Train-the-trainers in hand hygiene : a standardized approach to guide education in infection prevention and control

Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries.Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training.Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively.Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.peer-reviewe

Demostrar la importancia de la creación del departamento del talento humano en la panadería trigales

El presente trabajo permite mostrar las falencias existentes en la Panadería Trigales debido a la inexistencia del área de Gestión Humana, se realiza una investigación y análisis de las varias problemáticas encontradas en la microempresa, no hay un sistema de inducción y capacitación definido para los colaboradores, los procesos de selección son básicos sin ninguna especificación solo se busca que la persona tenga idea de los procesos, no hay procesos o procedimiento establecidos que involucren el área gestión humana, no hay normas, condiciones o deberes de cumplimiento que involucren a los colaboradores y al propietario, no hay asignación de sueldos específicos, no se ha desarrollado una evaluación que permita evidenciar la percepción del clima organizacional ni motivación no hay un programa de incentivos o compensación definido que motive a los tres empleados que contribuyen al funcionamiento y posicionamiento de la panadería en el municipio de Cogua. En el desarrollo de este trabajo se tomó como ejemplo una microempresa que cuenta con 4 trabajadores en la cual se evidencia que por su tamaño y actividad económica no se justifica la implementación de un área de recursos humanos, sin embargo es pertinente mencionar la importancia en la implementación de esta área en un futuro ya que la proyección de la Empresa es crecer y contar con más sucursales, la implementación de recursos humanos requiere de una planeación y una actividad económica que genere los recursos necesarios para su funcionamiento, la investigación se realizó mediante la obtención de investigación utilizando el método de encuestas y entrevistas, lo que permitió conocer detalles relacionados con el funcionamiento de la empresa. Toda empresa que se conforma y entra en el mercado competitivo busca crecer y ser reconocida inicialmente en su entorno, es por ello, por lo que se requiere tener gran variedad de productos y un excelente servicio al cliente, en conclusión, para que una empresa tenga éxito debe iniciar su proyecto de manera clara, buscando ser sostenible en el tiempo y en busca del crecimiento.The present work allows to show the existing shortcomings in the Trigales Bakery due to the non-existence of the Human Management area, an investigation and analysis of the various problems found in the microenterprise is carried out, there is no defined induction and training system for the collaborators, The selection processes are basic without any specification, it is only intended that the person has an idea of the processes, there are no established processes or procedures that involve the human management area, there are no standards, conditions or compliance duties that involve the collaborators and the owner, there is no assignment of specific salaries, an evaluation has not been developed that allows to show the perception of the organizational climate or motivation there is no defined incentive or compensation program that motivates the three employees who contribute to the operation and positioning of the bakery in the municipality of Cogua. In the development of this work, an example was taken of a microenterprise that has 4 workers in which it is evident that due to its size and economic activity the implementation of a human resources area is not justified, however it is pertinent to mention the importance in the implementation of this area in the future since the projection of the Company is to grow and have more branches, the implementation of human resources requires planning and economic activity that generates the necessary resources for its operation, The research was carried out by obtaining research using the method of surveys and interviews, which allowed to know details related to the operation of the company. Every company that is formed and enters the competitive market seeks to grow and be recognized initially in its environment, that is why it is required to have a wide variety of products and excellent customer service, in conclusion, for a company to be successful, it must start its project clearly, seeking to be sustainable over time and in search of growth

Inventario y descripción de las soluciones de accesibilidad a la web existentes para personas con discapacidad fisica y sensorial

El elemento más representativo de la nueva sociedad de la información lo constituye sin duda la World Wide Web. La Red, como es conocida popularmente, une a millones de ordenadores en todo el mundo, aportando una riqueza de información inimaginable hace pocos años y un interfaz de uso tan gráfico e intuitivo que ha significado una expansión permanente de su uso a millones de usuarios nuevos cada año. La accesibilidad Web se puede definir como la posibilidad de que un producto o servicio Web sea usado por el mayor número posible de personas, independientemente de las limitaciones del individuo o de las del contexto de uso. De acuerdo con el Tratado de Amsterdam de la Unión Europea, en aplicación de la cláusula de no-discriminación, las políticas europeas y la de los Estados miembros deberían inspirarse en el principio de no-discriminación con vistas a hacer realidad la igualdad para las personas con discapacidad. Este informe tiene como objetivo realizar un inventario de las soluciones, existentes en el mercado, tanto de software como de hardware para poder garantizar esa no discriminación de todas las personas

Immobilization of Hazardous Wastes on One-Part Blast Furnace Slag-Based Geopolymers

: The immobilization of hazardous wastes in ordinary Portland cement (OPC)-based materials has been widely studied and implemented. OPC-based materials have a high carbon footprint associated with their production and geopolymer materials are a sustainable and eco-friendly alternative. Therefore, this work aimed to immobilize two hazardous industrial wastes: copper wastewater sludge and phosphogypsum in one-part geopolymer materials. For that purpose, the precursor was partially substituted by these wastes (5, 10 and 20 wt.%) in the formulations. The geopolymer fresh and hardened state properties were evaluated, and the immobilisation of pollutants was determined through leaching tests. In phosphogypsum pastes (PG5, PG10 and PG20) it was observed that the compressive strength decreased with the increase in its amount, varying between 67 MPa and 19 MPa. In copper sludge pastes, the compressive strength of the specimens (CWS5 and CWS10) reached ~50 MPa. The mortars, MPG10 and MCWSs10, had compressive strengths of 13 MPa and 21 MPa, respectively. Leaching tests showed that pastes and mortars immobilise the hazardous species of the wastes, except for As from copper sludge, whose the best result was found in the compact paste (CWSs10) that leached 2 mg/kg of As. Results suggest that optimized compositions are suitable for the construction sectorThis research was funded by Ministerio de Ciencia e Innovación (MICINN), grant number PID2020-116461RB-C21 and Agencia de Innovación y Desarrollo de Andalucía (IDEA) grant number UHU-1255876. This work was done in the scope of the project CICECO- Aveiro Institute of Materials, UIDB/50011/2020 & UIDP/50011/2020, co-financed by national funds through the FCT/MEC. This research was funded by FCT (Portuguese Foundation for Science and Technology), grant number 2020.01135.CEECIND (R.M.N.) and SFRH/BD/144562/2019 (J.C.

Factor VII deficiency

La deficiencia del factor VII es una enfermedad hemorrágica rara, causada por la disminución o ausencia de este factor de la coagulación; menos de 200 casos se han reportado desde que se describió por primera vez en 1951. Es un trastorno autonómico recesivo que puede afectar a varios miembros de una familia. Su prevalencia es de 1:500.000 (0,5% de todos los trastornos hereditarios de la coagulación) y su distribución es igual entre los sexos. El defecto está localizado en el cromosoma 13q34. Sólo los individuos homocigotos o heterocigotos compuestos, es decir, que son portadores de dos mutaciones diferentes, presentan manifestaciones hemorrágicas. Los heterocigotos son asintomáticos. El déficit puede ser cualitativo o cuantitativo. La forma de presentación clínica es variable y la seriedad de las hemorragias no guarda relación directa con los niveles de factor VII o su actividad.El cuadro clínico puede ser muy grave y se puede presentar hemorragia intracerebral temprana, hemartrosis o manifestaciones moderadas, dadas por sangrado mucocutáneo o hemorragia tras una intervención quirúrgica; algunos casos pueden cursar asintomáticos, a pesar de valores muy bajos de factor VII.El diagnóstico se hace mediante pruebas de coagulación, al encontrar un tiempo de protrombina prolongado con un tiempo parcial de tromboplastina normal y con la posterior cuantificación de factor VII disminuido (valores normales de 70 a 130%).Reporte de caso86-9

Correction to : Train-the-trainers in hand hygiene : a standardized approach to guide education in infection prevention and control

Correction to: Antimicrob Resist Infect Control https://doi.org/10.1186/s13756-019-0666-4 The original article [1] contained a misspelling in author, Fernando Bellissimo-Rodrigues’s name which has since been corrected.peer-reviewe

Seguimiento de la coordinación: Evaluación continua del curso 3 del Grado de Teleco de la EPS

Uno de los problemas que se ha introducido con la implantación de la evaluación continua en los nuevos grados es el exceso de carga de trabajo que conlleva la propia evaluación de las materias a lo largo del curso. Este ha sido un motivo de queja recurrente por parte de los estudiantes, los cuales se sienten estresados casi desde el comienzo del curso, llegando muchas veces a dejar de asistir durante determinados periodos a las clases para poder dedicar su atención a las evaluaciones. Esto último, a su vez, provoca quejas entre el profesorado por la no asistencia de sus estudiantes. Con el fin de mitigar esta situación, en el presente trabajo se ha realizado un estudio sobre la evaluación continua del tercer curso del Grado en Ingeniería en Sonido e Imagen en Telecomunicación de la Universidad de Alicante, y se ha consensuado un calendario de evaluación continua en el cual se intenta dosificar el esfuerzo que los estudiantes deberán realizar para sacar adelante el curso. Este trabajo está enmarcado dentro de los mecanismos de coordinación que fomenta la Escuela Politécnica Superior en sus grados

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Patrimonio cultural : Contextos en transición: pedagogía, cultura y economía sustentable en comunidades americanas

El presente documento es una recopilación de experiencias que fueron parte del I Encuentro Internacional de Patrimonio Cultural celebrado en la Corporación Universitaria Minuto de Dios – UNIMINUTO en septiembre del 2019; así como de otros aportes de investigadores colombianos a la comprensión de temas relacionados con la tradición, la cultura, la memoria y el ecosistema natural en el cual como humanos nos desenvolvemos. Los aportes tienen origen en reflexiones de diferentes países desde Argentina hasta Canadá y cumple con el propósito de realizar un diálogo multidisciplinar de los aspectos que componen el patrimonio cultural en el continente americano