709 resultados para Sint Maarten


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'Dissertatio inauguralis', Halle.

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Mode of access: Internet.

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Title-page of stuk II: Hulde aan Gysbert Japiks door J. Hiddes Halbertsma. Leeuwarden, H.C. Schetsberg, 1827.

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El presente trabajo brinda una propuesta pedag?gica basada en la importancia de las controversias cient?fico-hist?rico para la ense?a de las ciencias naturales, especialmente para la ense?anza del desarrollo de la evoluci?n biol?gica. Se pretende, a trav?s de esta propuesta, propiciar un pensamiento y una actitud cr?tica frente al conocimiento, est? dirigida a los docentes en formaci?n de la Licenciatura en Ciencias Naturales y Educaci?n Ambiental. Se plantea la controversia de Lamarck y la teor?a sint?tica de la evoluci?n, para lo que es necesaria una perspectiva de la historia y la filosof?a de la ciencia no convencional, que permita conocer, analizar y valorar el contexto pol?tico, social, econ?mico, cultural y religioso en el que se desarroll? el conocimiento cient?fico. Lo que implico, adem?s, un estudio arduo de fuentes primarias como es el libro Filosof?a zool?gica (1986) de Lamarck. Cabe aclarar que dicho an?lisis del contexto solo se realiz? para el caso de Lamarck. La finalizaci?n que se propone para la controversia es una ?clausura por negociaci?n? con la cual se deja a un lado la idea de buenos y malos, o ganadores y perdedores, y se privilegia un pensamiento cr?tico. Tambi?n se evidencian los valores que cada una de las teor?as (la sint?tica de la evoluci?n y la de Lamarck) comunica y las implicaciones educativas de los mismos, haciendo ?nfasis en los valores que estas transmiten. Finalmente se reflexiona sobre lo que los planes de estudio y las pol?ticas del estado, enmarcado en los est?ndares b?sicos de competencias (en el contexto Colombiano), pretenden en cuanto al tema de evoluci?n biol?gica.

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En este trabajo se realiza un estudio del desarrollo hist?rico de la noci?n de curva desde la forma sint?tica hasta la representaci?n anal?tica; tomando como rejilla de an?lisis dos categor?as metodol?gicas presentes en el tratamiento hist?rico de la noci?n de curva como lo son la tematizaci?n y la generalizaci?n. Y considerando los aportes m?s importantes de la concepci?n de las curvas en la antigua Grecia, en la geometr?a cartesiana y en la representaci?n de las curvas mediante series de potencias.

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Recommendations to improve national diabetes-related foot disease (DRFD) care • National data collection on incidence and outcomes of DRFD. • Improved access to care, through the Medicare Benefits Schedule, for people with diabetes who have a current or past foot complication. • Standardised national model for interdisciplinary DRFD care. • National accreditation of interdisciplinary foot clinics and staff. • Subsidies for evidence-based treatments for DRFD, including medical-grade footwear and pressure off-loading devices. • Holistic diabetes care initiatives to “close the gap” on inequities in health outcomes for Aboriginal and Torres Strait Islander peoples.

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Summary Appropriate assessment and management of diabetes-related foot ulcers (DRFUs) is essential to reduce amputation risk. Management requires debridement, wound dressing, pressure off-loading, good glycaemic control and potentially antibiotic therapy and vascular intervention. As a minimum, all DRFUs should be managed by a doctor and a podiatrist and/or wound care nurse. Health professionals unable to provide appropriate care for people with DRFUs should promptly refer individuals to professionals with the requisite knowledge and skills. Indicators for immediate referral to an emergency department or multidisciplinary foot care team (MFCT) include gangrene, limb-threatening ischaemia, deep ulcers (bone, joint or tendon in the wound base), ascending cellulitis, systemic symptoms of infection and abscesses. Referral to an MFCT should occur if there is lack of wound progress after 4 weeks of appropriate treatment.

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Objective. The aim of this paper is to report the clinical practice changes resulting from strategies to standardise diabetic foot clinical management in three diverse ambulatory service sites in Queensland, Australia. Methods. Multifaceted strategies were implemented in 2008, including: multidisciplinary teams, clinical pathways, clinical training, clinical indicators, and telehealth support. Prior to the intervention, none of the aforementioned strategies were used, except one site had a basic multidisciplinary team. A retrospective audit of consecutive patient records from July 2006 to June 2007 determined baseline clinical activity (n = 101).Aclinical pathway teleform was implemented as a clinical activity analyser in 2008 (n = 327) and followed up in 2009 (n = 406). Pre- and post-implementation data were analysed using Chi-square tests with a significance level set at P < 0.05. Results. There was an improvement in surveillance of the high risk population of 34% in 2008 and 19% in 2009, and treating according to risk of 15% in 2009 (P < 0.05). The documentation of all best-practice clinical activities performed improved 13–66% (P < 0.03). Conclusion. These findings support the use of multifaceted strategies to standardise practice and improve diabetic foot complications management in diverse ambulatory services.