Continuidad asistencial: rol de la enfermera de enlace

ObjetivoEvaluar el programa de enfermera de enlace a los 2 años de funcionamiento.DiseñoEstudio descriptivo.EmplazamientoAtención primaria de los municipios de Sant Boi de Llobregat y Sant Vicenç dels Horts (Barcelona) y el Hospital Comarcal de Sant Boi.PacientesPacientes dados de alta del hospital (entre octubre de 2000 y octubre 2002) y que necesitaban cuidados de continuidad en el equipo de atención primaria o domicilio.IntervencionesVisitas conjuntas entre la enfermera de enlace y la supervisora de la unidad hospitalaria para elaborar el plan de cuidados previo al alta hospitalaria. Se comunica al equipo de atención primaria del traspaso del enfermo y su plan de cuidados. Las visitas posteriores al domicilio las realiza la enfermera de enlace, el equipo de atención primaria, o conjuntamente.ResultadosSe ha estudiado a 854 pacientes (57,6% mujeres); media de edad en mujeres 69,82±14,7 años y en varones de 61,7±19,6 años (p<0,0001).La enfermera de enlace ha realizado 2.241 visitas hospitalarias, 81 domiciliarias y 434 llamadas telefónicas. También se han hecho 636 coordinaciones.El diagnóstico de enfermería más frecuente ha sido trastorno de la movilidad física (61% de los pacientes).ConclusionesSe ha creado un mecanismo que mejora la continuidad desde el alta hospitalaria hasta el contacto con el equipo de atención primaria. La enfermera de enlace coordina y gestiona los casos antes de que el paciente sea traspasado al ámbito de la atención primaria.ObjectiveTo evaluate the link nurse programme after 2 years of operation.DesignDescriptive study.SettingPrimary vare in the towns of Sant Boi de Llobregat and Sant Vicenç dels Horts (Barcelona) and the County Hospital of Sant Boi, Spain.PatientsPatients discharged from the hospital (October 2000-October 2002) and who needed ongoing care in the primary care centre or at home.InterventionsJoint visits of the link nurse and the hospital unit's supervisor to work out the care plan before discharge. The PC team was informed of the transfer of the patient and his/her care plan. Subsequent home visits were by the link nurse, the primary care team or both together.Results854 patients (57.6% women) were studied.Women's mean age was 69.82 (SD, 4.7) and men's was 61.7 (SD, 9.6) (P<.0001). The link nurse made 2241 hospital visits, 81 home visits, and 434 phone calls. There were 636 co-ordinations.The most common nursing diagnosis made was physical mobility disorder (61% of patients).ConclusionsA mechanism was created to improve continuity from hospital discharge to contact with the PC team. The link nurse coordinates and manages patients before they are handed over to PC

PdZn catalysts for CO2 hydrogenation to methanol using chemical vapour impregnation (CVI)

The formation of PdZn bimetallic alloys on ZnO, TiO2 and Al2O3 supports was investigated, together with the effect of alloy formation on the CO2 hydrogenation reaction. The chemical vapour impregnation (CVI) method produced PdZn nanoparticles with diameters of 3–6 nm. X-ray photoelectron spectroscopy and X-ray diffraction revealed the changes in the structure of the PdZn alloy that help stabilise formate intermediates during methanol synthesis. PdZn supported on TiO2 exhibits high methanol productivity of 1730 mmol kgcat−1 h−1 that is associated with the high dispersion of the supported PdZn alloy

Lens-based Ka-band antenna system using planar feed

This paper presents a simple, low-cost and compact mobile ground terminal antenna for Ka-band satellite communications that operates in the downlink band (19.7-20.2 GHz). The antenna is composed of a shaped dielectric lens which tilts in front of a planar feed to direct the beam. The planar feed is a circularly polarized patch antenna placed inside a cavity. The lens allows a mechanical beam steering from 0° to 57° in relation to zenith with a scan loss of 4.5 dB. In order to show the potential of a planar antenna as a feeder for this application, the proposed system is compared with a previous solution composed of the same dielectric lens and a horn antenna as feeder.info:eu-repo/semantics/publishedVersio

Effect of Base on the Facile Hydrothermal Preparation of Highly Active IrO_x Oxygen Evolution Catalysts

The efficient electrochemical splitting of water is limited by the anodic oxygen evolution reaction (OER). IrO2 is a potential catalyst with sufficient activity and stability in acidic conditions to be applied in water electrolyzers. The redox properties and structural flexibility of amorphous iridium oxo-hydroxide compared to crystalline rutile-IrO2 are associated with higher catalytic activity for the OER. We prepared IrOx OER catalysts by a simple hydrothermal method varying the alkali metal base (Li2CO3, LiOH, Na2CO3, NaOH, K2CO3, KOH) employed during the synthesis. This work reveals that the surface area, particle morphology, and the concentration of surface hydroxyl groups can be controlled by the base used and greatly influence the catalyst activity and stability for OER. It was found that materials prepared with bases containing lithium cations can lead to amorphous IrOx materials with a significantly lower overpotential (100 mV @ 1.5 mA·cm–2) and increased stability compared to materials prepared with other bases and rutile IrO2. This facile method leads to the synthesis of highly active and stable catalysts which can potentially be applied to larger scale catalyst preparations

Novel thin and compact H-plane SIW horn antenna

The substrate integrated waveguide (SIW) technology allows to construct several types of commonly used antennas in a planar way. However, some practical constraints limit their performances when frequencies below 20 GHz are considered. In the case of SIW horn antennas, the available substrates are much thinner than the wavelength yielding to poor matching and undesired back radiation. In this paper, an innovative structure to overcome these limitations is presented. It consists of a transition printed on the same SIW substrate, which improves both the radiation and the matching performances of conventional SIW horns. The horn shape is also further optimized by reducing its dimensions required for a given directivity. This is obtained by modifying the horn profile in order to effectively combine different TE modes. Guidelines are provided to design this type of thin and compact SIW horn antenna. They were applied to manufacture a prototype in the Ku-band with a substrate thinner than lambda(0)/10. Measurement results validate the proposed concepts showing excellent performances

Nutrient and herbivore alterations cause uncoupled changes in producer diversity, biomass and ecosystem function, but not in overall multifunctionality

Altered nutrient cycles and consumer populations are among the top anthropogenic influences on ecosystems. However, studies on the simultaneous impacts of human-driven environmental alterations on ecosystem functions, and the overall change in system multifunctionality are scarce. We used estuarine tidal flats to study the effects of changes in herbivore density and nutrient availability on benthic microalgae (diversity, abundance and biomass) and ecosystem functions (N2-fixation, denitrification, extracellular polymeric substances -EPS- as a proxy for sediment cohesiveness, sediment water content as a proxy of water retention capacity and sediment organic matter). We found consistent strong impacts of modified herbivory and weak effects of increased nutrient availability on the abundance, biomass and diversity of benthic microalgae. However, the effects on specific ecosystem functions were disparate. Some functions were independently affected by nutrient addition (N2-fixation), modified herbivory (sediment organic matter and water content), or their interaction (denitrification), while others were not affected (EPS). Overall system multifunction remained invariant despite changes in specific functions. This study reveals that anthropogenic pressures can induce decoupled effects between community structure and specific ecosystem functions. Our results highlight the need to address several ecosystem functions simultaneously for better ecosystem characterization and management.Instituto de Limnología "Dr. Raul A. Ringuelet

A printed transition for matching improvement of SIW horn antennas

The substrate integrated waveguide (SIW) technology allows to construct several types of commonly used antennas in a planar way. However, frequency limitations associated to commercial substrates appear in the implementation of certain types of antennas, e.g., SIW horn antennas are not well matched when the substrate thickness is much smaller than the wavelength. A printed transition is proposed to overcome this problem. Differently from current solutions, no bulky elements are required allowing to maintain the most important features of this technology namely its compactness and ease of manufacturing. In order to quickly analyze and design the transition, both a coupled resonator and a transmission line models are developed, together with design guidelines. The proposed transition is designed to match a H-plane SIW horn antenna built in a thin substrate (thickness < lambda(0)/10) at different frequency bands at the Ku-band. Experimental results for 3 different transitions show that the matching characteristics are efficiently improved compared with the conventional SIW horn antenna and validates the proposed models

CO2 hydrogenation to CH3OH over PdZn catalysts, with reduced CH4 production

Metallic Pd, under CO 2 hydrogenation conditions (> 175 °C, 20 bar in this work), promotes CO formation via the reverse water gas shift (RWGS) reaction. Pd‐based catalysts can show high selectivity to methanol when alloyed with Zn, and PdZn alloy catalysts are commonly reported as a stable alternative to Cu‐based catalysts for the CO 2 hydrogenation to methanol. The production of CH 4 is sometimes reported as a minor by‐product, but nevertheless this can be a major detriment for an industrial process, because methane builds up in the recycle loop, and hence would have to be purged periodically. Thus, it is extremely important to reduce methane production for future green methanol synthesis processes. In this work we have investigated TiO 2 as a support for such catalysts, with Pd, or PdZn deposited by chemical vapour impregnation (CVI). Although titania‐supported PdZn materials show excellent performance, with high selectivity to CH 3 OH + CO, they suffer from methane formation (> 0.01%). However, when ZnTiO 3 is used instead as a support medium for the PdZn alloy, methane production is greatly suppressed. The site for methane production appears to be the TiO 2 , which reduces methanol to methane at anion vacancy sites

Hydrogenation of CO2 to dimethyl ether over brønsted acidic PdZn catalysts

Eschewing the common trend toward use of catalysts composed of Cu, it is reported that PdZn alloys are active for CO2 hydrogenation to oxygenates. It is shown that enhanced CO2 conversion is achievable through the introduction of Brønsted acid sites, which promote dehydration of methanol to dimethyl ether. We report that deposition of PdZn alloy nanoparticles onto the solid acid ZSM-5, via chemical vapor impregnation affords catalysts for the direct hydrogenation of CO2 to DME. This catalyst shows dual functionality; catalyzing both CO2 hydrogenation to methanol and its dehydration to dimethyl in a single catalyst bed, at temperatures of >270 °C. A physically mixed bed comprising 5% Pd 15% Zn/TiO2 and H-ZSM-5 shows a comparably high performance, affording a dimethyl ether synthesis rate of 546 mmol kgcat −1 h−1 at a reaction temperature of 270 °C

Combination of Cu/ZnO methanol synthesis catalysts and ZSM-5 zeolites to produce oxygenates from CO2 and H2

Cu/ZnO methanol catalysts were deposited over several ZSM-5 acid zeolites to directly synthesise oxygenates (methanol and dimethyl ether) from a CO2/H2 feed. Catalysts were prepared by two different preparation methodologies: chemical vapour impregnation (CZZ-CVI) and oxalate gel precipitation (CZZ-OG). Chemical vapour impregnation led to Cu/ZnO being deposited on the zeolite surface, whilst oxalate gel precipitation led to the formation of Cu/ZnO agglomerates. For both sets of catalysts a higher concentration of mild and strong acid sites were produced, compared to the parent ZSM-5 zeolites, and CZZ-CVI had a higher concentration of acid sites compared to CZZ-OG. Nevertheless, CZZ-OG shows considerably higher oxygenate productivity, 1322 mmol Kgcat−1 h−1, compared to 192 mmol Kgcat−1 h−1 over CZZ-CVI (ZSM-5(50), 250 ℃, 20 bar, CO2/H2 = 1/3, 30 ml min−1), which could be assigned to a combination of smaller particle size and enhanced methanol mass transfer within the zeolites