Lithic grain and mineral composition of sand and sandstones from the North Pacific Ocean and the Bering Sea (Table 3)

Sand and sandstone compositions from different types of basins reflect provenance terranes governed by plate tectonics. One hundred and one thin sections of Upper Miocene to Holocene sand-sized material were examined from DSDP/IPOD Sites in the North Pacific Ocean and the Bering Sea. The Gazzi-Dickinson point-counting method was used to establish compositional characteristics of sands from different tectonic settings. Continental margin forearc sands from the western North America continental margin arc system are clearly different from backarc/marginal-sea sands from the Aleutian intraoceanic arc system. The forearc sands have average QFL percentages of 29-42-29, LmLvLst percentages of 32-34-34, 3 Fmwk%M and 0.82 P/F. Aleutian backarc sands have average QFL percentages of 8-22-69. LmLvLst percentages of 9-85-6, 0.5 Fmwk%M and 0.96 P/F. A trend of increasing QFL%Q and decreasing LmLvLst%Lv westward in the backarc region of the Aleutian Ridge reflects the influence of the Asiatic continental margin. Aleutian backarc sands without continental influence have average QFL percentages of 1-20-79, LmLvLst percentages of 1-98-1, 0 Fmwk%M and 0.99 P/F. Of the continental margin forearc samples, sands on the Astoria Fan (west of the Oregon-Washington trench) contain the highest LmLvLst%Lv and lowest P/F; sands from mixed transform-fault and trench settings (Delgada Fan and Gulf of Alaska samples) have slightly higher Qp/Q (0.03); and sands from the Pacific-Juan de Fuca-North America triple junction have the highest Fmwk%M. Delgada Fan and Gulf of Alaska sands have average QFL percentages of 27-38-35, LmLvLst percentages of 37-26-37, 2 Fmwk%M and 0.86 P/F. Astoria Fan sands have average QFL percentages of 35-41-24, LmLvLst percentages of 30-47-23, 3 Fmwk%M and 0.74 P/F. The triple-junction sands have average QFL percentages of 28-59-13, LmLvLst percentages of 25-26-49, 9 Fmwk%M and 0.87 P/F. The petrologic data from the modern ocean basins examined in this study can provide useful analogs for interpretation of ancient oceanic sequences. Our data suggest some refinements of, but generally substantiate, existing petrologic models relating sandstone composition to tectonic setting.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Utilizing ICT to prevent loneliness and social isolation of the elderly. A literature review

Ageing of the population is a worldwide phenomenon. Numerous ICT-based solutions have been developed for elderly care but mainly connected to the physiological and nursing aspects in services for the elderly. Social work is a profession that should pay attention to the comprehensive wellbeing and social needs of the elderly. Many people experience loneliness and depression in their old age, either as a result of living alone or due to a lack of close family ties and reduced connections with their culture of origin, which results in an inability to participate actively in community activities (Singh & Misra, 2009). Participation in society would enhance the quality of life. With the development of information technology, the use of technology in social work practice has risen dramatically. The aim of this literature review is to map out the state of the art of knowledge about the usage of ICT in elderly care and to figure out research-based knowledge about the usability of ICT for the prevention of loneliness and social isolation of elderly people. The data for the current research comes from the core collection of the Web of Science and the data searching was performed using Boolean? The searching resulted in 216 published English articles. After going through the topics and abstracts, 34 articles were selected for the data analysis that is based on a multi approach framework. The analysis of the research approach is categorized according to some aspects of using ICT by older adults from the adoption of ICT to the impact of usage, and the social services for them. This literature review focused on the function of communication by excluding the applications that mainly relate to physical nursing. The results show that the so-called ‘digital divide’ still exists, but the older adults have the willingness to learn and utilise ICT in daily life, especially for communication. The data shows that the usage of ICT can prevent the loneliness and social isolation of older adults, and they are eager for technical support in using ICT. The results of data analysis on theoretical frames and concepts show that this research field applies different theoretical frames from various scientific fields, while a social work approach is lacking. However, a synergic frame of applied theories will be suggested from the perspective of social work.

Anclaje, dinámicas e impactos territoriales de la cadena global de cítricos dulces en el nordeste argentino

El artículo analiza firmas insertas en circuitos globalizados de exportación de frutas frescas, así como la interfase empresas-territorios. Se focaliza en la producción argentina de cítricos dulces y particularmente en un espacio productivo, y se interesa por cómo se traduce la construcción de los circuitos globales en los espacios y actores locales. Para ello, desarrolla una tipología de empresas e indicadores de anclaje y recurre a una combinación de fuentes cuantitativas y cualitativas, con vistas a desentrañar la “caja negra” del comportamiento empresarial. Se concluye que existen diferentes grados de anclaje territorial y combinaciones variables de fijación y movilidad por parte de las empresas. La adopción de una modalidad de agricultura empresarial multilocalizada, orientada al aprovechamiento de las peculiaridades de los diferentes ambientes locales, conduce a la desarticulación de espacios en función de sus características productivas y de sus diversos contextos sociales e institucionales. De esta forma se promueve la conformación de agentes de características flexibles, transformando su reproducción en contingente.

What is this thing called Historical Archaeology?

Historical archaeology, in its narrow temporal sense -as an archaeology of the emergence and subsequent evolution of the Modern world- is steadily taking pace in Spanish academia. This paper aims at provoking a more robust debate through understanding how Spanish historical archaeology is placed in the international scene and some of its more relevant particularities. In so doing, the paper also stresses the strong links that have united historical and prehistorical archaeology since its inception, both in relation to the ontological, epistemological and methodological definition of the first as to the influence of socio-political issues in the latter. Such reflection is partly a situated reflection from prehistory as one of the paper’s authors has been a prehistorian for most of her professional life.

La exploración del litoral atlántico norteafricano según el periplo de Hannón de Cartago

El periplo de Hannón, frente a las propuestas que lo interpretan como una obra literaria, creemos que recoge un periplo auténtico, que sólo alcanzó cabo Juby y algunas de las Islas Canarias. Las refundaciones cartaginesas fueron todas en la Mauretania fértil, en los 7 primeros días de la expedición. Desde el islote de Kérne, en la expedición primó una primera exploración de evaluación, indicativo de que se trataba de apenas 2 o 3 barcos, con una tripulación limitada, que evitaban enfrentamientos con la población local. Los intérpretes Lixítai parecen conocer todos los puntos explorados, el río Chrétes, los etíopes del Alto Atlas costero, el gran golfo caluroso que finalizaba en el Hespérou Kéras, el volcán Theôn Óchema, o las gentes salvajes que denominaban Goríllai. Probablemente la mayor sorpresa fuese encontrar un volcán activo, emitiendo lava, que pudo ser la razón última para redactar este periplo. La falta de agua, alimentos y caza como razón para finalizar la expedición exploratoria sólo es comprensible en un trayecto corto que alcanzó hasta el inicio del desierto del Sahara. Otro tanto sucede con la ausencia de ríos importantes al Sur del río Chrétes, una clara prueba de que no se alcanzaron latitudes ecuatoriales y que los barcos se fueron alejando de la costa norteafricana.

Receptive Vocabulary of CLIL and Non-CLIL Primary and Secondary School Learners

CLIL instruction has been reported to be beneficial for foreign language vocabulary learning since CLIL students show higher vocabulary profiles than students of their same age in traditional EFL contexts. However, to our knowledge, the receptive vocabulary knowledge of CLIL and non-CLIL learners at the end of primary and secondary education has not been examined yet. Hence, this study aims at comparing the receptive vocabulary size 79 CLIL primary learners with the receptive vocabulary knowledge of 331 non-CLIL learners at the end of primary and secondary school. Sex-based differences were also analysed. The 2k Vocabulary Levels Test (VLT) was used for the purposes of the study. Results revealed that learners’ receptive vocabulary sizes lie within the most frequent 1000 words, non-CLIL secondary school students throw better results than primary students but the differences between the secondary group and the CLIL group are not statistically significant. As for sex-based differences, we found no significant differences among the groups. These findings led us to believe that the CLIL approach offers a benefit for vocabulary acquisition since CLIL learners have been exposed to the foreign language for a shorter period of time and the results are quite similar to their non-CLIL secondary school partners.

Begeleiding van zelfsturende studententeams tijdens de emulatiefase

Deze exploratieve casestudie beschrijft manieren waarop lerarenopleiders hun studenten kunnen begeleiden tijdens de emulatiefase, een belangrijke modelleerfase bij zelfgestuurd leren. Aan deze doelstelling is in het studiejaar 2014/2015 gewerkt in een curriculum- innovatiegroep bestaande uit pabodocenten, leerkrachten van basisscholen en een onderzoeker, die in co-creatie werkten aan een nieuwe module. Deze module werd benoemd als 'ontwerpstudio' omdat de studenten er ontwerpgericht onderzoek leerden uitvoeren. Vanuit een probleemstelling van de basisscholen werkten studenten in zelf- sturende teams samen aan een ontwerp, hierbij begeleid door zowel de pabodocenten als de basisschoolleerkrachten. De resultaten laten zien dat het stellen van actie- en betekenisgerichte vragen een belangrijke begeleidingscategorie betreft in de emulatiefase. Naast de categorie 'vragen stellen' zijn aanvullende begeleidingscategorieën belangrijk zoals 'denkstappen formuleren' en 'suggesties doen voor vervolg'. De verschillende begeleidingscategorieën worden in het artikel verder uitgewerkt teneinde opleiders handvatten te geven voor het begeleiden van zelfsturende studententeams tijdens de emulatiefase.

The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Does video feedback analysis improve CPR performance in phase 5 medical students?

Background The use of simulation in medical education is increasing, with students taught and assessed using simulated patients and manikins. Medical students at Queen’s University of Belfast are taught advanced life support cardiopulmonary resuscitation as part of the undergraduate curriculum. Teaching and feedback in these skills have been developed in Queen’s University with high-fidelity manikins. This study aimed to evaluate the effectiveness of video compared to verbal feedback in assessment of student cardiopulmonary resuscitation performance Methods Final year students participated in this study using a high-fidelity manikin, in the Clinical Skills Centre, Queen’s University Belfast. Cohort A received verbal feedback only on their performance and cohort B received video feedback only. Video analysis using ‘StudioCode’ software was distributed to students. Each group returned for a second scenario and evaluation 4 weeks later. An assessment tool was created for performance assessment, which included individual skill and global score evaluation. Results One hundred thirty eight final year medical students completed the study. 62 % were female and the mean age was 23.9 years. Students having video feedback had significantly greater improvement in overall scores compared to those receiving verbal feedback (p = 0.006, 95 % CI: 2.8–15.8). Individual skills, including ventilation quality and global score were significantly better with video feedback (p = 0.002 and p < 0.001, respectively) when compared with cohort A. There was a positive change in overall score for cohort B from session one to session two (p < 0.001, 95 % CI: 6.3–15.8) indicating video feedback significantly benefited skill retention. In addition, using video feedback showed a significant improvement in the global score (p < 0.001, 95 % CI: 3.3–7.2) and drug administration timing (p = 0.004, 95 % CI: 0.7–3.8) of cohort B participants, from session one to session two. Conclusions There is increased use of simulation in medicine but a paucity of published data comparing feedback methods in cardiopulmonary resuscitation training. Our study shows the use of video feedback when teaching cardiopulmonary resuscitation is more effective than verbal feedback, and enhances skill retention. This is one of the first studies to demonstrate the benefit of video feedback in cardiopulmonary resuscitation teaching.

Proprioception in ankle sprain from exercises and bandages

Ankle sprains are the most common injuries in sports, usually causing damage to the lateral ligaments. Recurrence has as usual result permanent instability, and thus loss of proprioception. This fact, together with residual symptoms, is what is known as chronic ankle instability, CAI, or FAI, if it is functional. This problem tries to be solved by improving musculoskeletal stability and proprioception by the application of bandages and performing exercises. The aim of this study has been to review articles (meta-analisis, systematic reviews and revisions) published in 2009-2015 in PubMed, Medline, ENFISPO and BUCea, using keywords such as “sprain instability”, “sprain proprioception”, “chronic ankle instability”. Evidence affirms that there does exist decreased proprioception in patients who suffer from CAI. Rehabilitation exercise regimen is indicated as a treatment because it generates a subjective improvement reported by the patient, and the application of bandages works like a sprain prevention method limiting the range of motion, reducing joint instability and increasing confidence during exercise. As podiatrists we should recommend proprioception exercises to all athletes in a preventive way, and those with CAI or FAI, as a rehabilitation programme, together with the application of bandages. However, further studies should be generated focusing on ways of improving proprioception, and on the exercise patterns that provide the maximum benefit.

Evaluación de cuatro protocolos anestésicos fijos en diferentes técnicas quirúrgicas en Caninos

El presente estudio se llevó a cabo en la clínica veterinaria ubicada en la Facultad de Ciencia Animal de la Universidad Nacional Agraria . Se determinaron diferentes variables a evaluar para comparar la acción de 4 distintos protocolos anestésicos en caninos, utilizando propofol, ketamina, d iazepam, xilacina 2%, m idazolam, sulfato de atropina, maleato de acepromacina y ketoprofeno mediantes los cuales se evaluó el comportamiento de los 14 pacientes quirúr gicos determinándose los siguientes resultados: La frecuencia respiratoria promedio en los diferentes tiempo s fue: pre operatorio : 76 – 20 con una media de 48 , trans operatorio : 56 – 10 con una media de 33 y post operatorio : 36 – 8 con una media de 22 movi mientos por minuto. La frecuencia cardiaca promedio en los diferente tiempos fue: pre operatorio : 140 – 40 con una media de 90 , trans operatorio : 180 – 64 con una media de 122 y post operatorio 160 - 40 con una media de 100 pulsaciones por minuto. La temper atura rectal promedio en los di ferentes tiempo fue: pre operatorio : 40.4 - 37. 5 con una media de 38.9 , trans operatorio : 40 – 37 con una media de 38.5 y post operatorio : 39.2 - 37.2 con una media de °C. El porcentaje de hematocrito promedio en los diferentes tiempos fue: pre operatorio : 47 – 25 con una media de 37 , trans operatorio : 3 9 – 24 con una media de 31.5 y post operatorio : 39 – 24 con una media de 31.5 % . Donde al comparar la acción de estos protocolos en los diferentes tiempos, no conllevaron a ninguno de los pacientes intervenidos a situaciones críticas que condujeran a emergencias en el intraoperatorio, concluyendo que los protocolos empleados tienen amplio margen de seguridad y garantizaro n integralmente los cuatro puntos cardinales de la anestesia

Diagnóstico de la relación entre el uso excesivo de las TICs y síntomas depresivos y ansiedad en estudiantes de medicina, Universidad de Cuenca, Ecuador

Se trata de un estudio descriptivo de corte transversal entre estudiantes de la Facultad de Ciencias Médicas de la Universidad de Cuenca1, para determinar la magnitud del uso excesivo de Tecnologías de Información y Comunicación (TICs), su variación en función de la edad, sexo, estado civil y la carrera; así como su asociación con síntomas depresivos y de ansiedad. En el cuestionario previamente validado que fue aplicado a muestra aleatoria por conglomerados de 333 estudiantes, se integraron preguntas de información demográfica, test de uso excesivo de TICs y de síntomas depresivos y de ansiedad. El concepto de Riesgo Relativo y su Intervalo de Confianza al 95% fue utilizado para el análisis estadístico. Los resultados nos revelan que la edad promedio de la muestra de la población fue de 22 años, 37,2% con uso excesivo de TICs, el 18,3% presentan síntomas depresivos y 39,8% de ansiedad. Entre las variables asociadas de manera significativa con el uso excesivo de TICs están: la edad menor de 19 años (RR 2,04; IC 95% 1,31-3,20), el género masculino (RR 1,36; IC 95% 1,03-1,80) y la carrera de Tecnología Médica (RR 1,83; IC 95% 1,28-2,63). El uso excesivo de las TICs no está asociado con el estado civil. Sin embargo, el análisis estadístico nos muestra la existencia de una correlación positiva entre el uso excesivo de las TICs y la frecuencia de estudiantes con síntomas depresivos (RR 1,88; IC 95% 1,45-2,44) y de ansiedad (RR 2,61; IC 95% 1,64-4,15).

Guía clínica para el manejo interdisciplinario del paciente con secuelas de pérdida masiva de peso durante la cirugía plástica reconstructiva

Antecedentes y Objetivos. La obesidad está considerada como una pandemia y México ocupa uno de los primeros lugares mundiales en número de casos en población adulta y el primero en el grupo infantil. Desde 2008 se pusieron en marcha Unidades de Cirugía Bariátrica para el manejo del paciente obeso, con lo cual se inició también la Reconstrucción postpérdida masiva de peso por los Servicios de Cirugía Plástica. Sin embargo, no existen protocolos descritos de manejo perioperatorio de este tipo de pacientes en nuestro país. El objetivo del presente trabajo es crear una guía clínica para el manejo interdisciplinario del paciente con secuelas de pérdida masiva de peso basada en los resultados obtenidos en un centro de reconstrucción postbariátrica. Material y Método. Creamos para ello un equipo de expertos de cada área involucrada y se estandarizó el manejo pre, trans y postoperatorio de todos los pacientes con secuelas de pérdida masiva de peso a fin de evaluar los resultados obtenidos. Resultados. Se realizaron 314 procedimientos reconstructivos en 144 pacientes postbariátricos. El 93% fueron de sexo femenino. La edad promedio fue de 37.2 años. Los procedimientos realizados fueron: abdominoplastia en un 39.17%; mastopexia en un 10.5%; torsoplastia en un 7.69%; braquioplastia en un 7.01%; cruroplastia en un 5.09%; y ritidoplastia en un 2.54%. El tiempo quirúrgico promedio fue de 221.2 minutos, con un sangrado transoperatorio medio de 275 ml. Las complicaciones presentadas alcanzaron el 4.77% y la mortalidad fue de 0%. Las recomendaciones emitidas por cada experto involucrado en el proceso de reconstrucción permitieron obtener resultados favorables en relación a la morbi-mortalidad, que fue equiparable e incluso inferior a la reportada en otras series. Conclusiones. Creemos que el seguimiento de una guía clínica basada en la estandarización del manejo de 314 procedimientos en una población con características similares, nos permite realizar la reconstrucción postpérdida masiva de peso de forma eficaz y segura.

Prevalencia de hipertensión arterial y factores asociados en afiliados al Instituto Ecuatoriano de Seguridad Social (IESS) de la ciudad de Cuenca. 2006

Determinar la prevalencia de la HTA y factores asociados en la poblacion de afiliados al Instituto Ecuatoriano del Seguro Social (IESS) residentes en la ciudad de Cuenca en el alio 2006.- Es un estudio de prevalencia, descriptivo, transversal.- MUESTRA Población de empleados y trabajadores pOblicos y privados afiliados al IESS de la ciudad de Cuenca, Ecuador en 2006. -RESULTADOS. Participaron 1215 mujeres (30,8%) y 3560 varones (25,4%). La prevalencia fue de la HTA fue de 7,5%. La frecuencia de la HTA seg6n rango de edad fue, el rango de 45-54 con el 37,2%, para el grupo comprendido entre 55- 64 años con el 24,4%, el de 35 44 arias con 16,4%, entre 25 y 34 años el 11,4% y por fin el rango de 650 mas años de edad con 10,6%.- Los factores asociados a la hipertensión arterial con asociación positiva son: Diabetes, Gota, Consumo de Tabaco, Falta de actividad fisica, Consumo de alcohol, Diametro abdominal anormal, Hipercolesterolemia, Obesidad determinada por IMC.- CONCLUSION. Hay un aumento de la HTA conforme avanza la edad, existe una fuerte relación de la HTA con factores asociados.- Se recomienda implantar programas de prevención y control de la Hipertensión arterial par el alto riesgo de muerte cardiovascular que esta representa