Establishing an association between a peri-operative perfusion score system (PerfSCORE) and post-operative patient morbidity/mortality during CPB cardiac surgery.

BACKGROUND: To date, there is no quality assurance program that correlates patient outcome to perfusion service provided during cardiopulmonary bypass (CPB). A score was devised, incorporating objective parameters that would reflect the likelihood to influence patient outcome. The purpose was to create a new method for evaluating the quality of care the perfusionist provides during CPB procedures and to deduce whether it predicts patient morbidity and mortality. METHODS: We analysed 295 consecutive elective patients. We chose 10 parameters: fluid balance, blood transfused, Hct, ACT, PaO2, PaCO2, pH, BE, potassium and CPB time. Distribution analysis was performed using the Shapiro-Wilcoxon test. This made up the PerfSCORE and we tried to find a correlation to mortality rate, patient stay in the ICU and length of mechanical ventilation. Univariate analysis (UA) using linear regression was established for each parameter. Statistical significance was established when p < 0.05. Multivariate analysis (MA) was performed with the same parameters. RESULTS: The mean age was 63.8 +/- 12.6 years with 70% males. There were 180 CABG, 88 valves, and 27 combined CABG/valve procedures. The PerfSCORE of 6.6 +/- 2.4 (0-20), mortality of 2.7% (8/295), CPB time 100 +/- 41 min (19-313), ICU stay 52 +/- 62 hrs (7-564) and mechanical ventilation of 10.5 +/- 14.8 hrs (0-564) was calculated. CPB time, fluid balance, PaO2, PerfSCORE and blood transfused were significantly correlated to mortality (UA, p < 0.05). Also, CPB time, blood transfused and PaO2 were parameters predicting mortality (MA, p < 0.01). Only pH was significantly correlated for predicting ICU stay (UA). Ultrafiltration (UF) and CPB time were significantly correlated (UA, p < 0.01) while UF (p < 0.05) was the only parameter predicting mechanical ventilation duration (MA). CONCLUSIONS: CPB time, blood transfused and PaO2 are independent risk factors of mortality. Fluid balance, blood transfusion, PaO2, PerfSCORE and CPB time are independent parameters for predicting morbidity. PerfSCORE is a quality of perfusion measure that objectively quantifies perfusion performance.

Evaluación de los recursos pelágicos: anchoveta, sardina, jurel y caballa en primavera 1989 : Crucero de evaluacion acustica BIC/SNP-1 8911-12 (Chicama - Punta Doña Maria)

Describe los principales resultados obtenidos en el Crucero evaluación de recursos pelágicos, efectuado a bordo del BIC/SNP-1 del 14 de noviembre de 1989, entre Chicama y Punta Doña María, constituyendo la segunda prospección planificada dentro del marco del proyecto Evaluación de los recursos: anchoveta, sardina, jurel y caballa, auspiciado por el Instituto del mar del Perú y la Comunidad económica europea.

Estructura especiológica del subsistema costero. E/P San Jacinto I 9512-9601

Se presenta la composición especiológica, el análisis comunitario y distribución de las capturas, obtenidas durante la prospección pesquera EP San Jacinto 9512-9601, desde Puerto Pizarro (03°29,0S) hasta Ilo (17°38.4S). Los arrastres de fondo mostraron que entre Puerto Pizarro y Salaverry se encuentra la mayor diversidad de especies (95), constituyendo los peces (58) el 93% (3,391 kg); destacan la "merluza" Merluccius gayi peruanus (1.311,1 Kg), el "falso volador" Prionotus stephanophrys (626,1 kg), la "cabrilla" Paralabrax humeralis (316,4 kg) y la "lorna" Sciaena deliciosa (247,3 kg). La mayor riqueza (33 especies) y el mayor índice de diversidad se obtuvo en la subárea B (04°-05°S), pero la mayor captura (2.295,2 kg) correspondió a la subárea C (05°-06° S). Los arrastres de media agua, se realizaron desde la desembocadura del río Piura hasta Ilo. El "camaroncito rojo" Pleuroncodes monodon alcanzó el 94% (1.089 kg) de la captura total, pero su distribución abarcó desde los 12° S hasta Ilo con las mayores capturas en las subáreas J (12°.13° S y L(14°-15° S) con 351 y 700 kg respectivamente. Los peces sólo representaron el 6% (46 kg) del volumen total de captura.

Finnish Maritime Personnel's Conceptions on Safety Management and Safety Culture

The purpose of this thesis is to explore Finnish maritime personnel’s conceptions of safety management and its relationship with the concept of safety culture. In addition, the aim is to evaluate the impact of the ISM Code on the prevailing safety culture in the Finnish shipping business. A total of 94 interviewees and seven Finnish shipping companies were involved in this study. Thematic interviews were applied as the main research method for the study. The results were analysed qualitatively. The results indicate that maritime safety culture can simultaneously demonstrate features of integration, differentiation and ambiguity. Basically, maritime personnel have a positive attitude towards safety management systems since they consider safety management beneficial and essential in general. However, the study also found considerable criticism among the interviewees. The interviewed maritime personnel did not criticise the ISM Code as such, yet they criticised the way the ISM Code has been applied in practise. In order to understand the multiple perspectives of safety culture more comprehensively, multiple theoretical perspectives and methodological approaches are needed. This study indicates that safety culture and the impacts of the ISM Code should not be unambiguously studied solely quantitative methods or qualitative methods. By examining safety culture from several methodological and theoretical perspectives, one may gain a more versatile and holistic overview of safety culture.

L'Écho de Paris

1907/09/09 (Numéro 8487).

L'Écho de Paris

1885/01/21 (Numéro 316).