23 research outputs found
One or two faecal immunochemical tests in an organised population-based colorectal cancer screening programme in Murcia (Spain)
Knowledge transfer and the challenges of engineering training in the face of globalization.
La transferencia de conocimiento es una
máxima en la sociedad contemporánea.
Ante este fenómeno, impulsado por la
globalización neoliberal, se le impone a las
instituciones de educación universitaria
cambios radicales que apuntan a adecuar
los planes de estudio a los requerimientos
de la aldea global. La formación de ingenieros no puede situarse al margen de
estas perspectivas curriculares, pero ha
de imponer una visión humanista al quehacer científico y tecnológico. El presente
trabajo se inscribe en la ruta de fortalecer
la ética y la crítica en la formación de ingenieros.Knowledge transfer is a maximum in contemporary society. Faced with this phenomenon, driven by neoliberal globalization, university education institutions are required to make radical changes that aim to adapt the study plans, according to the requirements of the ‘global village’. The training of engineers cannot be placed outside of these curricular perspectives, but it must impose a humanistic vision on scientific and technological work. This work is part of the route to strengthen ethics and criticism in the training of engineers
Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study
Background
Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.
Methods
This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs.
Results
Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates.
Conclusions
Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility.
Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)
Knowledge transfer and the challenges of engineering training in the face of globalization.
La transferencia de conocimiento es una
máxima en la sociedad contemporánea.
Ante este fenómeno, impulsado por la
globalización neoliberal, se le impone a las
instituciones de educación universitaria
cambios radicales que apuntan a adecuar
los planes de estudio a los requerimientos
de la aldea global. La formación de ingenieros no puede situarse al margen de
estas perspectivas curriculares, pero ha
de imponer una visión humanista al quehacer científico y tecnológico. El presente
trabajo se inscribe en la ruta de fortalecer
la ética y la crítica en la formación de ingenieros.Knowledge transfer is a maximum in contemporary society. Faced with this phenomenon, driven by neoliberal globalization, university education institutions are required to make radical changes that aim to adapt the study plans, according to the requirements of the ‘global village’. The training of engineers cannot be placed outside of these curricular perspectives, but it must impose a humanistic vision on scientific and technological work. This work is part of the route to strengthen ethics and criticism in the training of engineers
Delimitation of potential recharge zones - case study: multilayer aquifer of eje bananero del Urabá Antioqueño-Colombia
El conocimiento del Modelo Hidrogeológico Conceptual permite adoptar y adaptar un procedimiento adecuado para cada caso de estudio, considerando acuíferos libres y acuíferos confinados, teniendo en cuenta las diferencias estructurales entre rocas duras, rocas blandas y depósitos no consolidados; y evaluando el rol de la textura y la capacidad de infiltración del suelo, en la dimensión de la función de la recarga directa. Para el sistema hidrogeológico del Eje Bananero del Urabá Antioqueño- Colombia la tarea de entender la recarga puso de manifiesto la necesidad de establecer una escala de calificación para evaluar el factor estructural en rocas blandas y depósitos no consolidados y definir categorías de importancia, basados en propiedades texturales y tasas de infiltración para las zonas de recarga directa difusa en acuíferos libres; también se determinó un procedimiento para delimitar zonas asociadas a las unidades hidrogeológicas que subrayasen a los acuíferos confinados.Knowledge of the Conceptual Hydrogeological Model allows adopting and adapting an appropriate procedure for each study case, considering phreatic and confined aquifers, taking into account differences in the structures between hard rocks, soft rocks and unconsolidated deposits; and evaluating the role of soil texture and infiltration capacity in the direct recharge function. For the hydrogeological system of “Eje Bananero del Urabá Antioqueño” - Colombia, direct recharge areas of major and minor importance and indirect recharge areas of high, medium and low importance were delimited. With this project, a method was found to evaluate structural factors in soft rocks and unconsolidated deposits; also, categories of importance in the recharge were defined, based on textural properties and infiltration rates for phreatic aquifers. Finally, a procedure was defined to delimit zones associated with hydrogeological units that overlay confined aquifers.Knowledge of the Conceptual Hydrogeological Model allows adopting and adapting an appropriate procedure for each study case, considering phreatic and confined aquifers, taking into account differences in the structures between hard rocks, soft rocks and unconsolidated deposits; and evaluating the role of soil texture and infiltration capacity in the direct recharge function. For the hydrogeological system of “Eje Bananero del Urabá Antioqueño” - Colombia, direct recharge areas of major and minor importance and indirect recharge areas of high, medium and low importance were delimited. With this project, a method was found to evaluate structural factors in soft rocks and unconsolidated deposits; also, categories of importance in the recharge were defined, based on textural properties and infiltration rates for phreatic aquifers. Finally, a procedure was defined to delimit zones associated with hydrogeological units that overlay confined aquifers.El conocimiento del Modelo Hidrogeológico Conceptual permite adoptar y adaptar un procedimiento adecuado para cada caso de estudio, considerando acuíferos libres y acuíferos confinados, teniendo en cuenta las diferencias estructurales entre rocas duras, rocas blandas y depósitos no consolidados; y evaluando el rol de la textura y la capacidad de infiltración del suelo, en la dimensión de la función de la recarga directa. Para el sistema hidrogeológico del Eje Bananero del Urabá Antioqueño- Colombia la tarea de entender la recarga puso de manifiesto la necesidad de establecer una escala de calificación para evaluar el factor estructural en rocas blandas y depósitos no consolidados y definir categorías de importancia, basados en propiedades texturales y tasas de infiltración para las zonas de recarga directa difusa en acuíferos libres; también se determinó un procedimiento para delimitar zonas asociadas a las unidades hidrogeológicas que subrayasen a los acuíferos confinados
Bioconstrução: sistemas sustentáveis e eficientes
The development of sustainable technologies is gaining more and more focus. Motivated by the demand for ecological construction techniques, a construction manual was developed using bioconstruction techniques, to democratize knowledge and revive construction techniques that do not harm the ecosystem. Among the techniques covered, the compacted earth block has as its basic principle the capacity of the earth to form a resistant aggregate from its compression. Bahareque is one of the simplest and quickest for construction: it consists of developing a plot with rigid material, where a mixture is applied, in order to fill the voids left by the plot, a light construction that does not require so much of the soil. The addition of alloys (such as sugar cane ash, rice husk and brachiaria) generates better resistance to mechanical compression and less water absorption from the blocks, encouraging the reuse of disposable materials and saving resources from the earth. Finally, in the long run, the increase in materials like this will allow the sector to significantly reduce its environmental footprint, especially considering the reduction in the amount of concrete used and the waste produced in the process.El desarrollo de tecnologías sostenibles está ganando cada vez más atención, motivados por la demanda de técnicas de construcción ecológica, se estudiaron dos técnicas de bioconstrucción para el futuro desarrollo de un manual práctico; esto con el fin de democratizar el conocimiento y reactivarlo, protegiendo así el ecosistema. Entre las técnicas abordadas están: el bloque de tierra compactada, el cual tiene como principio básico la capacidad de la tierra para formar un agregado resistente a partir de su compresión. El Bahareque es una de las construcciones más sencillas y rápidas, su sistema constructivo se basa en la combinación de maderas y cañas entre tejidas con un recubrimiento de barro, donde se aplica una mezcla, con el fin de llenar los vacíos, una construcción ligera que no requiere tanto de suelo. La adición de aleaciones (como ceniza de caña de azúcar, cascarilla de arroz y brachiaria) genera mejor resistencia a la compresión mecánica y menor absorción de agua de los bloques, favoreciendo la reutilización de materiales desechables y ahorrando recursos. Finalmente, el incremento en la utilización de materiales como este permitirá al sector reducir significativamente su huella ambiental, especialmente considerando la reducción de la cantidad de hormigón utilizado y los residuos producidos en el proceso.O desenvolvimento de tecnologias sustentáveis ganha cada vez mais enfoque. Motivado pela demanda de técnicas ecológicas de construção, foi desenvolvido um manual de construção utilizando técnicas de bioconstrução, com o intuito de democratizar o conhecimento e reviver técnicas de construção que não agridam o ecossistema. Dentre as técnicas abordadas, o bloco de terra compactada tem como seu princípio básico a capacidade da terra em formar um agregado resistente a partir de sua compressão. O Bahareque é uma das mais simples e rápidas para construção: consiste em desenvolver um tramado com material rígido, onde aplica-se uma mistura, com o intuito de preencher os vazios deixados pelo tramado, uma construção leve que não exige tanto do solo. O acréscimo das ligas (como a as cinzas da cana-de-açúcar, casca de arroz e braquiária) gera uma melhor resistência à compressão mecânica e uma menor absorção de água dos blocos, fomentando o reuso de materiais descartáveis e gerando uma economia de recursos da terra. Por fim, em longo prazo, o aumento de materiais como este permitirá ao setor uma redução considerável na pegada ambiental, considerando principalmente a redução da quantidade de concreto utilizado e de lixo produzido no processo
Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set
Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids