54 research outputs found

    New Media, Space and Marginality:Control and Regulation of Cybercafe Use in Small and Medium Cities in Asia

    Get PDF
    This paper is about how cybercafĂ©s in small and medium Asian towns highlight new aspects of modernity. Especially in the context of Asian modernity, the introduction of ICT-shaped social spaces in the form of cybercafĂ©s leads to multiple conflicting rhetoric of empowerment and progress on the one hand, and risk and moral degeneration on the other. Through an ethnographic study carried out in twelve small or medium towns in six Asian countries, the research explores how new media technologies influence the contexts of reimagining Asia’s encounter with modernity. The paper is based on a study drawing from secondary materials and primary information gathered through extensive field work in six developing countries in Asia: Thailand, Vietnam, Indonesia and the Philippines in South East Asia, and India and Bangladesh in South Asia. In this paper we set out to argue that the continuities, ruptures and innovations that constitute the Asian modernity, as well as their social impacts, are mirrored in the discourses surrounding the various technologies that embody this modernity, negotiating a new phase in its mediation and legitimization in Asia. In particular, new media technologies and social media are involved in multiple discourses of risk, opportunity and adaptation. In the case of the cybercafĂ©s in Asia, we argue that the situated nature of technological access gives rise to new dimensions of adaptation at individual and collective levels. Discourses emanating from representatives of civil society, State and various other stakeholders converge on cybercafĂ©s, and their attention on this particular space emerges as an indication of its complexity as a zone of mediated access to the worlds—both desired and undesired—that computers make possible. The complexity of defining an essential set of Asian values and a regionally unique trajectory of modernity notwithstanding

    The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation

    Get PDF
    The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≀(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08-0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients

    Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

    Get PDF
    Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 pĂĄgina

    Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

    Get PDF
    This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≄3 chronic diseases) and polypharmacy (≄5 drugs prescribed in ≄3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

    Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

    Get PDF
    Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

    IMPACTO DE VARIÁVEIS CONGNITIVAS E CONTEXTUAIS SOBRE O SUCESSO ACADÊMICO E O BEM ESTAR NA UNIVERSIDADE – QUE FAZER? QUE DEIXAR DE FAZER?

    Get PDF
    Este estudo parte de uma investigação longitudinal (2019-2022) mais ampla, vinculada ao Grupo Multidisciplinar de Pesquisa em Educação, Psicopedagogia e Psicologia Escolar, UFAM/CNPq, PROCAD/AMAZÔNIA-PPGEUFAM/UFPA/UFMT, Processo CAPES 8881.314288/2019-0, articula-se metodolĂłgica e teoricamente com interfaces entre a psicologia escolar, psicologia educacional, pedagogia do ensino superior e educação escolar. Atua no sentido de entender os efeitos de variĂĄveis cognitivas e contextuais sobre o sucesso acadĂȘmico e o bem estar na universidade. A metodologia para coleta de dados Ă© a aplicação de caderno de instrumentos prĂłprios com apoio do Googleodocs, a amostra atual Ă© de n=1112 estudantes de diferentes paĂ­ses (Brasil, MĂ©xico, RepĂșblica Dominicana, BolĂ­via, Moçambique, Angola, Venezuela, ColĂŽmbia, Espanha e Portugal), do sexo masculino e feminino, idade entre 18 e 54 anos e de 51 universidades pĂșblicas e privadas que colaboram com a iniciativa. Os dados sĂŁo analisados com auxĂ­lio do Excel e SPSS, de acordo com os interesses dos pesquisadores e objetivos da investigação. Os resultados atuais demonstram a importĂąncia da pesquisa sobre os temas abordados pela iniciativa considerando o impacto das variĂĄveis estudadas sobre o rendimento acadĂȘmico e bom estar tanto de estudantes como de docentes e tĂ©cnicos no ensino superior. Foram identificadas diferenças de paĂ­ses, renda, etnia, gĂȘnero e renda. No caso dos docentes e tĂ©cnicos verificamos evidĂȘncias da exaustĂŁo feminina. Os resultados podem apoiar a administração geral e coordenação educativa e psicopedagĂłgica universitĂĄria em sentido amplo, visando a melhoria dos indicadores de sucesso acadĂȘmico e bem estar, por meio da proposição de novas polĂ­ticas e gestĂŁo da educação superior. Palavras-chave: Pesquisa em educação, Ensino superior, Rendimento acadĂȘmico, Bem estar. PolĂ­ticas de gestĂŁo da educação superior. Educação comparada. &nbsp; IMPACT OF COGNITIVE AND CONTEXTUAL VARIABLES ABOUT ACADEMIC PERFORMANCE AND &nbsp;WELLBEING IN THE UNIVERSITY. Whato to do? Qhato not to do? &nbsp; Abstract: This study, part of a further longitudinal investigation (2019-2022), attached to a multidisciplinary group of Educational Research&nbsp; Scholar Psychotherapy and Psychology, UFAM/CNPq, PROCAD/AMAZONIA-PPGEUFAM/UFPA/UFMT, CAPES process 8881.314288/2019-0, it is articulated methodological and theoretically with interfaces between the scholar and educational psychology, upper and scholar education pedagogy. It acts in the direction of understanding 5he effects og cognitive and contextual variables about the academic achievement and wellness in the university. The methodology to data collection is the application of own instrument cards with the support of Googledocs, the actual sample is quantity of n=1112 students from 51 private and public universities of different countries (Brazil, Mexico, Dominican Republic, Bolivia, Mozambique, Angola, Venezuela, Colombia, Spain and Portugal), from both male and female genders, aging between 18 and 54 years-old. The data were analyzed with the support of software Excel and SPSS, according to the interests of researchers and investigation focus. The actual results show the importance of the research about the themes cited in the initiative considering the impacts of the studied variables over the academic performance and wellness of the students as the teachers and technicians from upper education. There were found differences between countries, income, ethnic and gender. In the cases of the teachers and technicians it was found evidences of female exhaustion. The results could support the general administration, educative and psychopedagogy coordination and in a wide range, looking forward the better successful academic indicators and wellness, through the proposition of new policies and management of upper education. Keywords: Educational Reserch, upper educatiĂłn, academic performance, wellness, upper educaciton mangement policies, compared education. &nbsp

    Métodos y técnicas de monitoreo y predicción temprana en los escenarios de riesgos socionaturales

    Get PDF
    Esta obra concentra los mĂ©todos y las tĂ©cnicas fundamentales para el seguimiento y monitoreo de las dinĂĄmicas de los escenarios de riesgos socionaturales (geolĂłgicos e hidrometeorolĂłgicos) y tiene como objetivo general orientar, apoyar y acompañar a los directivos y operativos de protecciĂłn civil en aterrizar las acciones y polĂ­ticas pĂșblicas enfocadas a la gestiĂłn del riesgo local de desastre

    Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

    Get PDF
    Peer reviewe
    • 

    corecore