Special commentary : a call for intensive metabolic support.

PURPOSE OF REVIEW: This special commentary addresses recent clinical reviews regarding appropriate nutrition and metabolic support in the critical care setting. RECENT FINDINGS: There are divergent approaches between North America and Europe for the use of early nutrition support and combined enteral nutrition and parenteral nutrition support possibly due to the commercial availability of specific parenteral nutrients. The advent of intensive insulin therapy has changed the landscape of metabolic support in the intensive care unit, and previous notions about infective risk of parenteral nutrition will need to be re-addressed. Patients with brain failure may benefit from an intensive insulin therapy with a blood glucose target that is higher than that used in patients without brain failure. Patients with heart failure may benefit from the addition of nutritional pharmacology that targets proximate oxidative pathophysiological pathways. Intradialytic parenteral nutrition may be viewed as another form of supplemental parenteral nutrition when enteral nutrition is insufficient in patients on hemodialysis in the intensive care unit. SUMMARY: It is proposed that intensive metabolic support be routinely implemented in the intensive care unit based on the following steps: intensive insulin therapy with an appropriate blood glucose target, nutrition risk assessment, early and if needed combined enteral nutrition and parenteral nutrition to target 20-25 kcal/kg/day and 1.2-1.5 g protein/kg/day, and nutritional and metabolic monitoring.

Exploration of the social dimension of corporate responsibility in a welfare state

This study focuses on corporate social responsibility (or CSR)as the latest dimension to emerge in the corporate responsibility and sustainability agenda, which in the recent past has rapidly risen to the top of the list of concerns for civil societies worldwide. Despite the continuing debates and discussions about the scope, benefits, and impacts of CSR to business and community in various sectors, levels, and types of society, many companies have moved forward to confront the opportunities and challenges of CSR. Thus, this study is about those proactive companies with a focus on the importance of CSR and its management inside and outside the company. It is an exploration and learning from the experience of Finnish companies, as well as other actors interested or involved in shaping the course of CSR, locally and globally. It also looks closely at how national culture affects the views, thinking, and management of CSR in a welfare state. This dissertation primarily draws on the analyses of information collected from a series of qualitative interviews and the existing literature in the area. This is complemented by an analysis of written and published documents on CSR from various sources. The results of the study give insightful information and detailed descriptions of a roadmap useful in learning and understanding CSR in Finnish companies. Despite the varying conceptual connotations, essential roadmap indicators point to the importance of framing CSR within the corporate responsibility concept, Finnish development and the welfare state system, globalization, stakeholders, and the pursuit of sustainable development as the main drivers of CSR, the remarkable progress of CSR in companies, and identification of key management areas and practices relevant to CSR. Similarly,the study reveals the importance of culture as essential in understanding and learning CSR. Finnish culture has a positive influence on the views, thinking, and management practices of CSR issues. Such a positive influence of culture, therefore, makes it easy for business people to discuss and understand CSR, because those CSR issues are already considered common and taken-for-granted by Finns and are implicit in the welfare state provisions. The experience of Finnish companies in implementing CSR policies in the supply chain is a concrete proactive step in advancing the message of CSR, that is, to bring companies and suppliers together to work on improving and strengthening relationships towards socially responsible practices worldwide. Such a forward step to deal with CSR issues in the supply chain reflects the companies' commitments and belief that CSR can be managed with the suppliers and gain positive benefits. Despite the problems and complexities, particularly in the global supply chain, managing CSR for Finnish companies presents new opportunities and challenges that are expected to intensify in the near future. The focus on CSR policy implementation inthe supply chain points to the importance of companies taking initiatives and forging cooperation with suppliers with the aim of addressing and improving CSR questions in the supply chains. The proactive stance of Finnish companies toward CSR is complemented by the active supporting role of important societalactors such as the government and NGOs. These actors carry out various promotional efforts and campaigns, thus bringing CSR into the mainstream of Finnish companies and strengthening the synergistic learning about CSR within the Finnish business and civil circles. The efforts of the government and NGOs to promote CSR are indicative of the importance of multipartite involvement and the emergence of better civil regulations. Likewise, their drive to learn from each other, exchange experiences, and contribute in CSR debates facilitated the evolution of CSRnetworks in the country. The results of this study add to the mounting evidence that CSR, in general, has created a new dimension in managing corporate sustainability. This study provides compelling empirical evidence and some direct quotations about CSR in the Finnish context. This information can be used to learn and gain new useful insights, approaches, and concepts for managing CSR.

Riskivastuullisuus turvallisuuskasvatuksen kulttuurissa. Oppilaiden vastuullisuus, turvallisuustaju ja tuottamistoiminnan riskiraja peruskoulun käsityön opetuksessa

Riskit ja riskittömyys uhkaavat yksilöitä, käsityötä ja yhteiskuntaa. Käsityökasvatukselleon haaste toimia kulttuurissa, joka tavoittelee täyttä riskittömyyttä. Käsityössä kasvatetaan kekseliäisyyteen ja varautumaan sen aiheuttaman riskin kohtaamiseen sekä ottamaan siitä vastuuta. Tämän tutkimuksen tehtävänä on riskivastuullisuuden mallin rakentamiseksi selvittää, kuinka oppilaiden vastuullisuus selittää riskirajaa käsityön turvallisuuskasvatuksen kulttuurissa. Välinearvojen saavuttamiseksi on siedettävä välineriskiä, joka ei ylitä turvallisuuskulttuurin riskirajaa. Välinearvot ovat välineiden laatua lisääviä ominaisuuksia, joilla pyritään peittämään välineriskejä. Siedettävän riskin rajan ratkaisemiseen tarvitaan tietoa käsityön tuottamisesta ja todellisuutta havainnoivien tiedonalojen tietoa. Viime kädessä ratkaisu tehdään rakentavalla ajattelulla, johon kuuluu välinearvojen tavoittelua ohjaava käsityötaju ja välineriskeihin varautumista ohjaava turvallisuustaju. Käsityössä onnistuminen kannustaa kohti uusia haasteita ja epäonnistumisen riski asettuu mittasuhteisiinsa. Kekseliäässä käsityön kulttuurissa kokeillaan omia ja ympäröivän todellisuuden mahdollisuuksia ottamalla oivaltaen riskejä, jotka saavat aikaan rakentavan kokemuksen riskistä. Käsityö on riskioivallusten oppiaine. Tutkimustehtävän toteuttamiseksi tässä tutkimuksessa rakennetaan uusi riskivastuullisuuden malli, jossa vastuullisuus selittää riskirajaa. Mallin vastaavuutta selvitetään valtakunnallisesti peruskoulun käsityön 6. ja 9. luokan käsityön opetuksessa (n = 393). Aineisto on analysoitu rakenneyhtälöanalyysein konfirmatorisella faktorianalyysilla ja polkumallinnuksella. Tutkimusaineisto ja riskivastuullisuuden malli vastaavat toisiaan. Vastuullisuuden selitysosuus turvallisuustajun ja käsityötajun ratkaisemasta riskirajasta on mallin mukaan 35 %. Oppilaat osoittivat tuntevansa oman tuottamisensa vaikutuksia ja vastuuta niistä. Vastuullisuus osoittautui tärkeäksi riskirajan selittäjäksi, joten käsityön turvallisuuskasvatuksen kulttuuri voi kohota uudelle tasolle riskivastuulliseksi. Käsityön turvallisuuskasvatus on kokonaisvaltaista turvallisuustajun kasvatusta. Riskivastuullisuus luo turvallisuuskulttuuriin yhteisen käsityksen siedettävän riskin rajasta. Oppilaiden mahdollisuuksia kekseliääseen tutkivaan tuottamiseen on vahvistettava eikä rajoitettava. Riskivastuullisessa käsityön turvallisuuskasvatuksen kulttuurissa opettajan tehtävänä ei ole estää mitään tapahtumasta vaan saada mahdollisimman paljon tapahtumaan, sillä vastuullisuus kasvaa vastuuta ottamalla. Se on kasvatuksen – käsityökasvatuksen – keino turvallisuustyössä.

Estado nutricional y características relacionadas en menores de cinco años en la ciudad de Bogotá, 2009

Introducción: La desnutrición infantil es una importante preocupación en países en desarrollo y se relaciona con condiciones de pobreza. Metodología: Estudio secundario de una muestra de 1.232 datos de menores de cinco años con diagnóstico nutricional obtenido en forma retrospectiva en la evaluación del SISVAN año 2009 para Bogotá. Se utilizó para el procesamiento de la información Epi Info 6.04 y SPSS 17.0. Resultados: Se encontró que el 37.2% de los menores está en riesgo de desnutrición, el 27.3% tiene desnutrición aguda y el 7.2% desnutrición crónica. Fontibón y Chapinero presentan la mayor desnutrición aguda y crónica respectivamente. Los menores con reducidos ingresos familiares, de estrato uno, con madres que estudian y trabajan, divorciadas o viudas, o que sean desplazados actuales presentan mayor riesgo de desnutrición. La desnutrición aguda es mayor en los niños con desplazamientos mayores de un año o con esquemas de vacunación incompleto. Cuando se presentan inadecuadas condiciones de saneamiento, peso al nacer inferior a 2000 gramos, madres con escolaridad primaria o grupos etáreos entre 3 y 5 años se observa mayor desnutrición crónica. Quienes reciben lactancia materna exclusiva presentan menor desnutrición aguda y crónica. Conclusiones: En la población estudiada, el riesgo de desnutrición está por encima de la desnutrición aguda y crónica. Los resultados sugieren que la desnutrición y el riesgo de desnutrición pueden ser reducidos mejorando educación materna, saneamiento, prolongando la lactancia y cumpliendo esquemas de vacunación.

Descripción de la Estructura Organizacional del área de Responsabilidad Social de PepsiCo Colombia en el año 2013

En línea con el artículo de Descripción organizacional de Helm Bank, este artículo es un aporte investigativo adicional al Proyecto general de “Descripción de las estructuras organizacionales de las áreas de Responsabilidad Social Empresarial” del investigador Rafael Piñeros de la Universidad del Rosario. Este artículo permite evaluar y entender la perspectiva desde el ángulo de una empresa multinacional que opera en casi todos los países del mundo en el sector de alimentos y bebidas, y que debe lograr adaptar su modelo de negocio y desarrollo sostenible de acuerdo al ambiente donde se desempeña, manteniendo unos lineamientos globales pero adaptados a las necesidades de las comunidades locales. Resulta muy interesante identificar la importancia que para PepsiCo tiene la Responsabilidad Social y su evolución para asegurar unos rendimientos y una sostenibilidad en el largo plazo que permite a la compañía y a las comunidades donde opera seguir creciendo, crear valor compartido y obtener beneficios a lo largo del tiempo.

Caracterización del perfil nutricional de pacientes pediátricos hospitalizados en la Clínica Infantil Colsubsidio

Introducción: La desnutrición intrahospitalaria es variable en los estudios publicados. Tiene impacto en el curso tórpido de la enfermedad, en la prolongación de la estancia hospitalaria y en los altos costos subsecuentes. No existen estudios realizados en Colombia en relación al estado nutricional del paciente pediátrico hospitalizado. Por este motivo se decidió caracterizar el perfil nutricional de pacientes pediátricos hospitalizados en la Clínica Infantil Colsubsidio Materiales y métodos: Se desarrolló un estudio transversal en pacientes pediátricos hospitalizados en un periodo entre Junio 2014 – Marzo 2015. Se realizó descripción de las variables y análisis univariado. Resultados: Se analizaron 320 pacientes: 50% niños y 50% niñas. Edad promedio: 4.6 años, predominio del grupo de los lactantes. Media de estancia hospitalaria: 4,6 días. Baja ingesta, ayuno, dolor de moderada intensidad y factor de estrés grado I fueron las variables más frecuentemente relacionadas con desnutrición. Al ingreso a hospitalización el 57.5 % se encontraron eutróficos, el 17.19% con desnutrición crónica, el 8.44% con desnutrición aguda y el 16.88% con aumento anormal de peso. Al egreso, los eutróficos disminuyeron a 56.25 %, la desnutrición crónica y el aumento anormal de peso se mantuvieron igual y la desnutrición aguda aumento al 10%. Conclusión: Los hallazgos de este estudio están en concordancia con los hallazgos descritos en la literatura. El mayor compromiso nutricional se asoció a patologías respiratorias y gastrointestinales y a mayor estancia hospitalaria.

Desire for memory, desire for museums: the experience of the Memory Hotspots

Considering the principles of the National Museum Policy, created in 2003, the Brazilian Museums Institute – Ibram supports and encourages the development of museum practices and processes aimed at rewriting the history of social groups which were deprived of the right to narrate and exhibit their memories and their heritage. As effective action, in 2008, the Department of Museums and Cultural Centres (Demu/Iphan) – which gave rise to Ibram in January 2009 – started the Memory Hotspots Programme, with the main goal of fostering wide popular participation in matters related to social memory and museums. The Memory Hotspots Programme was inspired in and directly influenced by the Ministry of Culture/MinC, which created the National Programme for Culture, Education and Citizenship (Living Culture). The purpose of this Programme is to contribute to make society conquer spaces, exchange experiences and develop initiatives that foster culture and citizenship, in a proactive manner. The partnership struck between civil society and the state power gave rise to Culture Hotspots, inspired in the anthropological “do-in” concept, idealized by the then Minster Gilberto Gil.

Prevalence and severity of dental caries in schoolchildren of Porto, Portugal

Objectives: To measure the prevalence and severity of dental caries in adolescents of the city of Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental caries experience. Methods: A sample of 700 thirteen-year-old schoolchildren was examined. Results from the dental examination were linked to anthropometric information and to data supplied by two structured questionnaires assessing nutritional factors, socio-demographic characteristics and behaviour related to health promotion. Dental caries was measured using the DMFT index, and two dichotomous outcomes, one assessing the prevalence of dental caries (DMFT>0); the other assessing the prevalence of a high level of dental caries (DMFT=4). Results: Consuming soft drinks derived from cola (irrespective of sugared or diet) two or more times per week, attending a public school, being female and having parents with low educational attainment were identified as risk factors both for having dental caries and for having a high level of dental caries. Conclusion: Caries levels were positively associated with frequency of intake of sweetened foods and drinks.

Overweight and obesity related factors in schoolchildren in Santa Catarina State, Brazil

The purpose of this study is to determine the correlation of socioeconomic, dietary, and anthropometric-nutritional variables of parents and their children to overweight (including obesity) in schoolchildren in Santa Catarina State, Brazil. This is a transversal study conducted on 4,964, 6 to 10-year-old schoolchildren registered in 345 Santa Catarina elementary schools. The following data were acquired: the children`s current weight and height, birth weight and length, duration of breastfeeding, age at which water, herbal tea and other foods were introduced to their diet; parental income, education level, age, weight and height were also obtained. The prevalence of overweight and obese children were estimated by point and by interval with a 95% confidence; prevalence rates were obtained based on the Poisson model. An hierarchical approach was used, in which variables were adjusted within blocks and included in the model when they presented p<0.05 at the outcome (overweight including obesity). The results indicate that 47.8% of the subjects were male. The prevalence of overweight and obese students was 15.4% (C195%: 14.4%-16.5%) and 6.1% (CI95%: 5.4%-6.7%) respectively and were statistically similar among sexes and age ranges. BMI values were higher in males and among older children (p<0.05). After adjustment within and among blocks, the variables per capita household income and parents` BM I values remained associated with overweight (including obesity). Overweight (including obesity) in schoolchildren is associated with a higher per capita household income and parental overweight and obesity.

A percepção dos riscos na atividade pericial: um estudo de caso, considerando a cultura da organização com um breve olhar fenomenológico à gestão

A pesquisa objetivou analisar e compreender, considerando os aspectos culturais da organização, como os servidores do Instituto de Criminalística percebem os riscos em seus ambientes interno e externo. A integração das dimensões investigadas (cultura, risco, percepção e gestão) a última sob um breve olhar fenomenológico, possibilitou desvelar até que ponto os valores da organização policial interferem na percepção dos riscos, adicionando uma contribuição às escassas publicações sobre o tema. Em busca da cultura da organização policial, uma incursão histórica esquadrinhou a linhagem da polícia e da Criminalística. No caminho metodológico, deparou-se com raras publicações sobre o tema, demandando um desenho específico para o estudo de caso, considerando o seu contexto atual, em caráter exploratório sobre o foco investigado. Uma abordagem qualitativa, acompanhada de dados estatísticos obtidos na própria instituição, favoreceu a compreensão do problema, envolvendo valores e riscos. Foram desenhadas planilhas ajustadas à realidade da unidade e orientadas aos gestores das seções internas e externas, configurando um mapa de risco do Instituto, resultando em um documento, sem precedentes, tipológico dos riscos na atividade pericial. Levantamento bibliográfico, documental, entrevistas e questionários, garantiram integridade à pesquisa. Em termos práticos, as identificações dos riscos (incluindo o mapa) e os esclarecimentos sobre a cultura, favorecerão, aos administradores, a programação de ações de gestão, visando à redução de instabilidades e tensões que contribuem para a ocorrência de acidentes e perdas no âmbito da criminalística. Concluiu-se, que a percepção e a própria gestão dos riscos são sensíveis às influências de valores culturais, exigindo dos gestores e administrados, em ação participativa, a construção de um ambiente redutor de instabilidades e tensões com a relevância do humano cuja essencialidade representou a senda de partida, de chegada e para retomada, na gestão organizacional.

Responsabilidade social e investimento social privado na empresa GTECH Brasil: estudo de caso

Esta dissertação traça uma trajetória, evitando, no entanto, uma linha evolucionista, dos termos e conceitos que foram usados no decorrer da história para identificar as intervenções das empresas em ações sociais, desde as atuações assistencialistas até a atuação direta em projetos, com criação de institutos e fundações ligados às empresas, compartilhando não só investimentos financeiros, mas conhecimento, tecnologia e mão de obra especializada. Mas, como veremos, só isso não é suficiente para que uma empresa seja caracterizada como socialmente responsável. Como parâmetro, será trabalhada a diferenciação entre responsabilidade social empresarial (RSE) e investimento social privado (ISP), usando as definições e modelos do Instituto Ethos de Responsabilidade Social e do Grupo de Institutos e Fundações e Empresas (GIFE), respectivamente. Como estudo de caso, será apresentada a GTECH Brasil, empresa multinacional do ramo de loterias online, que, para realizar ações sociais, criou o Instituto Gtech de Cidadania e Cultura (IGCC), em 2000. A empresa, fazendo uso da verba disponível de incentivo à cultura, com a Lei Rouanet, realizou um projeto corporativo de arte-educação, chamado Projeto Asa, que tinha por foco trabalhar com jovens de sete a 17 anos, englobando arte e tecnologia. Por acreditar no poder transformador da arte, o projeto foi se atualizando e passou a desenvolver o conceito de arte-cidadania. O Asa funcionou até 2009, durando mais do que a própria empresa, que, em 2006, encerrou as atividades no Brasil. Nesse período, atendeu a mais de 3.500 crianças e jovens. Por meio de documentos, manuais, relatórios e diversas entrevistas, o presente trabalho delineou as atividades sociais da GTECH, analisando se a empresa deveria se enquadrar como RSE ou ISP e também demonstrando alguns dos impactos gerados pelas ações realizadas tanto nos funcionários da empresa, quanto na equipe do projeto e, principalmente, nos jovens que participaram das atividades.

A mídia dos outros somos nós: a experiência audiovisual do Ponto de Cultura Cinema para Todos

This research aims to identify the process of appropriation of audio visual (in digital video) for collective symbolic production (participatory video practice that expresses popular culture) in a socio-cultural context where the minorities are. Therefore, we based this study on the students‟ experience of the film and video workshops held by Cinema para Todos (Culture Point Cine for All), in Natal, RN. Culture Point is the basis of the project Programa Nacional de Cultura, Educação e Cidadania Cultura Viva (National Program of Culture, Education and Citizenship - Living Culture) of the Brazilian Ministry of Culture. In 2010, the Cine for All developed three film and video workshops in the state of Rio Grande do Norte (Northeastern of Brazil), in the municipalities of Açu, Lajes and São Gonçalo do Amarante, within a public policy project of socio-cultural inclusion. These three workshops are the focus of this empirical investigation. To support the analysis of this research we consider that the spaces of workshops are sites of the social practices origin, assuming they show the development of the changes of actions that generate new practices. In this socio-cultural context the students as interlocutors process the communicative culture mediation, where come from the logics of action (using digital video) to become a mediatic practice (video auto ethnographic). With the overall goal set and the field of investigative action delimited we considered the methodology of case study suitable for the observation of the object, because it is a phenomenon of modernity, occurring in a context of real life and with little or no control over events. Participant observation and interviews was also applied to this case study. The analytical theoretical support comes from the notion of mediation by Jesús Martín-Barbero and the concept of habitus by Pierre Bourdieu. The research found that a new way of communicating has been developing by this social group, and this reflects the technological change experienced by them. The auto ethnographic videos, short movies, reveal an allegorical trial of the mainstream media, because while they use the mainstream format, they rework the aesthetic, but without revising the history, in fact they proposing to retell the history of themselves full of colorful details and with richness of their forgotten popular culture.

O território das novas economias e suas implicações socioambientais na comunidade pesqueira de Barra do Cunhaú

This dissertation aims to analyze the territory of the new economies and their social implications in the district of Barra do Cunhaú / Canguaretama. We used techniques of qualitative research (document analysis, interviews and observations in situ). It was found that the changes occurring in the territory are linked to the pressures caused by factors internal and external orders, such as the deployment and expansion of projects for development of tourism and shrimp in place, which led to the advancement of real estate speculation and intensification of the deforestation of areas of mangroves along the estuary of the river Curimataú / Cunhaú, contributing to the abandonment of fishing and agriculture for livelihood in this community, therefore, the loss of traditional knowledge applied in the conduct of this activity. It was also found that changes in the use of territory and resources threaten biodiversity and have contributed to the reduction of fish stocks of the Municipality of Canguaretama and thus bar the Cunhaú, especially the stock of crab, Uca (ucides cardatus ). The results indicated that the production in large scale in a market economy, as is the shrimp, ignores the search for balance in regional settings. Thus the environmental disturbances resulting from the shrimp and tourism have consequences for social and cultural aspects, directly affecting the livelihood of the residents of Barra do Cunhaú. Companies of shrimp and related to tourism have absorbed the fishermen who are leaving the fishing activity. However, the low level of education associated with age are factors that make them far outside the framework of employees of these companies. Therefore, it is necessary to create conditions that allow the development of the shrimp and tourism without putting at risk the sustainability of the region

Depósito de pulverização em diferentes sistemas de semeadura de soja no manejo da ferrugem asiática

Pós-graduação em Agronomia (Agricultura) - FCA