Estado de conocimiento sobre la integración de sistemas de gestión a partir del análisis bibliométrico de artículos publicados en revistas JCR

La implantación de sistemas de gestión integrados (SIG) puede proporcionar muchos beneficios a las organizaciones, pero, aún hoy en día, son desconocidos por muchas empresas. El objetivo principal de este trabajo es realizar un meta análisis de las publicaciones científicas aparecidas en la base de datos JRC referidas a la integración de sistemas de gestión, para, recopilar información sobre qué temática se publica, dónde se publica y de qué forma, para tener conocimiento sobre qué y cómo se está abordando la investigación en el ámbito de la integración de sistemas de gestión. Otro objetivo secundario es proponer un mapa del estado actual sobre conocimiento respecto a los Sistemas Integrados a partir de las aportaciones de los diferentes autores analizados. Para ello, en este TFG vamos a analizar los siguientes apartados: Metodología: en este apartado se explica cómo se han obtenido los datos de la literatura que se ha consultados, de dónde se han extraído los artículos seleccionados y cómo se han tratado. Análisis de los resultados: en primer lugar, se ha llevado a cabo un estudio biliométrico en revistas JCR con enfoque estadístico. A partir de este estudio se ha recopilado información sobre qué temática se está publicando, dónde se publica y de qué forma, para tener conocimiento sobre qué y cómo se está abordando la investigación en el ámbito de la integración de sistemas de gestión. En segundo lugar, se presenta un mapa de conocimiento a partir de los resultados y conclusiones de los diferentes artículos consultados donde se podrá observar cuál es el estado de conocimiento actual sobre la integración de sistemas de gestión a nivel mundial. Revisión de la literatura existente: se analiza la literatura existente y se extrae información sobre los sistemas de gestión para tener un mayor conocimiento sobre ellos a la hora de decidir implantarlos. Conclusiones: se exponen las principales conclusiones derivadas del análisis de datos

Nivells d'instrucció de la població adulta de Palma

Abstract not availabl

Revision of Spanish course books for foreigners

En nuestro estudio analizamos un gran número de manuales de ELE vigentes en el mercado editorial con el objeto de señalar tanto sus fortalezas como sus carencias didácticas. Presenta dos partes: la primera consiste en la descripción de una muestra de manuales acompañada de una encuesta a profesores; en la segunda, observamos si la destreza oral,en su plano comunicativo, se ha reflejado en los manuales contemporáneos. Para ello examinamos una serie de aspectos que afectan a distintos planos metodológicos: modalidad oral, dinámica de grupos planteada, etc. Y extraemos las conclusiones oportunas. La base teórica en la que nos apoyamos parte de la corriente lingüística denominada Gramática funcional dikeana, ya que consideramos que es la que mejor se adapta a la indicación fundamental del MRE: la metodología enfocada a la acción.In our study we analyze a large number of ELE course books in the market at the moment with the aim of presenting both their strengths and weaknesses from a didactic point of view. Our work is divided into two parts: the first is the description of samples taken from different course books accompanied by a survey conducted to find out teachers’ opinions about these materials; in the second, we try to observe if the oral skills, concentrating on the communicative competence, are worked by those course books. To do this we examine a number of issues affecting different methodological levels --oral skills, group dynamics, etc.-- and draw the appropriate conclusions. The theoretical basis on which we rely comes from the so called Dik’s Functional Grammar, as we believe that it is the most suitable trend to understand the CEFR: methodology focused on action.peerReviewe

Accuracy and reproducibility of lymphoscintigraphy for sentinel node detection in patients with cutaneous melanoma.

Lymphoscintigraphy is an important part of the mapping and identification of sentinel lymph nodes (SLNs). However, few studies report its reproducibility, and some concerns prevail. The aim of the study was to determine the reproducibility of lymphoscintigraphy performed by different team members following a strict protocol to assess lymphatic drainage and the location and number of SLNs. Methods: Sixty-eight melanoma patients were included. All underwent 2 separate lymphoscintigraphy studies, which followed the same acquisition protocol. Discordance was defined as a change in localization or a failure to identify the SLN in one of the studies. Results: All patients showed lymphatic drainage, and in all cases at least 1 sentinel node was identified. In 65 of 68 patients (96%), the findings of the first lymphoscintigraphy study were similar to those of the second. This similarity was also found in the number of sentinel nodes (171 in the first study and 173 in the second). Eighty percent of patients showed 1-3 SLNs in both lymphoscintigraphy studies. The 2 studies differed in 3 patients (4%): 2 melanomas were located on the trunk and 1 on the head and neck. Drainage was visualized to more than 1 lymphatic basin in 19 patients (28%) in the first study versus 18 patients in the second study. Conclusion: Lymphoscintigraphy is highly reproducible in the detection of sentinel nodes in melanoma patients. The classic protocol of radiotracer injection is reproducible and reliable enough to guarantee SLN identification, although a slight variation in isolated cases (especially when primary lesions are located on the trunk or the head and neck regions) is inevitable

Revisión de manuales de español para extranjeros

En nuestro estudio analizamos un gran número de manuales de ELE vigentes en el mer­cado editorial con el objeto de señalar tanto sus fortalezas como sus carencias didácticas. Presenta dos partes: la primera consiste en la descripción de una muestra de manuales acompañada de una encuesta a profesores; en la segunda, observamos si la destreza oral, en su plano comunicativo, se ha reflejado en los manuales contemporáneos. Para ello exa­minamos una serie de aspectos que afectan a distintos planos metodológicos: modalidad oral, dinámica de grupos planteada, etc. Y extraemos las conclusiones oportunas. La base teórica en la que nos apoyamos parte de la corriente lingüística denominada Gramática funcional dikeana, ya que consideramos que es la que mejor se adapta a la indicación fundamental del MRE: la metodología enfocada a la acció

Added value of intraoperative real-time imaging in searches for difficult-to-locate sentinel nodes.

Localization of sentinel lymph nodes can be challenging if they are in difficult anatomic locations or near high radiotracer activity The purpose of this study was to assess the value of intraoperative real-time imaging using a portable gamma-camera in conjunction with a conventional gamma-counting probe when it is difficult to localize the sentinel node

Clinical role of subtraction ictal SPECT coregistered to MR Imaging and 18F-FDG PET in pediatric epilepsy

A precise assessment of the drug-resistant epileptic pediatric population for surgical candidacy is often challenging, and to date there are no evidence-based guidelines for presurgical identification of the epileptogenic zone. To evaluate the usefulness of radionuclide imaging techniques for presurgical evaluation of epileptic pediatric patients, we compared the results of video-electroencephalography (EEG), brain MR imaging, interictal SPECT, ictal SPECT, subtraction ictal SPECT coregistered to MR imaging (SISCOM), and interictal PET with (18)F-FDG. METHODS: Fifty-four children with drug-resistant epilepsy who had undergone video-EEG monitoring, brain MR imaging, interictal and ictal brain perfusion SPECT, SISCOM, and (18)F-FDG PET were included in this study. All abnormal findings revealed by these neuroimaging techniques were compared with the presumed location of the epileptogenic zone (PEZ) as determined by video-EEG and clinical data. The proportion of localizing studies for each technique was statistically compared. In the 18 patients who underwent resective brain surgery, neuroimaging results were compared with histopathology results and surgical outcome. RESULTS: SISCOM and (18)F-FDG PET concordance with the PEZ was significantly higher than MR imaging (P < 0.05). MR imaging showed localizing results in 21 of 54 cases (39%), SISCOM in 36 of 54 cases (67%), and (18)F-FDG PET in 31 of 54 cases (57%). If we consider SISCOM and (18)F-FDG PET results together, nuclear medicine imaging techniques showed coinciding video-EEG results in 76% of patients (41/54). In those cases in which MR imaging failed to identify any epileptogenic lesion (61% [33/54]), SISCOM or (18)F-FDG PET findings matched PEZ in 67% (22/33) of cases. CONCLUSION: SISCOM and (18)F-FDG PET provide complementary presurgical information that matched video-EEG results and clinical data in three fourths of our sample. SISCOM was particularly useful in those cases in which MR imaging findings were abnormal but no epileptogenic lesion was identified. Radionuclide imaging techniques are both useful and reliable, extending the possibility of surgical treatment to patients who may have been discouraged without a nuclear medicine approach

Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis

Introduction: [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is part of the regular preoperative work-up in medically refractory epilepsy. As a complement to visual evaluation of PET, statistical parametric maps can help in the detection of the epileptogenic zone (EZ). However, software packages currently available are time-consuming and little intuitive for physicians. We develop a user-friendly software (referred as PET-analysis) for EZ localization in PET studies that allows dynamic real-time statistical parametric analysis. To evaluate its performance, the outcome of PET-analysis was compared with the results obtained by visual assessment and Statistical Parametric Mapping (SPM). Methods: Thirty patients with medically refractory epilepsy who underwent presurgical 18F-FDG PET with good post-operative outcomes were included. The 18F-FDG PET studies were evaluated by visual assessment, with SPM8 and PET-analysis. In SPM, parametric T-maps were thresholded at corrected p < 0.05 and cluster size k = 50 and at uncorrected p < 0.001 and k = 100 (the most used parameters in the literature). Since PET-analysis rapidly processes different threshold combinations, T-maps were thresholded with multiple p-value and different clusters sizes. The presurgical EZ identified by visual assessment, SPM and PET-analysis was compared to the confirmed EZ according to post-surgical follow-up. Results: PET-analysis obtained 66.7% (20/30) of correctly localizing studies, comparable to the 70.0% (21/30) achieved by visual assessment and significantly higher (p < 0.05) than that obtained with the SPM threshold p < 0.001/k = 100, of 36.7% (11/30). Only one study was positive, albeit non-localizing, with the SPM threshold corrected p < 0.05/k = 50. Concordance was substantial for PET-analysis (κ = 0.643) and visual interpretation (κ = 0.622), being fair for SPM (κ = 0.242). Conclusion: Compared to SPM with the fixed standard parameters, PET-analysis may be superior in EZ localization with its easy and rapid processing of different threshold combinations. The results of this initial proof-of-concept study validate the clinical use of PET-analysis as a robust objective complementary tool to visual assessment for EZ localization

Resposta dels Serveis Socials de la Mancomunitat del Pla de Mallorca a les persones grans de la Mancomunitat del Pla

El present article efectua un recorregut al llarg de la Mancomunitat del Pla de Mallorca per tal de poder exposar les prestacions i els serveis que té a la seva disposició la nostra gent gran. Cal tenir en compte que la Mancomunitat del Pla de Mallorca és la zona més envellida de la nostra illa: aquesta realitat fa que a l’hora de planificar des dels Serveis Socials Comunitaris, es prioritzi el sector de la gent gran. El 2008 els Serveis Socials Comunitaris de la Mancomunitat del Pla de Mallorca varen implementar el sistema de dependència, la qual cosa ens ha permès realitzar unes reflexions per afrontar el futur amb uns serveis de qualitat i adaptats a la realitat d’una societat en permanent canvi. Aquest fet ha suposat un gran esforç per part de l’equip tècnic del Departament de Serveis Socials Comunitaris, ja que s’ha hagut de reestructurar de bell nou per adaptar-se a aquesta realitat, amb el convenciment de treballar per millorar i apropar els serveis a la ciutadania dels municipis del Pla de Mallorca.El presente artículo efectúa un recorrido a lo largo de la Mancomunitat Pla de Mallorca con el fin de poder exponer las prestaciones y servicios que están a disposición de nuestros mayores. Se tiene que tener en cuenta que la Mancomunitat Pla de Mallorca es la zona más envejecida de nuestra Isla, esta realidad hace que a la hora de planificar desde los servicios sociales comunitarios se priorice el sector de las personas mayores. En el 2008 los servicios sociales comunitarios de la Mancomunitat Pla de Mallorca implementaron el sistema de dependencia, lo cual nos ha permitido realizar unas reflexiones para encarar un futuro con unos servicios de calidad y adaptados a la realidad de una sociedad en permanente cambio. Este hecho ha supuesto un gran esfuerzo por parte del equipo técnico del departamento de servicios sociales comunitarios, ya que se ha tenido que reestructurar de nuevo para adaptarse a esta realidad, con el convencimient

Diagnostic accuracy of 18F-FDG PET/CT in infective endocarditis and implantable cardiac electronic device infection: A cross-sectional study.

Early diagnosis of infective endocarditis (IE) is based on the yielding of blood cultures and echocardiographic findings. However, they have limitations and sometimes the diagnosis is inconclusive, particularly in patients with prosthetic valves (PV) and implantable cardiac electronic devices (ICED). The primary aim of this study was to evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with suspected IE an ICED infection. METHODS: A prospective study with 80 consecutive patients with suspected IE and ICED infection (65 men and 15 women with a mean age of 68±13 years old) between June 2013 and May 2015 was performed in our hospital. The inclusion criteria was clinically suspected IE and ICED infection at the following locations: native valve (NV) (n = 21), PV (n = 29) or ICED (n = 30) [(automatic implantable defibrillator (n = 11) or pacemaker (n = 19)]. Whole-body 18F-FDG PET/CT with a myocardial uptake suppression protocol with unfractionated heparin was performed in all patients. The final diagnosis of infection was established by the IE study Group according to the clinical, echocardiographic and microbiological findings. RESULTS: A final diagnosis of infection was confirmed in 31 patients: NV (n = 6), PV (n = 12) and ICED (n = 13). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for 18F-FDG PET/CT was 82%, 96%, 94% and 87%, respectively. 18F-FDG PET/CT was false negative in all cases with infected NV. 18F-FDG PET/CT was able to reclassify 63/70 (90%) patients initially classified as possible IE by modified Duke criteria. In 18/70 cases 18F-FDG PET/CT changed possible to definite IE (26%) and in 45/70 cases changed possible to rejected IE (64%). Additionally, 18F-FDG PET/CT identified 8 cases of septic embolism and 3 colorectal cancer in patients with final diagnosis of IE. CONCLUSION: 18F-FDG PET/CT proved to be a useful diagnostic tool in suspected IE and ICED infection and should be included in the diagnostic algorithm for early diagnosis. 18F-FDG PET/CT is not useful in the diagnosis of IE in NV, but should be also considered in the initial assessment of this complex scenario to rule out extracardiac complications and possible neoplasms