Effects of clinical experience in the nursing student attitudes toward people with psychiatric disabilities

Indexación: Scopus; Scielo.En la formación del estudiante de pregrado de Enfermería se hace fundamental la elección de experiencias de aprendizaje significativas. Objetivo: Determinar el efecto de la experiencia clínica en servicios de psiquiatría, en las actitudes de estudiantes de Enfermería hacia las personas con discapacidad psiquiátrica. Material y método: Diseño cuasi experimental de pre y postest. La muestra incluyó un total de 84 estudiantes de Enfermería de tercer año de dos universidades de Santiago de Chile. El total de la muestra completó la "Escala de Actitudes hacia las Personas con Discapacidad" (EAPD) forma G. Se consideró como intervención las estrategias usadas en las asignaturas clínicas de enfermería psiquiátrica en ambas universidades. Se realizó prueba t de student para muestras relacionadas. Resultados: Se encontró diferencia estadísticamente significativa (p< 0,05) en el postest, lo que está relacionado con las experiencias de aprendizaje que consideran el contacto con personas con discapacidad psiquiátrica, en diferentes dispositivos de la red de psiquiatría y el acompañamiento docente directo. Conclusión: Estos hallazgos validan la importancia de la elección de experiencias clínicas, en los currículos de formación de Enfermería, como instancias que disminuyen las actitudes negativas como la estigmatización.The choice of meaningful learning experiences becomes essential in basic Nursing education programs. The purpose of this study is to determine the effect of clinical experience in psychiatric services in Nursing students' attitudes towards people with mental illnesses. A quasi-experimental design method of pre-test and post-test was used. The sample was made up of 84 third-year-nursing students from two universities in Santiago, Chile. All of the participants completed the Scale of Attitudes Toward Disabled Persons (SADP)-G. The strategies used in subjects of psychiatric nursing at both universities were regarded as intervention. Student t test for related samples was performed. Results: Respondents reported statistically significant difference (p <0.05) in the post test, which is associated with learning experiences that consider contact with people with mental illness in any of the different psychiatry network nodes and direct educational support. Conclusion: Validate the importance of including the clinical experience in the nursing training curriculum as a way of reducing negative attitudes of Nursing students, such as stigmatization, towards people with mental illnesses.https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-95532017000300125&lng=en&nrm=iso&tlng=e

Node-based uniform strain virtual elements for compressible and nearly incompressible plane elasticity

We propose a combined nodal integration and virtual element method for compressible and nearly incompressible plane elasticity, wherein the strain is averaged at the nodes from the strain of surrounding virtual elements. For the strain averaging procedure, a nodal averaging operator is constructed using a generalization to virtual elements of the node-based uniform strain approach for finite elements. We refer to these new elements as node-based uniform strain virtual elements (NVEM). No additional degrees of freedom are introduced in this approach, thus resulting in a displacement-based formulation. A salient feature of the NVEM is that the stresses and strains become nodal variables just like displacements, which can be exploited in nonlinear simulations. Through several benchmark problems in plane elasticity, we demonstrate that the NVEM is accurate and optimally convergent, and devoid of volumetric locking in the nearly incompressible limit

Seasonal benthic patterns in a glacial Patagonian fjord: the role of suspended sediment and terrestrial organic matter

Complex marine-terrestrial interactions characterize Chilean fjords, where benthic communities influence the distribution of organic matter (OM). We examined spatial and seasonal changes in the hydrography, sediment conditions and soft-bottom macrobenthic, meiobenthic, and total microbial biomass in a glacial Patagonian fjord (Martinez Channel, Chile). The transport of a high load of glacial mineral and particulate OM to the fjord in the austral summer coincided with low total live benthic biomass. Multivariate analysis evidenced temporal-related macrofaunal groups influenced by the different environments produced by the advection of sediment transport and terrestrial OM from the Baker River, Chile. The relationships between density/biomass and respiration versus body size varied considerably with distance from major riverine inputs, but the slopes of density size spectra and normalized biomass size spectra were less negative in summer than in winter. Occasional large-scale advective processes in the water column affected sediment conditions and removed surface macrofauna, influencing the slope and intercept of the regression models. In the outer fjord, lateral advection and subsequent sedimentation of terrestrial OM contributed a significant fraction to total OM sediments (<14.76%). Stable carbon isotopes measured in benthic organisms suggest that benthic communities in the inner fjord may assimilate a significant fraction of terrestrial OM via heterotrophic bacteria in contrast to the minor input of terrestrial OM in the outer fjord

Estimating wound age: looking into the future

A critical review is made of the studies on wound healing used for forensic purposes, focusing on the problem of which characteristics indicate that a parameter could be used as evidence in court. A panel analysing the more important information obtained by each marker is given, and a perspective of what might be expected from future research is discussed

Status and initial physics performance studies of the MPD experiment at NICA

The Nuclotron-based Ion Collider fAcility (NICA) is under construction at the Joint Institute for Nuclear Research (JINR), with commissioning of the facility expected in late 2022. The Multi-Purpose Detector (MPD) has been designed to operate at NICA and its components are currently in production. The detector is expected to be ready for data taking with the first beams from NICA. This document provides an overview of the landscape of the investigation of the QCD phase diagram in the region of maximum baryonic density, where NICA and MPD will be able to provide significant and unique input. It also provides a detailed description of the MPD set-up, including its various subsystems as well as its support and computing infrastructures. Selected performance studies for particular physics measurements at MPD are presented and discussed in the context of existing data and theoretical expectations

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use

Edoxaban versus warfarin in patients with atrial fibrillation

Contains fulltext : 125374.pdf (publisher's version ) (Open Access)BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two once-daily regimens of edoxaban with warfarin in 21,105 patients with moderate-to-high-risk atrial fibrillation (median follow-up, 2.8 years). The primary efficacy end point was stroke or systemic embolism. Each edoxaban regimen was tested for noninferiority to warfarin during the treatment period. The principal safety end point was major bleeding. RESULTS: The annualized rate of the primary end point during treatment was 1.50% with warfarin (median time in the therapeutic range, 68.4%), as compared with 1.18% with high-dose edoxaban (hazard ratio, 0.79; 97.5% confidence interval [CI], 0.63 to 0.99; P<0.001 for noninferiority) and 1.61% with low-dose edoxaban (hazard ratio, 1.07; 97.5% CI, 0.87 to 1.31; P=0.005 for noninferiority). In the intention-to-treat analysis, there was a trend favoring high-dose edoxaban versus warfarin (hazard ratio, 0.87; 97.5% CI, 0.73 to 1.04; P=0.08) and an unfavorable trend with low-dose edoxaban versus warfarin (hazard ratio, 1.13; 97.5% CI, 0.96 to 1.34; P=0.10). The annualized rate of major bleeding was 3.43% with warfarin versus 2.75% with high-dose edoxaban (hazard ratio, 0.80; 95% CI, 0.71 to 0.91; P<0.001) and 1.61% with low-dose edoxaban (hazard ratio, 0.47; 95% CI, 0.41 to 0.55; P<0.001). The corresponding annualized rates of death from cardiovascular causes were 3.17% versus 2.74% (hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), and 2.71% (hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.008), and the corresponding rates of the key secondary end point (a composite of stroke, systemic embolism, or death from cardiovascular causes) were 4.43% versus 3.85% (hazard ratio, 0.87; 95% CI, 0.78 to 0.96; P=0.005), and 4.23% (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.32). CONCLUSIONS: Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes. (Funded by Daiichi Sankyo Pharma Development; ENGAGE AF-TIMI 48 ClinicalTrials.gov number, NCT00781391.)

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

Item does not contain fulltextOBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

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