39 research outputs found

    Propuesta de Supply Chain Management y Logística para la empresa Compass Group

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    Anexo 1 Gestión de inventarios en la empresa Compass Group. Anexo 2 Tabla 5. Estrategias de mejoras. Anexo 3 Encuesta sobre la gestión de aprovisionamiento de la empresa Compass Group. Anexo 4 Comparativa Colombia vs el LPI del banco mundialEl Supply Chain Management se basa en la gestión del flujo de bienes y servicios e incluye todos los procesos que transforman las materias primas en productos finales, implica la optimización activa de las actividades de suministro de una empresa para maximizar el valor para el cliente y obtener una ventaja competitiva en el mercado. (aula, 2021) Para conoce las oportunidades que tienen las organizaciones con la implementación de estrategias en Supply Chain Management, el Grupo 12 del curso Diplomado en SMC y Logística O.G 1605 del 2022, selecciono la empresa Compass Group como empresa de estudio para poder identificar y aplicar los conocimientos de los diferentes procesos logísticos como el aprovisionamiento, el transporte, la distribución y la gestión de almacenes e inventarios para dar soporte a la gestión de la red de valor de la empresa y esta pueda responder sin dificultad a las exigencias actuales de los mercados. Compass Group fue seleccionada como objeto de estudio gracias al acceso de información que se tiene sobre ella y sobre todo porque es una multinacional muy bien constituida lo que hace que el reto sea mucho más grande y que se tenga que investigue más afondo cada proceso para poder identificar falencias en ellos y proponer mejoras que estén a la altura de la empresa para que esta pueda catalogarse entre las mejores del mundo.The Supply Chain Management is based on the management of the flow of goods and services and includes all the processes that transform raw materials into final products, it implies the active optimization of the supply activities of a company to maximize the value for the client and obtain a competitive advantage in the marketplace. (classroom, 2021) To know the opportunities that organizations have with the implementation of strategies in Supply Chain Management, Group 12 of the Diploma course in SMC and Logistics O.G 1605 of 2022, selected the company Compass Group as a study company to be able to identify and apply the knowledge of the different logistics processes such as supply, transport, distribution and warehouse and inventory management to support the management of the company's value network and this can respond without difficulty to current market demands. Compass Group was selected as the object of study thanks to the access to information that is available about it and above all because it is a very well-established multinational, which makes the challenge much greater and that each process has to be investigated in greater depth to be able to identify shortcomings in them and propose improvements that are up to the company so that it can be classified among the best in the world

    Reducción de la prevalencia del bullying en alumnos de secundaria: intervenciones efectivas

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    El bullying, por sus características y presencia en los ambientes educativos, continúa siendo una prioridad a trabajar; sin embargo, son pocos los estudios que han logrado reconocer programas efectivos para disminuir su prevalencia. Es por esta razón que el objetivo de este trabajo es el de identificar programas de intervención efectivos que generen una disminución en la prevalencia del bullying en estudiantes de secundaria. Se revisan diferentes programas de los últimos años para indagar en su efectividad y utilidad para la comunidad educativa. Las bases de datos consultadas fueron Scopus y Proquest. Para el análisis de los resultados se seleccionaron investigaciones que cumplan con criterios de inclusión y exclusión (n = 14). Como resultados, se encuentra que sí existen programas efectivos para disminuir la prevalencia del bullying y que las variables más trabajadas son Estrategias de afrontamiento, Empatía y las Habilidades socioemocionales - sociocognitivas. En cuanto al nivel de evidencia, todas cuentan con un diseño experimental o cuasi - experimental. No se encontraron investigaciones aplicadas al contexto peruano, por lo que se evidencia la urgencia que existe en poder aplicar este tipo de intervenciones en base a nuestra realidad y contexto educativo.Bullying, due to its characteristics and presence in educational environments, continues to be a priority to work on; however, few studies have managed to recognize effective programs to reduce its prevalence. It is for this reason that the objective of this work is to identify effective intervention programs that generate a decrease in the prevalence of bullying in secondary students. Different programs of recent years are reviewed to investigate their effectiveness and usefulness for the educational community. The databases consulted were Scopus and Proquest. For the analysis of the results, investigations that meet the inclusion and exclusion criteria (n = 14) were selected. As a result, it is found that there are effective programs to reduce the prevalence of bullying and that the most worked variables are coping strategies, empathy and socio-emotional and socio-cognitive skills. Regarding the level of evidence, all of them have an experimental or quasi-experimental design. No research applied to the Peruvian context was found, so the urgency that exists in being able to apply this type of intervention based on our reality and educational context is evident

    Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals

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    Introduction: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI).Objective: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City.Design: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010.Methods: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis.Results: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score >= 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed.Conclusions: the cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.Pfizer Inc.Salvador Zubiran Natl Inst Med Sci & Nutr, Dept Med, Mexico City, DF, MexicoHosp Escuela Tegucigalpa, Tegucigalpa, HondurasUniversidade Federal de São Paulo, Escola Paulista Med, Div Infect Dis, São Paulo, BrazilNatl Canc Inst, Div Infect Dis, Mexico City, DF, MexicoUniv Nacl Colombia, Dept Internal Med, Bogota, ColombiaUniv Peruana Cayetano Heredia, Dept Med, Lima, PeruHosp Vargas Caracas, Caracas, VenezuelaCtr Med Caracas, Caracas, VenezuelaUniv Fed Rio de Janeiro, Univ Hosp, Rio de Janeiro, BrazilUniv Texas Med Sch Houston, Mem Hermann Texas Med Ctr, Dept Med, Houston, TX USAUniv Fed Parana, Hosp Clin, BR-80060000 Curitiba, Parana, BrazilUniv Chile, Fac Med, Hosp Luis Calvo Mackenna, Dept Pediat, Santiago 7, ChileUniv Desarrollo, Clin Alemana, Dept Med, Santiago, ChileHosp Clin Jose San Martin, Infect Dis Unit, Buenos Aires, DF, ArgentinaPontificia Univ Catolica Ecuador, Fac Med, Hosp Vozandes, Quito, EcuadorUniversidade Federal de São Paulo, Escola Paulista Med, Div Infect Dis, São Paulo, BrazilPfizer Inc.: INF-168Web of Scienc

    Comparación de la fuerza de adhesión de brackets utilizando dos métodos de acondicionamiento para porcelana

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    Introduction: During 2010 the degree research “Comparison of the shear bond strength of brackets using two surface conditioning methods for porcelain” was carried out at Universidad Cooperativa de Colombia in Bogota. Objective: To determine the shear bond strength of metal brackets cemented on porcelain using two surface conditioning methods. Materials and methods: Forty human premolars were used and prepared for further cementing porcelain-metal crowns. There were two groups of 20 teeth each one; Group 1 was conditioned with 9.6% hydrofluoric acid and silane coupling agents (hfa + s). Group 2 used 37% phosphoric acid and Primer porcelain (fa + pp). Then metal brackets were bonded using adhesive and Transbond xt resin. Samples were tested for shear bond strength with Instron, a universal testing machine. Results: The highest shear bond strength was given by Group 2 (fa + pp) with a 9.4 MPa average, but Group 1 (hfa + s) a 7.0 MPa value (p = 0.006). Conclusions: The chemical bonding method of 37% phosphoric acid and Primer porcelain provides better results of shear bond strength of metal brackets on porcelain surfaces and prevents to expose patients to toxic effects of hydrofluoric acid, reported in literature; also possible porcelain structure damage is minimized using acid etching.Introducción: durante el 2010, en la Universidad Cooperativa de Colombia, sede Bogotá, como trabajo de grado se realizó la&nbsp;investigación “Comparación de la fuerza de adhesión de brackets utilizando dos métodos de acondicionamiento para porcelana”.&nbsp; Objetivo: determinar la fuerza de adhesión de brackets metálicos cementados sobre porcelana, con el uso de dos métodos de&nbsp;acondicionamiento. Materiales y métodos: 40 premolares humanos fueron sometidos a preparaciones para cementación de coronas&nbsp;completas en metal porcelana. Se hicieron dos grupos cada uno de 20 dientes. Grupo 1. Grabado con ácido hidrofluorhídrico&nbsp;(9,6%) y aplicación de silano (ahf + s). Grupo 2. Ácido fosfórico (37%) y Primer para porcelana (af + pp). Luego se cementaron&nbsp;brackets metálicos, utilizando adhesivo y resina Transbond xt. Las muestras fueron sometidas a prueba de resistencia de fuerza&nbsp;de corte con una máquina universal de ensayo, Instron. Resultados: se obtuvo mayor fuerza de adhesión en el grupo 2 (af +&nbsp;pp) con un promedio de 9,4 MPa, y para el grupo 1 (ahf + s), un valor de 7,0 MPa (p = 0,006). Conclusiones: el método con&nbsp;ácido fosfórico (37%) y Primer para porcelana proporciona mejores resultados en la fuerza de adhesión de brackets metálicos sobre&nbsp;porcelana, evitando exponer al paciente a los efectos tóxicos del ácido hidrofluorhídrico, reportados en la literatura; también se&nbsp;minimizan los posibles daños en la estructura de la porcelana cuando se somete al grabado ácido

    Reappraisal of the outcome of healthcare-associated and community-acquired bacteramia: a prospective cohort study

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    Background: Healthcare-associated (HCA) bloodstream infections (BSI) have been associated with worse outcomes, in terms of higher frequencies of antibiotic-resistant microorganisms and inappropriate therapy than strict community-acquired (CA) BSI. Recent changes in the epidemiology of community (CO)-BSI and treatment protocols may have modified this association. The objective of this study was to analyse the etiology, therapy and outcomes for CA and HCA BSI in our area. Methods: A prospective multicentre cohort including all CO-BSI episodes in adult patients was performed over a 3-month period in 2006–2007. Outcome variables were mortality and inappropriate empirical therapy. Adjusted analyses were performed by logistic regression. Results: 341 episodes of CO-BSI were included in the study. Acquisition was HCA in 56% (192 episodes) of them. Inappropriate empirical therapy was administered in 16.7% (57 episodes). All-cause mortality was 16.4% (56 patients) at day 14 and 20% (71 patients) at day 30. After controlling for age, Charlson index, source, etiology, presentation with severe sepsis or shock and inappropriate empirical treatment, acquisition type was not associated with an increase in 14-day or 30-day mortality. Only an stratified analysis of 14th-day mortality for Gram negatives BSI showed a statically significant difference (7% in CA vs 17% in HCA, p = 0,05). Factors independently related to inadequate empirical treatment in the community were: catheter source, cancer, and previous antimicrobial use; no association with HCA acquisition was found. Conclusion: HCA acquisition in our cohort was not a predictor for either inappropriate empirical treatment or increased mortality. These results might reflect recent changes in therapeutic protocols and epidemiological changes in community pathogens. Further studies should focus on recognising CA BSI due to resistant organisms facilitating an early and adequate treatment in patients with CA resistant BSI

    Benefits of Decumanum Phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects

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    Introducción: El ejercicio intenso provoca un daño muscular inflamatorio que, en sujetos sedentarios provoca un aumento del riesgo cardiovascular. El Phlebodium decumanum (PD) ha evidenciado efectos inmunomoduladores protectores frente a ese daño en los deportistas. Para conocer los efectos del PD en una población sedentaria frente al ejercicio excéntrico, y como modelo del daño muscular inflamatorio. Metodología: Se llevó a cabo un estudio experimental, doble ciego, multigrupo, randomizado, con un grupo experimental (n = 17) al que se le administró una formulación de PD (3,6 g/sujeto distribuidos en 9 dosis de 400 mg desde el 3.er día pretest), y un grupo control (n = 16) que tomó sustancia placebo. Se realizaron dos ergoespirometrías en tapiz rodante a cada participante: una previa al estudio (protocolo de Bruce modificado) para descartar signos de isquemia durante el esfuerzo y valorar el VO2max; la segunda, aplicando un protocolo excéntrico (14% de desnivel descendente), durante 10 minutos en estado estable a una intensidad entre 70-80% del VO2max individual, como protocolo experimental. Se efectuaron comparaciones intragrupo e intergrupo del porcentaje de cambio pre-postesfuerzo en variables sanguíneas y de funcionalidad muscular. Resultados: El estudio evidencia aumentos significativos de enzimas musculares MG, CPK y LDH en los dos grupos de estudio, sin cambios para la TncI, siendo significativamente menores en el grupo al que se le administró PD. Se observaron reducciones significativas de los test funcionales SJ, CMJ en ambos grupos, lo que mostró un apreciable menor descenso en el grupo PD. Se apreció una reducción del índice elástico y de la dinamomentría manual solo en el grupo control, aunque las diferencias con el grupo PD no alcanzaron una significación estadística. Conclusiones: El protocolo del ejercicio excéntrico en el presente estudio ha inducido daños musculoesqueléticos y en la funcionalidad muscular, que han resultado significativamente menores en el grupo PD, al mostrar los efectos protectores del Phlebodium Decumanum en tratamientos cortos, frente al daño muscular también en el esfuerzo agudo.Introduction: Intense physical exercise provoke muscle damage, that in sedentary people can increase cardiovascular risk. Phlebodium decumanum (PD) has shown to have immunomodulator effects in models of moderateintense physical activities in well conditioned groups. To evaluate the PD effects during eccentric exercise, as a model of muscle inflammation protocol, on a sedentary population with cardiovascular risk. Methods. This is an experimental, double-blind, multigroup randomized study. Experimental Group 1 (n = 17) received PD, 9 dosis of 400 mg (total amount 3.6 g) every 8 hours during 3 days, and Control Group 2 (n = 16) received a placebo. All the subjects performed two treadmill ergoespirometry tests: first, a modified Bruce protocol to discard ischemic responses during exercise and to evaluate VO2max before the experimental phase; and second, with an eccentric protocol (14% descending ramp test) during 10 minutes in stable state at 70-80% VO2max, as experimental inflammatory protocol. We compared intra and inter groups to evaluate differences in the pre and post-test differences results on blood muscle damage variables. Results: The study shown statistically significant differences in all pre-post intra-groups results in muscle damage variables (CK, LDH and Myoglobin, but not in Cardiac Troponin), and in functional lower-limb test (SJ and CMJ). The comparison of inter-group results shown less muscle damage and less functional lower-limb deterioration in Group 1 compared with Control group, with statistical significance in both cases. Differences in hand grip dynamometry were no statistically significant. Conclusions: The eccentric exercise protocol in that study has proven to be a good model to induce muscle and functional damage in sedentary people. Short PD treatment has shown to reduce muscle and functional acute damages compared with placebo control group in this specific population

    Risk Factors and Predictive Score for Bacteremic Biliary Tract Infections Due to Enterococcus faecalis and Enterococcus faecium: a Multicenter Cohort Study from the PROBAC Project

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    Biliary-tract bloodstream infections (BT-BSI) caused by Enterococcus faecalis and E. faecium are associated with inappropriate empirical treatment and worse outcomes compared to other etiologies. The objective of this study was to investigate the risk factors for enterococcal BT-BSI. Patients with BT-BSI from the PROBAC cohort, including consecutive patients with BSI in 26 Spanish hospitals between October 2016 and March 2017, were selected; episodes caused by E. faecalis or E. faecium and other causes were compared. Independent predictors for enterococci were identified by logistic regression, and a predictive score was developed. Eight hundred fifty episodes of BT-BSI were included; 73 (8.5%) were due to target Enterococcus spp. (48 [66%] were E. faecium and 25 [34%] E. faecalis). By multivariate analysis, the variables independently associated with Enterococcus spp. were (OR; 95% confidence interval): cholangiocarcinoma (4.48;1.32 to 15.25), hospital acquisition (3.58;2.11 to 6.07), use of carbapenems in the previous month (3.35;1.45 to 7.78), biliary prosthesis (2.19;1.24 to 3.90), and moderate or severe chronic kidney disease (1.55;1.07 to 2.26). The AUC of the model was 0.74 [95% CI0.67 to 0.80]. A score was developed, with 7, 6, 5, 4, and 2 points for these variables, respectively, with a negative predictive value of 95% for a score # 6. A model, including cholangiocarcinoma, biliary prosthesis, hospital acquisition, previous carbapenems, and chronic kidney disease showed moderate prediction ability for enterococcal BT-BSI. Although the score will need to be validated, this information may be useful for deciding empirical therapy in biliary tract infections when bacteremia is suspected. IMPORTANCE Biliary tract infections are frequent, and a significant cause of morbidity and mortality. Bacteremia is common in these infections, particularly in the elderly and patients with cancer. Inappropriate empirical treatment has been associated with increased risk of mortality in bacteremic cholangitis, and the probability of receiving inactive empirical treatment is higher in episodes caused by enterococci. This is because many of the antimicrobial agents recommended in guidelines for biliary tract infections lack activity against these organisms. To the best of our knowledge, this is the first study analyzing the predictive factors for enterococcal BT-BSI and deriving a predictive score.8 página

    Epidemiology of Invasive Fungal Infections in Latin America

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    The pathogenic role of invasive fungal infections (IFIs) has increased during the past two decades in Latin America and worldwide, and the number of patients at risk has risen dramatically. Working habits and leisure activities have also been a focus of attention by public health officials, as endemic mycoses have provoked a number of outbreaks. An extensive search of medical literature from Latin America suggests that the incidence of IFIs from both endemic and opportunistic fungi has increased. The increase in endemic mycoses is probably related to population changes (migration, tourism, and increased population growth), whereas the increase in opportunistic mycoses may be associated with the greater number of people at risk. In both cases, the early and appropriate use of diagnostic procedures has improved diagnosis and outcome

    A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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