Quin és el impacte de la infermera d'anestèsia en els resultats de qualitat i/o productivitat en els pacients i en els hospitals?

Màster en Lideratge i Gestió d'Infermeria, Universitat de Barcelona. Escola Universitària d'Infermeria, curs: 2012-2013, Director: Eulàlia Juvé UdinaLa infermera d’anestèsia és un professional no qüestionat ja a nivell europeu, tot i que les seves competències varien d'un país a altre. Els estudis posen de manifest la relació entre formació postgraduada i rol autònom. En el nostre entorn manquen estudis que demostrin el impacte de la introducció de la infermera d'anestèsia. L’objectiu principal és avaluar l’efecte de la infermera d’anestèsia en els resultats clínics dels pacients i de productivitat dels professionals. La metodologia es basa en un disseny analític, observacional, longitudinal i prospectiu. La mostra de 237 participants, amb tècnica de mostreig tipus no probabilístic, consecutiu. La variable independent és la infermera d'anestèsia i les variables dependents són el número d'anul·lacions quirúrgiques (variable quantitativa) i les seves complicacions (variable qualitativa). Les dades seran analitzades amb estadístics descriptius: proporcions, mesures de tendència central i mesures de dispersió

Reconfigurable Flows and Defect Landscape of Confined Active Nematics

Using novel micro-printing techniques, we develop a versatile experimental setup that allows us to study how lateral confinement tames the active flows and defect properties of the microtubule/kinesin active nematic system. We demonstrate that the active length scale that determines the self-organization of this system in unconstrained geometries loses its relevance under strong lateral confinement. Dramatic transitions are observed from chaotic to vortex lattices and defect-free unidirectional flows. Defects, which determine the active flow behavior, are created and annihilated on the channel walls rather than in the bulk, and acquire a strong orientational order in narrow channels. Their nucleation is governed by an instability whose wavelength is effectively screened by the channel width. All these results are recovered in simulations, and the comparison highlights the role of boundary conditions

Active boundary layers

The role of boundary layers in conventional liquid crystals is commonly subsumed in their anchoring on confining walls. In the classical view, anchoring enslaves the orientational field of the passive material under equilibrium conditions. In this work, we experimentally explore the role of confining walls in the behavior of an active nematic. We find that, under slip boundary conditions, the wall induces the accumulation of negatively charged topological defects in its vicinity, resulting in the formation of a topological boundary layer that polarizes the wall. While the dynamics of wall and bulk defects are decoupled, we find that the active boundary layer influences the overall dynamics of the system, to the point of fully controlling the behavior of the active nematic in situations of strong confinement. Finally, we show that wall defects exhibit behaviors that are essentially different from those of their bulk counterparts, such as high motility or the ability to recombine with another defect of like-sign topological charge. These exotic behaviors result from a change of symmetry induced by the wall in the director field around the defect. Finally, we show that the collective dynamics of wall defects can be described in terms of a one-dimensional Kuramoto-Sivashinsky -like description of spatio-temporal chaos.Comment: 10 pages, 6 figures in main text, 5 figures in S

Active boundary layers in confined active nematics

The roleofboundary layers inconventional liquidcrystals is commonly related to the mesogen anchoring on confining walls. In the classical view, anchoring enslaves the orientational field of the passive material under equilibrium conditions. In this work, we show that an active nematic can develop active boundary layers that topologically polarize the confining walls. We find that negatively-charged defects accumulate in the boundary layer, regardless of the wall curvature, and they influence the overall dynamics of the system to the point of fully controlling the behavior of the active nematic in situations of strong confinement. Further, we show that wall defects exhibit behaviors that are essentially different from those of their bulk counterparts, such as high motility or the ability to recombinewith another defect of like-sign topological charge. These exotic behaviors result from a change of symmetry induced by the wall in the director field around the defect. Finally, we suggest that the collective dynamics of wall defects might be described in terms of a model equation for one-dimensional spatio-temporal chaos

Evaluación mediante simulación de las competencias clínicas de los alumnos del máster en Enfermería de Anestesia, Reanimación y Terapia del Dolor de la UB.

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Introduccion: EL MARTD es actualmente semipresencial con considerable contenido en prácticas clínicas que se desarrollan individualmente con tutores clínicos de varios centros asistenciales. La dispersión y posible variabilidad de esta organización debe garantizar el contenido y calidad del aprendizaje. En el curso 2013-14 planteamos evaluar los resultados de las prácticas con un doble objetivo: valorar las competencias de los alumnos y si nuestra organización conseguía los objetivos prácticos. El instrumento fue la observación de la actuación del alumno en un entorno simulado al final del periodo práctico. Metodologia: - Participaron los 60 alumnos matriculados, 30 evaluadores (15 enfermeras y 15 anestesiólogos) y 12 coordinadores de rotaciones y de estaciones. - Diseño de 6 estaciones con contenido relevante para la formación, ejecución en 10 min seguido de 15 min de “debriefing”, plantillas de evaluación de habilidades clínicas y no clínicas y criterios acordados por los evaluadores. Las estaciones fueron valoración preanestésica, bloqueo de plexo, anestesia general, preparación de perfusiones electrónicas de fármacos, depresión respiratoria y shock anafiláctico. - Se entrenó a los instructores sobre contenido y finalidad de la prueba, con 2 reuniones prácticas..

The neurobiological basis of cognitive side effects of electroconvulsive therapy : a systematic review

Altres ajuts: M.C. is founded by the Sara Borrell postdoctoral contract [CD20/00189].Decades of research have consistently demonstrated the efficacy of electroconvulsive therapy (ECT) for the treatment of major depressive disorder (MDD), but its clinical use remains somewhat restricted because of its cognitive side effects. The aim of this systematic review is to comprehensively summarize current evidence assessing potential biomarkers of ECT-related cognitive side effects. Based on our systematic search of human studies indexed in PubMed, Scopus, and Web of Knowledge, a total of 29 studies evaluating patients with MDD undergoing ECT were reviewed. Molecular biomarkers studies did not consistently identify concentration changes in plasma S-100 protein, neuron-specific enolase (NSE), or Aβ peptides significantly associated with cognitive performance after ECT. Importantly, these findings suggest that ECT-related cognitive side effects cannot be explained by mechanisms of neural cell damage. Notwithstanding, S-100b protein and Aβ40 peptide concentrations, as well as brain-derived neurotrophic factor (BDNF) polymorphisms, have been suggested as potential predictive biomarkers of cognitive dysfunction after ECT. In addition, recent advances in brain imaging have allowed us to identify ECT-induced volumetric and functional changes in several brain structures closely related to memory performance such as the hippocampus. We provide a preliminary framework to further evaluate neurobiological cognitive vulnerability profiles of patients with MDD treated with ECT

Active microfluidic transport in two-dimensional handlebodies

Unlike traditional nematic liquid crystals, which adopt ordered equilibrium configurations compatible with the topological constraints imposed by the boundaries, active nematics are intrinsically disordered because of their self- sustained internal flows. Controlling the flow patterns of active nematics remains a limiting step towards their use as functional materials. Here we show that confining a tubulin-kinesin active nematic to a network of connected annular microfluidic channels enables controlled directional flows and autonomous transport. In single annular channels, for narrow widths, the typically chaotic streams transform into well-defined circulating flows, whose direction or handedness can be controlled by introducing asymmetric corrugations on the channel walls. The dynamics is altered when two or three annular channels are interconnected. These more complex topologies lead to scenarios of synchronization, anti-correlation, and frustration of the active flows, and to the stabilisation of high topological singularities in both the flow field and the orientational field of the material. Controlling textures and flows in these microfluidic platforms opens unexplored perspectives towards their application in biotechnology and material science

¿Quién supervisa a Enfermería?

Màster en Administració i Gestió en Cures d'Infermeria, Escola Universitarias Santa Madrona, Universitat de Barcelona. Any: 1994Las necesidades de la comunidad en materia de salud han ido evolucionando de un modo progresivo a lo largo de la historia. La ciencia ha ido modificando sus contenidos, mejorando sus posturas y mostrando sus adelantos técnicos y de diversa índole. Los profesionales han pretendido, a lo largo del tiempo, adaptar sus aportaciones y prestaciones a esa dinámica cambiante y evolutiva, actualizando sus conocimientos y mejorando sus habilidades y destrezas, con el fin de aportar soluciones a lo que la sociedad percibe como sus necesidades. Algunos profesionales no han logrado esa adaptación al ritmo cambiante de las circunstancias y se han visto desplazados, pudiendo terminar en nuevos oficios u ocupaciones. Otros por el contrario, se ven inmersos aún en el proceso de definir su identidad y sus concepciones, es decir, en la dura defensa de su "identidad profesional" o papel en la cotidianeidad. Es evidente que en el campo de los profesionales relacionados con la salud, el cambio..

Influence of storage temperature on the quality of beef liver; pH as a reliable indicator of beef liver spoilage

The development of the microbial flora specifically involved in the spoilage of sliced beef livers packaged and stored under aerobic conditions at 0 and 3 °C for 14 days was studied. Changes in the pH value of the product were also determined. The possibility that pH value could be considered as a quick and reliable indicator of incipient spoilage was particularly considered. All microbial groups (except micrococci) showed differences in their rates of growth between 0 and 3 °C. Pseudomonads and lactic acid bacteria were the main components of the spoilage flora. When the 37 °C aerobic plate counts (APCs) reached 105–106 CFU g−1 and the 20 °C APCs and pseudomonad counts reached 106–107 CFU g−1, visible surface colonies (VSCs) were observed. The presence of VSCs is the most important criterion to determine organoleptic beef liver spoilage and has hence enabled us to establish a shelf-life of up to 8–10 and 5.5–6.5 days for samples stored at 0 and 3 °C respectively. Our study shows that the determination of pH, which is simple, economical and rapid, is capable of giving a reliable estimate of the spoilage status of beef livers. pH values lower than 6.15 may be considered as indicative of beef liver spoilage

Calidad higiénico-sanitaria de las ensaladas servidas en comedores universitarios

En el estudio de la evolución de la calidad higiénico-sanitaria de comidas servidas en los comedores universitarios de la Universitat Autònoma de Barcelona en el período 1990-1995 se constató que las ensaladas, en todas sus variedades son las principales responsables de incumplimiento de la Reglamentación Técnico Sanitaria (RTS) de Comedores Colectivos vigente (RD 2817/83), por lo que se planteó llevar a cabo un plan para mejorar la calidad higiénico-sanitaria de éstas y evaluar la eficacia de dicho plan