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Rural territories play an important role when progress is made toward a balanced regional development; thus, an analysis is required of the components and/or factors which have contributed to sustainable development. Therefore, the main subdimensions and variables identified represent the ecological, social and economic dimensions in rural areas. Rural area development is characterised by complex social phenomena, such as the lack of job opportunities, conditions of poverty, unequal development and health services coverage and quality, among others. Consequently, the dynamics and realities of rural territories pose great challenges to sustainable development, arising the following question: What components and/or factors represent sustainable development in rural territories? Therefore, this study aims to use SLR to identify a set of variables relevant to sustainable development in rural territories under the economic, social, and ecological dimensions of sustainability. Based on the foregoing discussion, the systematic literature review (SLR) method is applied. This procces consists of four phases: approach, search and selection, extraction, and information analysis. Then, five subdimensions and 59 variables are established in the Economic Dimension, seven subdimensions and 63 variables in the Social Dimension and five subdimensions and 42 variables in the Ecological Dimension. The results contribute to the comprehensive analysis of the object of study, the main subdimensions in which the ecological, social, and economic dimensions of sustainable development in rural territories are found. Likewise, it is intended to relate all these components found with some of the objectives of sustainable development so that, having a positive impact on these variables, the fulfilment of these objectives is reached to improve the well-being of rural regions.
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Abstract Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.
Resumen Introducción: Las complicaciones postanestésicas, especialmente las respiratorias, siguen siendo causa de preocupación por su alta frecuencia, en particular, en la población pediátrica. Objetivo: Describir la incidencia de complicaciones respiratorias en la unidad de cuidados postanestésicos de una institución de mediana complejidad, en un período de seis meses y explorar las variables relacionadas con las complicaciones respiratorias mayores. Materiales y métodos: Estudio de cohorte retrospectivo, basado en la valoración de historias clínicas. Se revisaron los registros de la unidad de cuidados postanestésicos de una institución pediátrica de mediana complejidad ubicada en Medellín. Esta institución utiliza un modelo de atención -basado en enfermería- que incluye la extubación del paciente en la unidad de cuidados postanestésicos. Resultados: Se analizaron los registros de 1181 pacientes. La incidencia acumulada de complicaciones mayores fue: broncoespasmo 1,44 %, laringoespasmo 0,68 % y depresión respiratoria 0,59 %. No se presentaron casos de paro cardiaco ni de edema agudo de pulmón. El antecedente de infección respiratoria menor a 15 días, rinitis y sexo femenino se asociaron con complicaciones respiratorias mayores. Conclusiones: Durante la atención en la unidad de cuidados postanestésicos por parte del personal de enfermería entrenado en la recuperación de la anestesia y de la vía aérea de los pacientes pediátricos, se encontró una baja frecuencia de complicaciones respiratorias.
Assuntos
Humanos , Masculino , Feminino , Edema Pulmonar , Insuficiência Respiratória , Anestesia , Anestésicos , Espasmo Brônquico , Rinite , Laringismo , Estudos de Coortes , Colômbia , Edema , Parada Cardíaca , Infecções , Recursos Humanos de EnfermagemRESUMO
Trypanosoma cruzi (T. cruzi) is a hemoflagellate protozoan parasite that causes Chagas disease, a neglected tropical disease that affects more than 6 million people around the world, mostly in Latin America. Despite intensive research, there is no vaccine available; therefore, new approaches are needed to further improve vaccine efficacy. It is well established that experimental T. cruzi infection induces a marked immunosuppressed state, which includes notably increases of CD11b+ GR-1+ myeloid-derived suppressor cells (MDSCs) in the spleen, liver and heart of infected mice. We previously showed that a trans-sialidase based vaccine (TSf-ISPA) is able to confer protection against a virulent T. cruzi strain, stimulating the effector immune response and decreasing CD11b+ GR-1+ splenocytes significantly. Here, we show that even in the immunological context elicited by the TSf-ISPA vaccine, the remaining MDSCs are still able to influence several immune populations. Depletion of MDSCs with 5 fluorouracil (5FU) at day 15 post-infection notably reshaped the immune response, as evidenced by flow cytometry of spleen cells obtained from mice after 21 days post-infection. After infection, TSf-ISPA-vaccinated and 5FU-treated mice showed a marked increase of the CD8 response, which included an increased expression of CD107a and CD44 markers in CD8+ cultured splenocytes. In addition, vaccinated and MDSC depleted mice showed an increase in the percentage and number of CD4+ Foxp3+ regulatory T cells (Tregs) as well as in the expression of Foxp3+ in CD4+ splenocytes. Furthermore, depletion of MDSCs also caused changes in the percentage and number of CD11chigh CD8α+ dendritic cells as well as in activation/maturation markers such as CD80, CD40 and MHCII. Thus, the obtained results suggest that MDSCs not only play a role suppressing the effector response during T. cruzi infection, but also strongly modulate the immune response in vaccinated mice, even when the vaccine formulation has a significant protective capacity. Although MDSC depletion at day 15 post-infection did not ameliorated survival or parasitemia levels, depletion of MDSCs during the first week of infection caused a beneficial trend in parasitemia and mice survival of vaccinated mice, supporting the possibility to target MDSCs from different approaches to enhance vaccine efficacy. Finally, since we previously showed that TSf-ISPA immunization causes a slight but significant increase of CD11b+ GR-1+ splenocytes, here we also targeted those cells at the stage of immunization, prior to T. cruzi challenge. Notably, 5FU administration before each dose of TSf-ISPA vaccine was able to significantly ameliorate survival and decrease parasitemia levels of TSf-ISPA-vaccinated and infected mice. Overall, this work supports that targeting MDSCs may be a valuable tool during vaccine design against T. cruzi, and likely for other pathologies that are characterized by the subversion of the immune system.
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Doença de Chagas , Células Supressoras Mieloides , Vacinas Protozoárias , Trypanosoma cruzi , Animais , Doença de Chagas/prevenção & controle , Glicoproteínas , Camundongos , NeuraminidaseRESUMO
Prophylactic and/or therapeutic vaccines have an important potential to control Trypanosoma cruzi (T. cruzi)infection. The involvement of regulatory/suppressor immune cells after an immunization treatment and T. cruzi infection has never been addressed. Here we show that a new trans-sialidase-based immunogen (TSf) was able to confer protection, correlating not only with beneficial changes in effector immune parameters, but also influencing populations of cells related to immune control. Regarding the effector response, mice immunized with TSf showed a TS-specific antibody response, significant delayed-type hypersensitivity (DTH) reactivity and increased production of IFN-γ by CD8+ splenocytes. After a challenge with T. cruzi, TSf-immunized mice showed 90% survival and low parasitemia as compared with 40% survival and high parasitemia in PBS-immunized mice. In relation to the regulatory/suppressor arm of the immune system, after T. cruzi infection TSf-immunized mice showed an increase in spleen CD4+ Foxp3+ regulatory T cells (Treg) as compared to PBS-inoculated and infected mice. Moreover, although T. cruzi infection elicited a notable increase in myeloid derived suppressor cells (MDSC) in the spleen of PBS-inoculated mice, TSf-immunized mice showed a significantly lower increase of MDSC. Results presented herein highlight the need of studying the immune response as a whole when a vaccine candidate is rationally tested.
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Teniendo en cuenta los aportes de Freud y Lacan, en este texto se trata, por una parte, de mirar cuál es la función del actor en la representación teatral o parafraseando al segundo de estos autores ¿Qué añade el actor a la obra escrita? de otro lado, profundizar en los mecanismos que en el espectador ponen en juego para conectarse con la obra y el actor, suscitando las vivencias y emociones propias de la experiencia teatral...
Taking in account Freud and Lacan works, this paper questions about what is the actor function in a theatrical performance; paraphrasing Lacan: What does the actor add to the written work? On the other hand, deeping into the mechanisms that the member of the audience uses to put in contact with the play and the actor, arousing his/her own life experiences and emotions through the theatrical experience...
En prenant compte des apports de Freud et de Lacan, ce texte essaie de voir quel est le rôle de lacteur dans la représentation théâtrale, ou si lon reprend les mots du deuxième de ces auteurs: Quest ce qui lacteur apporte à luvre écrite ? Dautre part, il essaie daller plus loin dans les mécanismes mis en jeu par le spectateur afin de se connecter avec luvre et avec lacteur, suscitant ainsi les expériences vécues et les émotions propres de lexpérience théâtrale...
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Humanos , Corpo Humano , PsicanáliseRESUMO
El arte es una de las mas primigenias manifestaciones de la cultura. Desde el psicoanálisis y tomando como referencia la obra del artista contemporáneo, Alfredo Jaar, intentaremos acercarnos a la función que en el campo social, tiene una de las vertientes del arte actual en tanto que por medio de él se vehiculiza lo innombrable del devenir humano.
Art is one of the most primal manifestations of culture. From the psychoanalysis and taking as reference the work of the contemporary artist, Alfredo Jaar, we will try to approach the function that in the social field, has one of the slopes of the current art while through it the unnameable of the human becoming is conveyed.