280 research outputs found
Caracterización de la hipertensión arterial en pacientes adultos de la ciudad de Manta
No full textDurante los últimos tiempos ha aumentado el interés por el tema de la tensión arterial, numerosos estudios han proporcionado información valiosa sobre sus valores, tendencia, variabilidad y capacidad predictiva, para la edad adulta. Se realizo un estudio descriptivo y transversal de 200 pacientes que acudieron al consultorio médico Xavier Basurto Zambrano, con cifras tensiónales elevadas, a fin de caracterizarles clínica y epidemiológicamente. Entre las variables analizadas figuraron: edad, sexo, actividad que desarrollaban, tipo de hipertensión (moderada, severa), de donde se derivó predominio del sexo femenino (56.5 %), con respecto al masculino y el grupo de edad mayoritario fue de 40-59 años. El número de hipertensos fue entre 40-59 años, con predominio del sexo femenino, y tipo moderada
Environmental Leadership in Developing Countries. Transnational Relations and Biodiversity Policy in Costa Rica and Boliva by Steinberg, P.F. (2001), Cambridge: MIT Press. Reviewed by Xavier Basurto
No full textMecenazgo y edición en la primera mitad del siglo XVI: el Florindo de Fernando Basurto (Zaragoza: Pedro Hardouin, 1530)
No full textSe analizan las funciones del editor y del mecenas en la publicación de libros impresos en el siglo XVI. Para esto se estudia en profundidad la actividad de Fernando Basurto, autor, y de Juan Fernández de Heredia, mecenas-editor, en torno a la primera edición del Florindo publicado por Pedro Hardouin en Zaragoza en 1530.
The paper discusses the functions of the publisher and patron in the publication of printed books during the 16th Century. With this purpose, the activity of Fernando Basurto, author, and Juan Fernandez de Heredia, patron-editor, about the fi rst edition of Florindo published in Zaragoza by Pedro Hardouin in 1530 is studied
Mecenazgo y edición en la primera mitad del siglo XVI: el Florindo de Fernando Basurto (Zaragoza: Pedro Hardouin, 1530)
No full textThe paper discusses the functions of the publisher and patron in the publication of printed books during the 16th Century. With this purpose, the activity of Fernando Basurto, author, and Juan Fernandez de Heredia, patron-editor, about the first edition of Florindo published in Zaragoza by Pedro Hardouin in 1530 is studied. Se analizan las funciones del editor y del mecenas en la publicación de libros impresos en el siglo XVI. Para esto se estudia en profundidad la actividad de Fernando Basurto, autor, y de Juan Fernández de Heredia, mecenas-editor, en torno a la primera edición del Florindo publicado por Pedro Hardouin en Zaragoza en 1530.
El Tlacuache Núm. 251 (2007). 251 Año 7 (2007) marzo. El Tlacuache
No full textMiguel Ángel Martínez Alfaro: Un etnobotánico comprometido por Eduardo Corona-M. - Al gran maestro Miguel Ángel Martínez Alfaro por Macrina Fuentes Mata. - Miguel Ángel Martínez Alfaro: profesor, amigo y colega por Margarita Avilés. - Miguel Ángel Martínez Alfaro por *Arturo Argueta Villamar. - El Maestro Miguel Angel Martínez Alfaro por *Paul Hersch Martínez. - Miguel Ángel Martínez Alfaro(1942-2007) Semblanza de su labor académica y en la formación de profesionales de la etnobotánica por *Francisco A. Basurto Peña
Maneig farmacològic del dolor agut a urgències. Compendi d’evidències
No full textAntecedents
La cefalàlgia per punció dural i el dolor abdominal de la pancreatitis aguda són dues de les entitats que cursen amb dolor agut presents als serveis d’urgències. Amb excessiva freqüència el maneig del dolor a urgències no és prou satisfactori per al pacient i una de les possibles raons és la manca de coneixement científic existent a mans dels actors implicats.
Mètodes
S'han portat a terme tres revisions sistemàtiques seguint la metodologia Cochrane amb l'objectiu d'identificar i avaluar els beneficis i riscs dels fàrmacs emprats en la prevenció i tractament el dolor agut. 1) Fàrmacs per a la prevenció de la cefalàlgia per punció dural, 2) Fàrmacs per al tractament de la cefalàlgia per punció dural i 3) Opioides per a la pancreatitis aguda.
Resultats
1) En la prevenció de la cefalàlgia per punció dural, la morfina epidural, la cosintropina intravenosa i l’aminofil·lina intravenosa, redueixen el risc de cefalàlgia amb un NNT de 2,8 (IC95% 1,7-7,9), 3,1 (IC95% 1,9-7,3) i 5,5 (IC95% 3,3-15,9) respectivament, especialment en aquells pacients d’alt risc.
2) En el tractament de la cefalàlgia per punció dural, la cafeïna intravenosa redueix la persistència de cefalàlgia i la necessitat d’altres intervencions complementàries; NNT de 1,6 (IC95% 1,2-2,7). La gabapentina oral, la teofil·lina oral i la hidrocortisona intravenosa redueixen la intensitat del dolor agut en 2-3 punts sobre 10.
3) En el tractament amb opioides del dolor abdominal de la pancreatitis aguda, la morfina subcutània i la pentazocina intravenosa, disminueixen la necessitat d’altres mesures analgèsiques complementàries; NNT de 2,4 (IC95% 1,7-3,7).
Discussió
Les revisions sistemàtiques presentades en aquesta tesi han intentat, seguint una metodologia rigorosa i sistemàtica, identificar les investigacions disponibles sobre el tema que s’està estudiant i sintetitzar els resultats dels estudis inclosos.
Una de les principals limitacions identificades en aquestes revisions sistemàtiques són l’escàs número d’estudis inclosos en cada revisió; un total de 22 assajos clínics en les 3 revisions. L’escàs nombre de participants en els assajos és una altre limitació; un total de 2043 persones en les 3 revisions amb una mediana de 55 participants. Una pobre qualitat en la publicació dels assajos en limita l’avaluació del risc de biaix. L’heterogeneïtat clínica entre estudis dificulta el procés de síntesi de resultats.
Conclusions
En relació al tractament farmacològic del dolor a urgències, s’incorpora nou coneixement científic disponible per al personal sanitari sobre el benefici i risc de diferents estratègies farmacològiques per a dues entitats que cursen amb dolor agut; la cefalàlgia per punció dural i la pancreatitis aguda.
• La morfina epidural, la cosintropina intravenosa i l’administració intravenosa d’aminofil·lina redueixen el risc de cefalàlgia per punció dural, especialment en pacients d’alt risc.
• La cafeïna intravenosa redueix la persistència de cefalàlgia per punció dural i la necessitat d’altres intervencions complementàries. La gabapentina oral, la teofil·lina oral i la hidrocortisona intravenosa disminueixen la intensitat del dolor agut.
• La morfina subcutània i la pentazocina intravenosa, disminueixen la necessitat d’altres mesures analgèsiques complementàries en el tractament del dolor abdominal de la pancreatitis aguda.
• S’aconsella als investigadors que en futurs assajos utilitzin variables de resultat clínicament rellevants i amb definicions estandarditzades que permetin fer síntesi de resultats en futures revisions.
• Es recomana als futurs investigadors d’assajos a utilitzar una grandària de mostra suficient per a donar resposta a les hipòtesis plantejades.
• S’aconsella a tots els investigadors a seguir les directrius de la declaració CONSORT per millorar la qualitat de la publicació d’assajos.
• S’anima als autors de revisions sistemàtiques a utilitzar el sistema GRADE per classificar la qualitat de l’evidencia i poder elaborar les recomanacions amb més rigor.Background
The post-dural puncture headache and the abdominal pain of acute pancreatitis are two entities with acute pain presents to the emergency services. Too often pain management is not satisfactory to the emergency patient and one of the possible reasons is the lack of existing scientific knowledge in the hands of those involved.
Methods
Carried out three systematic reviews using the Cochrane methodology in order to identify and evaluate risks and benefits of drugs used to prevent and treat acute pain. 1) Drugs for preventing post-dural puncture headache, 2) Drugs for treating post-dural puncture headache and 3) Opioids for acute pancreatitis.
Results
1) In the prevention of post-dural puncture headache, epidural morphine, intravenous cosyntropin and the intravenous aminophylline, reduce the risk of headache with a NNT of 2,8 (95%CI 1,7-7,9), 3,1 (95%CI 1,9-7,3) and 5,5 (95%CI 3,3-15,9) respectively, particularly in high-risk patients.
2) In the treatment of post-dural puncture headache, intravenous caffeine reduces the persistence of headache and the need for other complementary interventions; NNT of 1,6 (95%CI 1,2-2,7). Oral gabapentin, oral theophylline and intravenous hydrocortisone reduced the intensity of acute pain in 2-3 out of 10.
3) In the treatment of abdominal pain from acute pancreatitis with opioids, subcutaneous morphine and intravenous pentazocine, reduce the need for other measures complementary analgesic; NNT of 2,4 (95%CI 1,7-3,7).
Discussion
Systematic reviews presented in this thesis have attempted, following a rigorous and systematic methodology, to identify the available research on the topic being discussed and summarize the results of the included studies.
One of the main limitations identified in these systematic reviews are the limited number of studies included in each review; 22 trials in 3 reviews. The small number of participants in trials is another limitation; 2043 people in 3 reviews with a median of 55 participants. Poor quality publishing trials limits the risk assessment bias. Heterogeneity between studies difficults the process of synthesizing the results.
Conclusions
Regarding the pharmacological treatment of pain in the emergency department, new scientific knowledge is available to the medical staff on the benefits and risks of different pharmacological strategies for both entities that present with acute pain; the post-dural puncture headache and acute pancreatitis.
·The epidural morphine, intravenous cosyntropin and intravenous aminophylline reduce the risk of post-dural puncture headache, especially in high-risk patients.
·Intravenous caffeine reduces the persistence of post-dural puncture headache and the need for other complementary interventions. Oral gabapentin, oral theophylline and intravenous hydrocortisone reduced the intensity of acute pain.
·Subcutaneous morphine and intravenous pentazocine, reduce the need for other complementary analgesic in the treatment of abdominal pain from acute pancreatitis.
·It is recommended that researchers in future trials use a clinically relevant outcomes and standardized definitions that allow synthesis of results in future reviews.
·It is recommended that future researchers use a sample size sufficient to respond to the hypotheses.
·It is recommended to all researchers to follow the CONSORT statement to improve the quality of publication of clinical trials
·The review authors are encouraged to use the GRADE system in order to classify the quality of the evidence and to develop recommendations with more rigor
Theories and methods for the study of common goods. Three case studies. Water, forests and coasts
No full textResoconto in lingua inglese dell'incontro di dottorato dal titolo "Theories and methods for the study of common goods. Three case studies: water, forests, coasts" tenuto dal Prof. Xavier Basurto in data 21 marzo 2019 presso il Dipartimento di Scienze politiche dell'Università Sapienza di Roma
An Evaluation of GIS Prioritizations for Selecting Wetland Mitigation Sites: Cook Inlet Case Study
No full textRecent scientific research has demonstrated the multitude of ecosystem services and functions provided by wetlands. Despite the astronomical cost that would be required to replace these vital services with manmade mechanisms, humans have a long history of filling and destroying wetlands for development. Recent decades have seen wetland protection improve under the aegis of Section 404 of the Clean Water Act (CWA). The CWA requires compensatory mitigation for wetlands destroyed during development, but specific mitigation requirements remain vague and many projects continue to fail.
Developing better wetland mitigation site selection would provide improvements to mitigation without requiring a CWA amendment. Sites have traditionally been chosen based on geographic or monetary convenience. This study explores an increasingly popular method of selection: GIS prioritizations. GIS prioritizations can increase the efficiency, repeatability, and transparency of site selection. This project analyzes a case study in Cook Inlet, Alaska utilizing a GIS prioritization to locate high quality mitigation lands to compensate for a bridge proposed by the Knik Arm Bridge and Toll Authority. Mitigation is required because the construction will destroy 390 acres of wetlands. To determine the most appropriate mitigation locations, 3047 nearby parcels were evaluated using 8 selection criteria. The results ranked all parcels and identified the most suitable sites to compensate for the proposed effects of the bridge.
This study also compares the effectiveness of GIS prioritizations to other selection methods. GIS prioritizations were determined to be the most efficient technique for analyzing and ranking thousands of parcels. Initiating mitigation planning with a GIS prioritization can effectively direct fieldwork to just a subset of potentially high value wetlands. Hopefully better site selection with GIS prioritizations can improve overall wetland mitigation. Such improvements would not only fulfill the mitigation requirements under the CWA, but also effectively preserve remaining wetlands for future generations
A Holistic Approach to Reducing Plastic Marine Debris in Coastal North Carolina
No full textAffecting waters and coastlines worldwide, plastic marine debris is a pervasive issue that continues to intensify. It threatens wildlife, habitats, and ecosystem functioning, as well as coastal tourism and recreation. This problem can be addressed in ways ranging from local to international in scope, and voluntary to mandatory in implementation. Our objective was to reduce plastic marine debris generation in coastal North Carolina via both voluntary and mandatory approaches; therefore, we used both bottom-up and top-down methods.
We focused the bottom-up piece of our project on increasing awareness of the ecological hazards plastic marine debris causes and on encouraging consumers to stop using plastic shopping bags. To this end, we employed a combination of formal and informal education tools, which included presenting in classrooms, leading coastal cleanups, and designing a plastic marine debris exhibit that we displayed at environmentally themed community events. The school presentations targeted students from kindergarten to high school, and are adaptable to a variety of levels and teacher objectives. The coastal cleanups provided community members with an opportunity to see firsthand the local extent of marine debris. Our exhibit enabled us to reach a large and diverse audience, and to show the connection between our decisions and environmental impacts.
The top-down component of our project focused on understanding the effectiveness of the Outer Banks plastic bag ban (NC Senate Bill 1018) at reducing plastic marine debris and changing consumer behaviors, as well as its popularity among residents. NC Senate Bill 318, introduced in March 2011, calls for a repeal of this ban, so we composed a policy memo arguing against the repeal and sent it to all state senators. We supported our position with the results we obtained from surveys we conducted of Outer Banks and Carteret County residents. The majority of Outer Banks respondents were in support of the ban, and the majority of Carteret County respondents stated that they would support a plastic bag ban in their county, which lent credence to our argument.
Our holistic approach, based on bottom-up and top-down measures, enabled us to test and assess a variety of tools that could reduce plastic marine debris in coastal North Carolina
Small-scale Fisheries and the Global Economy: Understanding Common-pool Resource Governance in the Context of Market Pressures, Neoliberal Policies, and Transnational Institutions
No full textThe purpose of this dissertation is to contribute to a better understanding of how global seafood trade interacts with the governance of small-scale fisheries (SSFs). As global seafood trade expands, SSFs have the potential to experience significant economic, social, and political benefits from participation in export markets. At the same time, market connections that place increasing pressures on resources pose risks to both the ecological and social integrity of SSFs. This dissertation seeks to explore the factors that mediate between the potential benefits and risks of global seafood markets for SSFs, with the goal of developing hypotheses regarding these relationships. The empirical investigation consists of a series of case studies from the Yucatan Peninsula, Mexico. This is a particularly rich context in which to study global market connections with SSFs because the SSFs in this region engage in a variety of market-oriented harvests, most notably for octopus, groupers and snappers, lobster, and sea cucumber. Variation in market forms and the institutional diversity of local-level governance arrangements allows the dissertation to explore a number of examples. The analysis is guided primarily by common-pool resource (CPR) theory because of the insights it provides regarding the conditions that facilitate collective action and the factors that promote long-lasting resource governance arrangements. Theory from institutional economics and political ecology contribute to the elaboration of a multi-faceted conceptualization of markets for CPR theory, with the aim of facilitating the identification of mechanisms through which markets and CPR governance actually interact. This dissertation conceptualizes markets as sets of institutions that structure the exchange of property rights over fisheries resources, affect the material incentives to harvest resources, and transmit ideas and values about fisheries resources and governance. The case studies explore four different mechanisms through which markets potentially influence resource governance: 1) Markets can contribute to costly resource governance activities by offsetting costs through profits, 2) markets can undermine resource governance by generating incentives for noncompliance and lead to overharvesting resources, 3) markets can increase the costs of resource governance, for example by augmenting monitoring and enforcement burdens, and 4) markets can alter values and norms underpinning resource governance by transmitting ideas between local resource users and a variety of market actors. Data collected using participant observation, survey, informal and structured interviews contributed to the elaboration of the following hypotheses relevant to interactions between global seafood trade and SSFs governance. 1) Roll-back neoliberalization of fisheries policies has undermined cooperatives’ ability to achieve financial success through engagement with markets and thus their potential role as key actors in resource governance (chapter two). 2) Different relations of production influence whether local governance institutions will erode or strengthen when faced with market pressures. In particular, relations of production in which fishers own their own means of production and share the collective costs of governance are more likely to strengthen resource governance while relations of production in which a single entrepreneur controls capital and access to the fishery are more likely to contribute to the erosion of resource governance institutions in the face of market pressures (chapter three). 3) By serving as a new discursive framework within which to conceive of and talk about fisheries resources, markets can influence norms and values that shape and constitute governance arrangements.In sum, the dissertation demonstrates that global seafood trade manifests in a diversity of local forms and effects. Whether SSFs moderate risks and take advantage of benefits depends on a variety of factors, and resource users themselves have the potential to influence the outcomes of seafood market connections through local forms of collective action.</p
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