983 resultados para Hospitals -- Repair an reconstruction -- Spain -- Gandia
An investigation of primary human cell sources and clinical scaffolds for articular cartilage repair
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Damage to articular cartilage of the knee can be debilitating because it lacks the capacity to repair itself and can progress to degenerative disorders such as osteoarthritis. The current gold standard for treating cartilage defects is autologous chondrocyte implantation (ACI). However, one of the major limitations of ACI is the use of chondrocytes, which dedifferentiate when grown in vitro and lose their phenotype. It is not clear whether the dedifferentiated chondrocytes can fully redifferentiate upon in vivo transplantation. Studies have suggested that undifferentiated mesenchymal stem or stromal cells (MSCs) from bone marrow (BM) and adipose tissue (AT) can undergo chondrogenic differentiation. Therefore, the main aim of this thesis was to examine BM and AT as a cell source for chondrogenesis using clinical scaffolds. Initially, freshly isolated cells were compared with culture expanded MSCs from BM and AT in Chondro-Gide®, Alpha Chondro Shield® and Hyalofast™. MSCs were shown to grow better in the three scaffolds compared to freshly isolated cells. BM MSCs in Chondro-Gide® were shown to have increased deposition of cartilage specific extracellular matrix (ECM) compared to AT MSCs. Further, this thesis has sought to examine whether CD271 selected MSCs from AT were more chondrogenic than MSCs selected on the basis of plastic adherence (PA). It was shown that CD271+MSCs may have superior chondrogenic properties in vitro and in vivo in terms of ECM deposition. The repair tissue seen after CD271+MSC transplantation combined with Alpha Chondro Shield® was also less vascularised than that seen after transplantation with PA MSCs in the same scaffold, suggesting antiangiogenic activity. Since articular cartilage is an avascular tissue, CD271+MSCs may be a better suited cell type compared to the PA MSCs. Hence, this study has increased the current understanding of how different cell-scaffold combinations may best be used to promote articular cartilage repair.
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This Ph.D. thesis addresses current issues with ichnotaxonomic practice, and characterizes an exceptionally well preserved ichnological assemblage from the Carboniferous Stainmore Formation, Northumberland, United Kingdom. Samples were collected from closely localized float representative of various units throughout the succession, which was deposited in a storm-dominated marine shoreface. Three dominant ichnotaxa were selected for three-dimensional morphological analysis due to their complicated morphology and/or unclear taxonomic status: 1) Dactyloidites jordii isp. nov.; 2) Beaconites capronus, and; 3) Neoeione moniliformis comb. nov. Using serial grinding and photography, these ichnotaxa were ground and modelled in true colour. High-resolution models of three taxa produced in this study are the basis of the first complete three-dimensional consideration of the traces, and forms the basis for refined palaeobiological and ethological analysis of these taxa. Dactyloidites jordii isp. nov. is a stellate to palmate burrow composed of numerous long, narrow rays that exhibit three orders of branching arranged into tiered galleries radiating from a central shaft. It is considered to be the feeding structure produced by a vermiform organism. Beaconites capronus is a winding trace with distinctly chevron-shaped, meniscate backfill demonstrated herein to backfill the vertical shafts associated with its burrows in a comparable fashion to the horizontal portion of the burrow. This lack of a surface connection would result in the trace making organism being exposed to low-oxygen porewater. Coping with this porewater dysoxia could be approached by burrowing organisms in a number of ways: 1) revisiting the sediment-water interface; 2) creating periodic shafts; or 3) employing anaerobic metabolism. Neoeione moniliformis was originally introduced as Eione moniliformis, however, the genus Eione Tate, 1859 is a junior homonym of Eione Rafinesque, 1814. This led to the transfer of Eione moniliformis to Parataenidium. Through careful examination and three-dimensional characterization of topotypes, the transfer to Parataenidium moniliformis is demonstrated herein to be problematic, as Parataenidium refers to primarily horizontal burrows with two distinct layers and Eione moniliformis is composed of one distinct level. As such, the new ichnogenus Neoeione is created to accommodate Neoeione moniliformis.
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Acknowledgements The authors would like to thank M. N. Cueto and J. M. Antonio (ECOBIOMAR) for molecular analysis and technical support. K. MacKenzie (University of Aberdeen) and A. Roura (ECOBIOMAR) assisted with the taxonomic identification of parasites. We are also grateful to P. Caballero (Service Nature Conservation of the Xunta de Galicia) for fish sampling support.
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This research was supported by the Formación de Profesorado Universitario FPU13/05837 (Ministerio de Educación Cultura y Deporte) program, by the OAPN 053/2010 (Organismo Autónomo Parques Nacionales, MAGRAMA) project, by the I + D + I CGL2015-68144-R (Ministerio de Economia y Competitividad) project, by the Leverhulme Trust International Network Grant IN-2012-140 and the Royal Geographical Society Dudley Stamp Memorial Award.
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Background: Since 2007, there has been an ongoing collaboration between Duke University and Mulago National Referral Hospital (NRH) in Kampala, Uganda to increase surgical capacity. This program is prepared to expand to other sites within Uganda to improve neurosurgery outside of Kampala as well. This study assessed the existing progress at Mulago NRH and the neurosurgical needs and assets at two potential sites for expansion. Methods: Three public hospitals were visited to assess needs and assets: Mulago NRH, Mbarara Regional Referral Hospital (RRH), and Gulu RRH. At each site, a surgical capacity tool was administered and healthcare workers were interviewed about perceived needs and assets. A total of 39 interviews were conducted between the three sites. Thematic analysis of the interviews was conducted to identify the reported needs and assets at each hospital. Results: Some improvements are needed to the Duke-Mulago Collaboration model prior to expansion; minor changes to the neurosurgery residency program as well as the method for supply donation and training provided during neurosurgery camps need to examined. Neurosurgery can be implemented at Mbarara RRH currently but the hospital needs a biomedical equipment technician on staff immediately. Gulu RRH is not well positioned for Neurosurgery until there is a CT Scanner somewhere in the Northern Region of Uganda or at the hospital. Conclusions: Neurosurgery is already present in Uganda on a small scale and needs rapid expansion to meet patient needs. This progression is possible with prudent allocation of resources on strategic equipment purchases, human resources including clinical staff and biomedical staff, and changes to the supply chain management system.
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The purpose of this research is to investigate the various social, political and economic factors that contributed to Canada’s failure to implement a universal school lunch program during the 1940s. Although Canada developed several other social welfare programs in the post-war period, it remains one of the only industrialized nations that does not provide hot meals to children in elementary or secondary schools. Data from the province of Ontario, a major site of postwar reconstruction and policy-making, has been taken up to inform the broader national discourse on school lunches from the 1940s. National, Ontario provincial and City of Toronto archival records were collected and analyzed according to common themes, in order to identify key barriers that constrained government support of a hot meal program. Archival records were identified using key words, and were limited to materials created between 1930-1952. Analysis suggests that sufficient need for a hot meal program had not been established during the 1940s. Despite misleading nutrition messages, rates of malnutrition and nutrient-related disease were at an all-time low, and many Ontario school boards did not appear to have the necessary infrastructure required to supply all pupils with hot meals. The Canadian government had already employed significant resources to improve existing social security programs by coupling them with health education. This strategy reflected a shift in understanding malnutrition as a knowledge-based problem, as opposed to income-based. This understanding was further reinforced through the moralized dissemination of nutrition information, which placed blame on women for improperly raising their children. Ultimately, the strong uptake of nutrition as a public health issue in Ontario may have limited prospective responses to solutions already utilized in the public health domain, and directed favour away from a universal school lunch program for Canada.
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The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.
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[EN]We present the first U-series ages of corals from emergent marine deposits on the Canary Islands. Deposits at +. 20. m are 481 ± 39 ka, possibly correlative to marine isotope stage (or MIS) 11, while those at +. 12 and +. 8. m are 120.5 ± 0.8. ka and 130.2 ± 0.8. ka, respectively, correlative to MIS 5.5. The age, elevations, and uplift rates derived from MIS 5.5 deposits on the Canary Islands allow calculations of hypothetical palaeo-sea levels during the MIS 11 high sea stand. Estimates indicate that the MIS 11 high sea stand likely was at least +. 9. m (relative to present sea level) and could have been as high as +. 24. m.
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The relationship between the socio-economic status of parents and children is referred by the literature as intergenerational social mobility. The scope of this mobility encompasses different aspects such as educational attainment, income, wealth, prestige and occupational status. In particular, intergenerational occupational mobility is an interesting topic in the economic literature because it is positively associated with the economic achievement and the professional success. Low mobility implies that human capital, skills and talent can be misallocated. As a consequence, the workers’ efforts, their motivation and productivity could be negatively affected, which would have adverse effects on the economy growth and its competitiveness. This paper attempts to carry out the study of the evolution of intergenerational social mobility in Spain during the 21st century. The methodology applied involves to associate the National Classification of Occupations (CNO-94) with the New International Socio-economic Index of Occupational Status (ISEI-08), in order to establish a socio-economic hierarchy. Afterwards, once the occupational ranking is defined, we use statistic and econometric methods to assess the occupational transitions between fathers and children and to analyse the covariates’ effects on these transitions, including as explanatory variable the children’s educational attainment. Data used corresponds to the 2005 and 2011 Living Condition Survey (INE, 2005, 2011). The results of the study are displayed by distinguishing children according to their birth cohort.
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Objective: to describe the experience of Latin American working women regarding immigration, taking into account the expectations and conditions in which this process takes place. Method: ethnographic qualitative study. Data collection was performed by means of semi-structured interviews with 24 Latin American immigrant women in Spain. The information collected was triangulated through two focal groups. Results: the expectations of migrant women focus on improving family living conditions. Social support is essential for their settling and to perform daily life activities. They declare they have adapted to the settlement country, although they live with stress. They perceive they have greater sexual freedom and power with their partners but keep greater responsibility in childcare, combining that with the role of working woman. Conclusions: migrant women play a key role in the survival of households, they build and create new meanings about being a woman, their understanding of life, their social and couple relationships. Such importance is shaped by their expectations and the conditions in which the migration process takes place, as well as their work integration.
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The aim of this study is to determine which social agents are involved in the political debate on Twitter and whether the interpretive hegemony of actors that have traditionally been the most prominent is tempered by the challenge of framing shared with audiences. The relationship between the interpretations expressed and the profiles of participants is analyzed in comparison with the frames used by mainstream media. The chosen methodology combines content analysis and discourse analysis techniques on a sample of 1,504 relevant tweets posted on two political issues –the approval of the education law LOMCE and the evictions caused by the crisis, which have also been studied in the front pages of four leading newspapers in Spain. The results show a correlation between political issue singularities, frames and the type of discussion depending on the participants.
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In Spain, immigrant women have high rates for initiating breastfeeding. In contrast, the case of immigrant Chinese mothers stands out, due to the low rate. In China, breastfeeding has historically been the cultural norm. An ethnographic study was conducted to explore aspects related to the low rate of breastfeeding. Field observations and informal interviews were conducted in two hospitals and a primary care center. Semi-structured interviews were performed with Chinese mothers and health workers. Among Spanish health workers, there is a belief that Chinese women do not breastfeed due to cultural reasons. The rapid return to work and the popular phenomenon of sending babies back to China for grandparents to raise constitute barriers for breastfeeding. Although in China breastfeeding is common practice, in Madrid the prioritization of productivity over reproduction and the existence of the so-called “satellite babies” and transnational maternity make the establishment and maintenance of breastfeeding difficult.
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The Toledo Gate of Ciudad Real, Spain, constructed between the late 13th and early 14th centuries, is the last remaining portion of a once complete medieval city wall. It represents the long history of the city and constitutes its main heritage symbol, dividing the historic city centre from the later 19th and 20th century expansions. In October 2012, the Town Hall and the Montemadrid Foundation started the conservation works to preserve this important monument. The preliminary phase of this project included an in-depth series of scientific studies which were carried out by a multidisciplinary team focusing on archival research, historic investigations, archaeological excavations as well as material composition analysis and main treatment application tests. As a result of these studies a series of virtual 3D models were created to inform, discuss and study the monument. A first digital model permitted visualization of the gate in the 19th century and how the main entrance to the city was integrated as a fundamental part of the city walls. This virtual reconstruction also became an important part of the campaign to raise awareness among the citizens towards a monument that had remained in the shadows for the last century, isolated in a roundabout after the systematic demolition of the city walls in the late 19th century. Over the last three years and as a result of these archaeological and historic investigations and subsequent virtual models, surprisingly new and interesting data were brought to light thus permitting the establishment and corroboration of a new and updated hypothesis of the Toledo Gate that goes beyond the previous ideas. As a result of these studies a new architectural typology with construction techniques of has been suggested. This paper describes how the results of this continuous and interdisciplinary documentation process have benefitted from a computer graphic reconstruction of the gate. It highlights how virtual reconstruction can be a powerful tool for conservation decision making and awareness raising. Furthermore, the interesting results of the final reconstruction hypothesis convinced the technical team responsible for the conservation to alter some aspects of the final project physical interventions in order to focus on some of the features and conclusions discovered through the virtual model study.