Approach to the valley of Atlixco, Puebla and its sustainability_ Crimson Publishers

 Approach to the valley of Atlixco, Puebla and its sustainability by Andrés Armando Sánchez Hernández* in Environmental Analysis & Ecology Studies_ Journal of Environmental Sciences

 

Introduction
This valley or region has been considered a magnificent climate par excellence and has a number of aspects that are related to the agro-industrial production dedicated to the production of fruits, vegetables and infinity of flowers. It has been considered with the "best climate in the world", it has also been considered, at the municipal head, as "Atlixco de las flores", and related to cultural heritage, it has been protected as an area of historical monuments to a surface of the city of Atlixco of 0.59km2, a very small portion of the city, although with the extension of the concept of heritage it can be considered another heritage of different periods and typological conditions. To this is added the patrimonial value of the whole, seen as a cultural landscape, and is even inseparable to the idea of a mixed site for its natural and cultural values.

Likewise, it can be learned from this review that the heritage conditions of the region are associated with the natural and cultural. Where associated values are found, as well as problems to solve. In this context, this essay continues with the idea and methodology of complexity to know the aspects of greater incidence and relation with the idea of sustainability that start from the slogan: "That current generations use natural and cultural resources without compromising future generations". Starting from its impact on the economy, the environment, identity-culture. In this sense, the idea of complexity is added where everything is interrelated and it is clear that the settlements had to do with the idea of adaptation and use to the environment. On the other hand, the idea that the natural and cultural is now seen as heritage is analyzed. Idea of the value and sui generis of a place that gives identity, permanence and is in symbiosis of its inhabitants.

In this sense, the objective of this document is to outline the conditions of the valley-region and the points of greatest influence that require attention to be able to focus a series of actions for a sustainability in favor of ecology- environment, economic conditions, the identity and the cultural, as well as the conditions of an administration of the cultural and natural resources for the present and future generations.

https://crimsonpublishers.com/eaes/fulltext/EAES.000628.php

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Cultivating Connection: The Magic of Attuning, Wondering, Following & Holding in Crimson Publishers

Cultivating Connection: The Magic of Attuning, Wondering, Following & Holding by Ann Flanagan Petry* in COJ Nursing & Healthcare_ Nursing Healthcare Open Access Journal

 

 

Introduction

Remember what drew you to health care? And what makes your work meaningful now? Chances are caring for people is the answer to both questions.

In fact, healthcare is provided through relationships. Over a decade ago we developed a care delivery framework described in the award-winning book Relationship-Based Care: A Model for Transforming Practice. We were on the vanguard of a revolution toward more patient-centered caring. Indeed, we have always known the importance of connection to patient experience, employee attitudes, interpersonal relations, teams and performance. For nurses, caring relationships are so essential at work that it is inseparable from the work itself. We believe the best nursing care requires understanding of three key relationships:

A. Relationship to one’s self,
B. Relationship to co-workers and
C. Relationship to patients and families.

And, the hallmark of meaningful connection is attunement or tuning-in to others with genuine interest and care.

When we deconstruct what makes for a meaningful connection, surprisingly, it is micro-moments - an expression of compassion that eases another’s suffering, or a glance of warmth and gratitude flashed by a family member after a difficult conversation. Such moments make us feel better, but research is now showing that these micro-moments of connection are also critical achieving important outcomes, whether it is patient outcome or team outcomes.

Yet, nurses often feel they don’t experience genuine connections frequently enough [1]. A major contributor to this is a phenomenon called complexity compression. First described in 2007, complexity compression is defined as what nurses’ experience when expected to assume extra, impromptu responsibilities while simultaneously managing existing job duties in a condensed time frame [2]. This phenomenon coupled with frequent interruptions, often from communication devices, further pulls attention away from the patient. The impact? Relationships with patients and families are disjointed and hurried. Amidst the busyness, there is less ability to focus and really listen to patients or teammates. Consider the startling statistic that the typical human attention span is dwindling from an average of 12 seconds in 2000 to just about 8 seconds as of 2013-less than the attention span of a goldfish [3]. We all know what interruptions and lack of focus feel like - it’s everywhere.

https://crimsonpublishers.com/cojnh/fulltext/COJNH.000529.php

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Dexmedetomidine as a Sole Sedative Agent versus Propofol for Sedation during Upper and Lower Gastrointestinal Endoscopies_ Crimson Publishers

 Dexmedetomidine as a Sole Sedative Agent versus Propofol for Sedation during Upper and Lower Gastrointestinal Endoscopies by Alaa Ali Elzohry* in Developments in Anaesthetics & Pain Management_ Research and Reviews International Journals

 

Introduction

Introduction and objectives: Diagnostic and therapeutic procedures recently are done in gastroenterology setup as a part of fast-track concept. A major volume of gastrointestinal procedures are performed routinely on daycare basis under sedation as upper and lower GIT endoscopy. Many anesthetic agents used to provide sedation for these procures. Propofol, opioids, and midazolam form the backbone of the various regimes employed in the endoscopic suites all over the world. Dexmedetomidine is a pharmacologically active selective α 2-adrenergic receptor agonist. It was approved it in the intensive care unit (ICU) for sedation and analgesia for the duration of less than 24 hours. The aim of this study was to study efficacy and safety of Dexmedetomidine efficacy as sole sedating agent versus propofol for sedation during upper and lower GIT endoscopy.

Methods: This randomized controlled trial was carried out on 60 patients of either sex, aged 21-70 years of age undergoing upper and lower GIT endoscopy, with ASA I-II. Patients were randomly assigned into two groups, (30 patients in each group).

Dex group: Sedation was induced by loading dose of (dexmedetomidine 1μg/kg) followed by infusion of (dexmedetomidine 0.8μg/kg /h) Propofol group: Sedation was initially started by bolus dose of 0.5mg/kg propofol IV Then, infusion was started at the rate of 50μg /kg/min. Upper and lower GIT endoscopies were carried out in the usual standard manner for all patients, then patients were discharged to PACU after attaining an Aldrete Recovery Scale Score of 9-10 Time taken to achieve this score was recorded. The patient’s vital signs, Respiratory complications, VAS score for pain measurement, PONV, and any other adverse events were recorded.

Results: There was significant decrease in (HR and MAP) but not respiration rate (RR) and SpO2, in (Dex group) during the procedure and early post-operative (P. value 0.000**). But during the remaining of post-operative periods (HR and MAP) were comparable. VAS pain scores in both groups were decreased in comparable manner at all measured time points. But complications (atthythmia, air way obstruction, nausea, and vomiting) was significantly increased in Propofol group (P. value 0.001**). Mean time to achieve RSS 3-4 was 6 (±1.5) min in Dex group versus 9 (±1.9) min in Propofol group (P< 0.005) and to achieve an Aldrete Recovery Scale Score of 9-10 was 8 (±2.1) min in Dex group versus 6 10 (±1.6) min in Propofol group (P< 0.029).

https://crimsonpublishers.com/dapm/fulltext/DAPM.000520.php

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Are Virtual Relationships Real?_ Crimson Publishers

Are Virtual Relationships Real? by Mohd Nizar Battikhi* in Degenerative Intellectual & Developmental Disabilities_ Journal of Intellectual Disabilities

 

Introduction

The working of social and economic institutions, inequality is also a product of the way political institutions work. Government has known to serve the interest of economics elites and this most often works to the detriment of common people. This refers to the article ‘’Two trajectories’’ A Promise of reform and Ashaaram Pattern, what others do. A molar leadership deficit, our political leaders choose not to speak on certain issues. But they are forgetting that they have a molar responsibility towards domestic violence testing among divorced women begins privately manage pharmaceutical intuition associated to slums occupied area in Pune University, India. The horrific incidence in kathua and unnao has shown us the ugliest side of the country’s politician. The right procedure is not followed for the enquiry of the domestic violence and his contention by government police. The term intimate partner violence is often used synonymously with domestic abuse or domestic violence, but it specifically refers to violence occurring within a couple relationships (i.e., marriage, non-cohabitating intimate partners). To these, the World Health Organization (WHO) adds controlling behaviours as a form of abuse. Intimate partner violence has been observed in opposite and same-sex relationships, and in the former instance by both men against women and women against men.

https://crimsonpublishers.com/didd/fulltext/DIDD.000515.php

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Significant of Antimullerian Hormone (AMH) as Fertility Marker_ Crimson Publishers

 Significant of Antimullerian Hormone (AMH) as Fertility Marker by Mohd Nizar Battikhi* in Developments in Clinical & Medical Pathology_ Journal of Medical Pathology

 

Introduction

AMH is defined as: “Anti-mullerian hormone, it is a protein released by the ovaries that start the growth of an egg in the ovaries and is related to the development of follicles in the ovary. AMH levels correspond to the number of antral follicles, that can be used to indicate the number of eggs available in the ovaries [1,2]. It is virtually undetectable but increases gradually until puberty and remains relatively stable through the reproductive period [3,4]. A very low level of AMH may indicate poor ovarian reserves. A very high level of AMH may correspond to PCOS. One of the best uses currently of the AMH test is the ability to titrate fertility medications based on ovarian reserve and the ability to differentiate between polycystic Ovary Syndrome (PCOS) and those potential donors with a PCOS like ovarian response. By utilizing AMH, those woman with higher numbers may stimulate faster on less fertility medication and it can help decrease hyper stimulation in the high AMH and basal antral follicle count donors [1].

Level of AMH hormone corresponds to the number of eggs a woman has left in her ovarian reserve. That decline with age, however, not every woman is borne with the same number of eggs or loses them at the same rate [5]. There are some factors influence ovarian reserve such as genetics, exposure to chemotherapy, radiation and some medical conditions [5]. AMH detection is very good test because it indicates some information about biological clock, where no reliable test give such information before. [5]. AMH can be tested on any day of the menstrual cycle and It’s levels correlate with the number of oocytes retrieved and treatment can be individualized for optimal cycle [6-8], although level variation between different blood samples for the same patient was reported during the same menstrual cycle especially in young patients [9,10] never the less AMH can still show 80% sensitivity and 93% specificity in predicting poor ovarian response at random blood test [11] and It’s levels correlate with the number of oocytes retrieved and treatment can be individualized for optimal cycle.

https://crimsonpublishers.com/dcmp/fulltext/DCMP.000523.php

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