Relació entre el coneixement bàsic sobre alimentació i nutrició i els hàbits alimentaris de l'alumnat d'ESO de l'Institut Damià Campeny. Proposta d'intervenció

La recerca que presento a continuació té l’objectiu fonamental, com el seu propi títol indica, de relacionar els coneixements bàsics sobre alimentació i nutrició i els hàbits alimentaris de l’alumnat d’Educació Secundària Obligatòria (ESO) de l’Institut Damià Campeny de Mataró. Aquesta temàtica m’ha interessat des de la meva infància, ja que jo mateix era un jove amb sobrepès absorbit pels vicis alimentaris de la societat i la família. Vaig haver de sobreposar-me a aquest petit trauma i trobar solucions a una situació que m’era incòmode i perjudicial. Gràcies a l’esport i a una voluntat de millora dels meus hàbits alimentaris vaig poder reconvertir la situació fins a tenir un pes saludable. Des d’aleshores sempre m’ha interessat el tema d’alimentació i nutrició, i m’he anat formant gràcies a la meva recerca personal més que pels recursos que se m’han ofert, molt limitats sobretot des de l’escola i l’institut. Per últim vull agregar que aquesta recerca té un caràcter totalment individualitzat en l’Institut Damià Campeny de Mataró ja que ha estat el centre on jo he realitzat les pràctiques de professor d’Educació Física durant els mesos de febrer i maig de 2013. A més d’analitzar el seu context i planificar una proposta d’intervenció interdisciplinar el més adequada possible, m’agradaria que el treball no s’estanqués en aquest punt i que algú de l’Institut pogués aprofitar-se d’aquesta feina realitzada per intentar aplicar aquesta proposta a mig/llarg termini.

Sefer Ḳohelet Shelomoh : bo niḳhalu kamah devarim ṭovim mi-sefarim yeshanim ṿa-ḥadashim, lelamed le-khol adam laʿasoḳ ba-Torah u-va-ʿavodah ... und damiṭ oykh daz froyentsimmer di pflikhṭen ḳenne, di zi gegen Goṭṭ, gegen ihren mann, gegen di ṿelṭ und gegen zikh zelbsṭ tsu beobakhṭen haṭ, izṭ alles in rayner dayṭsher shprakhe tsum driṭṭen male umgearbayṭeṭ und neben dem hebräishen angebrakht

durkhoys alles feränderṭ, ferbesserṭ und zehr fermehrṭ ʿal yede Shelomoh ben Efrayim Blokh ...

Ograniczona względami ekonomicznymi dostępność świadczeń zdrowotnych a naruszenie przez lekarza reguł ostrożności

Odpowiedzialność karną lekarza łączy się powszechnie z problematyką błędu medycznego, choć właściwie odpowiada on nie za sam błąd medyczny, jako że prawo karne nie zna przestępstwa polegającego na popełnieniu błędu medycznego, ale za ewentualne jego skutki, które mogą być kwalifikowane jako nieumyślne spowodowanie śmierci, nieumyślne spowodowanie ciężkiego, średniego albo lekkiego uszczerbku na zdrowiu bądź nieumyślne narażenie na niebezpieczeństwo utraty życia albo ciężkiego uszczerbku na zdrowiu. Nie można oczywiście wykluczyć wystąpienia sytuacji, w której lekarz swoim zachowaniem zrealizowałby znamiona typu umyślnego, jednakże na potrzeby niniejszej publikacji przyjęto, że co do zasady lekarz działa w celu ratowania dóbr prawnych, jakimi są życie i zdrowie pacjenta, nie zaś z zamiarem narażenia ich na niebezpieczeństwo bądź naruszenia, a ewentualne negatywne skutki dla życia i pacjenta, powstałe w miejsce lub obok zamierzonego stanu rzeczy, nie są przez niego objęte umyślnością. Kluczowym warunkiem uznania, że czyn popełniony został nieumyślnie jest ustalenie, że sprawca naruszył reguły ostrożnego postępowania, wymagane w danych okolicznościach. W odniesieniu do zawodu lekarza na pierwszy plan wysuwa się wśród nich wymóg stosowania się do wskazań aktualnej wiedzy medycznej. Autorka przekłada ten obowiązek na grunt realiów systemu ochrony zdrowia i rozważa, jaki wpływ na jego niedopełnienie mają okoliczności ograniczonej względami ekonomicznymi dostępności świadczeń zdrowotnych oraz w jaki sposób niedostatek środków finansowych może rzutować na naruszenie przez lekarza reguł ostrożnego postępowania, o których mowa w art. 9 § 2 Kodeksu karnego.

Gest??o empreendedora na DAMF/PB

Apesar dos esfor??os para atingir a excel??ncia dos seus servi??os, a Delegacia de Administra????o do Minist??rio da Fazenda na Para??ba vinha se ressentindo de uma s??rie de problemas: aus??ncia de recursos p??blicos para sua moderniza????o, que resultava em condi????es inadequadas de trabalho para o N??cleo de Inform??tica, com falta de capacita????o local dos servidores e inexist??ncia de rede corporativa de comunica????o de dados. A solu????o foi encontrada no estabelecimento de um sistema de parcerias cont??nuo com outros ??rg??os p??blicos: Serpro, Delegacia de Receita Federal, PFN e Sunab, a partir das quais se estabeleceu o uso compartilhado dos recursos p??blicos. Com a utiliza????o compartilhada de recursos e a economia de custos, e integrando os ??rg??os fazend??rios da Para??ba, al??m de outros ??rg??os p??blicos, obteve-se a capacita????o e atualiza????o t??cnica de servidores e a implanta????o de infra-estrutura l??gica e el??trica para a interliga????o dos computadores em rede local e de longa dist??ncia. Com isso, tornou-se poss??vel acompanhar as demandas dos clientes atrav??s de agenda di??ria e mensal, atend??-los conclusivamente e aferir periodicamente a sua satisfa????o quanto aos servi??os prestados. A partir das parcerias foram compostas comiss??es mistas para licita????es, elabora????o de projetos, companhamento e fiscaliza????o de servi??os especializados na ??rea de inform??tica

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d− 1 for the university hospital, 155 g d− 1 for the general one, 14 g d− 1 for the pediatric hospital and 1.5 g d− 1 for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae.

Continuous fungal treatment of non-sterile veterinary hospital effluent: pharmaceuticals removal and microbial community assessment

Source point treatment of effluents with a high load of pharmaceutical active compounds (PhACs), such as hospital wastewater, is a matter of discussion among the scientific community. Fungal treatments have been reported to be successful in degrading this type of pollutants and, therefore, the white-rot fungus Trametes versicolor was applied for the removal of PhACs from veterinary hospital wastewater. Sixty-six percent removal was achieved in a non-sterile batch bioreactor inoculated with T. versicolor pellets. On the other hand, the study of microbial communities by means of DGGE and phylogenetic analyses led us to identify some microbial interactions and helped us moving to a continuous process. PhAC removal efficiency achieved in the fungal treatment operated in non-sterile continuous mode was 44 % after adjusting the C/N ratio with respect to the previously calculated one for sterile treatments. Fungal and bacterial communities in the continuous bioreactors were monitored as well.

Proportion of out of hospital adult non traumatic cardiac arrest presenting as a convulsion

Introduction: The majority of convulsions are due to an epilepticseizure or a convulsive syncope. In some cases, this is the firstsymptom of an out of hospital cardiac arrest (OH-CA).Objective: This study was aimed to measure the proportion of adultnon traumatic OH-CA presenting as a convulsion.Methodology: We prospectively collected all incoming calls with anout-of-hospital non traumatic seizure as the chief complaint in patients>18 years during a 24-months period. Among these calls, we collectedcases identified as OH-CA by paramedics.Results: During the 24-months period, the EMS dispatch centerreceived 561 calls for an out-of-hospital non traumatic convulsion in anadult. Twelve cases were ultimately classified as CA. In this group, onebystander spontaneously reported that the patient was known forepilepsy. The incidence of OH-CA presenting as convulsions wastherefore 2.1% of all calls for convulsion. Over the same period, theEMS dispatch center received 1035 calls related to an adult nontraumatic OH-CA. Therefore the rate of OH-CA presenting as aconvulsion represented 1.2% of all adult non traumatic OH-CA.Conclusion: Only 12 cases out of the 531 calls for non traumatic adultconvulsions were confirmed OH-CA (2.1%). Nevertheless, this unusualpresentation of OH-CA must be recognized by dispatchers, even whena patient is reported by bystander as a known epileptic. Dispatchersshould keep bystanders on line or call them back before paramedics'arrival, and have them confirm the progressive return of a normalpattern of breathing and state of consciousness; if not, they shouldencourage when necessary bystander to initiate CPR. For dispatchers,a past medical history of epilepsy should not be regarded as sufficientinformation to rule-out OH-CA. It is mandatory that known epilepticpatients should be monitored in the same way as non-epileptic patients.

Incidenceof out-of-hospital adult nontraumatic cardiac arrest presenting as a convulsion

Introduction: The majority of convulsions are due to an epileptic seizure or a convulsive syncope. The incidence of out-of-hospital cardiac arrest (OH-CA) presenting as a convulsion is unknown. Objective: This study aimed to measure the incidence of adult nontraumatic OH-CA presenting as a convulsion, a rate that has not been published so far, to the best of our knowledge. Methods: We prospectively collected all incoming calls with an out-of-hospital nontraumatic seizure as the chief complaint in patients >18 years old during a 24-month period. Among these calls, we collected cases identified as OH-CA by paramedics. Results: During the 24-month period, the emergency medical services (EMS) dispatch center received 561 calls for an out-of-hospital nontraumatic convulsion in an adult. Twelve cases were ultimately classified as CA. In this group, one bystander spontaneously reported that the patient was known for epilepsy. The incidence of OH-CA presenting as convulsions was therefore 2.1% of all calls for convulsion. Over the same period, the EMS dispatch center received 1,035 calls related to an adult nontraumatic OH-CA. Therefore, the rate of OH-CA presenting as a convulsion represented 1.2% of all adult nontraumatic OH-CA. Conclusion:L Only 12 cases out of the 531 calls for nontraumatic adult convulsions were confirmed OHCA (2.1%). Nevertheless, this unusual presentation of OH-CA must be recognized by dispatchers, even when a patient is reported by bystander as a known epileptic. Dispatchers should keep bystanders on the line or call them back before paramedics' arrival, and have them confirm the progressive return of a normal pat- tern of breathing and state of consciousness; if not, they should encourage the bystander to initiate CPR when necessary. An intervention should be implemented to improve the detection by dispatchers of OH-CA presenting as convulsion by the development of a specific interview and directed observation. For dispatchers, a past medical history of epilepsy should not be regarded as sufficient information to rule out OH-CA. It is mandatory that known epileptic patients should be monitored in the same way as nonepileptic patients.

Deep accidental hypothermia with core temperature below 24°c presenting with vital signs.

Abstract Pasquier, Mathieu, Noemi Zurron, Barbara Weith, Pierre Turini, Fabrice Dami, Pierre-Nicolas Carron, and Peter Paal. Deep accidental hypothermia with core temperature below 24°C presenting with vital signs. High Alt Med Biol. 15:58-63, 2014.-Background: According to the Swiss hypothermia clinical staging, patients with stage III are unconscious with preserved vital signs, with core temperature usually between 24° and 28°C. With stage IV, vital signs are absent with core temperature <24°C. Aims: To describe a patient presenting with HT stage III with vital signs but a core temperature of <24°C, and to search for similar patients in the medical literature. Materials and methods: MEDLINE was used to search for cases of deep accidental hypothermia (<24°C) and preserved vital signs. Results: We found 22 cases in addition to our case (n=23). Median age was 44 years (IQR 36; range 4-83) and median core temperature 22°C (IQR 1.7; 17-23.8). Vital signs were often minimal. Seven patients developed ventricular fibrillation (VF). Twenty patients survived with excellent neurological outcome. Conclusions: Vital signs can be present in hypothermic patients with core temperature <24°C. In deeply hypothermic patients, a careful check and prolonged check of vital functions should be made, as vital signs may be minimal. The clinical Swiss staging remains valuable in the prehospital evaluation of hypothermic patients; its correlation with core temperature should be better defined.

Implementació d'un sistema de compressió de dades en el dispositiu mota Cou24 sota TinyOS.

Les limitacions en la capacitat d'emmagatzemament dels dispositius sensors sense fils o motes és consubstancial al seu disseny, però pot convertir-se en un problema en determinades situacions. Aquest projecte de fi de carrera ha esta motivat per l'interès en superar aquestes limitacions en una situació concreta: una mota dedicada a prendre mostres amb alguns dels seus sensors que passa un període llarg de temps sense poder comunicar amb la base. Per aconseguir aquest objectiu s'ha dissenyat i implementat un sistema que comprimeix les mostres en una mota només quan l'espai d'emmagatzemament està pròxim a exhaurir-se. Aquest procés de compressió pot repetir-se indefinidament i cada vegada que actua elimina només les mostres menys significatives, tot preservant la freqüència del mostreig.A continuació es descriu l'algorisme que s'ha dissenyat, respectuós amb les capacitats de processament de la mota, la implementació que s'ha fet en nesC per a una mota Cou24 amb TinyOS, el programari complementari que s'ha desenvolupat en Java per a PC, i el resultat de les proves que s'han fet de tot aquest conjunt.

Implantació de l’etiqueta ecològica comunitària de l’Hotel Melià Girona

Estudi sobre les mesures que l’hotel Melià de Girona hauria d’adoptar per tal d’assolir l’etiqueta ecològica comunitària (EEC). També es fa una anàlisi comparativa entre aquesta ecoetiqueta i el sistema de gestió que utilitza actualment l’hotel (EMAS: Eco-Management and Audit Scheme)

Projecte d’una instal•lació d’aigua potable al municipi de Taradell

S’ha dissenyat i dimensionat la xarxa d’aigua potable amb els seus elements i components d’un dels barris més nous del municipi de Taradell de la comarca d’Osona