Revisiting individualization: The transitions to marriage and motherhood in Chile

The life course of Chilean women has experienced profound transformations in the past decades. It has been argued that transitions to marriage and motherhood are being postponed as they are experienced by women at an older age and are becoming events that characterize an increasingly smaller part of the female population. These changes have been often interpreted as part of a process of individualization that would have had reconfigured the cultural norms and social practices regarding gender roles and family formation in Chilean society. Nevertheless, the prevalence and diversification of the practices and norms that shape the transitions to marriage and motherhood at an empirical level remain unexplored. This paper aims to assess the individualization of the life course of women in Chile by empirically analyzing the destandardization of the practices and norms that shape the transitions to marriage and motherhood. By analyzing data from Encuesta Nacional Bicentenario Universidad Católica – Adimark (2009), it demonstrates that changes in the prevalence of the transitions to marriage and motherhood and the diversification of the practices and norms that shape their timing are ambivalent regarding destandardization. These results suggest that the life course of women in Chile is becoming individualized to some extent, but that this trend of cultural and social change is not consistent and uniform, but rather partial and fragmented, nonlinear, and significantly conditioned by the social structure

Fluid challenges in intensive care: the FENICE study A global inception cohort study

Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC.This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC.2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500-1000). The median time was 24 min (40-60 min), and the median rate of FC was 1000 [500-1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57-61 %). In 43 % (CI 41-45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34-37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20-24 %). No safety variable for the FC was used in 72 % (CI 70-74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response.The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Los productores experimentadores aportan su granito de arena al desarrollo tecnológico de Pantasma, Matagalpa, Nicaragua

20 páginas pdf.Este documento posee información sobre las experiencias de los agricultores de Pantasma, donde se pretende introducir una estrategia de trabajo en la zona para la implementación de procesos locales de generación y transferencia de tecnología

Expansión de la educación superior y sus efectos en matriculación y migración: evidencia de Colombia

La dinámica económica y social de las principales ciudades ha resultado en un crecimiento heterogéneo de la cobertura educativa del país. Así, la oferta de educación superior se ha concentrado históricamente en las ciudades de Bogotá, Medellín, Cali y Barranquilla, lo que las ha convertido en polos de atracción de estudiantes, que se han visto forzados a migrar asumiendo los costos económicos de esta decisión y creando asignaciones ineficientes en el acceso a la educación superior. Este artículo examina el efecto exógeno del incremento de la oferta en educación superior sobre la probabilidad de matricularse y migrar, al controlar por habilidades como el desempeño académico, características socioeconómicas y la cercanía a la oferta educativa. Los resultados muestran un efecto significativo del incremento en la oferta sobre la probabilidad de matricularse y un efecto no significativo sobre la migración. En este sentido, las políticas de regionalización y expansión de la educación superior en Colombia no tienen un efecto claramente identificable en la permanencia de los estudiantes en sus lugares de origen, aun cuando esto pueda ser deseable por parte de la política educativa del país

Socio-Environmental Regimes in Natural Protected Areas: A Case Study in La Sepultura Biosphere Reserve

In this chapter, we analyze the reasons why local socio-environmental systems have met in a limited way the purpose of balancing conservation with development in the Upper Basin of the Tablón River (UBTR), located in La Sepultura Biosphere Reserve (SEBIRE). The study used a transdisciplinary exercise which conceives the Local Socio-Environmental Systems (LSES) as complex and adaptive systems, in which four subsystems interact: (i) the local regime, (ii) the landscape, (iii) the agrarian system, and (iv) the territorial action group. Two common property holdings (“ejidos”) were studied with the case study method. The four subsystems were analyzed through participatory and qualitative research. The results indicated: (a) the local regime imposes norms that limit the decision-making capacity of local actors and its compensatory payments generate dependency and a reactive attitude; (b) the setback of forest frontiers has remained relatively stable due to SEBIRE environmental standards, but natural capital is increasingly vulnerable to socio-environmental disturbances; (c) domestic units (DUs) have little capacity to respond to environmental and market changes; their development is restricted by the geographical, social, and economic conditions of the basin; some producers are unable to cover their production costs and their limited resources barely reach the minimum welfare line; and (d) in the UBTR there are important socio-environmental innovation processes that have generated adaptive management alternatives, but these still face significant challenges at the basin level. In conclusion, the LSES of the UBTR has restrictions on its four components and has not reached the capacity to be socially reproduced. In these LSES, the local regime has promoted an economic model and territorial management mechanisms that have made it environmentally and economically vulnerable