en la gestión del patrimonio. Los cambios suscitados desde hace algunos años se han analizado desde diferentes estratos sociales ya que han provocado varios conflictos y disputas de poder. A pesar de que el presente proyecto incluye reseñas históricas y descripciones de la travesía religiosa, no es exclusivamente sobre el ritual de devoción. Más bien, se enfoca en comprender la gestión cultural a través de las prácticas sociales que realizan tanto la Iglesia Católica, liderada por el Obispo, como la familia Mendoza; mediante un análisis interpretativo. Posteriormente, se analiza cómo el Pase del “Niño Rey de Reyes” se ha relacionado con la comunidad riobambeña, vinculándose a ella desde varios aspectos. Esta fiesta constituye una herramienta de movilización social, cultural y política, que ha causado una lucha permanente entre los actores involucrados. Por ello, ha sido necesario identificar las causas de la disputa por el poder, surgidas alrededor de la procesión, la posesión de la imagen y el reconocimiento social. Se estudió a la religión como una expresión cultural que determina el accionar social. El diálogo con los actores involucrados en cada una de las celebraciones es esencial para analizar las prácticas sociales que se llevan a cabo. Por un lado, convergen las prácticas sociales desde la gestión cultural: cómo se obtienen todos los recursos necesarios para la celebración de las fiestas y cómo se gestionan y establecen compromisos sociales en la ciudadanía. Por otra parte, se halla la articulación con la religión, las creencias, tradición y simbolismos, instaurados en la población, y la repercusión que las mencionadas tensiones han provocado en la misma. A partir de este enfoque, se sitúa a la gestión cultural desde una visión crítica y no instrumentalista, con la capacidad de constituir un método de dinamización cultural y patrimonial que permita la participación activa de la comunidad
Leveling Up Hydrogels:Hybrid Systems in Tissue Engineering
Hydrogels can mimic several features of the cell native microenvironment and have been widely used as synthetic extracellular matrices (ECMs) in tissue engineering and regenerative medicine (TERM). However, some applications have specifications that hydrogels cannot efficiently fulfill on their own. Incorporating reinforcing structures like fibrous scaffolds or particles into hydrogels, as hybrid systems, is a promising strategy to improve their functionality. We describe recent advances in the fabrication and application of these hybrid systems, where structural properties and stimuli responsiveness of hydrogels are enhanced while their ECM-like features are preserved. Furthermore, we discuss how these systems can contribute to the development of more complex tissue engineered structures in the rapidly evolving field of TERM
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