Clinical indicators for the initiation of endotracheal suction in children: An integrative review.

BACKGROUND: Critical decisions and interpretation of observations by the nurse caring for the paediatric intensive care (PIC) patient can have dramatic and potential adverse impact on the clinical stability of the patient. A common PIC procedure is endotracheal tube (ETT) suction, however there is inconsistent evidence regarding the clinical indicators to guide and support nursing action. Justification for performing this procedure is not clearly defined within the literature. Further, a review of the literature has failed to establish clear standards for determining if the procedure is warranted, especially for paediatric patients. OBJECTIVE: The objective of the review is to identify current clinical indicators used in practice to determine why ETT suction should be performed. METHOD: An integrative review using a systematic approach to summarise the empirical and theoretical evidence within the literature as it relates to clinical practice was used. RESULTS: Consensus of opinion indicates that ETT suctioning should only be performed when clinically indicated. There is no general consensus regarding which clinical indicators should be measured and used to guide the decision to perform ETT suctioning. CONCLUSION: Research is required to identify the clinical indicators that could be used to design a valid and clinically appropriate tool to use to assist in the decision making process to perform ETT suction.

Enregistrement des fluctuations de la pression intraoculaire sur 24 heures par une lentille de contact intégrant un capteur: tolérance et résultats chez 10 sujets sains

AbstractPurpose: to evaluate the tolerability, comfort and precision of the signal transmission of an ocular Sensor used for 24-hour intraocular pressure fluctuation monitoring in humans.Patients and methods: In this uncontrolled open trial involving 10 healthy volunteers an 8.7 mm radius prototype ocular telemetry Sensor (SENSIMED Triggerfish®, Lausanne, Switzerland) and an orbital bandage containing a loop antenna were applied and connected to a portable recorder after full eye examination. Best corrected visual acuity and position, surface wetting ability and mobility of the Sensor were assessed after 5 and 30 minutes, 4, 12 and 24 hours. Subjective wearing comfort was scored and activities documented in a logbook. After Sensor removal a full eye examination was repeated and the recorded signal analyzed.Results: The comfort score was high and did not fluctuate significantly over time. The mobility of the Sensor was limited across follow-up visits and its surface wetting ability remained good. Best corrected visual acuity was significantly reduced during Sensor wear and immediately after its removal (from 1.07 before, to 0.85 after, P-value 0.008). Three subjects developed a mild, transient corneal abrasion. In all but one participant we obtained usable data of a telemetric signal recording with sufficient sensitivity to depict ocular pulsation.Conclusions: This 24-hour- trial has encouraging results on the tolerability and functionality of the ocular telemetric Sensor for intraocular pressure fluctuation monitoring. Further studies with different Sensor radii conducted on a larger study population are needed to improve comfort, precision and interpretation of the telemetric signal.

La Cantata a Europa a l’entorn del segle XVIII : música da camera italiana del Barroc tardà

La cantata da camera italiana va tenir el seu màxim esplendor durant el segle XVII i principis del XVIII. A partir de l’anàlisi d’obres de quatre compositors (Albinoni, Scarlatti, Caldara i Vivaldi) s’estudia l’evolució d’aquesta forma, els seus orígens i la seva interpretació, fent especial atenció al text i a l’ornamentació.

Clinical Proton MR Spectroscopy in Central Nervous System Disorders.

A large body of published work shows that proton (hydrogen 1 [(1)H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors present a summary of brain disorders in which MR spectroscopy has an impact on patient management, together with a critical consideration of common data acquisition and processing procedures. The article documents the impact of (1)H MR spectroscopy in the clinical evaluation of disorders of the central nervous system. The clinical usefulness of (1)H MR spectroscopy has been established for brain neoplasms, neonatal and pediatric disorders (hypoxia-ischemia, inherited metabolic diseases, and traumatic brain injury), demyelinating disorders, and infectious brain lesions. The growing list of disorders for which (1)H MR spectroscopy may contribute to patient management extends to neurodegenerative diseases, epilepsy, and stroke. To facilitate expanded clinical acceptance and standardization of MR spectroscopy methodology, guidelines are provided for data acquisition and analysis, quality assessment, and interpretation. Finally, the authors offer recommendations to expedite the use of robust MR spectroscopy methodology in the clinical setting, including incorporation of technical advances on clinical units. © RSNA, 2014 Online supplemental material is available for this article.

Aproximaciones al estudio de la interacción individuo-paisaje a modo de evocacion comunicativa intrapersonal (2a. parte)

El análisis de la interacción individuo-paisaje presenta numerosas perspectivas de estudio vinculadas a la generación e interpretación de simbolismos e imaginarios. La capacidad significante y/o de evocación comunicativa del paisaje encuentra, en la comunicación intrapersonal, una argumentación relevante en el proceso de construcción de un aparato teórico que permita estudiar el proceso de apropiación y vivencia del paisaje en términos de manifestación comunicativa. El despliegue de un aparato teórico que permita interpretar el mensaje del paisaje así como descodificar su discurso intangible, representa el objetivo principal de la investigación que se presenta a continuación.

Aproximaciones al estudio de la interacción individuo-paisaje a modo de evocación comunicativa intrapersonal (1a. parte)

El análisis de la interacción individuo-paisaje presenta numerosas perspectivas de estudio vinculadas a la generación e interpretación de simbolismos e imaginarios. La capacidad significante y/o de evocación comunicativa del paisaje encuentra, en la comunicación intrapersonal, una argumentación relevante en el proceso de construcción de un aparato teórico que permita estudiar el proceso de apropiación y vivencia del paisaje en términos de manifestación comunicativa. El despliegue de un aparato teórico que permita interpretar el mensaje del paisaje así como descodificar su discurso intangible, representa el objetivo principal de la investigación que se presenta a continuación.

Visualitzador de molècules d'ADN per laboratori virtual

RESUM Com a continuació del treball de final de carrera “Desenvolupament d’un laboratori virtual per a les pràctiques de Biologia Molecular” de Jordi Romero, s’ha realitzat una eina complementaria per a la visualització de molècules integrada en el propi laboratori virtual. Es tracta d’una eina per a la visualització gràfica de gens, ORF, marques i seqüències de restricció de molècules reals o fictícies. El fet de poder treballar amb molècules fictícies és la gran avantatge respecte a les solucions com GENBANK que només permet treballar amb molècules pròpies. Treballar amb molècules fictícies fa que sigui una solució ideal per a l’ensenyament, ja que dóna la possibilitat als professors de realitzar exercicis o demostracions amb molècules reals o dissenyades expressament per a l’exercici a demostrar. A més, permet mostrar de forma visual les diferents parts simultàniament o per separat, de manera que ofereix una primera aproximació interpretació dels resultats. Per altra banda, permet marcar gens, crear marques, localitzar seqüències de restricció i generar els ORF de la molècula que nosaltres creem o modificar una ja existent. Per l’implementació, s’ha continuat amb l’idea de separar la part de codi i la part de disseny en les aplicacions Flash. Per fer-ho, s’ha utilitzat la plataforma de codi lliure Ariware ARPv2.02 que proposa un marc de desenvolupament d’aplicacions Flash orientades a objectes amb el codi (classes ActionScript 2.0) separats del movieclip. Per al processament de dades s’ha fet servir Perl per ser altament utilitzat en Bioinformàtica i per velocitat de càlcul. Les dades generades es guarden en una Base de Dades en MYSQL (de lliure distribució), de la que s’extreuen les dades per generar fitxers XML, fent servir tant PHP com la plataforma AMFPHP com a enllaç entre Flash i la resta de parts.

Consideraciones educativas de la perspectiva ecológica de Urie Bronferbrenner

El objetivo de este artículo es presentar las bases teóricas y algunas aplicaciones contemporáneas de la teoría de Urie Bronfenbrenner. En primer lugar, se describe su biografía. Posteriormente, se explica su teoría ecología, su modelo “Proceso-Persona-Contexto-Tiempo” (PPCT) y su reciente aproximación bioecológica. A continuación, exponemos algunas consideraciones educativas de su teoría. Más específicamente, destacamos seis temas basados en algunas ideas de Bronfenbrenner: 1) la relación entre política social y ciencia, 2) la creación de contextos de desarrollo primarios y secundarios, 3) la implicación afectiva, 4) el currículo centrado en el cuidado o la atención de las personas, 5) la intervención comunitaria, y 6) el establecimiento de continuidades entre microsistemas (noción de “mesosistema”). Finalmente, revisamos algunas aportaciones contemporáneas en psicología y ciencias de la educación basadas en la perspectiva de Bronfenbrenner

Émergence du moi cérébral de Theodor Meynert à Antonio Damasio = Emergence of the cerebral self, from Theodor Meynert to Antonio Damasio

Antonio Damasio's works have brought emotions into line with current trends in neuroscience. They are conceived as the addition, to a perception, of the somatic effects it has induced. Nevertheless, this continuous and relatively steady process of body perception has also led to the less-known hypothesis of the "neural self." Behind the explicit and apparently contradictory reference to William James and Sigmund Freud, there lies a common source: Theodor Meynert's conception of a "cortical self." Our aim is to enlight a stream unified around what we call here "cerebral self." The Self is thus considered as the cerebral projection or presentation of the body. The specificity of this notion is particularly highlighted by its confrontation to the closely, yet disembodied, notion of "cerebral subject.". Pour citer cette revue : Psychiatr. Sci. Hum. Neurosci. 9 (2011).

Avaluació de revistes i avaluació de la recerca en humanitats i ciències socials a Catalunya: aproximació a un problema

The evaluation of the quality and impact of journals as a starting point to systematise the quality of research is an indirect method commonly used for obtaining information for systematic and major evaluation efforts, such as those needed for public tenders to aid projects and research groups. Nevertheless, this method runs into an important obstacle: preparing rankings of journals in the humanities and social sciences is considerably more complex than for those on experimental, biomedical or technological sciences. Cultural, linguistic and territorial components of research in the humanities and social sciences radically question the international rankings. Within this context, the article presents the experience of a study-in-progress whose intention is to evaluate the rankings of journals in the humanities and social sciences published in 1997 by the Generalitat de Catalunya. Even thought an attempt was made to bring this type of titles closer to the Catalan community of researchers, the initiative has been frequently surrounded by controversy and criticism and, at the present, does not enjoy the needed recognition of the Catalan academic sector.

Modifications in the Si valence band after ion-beam-induced oxidation

The changes undergone by the Si surface after oxygen bombardment have special interest for acquiring a good understanding of the Si+-ion emission during secondary ion mass spectrometry (SIMS) analysis. For this reason a detailed investigation on the stoichiometry of the builtup surface oxides has been carried out using in situ x-ray photoemission spectroscopy (XPS). The XPS analysis of the Si 2p core level indicates a strong presence of suboxide chemical states when bombarding at angles of incidence larger than 30°. In this work a special emphasis on the analysis and interpretation of the valence band region was made. Since the surface stoichiometry or degree of oxidation varies with the angle of incidence, the respective valence band structures also differ. A comparison with experimentally measured and theoretically derived Si valence band and SiO2 valence band suggests that the new valence bands are formed by a combination of these two. This arises from the fact that Si¿Si bonds are present on the Si¿suboxide molecules, and therefore the corresponding 3p-3p Si-like subband, which extends towards the Si Fermi level, forms the top of the respective new valence bands. Small variations in intensity and energy position for this subband have drastic implications on the intensity of the Si+-ion emission during sputtering in SIMS measurements. A model combining chemically enhanced emission and resonant tunneling effects is suggested for the variations observed in ion emission during O+2 bombardment for Si targets.

Comprehensive Bridge Deck Deterioration Mapping of Nine Bridges by Nondestructive Evaluation Technologies Final Report, January 2011

The primary objective of this research was to demonstrate the benefits of NDT technologies for effectively detecting and characterizing deterioration in bridge decks. In particular, the objectives were to demonstrate the capabilities of ground-penetrating radar (GPR) and impact echo (IE), and to evaluate and describe the condition of nine bridge decks proposed by Iowa DOT. The first part of the report provides a detailed review of the most important deterioration processes in concrete decks, followed by a discussion of the five NDT technologies utilized in this project. In addition to GPR and IE methods, three other technologies were utilized, namely: half-cell (HC) potential, electrical resistivity (ER), and ultrasonic surface waves (USW) method. The review includes a description of the principles of operation, field implementation, data analysis, and interpretation; information regarding their advantages and limitations in bridge deck evaluations and condition monitoring are also implicitly provided.. The second part of the report provides descriptions and bridge deck evaluation results from the nine bridges. The results of the NDT surveys are described in terms of condition assessment maps and are compared with the observations obtained from the recovered cores or conducted bridge deck rehabilitation. Results from this study confirm that the used technologies can provide detailed and accurate information about a certain type of deterioration, electrochemical environment, or defect. However, they also show that a comprehensive condition assessment of bridge decks can be achieved only through a complementary use of multiple technologies at this stage,. Recommendations are provided for the optimum implementation of NDT technologies for the condition assessment and monitoring of bridge decks.

Herpesvirus-associated B-cell proliferations

This article reviews the spectrum of Epstein-Barr virus and Kaposi sarcoma herpesvirus (KSHV/HHV-8)-associated B-cell lymphoid proliferations, their pathologic features and clinical presentation, diagnostic criteria, and pathogenetic aspects. Emphasis is on the differential diagnosis issues and difficulties that the pathologist may face for the correct identification and interpretation of these lesions.