Anteproyecto Arqutéctonico del hogar para el adulto mayor ubicado en el Km 29½ de la Carretera Vieja Panamericana Tramo San Roque Tipitapa, 2015-2017

En la década de los años 50, surge en los países desarrollados el interés social por la vejez, debido a diversos factores como la evolución demográfica y el aumento de la esperanza de vida, la jubilación obligatoria, el predominio de la familia y el impacto de la urbanización e industrialización; esta a su vez, perfila como objetivo social por determinación, planteando problemas, los cuales siguen vigentes hasta nuestros días, convirtiéndose en fenómeno social y problema social. En Nicaragua existen más de 430,000 adultos mayores, correspondientes al 7% de la población total, pero solo el 63,938 reciben pensiones de vejez según el Anuario Estadístico 2012 del INSS. 1 (Instituto Nicaragüense de Seguridad Social) En la actualidad el Municipio de Tipitapa cuenta únicamente con un alberge mixto, el cual no tiene un diseño apropiado que se adapte a las múltiples necesidades, es por ello la selección del mismo para la propuesta de un centro especializado en atención a las personas de la tercera edad, con capacidad para 150 usuarios como etapa inicial. Es una realidad: La sociedad se envejece. Es irreversible y uno de los principales problemas que deberán enfrentar, de aquí en adelante; es la gran masa de población adulto mayor a la que deben atender. Es una tendencia grave si no se plantean medidas a los municipios” 2 para el beneficio a todos los adultos mayores, tanto los que poseen los recursos económicos, como los que carecen de ellos, recibiendo todas las atenciones necesarias como cuidados fijos, atención médica y temporales según el individuo, pero principalmente la comprensión y apoyo que ellos requieren

Exploration of implementation variables impacting trauma informed practices in schools: A narrative review

Current literature suggests that by using trauma- informed practices (TIP) in our schools and classrooms, positive short and long-term outcomes can be achieved for both children and their communities. However, there is little research identifying what helps or hinders the implementation of trauma-informed practice in schools or the development of a practitioner’s trauma-informed pedagogy. As part of this narrative review, 25 trauma- informed practice implementation variables were identified from 34 peer-reviewed works of current (2015-2020) literature using a process of thematic analysis. This review utilised an ecological model as an overlay to present these variables in a useable format. The results of this research may be utilised to identify unaddressed implementation variables that support practice change and TIP in schools. The literature and this review support the idea that, if given the right input, conditions and setting events, an effective trauma-informed practice or pedagogy can be developed. Furthermore, by helping practitioners fill the gaps in their knowledge and assisting them to develop their trauma-informed pedagogy, they are able to create an environment where students who have experienced complex trauma may be healthy, safe, engaged, and supported

Exploration of implementation variables impacting trauma informed practices in schools: A narrative review

Current literature suggests that by using trauma- informed practices (TIP) in our schools and classrooms, positive short and long-term outcomes can be achieved for both children and their communities. However, there is little research identifying what helps or hinders the implementation of trauma-informed practice in schools or the development of a practitioner’s trauma-informed pedagogy. As part of this narrative review, 25 trauma- informed practice implementation variables were identified from 34 peer-reviewed works of current (2015-2020) literature using a process of thematic analysis. This review utilised an ecological model as an overlay to present these variables in a useable format. The results of this research may be utilised to identify unaddressed implementation variables that support practice change and TIP in schools. The literature and this review support the idea that, if given the right input, conditions and setting events, an effective trauma-informed practice or pedagogy can be developed. Furthermore, by helping practitioners fill the gaps in their knowledge and assisting them to develop their trauma-informed pedagogy, they are able to create an environment where students who have experienced complex trauma may be healthy, safe, engaged, and supported

Habitat and exposure modelling for ecological risk assessment: A

Contamination has a dramatic impact on the health of ecosystem and habitat suitability for the inhabited flora and fauna. The Environmental Protection Agency (EPA) mandates an ecological risk assessment (ERA) that evaluates the potential adverse impact of any anthropogenic activities on the ecosystem (US Environmental Protection Agency, 1997. Ecological Risk Assessment Guidance for Superfund: Process for Designing and Conducting Ecological Risk Assessment. EPA/630/R-021011, Washington, DC). This study provides a general framework and specific procedures to predict the contaminant exposure of midsized mammals using a geographical information system (GIS)-based Monte Carlo simulation model. The model was applied to the raccoons (Procyon lotor) on the Savannah River Site (SRS), a former nuclear production and current research facility. Habitat behavioral data of 13 radiocollared male raccoons were used to determine home range and core areas. Combined with other geographic data layers, such as distance to water, number of wetlands, and class landscape metrics, a logistic regression model was used to inductively derive the resource selection functions that define the occurrence of raccoon. The cross validation consistently revealed a high accuracy. A Monte Carlo simulation was then performed to estimate the likelihood of exposure and contaminant uptake of the species weighted by the resource selection probability. This model adopted conservative assumptions and spatial parameters. The proposed model served the purpose of assessing ecological risk and supporting decision-making. Implementation issues for a GIS-based ecological risk assessment model are discussed

Habitat and exposure modelling for ecological risk assessment: A

Contamination has a dramatic impact on the health of ecosystem and habitat suitability for the inhabited flora and fauna. The Environmental Protection Agency (EPA) mandates an ecological risk assessment (ERA) that evaluates the potential adverse impact of any anthropogenic activities on the ecosystem (US Environmental Protection Agency, 1997. Ecological Risk Assessment Guidance for Superfund: Process for Designing and Conducting Ecological Risk Assessment. EPA/630/R-021011, Washington, DC). This study provides a general framework and specific procedures to predict the contaminant exposure of midsized mammals using a geographical information system (GIS)-based Monte Carlo simulation model. The model was applied to the raccoons (Procyon lotor) on the Savannah River Site (SRS), a former nuclear production and current research facility. Habitat behavioral data of 13 radiocollared male raccoons were used to determine home range and core areas. Combined with other geographic data layers, such as distance to water, number of wetlands, and class landscape metrics, a logistic regression model was used to inductively derive the resource selection functions that define the occurrence of raccoon. The cross validation consistently revealed a high accuracy. A Monte Carlo simulation was then performed to estimate the likelihood of exposure and contaminant uptake of the species weighted by the resource selection probability. This model adopted conservative assumptions and spatial parameters. The proposed model served the purpose of assessing ecological risk and supporting decision-making. Implementation issues for a GIS-based ecological risk assessment model are discussed

Real world costs and cost-effectiveness of Rituximab for diffuse large B-cell lymphoma patients: a population-based analysis.

BackgroundCurrent treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative to CHOP alone as first-line treatment of DLBCL, but it remains unclear what its real-world costs and cost-effectiveness are in routine clinical practice.MethodsWe performed a population-based retrospective cohort study from 1997 to 2007, using linked administrative databases in Ontario, Canada, to evaluate the costs and cost-effectiveness of RCHOP compared to CHOP alone. A historical control cohort (n = 1,099) with DLBCL who received CHOP before rituximab approval was hard-matched on age and treatment intensity and then propensity-score matched on sex, comorbidity, and histology to 1,099 RCHOP patients. All costs and outcomes were adjusted for censoring using the inverse probability weighting method. The main outcome measure was incremental cost per life-year gained (LYG).ResultsRituximab was associated with a life expectancy increase of 3.2 months over 5 years at an additional cost of $16,298, corresponding to an incremental cost-effectiveness ratio of$61,984 (95% CI $34,087-$135,890) per LYG. The probability of being cost-effective was 90% if the willingness-to-pay threshold was $100,000/LYG. The cost-effectiveness ratio was most favourable for patients less than 60 years old ($31,800/LYG) but increased to $80,600/LYG for patients 60-79 years old and$110,100/LYG for patients ≥ 80 years old. We found that post-market survival benefits of rituximab are similar to or lower than those reported in clinical trials, while the costs, incremental costs and cost-effectiveness ratios are higher than in published economic models and differ by age.ConclusionsOur results showed that the addition of rituximab to standard CHOP chemotherapy was associated with improvement in survival but at a higher cost, and was potentially cost-effective by standard thresholds for patients <60 years old. However, cost-effectiveness decreased significantly with age, suggesting that rituximab may be not as economically attractive in the very elderly on average. This has important clinical implications regarding age-related use and funding decisions on this drug

Propuesta de rediseño del sistema de iluminación en edificio Marlon Zelaya del Recinto Universitario Pedro Arauz Palacios, implementando tecnología led

El presente trabajo es una Propuesta de rediseño del sistema de iluminación en edificio Marlon Zelaya del Recinto Universitario Pedro Arauz Palacios, implementando tecnología led, que comenzará comprobando el nivel de iluminación existente, seguido de un método de cálculo de iluminación aplicable a interiores con la finalidad de asegurar una visión confortable, adecuada y segura, según las normas existentes

Including pork in the Mediterranean diet for an Australian population: Protocol for arandomised controlled trial assessing cardiovascular risk and cognitive function

Background. The Mediterranean diet is characterised by the high consumption of extra virgin olive oil, fruits, vegetables, grains, legumes and nuts; moderate consumption of fish, poultry, eggs and dairy; and low consumption of red meat and sweets. Cross sectional, longitudinal and intervention studies indicate that a Mediterranean diet may be effective for the prevention of cardiovascular disease and dementia. However, previous research suggests that an Australian population may find red meat restrictions difficult, which could affect long term sustainability of the diet. Methods. This paper outlines the protocol for a randomised controlled trial that will assess the cardiovascular and cognitive benefits of a Mediterranean diet modified to include 2-3 weekly serves of fresh, lean pork. A 24-week cross-over design trial will compare a modified Mediterranean diet with a low-fat control diet in at-risk men and women. Participants will follow each of the two diets for 8 weeks, with an 8-week washout period separating interventions. Home measured systolic blood pressure will be the primary outcome measure. Secondary outcomes will include body mass index, body composition, fasting blood lipids, C-reactive protein, fasting plasma glucose, fasting serum insulin, erythrocyte fatty acids, cognitive function, psychological health and well-being, and dementia risk. Discussion. To our knowledge this research is the first to investigate whether an alternate source of protein can be included in the Mediterranean diet to increase sustainability and feasibility for a non-Mediterranean population. Findings will be significant for the prevention of cardiovascular disease and age-related decline, and may inform individuals, clinicians and public health policy