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2. Mass Critical Care Surge Response During COVID-19

Author

Jeffrey R. Dichter, Asha V. Devereaux, Charles L. Sprung, Vikramjit Mukherjee, Jason Persoff, Karyn D. Baum, Douglas Ornoff, Amit Uppal, Tanzib Hossain, Kiersten N. Henry, Marya Ghazipura, Kasey R. Bowden, Henry J. Feldman, Mitchell T. Hamele, Lisa D. Burry, Anne Marie O. Martland, Meredith Huffines, Pritish K. Tosh, James Downar, John L. Hick, Michael D. Christian, Ryan C. Maves, Anwar Al-Awadhi, Timur Alptunaer, Marie Baldisseri, Wanda Barfield, Joshua Benditt, Kasey Bowden, Richard Branson, Michael Christian, Guillermo Dominguez-Cherit, David Dries, Sharon Einav, Mill Etienne, Laura Evans, James Geiling, Ramon Gist, Kelly Griffin, Neil Halpern, Kiersten Henry, Attila Hertelendy, John Hick, Nathaniel Hupert, David Ingbar, Sameer S. Kadri, Sarah Kesler, Mary A. King, Niranjan Kissoon, Kristi Koenig, Joseph Lamana, Lindsay Leif, Deborah Levy, Alicia Livinsky, Christie Martin, Anne Marie Martland, Steven Mitchell, Mangala Narasimhan, Alexander Niven, Juan Ochoa, Doug Ornoff, J. Scott Parrish, Tia Powell, M.J. Reed, Dario Rodriguez, Gilbert Seda, Jaspal Singh, Julie Solar, Eric Toner, and Marian Von-Maszewski

Subjects
Pulmonary and Respiratory Medicine, Telemedicine, Surge Capacity, business.industry, Staffing, Guideline, Critical Care and Intensive Care Medicine, Triage, Nursing, Incident Command System, Interim, Intensive care, Medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Background Following the publication of 2014 consensus statement regarding mass critical care during public health emergencies, much has been learned about surge responses and the care of overwhelming numbers of patients during the COVID-19 pandemic.1 Gaps in prior pandemic planning were identified and require modification in the midst of ongoing surge throughout the world. Methods The Task Force for Mass Critical Care (TFMCC) adopted a modified version of established rapid guideline methodologies from the World Health Organization2 and the Guidelines International Network-McMaster Guideline Development Checklist.3 With a consensus development process incorporating expert opinion to define important questions and extract evidence, TFMCC developed relevant pandemic surge suggestions in a structured manner, incorporating peer-reviewed literature, “gray” evidence from lay media sources, and anecdotal experiential evidence. Results Ten suggestions were identified regarding staffing, load-balancing, communication, and technology. Staffing models are suggested with resilience strategies to support critical care staff. Intensive care unit (ICU) surge strategies and strain indicators are suggested to enhance ICU prioritization tactics to maintain contingency level care and avoid crisis triage, with early transfer strategies to further load-balance care. We suggest intensivists and hospitalists be engaged with the incident command structure to ensure two-way communication, situational awareness, and the use of technology to support critical care delivery and families of patients in intensive care units (ICUs). Conclusions A subcommittee from the Task Force for Mass Critical Care offers interim evidence-informed operational strategies to assist hospitals and communities to plan for and respond to surge capacity demands from COVID-19.

Published
2022
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3. PATIENT SAFETY, PRACTICE MANAGEMENT

Author

Nitin Sethi, Cabello Laura, Luca Ghislanzoni, S. Lindgren, Kazumi Ono, Say-Yang Ong, Pavel Rylov, Deivis Edward Marín Ríos, Agustín Viña, Belgin Yavascaoglu, Jose Andres Calvache España, Michal Tichy, Juan Carlos Bianco, Ikeda shigemasa, Jorge Luis Torrejón Rojas, Roberto Favaloro, Niels Anker Pedersen, Diana Finkel, Marcos Pacheco, Wimonrat Sriraj, Albert Lorena, Andreas Harsten, Pavel Daniljuk, Hulya Gunay, Sylviana Barsoum, Chiharu Tanaka, Karsten Skovgaard Olsen, Thomas Rahlfs, Claudia Fuxman, Lino L Gomes, Lisa Cunningham, Yusuke Koyama, Maria Cristina Almeida, Juan Ochoa, A. A. J. van Zundert, Juan Camilo Gómez Salgado, Farnaz Kamali, Teresa Verdu, Kappei Matsumoto, Baldassare Licata, Sirirat Rattana-arpa, Luis Felipe Montoya-Pelaez, A. L. Polenov, Angela María Ríos Medina, Sara Whynot, Diego Alvarez, Marcelo T. O. Carlucci, Fatma Nur Kaya, Isaak Dimitriadis, Xavier Santiveri, Dora Zuker, Udom Kachintorn, Kailash Chandra Pant, Jorge Negroni, Carlos Fava, Akihiro Kashiwai, Jonas Åkeson, Dae Ja Um, Steven R Hofstetter, Ioanis Xarikopoulos, Desigen Reddy, Gonzalo Valencia, Prabhat K Singh, Alejandro Bertolotti, Antoine Bahati Kabeza, Bindiya Hari, Mkhululi Lukhele, Petros Stefanidis, John Semple, Sanjay Gandhi, Rodriguez Consuelo, Celina Gomes, Jong Tak Park, Allen Finley Somboon, Maria Prodromiti, Surendra Singh, Chiew Kim Ng, Alejandro Leites, Takashi Nakamura, Usharani Nimmagadda, Antonio Ribo, Gustavo Lev, Julie Mathew, Sigrid Kessler, Si Gon Kim, Pasi Lahtinen, Jerry Tan, Yumi Hoshino, Giovani Locks, Sabrina Bent, Carmen Ingrassia De Cruzado, Maria Negron-Gonzalez, Frank Rosinia, Igor Idov, Nikita Trembach, Sean Gallagher, Celina Oliveira, Claudia Marquez Simões, Silvia Miller, Sumita Bery, Wiyada Chalayonnawin, Srirat Arunratanakul, Corina Lee, Natalia Lesteva, Martin Hartín Harguindeguy, Javier Garcia-Cayuela, Thrinadha Rao Polamarasetti, as Carlos Vargas, Richard Urman, Laurie Freyder, Somchai Amornyotin, Volker Lischke, Pintor Elena, Ricardo Marenchino, Andreas Pikwer, Katharina Brandner, Lieke Muntinga, Gabriel Azevedo Terra Cunha, Ellen Iannoli, Pablo Gorosito, Kim Escher, Karen Pastorio, Christian Mukwesi, Jennifer Weller, Puttachard Saengtawan, Mohamed A. Abdullah, Carla Fernandes, Filomena Cerejo, Charles Cowles, Noah Rosenberg, Guillermo Andres Tajtelbaum, Angela Truong, Ana Agrelo, David Stansfield, León Valdivieso, Ramiro Barolo, Serene Chang, Siriporn Kongphlay, Federica Lovisari, Akarin Nimmannit, Finn M. Radtke, Kim Hae, Junko Hirashima, Felipe Melo Benevides, Yanina Arzani, Dimitris Maliamanis, Wolf Brockhaus, Vitaly Novikov, Srinivas Combiatore, Fernando de Paiva Araújo, Tong Khee Tan, Jiri Lastuvka, Karina Rando, Nikolaos Noulas, Tadeusz Musialowicz, Devendra Gupta, Thienthong Pulsuk, Bangaru Reddiyar, Semiha Uzunalioglu, Martin Franck, Bernd Chr. Frankenberger, P. Jason Toppin, Somi Ramachary Desikan, Gonzalo M. Rivas, Siritda Chatrattanakulchai, Massimo Dal Bianco, Jayashree Sood, George Djaiani, Eva Bendova, Elif Copuroglu, Eric Arisi, Roser Terradas, Florencia Werhum, Tammo Brouwer, Seetharaman Hariharan, Raminder Sehgal, Diego Garcia Picasso, Allen Holmes, Siripul Raza Abidi, Kenneth Sapire, Patricia Livingston, Suan-Ling Lim, Kyuyong Jang, Silvia Niveyro, Voravut Laphisetpun, Srini Pyati, Louise Rovsing, Natascha Ghadiali, Eun Sung, Busisiwe Mrara, Dimitrios Maliamanis, Jung Kim, John Stenglein, Carmen Gómez, Carla Farré, Irina Savvina, Elisavet Karkala, Arun Krishnamurthy, Mario Parreño Caparros, Francesco Carli, Yong Sup Shin, Hidekuni Hidaka, Raquel Santos, Ihab Labbene, Filomena Farinha, John Lefante, Aneesh Srivastava, Kumkoon Wajanawichajirb, Elif Basagan-Mogol, Amreeta Yanamandra, Khoubaib Abdellatif, Fiona Murray, Jane Torrie, Sergio Candiotto, Vivian Grünzig, Lauren Zolpys, Elizabeth Rebello, Marta Garcia Orellana, Jaime Olivares, Christine Hunter, Daniel Absi, Sohini Mitra, M. Ramez Salem, Oscar David Aguirre Ospina, Yara Marcondes Machado Castiglia, Vicente Cesáreo, Luz María Gómez Buitrago, June Goh, Hyun Kyo Lim, Alejandro Javier Bernasconi, Seiji Hattori, Bernd Scheller, Carlos Alberto Fernández Muñoz, Natalia Navarro Garcia, T. Mpourtzinakos, Leandro Gobbo Braz, Ahed Zeidan, Pei-Fen Teoh, Kavi Rampersad, Sujeet K Gautam, Maycor Da Luz, Arzu Yildirim, Alberto Domenech, Christian Byhahn, Florencia Picaroni, Fred Shapiro, Shaul Cohen, Dmitry Gulaev, Jean Kronberg, Gurkan Turker, Manu-Priya Sharma, Belgin Yavaçcaoglu, Alberto Vieira Pantoja, Eman Awad, Maria Fezza, Mauro Signorelli, Fabiane Cardia Salman, Ruchi Verma, Sultan Al-Temyat, Stefano Merigliano, Karima Taamallah, Kazuhito Kusudo, Anil K. Agarwal, Mikko Hippeläinen, Isabeau Walker, Oscar Mendiz, Dariush Abtahi, Hedi Gharsallah, Fernanda Marques Ferraz de Sa, Ian Mc Lean, Pablo Ingelmo, Maurício Ceccon, Jana Janco, Evan G. Pivalizza, Ming-Li Kong, Eduardo Bilesio, Adam Snyman, Nikolaos Panagopoulos, Pamela J. Morgan, Masoumeh Heydari Farzan, Jin Young Chon, Otto Pitkänen, Guillermo Orce, Jin Lee Dong, Enis Donizetti Silva, Alamo Francisco, Afroditi Kouvalakidou, Stephanie Russo, Theogene Twagirumugabe, Imen Naas, Smita Gosavi, Robert Henderson, Antti Valtola, Tsutomu Oshima, Dam-Thuy Truong, Gabriel Canale, Joseph Ruiz, Anderson, John Denny, Daniela Fontes, Daniel Bracco, Michael Friedman, Evelin Mejía Escobar, Nisval de Magalhães Junior, Marco Antonio Cardoso de Resende, Davy Cheng, Arunotai Siriussawakul, Cor J. Kalkman, Lídia Raquel de Carvalho, Maureen Fitzpatrick, Paul Kessler, Theoneste Mwumvaneza, Jesper Troensegaard Petersen, Janet Martin, Gina Bledsoe, Deryk Chen, Ravi Saibaba, Aleksey Tokorenko, N. Nick Knezevic, Diogo Castro, Hjörtur Hjartarson, Osiel Isaías Gutiérrez Bermúdez, Priscila Kusano, Elias Leon-Ruiz, Mike Hernandez, Sören Toksvig-Larsen, Eon Moon, Uttam Singh, Siew-Luan Toh, Francisco Gorbaran, George J. Crystal, Fernanda Barros, Liam Brannigan, and Jong Taek Park

Subjects
Patient safety, Anesthesiology and Pain Medicine, business.industry, Medicine, Practice management, Medical emergency, business, medicine.disease
Published
2012
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4. Biodegradation and biosorption of tetracycline and tylosin antibiotics in activated sludge system

Author

Nolwenn Prado, Juan Ochoa, Abdeltif Amrane, and Université de Rennes (UR)

Subjects
Chemistry, Tetracycline, animal diseases, Biosorption, Bioengineering, Biodegradation, Tylosin, Membrane bioreactor, Applied Microbiology and Biotechnology, Biochemistry, Microbiology, [SPI]Engineering Sciences [physics], chemistry.chemical_compound, fluids and secretions, Activated sludge, Sodium benzoate, Bioreactor, medicine, Food science, medicine.drug
Abstract

The aim of this study was to determine the fate of veterinary antibiotics entering biological treatment process. Due to the prevalence of their respective antibiotic family usage in livestock, tetracycline and tylosin were selected. Using modified Sturm test (OECD 301-B), their biodegradation were compared to that of a referent pollutant, sodium benzoate, well-known for its high biodegradability. Biodegradation rates were −28 and −35% for tetracycline and 4 and −5% for tylosin showing an absence of biodegradability. OECD 301-B inhibition tests showed a potential toxicity of both molecules on activated sludge inoculum derived from membrane bioreactor. Tetracycline presented good adsorbability while tylosin remained mostly present in the soluble phase. The Langmuir maximum adsorption capacity ( C s,max ) was found to be 72 and 7.7 mg g −1 for tetracycline and tylosin, respectively. Adsorption was therefore the most favourable fate for tetracycline entering a biological process. Conclusions on tylosin case were more controversial.

Published
2009
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5. Zero Nuisance Piggeries: Long-term performance of MBR (membrane bioreactor) for dilute swine wastewater treatment using submerged membrane bioreactor in semi-industrial scale

Author

Abdeltif Amrane, Nolwenn Prado, and Juan Ochoa

Subjects
Environmental Engineering, Nitrogen, Swine, Industrial Waste, Membrane bioreactor, Waste Disposal, Fluid, Water Purification, Bioreactors, Bioreactor, Animals, Biomass, Waste Management and Disposal, Effluent, Water Science and Technology, Civil and Structural Engineering, Suspended solids, Sewage, Waste management, Chemistry, Ecological Modeling, Membrane fouling, Temperature, Agriculture, Equipment Design, Pollution, Refuse Disposal, Waste treatment, Wastewater, Waste disposal
Abstract

Effective aerobic/anoxic treatment of piggery manure wastewater was achieved in a real farm scale using a small piggery (72 pigs) with reuse of the treated water. The experimental procedure was followed for 9 months. Fresh manure (FM) is formed by daily flush on piggeries and biologically treated after centrifuge pre-treatment. For upgrade liquid/solid separation and pathogen retention in biological treatment, a membrane system was used with the aim of effluent reuse in flush. Despite an evolution of FM through time, centrifuge pre-treatment and bioreactor performances stayed at high level. An elimination of 86% of the suspended solids occurred through pre-treatment, and nitrogen and COD biological degradation remains at 90% all time long. Moreover, interestingly about half of the soluble part of phosphorus (20% of the global phosphorus content) was biologically removed via the recirculation between the anoxic and the aerobic tank which acted as an intermittent aerobic/anoxic sequence. A part of COD was proved not biodegradable and was accumulated via the reuse of the treated water for flushing purpose. This accumulation justifies washing of the biomass between two runs in purpose to enhance the treated water quality and also to meet the membrane tolerance. The membrane was proved reliable as far as the maintenance procedure was respected. Maintenance cleaning had to be operated as soon as the TransMembrane Pressure (TMP) achieved 50 mbar and curative washing was necessary if the TMP increased over 90 mbar or between 2 runs. The temperature was proved to influence both the bioactivity and the membrane fouling kinetic. Finally, it was demonstrated that the process was sustainable for long-term management of swine wastewater at semi-industrial scale.

Published
2009
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6. LEARNING TO TEACH: TEACHING TO LEARN

Author

E B Jorge Benavides, Melba Libia Cárdenas, Oscar Zuluaga, Carlos Alberto Ospina, Juan Ochoa, and Blanca Aparicio

Subjects
Learning styles, Point (typography), media_common.quotation_subject, Learning to teach, Mathematics education, Psychology, Duty, media_common
Abstract

The title of this working document encompasses two intimately interconnected and inseparable aspects of our profession: improving our daily teaching and leading the students to learn how to learn. They are so closely linked together that it is always a point of discussion which one should go first. The reason is that if we genuinely believe it is our duty to turn the students into independent, responsible and efficient learners, it is first necessary that we the teachers develop and practise the same learning styles. Thus we advocate for teachers who practise the theory supporting our profession that they can become models worth being followed initially, but encouraging of further learning in the students beyond our presence or influence. Learning to teach conveys, on the one hand, what the authors of this document consider should be the core of our work as both pre-service teacher trainers and as promoters of in-service education. Throughout this document, we have attempted to cater for the sector of ELT in Colombia that had somehow been neglected in the project before and which is the vast number of teachers already working in both primary and secondary school nation-wide.

Published
1995
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