Evaluación de diferentes vías de administración de un fago lítico en gallinas comerciales infectadas experimentalmente con Salmonella gallinarum

El objetivo de este trabajo fue evaluar la eficiencia de un bacteriófago lítico específico como alternativa para el control de SG,administrado por vía oral durante una semana y por vía intramuscular con una y dos dosis, en pollitas de recría infectadas experimentalmente conSG

Un llamado a enfermería para responder al cuidado de la salud de las personas en situación de enfermedad crónica, por su impacto en la calidad de vida

Objetivo: Describir la percepción que tienen sobre su calidad de vida las personas en situación de enfermedad crónica: diabetes e hipertensión arterial, en una institución de segundo nivel en el Programa de Promoción de la salud y Prevención de la enfermedad, en Barranquilla (Colombia). Materiales y métodos: Estudio descriptivo. Los informantes fueron en total 6 personas, conformados por 2 hombres con diagnóstico de diabetes mellitus y 4 mujeres, 2 de ellas con hipertensión arterial y 2 con diabetes mellitus. Para el análisis de los datos se empleó la técnica análisis de contenido. Los datos fueron sistematizados y procesados, mediante la herramienta Atlas T. Y los resultados se contrastaron con el modelo de calidad de vida en sobrevivientes del cáncer, propuesto por Betty Ferrell. Resultados: Las personas en situación de enfermedad crónica no trasmisibles, diabetes e hipertensión arterial, perciben su calidad de vida en las siguientes dimensiones: física: descrita con limitaciones y malestar; en la social: aislamiento, dependencia, alteración función sexual; en la psicológica: ansiedad, depresión desesperanza e incertidumbre; espiritual: fortaleza, fe, Dios sana. Conclusión: El profesional de enfermería y quienes lideran los programa de promoción de la salud y prevención de la enfermedad deben brindar un cuidado de manera holística, en el que tengan en cuenta todas las dimensiones de las personas que conviven con una enfermedad crónica no trasmisible, lo cual redundará en una mejor calidad de vida

Reduction of average lead time in outpatient service of obstetrics through six sigma methodology

In hospital services, operations efficiency and healthcare quality are two critical factors since both define the financial sustainability of the hospitals as well as patient health, safety and satisfaction. For this reason, it is necessary to explore different strategies for the improvement of quality and efficiency indicators in the provision of healthcare services. Specifically, this paper focuses on the application of Six Sigma methodology as an important option to solve this problematic. This methodology begins with the identification of improving opportunities that are aligned with the organization goals. Then, a portfolio of potential improvement projects is created. Later, these projects are prioritized with basis on multicriteria decision making techniques, with the purpose of choosing the project with the highest impact on the organization quality and efficiency. Finally, the selected project is developed through DMAIC cycle. An application case related to the process of obstetric outpatient in a maternal-child hospital located in the city of Barranquilla (Colombia) is presented to prove the validity of the proposed approach. The results show that the average lead time in the obstetric outpatient service in which pregnant women are monitored, was reduced from about 7 days/appointment to approximately 4 days/appointment

Integrating Lean Six Sigma and discrete-event simulation for shortening the appointment lead-time in gynecobstetrics departments: a case study

Long waiting time to appointment may be a worry for pregnant women, particularly those who need perinatology consultation since it could increase anxiety and, in a worst case scenario, lead to an increase in fetal, infant, and maternal mortality. Treatment costs may also increase since pregnant women with diverse pathologies can develop more severe complications. As a step towards improving this process, we propose a methodological approach to reduce the appointment lead-time in outpatient gynecobstetrics departments. This framework involves combining the Six Sigma method to identify defects in the appointment scheduling process with a discrete-event simulation (DES) to evaluate the potential success of removing such defects in simulation before we resort to changing the real-world healthcare system. To do these, we initially characterize the gynecobstetrics department using a SIPOC diagram. Then, six sigma performance metrics are calculated to evaluate how well the department meets the government target in relation to the appointment lead-time. Afterwards, a cause-and-effect analysis is undertaken to identify potential causes of appointment lead-time variation. These causes are later validated through ANOVA, regression analysis, and DES. Improvement scenarios are next designed and pretested through computer simulation models. Finally, control plans are deployed to maintain the results achieved through the implementation of the DES-Six sigma approach. The aforementioned framework was validated in a public gynecobstetrics outpatient department. The results revealed that mean waiting time decreased from 6.9 days to 4.1 days while variance passed from 2.46 days2 to 1.53 days2

Choosing the most suitable classifier For supporting assistive technology adoption In people with Parkinson’s disease: a fuzzy Multi-criteria approach

Parkinson’s disease (PD) is the second most common neurodegenerative disorder which requires a long-term, interdisciplinary disease management. While there remains no cure for Parkinson’s disease, treatments are available to help reduce the main symptoms and maintain quality of life for as long as possible. Owing to the global burden faced by chronic conditions such as PD, Assistive technologies (AT’s) are becoming an increasingly common prescribed form of treatment. Low adoption is hampering the potential of digital technologies within health and social care. It is then necessary to employ classification algorithms have been developed for differentiating adopters and non-adopters of these technologies; thereby, potential negative effects on people with PD and cost overruns can be further minimized. This paper bridges this gap by extending the Multi-criteria decision-making approach adopted in technology adoption modeling for people with dementia. First, the fuzzy Analytic Hierarchy Process (FAHP) is applied to estimate the initial relative weights of criteria and sub-criteria. Then, the Decisionmaking Trial and Evaluation Laboratory (DEMATEL) is used for evaluating the interrelations and feedback among criteria and sub-criteria. The Technique for Order of Preferences by Similarity to Ideal Solution (TOPSIS) is finally implemented to rank three classifiers (Lazy IBk – knearest neighbors, Naïve bayes, and J48 decision tree) according to their ability to model technology adoption. A real case study considering is presented to validate the proposed approach

Identification of best available thermal energy storage compounds for low-to-moderate temperature storage applications in buildings

Award-winning paper at III International Congress and V National on Sustainable Construction and Eco-Efficient Solutions (CICSE) March 2017Over the last 40 years different thermal energy storage materials have been investigated with the aim of enhancing energy efficiency in buildings, improving systems performance, and increasing the share of renewable energies. However, the main requirements for their efficient implementation are not fully met by most of them. This paper develops a comparative review of thermophysical properties of materials reported in the literature. The results show that the highest volumetric storage capacities for the best available sensible, latent and thermochemical storage materials are 250 MJ/m3, 514 MJ/m3 and 2000 MJ/m3, respectively, corresponding to water, barium hydroxide octahydrate, and magnesium chloride hexahydrate. A group of salt hydrates and inorganic eutectics have been identified as the most promising for the development of competitive thermal storage materials for cooling, heating and comfort applications in the short-term. In the long-term, thermochemical storage materials seem promising. However, additional research efforts are required.Identificación de los mejores compuestos disponibles de almacenamiento de energía térmica para aplicaciones de baja a moderada temperatura en edificación. En los últimos 40 años se han investigado diferentes materiales de almacenamiento térmico con el objetivo de mejorar la eficiencia energética en los edificios, mejorar el rendimiento de sistemas y aumentar el uso de renovables. Sin embargo, la mayoría no cumple los principales requisitos para su eficiente implementación. Este artículo desarrolla una revisión de las propiedades termofísicas de los materiales existentes en la literatura. Los resultados muestran que las mayores capacidades de almacenamiento volumétrico para los mejores materiales de almacenamiento sensible, latente y termoquímico son 250 MJ/m3, 514 MJ/m3 y 2000 MJ/m3, respectivamente, correspondientes a agua, hidróxido de bario octahidratado y cloruro de magnesio hexahidratado. Un conjunto de sales hidratadas y eutécticos han sido identificados como los más prometedores para el desarrollo de materiales competitivos para aplicaciones de enfriamiento, calefacción y confort a corto plazo. A largo plazo, el almacenamiento termoquímico parece prometedor. Sin embargo, investigación adicional es requerida.Fondo Europeo de Desarrollo Regional SOE1/P3/P0429EUMinisterio de Educación, Cultura y Deportes FPU14/06583Ministerio de Economía y Competitividad BES-2015-0703149Ministerio de Economía y Competitividad CTQ2014-52763-C2-2-RMinisterio de Economía y Competitividad CTQ2017- 83602-C2-2

Identifying the most appropriate classifier for underpinning assistive technology adoption for people with dementia: an integration of Fuzzy AHP and VIKOR methods

Recently, the number of People with Dementia (PwD) has been rising exponentially across the world. The main symptoms that PwD experience include AQ1 impairments of reasoning, memory, and thought. Owing to the burden faced by this chronic condition, Assistive Technology-based solutions (ATS) have been prescribed as a form of treatment. Nevertheless, it is widely acknowledged that low adoption rates of ATS have hampered their benefits within a health and social care context. It is then necessary to effectively discriminate between adopters and non-adopters of such solutions to avoid cost implications, improve the life quality of adopters, and find intervention alternatives for non-adopters. Several classifiers have been proposed as advancement towards the personalisation of self-management interventions for dementia in a scalable way. As multiple algorithms have been developed, an important step in technology adoption is to select the most appropriate classification alternative based on different criteria. This paper presents the integration of Fuzzy AHP (FAHP) and VIKOR to address this challenge. First, FAHP was used to calculate the criteria and sub-criteria weights under uncertainty and then VIKOR was implemented to rank the classifiers. A case study considering a mobile-based self-management and reminding solution for PwD is described to validate the proposed approach. The results revealed that Easiness of interpretation (GW = 0.192) and Handling of missing data (GW = 0.145) were the two most important criteria. Furthermore, SVM (Qj = 1.0) and AB (Qj = 0.891) were concluded to be the most suitable classifiers for supporting ATS adoption in PwD

Methodological approaches to support process improvement in emergency departments: a systematic review

The most commonly used techniques for addressing each Emergency Department (ED) problem (overcrowding, prolonged waiting time, extended length of stay, excessive patient flow time, and high left-without-being-seen (LWBS) rates) were specified to provide healthcare managers and researchers with a useful framework for effectively solving these operational deficiencies. Finally, we identified the existing research tendencies and highlighted opportunities for future work. We implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to undertake a review including scholarly articles published between April 1993 and October 2019. The selected papers were categorized considering the leading ED problems and publication year. Two hundred and three (203) papers distributed in 120 journals were found to meet the inclusion criteria. Furthermore, computer simulation and lean manufacturing were concluded to be the most prominent approaches for addressing the leading operational problems in EDs. In future interventions, ED administrators and researchers are widely advised to combine Operations Research (OR) methods, quality-based techniques, and data-driven approaches for upgrading the performance of EDs. On a different tack, more interventions are required for tackling overcrowding and high left-without-being-seen rate