Evaluación del Servicio de Ayuda a Domicilio en Alcorcón: diagnóstico para la mejora de la calidad del servicio

La irrupción de la cultura de la Gestión de Calidad en las Administraciones Públicas instaura una nueva mentalidad alejada de cualquier conformismo en cuanto a lo que puede ser exigido a lo público. La evaluación como práctica irrenunciable incardinada a la planificación y gestión operativa se vincula hoy a los principios democráticos de responsabilidad, transparencia, y participación. La universalización de los Servicios Sociales, la diversificación y urgencia de las problemáticas tratadas, elevan el nivel de exigencia en torno a las prestaciones y la atención social. El Servicio de Ayuda a Domicilio es, para cualquier municipio, probablemente el recurso social más relevante tanto por la problemática abordada como por la envergadura presupuestaria que moviliza. En este artículo se hace una exposición de la experiencia del Ayuntamiento de Alcorcón en la evaluación de este servicio domiciliario en el contexto de mejora continua articulado desde su puesta en marcha.The rapid development of the culture of Quality Management in Public Administration will reestablish a new way of thinking distant from what currently exists about what can be demanded of public services. Evaluation as an undeniably integrated practice within planning and operating management is now linked with the democratic principles of responsibility, transparency and participation. The demand for social services and attention rises as Social Services become universal and diversify and the issues they address become more urgent. For any municipality, Home Health Assistance Service is probably the most relevant social resource because of the issues it addresses as well as the budgetary impact it has. This article presents the experience of the City Government of Alcorcon in the evaluation of this in-home service within the context of continuous improvement since its inception

Lung Cancer Genomic Signatures

Background:Lung cancer (LC) is the dominant cause of death by cancer in the world, being responsible for more than a million deaths annually. It is a highly lethal common tumor that is frequently diagnosed in advanced stages for which effective alternative therapeutics do not exist. In view of this, there is an urgent need to improve the diagnostic, prognostic, and therapeutic classification systems, currently based on clinicopathological criteria that do not adequately translate the enormous biologic complexity of this disease.Methods:The advent of the human genome sequencing project and the concurrent development of many genomic-based technologies have allowed scientists to explore the possibility of using expression profiles to identify homogenous tumor subtypes, new prognostic factors of human cancer, response to a particular treatment, etc. and thereby select the best possible therapies while decreasing the risk of toxicities for the patients. Therefore, it is becoming increasingly important to identify the complete catalog of genes that are altered in cancer and to discriminate tumors accurately on the basis of their genetic background.Results and Discussion:In this article, we present some of the works that has applied high-throughput technologies to LC research. In addition, we will give an overview of recent results in the field of LC genomics, with their effect on patient care, and discuss challenges and the potential future developments of this area

Analysis of the implementation of GESIDA quality indicators in the HIV+ cohort PSITAR

Objective: To determine the compliance of quality care indicators (GESIDA) for adult patients living with HIV infection in PSITAR cohort. Methods: Multi-center, prospective observational study. All adult naive patients, that began treatment during 2011 belonging to the PSITAR cohort, were selected. We recorded demographic data, virological parameters at baseline and 48 weeks of treatment and pharmacotherapy variables. The selected indicators were: The compliance of initial antiretroviral therapy with the Spanish national treatment guidelines (GESIDA) for treatment-naive HIV-infected patient (95%), undetectable viral load at 48 weeks (80%), treatment initiation with Abacavir without screening for HLA-B*5701 (0%), treatment modifications within the first year (<30%), adherence treatment measure (95%), study of resistance in the virologic failure (90%) and average expenditure per patient in the first treatment (GESIDA median). Results: In total 108 HIV+ naive patients were included, 83.3% men. The median age was 40.5 years (21-75). The most frequent combination was tenofovir-emtricitabineefavirenz with 61.0%. 28 patients (29.7%) modified their treatment during the first year. Focusing on indicators compliance, starting of treatment with a recommended regimen had 95.4% of compliance, undetectable viral load indicator 74.1%, treatment initiation without Abacavir test 0%, treatment modifications within the first year 25.9%, adherence treatment measure 86.3%, study of resistance in the virologic failure 80% and average expenditure per patient was 8,846 euros. Conclusion: Quality care follow up indicators were fulfilled in their vast majority. The worst accomplished indicators such as undetectable viral load at 48 weeks, evaluation of adherence and study of resistance must be study to examine the possible improvement points.Objetivos: Determinar el cumplimiento de los indicadores de calidad de la actividad asistencial GESIDA en la cohorte de pacientes VIH+ PSITAR. Método: Estudio multicéntrico prospectivo. Se seleccionaron aquellos pacientes VIH naive adulto que iniciaron tratamiento en 2011. Se recogieron variables demográficas, analíticas y farmacoterapéuticas. Los indicadores seleccionados fueron: adecuación de las pautas iniciales de TAR a las guías españolas (95%), carga viral indetectable al año de tratamiento (80%), tratamiento con abacavir sin HLA-B*5701 previo (0%), cambios de tratamiento durante el primer año (<30%), registro de la adherencia al tratamiento (95%), estudio de resistencias en el fracaso virológico (90%) y gasto medio por paciente en primer tratamiento (mediana GESIDA). Resultados: Se incluyeron 108 pacientes, de ellos el 83,3% hombres. La mediana de edad fue de 40,5 años (21-75). La combinación de inicio más frecuente fue emtricitabina-tenofovir-efavirenz (61%). El 95,4% de los pacientes iniciaron con un tratamiento considerado preferente. El 74,1% presentó carga viral plasmática indetectable a las 48 semanas. Ningún paciente inicio tratamiento con abacavir sin la determinación del HLA-B*5701. El 25,9% discontinuó el TAR en el primer año, registrándose una valoración de la adherencia en el 86,3% de los casos. El estudio de las resistencias en fallo virológico se realizó en el 80,0% de los pacientes y el gasto medio fue de 8.846 euros. Conclusiones: Los indicadores de calidad de la actividad asistencial se cumplen ampliamente. La carga viral plasmática indetectable, la valoración de la adherencia y el estudio de resistencia requieren de un mayor estudio para detectar puntos de mejora

Choline kinase inhibitors EB-3D and EB-3P interferes with lipid homeostasis in HepG2 cells

A full understanding of the molecular mechanism of action of choline kinase α (ChoKα) inhibitors at the cell level is essential for developing therapeutic and preventive approaches for cancer. The aim of the present study was to evaluate the effects of the ChoKα inhibitors EB-3D and EB-3P on lipid metabolism in HepG2 cells. We used [methyl-14C]choline, [1,2-14C]acetic acid and [2-3H]glycerol as exogenous precursors of the corresponding phospholipids and neutral lipids. [Methyl-14C]choline was also used to determine choline uptake. Protein levels were determined by Western blot. Ultrastructural alterations were investigated by transmission electron microscopy. In this work, we demonstrate that EB-3D and EB-3P interfere with phosphatidylcholine biosynthesis via both CDP-choline pathway and choline uptake by the cell. Moreover, the synthesis of both diacylglycerols and triacylglycerols was affected by cell exposure to both inhibitors. These effects were accompanied by a substantial decrease in cholesterol biosynthesis, as well as alterations in the expression of proteins related to cholesterol homeostasis. We also found that EB-3D and EB-3P lowered ChoKα protein levels. All these effects could be explained by the modulation of the AMP-activated protein kinase signalling pathway. We show that both inhibitors cause mitochondrial alteration and an endoplasmic reticulum stress response. EB-3D and EB-3P exert effects on ChoKα expression, AMPK activation, apoptosis, endoplasmic reticulum stress and lipid metabolism. Taken together, results show that EB-3D and EB-3P have potential anticancer activity through the deregulation of lipid metabolism.This work was aided by the Andalusian Regional Government (P11-CVI-7859). The inhibitors were developed under the Cei-Biotic Project CEI2013-MP-1 (University of Granada)

Nitrous oxide and methane in Atlantic and Mediterranean waters in the Strait of Gibraltar: Air-sea fluxes and inter-basin exchange

14 páginas, 7 figuras, 2 tablas.-- Proyecto CarbochangeThe global ocean plays an important role in the overall budget of nitrous oxide (N2O) and methane (CH4), as both gases are produced within the ocean and released to the atmosphere. However, for large parts of the open and coastal oceans there is little or no spatial data coverage for N2O and CH4. Hence, a better assessment of marine emissions estimates is necessary. As a contribution to remedying the scarcity of data on marine regions, N2O and CH4 concentrations have been determined in the Strait of Gibraltar at the ocean Fixed Time series (GIFT). During six cruises performed between July 2011 and November 2014 samples were collected at the surface and various depths in the water column, and subsequently measured using gas chromatography. From this we were able to quantify the temporal variability of the gas air-sea exchange in the area and examine the vertical distribution of N2O and CH4 in Atlantic and Mediterranean waters. Results show that surface Atlantic waters are nearly in equilibrium with the atmosphere whereas deeper Mediterranean waters are oversaturated in N2O, and a gradient that gradually increases with depth was detected in the water column. Temperature was found to be the main factor responsible for the seasonal variability of N2O in the surface layer. Furthermore, although CH4 levels did not reveal any feature clearly associated with the circulation of water masses, vertical distributions showed that higher concentrations are generally observed in the Atlantic layer, and that the deeper Mediterranean waters are considerably undersaturated (by up to 50%). Even though surface waters act as a source of atmospheric N2O during certain periods, on an annual basis the net N2O flux in the Strait of Gibraltar is only 0.35 ± 0.27 μmol m−2 d−1, meaning that these waters are almost in a neutral status with respect to the atmosphere. Seasonally, the region behaves as a slight sink for atmospheric CH4 in winter and as a source in spring and fall. Approximating the circulation pattern in the Strait to a bi-layer scheme, N2O exchange between basins was also calculated, and a net export from the Mediterranean Sea to the Atlantic Ocean equivalent to 39 μmol m−2 d−1 was foundFunding for this work was provided by the INGOS (Grant Agreement 284274), CARBOCHANGE IP (264879GOCE) and PERSEUS of the European Commission, the CATARINA Project supported by the MICINN and co-funded by FEDER (CTM2010-17141/MAR) and OSIMON project funded by the Regional Government of Galicia (Xunta de Galicia, 09MDS035402PR)Peer reviewe

Retos y resultados de la puesta en valor del área arqueológica protegida de Tunja

Initiating a value enhancement process that guarantees the conservation and safeguarding of archaeological heritage sites in a university context was the objective of the research. The ignorance of the historical continuity for more than 2000 years at the headquarters of the Universidad Pedagógica y Tecnológica de Colombia -uptc led us to develop and execute an enhancement Plan that prioritized the recognition of the uptc Archaeological Museum Park as an area of historical-cultural importance of regional and national character. Through a participatory work of cultural and educational management, the educational community was recognized as an actor-agent in the conservation and dissemination of the area, a Preventive Conservation Plan was drawn up that articulated the archaeological area to the university campus, responding to the educational demands of the region, strengthening the appropriation process and enhancing the protected archaeological area of Tunja.El objetivo de esta investigación fue iniciar un proceso de puesta en valor que garantizara la conservación y la salvaguarda de los sitios patrimoniales arqueológicos en un contexto universitario. El desconocimiento de la continuidad histórica por más de 2 000 años en la sede central de la Universidad Pedagógica y Tecnológica de Colombia (uptc) nos llevó a elaborar y ejecutar un plan depuesta en valor que priorizó el reconocimiento del parque museo arqueológico de la uptc como área de importancia histórico-cultural de carácter regional y nacional. Mediante un trabajo participativo de gestión cultural y educativa se reconoció a la comunidad educativa como actor-agente en la conservación y divulgación del área, se elaboró un plan de conservación preventiva que articuló el área arqueológica al campus universitario. De esta manera, se respondió a las demandas educativas de la región, se fortaleció el proceso de apropiación y se puso en valor el área arqueológica protegida de Tunja

Procesos de incorporación del aula de las tecnologías de la información y la comunicaciones (TIC) de la fundación telefónica y su uso en la escuela corazón de maría de la ciudad de San Juan de Pasto

El presente documento contiene la investigación realizada en la Escuela Corazón de María de la ciudad de San Juan de Pasto, Departamento de Nariño. Investigación que se realizó como requisito parcial para optar al título de Licenciado en Educación Básica con énfasis es Humanidades y Lengua Castellana, programa a distancia de la Pontificia Universidad Javeriana. La temática que aborda este documento gira en torno al proceso de incorporación y uso de un aula de tecnologías de la información y la comunicación (TIC) concedida por la Fundación Telefónica, temática directamente relacionada con la Línea de investigación formativa: Tecnologías en educación, que se desarrolla al interior del programa antes mencionado. En esta Línea se entiende que la incorporación de TIC en la escuela es un fenómeno complejo que requiere para su abordaje de marcos explicativos multidisciplinarios que van más allá de los conocimientos técnicos y especializados de la informática (Módulo de Problematización la Línea).Licenciado (a) en Educación Básica con Énfasis en Humanidades y Lengua CastellanaPregrad

Plan exportador de hamacas artesanales a Winnipeg-Canadá- por parte de Hammocks & Things /

Para poder identificar las Razones que tiene la empresa Hammocks & things para exportar hamacas al mercado de Winnipeg será necesario aplicar un formato de entrevista al gerente y propietario de la empresa. Por otro lado, para definir la capacidad de producción y comercialización que tiene la empresa será necesario reunirnos con los artesanos productores de Hamacas y con el propietario de la empresa, identificando así, la capacidad productora de la empresa, rutas de acceso y penetración de mercado. Así mismo, para identificar las características socio- culturales y económicas del mercado de Winnipeg, analizaremos sus tendencias culturales desde el punto de vista social y económico basándonos en datos históricos del País Canadá y sus ciudades más importantes, a través de su PIB per cápita, costumbres etc. Evaluaremos las condiciones técnicas y financieras de la empresa para la exportación del producto al mercado objetivo