Propuesta para la implementación de un sistema de costos ABC en el centro de distribución (CEDI) Funza de la Cooperativa Colanta

46 Páginas.Se plantea un modelo de costeo basado en actividades (ABC), para el centro de distribución (CEDI), Funza, Cundinamarca de la cooperativa Colanta; se presenta una herramienta en Excel para la consolidación de la información de dicho modelo. La herramienta permite ingresar los costos directos e indirectos y su participación en cada una de las actividades; el modelo genera como resultados datos sobre los costos totales de cada actividad y consolida los mismos por tipología de cliente

Effects of surgery on the mental status of older persons. A meta-analytic review

The data bases of 18 empirical studies were combined into one comprehensive data set and subjected to meta-analysis. The following trends were observed: (1) surgery has a significantly decompensating impact on the mental status of older persons, and the average effect size observed is modest (r = .37); (2) for all mental status measures included in the review (cognition, delirium and affect), effect size appears to be significantly moderated by patient age; (3) patient sex may be predictive of the kind of mental impairment that is most likely to occur within an older surgery population, with women manifesting a greater affinity for delirious and men for cognitive decompensation; (4) most existing research within this domain of study is either purely descriptive or anecdotal: of 46 studies reviewed, only 18, or 39.1% of the total published output, were of sufficient methodologic rigor to allow for scientifically valid effect-size computations. The implications of these findings for future research are discussed

Primary cytomegalovirus infection in pregnancy: prognostic factors of symptomatic disease determinable within the twenty-second week of gestation

Background. L’infezione primaria da Citomegalovirus (CMV) in gravidanza può portare a infezione congenita in circa il 30% dei casi, di cui 15-20% possono sviluppare sintomi a lungo termine inclusi deficit uditivi e sequele neurologiche. Gravi anomalie cerebrali nello studio ecografico prenatale sono associate a peggiore prognosi, ma è più difficile stabilire gli esiti post-natali nei feti con anomalie ecografiche non gravi. Obiettivi. Valutazione del potere predittivo di malattia sintomatica delle anomalie ecografiche non gravi, in associazione all’amniocentesi, determinabili entro la ventiduesima settimana di gestazione. Metodi. Studio prospettico osservazionale di donne con infezione primaria in gravidanza tra il 2007 e 2015: le pazienti sono state sottoposte a studio ecografico e neurosografico della morfologia fetale ed isolamento virale su liquido amniotico tra 20 e 21 settimane di gestazione, ad almeno 6 settimane dal presunto contagio materno. I segni e i sintomi di malattia congenita sono stati valutati alla nascita e al follow up nei nati vivi e attraverso l’esame autoptico nei casi di interruzione di gravidanza. Risultati. Lo studio ecografico prenatale di 306 gravidanze complicate da infezione primaria da CMV ha rilevato la presenza di anomalie cerebrali lievi e/o extracerebrali in 15 casi (4.9%). Tali reperti si sono dimostrati significativamente associati alla presenza di malattia sintomatica post-natale (OR= 18.5; 95% CI: 5.43-62.8, P<0.001), con alta specificità (97.6%) e valore predittivo negativo (95.6%) La contemporanea presenza di anomalie ecografiche e isolamento di DNA virale su liquido amniotico ha mostrato specificità e valore predittivo negativo pari a 99.7% e 95.7%, mentre la presenza di uno solo dei due reperti ha raggiunto una sensibilità di 94.7% e valore predittivo negativo di 99.6%. Conclusioni. La valutazione del rischio di malattia sintomatica può essere realizzata prima della ventiduesima settimana con buona sensibilità e specificità, attraverso un dettagliato esame ecografico morfologico ed isolamento virale su liquido amniotico.Background. Primary maternal Cytomegalovirus (CMV) infection during pregnancy can lead to congenital infection in around 30% of newborns, with 15-20% of infected children developing long-term symptoms including hearing loss and neurological sequelae. Severe brain ultrasound anomalies are associated with poor prognosis, but post-natal outcomes of fetuses with mild ultrasound anomalies are difficult to establish. Objective. The aim of the study was to evaluate the predictive value of mild ultrasound anomalies and viral load in amniotic fluid, performed before twenty-second week of gestation, in relation to the presence of symptomatic congenital disease. Methods. This is a prospective observational study of pregnant women with primary CMV infection enrolled between 2007 and 2015: fetal ultrasound scan with detailed neurosonogram and viral isolation in amniotic fluid were performed in all pregnancies between 20 and 21 weeks of gestation, at least 6 weeks after maternal infection. Sign and symptoms of congenital infection were evaluated at birth and at neonatal follow up in live-borns, post-mortem examinations were carried out in second trimester aborted fetuses. Results. Ultrasound fetal scan of 306 pregnant women with primary CMV infection detected the presence of mild cerebral and extracerebral anomalies in 15 cases (4.9%). These features was significantly associated with symptomatic congenital disease (OR= 18.5; 95%CI: 5.43-62.8, P<0.001) with high specificity (97.6%) and high negative predictive value (95.6%). The combined specificity and negative predictive value of ultrasound and viral isolation in amniotic fluid were 99.7% and 95.7%, respectively. The presence of one of this features alone reached sensibility of 94.7% and negative predictive value of 99.6%. Conclusion. The evaluation of neonatal risk of symptomatic CMV congenital disease can be realized with a good sensibility and specificity through the combination of detailed ultrasound fetal scan and viral isolation within the twenty-second week of gestation

Erosividad de las lluvias en la región centro-sur del departamento de caldas, colombia.

Se calculó la erosividad y la variación temporal de las lluvias, mediante los índices de Fournier Anual (IFA), Modificado de Fournier (IMF) y Concentración de las Precipitaciones (ICP). Se utilizaron los registros pluviométricos diarios de 10 años en 15 estaciones meteorológicas ubicadas en la región Centro-Sur del departamento de Caldas. El IFA se calculó mediante cuatro procedimientos (IFA1, IFA2, IFA3, e IFA4), el IMF a través de dos metodologías (IMF1 e IMF2), al igual que el ICP (ICP1 e ICP2). Con una matriz de coeficientes de correlación de Spearman, se obtuvieron correlaciones lineales altamente significativas entre IFA1, IFA2, IFA3, IMF1 e IMF2. Entre las dos primeras metodologías, se obtuvo un coeficiente de correlación (r=0,91) y entre el IMF1 y el IMF2 (r=0,97). El IFA4 no se correlacionó con ninguno de los procedimientos. De otro lado, según el ICP1, la precipitación media mensual se distribuye uniformemente, siguiendo la tendencia bimodal característica de la región andina colombiana, concentrándose aproximadamente el 70% del volumen anual de lluvias durante las dos temporadas más lluviosas (marzo-abril-mayo y septiembre-octubre-noviembre). El estudio permite concluir que los riesgos de erosión hídrica pueden ser mayores en la zona de influencia de las estaciones climáticas de los municipios de Manizales, Chinchiná y Palestina, ubicadas en el rango altitudinal comprendido entre 1.010 y 1.800 msnm, específicamente en la zona cafetera central del departamento de Caldas

Deber jurídico

Muchas veces se cometen imprudencias por falta de conocimiento frente a las leyes o el desconocimiento de algunos conceptos como lo es el deber jurídico, junto a esto viene la relación de desconocer todo lo que envuelve este concepto jurídico, por lo que es necesario tener una visión clara frente a diversos temas que además de enriquecernos cognitivamente, nos ayudarán a manejar de manera más profunda en temas legales