Indicadores de gestión en hospitales nacionales. Nicaragua. 2007- 2016

El hospital es la unidad de salud de alta complejidad y alto nivel de resolución, integrado en la red de servicios del Ministerio de Salud de Nicaragua. Su organización está prevista para atención de personas enfermas, embarazo, parto y puerperio, a través de un régimen de internamiento, atención ambulatoria y en algunas unidades con cirugías ambulatorias y hospitalización de día. El hospital forma parte de una red y atiende tanto la demanda espontanea como la referida de otros niveles de atención primaria. El hospital está dotado de una infraestructura apropiada en donde los medios diagnósticos y terapéuticos se adecuan al nivel de resolución y donde el trabajador de la salud y el recurso cama son los activos más importantes para su funcionamiento. La cama hospitalaria constituye un punto de partida para la planificación de la producción de servicios, de la calidad y la presupuestación, con lo cual se generan una serie de datos que nos sirven para construir indicadores como metas a alcanzar. En Nicaragua progresivamente se han venido construyendo indicadores (Estancia media, Índice Ocupacional, Giro Cama, Intervalo de Sustitución, Presión de Urgencias, etc.), donde los estándares se basan en datos internacionales cuyas realidades difieren de la nuestra, por lo tanto el presente trabajo depende básicamente del análisis de series históricas para construir estándares de esos indicadores acordes a la realidad nacional. La planificación de producción de servicios hospitalarios utiliza el método de pronósticos cuantitativos, a través de descomposición de una serie temporal de estacionalidad, método tan útil en la planificación, a este método no se ha logrado realizar evaluación del mismo con respecto a resultados de impactos en la población, calidad de los servicios y la oferta de los mismos, a partir de lo antes expuesto nace la interrogante ¿Cuáles son los estándares nacionales de los indicadores de gestión para el mejor aprovechamiento del recurso cama

Estudi teòric de l'estructura i la reactivitat de compostos orgànics fosforats

Descripció del recurs: el 24 de novembre de 2010Vgeu casresum1de1.pd

Fire resistance performance of concrete-PVC panels with polyvinyl chloride (PVC) stay in place (SIP) formwork

Stay-in-place (SIP) formwork is a more-practical alternative to traditional steel or wood formworks due to its improved constructability and durability. The aim of this paper was to study the fire resistance performances of structural and non-structural concrete panels with polyvinyl chloride (PVC) SIP formwork. Three 124.01 in × 110.24 in × 3.15 in panels of PVC SIP formwork were tested and compared to one another. All panels were aged for 28 days, then exposed to the standard fire curve based on the ISO 834:2014 standard, and the temperatures in each panel surface recorded. The results indicate that concrete strength significantly influenced the structural stability and the fire resistance time of the panels (under load), even in this type of panels when exposed to high temperatures. It was found that the PVC encasement enhanced the thermal insulation property, one of the fire resistance performance criteria. Overall, the importance of this alternative formwork is the reduction in the use of forest resources, the raise of awareness of their conservation, and the promotion of their rational use as this a material is friendly to the environment

Identificação dos Aspectos Conceituais e elementos que constituem o Branding e Destination Branding

Con el crecimiento acelerado del mercado turístico, el consumidor tiene muchas opciones para elegir y las empresas pretenden, a través de herramientas como Branding y, en el caso del turismo, Destination Branding, posicionar la imagen de su producto a fin de obtener una ventaja competitiva al influir en la elección de su público objetivo. En este sentido, este estudio se propone a comprender y abordar los aspectos conceptuales, así como identificar las variables, del Branding y del Branding Destination, listando los procesos que componen las líneas de investigación dirigidas a lo largo de los estudios. Los conceptos fueron analizados en una perspectiva longitudinal. Para cumplir el objetivo de la investigación, se utilizó el método de búsqueda bibliográfica en libros y artículos científicos y se realizaron análisis exploratorios. Los resultados presentaron diversos materiales sobre el tema, aunque pocos autores se posicionen conceptualmente sobre el tema en sus marcos teóricos. Los factores identificados demuestran que existen deficiencias de estudios que deben completarse de modo que puedan dar subsidios teóricos y metodológicos para nuevos estudios, además de generar contribuciones de gestión.Com o crescimento acelerado do mercado turístico o consumidor tem diversas opções de escolha, e as empresas visam através de ferramentas como o Branding e no caso do Turismo o Destination Branding posicionar a imagem de seu produto a fim de obter vantagens competitivas, influenciando a escolha de seu público alvo. Neste sentido o presente estudo visa compreender e abordar os aspectos conceituais bem como identificar as variáveis do Branding e Destination branding, elencando os processos que os compõe, as linhas de pesquisa abordadas ao longo da evolução dos estudos. Os conceitos foram analisados numa perspectiva longitudinal, para cumprir com o objetivo da pesquisa e fazer as incursões exploratórias deste artigo, foi utilizado o método de pesquisa bibliográfica em livros e artigos científicos. Foi feita uma análise exploratória, e que deram subsidio para o desenvolvimento da pesquisa. Quanto os resultados os mesmos apresentaram diversos materiais sobre o tema, poucos autores se posicionam conceitualmente sobre o tema nos seus marcos teóricos, quanto aos elementos identificados os mesmos demostram que há lacunas de estudos a serem preenchidas para que possam dar subsidio teórico e metodológico para novos estudos, além de gerar contribuições gerenciais.   Due to the fast growth of the tourism market, consumers have several options and companies aim, using tools like branding (in tourism, destination branding), to position their product image and to have competitive advantages, influencing the choice of their target audience. In this sense, this study aims to understand and address the conceptual aspects, as well as to identify the branding and destination branding variables, defining their processes and the research lines addressed throughout the studies. The concepts were analyzed from a longitudinal perspective. To fulfill the research objective, a bibliographic review method in books and scientific articles was used and an exploratory analysis of this study was conducted. The results presented several materials on the subject, although few authors conceptually position themselves on the subject in their heories. The elements identified in this study indicate a gap to be filled in research to allow a theoretical and methodological basis for new studies, as well as generating managerial contributions

Comparison of Mechanical and Structural Properties of Nickel-titanium Alloy with Titanium-molybdenum Alloy and Titanium-niobium Alloy as Potential Metals for Endodontic Files

Introduction: The objective of this study was to compare the mechanical and structural properties of the nickel-titanium (Ni-Ti) alloy already used in endodontics with titanium-molybdenum (Ti-Mo) and titanium-niobium (Ti-Nb) alloys to determine if these can be suggested in the manufacture of endodontic files. Methods and Materials: Orthodontic wires made of the different alloys were used. The previously mentioned alloys were characterized by energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and torsion tests. Cyclic fatigue tests were performed on a simulated canal with a curvature of 86° to 375 rpm. The fractured surfaces of the wires were observed by means of scanning electron microscopy (SEM). A Kruskal-Wallis test and U Mann Whitney test were used to determine significant differences in cyclic fatigue between groups. Results: In the mechanical tests, similar values of torsion were found for the three alloys. In XRD, the Ti-Nb showed less structural changes. In the cyclic fatigue test, Ti-Nb was found to be significantly more resistant with respect to Ni-Ti and Ti-Mo. Conclusion: Based on our in vitro study, Ti-Nb is suggested as a possible alloy for the manufacture of rotary files due to its impressive properties

Photo-Fenton reaction at mildly acidic conditions: assessing the effect of bio-organic substances of different origin and characteristics through experimental design

This is an Author's Accepted Manuscript of an article published in Arlen Mabel Lastre-Acosta, Rafael Vicente, Margarita Mora, Ulises Javier Jáuregui-Haza, Antonio Arques & Antonio Carlos Silva Costa Teixeira (2019) Photo-Fenton reaction at mildly acidic conditions: assessing the effect of bio-organic substances of different origin and characteristics through experimental design, Journal of Environmental Science and Health, Part A, 54:8, 711-720 [copyright Taylor & Francis], available online at: http://www.tandfonline.com/10.1080/10934529.2019.1585721[EN] Urban-waste bio-organic substances (UW-BOS) have been shown to be capable of extending the photo-Fenton reaction to mildly acidic conditions. In this study, the effects of pH (3-7), UW-BOS, H2O2 and iron concentrations on the photo-Fenton process were systematically assessed using a Doehlert experimental design and response surface methodology for two UW-BOS (CVT230 and FORSUD). Solutions of the model antibiotic sulfadiazine (SDZ) were irradiated in a solar simulator equipped with a 550W Xenon lamp. The results showed that for UW-BOS contents below 30mg L-1, SDZ removal proceeds at pH 5 with similar rates for both CVT230 and FORSUD, regardless of Fe(III) concentration. For 50mg L-1 of UW-BOS or higher, CVT230 performs better than FORSUD, even for low Fe(III) content (1-3mg L-1). In contrast, half-life times of 35-40min can only be achieved under mildly acidic conditions with FORSUD for iron concentrations higher than 10mg L-1. The better performance of CVT230 can be associated with its high hydrophilic/hydrophobic ratio, low E2:E3, higher iron content and possibly higher yields of triplet reactive species generation upon solar irradiation. The most appropriate conditions for each UW-BOS studied are discussed for the first time, which are advantageous for possible engineered applications.The authors express their gratitude to CNPq (National Council for Scientific and Technological Development) and to the European Union (PIRSES-GA-2010-269128, EnvironBOS). This study was financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - Brasil (CAPES) - Finance Code 001.Lastre-Acosta, AM.; Vicente Candela, R.; Mora Carbonell, M.; Jáuregui-Haza, UJ.; Arqués Sanz, A.; Teixeira, ACSC. (2019). Photo-Fenton reaction at mildly acidic conditions: assessing the effect of bio-organic substances of different origin and characteristics through experimental design. Journal of Environmental Science and Health Part A. 54(8):711-720. https://doi.org/10.1080/10934529.2019.1585721S711720548Ikehata, K., Jodeiri Naghashkar, N., & Gamal El-Din, M. (2006). Degradation of Aqueous Pharmaceuticals by Ozonation and Advanced Oxidation Processes: A Review. Ozone: Science & Engineering, 28(6), 353-414. doi:10.1080/01919510600985937Klavarioti, M., Mantzavinos, D., & Kassinos, D. (2009). Removal of residual pharmaceuticals from aqueous systems by advanced oxidation processes. Environment International, 35(2), 402-417. doi:10.1016/j.envint.2008.07.009Malato, S., Fernández-Ibáñez, P., Maldonado, M. I., Blanco, J., & Gernjak, W. (2009). Decontamination and disinfection of water by solar photocatalysis: Recent overview and trends. Catalysis Today, 147(1), 1-59. doi:10.1016/j.cattod.2009.06.018Pignatello, J. J., Oliveros, E., & MacKay, A. (2006). Advanced Oxidation Processes for Organic Contaminant Destruction Based on the Fenton Reaction and Related Chemistry. Critical Reviews in Environmental Science and Technology, 36(1), 1-84. doi:10.1080/10643380500326564Wu, Y., Passananti, M., Brigante, M., Dong, W., & Mailhot, G. (2014). Fe(III)–EDDS complex in Fenton and photo-Fenton processes: from the radical formation to the degradation of a target compound. Environmental Science and Pollution Research, 21(21), 12154-12162. doi:10.1007/s11356-014-2945-1Klamerth, N., Malato, S., Agüera, A., & Fernández-Alba, A. (2013). Photo-Fenton and modified photo-Fenton at neutral pH for the treatment of emerging contaminants in wastewater treatment plant effluents: A comparison. Water Research, 47(2), 833-840. doi:10.1016/j.watres.2012.11.008Bernabeu, A., Palacios, S., Vicente, R., Vercher, R. F., Malato, S., Arques, A., & Amat, A. M. (2012). Solar photo-Fenton at mild conditions to treat a mixture of six emerging pollutants. Chemical Engineering Journal, 198-199, 65-72. doi:10.1016/j.cej.2012.05.056Gomis, J., Gonçalves, M. G., Vercher, R. F., Sabater, C., Castillo, M.-A., Prevot, A. B., … Arques, A. (2015). Determination of photostability, biocompatibility and efficiency as photo-Fenton auxiliaries of three different types of soluble bio-based substances (SBO). Catalysis Today, 252, 177-183. doi:10.1016/j.cattod.2014.10.015Gomis, J., Carlos, L., Prevot, A. B., Teixeira, A. C. S. C., Mora, M., Amat, A. M., … Arques, A. (2015). Bio-based substances from urban waste as auxiliaries for solar photo-Fenton treatment under mild conditions: Optimization of operational variables. Catalysis Today, 240, 39-45. doi:10.1016/j.cattod.2014.03.034Gomis, J., Vercher, R. F., Amat, A. M., Mártire, D. O., González, M. C., Bianco Prevot, A., … Carlos, L. (2013). Application of soluble bio-organic substances (SBO) as photocatalysts for wastewater treatment: Sensitizing effect and photo-Fenton-like process. Catalysis Today, 209, 176-180. doi:10.1016/j.cattod.2012.08.036Montoneri, E., Boffa, V., Savarino, P., Perrone, D., Ghezzo, M., Montoneri, C., & Mendichi, R. (2011). Acid soluble bio-organic substances isolated from urban bio-waste. Chemical composition and properties of products. Waste Management, 31(1), 10-17. doi:10.1016/j.wasman.2010.08.029Arques, A., & Bianco Prevot, A. (Eds.). (2015). Soluble Bio-based Substances Isolated From Urban Wastes. SpringerBriefs in Molecular Science. doi:10.1007/978-3-319-14744-4Bianco Prevot, A., Fabbri, D., Pramauro, E., Baiocchi, C., Medana, C., Montoneri, E., & Boffa, V. (2010). Sensitizing effect of bio-based chemicals from urban wastes on the photodegradation of azo-dyes. Journal of Photochemistry and Photobiology A: Chemistry, 209(2-3), 224-231. doi:10.1016/j.jphotochem.2009.11.020Bianco Prevot, A., Avetta, P., Fabbri, D., Laurenti, E., Marchis, T., Perrone, D. G., … Boffa, V. (2010). Waste-Derived Bioorganic Substances for Light-Induced Generation of Reactive Oxygenated Species. ChemSusChem, 4(1), 85-90. doi:10.1002/cssc.201000237Carlos, L., Mártire, D. O., Gonzalez, M. C., Gomis, J., Bernabeu, A., Amat, A. M., & Arques, A. (2012). Photochemical fate of a mixture of emerging pollutants in the presence of humic substances. Water Research, 46(15), 4732-4740. doi:10.1016/j.watres.2012.06.022Mohajerani, M., Mehrvar, M., & Ein-Mozaffari, F. (2012). Using an external-loop airlift sonophotoreactor to enhance the biodegradability of aqueous sulfadiazine solution. Separation and Purification Technology, 90, 173-181. doi:10.1016/j.seppur.2012.02.025Conde-Cid, M., Álvarez-Esmorís, C., Paradelo-Núñez, R., Nóvoa-Muñoz, J. C., Arias-Estévez, M., Álvarez-Rodríguez, E., … Núñez-Delgado, A. (2018). Occurrence of tetracyclines and sulfonamides in manures, agricultural soils and crops from different areas in Galicia (NW Spain). Journal of Cleaner Production, 197, 491-500. doi:10.1016/j.jclepro.2018.06.217Amat, A. M., Arques, A., García-Ripoll, A., Santos-Juanes, L., Vicente, R., Oller, I., … Malato, S. (2009). A reliable monitoring of the biocompatibility of an effluent along an oxidative pre-treatment by sequential bioassays and chemical analyses. Water Research, 43(3), 784-792. doi:10.1016/j.watres.2008.11.017Ferreira, S. L. ., dos Santos, W. N. ., Quintella, C. M., Neto, B. B., & Bosque-Sendra, J. M. (2004). Doehlert matrix: a chemometric tool for analytical chemistry—review. Talanta, 63(4), 1061-1067. doi:10.1016/j.talanta.2004.01.015Gomis, J., Bianco Prevot, A., Montoneri, E., González, M. C., Amat, A. M., Mártire, D. O., … Carlos, L. (2014). Waste sourced bio-based substances for solar-driven wastewater remediation: Photodegradation of emerging pollutants. Chemical Engineering Journal, 235, 236-243. doi:10.1016/j.cej.2013.09.009Silva, M. P., Lastre-Acosta, A. M., Mostafa, S., McKay, G., Linden, K. G., Rosario-Ortiz, F. L., & Teixeira, A. C. S. C. (2017). Photochemical generation of reactive intermediates from urban-waste bio-organic substances under UV and solar irradiation. 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Technical and market evaluation of thermal generation power plants in the Colombia power system

Thermal power plants are the widely conventional generation unit technology used to produce electricity being controllable and dispatchable. The location of thermal power plants depends on the energy availability conditions of the areas and the capacity to fuels access. Their location and geographical distribution define a high level of concentration in areas defined as thermal districts and its location define reliability, security, availability, and flexibility indices to avoid critical scenario or support system from contingencies. However, in many cases the electrical configuration does not correspond to requirements. This paper links the concentration by political distribution in Colombia and the configuration used in the generating substations to guarantee requirements. The Hirschman-Herfindahl index as a market tool is used to evaluate energy concentration facing representative participation in certain departments of Colombia. Results evidenced configurations and concentration in a study case, results and analysis could be used for planner to promote participation, reliability and promote. The paper’s contribution and conclusions are linked to guide planners towards market and technical tool to evaluate installed capacities, avoid market concentration, and reduce risky scenarios

Factors affecting the big data adoption as a marketing tool in SMEs

The change brought by Big Data about the way to analyze the data is revolutionary. The technology related to Big Data supposes a before and after in the form of obtaining valuable information for the companies since it allows to manage a large volume of data, practically in real time and obtain a great volume of information that gives companies great competitive advantages. The objective of this work is evaluating the factors that affect the acceptance of this new technology by small and medium enterprises. To that end, the technology acceptance model called Unified Theory of Technology Adoption and Use of Technology (UTAUT) was adapted to the Big Data context to which an inhibitor was added: resistance to the use of new technologies. The structural model was assessed using Partial Least Squares (PLS) with an adequate global adjustment. Among the results, it stands out that a good infrastructure is more relevant for the use of Big Data than the difficulty of its use, accepting that it is necessary to make an effort in its implementation.Universidad Peruana de Ciencias Aplicadas, Universidad de la Costa, Fundación Universitaria Popayán, Corporación Universitaria Latinoamericana, Corporación Universitaria Reformada

Síndrome de quilomicronemia familiar, deficiencia del factor de maduración de lipasa

. Introducción: el síndrome de quilomicronemia familiar se considera un trastorno autosómico recesivo, poco frecuente, que puede presentarse clínicamente desde la infancia, pero se manifiesta después de su debut a cualquier edad. Clínicamente se presenta con dolor abdominal, pancreatitis aguda recurrente, xantomas cutáneos y hepatoesplomegalia. Por NGS su confirmación precisa que la variante encontrada siempre es bialélica; los progenitores por definición son heterocigotos para la misma variante y no presentan la enfermedad, solo portan la mutación sin presentar síntomas. Objetivo: investigar la presencia de la quilomicronemia y determinar su patrón de herencia, ya sea como una forma familiar con un patrón monogénico bialélico o como una condición de naturaleza multifactorial. Presentación del caso: se presenta el caso de un paciente con múltiples comorbilidades que acude por dolor abdominal e hipertrigliceridemia de etiología no filiada, al cual se le envían estudios genéticos para filiar la etiología y establecer un tratamiento adecuado. Discusión y conclusión: se realiza un estudio genético de análisis molecular por secuenciación de nueva generación, identificado en homocigosis en el gen LMF1. Esta variante se caracteriza por ser patogénica. Para diagnosticar el síndrome de quilomicronemia se deben identificar variantes bialélicas no patogénicas en el complejo LPL y proteínas relacionadas. El tratamiento consiste en la restricción de grasa en la dieta para reducir la morbilidad y mortalidad, así como el seguimiento por parte de genética para el estudio de familiares con riesgo