La Planificación Estratégica como proceso de integración de un equipo de salud.

Strategic Planning is a process that leads to human capital to establish organizational goals, strategies and policies for achieving those goals, develop plans to ensure implementation of strategies and obtain the ends sought. This study is framed in the research: Human Resource Management, whose purpose was to design a strategic plan for integration of the healthcare team to optimize service to users who visited the outpatient IVSS" in the state of Carabobo. This study was characterized as a feasible project, based on field research and descriptive, the sample was intentional and consisted of 17 people who belong to health strategists of the ambulance team. For data collection technique was used as an instrument survey and structured questionnaire of 30 items, which was validated by experts, who provided positive results to determine the internal reliability was calculated Cronbach alpha coefficient, obtaining significant value of 0.83%. The data were analyzed using simple percentage analysis technique and were presented by tables and circle graphs. It proposes anintegration plan based on strategic planning in order to provide the tools necessary to enable it to overcome the weaknesses and threats and capitalize on the strengths and opportunities to improving health care for the users who come to the ambulanceLa Planificación Estratégica es un proceso que conduce al capital humano a establecer metas organizacionales, definir estrategias y  políticas para el logro de esas metas,  desarrollar planes para asegurar la implantación de las estrategias y así obtener los fines buscados. Este estudio está enmarcado en la línea de investigación: Administración de los Recursos Humanos, cuyo propósito fue diseñar un plan estratégico de integración del equipo de salud para optimizar la atención a los usuarios que acuden a un ambulatorio del IVSS“en el Estado Carabobo. Este estudio se caracterizo como un proyecto factible, basado en una investigación de campo de tipo descriptivo, la muestra fue de tipo intencional y estuvo conformada por 17 personas que corresponden a estrategas del equipo de salud del ambulatorio. Para la recolección de la información se utilizó la técnica de encuesta y como instrumento el cuestionario estructurado en 30 ítems, el cual fue validado por juicio de expertos, quienes aportaron resultados positivos; para determinar la confiabilidad interna se calculo el coeficiente Alpha de Cronbach, obteniendo un valor significativo de 0,83%. Los datos fueron analizados mediante la técnica de análisis porcentual simple y fueron presentados por cuadros y graficas circulares. Se propone un plan de integración  fundamentado en la planificación estratégica con el objetivo de proporcionar las herramientas necesarias que le permitan superar las debilidades y amenazas y aprovechar las fortalezas y oportunidades para optimizar la atención en salud a los usuarios que acuden al ambulatorio

The distinct category of healthcare associated bloodstream infections

<p>Abstract</p> <p>Background</p> <p>Bloodstream infections (BSI) have been traditionally classified as either community acquired (CA) or hospital acquired (HA) in origin. However, a third category of healthcare-associated (HCA) community onset disease has been increasingly recognized. The objective of this study was to compare and contrast characteristics of HCA-BSI with CA-BSI and HA-BSI.</p> <p>Methods</p> <p>All first episodes of BSI occurring among adults admitted to hospitals in a large health region in Canada during 2000-2007 were identified from regional databases. Cases were classified using a series of validated algorithms into one of HA-BSI, HCA-BSI, or CA-BSI and compared on a number of epidemiologic, microbiologic, and outcome characteristics.</p> <p>Results</p> <p>A total of 7,712 patients were included; 2,132 (28%) had HA-BSI, 2,492 (32%) HCA-BSI, and 3,088 (40%) had CA-BSI. Patients with CA-BSI were significantly younger and less likely to have co-morbid medical illnesses than patients with HCA-BSI or HA-BSI (p < 0.001). The proportion of cases in males was higher for HA-BSI (60%; p < 0.001 vs. others) as compared to HCA-BSI or CA-BSI (52% and 54%; p = 0.13). The proportion of cases that had a poly-microbial etiology was significantly lower for CA-BSI (5.5%; p < 0.001) compared to both HA and HCA (8.6 vs. 8.3%). The median length of stay following BSI diagnosis 15 days for HA, 9 days for HCA, and 8 days for CA (p < 0.001). Overall the most common species causing bloodstream infection were <it>Escherichia coli, Staphylococcus aureus</it>, and <it>Streptococcus pneumoniae</it>. The distribution and relative rank of importance of these species varied according to classification of acquisition. Twenty eight day all cause case-fatality rates were 26%, 19%, and 10% for HA-BSI, HCA-BSI, and CA-BSI, respectively (p < 0.001).</p> <p>Conclusion</p> <p>Healthcare-associated community onset infections are distinctly different from CA and HA infections based on a number of epidemiologic, microbiologic, and outcome characteristics. This study adds further support for the classification of community onset BSI into separate CA and HCA categories.</p

Cost-effectiveness of HBV and HCV screening strategies:a systematic review of existing modelling techniques

Introduction: Studies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches. Methods: A structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions. Results: The overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology. Conclusion: When assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers

Functional Evolution of Duplicated Odorant-Binding Protein Genes, Obp57d and Obp57e, in Drosophila

Odorant-binding proteins (OBPs) are extracellular proteins found in insect chemosensilla, where they participate in the sensing of odors, tastes, and pheromones. Although a large number of OBP genes have been identified in insect genomes, their molecular functions and biological roles have been clarified in limited cases. Two OBP genes, Obp57d and Obp57e, were involved in the evolution of host-plant preference in Drosophila sechellia. Comparative analyses of the Obp57d/e genomic sequences from 27 closely related species suggested that the two genes arose by tandem gene duplication and functionally diverged from each other. In this study, the functional evolution of Obp57d and Obp57e was examined by in vitro binding assays using recombinant proteins synthesized in a bacterial system. Compared to the ancestral Dpse\OBP57de, Dmel\OBP57d was more specialized to tridecanoic acid while Dmel\OBP57e was generalized regarding their binding affinity, suggesting that the two OBP genes underwent subfunctionalization and neofunctionalization. A behavioral analysis using knockout flies supported that the biological role is different between OBP57d and OBP57e in vivo. Site-directed mutagenesis of the evolutionarily conserved amino acids revealed that these residues play an important role in protein folding. These findings provide a clue to understanding how the repertoire of OBP genes is maintained in a genome under natural selection

Diffusion Model Based Spectral Clustering for Protein-Protein Interaction Networks

BACKGROUND: A goal of systems biology is to analyze large-scale molecular networks including gene expressions and protein-protein interactions, revealing the relationships between network structures and their biological functions. Dividing a protein-protein interaction (PPI) network into naturally grouped parts is an essential way to investigate the relationship between topology of networks and their functions. However, clear modular decomposition is often hard due to the heterogeneous or scale-free properties of PPI networks. METHODOLOGY/PRINCIPAL FINDINGS: To address this problem, we propose a diffusion model-based spectral clustering algorithm, which analytically solves the cluster structure of PPI networks as a problem of random walks in the diffusion process in them. To cope with the heterogeneity of the networks, the power factor is introduced to adjust the diffusion matrix by weighting the transition (adjacency) matrix according to a node degree matrix. This algorithm is named adjustable diffusion matrix-based spectral clustering (ADMSC). To demonstrate the feasibility of ADMSC, we apply it to decomposition of a yeast PPI network, identifying biologically significant clusters with approximately equal size. Compared with other established algorithms, ADMSC facilitates clear and fast decomposition of PPI networks. CONCLUSIONS/SIGNIFICANCE: ADMSC is proposed by introducing the power factor that adjusts the diffusion matrix to the heterogeneity of the PPI networks. ADMSC effectively partitions PPI networks into biologically significant clusters with almost equal sizes, while being very fast, robust and appealing simple