El regreso de los virus mutantes. Invasiones, resistencias y pandemias. Diálogo entre Carlos A. Scolari y Ricardo Bedoya

Presentamos un adelanto de esta conversación que será publicada de forma íntegra en el libro de Carlos Alberto Scolari No pasarán. Las invasiones alienígenas: de H. G. Wells a Steven Spielberg (y mas allá), que será lanzado por el Fondo Editorial de la Universidad de Lima

CAR: Cooperació, Actitud & Resiliencia

Recerca; Emprenedoria biblioteques; Co-investigadorResearch; Entrepreneurship libraries; Co-investigatorInvestigación; Emprendimiento bibliotecas; Co-investigadorIntroducció : El procés de superar adversitats es reconeix com a resiliència. Aquest procés està vinculat amb la transformació que viuen les unitats d informació i, per extensió, amb la capacitat dels bibliotecaris d'adaptar-se al canvi. Assumir noves competències és un fet que respon a les necessitats de l'entorn més immediat. Identificar , descriure i desenvolupar aquestes competències és el punt de trobada que impulsa la col·laboració de tres biblioteques hospitalàries del Vallés Occidental. Material i Mètode : S'analitzen els serveis bibliotecaris de l'Hospital Universitari Mútua de Terrassa, Consorci Sanitari de Terrassa i Corporació Sanitària Parc Taulí amb l'objectiu de descriure i consensuar línies d'actuació comunes. Els serveis queden agrupats sota 3 àrees: 1.Biblioteca, 2.Suport a la recerca i 3.Suport institucional. Es detecten 5 Línies d'Actuació Conjunta (LAC): 1.Estàndars i producció científica, 2.Compra consorciada de recursos, 3.Pla d'Alfabetització Informacional, 4.Assessor (COACH) a clients i investigadors, 5.Gestió del coneixement, 6. Suport a la publicació. Resultats : Com a resultat cada LAC queda definida en un 'Quadre de Valoració' sota els següents criteris: Objectiu, Accions, Valor aportat pels Agents Implicats i Punts Crítics d'Èxit. De les 5 LACs es trien la 4 i la 6 com les més significatives atenent al nou rol del bibliotecari. L'elecció queda subjecte als criteris estratègics de les institucions (entorn) de les quals depenen, ja que incideixen en la divulgació dels resultats de la seva recerca. La descripció realitzada ens permet valorar dos nous perfils del bibliotecari: assessor/coach per LAC4; co-autor per la LAC6. El resultat final ens permet identificar al professional bibliotecari com a membre actiu dins els grups de recerca. Conclusions : L'estudi de benchmarking realitzat entre les 3 institucions ajuda a identificar competències poc definides del paper del bibliotecari dins una institució de recerca com és un centre sanitari i com assolir amb èxit el canvi de les habilitats interprofessionals emergents.Introducción: El proceso de superar adversidades se reconoce como resiliencia. Este proceso está vinculado con la transformación que viven las unidades de información y, por extensión, con la capacidad de los bibliotecarios de adaptarse al cambio. Asumir nuevas competencias es un hecho que responde a las necesidades del entorno más inmediato. Identificar, describir y desarrollar estas competencias es el punto de encuentro que impulsa la colaboración de tres bibliotecas hospitalarias del Vallés Occidental.Introduction: The process of overcoming adversity is recognized as a resilience. This process is linked to the transformation of information units and, by extension, with the ability of librarians to adapt to change. Assuming new competencies is a fact that responds to the needs of the immediate environment. Identifying, describing and developing these competences is the meeting point that promotes the collaboration of three hospital libraries in the Vallés Occidental

Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

BACKGROUND: Medically unexplained symptoms are an important mental health problem in primary care and generate a high cost in health services.Cognitive behavioral therapy and psychodynamic therapy have proven effective in these patients. However, there are few studies on the effectiveness of psychosocial interventions by primary health care. The project aims to determine whether a cognitive-behavioral group intervention in patients with medically unexplained symptoms, is more effective than routine clinical practice to improve the quality of life measured by the SF-12 questionary at 12 month. METHODS/DESIGN: This study involves a community based cluster randomized trial in primary healthcare centres in Madrid (Spain). The number of patients required is 242 (121 in each arm), all between 18 and 65 of age with medically unexplained symptoms that had seeked medical attention in primary care at least 10 times during the previous year. The main outcome variable is the quality of life measured by the SF-12 questionnaire on Mental Healthcare. Secondary outcome variables include number of consultations, number of drug (prescriptions) and number of days of sick leave together with other prognosis and descriptive variables. Main effectiveness will be analyzed by comparing the percentage of patients that improve at least 4 points on the SF-12 questionnaire between intervention and control groups at 12 months. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. DISCUSSION: This study aims to provide more insight to address medically unexplained symptoms, highly prevalent in primary care, from a quantitative methodology. It involves intervention group conducted by previously trained nursing staff to diminish the progression to the chronicity of the symptoms, improve quality of life, and reduce frequency of medical consultations. TRIAL REGISTRATION: The trial was registered with ClinicalTrials.gov, number NCT01484223 [http://ClinicalTrials.gov].S

To what extent has Sustainable Intensification in England been achieved?

Agricultural intensification has significantly increased yields and fed growing populations across the planet, but has also led to considerable environmental degradation. In response an alternative process of ‘Sustainable Intensification’ (SI), whereby food production increases while environmental impacts are reduced, has been advocated as necessary, if not sufficient, for delivering food and environmental security. However, the extent to which SI has begun, the main drivers of SI, and the degree to which degradation is simply ‘offshored’ are uncertain. In this study we assess agroecosystem services in England and two contrasting sub-regions, majority-arable Eastern England and majority-pastoral South-Western England, since 1950 by analysing ecosystem service metrics and developing a simple system dynamics model. We find that rapid agricultural intensification drove significant environmental degradation in England in the early 1980s, but that most ecosystem services except farmland biodiversity began to recover after 2000, primarily due to reduced livestock and fertiliser usage decoupling from high yields. This partially follows the trajectory of an Environmental Kuznets Curve, with yields and GDP growth decoupling from environmental degradation above ~£17,000 per capita per annum. Together, these trends suggest that SI has begun in England. However, the lack of recovery in farmland biodiversity, and the reduction in UK food self-sufficiency resulting in some agricultural impacts being ‘offshored’, represent major negative trade-offs. Maintaining yields and restoring biodiversity while also addressing climate change, offshored degradation, and post-Brexit subsidy changes will require significant further SI in the future

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat