Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Flame-Retardant Performance Evaluation of Functional Coatings Filled with Mg(OH)2 and Al(OH)3

In the shipbuilding sector (cruises, ferries, etc.), the design and control constraints applied to improve the fire safety conditions of naval vessels are acquiring important relevance. Research activities have aimed at enhancing the fire resistance of structures and surface coatings to make ships’ working environments safer, trying to combine performance, durability and low costs. In this context, the aim of this paper is to develop and optimize flame-retardant coatings for naval applications. In particular, in an acrylic carrier, Mg(OH)2 and Al(OH)3 fillers were added to exalt the fire resistance capabilities of the coatings. Furthermore, the effect of the particle size of the hydroxides on the coatings’ fire resistance was investigated. The coatings were studied by structural (XRD), thermo-physical (TG) and morphological (SEM) characterization to evaluate their thermal stability and the damage level due to fire exposition. Specifically, fire reaction tests were applied at different fire exposure times (15 s, 30 s) to estimate the fire resistance of the proposed coatings compared to the commercial reference. The results show that the coatings based on aluminum and magnesium hydroxides exhibit favorable fire resistance. Particularly, effective performances were observed for short times of exposure to direct flames. Furthermore, the temperature monitoring of the steel alloy support during the test allowed us to evaluate the degree of insulation of the coating, highlighting a better result for the specimen filled with Mg(OH)2, making this product promising for its optimization in this context

Study of Intumescent Coatings Growth for Fire Retardant Systems in Naval Applications: Experimental Test and Mathematical Model

Onboard ships, fire is one of the most dangerous events that can occur. For both military and commercial ships, fire risks are the most worrying; for this reason they have an important impact on the design of the vessel. The intumescent coatings react when heated or in contact with a living flame, and a multi-layered insulating structure grows up, protecting the underlying structure. In this concern, the aim of the paper is to evaluate the intumescent capacity of different composite coatings coupling synergistically modeling and experimental tests. In particular, the experiments have been carried out on a new paint formulation, developed by Colorificio Atria S.r.l., in which the active components are ammonium polyphosphate or pentaerythritol. The specimens were exposed to a gas-torch flame for about 70 s. The degree of thermal insulation of the coating was monitored by means of a thermocouple placed on the back of the sample. In order to get insights into the intumescent mechanism, experimental data was compared with the results of a mathematical model and a good agreement is detected. Furthermore, a predictive model on the swelling rate is addressed. The results highlight that all coatings exhibit a clear intumescent and barrier capacity. The best results were observed for coating enhanced with NH4PO3 where a regular and thick, porous char was formed during exposure to direct flame

El devenir de la utopía economicista en el sistema escolar chileno

Asumiendo que las transformaciones radicales introducidas a partir de la década de los 80, por la dictadura cívico-militar en el sistema educativo chileno, constituyen lo que se designa como utopía economicista, que estipuló el paso de un sistema eminentemente público y centralizado a uno gobernado por las reglas del mercado, se examinan los defectos que el esquema mostró en su desarrollo, defraudando a poco andar las promesas de eficiencia y calidad que eran los objetivos perseguidos y que motivaron dichas transformaciones. Con este objetivo, el trabajo muestra la devaluación de dicha utopía y cómo la analogía del mercado se revela errónea. Para ello se caracteriza críticamente el rol del Estado, en su calidad de proveedor, regulador y garante en el sistema escolar, la utilización de la información de resultados del sistema educativo, con sus usos dispares y en ocasiones contradictorios y, por último, la participación de los padres, de acuerdo al rol que les fue asignado por las reformas y el que efectivamente presentan en la actualidad. Se concluye señalando que para superar la situación es necesaria una racionalidad ampliada que sustituya aquella que orientó las políticas introducidas hace tres décadas y que ofrezca una respuesta a los problemas del sistema escolar chileno en su calidad y equidad