Nonadherence to fluid restrictions is a common problem with serious health consequences for patients with end-stage renal disease (ESRD). For the present study, the authors evaluated psychological variables of stress, as measured by major and minor life events, and depression. They sought to determine the role of these events in patients’failure to adhere to fluid restrictions as measured by increased interdialytic weight gain. Forty-two hemodialysis patients completed inventories assessing major life events, daily stressful events, and depression on three consecutive dialysis sessions. Fluid adherence was measured by interdialytic weight gain. A path analysis model found daily minor stress to have a direct effect on nonadherence, whereas there was a direct inverse effect of depression on nonadherence. Possible mechanisms and implications for future studies arediscussed.

Objectives: In patients with severe aortic stenosis who are at high risk for surgery, transcatheter aortic valve replacement (TAVR) has emerged as an alternative procedure using EV or CV. The objective of this meta-analysis is to compare 1-year mortality and major adverse cardiovascular and cerebrovascular events (MACCE) between Edwards valve (EV) and Medtronic CoreValve (CV). Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched through December 2014. Twenty seven studies (n = 12,249) comparing TAVR procedure that used EV (n = 5745) and CV (n = 6504) were included. End points were procedural success rates, post-procedural mortality, myocardial infarction (MI), stroke, major bleeding, major vascular complications, incidence of new permanent pacemaker (PPM) placement and new left bundle branch block (LBBB). The odds ratio (OR) with 95% confidence interval (CI) was computed and p < 0.05 was considered for significance. Results: There were no significant differences between EV and CV for post-procedural in-hospital, 30-day and 1-year all-cause mortality rates (p = 0.53, 0.33 and 0.94 respectively), cardiovascular mortality (p = 0.61), stroke (p = 0.54), major bleeding (p = 0.25) and major vascular complications (p = 0.27). MI was significantly lower with EV compared to CV (OR: 0.56, CI: 0.35-0.89, p = 0.01). Placement of new PPM and new onset LBBB were significantly higher in CV compared to EV (OR: 3.35, CI: 2.96-3.79, p < 0.00001 and OR: 6.55, CI: 4.76-9.03, p < 0.00001 respectively). Conclusions: The results of our meta-analysis suggest that TAVR procedure using CV may be associated with a higher incidence of MI, new PPM placement, and new onset LBBB compared to EV. However, the type of valve placed does not affect mortality.

Background: Periprocedural intravenous hydration is suggested to decrease the risk of post-ERCP pancreatitis (PEP). However, quality of evidence supporting this suggestion remains poor. Here we hypothesized that aggressive hydration(AH) could be an effective preventive measure. Methods: Pubmed, EMBASE, CINAHL, Google Scholar, Clinical Trials. gov, Clinical Key, International Standard Randomized Trial Number registry as well as secondary sources were searched through January 2019 to identify randomized controlled studies comparing AH to standard hydration (SH) for prevention of PEP. Pooled odds ratio (OR) and 95% confidence intervals (CIs) were calculated using the random-effects model. RevMan 5.3 was used for analysis. Results: A total of 9 RCTs, with 2094 patients, were included in the meta-analysis. AH reduced incidence of PEP by 56% compared to SH (OR = 0.44, CI:0.28–0.69; p = 0.0004). The incidence of post-ERCP hyperamylasemia also decreased with AH compared to SH (OR = 0.51; p = 0.001). Length of stay decreased by 1 day with AH (Mean Difference (MD): −0.89 d; p = 0.00002). There was no significant difference in adverse events related to fluid overload between two groups (OR:1.29; p = 0.81) and post-ERCP abdominal pain (OR:0.35; p = 0.17). Numbers of patient to be treated with AH to prevent one episode of PEP was 17. Final results of the meta-analysis were not affected by alternative effect measures or statistical models of heterogeneity. Conclusion: Aggressive hydration is associated with a significantly lower incidence of PEP and it appears to be an effective and safe strategy for the prevention of Post ERCP pancreatitis.

Thesis advisor: Judith Vessey / Purpose: The purpose of this study was to explore the relationships between psychological safety, perception of working in a high reliability organization (HRO) and safety event reporting intentions among pediatric nurses working in acute care. Background: The quality and safety of patient care is dependent upon nurses to report safety events and near-misses in order to address systems’ issues and identify improvement opportunities. To encourage feedback and promote reporting, many health care organizations have adopted the high reliability framework and strategies to promote team psychological safety. A dearth of literature exists on how the pediatric nurse perceives their workplace. This study addressed this gap by measuring the pediatric nurse’s level of psychological safety, perception of whether or not they work in an HRO and their safety event reporting intentions. Methods: Using nonprobability convenience sampling, data were collected from pediatric nurses (N=244) during a one-time, anonymous, 10-minute web-based survey. The survey was distributed to members of the Society of Pediatric Nurses (SPN) and by members of the National Pediatric Nurse Scientist Collaborative (NPNSC) to their respective constituent groups. The online survey comprised of four sections: a demographic form, the Safety Organizing Scale (SOS), the Team Psychological Safety Scale, and the Intention to Report Safety Events Scale. A two-part statistical model was fit using logistic regression and linear regression. Results: Psychological safety was found to have a positive and statistically significant relationship with Intention to Report Safety Events Scores (p<0.01; β=0.274). The findings also revealed that when all other variables were excluded from the statistical model, a positive and statistically significant relationship between HRO perception and safety event reporting intentions (p=0.034) existed. The logistic regression model revealed that the odds of a pediatric nurse achieving the highest safety reporting intention score of 7 increased by a factor of 0.3 with each additional year of practice. Conclusions: The findings demonstrated that a nurse’s perception of whether they work in a high reliability setting and how psychologically safe they feel profoundly effects their attitude towards safety event reporting. This work advances the state of the science by demonstrating how workplace culture, and specifically psychological safety and the HRO framework, influences reporting intentions. The information gained from this study will be useful to organizational leaders and professional groups who seek to improve patient safety reporting systems, communication strategies and existing workplace cultures. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

El presente trabajo explora cómo el uso de los drones de carrera ayuda a crear una cobertura audiovisual deportiva automotriz en las competencias de derrapes en la ciudad de Lima, Perú. Además, se explicará cómo se iniciaron las competencias de derrapes en el país de origen de Japón, cómo se expandió alrededor del mundo, llegando incluso al Perú y sumado a esto la creación de los drones que, mediante décadas de innovación tecnológica, se han ido perfeccionando hasta hoy en día tener drones más pequeños y con más versatilidad de vuelo que permite a los operadores de drones y creadores de contenido explorar nuevas técnicas de filmación. / This work explores how the use of racing drones help create audiovisual automotive sports coverage in the drift competitions in Lima, Peru. In addition, it will be explained how the drift competitions began in the country of origin of Japan, how it expanded around the world, even reaching Peru and added to this the creation of drones that, through decades of technological innovation, have gone refining to this day having smaller, more versatile drones that allow drone operators and content creators to explore new filming techniques. / Trabajo de investigación

El presente trabajo se creó con la finalidad de impulsar un nuevo modelo de negocio de servicios de arbitraje. Por ello, se observó detalladamente la necesidad que muestran las distintas empresas al momento de buscar personas que realicen sus diferentes eventos deportivos internos; también tenemos que mencionar a los árbitros de distintas categorías que averiguan nuevas oportunidades para ganar una mayor experiencia, y obtener ingresos adicionales. A partir de esta realidad, encontramos una solución similar a la que se presentan países de Europa, lo cual consideramos que es una nueva propuesta en el mercado peruano donde podríamos tener un buen porcentaje de aceptación por dichas empresas. Con todo lo mencionado, nuestro objetivo es brindar una facilidad, al tener nuestra propia plataforma para ofrecer un excelente servicio de arbitraje, esto se realizará a partir de evaluaciones de desempeño hacia nuestros socios (árbitros), donde le otorgaremos nuevas oportunidades de crecimiento a las personas que están comenzando en el mundo de arbitraje y mejorar el desempeño de los árbitros que han podido tener experiencia. De esta manera, como autores del proyecto queremos lograr una fuerte fidelidad con las diferentes empresas de eventos deportivos que existe en Lima Metropolitana y poder posicionarnos en el mercado peruano. / This work was created with the aim of promoting a new business model for arbitration services. Therefore, the need that different companies show when looking for people to carry out their different internal sporting events was observed in detail; We also have to mention the referees from different categories who find new opportunities to gain more experience, and earn additional income. Based on this reality, we found a solution similar to the one presented in European countries, which we consider to be a new proposal in the Peruvian market where we could have a good percentage of acceptance by these companies. With all the aforementioned, our objective is to provide a facility, since we have our own platform to offer an excellent arbitration service, this will be done based on performance evaluations towards our partners (arbitrators), where we will grant new growth opportunities to the people who are starting in the world of arbitration and improve the performance of arbitrators who may have had experience. In this way, as authors of the project we want to achieve strong loyalty with the different sports event companies that exist in Metropolitan Lima and to position ourselves in the Peruvian market. / Trabajo de investigación

It has been suggested that commuting behaviours become habitual and that changes to commute mode are more likely at the time of major life events. However, evidence to support this has so far been limited to analyses of small-scale samples. To address this evidence gap, we use two waves of panel data from the UK Household Longitudinal Study (2009/10 and 2010/11) to identify and explain the prevalence of individual change in commute mode from year to year amongst a representative sample of the English working population (n = 15,200). One third of those that cycle or get the bus to work, and one quarter of those that walk to work, are shown to change commuting mode by the following year. Car commuting is more stable, with only one in ten car commuters changing mode by the following year. Commute mode changes are found to be primarily driven by alterations to the distance to work which occur in association with changing job or moving home. Switching to non-car commuting becomes much more likely (9.2 times) as the distance to work drops below three miles. High quality public transport links to employment centres are shown to encourage switches away from car commuting and mixed land uses are shown to encourage switches to active commuting (walking and cycling). Switches away from car commuting are found to be more likely (1.3 times) for those with a pro-environmental attitude. The attitude orientation is shown to precede the behaviour change, demonstrating evidence of ‘cause and effect’. Overall, the study shows that changes in commuting behaviour are strongly influenced by life events, spatial context and environmental attitude.

Esta propuesta de negocio nació de un grupo de cuatro estudiantes universitarios, como una idea innovadora al mercado de mascotas, ofreciendo un servicio único que pudiera abastecer las necesidades de un segmento que se encontraba desatendido. Este trabajo de investigación está basado en la recolección de información de fuentes primarias y secundarias, que permiten determinar al mercado objetivo al cuál queremos dirigirnos, además, refuerzan el establecimiento de metas y objetivos trazados, de los cuales se ha diseñado el plan de marketing, los procesos operativos, la gestión de recursos humanos y el diseño financiero para poder alcanzarlas. La propuesta de negocio de Happy Pets, ofrece el servicio completo de organización de eventos para mascotas, desde la selección de productos alimenticios de garantía, hasta la mejor calidad en decoraciones y fotografía que existe en el mercado para mascotas, permitiendo que el cliente pueda relajarse y disfrutar de la fiesta junto con su engreído y sin preocupaciones. / This business proposal was born from a group of four university students, as an innovative idea to the pet market, offering a unique service that could supply the needs of a segment that was neglected. This research work is based on a collection of information from primary and secondary sources, which allows us to determine the target market to which we want to reach, in addition, they reinforce the establishment of goals and objectives outlined, from which it has been designed the marketing plan, the operational processes, human resources management and the financial design to achieve them. The Happy Pets business proposal offers de the complete service of organizing pet events, from the guarantee of the selection of the best food products , to the best qualities in decorations and photography that exists in the pet market, allowing the client to relax and enjoy the party together with his pet pal without any kind of worries. / Trabajo de investigación

Introduction Oral Non-steroidal anti-inflammatory drugs (NSAID) is an analgesia and is commonly used by people with osteoarthritis (OA). Oral NSAID is currently recommended as the second level of treatment for OA, and could be considered if physical activity, topical NSAID or paracetamol do not supply sufficient pain relief.   Aim To investigate how frequently oral NSAID is used in a sample of New Zealanders with OA and also to investigate the exposure to heightened risk of adverse events while using oral NSAID.   Method A cross-sectional survey was conducted to collect information about the use of oral NSAID by people with self-reported OA. The survey included 75 participants who were over the age of 45 with an average age of 70.6 years.   Results While having OA, 57,3% of the sample reported oral NSAID use. The results also show that 52% of the participants with cardiovascular (CV), gastrointestinal (GI) or renal comorbidities used oral NSAID, and 17,3% of them also combined that NSAID with medication for their comorbidity. Concerning the heightened risks of adverse events, 21% of the participants did acquire the analgesia over the counter (OTC), and 76,6% stated that they were over the age of 65.    Conclusion A majority of the participants in the study with self-reported OA take NSAID as an analgesia. Also, the study shows that NSAID is commonly used among participants with co-morbidity, which is similar to figures presented in previous studies in the area. However, the small sample size limits its generalizability to a larger population. / Introduktion Orala icke-steroida antiinflammatoriska läkemedel (NSAID) är en grupp smärtstillande mediciner som är vanligt använt av personer mer artros. Orala NSAID-preparat rekommenderas idag som en andrahandsbehandling och kan övervägas om fysisk aktivitet, topikala NSAID-preparat eller paracetamol inte ger tillräcklig smärtlindrande effekt.   Syfte Att undersöka hur vanligt användandet av orala NSAID-preparat är i ett stickprov av personer med artros i Nya Zeeland samt att undersöka exponering av orala NSAID-preparat i subgrupper med ökad risk för biverkningar vid användande av orala NSAID-preparat.   Metod En tvärsnittsstudie genomfördes för att samla in information kring användning av orala NSAID-preparat av personer med självrapporterad artros. Studiepopulationen bestod av 75 personer över 45 års ålder med en medelålder på 70,6 år.   Resultat 57,3% av deltagarna använder orala NSAID-preparat som behandling för sin självrapporterad artros. Gällande subgrupper med ökad risk för biverkning av NSAID användning visar studien att 52% av deltagare med kardiovaskulära, gastrointestinala eller njurpåverkade sjukdomar använder orala NSAID-preparat och av dessa kombinerar 17,3% NSAID-preparaten med medicin för sin samsjuklighet. Av deltagarna som uppgav att de använder orala NSAID-preparat erhåller 21% av dessa NSAID-preparaten receptfritt över disk. Av deltagare som var 65 år eller äldre uppgav 76,6% att de använder orala NSAID-preparat för behandling av artros.   Slutsats En majoritet av deltagarna med självrapporterad artros tar orala NSAID-preparat i smärtstillande syfte för sin artros. Studien visar också att NSAID ofta används bland deltagare med samsjuklighet, vilket motsvarar presenterade siffror från tidigare studier inom området. Den lilla stickprovsstorleken begränsar emellertid studiens generaliserbahet gentemot en större population.

Ce projet doctoral a pour finalité d’investiguer la place de la spécificité d’un contexte sportif, dans le processus d’adaptation de l’échelle de mesure Points of Attachment Index à un terrain d’étude particulier. Cette échelle se propose de mesurer l’attachement des spectateurs à l’égard des composantes des événements sportifs. Les concepts d’attachement, voire d’attachement émotionnel sont mobilisés dans les recherches sur la relation spectateurs - événements sportifs. Considéré comme animal, athlète et coproducteur de la pratique en tant que spécificité du milieu sportif, le cheval est étudié dans le contexte français et équestre. La question de recherche tend ainsi à s’intéresser à la prise en compte de cette spécificité dans l’utilisation d’une échelle de mesure dédiée à l’attachement des spectateurs aux composantes des événements sportifs liés au contexte sportif examiné. Pour cela, différentes étapes articulées sous forme d’études ont été menées. Après avoir identifié et observé les parties prenantes des concours équestres visibles par les spectateurs, une étude qualitative menée auprès 42 spectateurs nous a permis de mieux appréhender la relation affective vis-à-vis des composantes des concours équestres, et d’ainsi faire émerger des items propres à la composante « spécificité ». Par la suite, une étude quantitative (n=463) nous a donné l’opportunité d’analyser la place de cette spécificité dans l’échelle de mesure adaptée, ainsi que sa place dans l’attachement des spectateurs aux composantes des concours équestres. En conclusion, ces résultats se proposent de présenter de nouvelles connaissances quant à la relation spectateur-événement sportif, ainsi que, de suggérer l’éventualité d’adapter les instruments de mesure mobilisée au contexte étudiée (et implicitement étudier ses spécificités) dans la finalité d’être au plus près de la réalité du terrain. / This thesis aims at investigating the position of the specificity of sport context, in the adapted Points of Attachment Index scale to a particular filed. This scale measures the spectators' attachment to sporting event and their dimensions. Attachment and emotional attachment concepts are used for spectator-sporting event relationships researches. As a specificity of sport, we study horse in French and equestrian context. This research tends to examine the consideration of this specificity of scale. Several steps of this thesis are associated with studies. Firstly, we identify the stakeholders of equestrian competitions, with spectator’s equestrian sporting event. The main goal of this study is to emerge “specificity-horse” items. Then, a quantitative study is conducted (n=463). On the one hand, it gives us the opportunity to analyze the consideration of specificity dimension to adapted scale. On the other hand, we examine spectators’ attachment to horse and other dimensions of sporting events. These results provide a better understanding of spectator-sporting event relationships. For it, this research suggests to examine sport and cultural context and to adapt scale, in order to make the results representing the field reality at its best