Reviewing the evidence base for the Children and Young People Safety Thermometer (CYPST):a mixed studies review

The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods). A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.

Armed Groups and Violence in Paraguay

Armed violence in Paraguay is not a recent phenomenon. During the second half of the XX Century, Paraguay saw the rise of a larger number of underground, revolutionary movements that sought the overthrow of the Alfredo Stroessner’s (1954-1989) government. From among those movements emerged the Partido Patria Libre (or, Free Fatherland, also known for its acronym PPL), made up of a two branches: one legal and the other one, operational. The latter was based on people’s power, as represented by “Ejército del Pueblo Paraguayo” (or, the Paraguayan People’s Army, with acronym EPP). After EPP broke with PPL in March 2008, this Marxist-oriented revolutionary project, which was apparently oriented to put an end to the social, political and economic inequalities in Paraguay, began to carry out markedly criminal activities, which included bank robberies, kidnappings, assassinations, terrorist attacks and armed confrontations. Its strategies and modus operandi utilized by the Armed Revolutionary Forces of Colombia (FARC). Paraguay features a farm sector in a state of crisis, in which cattle-ranchers, peasants and agro-exporting companies live in a constant strife. The Paraguayan Departments that are the most affected by this situation are Concepciόn, San Pedro, Canindeyú y Caazapá, which also suffer from a weak government presence. This deficiency has made these departments ripe for drug-trafficking activity by Brazilian groups such as Primer Comando Capital (i.e., First Capital command), also PCC and Comando Vermelho, (i.e., The Red Command). That is why many peasants, now recruited by EPP, have joined the drug-trafficking business and that, not only as marihuana growers but as “campanas” (i.e., early warning sentinels) for the organization. This helps shape their attitudes for their future involvement in all areas of drug-trafficking. Paraguayan society is the result of social inequity and inequality, such as those resulting from a lack of opportunity. Although Paraguay has successfully recovered from the last world economic crisis, economic growth, by itself, does not ensure an improvement in the quality of life. As long as such economic and social gaps persist and the government fails to enact the policies that would result in a more just society and toward EPP neutralization or containment, the latter is bound to grow stronger. In this context, the situation in Paraguay calls for more research into the EPP phenomenon. It would also seem necessary for Paraguay to promote an open national debate that includes all sectors of society in order to raise consciousness and to induce society to take actual steps to eliminate the EPP, as well as any other group that might arise in the immediate future. EPP has strong connections with the Frente Patriόtico Manuel Rodríguez in Chile and other armed groups and peasant movements in other countries of this region. Although most governments in the region are aware that the armed struggle is not a solution to current problems, it might be worth it to hold a regional debate about armed or insurgent groups in Latin American to seek common strategies and cooperation on dealing with them since the expansion of these armed groups is a problem for all.

Second Quarter 2016: Slowdown for Large Hotels Continues; Small Hotels Have Now Slowed as Well

Our Standardized Unexpected Price (SUP) metric continues to show a decline in the price of large hotels, and now also the price of small hotels has eased—even though hotel transaction volume has increased. Although debt and equity financing for hotels remain relatively inexpensive, we are concerned that the total volatility of hotel returns is greater relative to the return volatility for other commercial real estate. If this trend continues, lenders will eventually start to tighten hotel lending standards. Our early warning indicators all continue to suggest that the downward trend in hotel prices should continue into the next quarter. This is report number 19 of the index series.

Exploring associations between violent discipline and aggressive behavior in children ages 4-5 in The Republic of Nicaragua: A secondary data analysis of the 2011 Demographic and Health Survey

Thesis (Master's)--University of Washington, 2016-06

Third Quarter 2016: Hotels Exhibit Positive Momentum

Our Standardized Unexpected Price (SUP) metric showed an uptick in the price of large hotels during the third quarter of 2016, with a continued decline in the price of small hotels. Although debt and equity financing for hotels were still relatively inexpensive during this quarter, we remain concerned that the increasing relative riskiness of hotels compared to other commercial real estate suggests that lenders will eventually start to tighten hotel lending standards if this trend continues. Our early warning indicators continue to suggest an eventual downward trend in large hotel prices. This is report number 20 of the index series.

Panoramic Sea Happening (After Kantor): Video Installation

Panoramic Sea Happening (After Kantor) is a 7 minute durational film that reimagines part of Tadeusz Kantor's original sea happenings from 1967 in a landscape in which the sea has retreated. The conductor of Kantor’s original performance is replaced with a sound object cast adrift on a beach in Dungeness (UK). The object plays back the sound of the sea into the landscape, which was performed live and then filmed from three distinct angles. The first angle mimics the position of the conductor in Kantor’s original happening, facing outwards into the horizon of the beach and recalls the image in Kantor’s work of a human figure undertaking the absurd task of orchestrating the sound of a gigantic expanse of water. The second angle exposes the machine itself and the large cone that amplifies the sound, reinforcing the isolation of the object. The third angle reveals a decommissioned nuclear power station and sound objects used as a warning system for the power plant. Dungeness is a location where the sea has been retreating from the land, leaving traces of human activity through the disused boat winches, abandoned cabins and the decommissioned nuclear buildings. It is a place in which the footprint of the anthropocene is keenly felt. The sound object is intended to act as an anthropomorphic figure, ghosting the original conductor and offering the sound of the sea back into the landscape through a wide mouthpiece, echoing Kantor’s own load hailer in the original sequence of sea happenings. It speculates on Kantor's theory of the bio-object, which proposed a symbiotic relationship between the human and the nonhuman object in performance, as a possible instrument to access a form of geologic imagination. In this configuration, the human itself is absent, but is evoked through the objects left behind. The sound object, helpless in a red dingy, might be thought of as a co-conspirator with the viewer, enabling a looking back to the past in a landscape of an inevitable future. The work was originally commissioned by the University of Kent in collaboration with the Polish Cultural Institute for the Symposium Kantorbury Kantorbury in Canterbury (UK) to mark the 100 years since Tadeusz Kantor’s birth (15 - 19 September 2015). It should be projected and requires stereo speakers.

Spatial and Temporal Variations in Airborne Ambrosia Pollen in Europe

Aim: The European Commission Cooperation in Science and Technology (COST) Action FA1203 “SMARTER” aims to make recommendations for the sustainable management of Ambrosia across Europe and for monitoring its efficiency and cost effectiveness. The goal of the present study is to provide a baseline for spatial and temporal variations in airborne Ambrosia pollen in Europe that can be used for the management and evaluation of this noxious plant . Location: The full range of Ambrosia artemisiifolia L. distribution over Europe (39oN-60oN; 2oW-45oE). Methods: Airborne Ambrosia pollen data for the principal flowering period of Ambrosia (August-September) recorded during a 10-year period (2004-2013) were obtained from 242 monitoring sites. The mean sum of daily average airborne Ambrosia pollen and the number of days that Ambrosia pollen was recorded in the air were analysed. The mean and Standard Deviation (SD) were calculated regardless of the number of years included in the study period, while trends are based on those time series with 8 or more years of data. Trends were considered significant at p < 0.05. Results: There were few significant trends in the magnitude and frequency of atmospheric Ambrosia pollen (only 8% for the mean sum of daily average Ambrosia pollen concentrations and 14% for the mean number of days Ambrosia pollen was recorded in the air). Main conclusions: The direction of any trends varied locally and reflect changes in sources of the pollen, either in size or in distance from the monitoring station. Pollen monitoring is important for providing an early warning of the expansion of this invasive and noxious plant.

A Stationless Bikeshare Proof of Concept for College Campuses

Bikeshares promote healthy lifestyles and sustainability among commuters, casual riders, and tourists. However, the central pillar of modern systems, the bike station, cannot be easily integrated into a compact college campus. Fixed stations lack the flexibility to meet the needs of college students who make quick, short-distance trips. Additionally, the necessary cost of implementing and maintaining each station prohibits increasing the number of stations for user convenience. Therefore, the team developed a stationless bikeshare based on a smartlock permanently attached to bicycles in the system. The smartlock system design incorporates several innovative approaches to provide usability, security, and reliability that overcome the limitations of a station centered design. A focus group discussion allowed the team to receive feedback on the early lock, system, and website designs, identify improvements and craft a pleasant user experience. The team designed a unique, two-step lock system that is intuitive to operate while mitigating user error. To ensure security, user access is limited through near field ii communications (NFC) technology connected to a mechatronic release system. The said system relied on a NFC module and a servo working through an Arduino microcontroller coded in the Arduino IDE. To track rentals and maintain the system, each bike is fitted with an XBee module to communicate with a scalable ZigBee mesh network. The network allows for bidirectional, real-time communication with a Meteor.js web application, which enables user and administrator functions through an intuitive user interface available on mobile and desktop. The development of an independent smartlock to replace bike stations is essential to meet the needs of the modern college student. With the goal of creating a bikeshare that better serves college students, Team BIKES has laid the framework for a system that is affordable, easily adaptable, and implementable on any university expressing an interest in bringing a bikeshare to its campus.

Novas tecnologias para o controle da giberela do trigo na safra 2014 no sudoeste do Paraná

The work consists in wheat production system and the evolution of damage caused by wheat scab. The study considers the lack of resistant cultivars to the disease, the low efficiency of chemical control and the presence of mycotoxins in grains. The study aimed to confirm the effectiveness of fungicides prothioconazole and metconazole; prove the bar deposition efficiency with nozzles directed jets the side of the ear resulting in full coverage of trapped anthers; prove the viability of using a warning system (application after the start of flowering before the onset of rains provided for future 24-48 hours and try to improve the efficiency in controlling scab. The experiment was conducted in the experimental field of Technological University Federal do Paraná in the city of Pato Branco, Paraná, conducted in two seasons, the first established on May 6, 2014 and the second on 21 May 2014. It was used to cultivate Amethyst field of OR Improvement seeds, . Passo Fundo, Rio Grande do Sul Treatments consisted of a control without fungicide application and one and two applications of prothioconazole + 17.5% trifloxystrobin (Fox) 500 ml / ha; metconazole 8.0% + pyraclostrobin 13% ( Opera Ultra) 750 mL / ha In the evaluation, second season, metconazole + pyraclostrobin with two application statistically was the treatment that showed a lower incidence in spikes reducing from 100 to 63.3%;. metconazole + pyraclostrobin performed better also in reducing the incidence of spikelets, 80.3% to 34.7%; the control ears had better results in the second season with two applications of metconazole + pyraclostrobin; in spikelets, in his first season, metconazole + pyraclostrobin with two application resulted in better control with 67%; with two applications of metconazole + pyraclostrobin gave the highest yield even under climatic conditions favorable to disease; metconazole + pyraclostrobin in both seasons showed superior efficiency in controlling FHB giving greater weight gain; with two application of both fungicides, the hectoliter weight was 81 and 79, respectively, each fungicide; the application of fungicides was made in advance of expected rain, occurring seven days of rain and a total volume of 85,2mm the first time, and 16 days of rain and an accumulation of 400 mm in the second period; the test efficiency can be confirmed when the direction of the spray jets launched wings coupled in double nozzle bodies perpendicular to the target upright reaches the sides of the spike. The metconazole + pyraclostrobin proved the most effective fungicide against the prothioconazole + trifloxystrobin in wheat scab control in the 2014 harvest.

Post-Traumatic Stress Disorder (PTSD) and Its relationship with perinatal bereavement: definitions, reactions, adjustments, and grief.

A small percentage of women present with diagnosed PTSD post childbirth; however, though this an area of increasing research and clinical interest generally, little is known about PTSD in relation to perinatal bereavement. Health professionals must however be aware of the mechanisms and models of loss following perinatal bereavement in order to identify potential mental health phenomena which may be implicated in the development of PTSD symptomology. Understanding the predictive factors which may give early warning signs is an important component of the clinical evidence base. This chapter discusses mechanisms, models, and risk factors in relation to perinatal bereavement and the development of PTSD.

Empleo de la diplomacia preventiva por parte de la Organización de Naciones Unidas en el conflicto de Kosovo de 1998-1999

En el interés de alcanzar la estabilidad y promover el mantenimiento de la paz internacional, la diplomacia preventiva nace como un concepto generador de estrategias encaminadas a actuar antes, durante y después del conflicto. El siguiente documento busca analizar el funcionamiento de los instrumentos de diplomacia preventiva empleados por las Naciones Unidas en la crisis de Kosovo de 1998 y 1999. Esta crisis surgida a raíz del conflicto entre el gobierno serbio y un movimiento disidente, conocido como el Ejército de Liberación Albano-Kosovar, que pretendía darle un perfil más autónomo al territorio y a la población albano-kosovar, reveló una serie de debilidades estructurales que sigue enfrentando este mecanismo en la resolución de conflictos étnicos al interior de los Estados.

Analysis of slip distribution of large earthquakes oriented to tsunamigenesis characterisation

The present thesis focuses on the on-fault slip distribution of large earthquakes in the framework of tsunami hazard assessment and tsunami warning improvement. It is widely known that ruptures on seismic faults are strongly heterogeneous. In the case of tsunamigenic earthquakes, the slip heterogeneity strongly influences the spatial distribution of the largest tsunami effects along the nearest coastlines. Unfortunately, after an earthquake occurs, the so-called finite-fault models (FFM) describing the coseismic on-fault slip pattern becomes available over time scales that are incompatible with early tsunami warning purposes, especially in the near field. Our work aims to characterize the slip heterogeneity in a fast, but still suitable way. Using finite-fault models to build a starting dataset of seismic events, the characteristics of the fault planes are studied with respect to the magnitude. The patterns of the slip distribution on the rupture plane, analysed with a cluster identification algorithm, reveal a preferential single-asperity representation that can be approximated by a two-dimensional Gaussian slip distribution (2D GD). The goodness of the 2D GD model is compared to other distributions used in literature and its ability to represent the slip heterogeneity in the form of the main asperity is proven. The magnitude dependence of the 2D GD parameters is investigated and turns out to be of primary importance from an early warning perspective. The Gaussian model is applied to the 16 September 2015 Illapel, Chile, earthquake and used to compute early tsunami predictions that are satisfactorily compared with the available observations. The fast computation of the 2D GD and its suitability in representing the slip complexity of the seismic source make it a useful tool for the tsunami early warning assessments, especially for what concerns the near field.

New dimensions in early flood warning across the globe using grand-ensemble weather predictions

Early and effective flood warning is essential to initiate timely measures to reduce loss of life and economic damage. The availability of several global ensemble weather prediction systems through the “THORPEX Interactive Grand Global Ensemble” (TIGGE) archive provides an opportunity to explore new dimensions in early flood forecasting and warning. TIGGE data has been used as meteorological input to the European Flood Alert System (EFAS) for a case study of a flood event in Romania in October 2007. Results illustrate that awareness for this case of flooding could have been raised as early as 8 days before the event and how the subsequent forecasts provide increasing insight into the range of possible flood conditions. This first assessment of one flood event illustrates the potential value of the TIGGE archive and the grand-ensembles approach to raise preparedness and thus to reduce the socio-economic impact of floods.

Early Complication Rates in a Single-Surgeon Series of 2500 Robotic-Assisted Radical Prostatectomies: Report Applying a Standardized Grading System

Background: Perioperative complications following robotic-assisted radical prostatectomy (RARP) have been previously reported in recent series. Few studies, however, have used standardized systems to classify surgical complications, and that inconsistency has hampered accurate comparisons between different series or surgical approaches. Objective: To assess trends in the incidence and to classify perioperative surgical complications following RARP in 2500 consecutive patients. Design, setting, and participants: We analyzed 2500 patients who underwent RARP for treatment of clinically localized prostate cancer (PCa) from August 2002 to February 2009. Data were prospectively collected in a customized database and retrospectively analyzed. Intervention: All patients underwent RARP performed by a single surgeon. Measurements: The data were collected prospectively in a customized database. Complications were classified using the Clavien grading system. To evaluate trends regarding complications and radiologic anastomotic leaks, we compared eight groups of 300 patients each, categorized according the surgeon`s experience (number of cases). Results and limitations: Our median operative time was 90 min (interquartile range [IQR]: 75-100 min). The median estimated blood loss was 100 ml (IQR: 100-150 ml). Our conversion rate was 0.08%, comprising two procedures converted to standard laparoscopy due to robot malfunction. One hundred and forty complications were observed in 127 patients (5.08%). The following percentages of patients presented graded complications: grade 1, 2.24%; grade 2, 1.8%; grade 3a, 0.08%; grade 3b, 0.48%; grade 4a, 0.40%. There were no cases of multiple organ dysfunction or death (grades 4b and 5). There were significant decreases in the overall complication rates (p = 0.0034) and in the number of anastomotic leaks (p < 0.001) as the surgeon`s experience increased. Conclusions: RARP is a safe option for treatment of clinically localized PCa, presenting low complication rates in experienced hands. Although the robotic system provides the surgeon with enhanced vision and dexterity, proficiency is only accomplished with consistent surgical volume; complication rates demonstrated a tendency to decrease as the surgeon`s experience increased. (C) 2010 European Association of Urology. Published by Elsevier B. V. All rights reserved.

Transcriptional Response of Peripheral Lymphocytes to Early Fibrosarcoma: A Model System for Cancer Detection Based on Hybridization Signatures

Since circulating leukocytes, mainly B and T cells, continuously maintain vigilant and comprehensive immune surveillance, these cells could be used as reporters for signs of infection or other pathologies, including cancer. Activated lymphocyte clones trigger a sensitive transcriptional response, which could be identified by gene expression profiling. To assess this hypothesis, we conducted microarray analysis of the gene expression profile of lymphocytes isolated from immunocompetent BALB/c mice subcutaneously injected with different numbers of tumorigenic B61 fibrosarcoma cells. Flow cytometry demonstrated that the number of circulating T (CD3(+)CD4(+) or CD3(+)CD8(+)) or B (CD19(+)) cells did not change. However, the lymphocytes isolated from tumor cell-injected animals expressed a unique transcriptional profile that was identifiable before the development of a palpable tumor mass. This finding demonstrates that the transcriptional response appears before alterations in the main lymphocyte subsets and that the gene expression profile of peripheral lymphocytes can serve as a sensitive and accurate method for the early detection of cancer. Exp Biol Med 234:802-812, 2009