74 research outputs found
The Standardization of Supporting Tools: Advantage Competitive for Collaborative Networks
doi: 10.1016/j.proeng.2013.08.277Traditionally, manufacturing companies, the gateway for information technology (IT) have been implementing business management tools, tools typically enterprise resource planning (ERP) focused exclusively on internal processes manufacturing and remaining largely isolated from the rest of the elements of the value chain (suppliers, customers, etc.). The objective of this paper is to propose action lines to solve the problems inherent in collaborative knowledge management related technological barrier by implementation project business management tools. As mist relevant contribution are both the search for standardization and the application of techniques in Project Management to try to achieve success in the implementation and establishing of collaborative networks.The authors thank the ConsejerĂa de EconomĂa, InnovaciĂłn y Ciencia of the Junta de AndalucĂa and to the European Union for their incentives for the training of teaching staff and pre-doctoral researchers in deficient areas of knowledge (2009 Edict) co-financed by the Fondo Social Europeo (FSE).
Thanks also to the Department of Mechanical Engineering and Industrial Design at the University of Cadiz School of Engineering
Lectura de contexto y abordaje psicosocial desde los enfoques narrativos Bogotå, Coveñas.
Durante la Ășltima fase de aprendizaje en el diplomado de profundizaciĂłn acompañamiento psicosocial en escenarios de violencia se abordarĂĄn los enfoques narrativos, estos nos brindan herramientas trasformadoras de historias logrando cambiar el guion del dolor a la esperanza. Para ello se analizarĂĄn relatos de victimas reales y a partir de ellos generar estrategias de moldeamiento de la historia de forma que ayude a la persona a salir adelante.
De esta forma, la narrativa y en especial la pregunta se convierte en una herramienta de eficaz pues nos lleva a desarrollar habilidades para el acercamiento a la comunidad y a la realidad del conflicto, por otra parte, permite a la vĂctima descubrir aspectos mĂĄs allĂĄ de la situaciĂłn vivida y tener conciencia frente a las potencialidades que puede desarrollar a partir de un hecho traumĂĄtico.During the last phase of learning in the course of deepening psychosocial accompaniment in scenarios of violence, narrative approaches will be addressed, these provide us with transforming tools of stories managing to change the script from pain to hope. For this purpose, stories of real victims will be analyzed and from them generate strategies for shaping the story in a way that helps the person to get ahead.
In this way, the narrative and especially the question becomes an effective tool as it leads us to develop skills to approach the community and the reality of the conflict, on the other hand it allows the victim to discover aspects beyond the situation lived and be aware of the potentialities that can develop from a traumatic event
Clinical Practice Guideline for the Diagnosis and Management of Adult Patients with Functional Chronic Constipation
Resumen
Objetivo: diseñar una guĂa de prĂĄctica clĂnica para orientar el diagnĂłstico, y establecer la clasificaciĂłn y el
tratamiento farmacológico y no farmacológico en los pacientes adultos con estreñimiento crónico funcional
en Colombia.
Materiales y mĂ©todos: el grupo desarrollador de la presente guĂa estuvo conformado por un equipo
multidisciplinario con apoyo de la AsociaciĂłn Colombiana de GastroenterologĂa, el Grupo Cochrane ITS y
el Instituto de Investigaciones ClĂnicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clĂnicas relevantes y se realizĂł la bĂșsqueda de guĂas nacionales e internacionales en bases de datos
especializadas. Las guĂas existentes fueron evaluadas en tĂ©rminos de calidad y aplicabilidad; ninguna de
ellas cumpliĂł criterios de adaptaciĂłn, por lo que se decidiĂł desarrollar una guĂa de novo. El Grupo Cochrane
realizĂł la bĂșsqueda sistemĂĄtica de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas
usando la metodologĂa GRADE.
Resultados: se desarrollĂł una guĂa de prĂĄctica clĂnica basada en la evidencia para el diagnĂłstico, clasificaciĂłn y tratamiento farmacolĂłgico y no farmacolĂłgico de los pacientes con estreñimiento crĂłnico funcional
en Colombia.
Conclusiones: se establecieron los criterios clĂnicos y signos de alarma, las pruebas diagnĂłsticas y los
esquemas terapĂ©uticos que se recomiendan en la atenciĂłn de los pacientes con estreñimiento crĂłnico funcional en Colombia.GuĂas de prĂĄctica clĂnica basadas en la evidencia57-66Abstract
Objective: Design a clinical practice guideline to orient the diagnosis and establishing the classification and
pharmacological and non-pharmacological treatment in adult patients with chronic functional constipation in
Colombia.
Materials and Methods: This guide was developed by a multidisciplinary team with the support of the
Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the
Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national
and international guidelines in databases was performed. Existing guidelines were evaluated for quality and
applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo
guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and
recommendations were made based on the GRADE methodology.
Results: A clinical practice based on evidence was developed for the diagnosis, classification and pharmacological and non-pharmacological treatment of patients with chronic functional constipation in Colombia.
Conclusions: The clinical criteria and warning signs, diagnostic tests and therapeutic regimens that are
recommended in the care of patients with chronic functional constipation were established in Colombi
Perspectivas de la empresa y la economĂa mexicana frente a la reestructuraciĂłn productiva
1 archivo PDF (404 pĂĄginas)Este texto se presenta una reflexiĂłn de investigadores de la UAM, asĂ como de otras Instituciones de EducaciĂłn Superior respecto al marco en el que se han desenvuelto las empresas mexicanas en los Ășltimos años, asĂ como del desarrollo en algunos de sus sistemas organizacionales. PALABRAS CLAVE: Mexico Economic policy 1970-1994
Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID
Background: Most patients with COVID-19 receive antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased complications, including antibacterial resistance. We aim to analyze risk factors for inappropriate antibiotic prescription in these patients and describe possible complications arising from their use. Methods: The SEMI-COVID-19 Registry is a multicenter, retrospective patient cohort. Patients with antibiotic were divided into two groups according to appropriate or inappropriate prescription, depending on whether the patient fulfill any criteria for its use. Comparison was made by means of multilevel logistic regression analysis. Possible complications of antibiotic use were also identified. Results: Out of 13,932 patients, 3047 (21.6%) were prescribed no antibiotics, 6116 (43.9%) were appropriately prescribed antibiotics, and 4769 (34.2%) were inappropriately prescribed antibiotics. The following were independent factors of inappropriate prescription: February-March 2020 admission (OR 1.54, 95%CI 1.18-2.00), age (OR 0.98, 95%CI 0.97-0.99), absence of comorbidity (OR 1.43, 95%CI 1.05-1.94), dry cough (OR 2.51, 95%CI 1.94-3.26), fever (OR 1.33, 95%CI 1.13-1.56), dyspnea (OR 1.31, 95%CI 1.04-1.69), flu-like symptoms (OR 2.70, 95%CI 1.75-4.17), and elevated C-reactive protein levels (OR 1.01 for each mg/L increase, 95% CI 1.00-1.01). Adverse drug reactions were more frequent in patients who received ANTIBIOTIC (4.9% vs 2.7%, p < .001). Conclusion: The inappropriate use of antibiotics was very frequent in COVID-19 patients and entailed an increased risk of adverse reactions. It is crucial to define criteria for their use in these patients. Knowledge of the factors associated with inappropriate prescribing can be helpful
Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism
Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio
Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-Ï auto-Abs in children
We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2
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