Plan de cuidados al paciente intervenido de artroplastia de rodilla

El envejecimiento propio de la población y la presencia de patología médica asociada a la artroplastia total de rodilla (ATR), es la causa de que en la actualidad sea una de las intervenciones quirúrgicas que presenta mayor incidencia en los servicios de cirugía ortopédica y traumatológica. Como consecuencia de ello ha aumentado el número de planes de cuidados al respecto. El objetivo principal del trabajo se ha centrado en la exposición de un caso práctico de ATR y la elaboración de un plan de cuidados individualizado basado en los diagnósticos NANDA. El objetivo específico se ha basado en el contraste de nuestro plan de cuidados con los diferentes planes de cuidados estándar, guías y artículos referentes al tema. Para la realización del trabajo se ha utilizado como método la búsqueda bibliográfica en bases de datos y búsqueda libre en un motor de búsqueda en Internet. Como resultado de todo ello se han encontrado diferencias significativas entre algunos protocolos de actuación estándar y la existencia de distintas herramientas en las que se basan profesionales que se dedican a este tipo de pacientes

An asymptotic analysis of chain-branching ignition in the laminar wake of a splitter plate separating streams of hydrogen and oxygen

Abstract. The chain-branching process leading to ignition in the high-temperature laminar wake that forms at the trailing edge of a thin splitter plate separating a stream of hydrogen from a stream of oxygen is investigated with a reduced chemistry description that employs H as the only chain-branching radical not in steady state. The analysis presented covers ignition events occurring in the Rott-Hakkinen and Goldstein regions, where self-similar solutions for the different flow variables are available. It is found that the initiation reactions, which create the first radicals, are only important in a relatively small initial region, becoming negligible downstream as the radical mole fractions increase to values larger than the ratio of the characteristic branching time to the characteristic initiation time, a very small quantity at temperatures of practical interest. As a result, most of the ignition history is controlled by the autocatalytic branching reactions, giving rise to a radical pool that increases exponentially with distance in a process that is described by using as a large parameter the ratio of the streamwise distance to the downstream extent of the initial region where initiation reactions are significant. Comparisons of the asymptotic results with numerical integrations of the conservation equations reveal that a three-term expansion for the H-atom profile is necessary in this case to provide an accurate prediction for the ignition distance

Large-activation-energy analysis of gaseous reacting flow in pipes

This paper analyzes the exothermic reaction of an initially cold gaseous mixture flowing with a moderately large Reynolds number along a cylindrical pipe with constant wall temperature. An overall irreversible reaction with an Arrhenius rate having a large activation energy is used for the chemistry description. The flow is chemically frozen in the cold entrance region, where the velocity evolves towards the Poiseuille profile as the gas temperature increases towards the wall value, ushering in a reaction stage during which the rate of heat transfer from the wall changes from positive to negative. The subsequent downstream evolution of the flow depends critically on the competition between the heat released by the chemical reaction and the heat-conduction losses to the wall, as measured by the Damkohler number 8, first introduced by Frank-Kamenetskii in his seminal analysis of thermal explosions in cylindrical vessels. For values of delta below the critical value delta &#61; 2 corresponding to the quasi-steady explosion limit, heat losses to the wall keep the gas temperature close to the wall value, so that the chemical reaction occurs slowly along the pipe in a flameless mode, which is analyzed to give an implicit expression for the streamwise reactant distribution. By way of contrast, for delta > 2 the slow reaction rates occur only in an initial ignition region, which ends abruptly when very large reaction rates cause a temperature runaway, or thermal explosion, at a well-defined location, whose computation must account for the temperature found at the end of the entrance region. The predictions of the large-activation-energy analyses, including ignition distances for delta > 2 and flameless reactant consumption rates for delta < 2, show good agreement with numerical computations of the reactive pipe flow for finite values of the activation energy.This work was supported by the Spanish MCINN through project # CSD2010-00011

El aumento de la escolarización en Educación Infantil y la disminución de las tasas de abandono temprano: dos indicadores que favorecen las políticas de inclusión

No se entiende hoy un sistema educativo de calidad si no incluye políticas encaminadas a mejorar las oportunidades educativas de todos los estudiantes. En todos los casos, los sistemas deben evolucionar favoreciendo las características personales y, a la vez, integrando las diferencias económicas, sociales, culturales, religiosas de cada país. Esta pluralidad solo tendrá verdadero sentido si se presentan como oportunidades y, en definitiva, como un camino necesario para lograr la inclusión, para mejorar y evolucionar. Para que cada sociedad alcance una mayor igualdad, tanto la educación como la formación juegan un papel determinante. En la Unión Europea, la Comisión en materia de educación y formación ha propuesto, de cara al 2020, la consecución de seis objetivos. Entre ellos se anuncia la importancia que tiene mejorar la escolarización de las etapas de educación infantil así como las tasas de abandono prematuro. Concretamente, en el próximo bienio, las cifras de niños y niñas en edad preescolar de más de cuatro años deben alcanzar el 95% y, por otro lado, se debe lograr reducir por debajo del 10%, el abandono temprano de escolares en la educación y la formación. Este estudio analiza estos dos indicadores, viendo su evolución en diversos países y reconociendo la relevancia que pueden tener ambos, ya directa o indirectamente, en los procesos de inclusión y en su optimización. Aumentando el primero y disminuyendo el segundo se favorecen las medidas relacionadas con la proporcionalidad y la equidad educativa. La elección de estos dos ámbitos tiene su explicación en el propio concepto de inclusión y en las dimensiones asociadas al mismo. ¿Sería acertado indicar que aquellos países que tienen mejores cifras en materia de educación infantil y de abandono temprano tienen también mejores datos acerca de la calidad educativa y, por consiguiente, en materia de inclusión? Buscamos algunos ejemplos que nos ayuden a entender y explicar estos argumentos aunque, realmente, no parece oportuno considerarlos como hechos absolutos pero sí relacionados.A quality education system needs to include policies aimed at improving the educational opportunities of all students. The development of education systems should promote personal characteristics in all cases while, at the same time, integrating the economic, social, cultural, and religious differences within each country. This diversity will only have real meaning if it is presented as an opportunity and ultimately, as a necessary inclusionary path for improvement and growth. Education and training play a decisive role in achieving greater social equality. In the European Union, the Education and Training Commission has proposed six benchmarks to be met by 2020. These include improving schooling provision for the early stages of primary education, as well as improving early drop-out rates. Specifically, in the next two years, at least 95% of children (from 4 to compulsory school age) should participate in early childhood education school; and the rate of early leavers from education and training aged 18-24 should be below 10%. This study analyses these two indicators by looking at how they have fared in different countries and recognising their direct or indirect impact in the optimisation of inclusion processes. Increasing the first indicator while decreasing the second encourages measures related to proportionality and educational equality. The choice of these two areas can be explained by the concept of inclusion and its associated dimensions. Would it be accurate to say that those countries that have better figures in terms of early childhood educa - tion and early school drop-out rates also have better data in terms of educational quality and, consequently, of inclusion? This paper provides some examples to gain a better understanding of these arguments, since it does not seem appropriate to consider them in isolation but rather as interrelated aspect

Performance mutation testing

Performance bugs are known to be a major threat to the success of software products. Performance tests aim to detect performance bugs by executing the program through test cases and checking whether it exhibits a noticeable performance degradation. The principles of mutation testing, a well-established testing technique for the assessment of test suites through the injection of artificial faults, could be exploited to evaluate and improve the detection power of performance tests. However, the application of mutation testing to assess performance tests, henceforth called performance mutation testing (PMT), is a novel research topic with numerous open challenges. In previous papers, we identified some key challenges related to PMT. In this work, we go a step further and explore the feasibility of applying PMT at the source-code level in general-purpose languages. To do so, we revisit concepts associated with classical mutation testing, and design seven novel mutation operators to model known bug-inducing patterns. As a proof of concept, we applied traditional mutation operators as well as performance mutation operators to open-source C++ programs. The results reveal the potential of the new performance-mutants to help assess and enhance performance tests when compared to traditional mutants. A review of live mutants in these programs suggests that they can induce the design of special test inputs. In addition to these promising results, our work brings a whole new set of challenges related to PMT, which will hopefully serve as a starting point for new contributions in the area

Performance mutation testing: Hypothesis and open questions

Performance bugs are common, costly, and elusive. Performance tests aim to detect performance bugs by running the program with specific inputs and determining whether the observed behaviour is acceptable. There not exist mechanisms, however, to assess the effectiveness of performance tests. Mutation testing is a technique to evaluate and enhance functional test suites by seeding artificial faults in the program under test. In this new idea paper, we explore the applicability of mutation testing to assess and improve performance tests. This novel approach is motivated with examples and open questions

TANDEM: A Taxonomy and a Dataset of Real-World Performance Bugs

The detection of performance bugs, like those causing an unexpected execution time, has gained much attention in the last years due to their potential impact in safety-critical and resource-constrained applications. Much effort has been put on trying to understand the nature of performance bugs in different domains as a starting point for the development of effective testing techniques. However, the lack of a widely accepted classification scheme of performance faults and, more importantly, the lack of well-documented and understandable datasets makes it difficult to draw rigorous and verifiable conclusions widely accepted by the community. In this paper, we present TANDEM, a dual contribution related to real-world performance bugs. Firstly, we propose a taxonomy of performance bugs based on a thorough systematic review of the related literature, divided into three main categories: effects, causes and contexts of bugs. Secondly, we provide a complete collection of fully documented real-world performance bugs. Together, these contributions pave the way for the development of stronger and reproducible research results on performance testing

Simulations of starting gas jets at low mach numbers

The starting jet produced by the impulsively started discharge of a submerged gas stream of constant velocity through a circular orifice in a plane wall is investigated by integrating numerically the axisymmetric Navier-Stokes equations for moderately large values of the jet Reynolds number. The analysis is restricted to low-Mach-number jets, for which the jet-to-ambient temperature ratio gamma=T/sub j//T/sub o/ emerges as the most relevant parameter. It is seen that the leading vortex approaches a quasisteady structure propagating at an almost constant velocity, which is larger for smaller values of gamma. The action of the baroclinic torque in regions of nonuniform temperature leads to significant vorticity production, with a constant overall rate equal to that of an inviscid starting je

Search-based mutation testing to improve performance tests

Performance bugs are common and can cause a significant deterio ration in the behaviour of a program, leading to costly issues. To detect them and reduce their impact, performance tests are typi cally applied. However, there is a lack of mechanisms to evaluate the quality of performance tests, causing many of these bugs re main unrevealed. Mutation testing, a fault-based technique to assess and improve test suites, has been successfully studied with func tional tests. In this paper, we propose the use of mutation testing together with a search-based strategy (evolutionary algorithm) to find mutants that simulate performance issues. This novel approach contributes to enhance the confidence on performance tests while reducing the cost of mutation testing.Ministerio de Economía y Competitividad BELI (TIN2015-70560-R)Ministerio de Economía y Competitividad TIN2015-65845-C3-3-

Performance mutation testing

Performance bugs are known to be a major threat to the success of software products. Performance tests aim to detect performance bugs by executing the program through test cases and checking whether it exhibits a noticeable performance degradation. The principles of mutation testing, a well-established testing technique for the assessment of test suites through the injection of artificial faults, could be exploited to evaluate and improve the detection power of performance tests. However, the application of mutation testing to assess performance tests, henceforth called performance mutation testing (PMT), is a novel research topic with numerous open challenges. In previous papers, we identified some key challenges related to PMT. In this work, we go a step further and explore the feasibility of applying PMT at the source-code level in general purpose languages. To do so, we revisit concepts associated with classical mutation testing, and design seven novel mutation operators to model known bug-inducing patterns. As a proof of concept, we applied traditional mutation operators as well as performance mutation operators to open-source C++ programs. The results reveal the potential of the new performance-mutants to help assess and enhance performance tests when compared to traditional mutants. A review of live mutants in these programs suggests that they can induce the design of special test inputs. In addition to these promising results, our work brings a whole new set of challenges related to PMT, which will hopefully serve as a starting point for new contributions in the areaMinisterio de Economía y Competitividad TIN2015-65845-C3-3-RMinisterio de Economía y Competitividad RTI2018- 093608-B-C33Ministerio de Economía y Competitividad BELI (TIN2015-70560-R)Ministerio de Economía y Competitividad (HORATIO) RTI2018-101204-B-C2