S?ndrome de burnout en el personal de enfermer?a de un hospital de referencia Ibagu? 2014.

94 P?ginasRecurso Electr?nicoIntroducci?n: El S?ndrome de Burnout (SB) se define como la respuesta al estr?s laboral caracterizado por el cansancio emocional, la despersonalizaci?n y la baja realizaci?n personal, la desmotivaci?n, el desinter?s, el malestar interno o la insatisfacci?n laboral. Objetivo: Determinar la prevalencia del SB en el personal de enfermer?a de un hospital de referencia de una ciudad colombiana y su relaci?n con variables sociodemogr?ficas. Materiales y m?todos: Se llev? a cabo un estudio de corte transversal en una muestra aleatoria y representativa de 174 enfermeras(os), estratificada seg?n si la enfermera era profesional o auxiliar, en un hospital de referencia de una ciudad colombiana. Se utiliz? como instrumento para la determinaci?n del evento la escala validada en Colombia del MBI (Maslach Burnout Inventory). Para la obtenci?n de los resultados se utilizaron pruebas ji-cuadrado de independencia, t para diferencia de promedios en muestras independientes y an?lisis de la varianza de una v?a o de Kruskal Wal?s seg?n si las variables en los grupos de comparaci?n proven?an de una poblaci?n con distribuci?n normal. En an?lisis multivariado, se seleccionaron como variables candidatas a ingresar al modelo de regresi?n log?stica, aquellas que cumplieran con el criterio de Hosmer Lemeshow. En la construcci?n del modelo se tom? como medida de la asociaci?n el OR acompa?ado de su respectivo intervalo de confianza del 95%. Resultados: La prevalencia de Burnout fue del 20.1% (IC 95%: 13,9 26,4) y adem?s el 52,3% est?n a riesgo de padecerlo. Quienes afirmaron ser solteros/viudos/separados, las profesionales de enfermer?a, los que al momento de la encuesta ten?an una vinculaci?n temporal o de supernumerario, quienes laboraban en servicios administrativos/oncolog?a/camillero/esterilizaci?n y los 11 hombres y aquellos que afirmaron tener m?s de un contrato, fueron quienes presentaron indicadores de la proporci?n de Burnout mayores del 20,1%.En el an?lisis multivariado, los factores conjuntos que probablemente tienen mayor incidencia en la presencia del Burnout son el n?mero de hijos y ser hombre. Conclusiones: Con respecto a otros estudios, este estudio revela que la prevalencia del s?ndrome de Burnout en el hospital de referencia es mayor.Introduction: Burnout Syndrome (BS) is defined as the response to occupational stress characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, discouragement, disinterest, internal discomfort or dissatisfaction labor. Objective: To determine the prevalence of BS nurses in a hospital reference a Colombian city and its relationship with sociodemographic variables. Materials and methods: A cross sectional study was conducted in a random and representative sample of 174 nurses, stratified according to whether they were professional or nurse assistant in a referral hospital of a Colombian city, was used as an instrument for determining the scale of the event in Colombia validated MBI (Maslach Burnout Inventory). To obtain the results chi- square test of independence, t-tests for mean differences in independent samples and analysis of variance or one-way Kruskal Wallis were used depending on whether the variables in the comparison groups were drawn from a population with normal distribution. In multivariate analysis, were selected as candidate variables to enter the logistic regression model those that met the criteria of Hosmer-Lemeshow. In building the model was taken as the measure of association OR accompanied by its respective confidence interval 95 %. Results: The prevalence of burnout was 201.1 % (95 % CI: 13.9 26.4) and also the 52.3 % are at risk for suffering. Who claimed to be single / widowed / separated, nursing professionals, which at the time of the survey had a temporary or temporary bonding, who worked in administrative / oncology / orderly / sterilization services and those men who reported having more than a contract, who presented were indicators of burnout higher proportion of 20.1%. In the multivariate analysis, the factors that sets probably have a greater incidence in the presence of burnout are the number of children and be a man. 13 Conclusions: With respect to other studies, this study reveals that the prevalence of burnout syndrome in the referral hospital is greater.RESUMEN 10 ABSTRACT 12 INTRODUCCI?N 14 1. PLANTEAMIENTO DEL PROBLEMAS Y JUSTIFICACION 16 2. MARCO TE?RICO 19 2.1 ESTR?S LABORAL 19 2.2 CONCEPTUALIZACI?N DEL S?NDROME DE BURNOUT 20 2.2.1 Caracter?sticas del s?ndrome de Burnout 22 2.2.2 Consecuencias del s?ndrome de Burnout 23 2.2.3 Instrumento de medici?n del s?ndrome de Burnout 25 2.2.4 Prevenci?n del s?ndrome de Burnout 27 2.2.5 Tratamiento del s?ndrome de Burnout 30 2.3 DEFINICI?N DE ENFERMER?A 35 2.4 GENERALIDADES DEL HOSPITAL DE REFERENCIA 39 2.5 LEGISLACI?N LABORAL EN COLOMBIA 40 3. OBJETIVOS 43 3.1 OBJETIVO GENERAL 43 3.2 OBJETIVOS ESPEC?FICOS 43 4. METODOLOG?A 44 4.1 TIPO DE ESTUDIO 44 4.2 POBLACI?N DE ESTUDIO 44 4.3 MUESTREO 44 5 4.4 CRITERIOS DE INCLUSI?N Y EXCLUSI?N 47 4.5. INSTRUMENTO DE RECOLECCI?N DE INFORMACI?N 47 4.6 CONTROL DE SESGOS 48 4.7 CONSIDERACIONES ?TICAS 49 5. RESULTADOS 50 5.1 CARACTERISTICAS SOCIODEMOGRAFICAS DEL 50 PERSONAL ENCUESTADO 5.1.1 Variables cualitativas 50 5.1.2 Variables cuantitativas 51 5.2 MASLASCH BURNOUT INVENTORY (MBI) 52 5.2.1 An?lisis de los ?tems 53 5.2.2 Grados del Burnout 55 5.2.3 An?lisis por patrones: Niveles del Burnout 56 5.2.4 Prevalencia del Burnout 59 5.2.5 Descripci?n de las dimensiones del MBI 62 5.3 ANALISIS BIVARIADO 65 5.4 ANALISIS MULTIVARIADO 69 6. DISCUSI?N 72 7. CONCLUSIONES 77 8. RECOMENDACIONES 78 9. LIMITACIONES 79 REFERENCIAS 8

Marco normativo y generaci?n de valor en empresas mineras : an?lisis comparativo entre el Per? y Chile

La inversi?n en proyectos mineros ha cobrado nuevamente relevancia debido a la recuperaci?n de los precios de los metales despu?s de la crisis financiera internacional, lo que ha determinado que ahora varios de los proyectos en Am?rica Latina, especialmente en el Per?, sean viables. Sin embargo, la decisi?n de implementar o no implementar un megaproyecto minero debe considerar no solo la informaci?n acerca de los resultados econ?micos, operativos y financieros esperados, sino tambi?n el impacto de las obligaciones tributarias, laborales y sectoriales sobre la generaci?n de valor. El objetivo de esta investigaci?n es desarrollar un an?lisis comparativo entre el Per? y Chile acerca de los efectos e impactos de la legislaci?n y normatividad tributaria, laboral y de derechos mineros sobre la generaci?n de valor en los proyectos mineros de gran envergadura. Se ha elegido Chile porque en la regi?n es el pa?s con mayor recepci?n de inversi?n extranjera en miner?a, pues aunque la inversi?n minera en el Per? durante la ?ltima d?cada ha crecido sostenidamente, todav?a no llega a alcanzar los niveles del pa?s sure?o. A trav?s de la comparaci?n de la legislaci?n de ambos pa?ses se identifican los factores que inclinan la orientaci?n de las inversiones hacia uno u otro pa?s. El modelo elaborado determina que las normas tributarias con mayor impacto en el Per? son el impuesto a la renta, el impuesto general a las ventas, las regal?as mineras, los aranceles y otros, como el aporte voluntario de las empresas mineras; en Chile, son el impuesto a la renta, el impuesto al valor agregado, el impuesto espec?fico a la actividad minera y el impuesto al comercio exterior

Remarks on Semileptonic B and D Decays into Orbitally Excited Mesons

We have obtained the differential decay rate and calculated the branching ratios of the exclusive semileptonic decays $B(D) \to Xl\nu$, where $X$ is a p-wave meson, using the nonrelativistic ISGW quark model. Our results are compared with the predictions of the ISGW2 model. We have computed some branching ratios that were not reported or were reported with 0.00 in this model. For example, we find that $Br(B_c^- \to \bar{B_{s2}^{*0}}l^-\bar{\nu}) = 4.03 \times 10^{-5}$, $Br(B_c^- \to \bar{B_2^{*0}}l^- \bar{\nu}) =3.65 \times 10^{-6}$ and $Br(D_s^+ \to f_2l^+\nu) = 2.7 \times 10^{-5}$, which seems to be at the reach of forthcoming experiments. Furthermore, we have classified the $B_{u,d,s} \to Tl\nu$ decays in two groups and compared the semileptonic and nonleptonic decays including a tensor meson in the final state.Comment: 11 pages, LaTe

Magnetosomes could be protective shields against metal stress in magnetotactic bacteria

Magnetotactic bacteria are aquatic microorganisms with the ability to biomineralise membrane enclosed magnetic nanoparticles, called magnetosomes. These magnetosomes are arranged into a chain that behaves as a magnetic compass, allowing the bacteria to align in and navigate along the Earth s magnetic field lines. According to the magneto aerotactic hypothesis, the purpose of producing magnetosomes is to provide the bacteria with a more efficient movement within the stratified water column, in search of the optimal positions that satisfy their nutritional requirements. However, magnetosomes could have other physiological roles, as proposed in this work. Here we analyse the role of magnetosomes in the tolerance of Magnetospirillum gryphiswaldense MSR 1 to transition metals Co, Mn, Ni, Zn, Cu . By exposing bacterial populations with and without magnetosomes to increasing concentrations of metals in the growth medium, we observe that the tolerance is significantly higher when bacteria have magnetosomes. The resistance mechanisms triggered in magnetosome bearing bacteria under metal stress have been investigated by means of x ray absorption near edge spectroscopy XANES . XANES experiments were performed both on magnetosomes isolated from the bacteria and on the whole bacteria, aimed to assess whether bacteria use magnetosomes as metal storages, or whether they incorporate the excess metal in other cell compartments. Our findings reveal that the tolerance mechanisms are metal specific Mn, Zn and Cu are incorporated in both the magnetosomes and other cell compartments; Co is only incorporated in the magnetosomes, and Ni is incorporated in other cell compartments. In the case of Co, Zn and Mn, the metal is integrated in the magnetosome magnetite mineral cor

Non-Hermitian SUSY Hydrogen-like Hamiltonians with real spectra

It is shown that the radial part of the Hydrogen Hamiltonian factorizes as the product of two not mutually adjoint first order differential operators plus a complex constant epsilon. The 1-susy approach is used to construct non-hermitian Hamiltonians with hydrogen spectra. Other non-hermitian Hamiltonians are shown to admit an extra `complex energy' at epsilon. New self-adjoint hydrogen-like Hamiltonians are also derived by using a 2-susy transformation with complex conjugate pairs epsilon, (c.c) epsilon.Comment: LaTeX2e file, 13 pages, 6 EPS figures. New references added. The present is a reorganized and simplified versio

Propuesta de plan de branding estrat?gico para un nuevo concepto en la categor?a de urnas de mascotas en la ciudad de Lima Metropolitana

El objetivo principal de esta tesis es desarrollar un plan de branding estrat?gico para posicionar una marca dentro del mercado de urnas para mascotas. Existe un crecimiento global del mercado de las mascotas que implica el desarrollo de una serie de novedosos productos y servicios para su cuidado. En el Per?, esto se percibe a trav?s del incremento de veterinarias, de una mayor oferta de alimentos y accesorios a nivel masivo, as? como del surgimiento de instituciones que las protegen u ofrecen servicios adicionales. Durante la investigaci?n se detect? que uno de los rubros con mayor proyecci?n son los servicios de cremaci?n donde actualmente hay una oferta muy tradicional y poco diferenciada, con escasa competencia. Existe un inter?s de parte de los consumidores potenciales por recibir las cenizas de sus mascotas en una urna ecol?gica, la cual pueden incorporar como pieza decorativa. Esto se debe a que m?s del 60% las considera como parte de su familia. Por ello se propone un branding que detalla el proceso de dise?o, posicionamiento y comunicaci?n de la marca. Para ello se realizaron estudios que evidenciaron un p?blico dispuesto a utilizar dicho servicio si ?ste ofreciera alguna ventaja comparativa

Young Women With Type 1 Diabetes Have Lower Bone Mineral Density That Persists Over Time

OBJECTIVE—Individuals with type 1 diabetes have decreased bone mineral density (BMD), yet the natural history and pathogenesis of osteopenia are unclear. We have previously shown that women with type 1 diabetes (aged 13–35 years) have lower BMD than community age-matched nondiabetic control subjects. We here report 2-year follow-up BMD data in this cohort to determine the natural history of BMD in young women with and without diabetes

Coadministration of Adenoviral Vascular Endothelial Growth Factor and Angiopoietin-1 Enhances Vascularization and Reduces Ventricular Remodeling in the Infarcted Myocardium of Type 1 Diabetic Rats

OBJECTIVE - Hyperglycemia impairs angiogenesis in response to ischemia, leading to ventricular remodeling. Although the effects of overexpressing angiogenic growth factors have been studied in inducing angiogenesis, the formation of functional vessels remains a challenge. The present study evaluates the reversal of diabetes-mediated impairment of angiogenesis in the infarcted diabetic rat myocardium by proangiogenic gene therapy. RESEARCH DESIGN AND METHODS - Ad.VEGF and Ad.Ang1 were intramyocardially administered in combination immediately after myocardial infarction to nondiabetic and diabetic rats. Ad.LacZ was similarly administered to the respective control groups. The hearts were excised for molecular and immunohistochemical analysis at predetermined time points. The myocardial function was measured by echocardiography 30 days after the intervention. RESULTS - We observed reduced fibrosis and increased capillary/arteriolar density along with reduced ventricular remodeling, as assessed by echocardiography in the treated diabetic animals compared with the nontreated diabetic controls. We also observed increased phosphorylated mitogen-activated protein kinase-activated protein kinase-2, 2 days after the treatment and increased expression of vascular endothelial growth factor (VEGF), Flk-1, angiopoietin-1 (Ang-1), Tie-2, and survivin, 4 days after treatment in the diabetic animals. Gel shift analysis revealed that the combination gene therapy stimulated the DNA binding activity of nuclear factor-κB in the diabetic animals. CONCLUSIONS - Our preclinical data demonstrate the efficacy of coadministration of adenoviral VEGF and Ang-1 in increasing angiogenesis and reducing ventricular remodeling in the infarcted diabetic myocardium. These unique results call for the initiation of a clinical trial to assess the efficacy of this therapeutic strategy in the treatment of diabetes-related human heart failure

Green Light Photoelectrocatalysis with Sulfur Doped Carbon Nitride Using Triazole Purpald for Enhanced Benzylamine Oxidation and Oxygen Evolution Reactions

Materials dictate carbon neutral industrial chemical processes. Visible light photoelectrocatalysts from abundant resources will play a key role in exploiting solar irradiation. Anionic doping via pre organization of precursors and further co polymerization creates tuneable semiconductors. Triazole derivative purpald, an unexplored precursor with sulfur S container, combined in different initial ratios with melamine during one solid state polycondensation with two thermal steps yields hybrid S doped carbon nitrides C3N4 . The series of S doped C3N4 based materials show enhanced optical, electronic, structural, textural, and morphological properties and exhibit higher performance in organic benzylamine photooxidation, oxygen evolution, and similar energy storage capacitor brief investigation . 50M 50P exhibits the highest photooxidation conversion 84 3 of benzylamine to imine at 535 nm green light for 48 h, due to a discrete shoulder amp; 8776;700 nm, high sulfur content, preservation of crystal size, new intraband energy states, structural defects by layer distortion, and 10 16 nm pores with arbitrary depth. This work innovates by studying the concomitant relationships between 1 the precursor decomposition while C3N4 is formed, 2 the insertion of S impurities, 3 the S doped C3N4 property activity relationships, and 4 combinatorial surface, bulk, structural, optical, and electronic characterization analysis. This work contributes to the development of disordered long visible light photocatalysts for solar energy conversion and storag