Correlación entre el resultado refractivo post-catarata con la predicción biométrica pre-operatoria

La cirugía de cataratas por Facoemulsificación es tal vez uno de los procedimientos más realizados en la práctica de oftalmología general, sin embargo el resultado refractivo de esta cirugía no siempre llena las expectativas del oftalmólogo y del paciente, es por esto que es de gran importancia observar los resultados post quirúrgicos obtenidos y las distintas variables que pudieron influir en dicho resultado. Objetivo: determinar la capacidad predictiva de la formula biométrica empleada en el preoperatorio con el resultado refractivo post operatorio expresada en porcentajes. Materiales y métodos: se realizó un estudio de correlación basándose en la refracción prevista por la biometría y la refracción encontrada en el post operatorio. Se analizó los diferentes grupos de pacientes miopes, hipermétropes y emétropes en de los rangos de 0,50D, 0,75 D y 1,00D. Resultados: el porcentaje de pacientes que presento 0,50D de diferencia con el previsto fue de 57,7% para el total, 100% para hipermétropes, 53,1% para emétropes, 56,3% para miopes. En el rango de 0,75D 71,2% para el total, 62,5% para emétropes y 81,3% para miopes. En el rango de 1,00D 82,7% para el total, 75% para emétropes y 93,8% para miopes. Conclusiones: la formula SRK/T presento un buen desempeño en todos los grupos encontrándose resultados concordantes con los descritos en la literatura.

Intervención psicológica pre y post-quirúrgica para pacientes adultos con amputación de miembros superiores y/o inferiores

La presente revisión de la literatura tiene el objetivo de identificar las intervenciones psicológicas pre y postquirúrgicas para pacientes con amputación no traumática. Se identifica que las amputaciones por artropatía diabética son más frecuentes que las causadas por otras enfermedades aunque las amputaciones por cáncer, arterioesclerosis e infección también son prevalentes. La amputación es un evento altamente significativo en el sujeto y demanda un costoso reajuste que se ve influenciado por variables sociodemográficas y que tiene consecuencias psicosociales que requieren de la atención y acompañamiento de un equipo interdisciplinario. En la fase preoperatoria, al manifestarse ansiedad y temores subjetivos con respecto la amputación, las intervenciones se dirigen a favorecer la verbalización e identificación de recursos. En la fase postoperatoria se acompaña el proceso de adaptación y rehabilitación con el manejo de las consecuencias psicosociales más demandantes para el sujeto. La terapia cognitivo conductual en el proceso postoperatorio es la más frecuentemente utilizada.

Mediastinitis post revascularización miocárdica: impacto del cambio de profilaxis antibiótica en la fundación Cardioinfantil 2012 - 2013

INTRODUCCIÓN. La mediastinitis posterior a cirugía de revascularización miocárdica es una infección infrecuente, pero potencialmente fatal. En la Fundación Cardioinfantil se ha observado una tendencia al incremento de la misma en los últimos años, obligando a un cambio en las medidas de profilaxis antimicrobiana, pasando de cefalosporinas a vancomicina – gentamicina, sin embargo no se conoce aún el impacto de estas medidas. OBJETIVO: Determinar si el cambio de la profilaxis antibiótica en pacientes sometidos a revascularización miocárdica influye en una disminución de la incidencia de mediastinitis durante los años 2012 – 2013. METODOLOGÍA: Estudio de cohortes retrospectivo, evaluando la incidencia de mediastinitis post revascularización miocárdica, en pacientes expuestos a 2 diferentes tipos de profilaxis antimicrobiana (cefalosporinas vs vancomicina-gentamicina). Se describieron los patrones de susceptibilidad y resistencia de los patógenos encontrados en mediastinitis y la mortalidad de esta patología. RESULTADOS: Los patógenos más frecuentemente aislados en la mediastinitis fueron Staphylococcus aureus y Klebsiella pneumoniae, en la mayoría monomicrobiano. Se encontraron patógenos con perfiles de resistencia como betalactamasas de espectro extendido en Gram negativos y resistencia a la meticilina en cocos Gram positivos. El RR de mediastinitis del grupo expuesto a vancomicina-gentamicina respecto al grupo de cefalosporinas fue de 0,9 con IC 95% 0,28 – 3,28. CONCLUSIÓN: la epidemiologia microbiana de la mediastinitis no difiere de la reportada en otras series. La profilaxis antimicrobiana con vancomicina - gentamicina en pacientes sometidos a revascularización miocárdica, no redujo la incidencia de mediastinitis. Se propone regresar a la terapia de profilaxis con cefalosporinas.

Corticoides versus Placebo o tratamiento conservador en Cefalea post punción dural. Revisión sistemática y metaanálisis

Introducción Se realizó una revisión sistemática de la literatura y metaanálisis para determinar la utilidad, en términos de reducción de la intensidad y la prevención de la cefalea post-punción dural, de los corticoides endovenosos. Materiales y métodos Revisión sistemática y metaanálisis, dos revisores seleccionaron y analizaron los artículos definidos en los términos de entrada, extrajeron características generales de los estudios incluidos, describieron los principales hallazgos y resumieron sus resultados. Se analizó la heterogeneidad por el coeficiente de I2 y Tau2 , la magnitud del efecto se analizó en el coeficiente Z, todos los estadísticos asumieron un nivel de significancia del 95%, en cuadros y figuras (de control de sesgos y Forres Plot) Resultados 75 Referencias fueron seleccionadas, 33 identificadas en la búsqueda y 48 por método de Snowball; Seis concordaron con los criterios de elegibilidad; 69 fueron excluidas por no cumplir con los criterios de inclusión; el enmascaramiento aspecto de mayor riesgo de sesgo (intermedio); en conjunto hubo buen control del riesgo de sesgo entre los estudios incluidos. Los resultados muestran baja heterogeneidad a favor de la intervención con corticoides en el tratamiento de la cefalea post-dural; amplia heterogeneidad y sin efecto para la prevención de la cefalea post-dural. Conclusiones Se recomienda el uso de hidrocortisona o metilprednisolona en la reducción de la intensidad de la cefalea post-dural. No se cuenta con evidencia de dexametasona en la prevención de cefalea postdural. Se requiere de estudios adicionales, con otras intervenciones farmacológicas que sobre la plausibilidad de la condición (cefalea post-dural) pudieran prevenir o disminuir su ocurrencia

Teaching character education through literature : awakening the moral imagination in secondary classrooms.

Trata de cómo los profesores de secundaria y post-secundaria pueden ayudar a los alumnos a ser más receptivos en los temas y cuestiones éticas que surgen de los relatos literarios estudiados en el aula. Se ofrecen al profesor varias maneras de sacar ideas instructivas de las narraciones de ficción. El libro está dividido en dos partes, la primera tiene un enfoque teórico, mientras que, en la segunda se dan los casos para su estudio, que corresponden a cuatro personajes literarios de otras tantas novelas, así como, una serie de preguntas planteadas para despertar la moral y estimular la reflexión ética en los estudiantes. Aunque, este planteamiento se puede aplicar, tambien, a los protagonistas de otras obras narrativas del plan de estudios.

Post-Sustainable Development

The past 15 years have witnessed the rise of post-development theory as a means of understanding the development discourse since the 1940s. Post-development argues that intentional development (as distinct from immanent development - what people are doing anyway) is a construct of Western hegemony. Sustainable development, they argue, is no different and indeed is perhaps worse, given that most of the global environmental degradation has been driven by consumerism and industrialization in the West. Critics of post-development counter by stating that it only provides destruction by tearing apart what is currently practiced in 'development' without providing an alternative. When post-developmentalists do offer an alternative it typically amouints to little more than a call for more grassroots involvement in development and disengagement from a Western agenda. Post-sustainable development analysis and counter-analysis has received remarkably little attention within the sustainable development literature, yet this paper argues that it can make a positive contributrion by calling for an analysis of discourse rather than a hiding of power differentials and an assumption that consensus must exist within a community. A case is made for a post-sustainable development that acknowledges that diversity will exist and consensus may not be achievable, but at the same time participation can help with learning. The role of the expert within sustainable development is also discussed. Copyright (C) 2008 John Wiley & Sons, Ltd and ERP Environment.

Critical review of health effects of soyabean phyto-oestrogens in post-menopausal women

A consensus view of soyabean phyto-oestrogens in clinical interventions in post-menopausal women is presented that is based on data from the EU-funded project Phytohealth. The phyto-oestrogens, primarily genistein and daidzein, were given as soyabean-protein isolates, whole-soyabean foods or extracts, supplements or pure compounds. A comprehensive literature search was conducted with well-defined inclusion or exclusion criteria. For areas for which substantial research exists only placebo-controlled double-blind randomised controlled trials (RCT) conducted on healthy post-menopausal women were included. For emerging areas all available human studies in post-menopausal women were reviewed. In order to make cross comparisons between studies the doses of isoflavones were calculated as aglycone equivalents. There is a suggestion, but no conclusive evidence, that isoflavones from the sources studied so far have a beneficial effect on bone health. The consumption of whole-soyabean foods and soyabean-protein isolates has some beneficial effects on lipid markers of cardiovascular risk. The consumption of isolated isoflavones does not affect blood lipid levels or blood pressure, although it may improve endothelial function. For menopausal symptoms there is currently limited evidence that soyabean-protein isolates, soyabean foods or red-clover (Trifolium pratense L.) extract are effective but soyabean isoflavone extracts may be effective in reducing hot flushes. There are too few RCT studies to reach conclusions on the effects of isoflavones on breast cancer, colon cancer, diabetes or cognitive function. The health benefits of soyabean phyto-oestrogens in healthy post-menopausal women are subtle and even some well-designed studies do not show protective effects. Future studies should focus on high-risk post-menopausal women, especially in the areas of diabetes, CVD, breast cancer and bone health.

Modelling oil absorption during post-frying cooling - II: solution of the mathematical model, model testing and simulations

The mathematical models that describe the immersion-frying period and the post-frying cooling period of an infinite slab or an infinite cylinder were solved and tested. Results were successfully compared with those found in the literature or obtained experimentally, and were discussed in terms of the hypotheses and simplifications made. The models were used as the basis of a sensitivity analysis. Simulations showed that a decrease in slab thickness and core heat capacity resulted in faster crust development. On the other hand, an increase in oil temperature and boiling heat transfer coefficient between the oil and the surface of the food accelerated crust formation. The model for oil absorption during cooling was analysed using the tested post-frying cooling equation to determine the moment in which a positive pressure driving force, allowing oil suction within the pore, originated. It was found that as crust layer thickness, pore radius and ambient temperature decreased so did the time needed to start the absorption. On the other hand, as the effective convective heat transfer coefficient between the air and the surface of the slab increased the required cooling time decreased. In addition, it was found that the time needed to allow oil absorption during cooling was extremely sensitive to pore radius, indicating the importance of an accurate pore size determination in future studies.

Traditional Chinese medicine research in the post-genomic era: good practice, priorities, challenges and opportunities

Background and aims: GP-TCM is the 1st EU-funded Coordination Action consortium dedicated to traditional Chinese medicine (TCM) research. This paper aims to summarise the objectives, structure and activities of the consortium and introduces the position of the consortium regarding good practice, priorities, challenges and opportunities in TCM research. Serving as the introductory paper for the GPTCM Journal of Ethnopharmacology special issue, this paper describes the roadmap of this special issue and reports how the main outputs of the ten GP-TCM work packages are integrated, and have led to consortium-wide conclusions. Materials and methods: Literature studies, opinion polls and discussions among consortium members and stakeholders. Results: By January 2012, through 3 years of team building, the GP-TCM consortium had grown into a large collaborative network involving ∼200 scientists from 24 countries and 107 institutions. Consortium members had worked closely to address good practice issues related to various aspects of Chinese herbal medicine (CHM) and acupuncture research, the focus of this Journal of Ethnopharmacology special issue, leading to state-of-the-art reports, guidelines and consensus on the application of omics technologies in TCM research. In addition, through an online survey open to GP-TCM members and non-members, we polled opinions on grand priorities, challenges and opportunities in TCM research. Based on the poll, although consortium members and non-members had diverse opinions on the major challenges in the field, both groups agreed that high-quality efficacy/effectiveness and mechanistic studies are grand priorities and that the TCM legacy in general and its management of chronic diseases in particular represent grand opportunities. Consortium members cast their votes of confidence in omics and systems biology approaches to TCM research and believed that quality and pharmacovigilance of TCM products are not only grand priorities, but also grand challenges. Non-members, however, gave priority to integrative medicine, concerned on the impact of regulation of TCM practitioners and emphasised intersectoral collaborations in funding TCM research, especially clinical trials. Conclusions: The GP-TCM consortium made great efforts to address some fundamental issues in TCM research, including developing guidelines, as well as identifying priorities, challenges and opportunities. These consortium guidelines and consensus will need dissemination, validation and further development through continued interregional, interdisciplinary and intersectoral collaborations. To promote this, a new consortium, known as the GP-TCM Research Association, is being established to succeed the 3-year fixed term FP7 GP-TCM consortium and will be officially launched at the Final GP-TCM Congress in Leiden, the Netherlands, in April 2012.

The post-financial crisis challenges for corporate governance and banking reform in China

The purpose of this paper is to review the impact of the global financial crisis on banking reform in China. The significant doubt concerning the efficiencies of Anglo-American model of corporate governance has raised a critical political question amongst scholars and practitioners as to whether China should continue to follow the U.K.-U.S. path in relation to financial reform. This conceptual paper provides an insightful review of the corporate governance literature and regulatory reports. After examining the fundamental limitations of the laissez-faire philosophy that underpins the neo-liberal model of capitalism, which promotes greater liberalization and less control, the paper considers the risks in opening China’s financial markets and relaxing monetary and fiscal policies. A critique of shareholder-capitalism is outlined in relation to the German’s “social market economy” styled capitalism. Through such analysis the paper explores a number of implications for China to consider in terms of developing a new and sustainable corporate governance model applicable to the Chinese context.

Entrepreneurial dynamics and higher education institutions in the post-communist world

This study draws on the institutional and regional entrepreneurship literature to develop a conceptual framework that analyses the impact of higher education institutions on entrepreneurial dynamics. It is used to examine the cities of the Commonwealth of Independent States (CIS) during the period 1995–2008. Extending the multi-pillar institutional concept, it is found that higher education institutions play a prominent role in fostering entrepreneurial dynamics in CIS cities through multiple channels, including human capital development, cultivating a positive attitude towards entrepreneurship, affecting the perceptions of the knowledge and skills needed to start up a successful business, and knowledge spillovers.

En applikationsinfrastruktur för massutskick av e-post

In today's society it is becoming more and more important with direct marketing. Some of the direct marketing is done through e-mail, in which companies see an easy way to advertise himself. I did this thesis work at WebDoc Systems. They have a product that creates web documents directly in your browser, also called CMS. The CMS has a module for sending mass e-mail, but this module does not function properly and WebDoc Systems customers are dissatisfied with that part of the product. The problem with the module was that sometimes it didn't send the e-mail, and that it was not possible to obtain some form of follow-up information on the e-mail. The goal of this work was to develop a Web service that could easily send e-mail to many receivers, just as easily be able to view statistics on how mailing has gone. The first step was to do a literature review to get a good picture of available programming platforms, but also to be able create a good application infrastructure. The next step was to implement this design and improve it over time by using an iterative development methodology. The result was an application infrastructure that consists of three main parts and a plugin interface. The parts that were implemented were a Web service application, a Web application and a Windows service application. The three elements cooperate with each other and share a database, and plugins.

The power of literature : A literature review on the incorporation of children’s literature in the lower-elementary English as a Second- Language classroom.

The use of children’s literature in the English as a Second language (ESL) classroom is a widely used teaching method. This study aims to find research relating to the incorporation of children’s literature in the lower elementary English as a secondlanguage classroom. The main questions are how children’s literature can be used in the classroom and what potential benefits it has. A systematic literature review was carried out and research from six studies was included. The included studies, analyzed in this thesis, involved children aged 6-9, who are learning a second language. The results reveal multiple benefits with the use of children’s literature in the lower elementary ESL classroom, such as vocabulary gains, improved speaking and listening skills, increased motivation and better pronunciation. The results also present a few suggestions on how to incorporate the literature in the classroom, where reading aloud to the students appears to be the most common practice. It also appears common to have post-reading sessions that include discussions about what has been read.

Постсекулярность и цифровой антиклерикализм в Рунете [Post-Secularity and Digital Anti-Clericalism on Runet]

This article deals with the phenomenon of “digital anti-clericalism” in the Russian-speaking sphere of the Internet (Runet). In the context of post-secularism the claims of Russian clerical and bureaucratic elites to the ideological monopoly in the political and social life face a strong resistance from the champions of religious pluralism and preservation of a secular state. Presented here is a detailed analysis of the topics and the stylistic features of different types of anti-clerical Internet communication – a variety of political folklore (memes, demotivators, photoshopped pictures). Also traced is the connection between the modern anti-clericalism on Runet and the late Soviet counter-culture. Suggested for the first time is a classification of anticlerical and atheist websites that constitute a vital part of the Russian blogosphere.