Sedación y analgesia en pacientes con ventilación mecánica en unidades de cuidado intensivo: una revisión narrativa

Trabajo fin de grado en EnfermeríaObjetivo: En el presente trabajo se pretende identificar las últimas líneas de revisión y recomendación de las prácticas de sedoanalgesia en pacientes sometidos a Ventilación Mecánica (VM) en Unidades de Cuidados Intensivos (UCI), observar la representación del rol de la enfermera y la importancia otorgada a esta figura, y explorar la monitorización utilizada para los niveles de sedación y necesidad de analgesia en este contexto. Metodología: Revisión narrativa. La búsqueda se realizó en cinco bases de datos cuya especialización es las Ciencias de la Salud: CUIDEN, SciELO, Cochrane, CINAHL y PUBMED, desde 2013 a 2018. Resultados: 17 de los artículos cumplían los criterios de exclusión e inclusión. Las mayores barreras para la evolución de las prácticas de sedoanalgesia son la falta educativa del personal y el miedo a la sedación ligera y aumento de carga de trabajo, siendo más común en enfermería. Las enfermeras tienen un rol esencial en la monitorización y manejo de la sedoanalgesia, además del uso de escalas. Las más utilizadas para la valoración de pacientes son las RASS y la CPOT. Se observa la importancia de las recomendaciones de las guías PAD en los protocolos/ estrategias implementadas. Conclusiones: Es preciso trabajar la educación del personal, en especial el de enfermería, que presenta más barreras para el avance de la sedoanalgesia, siendo un pilar básico en la monitorización y manejo del paciente crítico. Se debe promover la concienciación del personal de UCI en el seguimiento y aceptación de protocolos/estrategias en vez de centrar la investigación en su renovaciónObjective: This work identifies the latest information about sedoanalgesia practices in patients with Mechanical Ventilation (MV) admitted in Intensive Care Units (ICU), followed by an observation into the responsibilities of the nurse and the importance given to this figure. Moreover, a review of the monitoring techniques used to quantify sedation and pain levels. Methodology: A narrative review was conducted with the use of five databases that specialize in health sciences; notably, CUIDEN, SciELO, Cochrane, CINAHL and PUBMED during the time-period of 2013 to 2018. Results: seventeen of the articles met the exclusion and inclusion criteria. Some of great limitations to the evolution of sedoanalgesia practices are due to staff having a lack of vital knowledge and the fear of light sedation and increased workload, which is becoming increasingly common amongst nurses. Nurses have a fundamental role in monitoring and adjusting sedoanalgesia, in addition to using scales. RASS and the CPOT were commonly used during out assessments of the patients. The importance of the recommendations of the PAD guidelines in the protocols and strategies implemented is observed. Conclusions: we deduced that it was fundamentally important to further educate the staff, specifically nurses that are responsible for preventing the advancement of sedoanalgesia whilst caring and managing the critical patient. The awareness of UCI staff in the monitoring and acceptance of protocols and strategies should be promoted instead of focusing the research on its renewa

Kinetic study of pilot-scale supercritical CO2 extraction of rosemary (Rosmarinus officinalis) leaves

NOTICE: This is the author’s version of a work that was accepted for publication in Journal of Supercritical Fluids. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Supercritical Fluids, 55 (2011). http://dx.doi.org/10.1016/j.supflu.2010.09.030Rosmarinus officinalis (rosemary) extracts were obtained in a supercritical pilot-scale plant. Based on experimental information available in the literature for analytical or low-scale processes, extraction temperature and pressure were selected to be 313 K and 30 MPa. At these extraction conditions, the kinetic behavior of the pilot-scale overall extraction curve were determined with respect to yield, antioxidant activity and carnosic acid content. The overall extraction curve was represented using Sovova’s model; the average deviation between measured and calculated yields was lower than 2%. Mass transfer coefficients in the fluid and solid phases were determined and were compared with previous data reported in the literature for low-scale rosemary supercritical extraction. A two-stage depressurization procedure was accomplished and the effect of both on-line fractionation and extraction time on the antioxidant activity of the samples collected was studied. The antioxidant activity of the different fractions could be straight correlated with the carnosic acid content with a regression coefficient of 0.92This work has been financed by Universidad Autónoma de Madrid and Comunidad Autónoma de Madrid (ALIBIRD-S2009/AGR-1469) and project FUN-C-FOOD, CSD2007-00063 (CONSOLIDER-INGENIO) from Ministerio de Ciencia e Innovación, Spain

Digitalizacija filmova i odabir filmova za digitalizaciju iz perspektive korisnika

Purpose. The selection of films that archivists carry out today has an important impact on the future configuration of digitalised and virtually accessible film collections. Given the responsibility that this task entails, we consider it interesting to explore what the different profiles of the users of film archives think about selection and digitisation of films. Approach/Methodology/Design. To this end, structured interviews were conducted with 31 subjects belonging to four groups of users: film researchers, film professionals, journalists/ film critics, and last year audio-visual communication undergraduates from the University of Seville. Findings. The most notable results, which do not differ in essence from what is known in the archival field, include, on the one hand, the unanimous view that digitisation is an effective way of conserving audio-visual memory and fostering public interest in film collections and archives and, on the other, that when films have to be selected for their digitisation, this should be done following rigorous and systematic selection criteria, thus avoiding the detrimental effects of random methods. Lastly, some future research lines are offered. Originality/Value. All the bibliography consulted view topics relating to film selection and digitisation exclusively through the prism of archival and library and information sciences. Namely, these studies are restricted to these specific areas of knowledge and aimed at professional and experts in the field. For that reason, it may be interesting to explore other viewpoints and perspectives that go beyond purely technical, theoretical or methodological approach to film curation.Cilj. Odabir filmova za digitalizaciju u arhivima ima veliki utjecaj na buduće oblikovanje digitaliziranih i virtualno dostupnih filmskih zbirki. S obzirom na odgovornost koju taj zadatak nosi, smatramo zanimljivim istražiti što različiti profili korisnika filmskog arhiva misle o selekciji i digitalizaciji filmova. Pristup/metodologija/dizajn. U tu su svrhu obavljeni strukturirani intervjui s 31 ispitanikom koji pripadaju četirima skupinama korisnika: filmskim istraživačima, filmskim profesionalcima, novinarima/filmskim kritičarima i prošlogodišnjim studentima audiovizualne komunikacije Sveučilišta u Sevilli. Rezultati. Najvažniji rezultati, koji se zapravo ne razlikuju od onoga što je već poznato u području arhivistike, uključuju, s jedne strane, jedinstven stav da je digitalizacija učinkovit način očuvanja audiovizualne memorije i poticanja javnog interesa za filmske zbirke i arhive i, s druge strane, da odabir filmova za digitalizaciju treba biti vođen prema rigoroznim i sustavnim kriterijima, čime se izbjegavaju štetni učinci nasumičnih metoda. Na kraju, ponuđene su neke buduće istraživačke teme. Originalnost/vrijednost. Konzultirana literatura sagledava teme koje se odnose na odabir filmova i digitalizaciju isključivo kroz prizmu arhivistike, odnosno knjižničnih i informacijskih znanosti. Ograničena je na navedena specifična područja znanja i usmjerena na profesionalce i stručnjake iz toga područja. Iz toga razloga moglo bi biti zanimljivo istražiti i druga gledišta i perspektive koje nadilaze čisto tehnički, teorijski ili metodološki pristup očuvanju i brige o filmu

Correlation between Mn oxidation state and magnetic behavior in Mn/ZnO multilayers prepared by sputtering

Compositional, microstructural, and magnetic characterization of ZnO 30 Å/Mn x n multilayers prepared by sputtering is presented to study the observed ferromagnetism in the Mn-ZnO system. The nominal Mn layer thickness, x, is varied from 3 to 60 Å, while the number of bilayers, n, is increased to maintain the total amount of Mn constant. Microstructure information was deduced from x-ray reflectivity, Mn oxidation state was determined by x-ray absorption spectroscopy, and magnetic properties were measured over a temperature range of 5–400 K. Magnetic behavior of these samples is found to be related to the Mn layer thickness x. Multilayers with x 30 Å exhibit ferromagnetism with a Curie temperature above 400 K, while mostly paramagnetic behavior is obtained for x15 Å. Magnetic behavior is discussed in terms of electronic and structural parameters of samples. Mn-ZnO interface effect is related to the ferromagnetic order of the samples, but it is not a sufficient condition. The essential role of the Mn oxidation state in the magnetic behavior of this system is pointed out. It is shown a correlation between the obtained ferromagnetism and a Mn oxidation state close to 2+.Ministerio de Educación y Ciencias de España-MAT2003-01880 y MAT2006-0100

Inclusión como aspecto esencial en organizaciones: religión y genéro

The future of industrial and labour relations is shaping up to be diverse and inclusive. One of the main elements is respect for religious choices, but this is not always the case, as we discuss in the article. Moreover, this inclusion and non-discrimination is obviously one that takes into account equality between men and women. The article explores how both aspects, depending on countries and religious orientations (or non-secularisation, if this is the case) impact on organisations. In addition to the legal perspective, we analyse how this translates into the development of countries.El futuro de las relaciones laborales se perfila diverso e integrador. Uno de los principales elementos es el respeto de las opciones religiosas, pero no siempre es así, como analizamos en el artículo. Además, esta inclusión y no discriminación tiene obviamente en cuenta la igualdad entre hombres y mujeres. El artículo explora cómo ambos aspectos, según los países y las orientaciones religiosas (o la no secularización, si es el caso) repercuten en las organizaciones. Además de la perspectiva jurídica, se analiza cómo se traduce esto en el desarrollo de los países

Single-molecule kinetic energy of condensed normal deuterium

8 págs.; 9 figs.; 1 tab.Inelastic scattering of 300-meV neutrons allows the study of the liquid (T=20 and 30 K, saturated vapor pressure) and solid (T=4.2 K, saturated vapor pressure) phases of the normal deuterium mixture (2/3 o-D2+1/3 p -D2) in the region of momentum transfer where a single-molecule response is expected. The spectra are analyzed within the impulse approximation and assuming Gaussian momentum distributions for the translation of the molecules. For the solid, the estimated value of the single-molecule average kinetic energy does not compare unfavorably with those obtained scaling experimental results in parahydrogen solids. In the liquid state, substantial departures seem to exist from the classical liquid behavior, even if up to second-order quantum corrections are taken into account. ©1996 American Physical SocietyThis research has been made possible in part by the Spanish DGICYT through Grant No. PB92-0015.Peer Reviewe

Diseño de un tesauro sobre las Fuerzas y Cuerpos de Seguridad del Estado.

Este Trabajo Fin de Grado desarrolla y propone un tesauro de las Fuerzas y Cuerpos de Seguridad del Estado (FFCCS) de España. El objetivo es organizar y clasificar la información y la documentación de las FFCCSE, entender su estructura tanto interna como externa, conocer su modus operandi, así como facilitar el aprendizaje del vocabulario controlado para las personas que deseen opositar a estas fuerzas de seguridad, a estudios relacionados, o al público general mediante el desglose terminológico. Puesto que el trabajo trata sobre las FFCCS del Estado y no de las autonomías, no están incluidas las lenguas autonómicas distintas al castellano. Este trabajo sigue la norma “ISO 25964 Information and documentation — Thesauri and interoperability with othervocabularies”, tanto la parte primera como la segunda, y está organizado en un sistema de facetas, la de agente y la de actividades. Este diseño se centra en España, pero puede extenderse al ámbito internacional.<br /

Simultaneous quantification of light elements in thin films deposited on Si substrates using proton EBS (Elastic Backscattering Spectroscopy)

Quantification of light elements content in thin films is an important and difficult issue in many technological fields such as polymeric functional thin films, organic thin film devices, biomaterials, and doped semiconducting structures. Light elements are difficult to detect with techniques based on X-ray emission, such as energy dispersive analysis of X-rays (EDAX). Other techniques, like X-ray photoelectron spectroscopy (XPS), can easily quantify the content of light elements within a surface but often these surface measurements are not representative of the lights elements global composition of the thin film. Standard Rutherford backscattering spectroscopy (RBS), using alpha particles as probe projectiles, is not a good option to measure light elements deposited on heavier substrates composed of heavier elements like Si or glass. Nuclear Reaction Analysis (NRA) offers a good quantification method, but most of the nuclear reactions used are selective for the quantification of only one element, so several reactions and analysis are necessary to measure different elements. In this study, Elastic Backscattering Spectroscopy (EBS) using proton beams of 2.0 MeV simultaneously quantified different light elements (helium, carbon, nitrogen, oxygen, and fluorine) contained in thin films supported on silicon substrates. The capabilities of the proposed quantification method are illustrated with examples of the analysis for a series of thin film samples: amorphous silicon with helium bubbles, fluorinated silica, fluorinated diamond-like carbon and organic thin films. It is shown that this simple and versatile procedure allows the simultaneous quantification of light elements in thin films with thicknesses in the 200-500 nm range and contents lower than 10 at.%.España Mineco CSD2007- 42 CSD2008-00023 MAT2010-21228 MAT2010-1844

Assessment of satisfaction in patients after hysterectomy by myomatous uterus

Objetivo: el objetivo de este estudio es evaluar los resultados, en cuanto a calidad de vida, de aquellas pacientes que han sido sometidas a una histerectomía por útero miomatoso. Material y métodos: se realiza una encuesta sobre calidad de vida a todas las pacientes sometidas a histerectomía con indicación de útero miomatoso, en un hospital de tercer nivel dentro de la red de hospitales del servicio de salud de la Comunidad de Madrid, en el año 2010. Resultados: Se identificaron un total de 152 pacientes a las que se les había realizado una histerectomía por útero miomatoso, de las cuales contestaron la encuesta un total de 112 (74%) pacientes. Cuando se les preguntó a las pacientes si había mejorado su calidad de vida tras la realización de la histerectomía, un 78’6% (88/112) respondió afirmativamente, un 17% (19/112) refirió tener la misma calidad de vida, y un 4’4% (5/112) respondió que su calidad de vida había empeorado tras la intervención. Conclusiones: las pacientes sometidas a una histerectomía por útero miomatoso presentan un alto grado de satisfacción tras la cirugía, comunicando en su mayoría una mejora en cuanto al dolor pélvico previo a la cirugía, y una mejor calidad de vida tras la intervenciónObjective: the objective of this study is to evaluate the results, in terms of quality of life of those patients who have undergone hysterectomy for fibroid uterus. Material and methods: we performed a survey on quality of life for all patients undergoing hysterectomy with uterine fibroid indication in a tertiary care hospital within the hospital network of the health service of the Community of Madrid, in the year 2010. Results: a total of 152 patients which had undergone a hysterectomy for uterine myoma, which answered the survey a total of 112 (74%) patients. When asked patients if they had improved their quality of life after performing a hysterectomy, a 78’6% (88/112) responded affirmatively, 17% (19/112) reported having the same quality of life, and 4.4% (5/112) responded that their quality of life had worsened after surgery. Conclusions: patients undergoing a hysterectomy for uterine fibroids have a high degree of satisfaction after the surgery, communicating mostly an improvement in pelvic pain prior to surgery, and improved quality of life after surger