Let the Patient Discharge Follow-Up Call Data Do the Talking!

Abstract Category: Practice Innovation / Performance Improvement (PI) Purpose: The purpose of this initiative was to review the Patient Discharge Follow-Up Call (PDFC) Data, point out its importance and identify the issues presented in order to bring awareness to key stakeholders and continue to monitor the impact on patient outcomes. Methods: In mid-February of 2018, based on the collected PDFC Data, the PI Director, PI Coordinator, Statistician and Quality Assurance Nurse (QAN) identified opportunities to educate Nursing, Hospitalists, Pharmacy, and Leadership on the issues related to discharge medications potentially leading to a return visit to the Emergency Department (ED), possible readmission and adverse patient outcomes. In early March of 2018, this team presented information for awareness purposes, gathered an Interdisciplinary team to review data and worked on opportunities. Findings: All patients discharged from West Kendall Baptist Hospital (WKBH) receive a follow-up phone call from the QAN within 24-48 hours. Out of the 3,897 PDFC in the period of September 2017-February 2018 approximately 70% of patients were reached. Of those patients that reported issues (2.7%), the majority (63%) reported issues related to discharge medications. Discussion: In as much as the majority of the patients reported no issues, the small percentage who had problems with medications related to prescribing warranted an intervention to prevent possible readmissions and reduce adverse patient outcomes. The team decided to address the medication issues by implementing the following: Address verification of accuracy of preferred pharmacy during Interdisciplinary Rounds Emphasize Hospitalists to communicate with RN or AP when printing prescriptions Hospitalists and Case Management/SWS to start processing medications that need preauthorization prior to the day of discharge Bring awareness to Pharmacy & Hospitalist teams - to be cognizant of patients on Nebulizer and switch to inhaler upon discharge Bring awareness to interdisciplinary team members of impact of PDFC data on their practice Implications for Practice: Completion of the process related to medication upon discharges plays a vital role for improved patient outcomes, can reduce both return visits to the Emergency Department and readmission rates and can maintain higher standards of clinical practice and service excellence, thereby promoting a culture of patient safety. Future plans include: pharmacy and nursing verifying accuracy of patient’s preferred pharmacy during daily rounds, pharmacy tracking and reviewing specific medication cases, Case Management/Social Work Services (SWS) assisting in following-up on medications that need preauthorization and the data being presented at Nursing Operations and Hospitalist Meetings

Photometric candidate selection and spectroscopic confirmation of new PNe and SySts in the Galactic plane

About 3,500 planetary nebulae (PNe) are currently known in the Milky Way, which shows a great discrepancy with the expected number for these objects, regardless of the reference used, $33-59 \times 10^{3}$. The same holds for symbiotic stars (SySts) as well, since the expected number in the Galaxy ($3-400 \times 10^{3}$) differs considerably from the amount of known ones (approximately 300). Studies on PNe and SySts are of great importance because they provide vital clues to the understanding of the late-stage of stellar evolution for low-to-intermediate mass stars. In addition, these classes of objects play a large role in the chemical evolution of the Galaxy through the ejection of their material to the interstellar medium (ISM), enriching it with the various chemical elements produced throughout their evolution. This project aims to contribute to the detection of new PNe and SySts in the Galaxy, thus decreasing the discrepancy between the observed and theoretical populations. Using simultaneously the third data release from the optical survey VPHAS+ (The VST Photometric H$\alpha$ Survey of the Southern Galactic Plane and Bulge), which maps the southern hemisphere of the Galaxy's plane with the $r$, $i$, and H{$\alpha$} filters, and the IR colors of the catalog AllWISE (Wide-field Infrared Survey Explorer + The Two Micron All Sky Survey), we end up with a number of PN and SySt candidates. Subsequently, we confirm the nature of these objects through spectroscopic observations at the SOAR telescope (Southern Astrophysical Research Telescope). So far, we have selected PN candidates and performed the spectroscopic follow-up of 8 of them. In this presentation we show the project's preliminary results, which consist of the discovery of at least one new planetary nebula, and other emission-line sources still to be confirmed either as PN or SySt.Comment: 4 pages, 5 figures, proceedings of the XLV annual meeting of the Brazilian Astronomical Societ

Exportación y comercialización competitiva del Camu Camu en el mercado japonés entre los años 2015 al 2017

La presente tesis tuvo como propósito general determinar la relación entre la comercialización competitiva y la exportación del Camu Camu en el mercado japonés entre los años 2015 al 2017. La metodología empleada fue de enfoque cuantitativo y de diseño no experimental de alcance correlacional. La muestra estuvo conformada por 37 personas entre gerentes, propietarios y trabajadores de las empresas exportadoras de Camu Camu al mercado japonés; para la obtención de información se usó como técnica la encuesta y como instrumento el cuestionario el cual estuvo conformado por 21 interrogantes estructuradas. Los resultados indican que, si existe relación entre la exportación y la comercialización competitiva del Camu Camu, con un nivel de correlación positivo grande; para ello, se usó la prueba R de Pearson equivalente a 0,803; teniendo un nivel de significancia alcanzado de 0,001, el cual es menor a 0,05 y permite afirmar la hipótesis general. Respecto a las hipótesis especificas el resultado del R de Pearson (0,974) entre las variables exportación y comercialización tienen una correlación positiva grande. El resultado del R de Pearson (0,974) entre las variables estrategias de precio y exportación tienen una correlación positiva grande. El resultado del R de Pearson (0,988) entre las variables estrategias de producto y exportación tienen una correlación positiva grande. El resultado del R de Pearson (0,929) entre las variables estrategias de distribución y exportación tienen una correlación positiva grande. Finalmente, el resultado del R de Pearson (0,974) entre las variables estrategias de promoción y exportación tienen una correlación positiva grande

La pedagogía de la muerte en niños de 5 años en una institución educativa privada, Lima, 2022

El trabajo tuvo como objetivo analizar cómo la Pedagogía de la Muerte (PdM) se articuló en una institución educativa privada, partiendo de las experiencias de los docentes de dicho centro de estudios, en relación a la enseñanza de la muerte. El resultado de la investigación nos permitió inaugurar en el espacio educativo peruano una sana discusión en torno a la Pedagogía de la Muerte. La investigación es de tipo básica con un enfoque cualitativo. Se tomó una muestra no probabilística discrecional; y se empleó la técnica de la entrevista y, como instrumento de recolección de datos, la guía de entrevistas. Los resultados mostraron que el profesorado considera necesario abordar el tema de la muerte desde una edad escolar temprana, aunque admiten ciertos obstáculos: falta de estrategias educativas para la enseñanza de la muerte, objeciones de los padres de familia, resistencia a la inclusión de estos temas por las autoridades educativas, etc. Se concluyó que la Pedagogía de la Muerte favorece un mejor desarrollo del niño al consolidar valores humanos como la solidaridad, la empatía y el respeto por la vida

Effects of Exogenous Enzymes and Salix babylonica L. Extract on Cellular Immune Response and its Correlation with Average Daily Weight Gain in Growing Lambs

The aim of this study was to determine the effects of exogenous enzyme (EZ) and Salix babylonica L. (SB) extract on cellular immune response, and its correlation with average daily weight gain (ADG). Twenty Suffolk lambs, 6-8 months of age and average live weight of 24±0.3 kg, were used in a trial which lasted 60 days. The lambs were distributed into 4 groups of 5 lambs each and housed in individual 1.5x1.5 m cages in a completely randomized design. The treatments were: (i) Control; lambs consuming basal diet (BD) only; (ii) EZ; lambs consuming BD plus 10g of EZ (ZADO®); (iii) SB; lambs consuming BD plus 30 mL of SB, and (iv) EZSB; lambs consuming BD plus 10g EZ and 30 mL of SB. Blood samples were collected on days 0, 15, 30, 45 and 60 and analysed for helper T lymphocytes, cytotoxic T limphocytes, granulocytes and monocytes by flow cytometry. Treatments had no effect on parameters measured, but day of sampling had linear and cubic effects on helper T lymphocytes, granulocytes and monocytes (P<0.01) and cubic effects on cytotoxic T lymphocytes (P<0.01). The results suggest that EZ and SB have immunosuppressant effects in the first 15 days, after this effect were immunosuppressive on cytotoxic T lymphocytes and granulocytes, for monocytes the effect was immunostimulant. No there were correlation between ADG and cellular immune response in this experiment

Propriedades psicométricas e invariância de medida de uma escala de autoeficácia acadêmica em estudantes universitários de cinco países da América Latina

Our objective was to analyze the measurement invariance of the Academic Situations Specific Perceived Self-Efficacy Scale (ASSPSES) among Peruvian, Mexican, Colombian, Argentinean, and Brazilian college students, and its relationship with academic emotional exhaustion (AEE). In addition to the ASSPSES, the Emotional Exhaustion Scale (EES) was used. Two thousand one hundred forty-two college students (70.26% women) between the ages of 16 and 35 (M = 21.79 years) participated. The one-dimensional structure of ASSPSES was corroborated in each sample with a confirmatory factor analysis and the measurement invariance analysis was carried out with a multi-group factor analysis (MGFA) and with the differential item functioning. The relationship with the AEE was tested with the Pearson correlation coefficient. Regard the results, in all of the samples, the one-dimensional model presented adequate psychometric indicators with respect to both dimensionality and reliability. Similarly, regarding the analysis of measurement invariance, a strong variance was attained, and DIF is weak, which together with the MGFA results provides favorable evidence of measurement invariance. We conclude that ASSPSES is an invariant measure among the analyzed groups although replicating the study is necessary for the consolidation of the findings. These findings contribute to the understanding of the internal structure of the ASSPSES, something that had been awaiting evaluation, given how the scale is used in various contexts.El objetivo fue analizar la invarianza de medición de la Escala de Autoeficacia Percibida Específica para Situaciones Académicas (EAPESA) entre estudiantes universitarios peruanos, mexicanos, colombianos, argentinos y brasileños, y su relación con el agotamiento emocional académico (AEA). Además de la EAPESA, se usó la Escala de Cansancio Emocional (ECE). Participaron 2142 estudiantes universitarios (70.26 % mujeres) entre los 16 y 35 años (M = 21.79). La estructura unidimensional de la EAPESA se corroboró en cada muestra con un análisis factorial confirmatorio, y la invarianza de medición se llevó a cabo con un análisis factorial de grupo múltiple (AFGM) y con el funcionamiento diferencial de los ítems (FDI). La relación con el AEA se evaluó con el coeficiente de correlación de Pearson. Respecto a los resultados, en todas las muestras el modelo unidimensional presentó adecuados indicadores psicométricos, tanto en lo que respecta a su dimensionalidad como en cuanto a su confiabilidad. Del mismo modo, en cuanto al análisis de invarianza de medición, se alcanza la invarianza fuerte, y el FDI es débil, lo que junto con el AFGM brinda evidencia favorable de invarianza de medición. Se concluye que la EAPESA es una medida invariante entre los grupos analizados, aunque es necesario replicar la investigación para consolidar los hallazgos. Estos resultados contribuyen a entender la estructura interna de la EAPESA, algo que estaba aguardando una valoración, ya que dicha escala es usada en varios contextos.El objetivo fue analizar la invarianza de medición de la Escala de Autoeficacia Percibida Específica para Situaciones Académicas (EAPESA) entre estudiantes universitarios peruanos, mexicanos, colombianos, argentinos y brasileños, y su relación con el agotamiento emocional académico (AEA). Además de la EAPESA, se usó la Escala de Cansancio Emocional (ECE). Participaron 2142 estudiantes universitarios (70.26% mujeres) entre los 16 y 35 años (M = 21.79). La estructura unidimensional de la EAPESA se corroboró en cada muestra con un análisis factorial confirmatorio, y la invarianza de medición se llevó a cabo con un análisis factorial de grupo múltiple (AFGM) y con el funcionamiento diferencial de los ítems (FDI). La relación con el AEA se evaluó con el coeficiente de correlación de Pearson. Respecto a los resultados, en todas las muestras el modelo unidimensional presentó adecuados indicadores psicométricos, tanto en lo que respecta a su dimensionalidad como en cuanto a su confiabilidad. Del mismo modo, en cuanto al análisis de invarianza de medición, se alcanza la invarianza fuerte, y el FDI es débil, lo que junto con el AFGM brinda evidencia favorable de invarianza de medición. Se concluye que la EAPESA es una medida invariante entre los grupos analizados, aunque es necesario replicar la investigación para consolidar los hallazgos. Estos resultados contribuyen a entender la estructura interna de la EAPESA, algo que estaba aguardando una valoración, ya que dicha escala es usada en varios contextos

Part III. Qasiri's Feminine Appreciation and Sense of Ethnic Identity

1. Pueblo de Qasire y su significado Qasiri, deriva del quechua Qasiriy que significa abstenerse, tranquilizarse, calmarse, es decir abstente, tranquilízate, cálmate. Pertenece al distrito de Pauza en Ayacucho, a 3000 msnm, dicho distrito está formado por 7 anexos: Qasire, Huancara, Marán, Mirmaca, Pirca, Rauripa, Toncio y 8 barrios: Acola, Atapillo, Ayraranca, Huampo, Hanan Huayllas, Huánuco, Otococha, Urin Huayllas

Aquaculture’s struggle for space: the need for coastal spatial planning and the potential benefits of Allocated Zones for Aquaculture (AZAs) to avoid conflict and promote sustainability

Aquaculture is an increasingly important food-producing sector, providing protein for human consumption. However, marine aquaculture often struggles for space due to the crowded nature of human activities in many marine coastal areas, and because of limited attention from spatial planning managers. Here, we assess the need for coastal spatial planning, emphasising the establishment of suitable areas for the development of marine aquaculture, termed Allocated Zones for Aquaculture (AZAs), in which aquaculture has secured use and priority over other activities, and where potential adverse environmental impacts and negative interactions with other users are minimised or avoided. We review existing examples of marine aquaculture spatial development worldwide and discuss the proper use of site selection in relation to different legal and regulatory requirements. National or regional authorities in charge of coastal zone management should carry out spatial planning defining optimal sites for aquaculture to promote development of sustainable marine aquaculture and avoid conflict with other users, following a participatory approach and adhering to the principles of ecosystem-based management

Environmental noise reduces predation rate in an aquatic invertebrate

Noise is one of a wide range of disturbances associated with human activities that have been shown to have detrimental impacts on a wide range of species, from montane regions to the deep marine environment. Noise may also have community-level impacts via predator–prey interactions, thus jeopardising the stability of trophic networks. However, the impact of noise on freshwater ecosystems is largely unknown. Even more so is the case of insects, despite their crucial role in trophic networks. Here, we study the impact of underwater noise on the predatory functional response of damselfly larvae. We compared the feeding rates of larvae under anthropogenic noise, natural noise, and silent conditions. Our results suggest that underwater noise (pooling the effects of anthropogenic noise and natural noise) decreases the feeding rate of damselflies significantly compared to relatively silent conditions. In particular, natural noise increased the handling time significantly compared to the silent treatment, thus reducing the feeding rate. Unexpectedly, feeding rates under anthropogenic noise were not reduced significantly compared to silent conditions. This study suggests that noise per se may not necessarily have negative impacts on trophic interactions. Instead, the impact of noise on feeding rates may be explained by the presence of nonlinearities in acoustic signals, which may be more abundant in natural compared to anthropogenic noise. We conclude by highlighting the importance of studying a diversity of types of acoustic pollution, and encourage further work regarding trophic interactions with insects using a functional response approach

Manual de la prueba diagnóstica de Lectura (Comprensión de textos oralizados), Escritura y Matemática, 1er. grado de primaria

En este manual, se brindan las pautas para la aplicación de las pruebas y para el registro de las respuestas de los estudiantes, así como algunos ejemplos para la retroalimentación y orientaciones para el análisis de los resultados. Es necesario señalar que el análisis pedagógico de los resultados de estas pruebas es solo un insumo de un diagnóstico más amplio e integral. Para realizar un diagnóstico adecuado, también deben considerarse otras evidencias de aprendizaje, como el portafolio del estudiante u otros instrumentos generados por la escuela, las instancias de gestión descentralizada o el Ministerio de Educación. Toda esta información debería ser útil para tomar decisiones respecto de la planificación curricular con vistas a la continuidad de los aprendizajes durante el 2021