La familia del paciente en Unidad de Cuidado Intensivo (UCI)

Introducción: Ingresar a la UCI no es una experiencia exclusiva del paciente; implica e involucra directamente a la familia, en aspectos generadores de estrés, estrategias de afrontamiento, temores, actitudes y expectativas, la participación de la familia en el cuidado y el rol del psicólogo. Objetivo: Revisar de los antecedentes teóricos y empíricos sobre la experiencia de la familia en UCI. Metodología: Se revisaron 62 artículos indexados en bases de datos. Resultados: la UCI es algo desconocido tanto para el paciente como para la familia, por esto este entorno acentúa la aparición de síntomas ansiosos, depresivos y en algunos casos estrés post traumático. La muerte es uno de los principales temores que debe enfrentar la familia. Con el propósito de ajustarse a las demandas de la UCI, los familiares exhiben estrategias de afrontamiento enfocadas principalmente en la comunicación, el soporte espiritual y religioso y la toma de decisiones. El cuidado centrado en la familia permite una mejor comunicación, relación con el paciente y personal médico. El papel del psicólogo es poco explorado en el espacio de la UCI, pero este puede promover estrategias de prevención y de rehabilitación en el paciente y su grupo familiar. Discusión: es importante tener en cuenta que la muerte en UCI es una posibilidad, algunos síntomas como ansiedad, depresión pueden aparecer y mantenerse en el tiempo, centrar el cuidado en la familia permite tomar las decisiones basados en el diagnóstico y pronóstico y promueve expectativas realistas. Conclusiones: temores, expectativas, actitudes, estrategias de afrontamiento, factores generadores de estrés permiten explicar y comprender la experiencia de la familia del paciente en UCI.

La presión laboral tendenciosa (Mobbing)

El trabajo de investigación surge en el año 2001, ante la necesidad de hacer frente a una nueva realidad jurídica, el mobbing. Para ello fue decisivo el estudio de lo publicado (básicamente de ramas ajenas al Derecho) pero sobre todo las entrevistas con las víctimas de mobbing y sus asociaciones; este extremo, unido a la ausencia de un tratamiento internacional, obligó a un camino autodidacta para definir mobbing jurídicamente. La Tesis define mobbing como la presión laboral tendente a la autoeliminación de un trabajador mediante su denigración (presión laboral tendenciosa), y con ello por primera vez se tiene una definición de mobbing en línea y media, con plena validez jurídica, que es susceptible de ser memorizada y por lo tanto divulgada, para corregir el problema. El denominado "concepto uniformado de mobbing" recalca la denigración como mecanismo frente a los tratos degradantes y recalca la autoeliminación como finalidad de un comportamiento doloso. El trabajo aporta fórmulas para deslindar casos de mobbing de otras figuras próximas, y en este sentido debe citarse "la regla del 9" para saber si hay mobbing; en sede de estadísticas se critican metodológicamente muchas de ellas presentadas hasta el momento y se aporta alguna en sede de Tribunales; pero sobre todo se advierte de los riesgos jurídicos de una previsible regulación específica antimobbing, mediante el examen de las distintas definiciones que se han esgrimido hasta el momento. La segunda parte de la Tesis profundiza sobre el grado de sensibilización de nuestro ordenamiento jurídico y Tribunales, a cuyo fin se ha trabajado con más de un centernar y medio de sentencias dictadas sobre la materia, y por supuesto la totalidad de las recogidas en las bases de datos de las editoriales. El análisis sirve para apreciar la bondad de la sistemática aquí defendida, poniendo en evidencia errores, y contradicciones. La Tesis advierte que la presión laboral tendenciosa más allá de vulnerar el derecho constitucional al trabajo, o los derechos fundamentales a la integridad moral y el honor, es una transgresión a todo un "espíritu constitucional", y en este sentido se analiza con detalle tanto la posibilidad de recurrir en amparo, como el derecho a la indemnidad para quien se enfrenta a esta situación. Advirtiendo de las ventajas de efectuar esta reacción mediante la modalidad procesal de tutela de los derechos fundamentales, se analiza la recurrida acción del art.50 ET, donde se realizan aportaciones sugerentes como el plazo prescripción o la "doctrina de los antecedentes", y se otorgan respuestas a las preguntas sobre obligación de seguir trabajando y ejecución provisional. En sede de acciones de Seguridad Social, la Tesis distingue entre la incapacidad temporal y permanente (depresiones) y la muerte y supervivencia, aportándose sobre la primera la técnica denominada "interpretación en tres niveles" y descartando la posibilidad de considerar accidente de trabajo el suicidio tras un mobbing por imperativo legal, pero aportando un sucedáneo bastante razonable como es el accidente no laboral. Junto a ello se razona por la viabilidad del recargo del art.123 LGSS. Civilmente, la Tesis se posiciona de "lege ferenda" por reconducir este tipo de acciones resarcitorias del daño psíquico y moral al orden civil, por una mayor explicación sobre el origen del quantum, pero sobre todo considera inadmisible la STS 11-3-04, y ello por una pluralidad de argumentos, pero sobre todo por cuanto viene a autorizar "de facto" este tipo de conductas. La posibilidad de accionar administrativamente frente a este riesgo psicosocial se analiza en un doble terreno, la empresa y la Administración. Si bien el cauce sobre el primero tiene algunos meandros que se desbelan, la situación es radicalmente frustrante en la Administración -donde se encuentra el mayor caldo de cultivo del mobbing- , y ello por el RD 707/2002, pero todavía en mayor medida por el Criterio Técnico 34/2003 mediante el cual la interpretación del Director General de la Inspección de Trabajo y Seguridad Social ha venido tácitamente a derogar parcialmente la Ley de Prevención de Riesgos Laborales para la Administración. En materia penal, la Tesis se decanta "a priori" por dos tipos penales, los delitos contra los derechos de los trabajadores, y el delito de trato degradante; sin embargo, en la práctica sólo este segundo es el camino que puede alcanzar buen puerto. Finalmente se realiza un estudio detallado de la Ley 62/2003, ley que se divulgó como reguladora del acoso moral, y que después se defiende como un avance frente al mobbing. La Tesis advierte que no es cierto ni lo uno, ni lo otro, habiendo creado un "espejismo legal" que puede perjudicar a las víctimas de mobbing, además de no servir su estructura para una futura regulación explícita antimobbing.

Two Boats in the Mediterranean and their Unfortunate Encounters with Europe’s Policies towards People on the Move. CEPS Liberty and Security in Europe No. 48, 20 July 2012

Two stark reminders of the difficulties that people on the move encounter in the Mediterranean have been grabbing headlines recently: the so-called ‘left-to-die’ boat report and the ground-breaking Hirsi judgment. These two instances present the worst of both worlds: the first concerns a migrant boat that was ignored altogether, resulting in many deaths, whereas the second concerns a migrant boat being intercepted but subsequently dealt with in a way that contradicts Europe’s human rights standards. These two cases are neither isolated nor incidental. Instead they are of wider concern to the EU and reminders of structural deficiencies in Europe’s approach to people on the move in the Mediterranean. This paper identifies those cross-cutting deficiencies and proposes recommendations to correct them.

The application of ichnofabrics towards bridging the dichotomy between siliciclastic and carbonate shelf facies: examples from the Upper Jurassic Fulmar Formation (UK) and the Jubaila Formation (Saudi Arabia)

An initial study of the ichnofabrics of the Upper Jurassic (Kimmeridgian) Jubaila Formation of Saudi Arabia shows that the ichnofabrics are closely matched to the relatively well-described ichnofabrics of the contemporary Fulmar Formation of the UK Continental Shelf (North Sea), in respect of the lower shoreface/offshore transition facies to offshore facies. The ichnology and ichnofabrics of the Lower Jubaila Formation show that deposition took place on an open-marine platform on the Arabian craton subject to periodic storm activity, but under a persisting equilibrium between sediment accumulation and subsidence. This is consistent with the moderately deep-marine foraminiferal assemblages and the presence of calcareous nannofossils. Cyclicity is absent, though storm beds may be grouped, in contrast with the genetic sequences present in the rift and halokinetic scenario of the North Sea. In contrast with the siliciclastic setting hardgrotinds (with Gastrochaenolites), more common firmground omission surfaces, and micritic mudstones with Chondrites and Zoophycos are notable features of the carbonate facies. In siliciclastic successions (parasequences) the latter ichnotaxa are generally regarded as having been deposited in rather deeper water, but in the carbonate Jubaila Formation are interpreted as being associated with local areas of lower turbulence. Likewise, the hardgrounds and firmgrounds, which have not been traced laterally, are tentatively regarded to be of local significance.

Water deficits promote flowering in Rhododendron via regulation of pre and post initiation development

Flowering is generally considered to be advanced by water deficits in many woody perennial species. A long-standing paradigm being that as a plant senses severe environmental conditions resources are diverted away from vegetative growth and towards reproduction before death. It is demonstrated that in Rhododendron flowering is promoted under water deficit treatments. However, the promotion of flowering is not achieved via all increase in floral initiation, but through separate developmental responses. If regulated deficit irrigation (RDI) is imposed prior to the time of initiation, fewer vegetative nodes are formed before the apical meristems switch to floral initiation, and chronologically, floral initiation occurs earlier. Both RDI and partial rootzone drying (PRD) treatments stimulate the development of more flowers Oil each inflorescence if the treatments are continued after the plant has undergone floral initiation. However, floral initiation is inhibited by soil water deficits. If the soil water deficit continues beyond the stages of floral development then anthesis call occur prematurely oil the fully formed floral buds without a need for a winter chilling treatment. It is hypothesised that inhibition of floral initiation in plants experiencing severe soil water deficits results from the inhibitory action Of ABA transportation to the apical meristem from stressed roots. It is demonstrated that ABA applications to well-watered Rhododendron inhibit floral initiation. (c) 2008 Elsevier B.V. All rights reserved.

Towards a definition of a crop wild relative

Crop wild relatives are an important socio-economic resource that is currently being eroded or even extinguished through careless human activities. If the Conference of the Parties (COP) to the CBD 2010 Biodiversity Target of achieving a significant reduction in the current rate of loss is to be achieved, we must first define what crop wild relatives are and how their conservation might be prioritised. A definition of a crop wild relative is proposed and illustrated in the light of previous Gene Pool concept theory. Where crossing and genetic diversity information is unavailable, the Taxon Group concept is introduced to assist recognition of the degree of crop wild relative relatedness by using the existing taxonomic hierarchy.

Effect of H-bonding on the ambivalence of SCN- towards copper(II)

Condensations of 2-(2-aminoethyl)pyridine with 4-methylimidazole-5-carboxaldehyde and 1-methyl-2-imidazolecarboxaldehyde generate the tridentate N donor ligands L and L' respectively. Reactions of Cu(NCS)(2) with L and L' yield respectively CuL(SCN)(NCS) (1) containing a CuN4S core and CuL'(NCS)(2) (2) having a CuN5 core. Both the cores are square pyramidal with SCN bound in 1 at the axial position through the S end. This differential behaviour of SCN in the two complexes despite the ligands being very similar, is investigated by DFT calculations at the B3LYP/TZV level. It is found that DFT calculations predict isolation of the Cu(ligand)(NCS)(2) species for both the ligands L and L'. Presence of an offsetting intermolecular H-bonding between the N atom of the thiocyanate and the N-H proton of the ligand L of an adjacent molecule makes the binding of SCN via the S end feasible in 1 resulting in the H-bonded-dimer Cu2L2(SCN)(2)(NCS)(2). The strength of the H-bond is estimated as 27.1 kJ mol (1) from the DFT calculations. The question of such H-bonding does not arise with L' as it lacks in a similar H atom. Dimeric 1 represents a case of two non-interacting spins. (C) 2008 Elsevier B. V. All rights reserved.

Partnering in flight: From being to becoming

Current literature offers little understanding about how procurement methods are enacted in practice. Developments in procurement are often viewed as the result of responding to recommendations from particular constituents within the sector. The research seeks to remove itself from such deterministic leaning, counselling instead that procurement should not be viewed in static terms, but dynamically manifesting over time within a complex web of interconnections between various actors, their situated context and the broader industrial structure. Attention is given to how a client and construction firm engaged in a collusive interaction to realise an innovative procurement method that derived its legitimacy from a backcloth of initiatives promoted by various commentators. A case study of a medium-size regional contractor demonstrates how the first partnering arrangement was enacted within the UK affordable housing maintenance sector in the UK. The case study finds that the enactment of new procurement methods strongly relies on iterative learning between clients and contractors. It is further suggested that construction firms need to initiate new procurement in order to remain competitive within the sector. The findings point towards a pro-active initiative by the contractor and client to enact a ‘procurement first’. Encouragement may be drawn from this example by other contractors seeking to offer more than simply responsive procurement solutions.

Characterisation of cell death in bagged baby salad leaves

Baby leaf salads are gaining in popularity over traditional whole head lettuce salads in response to consumer demand for greater variety and convenience in their diet. Baby lettuce leaves are mixed, washed and packaged as whole leaves, with a shelf-life of approximately 10 days post-processing. End of shelf-life, as determined by the consumer, is typified by bruising, water-logging and blackening of the leaves, but the biological events causing this phenotype have not been studied to date. We investigated the physiological and ultrastructural characteristics during postharvest shelf-life of two lettuce varieties with very different leaf morphologies. Membrane disruption was an important determinant of cell death in both varieties. although the timing and characteristics of breakdown was different in each with Lollo rossa showing signs of aging such as thylakoid disruption and plastoglobuli accumulation earlier than Cos. Membranes in Lollo rossa showed a later, but more distinct increase in permeability than in Cos. as indicated by electrolyte leakage and the presence of cytoplasmic fragments in the vacuole, but Cos membranes show distinct fractures towards the end of shelf-life. The tissue lost less than 25% fresh weight during shelf-life and there was little protein loss compared to developmentally aging leaves in an ambient environment. Biophysical measurements showed that breakstrength was significantly reduced in Lollo rossa, whereas irreversible leaf plasticity was significantly reduced in Cos leaves. The reversible elastic properties of both varieties changed throughout shelf-life. We compared the characteristics of shelf-life in both varieties of bagged lettuce leaves with other leafy salad crops and discuss the potential targets for future work to improve postharvest quality of baby leaf lettuce. (C) 2007 Elsevier B.V. All rights reserved.

Modulation of the human gut microflora towards improved health using prebiotics: assessment of efficacy

There is increasing awareness that the human gut microflora plays a critical role in maintaining host health, both within the gastrointestinal tract and, through the absorption of metabolites, systemically. An 'optimal' gut microflora establishes an efficient barrier to the invasion and colonisation of the gut by pathogenic bacteria, produces a range of metabolic substrates which in turn are utilized by the host (e.g. vitamins and short chain fatty acids) and stimulates the immune system in a non-inflammatory manner. Although little is known about the individual species of bacteria responsible for these beneficial activities, it is generally accepted that the bifidobacteria and lactobacilli constitute important components of the beneficial gut microflora. A number of diet-based microflora management tools have been developed and refined over recent decades including probiotic, prebiotic and synbiotic approaches. Each aims to stimulate numbers and/or activities of the bifidobacteria and lactobacilli within the gut microflora. The aim of this article is to examine how prebiotics are being applied to the improvement of human health and to review the scientific evidence supporting their use.

Pectins and pectic-oligosaccharides inhibit Escherichia coli O157 : H7 Shiga toxin as directed towards the human colonic cell line HT29

Pectins and pectic-oligosaccharides, as derived by controlled enzymatic hydrolysis, were evaluated for their ability to interfere with the toxicity of Shiga-like toxins from Escherichia coli O157:H7. Both types of material resulted in some degree of protection but this was significantly higher (P > 0.01) with the oligosaccharide fractions (giving 90-100% cell survival, compared to 70-80% with the polymer). An effect of methylation on the protective effect was detected with lower degrees being more active. The pectic-oligosaccharides and galabiose, the minimum toxin receptor analogue, were shown to inhibit toxicity and were both protective at 10 mg ml(-1), but not at lower concentrations. (C) 2002 Federation of European Microbiological Societies. Published by Elsevier Science B.V. All rights reserved.

How the brain blinks: towards a neurocognitive model of the attentional blink

When people monitor a visual stream of rapidly presented stimuli for two targets (T1 and T2), they often miss T2 if it falls into a time window of about half a second after T1 onset-the attentional blink (AB). We provide an overview of recent neuroscientific studies devoted to analyze the neural processes underlying the AB and their temporal dynamics. The available evidence points to an attentional network involving temporal, right-parietal and frontal cortex, and suggests that the components of this neural network interact by means of synchronization and stimulus-induced desynchronization in the beta frequency range. We set up a neurocognitive scenario describing how the AB might emerge and why it depends on the presence of masks and the other event(s) the targets are embedded in. The scenario supports the idea that the AB arises from "biased competition", with the top-down bias being generated by parietal-frontal interactions and the competition taking place between stimulus codes in temporal cortex.

Mediating punitiveness: understanding public attitudes towards work-related fatality cases

This paper concerns an empirical investigation into public attitudes towards work-related fatality cases, where organizational offenders cause the death of workers or members of the public. This issue is particularly relevant following the introduction of the Corporate Manslaughter and Corporate Homicide Act 2007 into UK law. Here, as elsewhere, the use of criminal law against companies reflects governmental concerns over public confidence in the law’s ability to regulate risk. The empirical findings demonstrate that high levels of public concern over these cases do not translate into punitive attitudes. Such cases are viewed rationally and constructively, and lead to instrumental rather than purely expressive enforcement preferences.

The hanging man: death, indeterminacy and the event

This article discusses approaches to the interpretation and analysis an event that is poised between reality and performance. It focuses upon a real event witnessed by the author while driving out of Los Angeles, USA. A body hanging on a rope from a bridge some 25/30 feet above the freeway held up the traffic. The status of the body was unclear. Was it the corpse of a dead human being or a stuffed dummy, a simulation of a death? Was it is tragic accident or suicide or was it a stunt, a protest or a performance? Whether a real body or not, it was an event: it drew an audience, it took place in a defined public space bound by time and it disrupted everyday normality and the familiar. The article debates how approaches to performance can engage with a shocking event, such as the Hanging Man, and the frameworks of interpretation that can be brought to bear on it. The analysis takes account of the function of memory in reconstructing the event, and the paradigms of cultural knowledge that offered themselves as parallels, comparators or distinctions against which the experience could be measured, such as the incidents of self-immolation related to demonstrations against the Vietnam War, the protest by the Irish Hunger Strikers and the visual impact of Anthony Gormley’s 2007 work, 'Event Horizon'. Theoretical frameworks deriving from analytical approaches to performance, media representation and ethical dilemmas are evaluated as means to assimilate an indeterminate and challenging event, and the notion of what an ‘event’ may be is itself addressed.

Towards a holistic modelling framework for embodied carbon and waste in the building lifecycle

As the building industry proceeds in the direction of low impact buildings, research attention is being drawn towards the reduction of carbon dioxide emission and waste. Starting from design and construction to operation and demolition, various building materials are used throughout the whole building lifecycle involving significant energy consumption and waste generation. Building Information Modelling (BIM) is emerging as a tool that can support holistic design-decision making for reducing embodied carbon and waste production in the building lifecycle. This study aims to establish a framework for assessing embodied carbon and waste underpinned by BIM technology. On the basis of current research review, the framework is considered to include functional modules for embodied carbon computation. There are a module for waste estimation, a knowledge-base of construction and demolition methods, a repository of building components information, and an inventory of construction materials’ energy and carbon. Through both static 3D model visualisation and dynamic modelling supported by the framework, embodied energy (carbon), waste and associated costs can be analysed in the boundary of cradle-to-gate, construction, operation, and demolition. The proposed holistic modelling framework provides a possibility to analyse embodied carbon and waste from different building lifecycle perspectives including associated costs. It brings together existing segmented embodied carbon and waste estimation into a unified model, so that interactions between various parameters through the different building lifecycle phases can be better understood. Thus, it can improve design-decision support for optimal low impact building development. The applicability of this framework is anticipated being developed and tested on industrial projects in the near future.