Evaluación de la validez de la escala llanto para el dolor en neonatos y menores de cinco años

Introducción: La escala LLANTO para dolor es una escala que hasta la fecha ha sido solo validada en población infantil española, actualmente no se conocen datos en población colombiana. Se pretende validar la escala de dolor LLANTO en pacientes neonatos y menores de 5 años, a través de su aplicación en pacientes atendidos en una de tres instituciones, además comparándola con las escalas FLACC y PIPP dependiendo de edad del paciente. Metodología: Se incluyeron niños con cualquier tipo de dolor, clasificándolos en dos grupos por edad: 1) neonatos y 2) niños entre 1 mes y 5 años de edad, que asistieron a la Fundación Cardioinfantil, Clínica Infantil Colsubsidio o al Hospital Universitario Mayor. Las escalas fueron aplicadas por dos residentes de pediatría y una enfermera especializada en el cuidado de población infantil. Para la prueba piloto se diseñó un cuestionario determinar dificultades en la aplicación de la escala LLANTO. Una vez corregidos los problemas identificados se procederá a la validación de la escala. Resultados: Se presentan los datos de la prueba piloto. Se incluyeron 8 neonatos y 8 niños entre 1 mes y 5 años, esta muestra fue obtenida en un periodo de un mes, con la encuesta se evaluó la aceptación y entendimiento de la escala LLANTO por parte de los evaluadores. La prueba piloto mostró resultados favorables en el 100% de los encuestados. Discusión: Se considera que la escala LLANTO no requiere cambios para continuar con su validación.

Protección miocárdica con custodiol y trastornos de la osmolalidad

En análisis retrospectivo evaluamos 91 pacientes llevados a cirugía cardiaca entre 2013 y 2014 en la Fundación Cardioinfantil, en quienes se administro Custodiol, analizando los niveles de sodio y osmolalidad plasmática efectiva antes, durante y después del procedimiento quirúrgico. Nosotros evaluamos la relación entre administración de Custodiol y cambios en el sodio y osmolalidad plasmática del paciente llevado a cirugía cardiaca.

Ecologia demogràfica de la perca americana (Micropterus salmoides) a l'Estany de Banyoles

L'Estany de Banyoles, sistema peculiar tant des del punt de vista de la seva formació geològica com de les seves característiques limnològiques, conté actualment una comunitat de peixos profundament modificada respecte de la comunitat original. La perca americana (Micropterus salmoides), introduïda a finals dels anys seixanta del segle XX, és avui una de les espècies dominants en aquesta comunitat, i ocupa sobretot l'hàbitat litoral de l'Estany. Es tracta d'una espècie molt ben estudiada a Nord Amèrica des de diverses disciplines de la biologia i des de fa diverses dècades, cosa que ha comportat que actualment es disposi d'un gran volum d'informació sobre ella. Amb tot, fora del seu continent d'origen ha rebut poca atenció, malgrat l'amplia expansió que ha experimentat arreu del món. En aquesta tesi doctoral s'han abordat, amb un enfocament descriptiu, aspectes fins ara desconeguts per a l'espècie a l'Estany de Banyoles, a la península ibèrica i fins i tot a Europa. Concretament, se n'ha analitzat la condició, el creixement i la demografia, així com les seves variacions temporals. Amb aquesta finalitat, s'ha dissenyat un mostreig composat de deu campanyes de pesca intensives més alguns petits mostrejos addicionals intercalats, mostreig que s'ha allargat des del juliol del 1997 i fins el novembre del 1999. La captura dels exemplars s'ha realitzat mitjançant una tècnica de pesca elèctrica amb una embarcació posada a punt expressament per a aquest estudi, la qual s'ha mostrat considerablement eficient malgrat les dificultats que ofereix el medi. S'ha realitzat un mostreig de marcatge-recaptura basat en la mutilació d'aletes i, en alguns casos, en el marcatge amb pintura acrílica. Només en la darrera campanya (novembre del 1999) s'ha sacrificat una part important de les captures a fi de retirar-ne els otòlits per a la determinació de l'edat. Pel que fa a l'anàlisi de les dades, s'ha aplicat un ampli ventall de mètodes i models per a cada un dels aspectes estudiats, a fi de contrastar-ne els resultats i validar-ne la seva fiabilitat. En el cas de la condició, s'han aplicat mètodes d'anàlisi de la covariància (ANCOVA) i altres mètodes anàlegs, així com, paral·lelament, regressions i anàlisis derivades a partir de la relació longitud-pes. En l'estudi del creixement, s'han realitzat ajustaments de diversos models mitjançant regressions sobre dades de mida a l'edat i sobre dades d'increments de mida observats per interval de temps. També s'han aplicat anàlisis de freqüències de longitud, i, finalment, s'han aplicat mètodes de retrocàlcul a partir dels increments anuals del radi observats en els otòlits. Finalment, en el cas de l'estudi de la demografia, s'han aplicat models de marcatge-recaptura per a l'estimació de la grandària poblacional i de la supervivència, i, a més, s'han ajustat diversos models continus de supervivència sobre aquestes estimacions prèvies. També s'han estimat les capturabilitats associades a la nova tècnica de captura. Per una altra banda, s'ha implementat i realitzat un mostreig sobre la població de pescadors esportius de l'Estany encarat a determinar, bàsicament, la pressió de pesca a què es veu sotmesa l'espècie. Els resultats mostren sobretot una alta estabilitat interanual en tots els aspectes estudiats, que s'explica per l'estabilitat ambiental que, al seu torn, és característica d'aquest ecosistema lacustre. Això reverteix en una longevitat màxima observada que iguala la màxima descrita a la literatura per a l'espècie. Alhora, també s'han descrit fortes oscil·lacions estacionals tant en la condició, com en el creixement, com també en la supervivència, les quals, però, presenten certes diferències en la seva temporalitat, cosa que indica una certa diferenciació en els factors que les regulen.

Desenvolupament de mètodes de preconcentració emprant membranes líquides suportades i extracció en fase sòlida per a la determinació de l'herbicida glifosat i el seu metabòlit AMPA en aigües naturals

El glifosat, N-(fosfonometil) glicina, és un dels herbicides més utilitzats arreu del món a causa de la seva baixa toxicitat i al seu ampli espectre d'aplicació. A conseqüència del gran ús que se'n fa, és necessari monitoritzar aquest compost i el seu principal metabòlit, l'àcid aminometilfosfònic (AMPA), en el medi ambient. S'han descrit diversos mètodes instrumentals basats en cromatografia de gasos (GC) i de líquids (HPLC), sent aquesta darrera l'opció més favorable a causa del caràcter polar dels anàlits. Per assolir nivells de concentració baixos cal, però, la preconcentració dels anàlits. En aquest treball s'estudien diferents alternatives amb aquest objectiu. S'ha avaluat la tècnica de membrana líquida suportada (SLM) on la membrana consisteix en una dissolució orgànica, que conté un transportador (en el nostre cas, un bescanviador d'anions comercial, Aliquat 336), que impregna un suport polimèric microporós que se situa entre dues solucions aquoses: la de càrrega, que conté els anàlits inicialment, i la receptora, on es retenen els anàlits després del seu transport a través de la membrana. Les condicions d'extracció més adequades s'obtenen treballant en medi bàsic amb NaOH on els anàlits estan en forma aniònica i les majors recuperacions s'obtenen amb HCl 0,1 M o NaCl 0,5 M, la qual cosa indica que l'ió clorur és la força impulsora del transport. Un cop dissenyat el sistema, es duen a terme experiments de preconcentració amb dues geometries diferents: un sistema de membrana laminar (LSLM) on recircula la fase receptora i un sistema de fibra buida (HFSLM). Els millors resultats s'obtenen amb el mòdul de fibra buida, amb factors de concentració de 25 i 3 per a glifosat i AMPA, respectivament, fent recircular durant 24 hores 100 ml de solució de càrrega i 4 ml de solució receptora. També s'aplica una tècnica més selectiva, la cromatografia d'afinitat amb ió metàl·lic immobilitzat (IMAC), basada en la interacció entre els anàlits i un metall immobilitzat en una resina a través d'un grup funcional d'aquesta. En aquest estudi s'immobilitza pal·ladi al grup funcional 8-hidroxiquinoleïna de la resina amb matriu acrílica Spheron Oxine 1000 i s'avalua per a l'extracció i preconcentració de glifosat i AMPA. Per a ambdós anàlits l'adsorció és del 100 % i les recuperacions són superiors al 80 % i al 60 % per a glifosat i AMPA, respectivament, utilitzant HCl 0,1 M + NaCl 1 M com a eluent. Aquests resultats es comparen amb els obtinguts amb dues resines més, també carregades amb pal·ladi: Iontosorb Oxin 100, que té el mateix grup funcional però matriu de cel·lulosa, i Spheron Thiol 1000, on el grup funcional és un tiol i la matriu també és acrílica. Per al glifosat els resultats són similars amb totes les resines, però per a l'AMPA la resina Spheron Thiol és la única que proporciona recuperacions superiors al 93 %. Finalment, una altra opció estudiada és l'acoblament de dues columnes de cromatografia líquida (LC-LC). En l'estudi l'objectiu és millorar el mètode existent per a glifosat i AMPA en aigües naturals on el LOD era de 0,25 ug/l. El mètode consisteix en la derivatització precolumna amb el reactiu fluorescent FMOC i l'anàlisi amb l'acoblament LC-LC-fluorescència. Variant lleugerament les condicions de derivatització s'aconsegueix quantificar 0,1 ug/l de glifosat i AMPA. Es fortifiquen aigües naturals amb 0,1, 1 i 10 ug/l dels anàlits per validar el mètode. S'obtenen recuperacions d'entre el 85 % i el 100 %, amb desviacions estàndard relatives inferiors al 8 %. Aplicant una tècnica de preconcentració prèvia a la derivatització i anàlisi utilitzant una resina de bescanvi aniònic, Amberlite IRA-900, es millora la sensibilitat del mètode i s'assoleix un LOD per al glifosat de 0,02 ug/l.

Aquisição de hábitos de trabalho e valores de cidadania em Percursos Curriculares Alternativos: uma educação inclusiva ou excludente?

O trabalho apresentado decorre do Projecto de Intervenção realizado no âmbito do Mestrado em Educação Especial: domínio cognitivo e motor, na Universidade Lusófona de Humanidades e Tecnologias. A presente intervenção contempla o trabalho realizado com uma turma de currículo alternativo (Cursos de Educação e Formação de Jovens), no que concerne à aquisição de hábitos e métodos de estudo e trabalho, bem como à interiorização de determinados valores de cidadania, potenciadores da aquisição de alguma motivação para a aprendizagem. O enquadramento teórico facilitará a compreensão das pedras basilares da intervenção, bem como das posições defendidas relativamente à escola inclusiva, à educação para a cidadania, à escola como espaço de luta contra a exclusão e o estigma e à possibilidade de uma aprendizagem significativa e integradora. Para obter informações sobre a turma em questão, sobre a sua integração num espaço escolar específico e para delinear todo o processo de intervenção foram utilizados vários suportes metodológicos, a saber, a pesquisa documental, a observação naturalista, os questionários e diversos instrumentos de registo (notas de campo). Os princípios que orientaram a intervenção realizada, tendo como horizonte uma investigação - acção, bem como os objectivos definidos para a turma, as diversas actividades realizadas, os métodos de avaliação dessa mesma aprendizagem e a colaboração de todos os intervenientes neste processo, permitiram a constatação de algumas melhorias relevantes na área académica e social, em alguns alunos. As práticas educativas que delinearam esta intervenção permitiram desbravar novos caminhos em direcção a novas formas de encarar o ensino de jovens em risco de abandono escolar, permitindo uma nova visão da importância de uma escola democrática, integradora e acolhedora. Considerando-se que no início estávamos perante um grupo-turma com muitas dificuldades comportamentais, com falta de auto-estima e gosto pela escola e com total ausência de métodos e hábitos de estudo e trabalho, pode afirmar-se que todos os alunos melhoraram nos aspectos referidos, demonstrando um comportamento mais adequado em sala de aula e adquirindo alguns métodos e hábitos de estudo relevantes para o sucesso escolar.

(In)disciplina e (inter)ação pedagógica : do discurso às práticas

O tema deste trabalho é a (in)disciplina em contexto de sala de aula, colocando - se o enfoque nas representações alunos do 3º ciclo, pais e professores sobre esta problemática e as suas perceções sobre o tipo de ocorrências e causas. Este estudo de caso procura um entendimento da indisciplina, reconhecendo-se a existência de uma miríade de fatores subjacentes a este conceito, cruzando diferentes olhares da psicologia, sociologia e pedagogia. O conceito de indisciplina é definido com referência ao conceito de disciplina traduzindo um comportamento disruptivo que emerge na relação pedagógica. A construção da relação interpessoal entre professor/aluno e a gestão do comportamento dos alunos assegura a manutenção de um clima que permite a efetividade do processo ensino – aprendizagem. Realiza-se uma abordagem numa perspetiva conceptual, procurando-se o conhecimento e natureza do conceito, a identificação das causas centrados no aluno desde as suas características psicológicas, sócio – económicas, de contexto familiar e culturais, as causas centradas no professor e na organização escolar, bem como as causas sociais que influenciam a ocorrência de (in)disciplina. Explanam-se formas de gestão e resolução de comportamentos disruptivos, atendendo a diferentes e possíveis abordagens. Efetua-se, numa perspetiva empírica, na tentativa de compreender o impacto da interação pedagógica na ocorrência de atos disruptivos, a análise e interpretação de dados obtidos por triangulação de métodos, a partir de uma população de alunos de 3ºciclo, professores e pais, permitindo uma reflexão e confrontação sobre as representações destes atores e as realidades observadas.

Improving computer interaction for older people - studying mouse clicks

Interactions using a standard computer mouse can be particularly difficult for novice and older adult users. Tasks that involve positioning the mouse over a target and double-clicking to initiate some action can be a real challenge for many users. Hence, this paper describes a study that investigates the double-click interactions of older and younger adults and presents data that can help inform the development of methods of assistance. Twelve older adults (mean age = 63.9 years) and 12 younger adults (mean age = 20.8 years) performed click and double-click target selections with a computer mouse. Initial results show that older users make approximately twice as many errors as younger users when attempting double-clicks. For both age groups, the largest proportion of errors was due to difficulties with keeping the cursor steady between button presses. Compared with younger adults, older adults experienced more difficulties with performing two button presses within a required time interval. Understanding these interactions better is a step towards improving accessibility, and may provide some suggestions for future directions of research in this area.

Data assimilation for marine monitoring and prediction: The MERCATOR operational assimilation systems and the MERSEA developments

During the past 15 years, a number of initiatives have been undertaken at national level to develop ocean forecasting systems operating at regional and/or global scales. The co-ordination between these efforts has been organized internationally through the Global Ocean Data Assimilation Experiment (GODAE). The French MERCATOR project is one of the leading participants in GODAE. The MERCATOR systems routinely assimilate a variety of observations such as multi-satellite altimeter data, sea-surface temperature and in situ temperature and salinity profiles, focusing on high-resolution scales of the ocean dynamics. The assimilation strategy in MERCATOR is based on a hierarchy of methods of increasing sophistication including optimal interpolation, Kalman filtering and variational methods, which are progressively deployed through the Syst`eme d’Assimilation MERCATOR (SAM) series. SAM-1 is based on a reduced-order optimal interpolation which can be operated using ‘altimetry-only’ or ‘multi-data’ set-ups; it relies on the concept of separability, assuming that the correlations can be separated into a product of horizontal and vertical contributions. The second release, SAM-2, is being developed to include new features from the singular evolutive extended Kalman (SEEK) filter, such as three-dimensional, multivariate error modes and adaptivity schemes. The third one, SAM-3, considers variational methods such as the incremental four-dimensional variational algorithm. Most operational forecasting systems evaluated during GODAE are based on least-squares statistical estimation assuming Gaussian errors. In the framework of the EU MERSEA (Marine EnviRonment and Security for the European Area) project, research is being conducted to prepare the next-generation operational ocean monitoring and forecasting systems. The research effort will explore nonlinear assimilation formulations to overcome limitations of the current systems. This paper provides an overview of the developments conducted in MERSEA with the SEEK filter, the Ensemble Kalman filter and the sequential importance re-sampling filter.

How could construction supply chain benefit from RFID/GPS integration: a knowledge management perspective

Construction materials and equipment are essential building blocks of every construction project and may account for 50-60 per cent of the total cost of construction. The rate of their utilization, on the other hand, is the element that most directly relates to a project progress. A growing concern in the industry that inadequate efficiency hinders its success could thus be accommodated by turning construction into a logistic process. Although mostly limited, recent attempts and studies show that Radio Frequency IDentification (RFID) applications have significant potentials in construction. However, the aim of this research is to show that the technology itself should not only be used for automation and tracking to overcome the supply chain complexity but also as a tool to generate, record and exchange process-related knowledge among the supply chain stakeholders. This would enable all involved parties to identify and understand consequences of any forthcoming difficulties and react accordingly before they cause major disruptions in the construction process. In order to achieve this aim the study focuses on a number of methods. First of all it develops a generic understanding of how RFID technology has been used in logistic processes in industrial supply chain management. Secondly, it investigates recent applications of RFID as an information and communication technology support facility in construction logistics for the management of construction supply chain. Based on these the study develops an improved concept of a construction logistics architecture that explicitly relies on integrating RFID with the Global Positioning System (GPS). The developed conceptual model architecture shows that categorisation provided through RFID and traceability as a result of RFID/GPS integration could be used as a tool to identify, record and share potential problems and thus vastly improve knowledge management processes within the entire supply chain. The findings thus clearly show a need for future research in this area.

Flesh colour dominates consumer preference for chicken

Existing research investigating interactions between visual and oral sensory cues has tended to use model food systems. In contrast, this study compared product quality assessments of corn-fed and wheat-fed chicken products among persons recruited in Northern Ireland. Three approaches have been adopted to investigate the effect of colour upon consumer choice of chicken: sensory assessment under normal lighting; focus group discussion; and sensory assessment under controlled lighting conditions. Initial consumer sensory assessment indicated that wheat-fed chicken was perceived to be tenderer and to have a more intense flavour than that which was corn-fed. Qualitative enquiry discerned that this was because consumers perceived the yellow colour of corn-fed chicken negatively. Yellow-coloured corn-fed chicken was therefore again compared with wheat-fed chicken in terms of flavour, texture and overall liking with the flesh colour disguised by means of controlled lighting. Quality ratings for corn-fed chicken were more positive when the yellow flesh colour was disguised, with corn-fed chicken judged to be tenderer than wheat-fed chicken and more flavoursome. This study illustrates the importance of using a combination of methods to gain insight into interactions between different sensory modalities in consumer quality judgements and adds to previous research on the importance of colour upon consumer choice of real foods. (c) 2005 Elsevier Ltd. All rights reserved.

Semiotic modelling for complex enterprise systems

An enterprise is viewed as a complex system which can be engineered to accomplish organisational objectives. Systems analysis and modelling will enable to the planning and development of the enterprise and IT systems. Many IT systems design methods focus on functional and non-functional requirements of the IT systems. Most methods are normally capable of one but leave out other aspects. Analysing and modelling of both business and IT systems may often have to call on techniques from various suites of methods which may be placed on different philosophic and methodological underpinnings. Coherence and consistency between the analyses are hard to ensure. This paper introduces the Problem Articulation Method (PAM) which facilitates the design of an enterprise system infrastructure on which an IT system is built. Outcomes of this analysis represent requirements which can be further used for planning and designing a technical system. As a case study, a finance system, Agresso, for e-procurement has been used in this paper to illustrate the applicability of PAM in modelling complex systems.

Knowledge and information evaluation practice: an exploratory study in a construction firm

There are a number of challenges associated with managing knowledge and information in construction organizations delivering major capital assets. These include the ever-increasing volumes of information, losing people because of retirement or competitors, the continuously changing nature of information, lack of methods on eliciting useful knowledge, development of new information technologies and changes in management and innovation practices. Existing tools and methodologies for valuing intangible assets in fields such as engineering, project management and financial, accounting, do not address fully the issues associated with the valuation of information and knowledge. Information is rarely recorded in a way that a document can be valued, when either produced or subsequently retrieved and re-used. In addition there is a wealth of tacit personal knowledge which, if codified into documentary information, may prove to be very valuable to operators of the finished asset or future designers. This paper addresses the problem of information overload and identifies the differences between data, information and knowledge. An exploratory study was conducted with a leading construction consultant examining three perspectives (business, project management and document management) by structured interviews and specifically how to value information in practical terms. Major challenges in information management are identified. An through-life Information Evaluation methodology (IEM) is presented to reduce information overload and to make the information more valuable in the future.

Changing building user attitude and organisational policy towards sustainable resource use in healthcare

Health care provision is significantly impacted by the ability of the health providers to engineer a viable healthcare space to support care stakeholders needs. In this paper we discuss and propose use of organisational semiotics as a set of methods to link stakeholders to systems, which allows us to capture clinician activity, information transfer, and building use; which in tern allows us to define the value of specific systems in the care environment to specific stakeholders and the dependence between systems in a care space. We suggest use of a semantically enhanced building information model (BIM) to support the linking of clinician activity to the physical resource objects and space; and facilitate the capture of quantifiable data, over time, concerning resource use by key stakeholders. Finally we argue for the inclusion of appropriate stakeholder feedback and persuasive mechanism, to incentivise building user behaviour to support organisational level sustainability policy.

An organisational semiotics inspired information architecture: pervasive healthcare as a case study

Information architecture (IA) is defined as high level information requirements of an organisation. It is applied in areas such as information systems development, enterprise architecture, business processes management and organisational change management. Still, the lack of methods and theories prevents information architecture becoming a distinct discipline. Healthcare organisation is always seen as information intensive organisation, moreover in a pervasive healthcare environment. Pervasive healthcare aims to provide healthcare services to anyone, anywhere and anytime by incorporating mobile devices and wireless network. Information architecture hence plays an important role in information provisioning within the context of pervasive healthcare in order to support decision making and communication between clinician and patients. Organisational semiotics is one of the social technical approaches that contemplate information through the norms or activities performed within an organisation prior to pervasive healthcare implementation. This paper proposes a conceptual design of information architecture for pervasive healthcare. It is illustrated with a scenario of mental health patient monitoring.

A high resolution late Holocene palaeo environmental record from the central Adriatic Sea

A multi-proxy study of a Holocene sediment core (RF 93-30) from the western flank of the central Adriatic, in 77 m of water, reveals a sequence of changes in terrestrial vegetation, terrigenous sediment input and benthic fauna, as well as evidence for variations in sea surface temperature spanning most of the last 7000 yr. The chronology of sedimentation is based on several lines of evidence, including AMS 14C dates of foraminifera extracted from the core, palaeomagnetic secular variation, pollen indicators and dated tephra. The temporal resolution increases towards the surface and, for some of the properties measured, is sub-decadal for the last few centuries. The main changes recorded in vegetation, sedimentation and benthic foraminiferal assemblages appear to be directly related to human activity in the sediment source area, which includes the Po valley and the eastern flanks of the central and northern Appenines. The most striking episodes of deforestation and expanding human impact begin around 3600 BP (Late Bronze Age) and 700 BP (Medieval) and each leads to an acceleration in mass sedimentation and an increase in the proportion of terrigenous material, reflecting the response of surface processes to widespread forest clearance and cultivation. Although human impact appears to be the proximal cause of these changes, climatic effects may also have been important. During these periods, signs of stress are detectable in the benthic foram morphotype assemblages. Between these two periods of increased terrigeneous sedimentation there is smaller peak in sedimentation rate around 2400BP which is not associated with evidence for deforestation, shifts in the balance between terrigenous and authigenic sedimentation, or changes in benthic foraminifera. The mineral magnetic record provides a sensitive indicator of changing sediment sources: during forested periods of reduced terrigenous input it is dominated by authigenic bacterial magnetite, whereas during periods of increased erosion, anti-ferromagetic minerals (haematite and/or goethite) become more important, as well as both paramagnetic minerals and super-paramagnetic magnetite. Analysis of the alkenone, U37k′, record provides an indication of possible changes in sea surface temperature during the period, but it is premature to place too much reliance on these inferred changes until the indirect effects of past changes in the depth of the halocline and in circulation have been more fully evaluated. The combination of methods used and the results obtained illustrate the potential value of such high resolution near-shore marine sedimentary sequences for recording wide-scale human impact, documenting the effects of this on marine sedimentation and fauna and, potentially, disentangling evidence for human activities from that for past changes in climate.