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Higher education institutions (HEIs) transfer skills and knowledge between industries, the government, and the public, playing a vital role at educating future leaders in creating a globally sustainable system. Therein, evaluating greenhouse gas emissions from an educational institute is the first step towards the proposed reduction targets at the local, national, and international levels. In this research, we report the first approximate carbon footprint calculation of emissions corresponding to scope 1, scope 2, and scope 3 emissions for the main urban campuses of Universidad Nacional de Colombia, Medellín, using the UNE-ISO 14064-1 and WRI/WBCSD GHG Protocol Corporate standard. The carbon footprint in 2019 was approximately 7250.52 tons CO2 eq, and 0.432 tons CO2 eq per person. Scope 1 emissions accounted for about 2.84% of the carbon footprint, while scope 2 and 3 emissions each contributed nearly 14% and 83%, respectively. The largest sources of greenhouse gas emissions were the transportation process (58.51%), the wastewater process (17.01%), followed by electricity consumption (14.03%), and the e-mails that are sent (6.51%). It is suggested some proposals and strategies for mitigating and reducing emissions. Colombian HEIs exhibit the lowest ton of CO2 eq. per person compared to the other HEIs. Several reasons explain this behavior across the document such as geographic location (climate and topography), cultural factors (consumption patterns and types of transportation), population size, typology (public or private), gross domestic product (GDP) of each country, and methodology implemented. Results cannot be extrapolated to the Colombian case for the differences in the local conditions; therefore, it is not possible to get solid conclusions on the CF behavior in the Colombian HEIs. In this research, we provide for the first time a carbon footprint calculation where the sociological, political, and geographic conditions not extrapolated representing a valuable contribution to the HEI's of the country. This research can be a benchmark in the carbon footprint calculation and a methodological contribution to HEIs in the country.
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Pegada de Carbono , Gases de Efeito Estufa , Humanos , Gases de Efeito Estufa/análise , Colômbia , Universidades , Efeito EstufaRESUMO
En esta revisión narrativa se plantea como objetivo realizar una descripción amplia y específica acerca de los agentes abultantes utilizados para la corrección endoscópica del reflujo vesicoureteral disponibles en el mercado hasta la actualidad, sus tasas de éxito y de complicaciones. Este texto se realizó a partir de una búsqueda sistemática con las palabras clave enunciadas a continuación como términos MESH. Se describen los distintos tipos de sustancias y se exponen los resultados de los artículos revisados. Finalmente se plantean las conclusiones.
The objective of this narrative review is to describe in a broad and specific way all the bulking agents used in the endoscopic correction of vesicoureteral reflux currently available, their success and complication rates. This text was done by a systematic search with the keywords seen below in MESH terms. The different types of substances are described, and the results of the reviewed articles are presented. Finally, conclusions are made.
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Humanos , DextranosRESUMO
The increase in the global demand for energy and fossil fuel dependency is hindering efforts to reduce greenhouse gas (GHG) emissions. Geothermal resources supplement this increase in energy demand with reduced emissions because of their availability, base-load production profile, and climatic independence. Despite these advantages, the development of geothermal energy is limited because of different reasons such as subsurface exploration risk and high upfront capital cost for drilling and facility construction. However, similarities in infrastructure and operations between the oil and gas industry and the geothermal industry can optimize expense and development when exploiting geothermal resources. Thus, in this review, we present recent advances and applications of geothermal power systems in the oil and gas industry starting from the fundamentals and basic principles of geothermal energy and the organic Rankine cycle (ORC). These applications include the use of geothermal resources via abandoned wells, active wells, and paired thermal enhanced oil recovery processes with injection for fluid heating and energy production. Abandoned wells are alternatives that reduce costs in geothermal energy-use projects. The use of geothermal resources via active wells allows the valorization of a resource, such as the production of water, which is considered a byproduct of production activities in an oilfield. The use of thermally enhanced oil recovery processes enhances the energy conditions of fluids produced in the field, improving geothermal systems with fluids at higher temperatures. Finally, an overview is presented of the challenges and opportunities of geothermal energy in the oil industry where the requirement to improve the usage of technologies, such as the ORCs, with the working fluids used in the cycles, is highlighted. Furthermore, the importance of environmental studies and use of novel tools, such as nanotechnology, to improve the efficiency of geothermal energy usage is highlighted.
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BACKGROUND AND AIMS: Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c ) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM. METHODS: We included randomised controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality-of-life changes and questionnaires on satisfaction with treatment of diabetes. RESULTS: Data from 11 studies with 899 patients were retrieved with a mean follow-up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1c levels (SMD-0.24%, 95% CI -0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD-0.52%, 95% CI -0.82 to -0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time. CONCLUSIONS: Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499.
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Diabetes Mellitus Tipo 1 , Hipoglicemia , Adulto , Criança , Humanos , Diabetes Mellitus Tipo 1/tratamento farmacológico , Qualidade de Vida , Hemoglobinas Glicadas/análise , Hipoglicemia/prevenção & controle , Insulina/efeitos adversos , Peso Corporal , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Background The World Health Organization considers medication errors to be an issue that requires attention at all levels of care, to reduce the severe and preventable harm related to drug therapy. Different standards for clinical pharmaceutical practices have been proposed by various organizations across the world, where the pharmacist, as part of the multidisciplinary health team, can help improve patient safety. Objective To assess the impact of the introduction of a clinical pharmacy practice model on medication error in patients of a university hospital. Setting The study was conducted in a tertiary care hospital, Medellín, Colombia. Methods A randomized, controlled cluster-wedge staggered trial with a duration of 14 months was conducted to compare the clinical pharmacy practice model with the usual care process in the hospital. Five hospital health care units were included, which were initially assigned to the control group, and after an observation period of 2 months, they were randomly assigned to the intervention group. The trial protocol was registered in ClinicalTrials.gov (identifier NCT03338725). Main outcome measure The incidence of medication errors in hospitalized patients was the main outcome measure. Results The incidence of medication error was 13.3% and 22.8% for the intervention group and control group, respectively. The probability of presenting a medication error was 48% lower when the patient was in the intervention group (RR 0.52; 95% CI: 0.34-0.79). The probability of presenting a medication error over time was 44% lower in the intervention group (p = 0.0005); meanwhile, the resolution of a medication error over time was 70% higher in the intervention group (p = 0. 0029). Conclusion The clinical pharmacy practice model, made up of strategies focused on reducing medication errors, significantly reduces medication errors in patients during hospitalization compared with usual practice. This work assessed the effect of a clinical pharmacy model on the incidence of medication errors and demonstrated its effectiveness in reducing these errors in hospitalized patients. Trial registration ClinicalTrials.gov, NCT03338725. Registered on 9 November 2017. First patient randomized on February 2, 2018.
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Serviço de Farmácia Hospitalar , Farmácia , Hospitais Universitários , Humanos , Incidência , Erros de Medicação/prevenção & controle , FarmacêuticosRESUMO
OBJETIVO: Reconstruir las actividades del Programa Panamericano de Erradicación de la Poliomielitis, a través de los documentos generados por la Organización Panamericana de la Salud (OPS) entre 1985 y 1994 MÉTODOS: Se utilizaron, como fuentes primarias de información, los documentos sobre erradicación de la poliomielitis generados entre 1985 y 1994, a través del portal de acceso de publicaciones de la página oficial de la OPS. Se estableció una clasificación de los documentos y se estudiaron sus contenidos, contextualizándolos en el marco de la historia de salud pública internacional RESULTADOS: Se encontraron 260 documentos clasificados en boletines, resoluciones, artículos y libros. En 1985, la OPS puso en marcha la iniciativa de erradicación de la transmisión del poliovirus salvaje en las Américas para 1990. Se establecieron comisiones nacionales, un grupo técnico asesor, reuniones interfronteras y otros mecanismos de coordinación. El seguimiento de las acciones de erradicación por parte de la Comisión Internacional para la Certificación de la Erradicación de la Poliomielitis se llevó a cabo a través de cinco indicadores; obteniéndose la certificación oficial para la Región de las Américas en 1994 CONCLUSIONES: El camino que condujo a la erradicación de la poliomielitis en la Región de las Américas estuvo condicionado por las diferentes circunstancias políticas, sociales y económicas de los diferentes países integrantes y no estuvo exento de problemas. Aun así, se lograron importantes acuerdos de colaboración e intercambio de experiencias y recursos, que condujeron a alcanzar la meta final antes que otras regiones. La OPS jugó un papel central y lideró todo el proceso.
OBJECTIVE: Reconstruct the activities of the Pan American Poliomyelitis Eradication Program, through documents produced by the Pan American Health Organization (PAHO) from 1985 to 1994 METHODS: Documents on polio eradication produced from 1985 to 1994, obtained through the publications portal at the official PAHO website, were used as primary sources of information. Documents were categorized by type and their contents studied, revealing their context in the framework of the history of international public health RESULTS: Two hundred sixty documents were found and categorized as bulletins, resolutions, articles, and books. In 1985, PAHO implemented an initiative to eradicate transmission of wild poliovirus in the Americas by 1990. National commissions, a Technical Advisory Group, cross-border meetings, and other coordination mechanisms were established. Eradication activities were monitored by the International Commission for the Certification of Polio Eradication, using five indicators. The Region of the Americas was officially certified in 1994 CONCLUSIONS: The road to polio eradication in the Region of the Americas was affected by different political, social, and economic circumstances in the different member countries and was not problem-free. Nonetheless, important collaboration agreements were reached and experiences and resources were shared. This led to achieving the final goal before other regions. PAHO played a key role and spearheaded the entire process.