Efectos de un protocolo aplicado por enfermeras en el control metabólico a personas con diabetes tipo 2

Considerando el papel tan importante de la enfermera en la aplicación de un programa de intervención para enfrentar los retos de la alta prevalencia de la diabetes en México, nace la decisión para introducir acciones complementarias sobre el cuidado del paciente con diabetes tipo 2.The purpose of this quasi-experimental study was to evaluate the effects of metabolic control before and after the educational intervention in patients with type 2 diabetes in the state of Hidalgo, México. 82 patients were enrolled, two groups were created: the intervention group received nursing visits along with the multidisciplinary team, and control group with traditional intervention. In both group, weight, height, serum fasting blood glucose, cholesterol, HDL, LDL, glycasted hemoglobin were determined and measured for six months. Data analysis was performed using the Student t test of significance p = 0.05. Both groups predominantly female participants, aged 50 years, married, employed and retired, and with an average schooling of 5.9 ± 2.8 years. After the intervention, the mean HbA1c decreased significantly in the intervention group, HbA1c levels were higher in the control group (5.65 ± 0.99 versus 7.88 ± 1.95). Te results of the nursing intervention in México facilitate the development of new programs for permanent follow up since it showed better control of blood glucose levels than in the control group.Sin financiament

Asesoramiento en gestión del turismo sostenible Hotel Cristal Ballena Boutique & SPA, Bahía Ballena, Puntarenas

Proyecto de Graduación (Bachillerato en Gestión del Turismo Sostenible) Instituto Tecnológico de Costa Rica, Escuela de Ciencias Sociales, 2017.This advice was carried out in a tourist accommodation project, located in the district of Bahía Ballena. The objective was to establish the steps required to achieve tourism sustainability certification (NCST) in the socioeconomic area. In general terms, the work done is described as follows: a. A diagnosis was made to determine the degree of knowledge of employees about sustainability; b. In addition, an assessment was made of the compliance of indicators and descriptors of the socioeconomic area by means of scheduled tasks in the short, medium and long term. The purpose of the advice provided was to guide and organize the administrative processes that the Hotel Cristal Ballena has to perform to achieve the Certification of Tourism Sustainability.Hotel Cristal Ballena Boutique & SP

The power threshold of H-mode access in mixed hydrogen–tritium and pure tritium plasmas at JET with ITER-like wall

The heating power to access the high confinement mode (H-mode), PLH, scales approximately inversely with the isotope mass of the main ion plasma species as found in (protonic) hydrogen, deuterium and tritium plasmas in many fusion facilities over the last decades. In first dedicated L–H transition experiments at the Joint European Torus (JET) tokamak facility with the ITER-like wall (ILW), the power threshold, PLH, was studied systematically in plasmas of pure tritium and hydrogen–tritium mixtures at a magnetic field of 1.8 T and a plasma current of 1.7 MA in order to assess whether this scaling still holds in a metallic wall device. The measured power thresholds, PLH, in Ohmically heated tritium plasmas agree well with the expected isotope scaling for metallic walls and the lowest power threshold was found in Ohmic phases at low density. The measured power thresholds in ion cyclotron heated plasmas of pure tritium or hydrogen–tritium mixtures are significantly higher than the expected isotope mass scaling due to higher radiation levels. However, when the radiated power is taken into account, the ion cyclotron heated plasmas exhibit similar power thresholds as a neutral beam heated plasma, and are close to the scaling. The tritium plasmas in this study tended to higher electron heating fractions and, when heated with ion cyclotron waves, to relatively higher radiation fractions compared to other isotopes potentially impeding access to sustained H-modes.The authors thank P.A. Schneider, F. Ryter, A. Nielsen, and A. Kappatou for fruitful discussions and for help with data analysis tools. This work has been carried out within the framework of the EUROfusion Consortium and has received funding from the Euratom Research and Training Programme 2014–2018 and 2019–2020 under Grant Agreement No. 633053. The views and opinions expressed herein do not necessarily reflect those of the European Commission. G. Birkenmeier received funding from the Helmholtz Association under Grant No. VH-NG-1350.Peer Reviewed"Article signat per 27 autors/es: G. Birkenmeier, E.R. Solano, E. Lerche, D. Taylor, D. Gallart, M.J. Mantsinen, E. Delabie, I.S. Carvalho, P. Carvalho, E. Pawelec, J.C. Hillesheim, F. Parra Diaz, C. Silva, S. Aleiferis, J. Bernardo, A. Boboc, D. Douai, E. Litherland-Smith, R. Henriques, K.K. Kirov, C.F. Maggi, J. Mailloux, M. Maslov, F.G. Rimini, S.A. Silburn, P. Sirén, H. Weisen and JET Contributors"Postprint (published version

Influência do gênero e da idade: satisfação no trabalho de profissionais da saúde

OBJECTIVE: to analyze the influence of gender and age on the quality of the professional lives of health care professionals at a university hospital. METHOD: a total of 546 professionals completed a general questionnaire that measured sociodemographic variables and evaluated job satisfaction using a scale adopted from the NTP 394 Job Satisfaction scale and translated into Spanish. RESULTS: overall, 77.2% of the professionals surveyed were satisfied with the work they perform. With regards to gender, we found overwhelming evidence of the feminization of practically all health care professions included in the study, with higher levels of job satisfaction among women than men. Regarding age, 20-30-year-olds and professionals over 61 years old showed higher satisfaction levels than did middle-aged professionals. Higher levels of dissatisfaction were reported by professionals between 41 and 50 years old. CONCLUSIONS: we were able to detect the influence of gender and age on the level of job satisfaction, finding significant associations between job satisfaction and both of these variables. Generally, women expressed more satisfaction than men, and elderly professionals showed higher satisfaction compared to younger professionals. Management policies should focus on taking action to correct the conditions that produce dissatisfaction among certain groups of employees.OBJETIVO: analizar la influencia del género y edad en la satisfacción de la vida laboral en los profesionales sanitarios de un Hospital Universitario. MÉTODO: la muestra quedó constituida por 546 profesionales, administrándose un cuestionario general con variables sociodemográficas y otro específico, el NTP 394 Satisfacción Laboral: escala general de satisfacción adaptada y validada al castellano. RESULTADOS: en general un 77,2% se encuentra satisfecho con el trabajo que desempeña. En relación al género, se evidencia la feminización de prácticamente todas las profesiones sanitarias sin excepción, quedando patente niveles de satisfacción superior en las mujeres. La edad, presenta niveles más elevados de satisfacción en profesionales de edades entre 20 y 30 años y en los mayores de 61; en contrapartida los niveles de insatisfacción se presentan en los profesionales de edades comprendidas entre 41 y 50 años. CONCLUSIONES: podemos delimitar la influencia del género y la edad en los niveles de satisfacción laboral, obteniéndose asociaciones significativas en ambas variables; respecto al género, las mujeres se muestran más satisfechas y en cuanto a la edad los profesionales de mayor edad muestran mayor satisfacción. Así, las líneas de gestión deben orientarse al establecimiento de acciones de mejora en aquellas variables que producen insatisfacción.OBJETIVO: analisar a influência do gênero e da idade na satisfação no trabalho de profissionais da saúde num hospital universitário. MÉTODO: a amostra foi constituída por 546 profissionais, aos quais foi administrado um questionário genérico, contendo variáveis sociodemográficas e um questionário específico, o NTP 394: Satisfação no Trabalho: Escala de Satisfação Global adaptada e validada para o castelhano. RESULTADOS: de modo geral, 77,2% da amostra manifestou estar satisfeita com o trabalho que realiza. Quanto ao gênero, foi evidenciada a feminização de praticamente todas as profissões em saúde, sem exceções, sendo que as mulheres manifestaram níveis mais elevados de satisfação. Com relação à idade, as faixas etárias que manifestaram os níveis mais elevados de satisfação foram entre 20 e 30 anos e acima de 61 anos. Em contrapartida, os profissionais entre 41 e 50 anos de idade apresentaram níveis de insatisfação. CONCLUSÕES: pode-se estabelecer a influência do gênero e da idade nos níveis de satisfação no trabalho da amostra estudada, visto que foram identificadas associações significativas. Em relação ao gênero, as mulheres manifestaram estar mais satisfeitas e, com respeito à idade, os maiores níveis de satisfação foram manifestos pelos participantes mais idosos. Sendo assim, as políticas de gestão devem focar na implantação de ações destinadas a melhorar as variáveis que se associam à insatisfação

The role of isotope mass and transport for H-mode access in tritium containing plasmas at JET with ITER-like wall

Special Issue Featuring the Invited Talks from the 48th EPS Conference on Plasma Physics, 27 June - 1 July 2022The required heating power, , to access the high confinement regime (H-mode) in tritium containing plasmas is investigated in JET with ITER-like wall at a toroidal magnetic field of T and a plasma current of MA. , also referred to as the L-H power threshold, is determined in plasmas of pure tritium as well as mixtures of hydrogen with tritium (H-T) and mixtures of deuterium with tritium (D-T), and is compared to the L-H power threshold in plasmas of pure hydrogen and pure deuterium. It is found that, for otherwise constant parameters, is not the same in plasmas with the same effective isotope mass, , when they differ in their isotope composition. Thus, is not sufficient to describe the isotope effect of in a consistent manner for all considered isotopes and isotope mixtures. The electron temperature profiles measured at the L-H transition in the outer half of the radius are very similar for all isotopes and isotope mixtures, despite the fact that the L-H power threshold varies by a factor of about six. This finding, together with the observation of an offset linear relation between the L-H power threshold, , and an effective heat diffusivity, , indicates that the composition-dependent heat transport in the low confinement mode (L-mode) determines, how much power is needed to reach the necessary electron temperatures at the edge, and hence PLH.This work has been carried out within the framework of the EUROfusion Consortium, funded by the European Union via the Euratom Research and Training Programme (Grant Agreement No. 101052200—EUROfusion). Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union nor the European Commission can be held responsible for them. G Birkenmeier received funding from the Helmholtz Association under Grant No. VH-NG-1350Peer Reviewed"Article signat per 50 autors/es: G Birkenmeier, E R Solano, I S Carvalho, J C Hillesheim, E Delabie, E Lerche, D Taylor, D Gallart, M J Mantsinen, C Silva, C Angioni, F Ryter, P Carvalho, M Fontana, E Pawelec, S A Silburn, P Sirén, S Aleiferis, J Bernardo, A Boboc, D Douai, P Puglia, P Jacquet, E Litherland-Smith, I Jepu, D Kos, H J Sun, A Shaw, D King, B Viola, R Henriques, K K Kirov, M Baruzzo, J Garcia, A Hakola, A Huber, E Joffrin, D Keeling, A Kappatou, M Lennholm, P Lomas, E de la Luna, C F Maggi, J Mailloux, M Maslov, F G Rimini, N Vianello, G Verdoolaege, H Weisen, M Wischmeier and JET Contributors"Postprint (published version

Prevention of Cesarean Scar Defects: What Is Possible?

Defect healing of the uterotomy at ceasarean section (CS) results in a morphological und probably functional disruption of the anterior uterine wall. Clinical sequelae concern subsequent pregnancies with a broad range of complications before and during pregnancy as well as at birth. In the following chapter, we provide an overview about the definition, diagnosis, symptoms and pathogenetical mechanisms of CS scar defects. Keeping in mind the pathogenesis allows to introduce preventative approaches

Descenso de la mortalidad por desnutrición en niños menores de cinco años en Costa Rica, 1970 y 1976

artículo (arbitrado) -- Universidad de Costa Rica, Instituto de Investigaciones en Salud (INISA). 1980En 1970 y 1976, la desnutrición como causa de muerte en niños menores de cinco años ocupó el décimo y quinto lugar, respectivamente, según las estadísticas vitales de Costa Rica. Tales cifras, revelaban un aumento de 119 % en la mortalidad por desnutrición en menores de cinco años entre 1970 y 1976, dato incongruente con las mejoras sustanciales registradas en la mortalidad infantil y en el nivel de vida del costarricenses. Consecuentemente, se procedió a verificar la calidad del registro por medio de la revisión y recodificación de los certificados de defunción de menores de cinco años, en que la desnutrición aparecía registrada como causa directa o asociada. El análisis pertinente reveló, contrario a lo descrito oficialmente, una disminución de 65 %en el número de muertes por desnutrición en menores de cinco años, particularmente en varones menores de un año. Por el contrario, la diarrea se presentó como la causa principal de muerte del niño desnutrido. El cambio descrito es congruente con las rápidas mejoras en los índices de salud y nivel de vida en Costa Rica. la desnutrición como causa directa de muerte ha dejado de ser tan importante en Costa Rica. Las cifras presentadas en este estudio parecen predecir que la desnutrición dejará de ser una causa importante de muerte a muy corto plazo.Malnutrition, as a cause of death among children under five vear of age, occupied the tenth and fifth places in 1970 and 1976, respectively, according to the official statistics of Costa Rica. Such figures showed an increased of 119% in the mortalitv due to malnutrition in children under five years trom 1970 to 1976; the change is incompatible with observed substantial improvements in over all childhood mortality and in the global living standards. Consequently, verification of the qualitv of death certificates for children under five was undertaken, aiming at those in which malnutrition appeared registered as the direct or associated cause of death. The analysis revealed, contrary to the official records, a 65 % decrease in the number of deaths due to malnutrition in children under five years, particularly among males under one year. Contrasting, diarrhea appeared as the main cause of death of malnourished children. The change described is compatible wíth the rapid improvement in health indicators and living conditions in Costa Rica. Malnutrition as a direct cause of death is not so important in this country; the figures described in this paper seem to predict that malnutrítion will no longar remain as an important cause of death within a short span.Universidad de Costa Rica, Instituto de Investigaciones en Salud (INISA)UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones en Salud (INISA