Stop the Bleed and Seize Control: Educating Emergency Department Staff on Maternal Hypertension and Hemorrhage

Problem: A Not-for-Profit Hospital accredited by the Joint Commission was fined for not having a current policy or procedure set in place for the treatment of obstetric emergencies. This quality improvement project implemented a simulation and a training video to prepare Emergency Department (ED) nurses and clinical staff for the awareness of preeclampsia and postpartum hemorrhage (PPH). Context: This quality improvement project was implemented in two different Emergency Room locations for this Not-for-Profit Hospital. One of the campuses does not have a Labor and Delivery (L&D) unit while the other one does. The overarching goal is to increase awareness of obstetric emergencies on both campuses in addition to meeting the Joint Commission standards. Intervention: With very limited time CNL students within the quality improvement team had to create a fictitious simulation scenario and a training video to prepare the ED staff for managing and treating preeclampsia and PPH. Measures: The measures utilized for this quality improvement project were from the pre-and post-surveys that were completed by the ED staff that participated in the simulation. These surveys were used to assess the ED staff\u27s knowledge and self-reported confidence in managing obstetric emergencies. In addition, the training video would be measured by the completion of the training at the knowledge center for this Not-for-Profit Hospital staff and newly hired. Results: A total of 30 ED staff participated in both simulation days. The ED staff that participated in these simulations were ED Nurses, ED Technicians, ED directors, Clinical Nurse specialists, OB doctors, Midwives, and L&D nurses. The results were taken from the pre-and post-surveys. No result of the training video was given, the training video is not going to be implemented until the year 2023. Conclusions: This quality improvement project showed that with the implementation of simulation and training videos the ED staff felt more confident to recognize and treat maternal complications. In addition, after completing both simulations, this Not-for-Profit Hospital did meet the Joint Commission standards

Implantación de un Ambiente Virtual de Aprendizaje en la plataforma moodle con cuatro módulos de apoyo para los funcionarios del CTI dirección seccional Nariño-Putumayo.

Debido a que las instituciones gubernamentales tales como la Dirección Seccional Nariño-Putumayo del Cuerpo Técnico de Investigación quieren optimizar las competencias del talento humano de la entidad generando profesionalismo y aumentando la productividad de sus funcionarios, el proyecto que se describe a continuación busca el desarrollo, diseño e implementación de recursos digitales como apoyo al proceso de formación de peritos del CTI en las distintas áreas tales como Documentología, Automotores, Fotografía Forense y Video. La implantación de un ambiente virtual de aprendizaje en la plataforma Moodle con cuatro módulos de apoyo al proceso de formación, permite establecer estrategias de enseñanza y aprendizaje utilizando un recurso tecnológico acorde a la educación de dichos funcionarios

Compact set of invariants characterizing graph states of up to eight qubits

The set of entanglement measures proposed by Hein, Eisert, and Briegel for n-qubit graph states [Phys. Rev. A 69, 062311 (2004)] fails to distinguish between inequivalent classes under local Clifford operations if n > 6. On the other hand, the set of invariants proposed by van den Nest, Dehaene, and De Moor (VDD) [Phys. Rev. A 72, 014307 (2005)] distinguishes between inequivalent classes, but contains too many invariants (more than 2 10^{36} for n=7) to be practical. Here we solve the problem of deciding which entanglement class a graph state of n < 9 qubits belongs to by calculating some of the state's intrinsic properties. We show that four invariants related to those proposed by VDD are enough for distinguishing between all inequivalent classes with n < 9 qubits.Comment: REVTeX4, 9 pages, 1 figur

El agua : ¿bien común o mercancía?

Sin agua no es posible la vida y por lo tanto ningún tipo de producción y reproducción de la vida humana, animal ni vegetal. La civilización y la cultura humanas han sido posibles y se han desarrollado a través de la canalización del agua potable, primero como forma de regar los cultivos para la permanencia de las primeras comunidades sedentarias, luego una vez asentadas, se hizo necesario construir canales de desecho de las aguas servidas para evitar la proliferación de enfermedades. Analizar exhaustivamente el tema del agua como derecho humano, implica una infi nidad de variables que intervienen de manera directa e indirecta sobre su goce, teniendo en cuenta que se trata de un bien indispensable para la vida de todos los seres del planeta y que no puede ser garantizado sin los componentes de disponibilidad, accesibilidad y calidad

Targeted-pig trial on safety and immunogenicity of serum-derived extracellular vesicles enriched fractions obtained from Porcine Respiratory and Reproductive virus infections

The Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) is the etiological agent of one of the most important swine diseases with a significant economic burden worldwide. Unfortunately, available vaccines are partially effective highlighting the need of novel approaches. Previously, antigenic viral proteins were described in serum-derived extracellular vesicles (EVs) from pigs previously infected with PRRSV. Here, a targeted-pig trial was designed to determine the safety and immunogenicity of such extracellular vesicles enriched fractions. Our results showed that immunizations with EV-enriched fractions from convalescence animals in combination with montanide is safe and free of virus as immunizations with up-to two milligrams of EV-enriched fractions did not induce clinical symptoms, adverse effects and detectable viral replication. In addition, this vaccine formulation was able to elicit specific humoral IgG immune response in vaccinated animals, albeit variably. Noticeably, sera from vaccinated animals was diagnosed negative when tested for PRRSV using a commercial ELISA test; thus, indicating that this new approach differentiates vaccinated from infected animals. Lastly, after priming animals with EV-enriched fractions from sera of convalescence animals and boosting them with synthetic viral peptides identified by mass spectrometry, a distinctive high and specific IFN-γ response was elicited. Altogether, our data strongly suggest the use of serum EV-enriched fractions as a novel vaccine strategy against PRRSV.Anti-CD9, Anti-CD63 and anti-CD81 antibodies were kindly donated by Francisco Sánchez-Madrid and Maria Yañez-Mo, Hospital de la Princesa, Madrid, Spain. The authors wish to particularly thank Glòria Abella for her collaboration in conducting the field study and to Marta Alcobé, Miriam Moron Font and Paula Crego Mendez for technical assistance. This study received support from Innovex Therapeutics S.L., Pinsos del Segre SA, Granja Casanyé, Grup de Sanejament Porci (GSP, Lleida, Spain) and the FEDER project (COMRDI16-1-0035-03). Sergio Montanter-Tarbes is an industrial doctorate awarded by the Government of Catalonia, Spain (No. 2014 DI 044). ISGlobal and IGTP are members of the CERCA Programme, Generalitat de Catalunya

The water footprint of a river basin with a special focus on groundwater: The case of Guadalquivir basin (Spain).

In addition to revealing the hidden link between products or consumption patterns of populations and their needs in terms of water resources, the water footprint (WF) indicator generates new debates and solutions on water management at basin scale. This paper analyses the green and blue WF of the Guadalquivir basin and its integration with environmental water consumption, with a special emphasis on the WF from groundwater and its consequences on current and future depletion of surface water. In a normal year, green WF (agriculture and pastures) amounts to 190 mm on a total green water consumption of 410 mm, while the blue WF (50 mm) represents half of the total blue water flows. This constitutes a first overview and alternative interpretations of the WF as human water appropriation are introduced. The blue WF is almost entirely associated to agriculture (40 mm). The presentation of its evolution over the period 1997?2008 reveals the rising WF from groundwater (13 mm in 2008), 86% being current consumption of surface flows. This evolution is particularly ascribed to the recent development of irrigated olive groves from groundwater. To prevent a higher pressure on the environment, this new use, like all others (thermo-solar plants, tourism, etc.), could have been obtained from the reallocation of water from crops with low water productivity. It means that water is not lacking in the Guadalquivir basin if the governance setting integrates more flexibility and equity in the allocation of water to address climatic variability and the emergence of new demands