Time and space: the “Talapazo” site (Yocavil Valley, Tucuman province)

El objetivo de este trabajo es caracterizar la ubicación del sitio arqueológico Talapazo (valle de Yocavil) en su espacio geomorfológico y su cronología relativa y establecer comparaciones con otros sitios vecinos. Para ello se efectuó la fotointepretación morfogenética (escala 1:50000), se identificaron posibles sitios arqueológicos, se realizaron recolecciones de superficie y excavaciones y análisis macroscópico del material cerámico. Se concluye que las instalaciones formativas (500 AC-1000 DC) están dispersas en la ladera, valle fluvial secundario, abanico fluvio-aluvial y terrazas del valle fluvial del río Santa María, mientras que las del periodo de Desarrollos Regionales (1000-1480 DC) e Inca (1480-1535 DC) están en el sector apical del abanico, superpuestas a las formativas. Sitios arqueológicos vecinos y del tercio central de la Sierra de Quilmes presentan distribución similar, lo que puede relacionarse con cambios en las condiciones de humedad durante los períodos aludidos.The objective of this paper is to characterize the localization of the archaeological site Talapazo (Yocavil Valley) on its geomorphological space and relative chronology, and to compare it with other close sites. We made the morphogenetic photointerpretation (scale 1:50.000), identifying possible archaeological sites, superficial potsherds were recollected together with archaeological digs and macroscopic ceramic analysis. It was possible to conclude that Formative settlements (500 BC-1000 AC) were dispersed on slopes, secondary fluvial valleys, fluvio-alluvial fans and terraces of Santa María River, while Regional Developments (1000-1500 AC) and Inca settlements are disposed on the apical area of fluvio-alluvial fans, overlying formative structures. Neighbor archaeological sites, and from the central third of the Sierra de Quilmes, present similar distribution. This could be related with changes on humidity conditions during those archaeological periods.Facultad de Ciencias Naturales y Muse

O Que Jobs Diz? A Construção do Herói por Meio do Discurso / What Does Jobs Say? Hero's Construction by Speech

A estética da criação verbal, obra desenvolvida por Mikhail Bakhtin, aborda a forma espacial do herói, o qual contém o excedente da visão estética, que se torna uma importante ferramenta para se analisar o discurso. O objetivo principal a ser alcançado com este trabalho é identificar como o eu­-para-mim, o eu-para-outro e o outro-para-mim se constituem entre Steve Jobs e os formandos de 2005, da Universidade de Stanford nos Estados Unidos, de modo a analisar as representações contidas em seu discurso, bem como realçar as intenções de construção de imagens que estão presentes em sua fala. Para tanto, serão analisadas as três histórias que são narradas por Steve Jobs, sendo: sobre conectar os pontos, amor e perda, e morte. A análise do discurso destas três histórias traz a relação da construção do herói, observando o excedente da visão estética. Considera-se que tal discurso proferido em Stanford estreitou a relação que os formandos tinham com o seu herói, possibilitando maior compreensão de alguns dos momentos vivenciados por Steve Jobs. Palavras-chave: Steve Jobs. Forma Espacial do Herói. Excedente da Visão Estética. ABSTRACT The aesthetics of verbal creation, a work developed by Mikhail Bakhtin, addresses the spatial form of the hero, which contains the surplus of aesthetic vision, which becomes an important tool for analyzing discourse. The main goal to be achieved with this work is to identify how the self-for-self, the self-for-self and the other-for-me constitute between Steve Jobs and the 2005 graduates of Stanford University in United States, in order to analyze the representations contained in his speech, as well as to highlight the intentions of constructing images that are present in his speech. To do so, we will analyze the three stories that are narrated by Steve Jobs, being: about connecting points, love and loss, and about death. The analysis of the discourse of these three stories brings the relation of the construction of the hero observing the surplus of the aesthetic vision. It is considered that such a speech at Stanford narrowed the relationship that the trainees had with their hero, allowing a greater understanding of some of the moments experienced by Steve Jobs. Keywords: Steve Jobs. Spatial Form of the Hero. Surplus of Aesthetic Vision

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine