Autopercepción de la enfermera frente a la comunicación con pacientes imposibilitados de comunicarse verbalmente

La comunicación es una herramienta esencial en la relación enfermera-paciente; permite comprender y atender a las necesidades alteradas del mismo. Se considera que para que ésta sea efectiva, la enfermera debe autoconocerse y autopercibirse en su rol de comunicadora y ser consciente además, del desafío que implica lograrlo con un paciente que no verbaliza, ya que, en este caso, es una situación que requiere no solo de educación al respecto sino además, de una reflexión personal de cada profesional enfermero frente a la comunicación no verbal, donde debe tener un buen conocimiento de sí mismo que permita controlar y reconocer mejor las manifestaciones corporales y emocionales que se expresan en la no verbalidad para lograr un actuar asertivo. El objetivo de este trabajo es lograr entender cómo se autopercibe la enfermera frente a la situación de comunicación con un paciente imposibilitado de comunicarse verbalmente. Es un estudio de tipo cualitativo, descriptivo y transversal. La muestra tomada fue de 12 enfermeros que prestan servicio asistencial en el Servicio de Terapia Intensiva de Clínica de Cuyo, Mendoza durante el primer semestre de 2015.Fil: Chara, Evelina . Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Ochoa, Jorge A.. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Tuseddú, Ana Laura. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería.

La wak'a awicha Anselma

La religión del quechua contemporáneo, a nivel comunal, ha comenzado a llamar la atención de los estudiosos interesados en estos temas. La mayoría de ellos la describen ya sea como siempre supervivencia, o como la continuación de la pre-hispánica, con obvias influencias de las traídas por los europeos a partir del siglo XVI. Pero, casi siempre, se la ha visto como bastante estática y sometida a modificaciones imperceptibles. Cuando se aceptan cambios, se considera que son obra de los catequistas y de los predicadores y que la dirección del cambio es hacia la religión cristiana. También se acepta que la modernización, en todos sus aspectos, y por tanto en lo religioso, es una fuerza de cambio que irá occidentalizando cada vez más la religión tradicional del quechua del sur.La religión del quechua contemporáneo, a nivel comunal, ha comenzado a llamar la atención de los estudiosos interesados en estos temas. La mayoría de ellos la describen ya sea como siempre supervivencia, o como la continuación de la pre-hispánica, con obvias influencias de las traídas por los europeos a partir del siglo XVI. Pero, casi siempre, se la ha visto como bastante estática y sometida a modificaciones imperceptibles. Cuando se aceptan cambios, se considera que son obra de los catequistas y de los predicadores y que la dirección del cambio es hacia la religión cristiana. También se acepta que la modernización, en todos sus aspectos, y por tanto en lo religioso, es una fuerza de cambio que irá occidentalizando cada vez más la religión tradicional del quechua del sur

El estado actual de los estúdios de la economia campesina en los Andes centrales

Parece que el primer antropólogo profesional que ha trabajado en las tierras altas de la sierra sur del Perú ha sido Bernard Mishkin. A fines de la década de los treinta, hizo trabajo de campo en la comunidad campesina indígena de Kawri en el departamento del Cuzco. Debido a su interés evolucionista, buscaba comprobar algunas ideas morganianas, por lo que incidió su pesquiza en el estudio de la organización social, la familia y el parentesco quechua. Sin embargo sus principales publicaciones no reflejan esta intención, porque es la economía el aspecto que más resalta a través del estudio de la tenencia de la tierra y los diversos procesos productivos agrícolas (1946, p. 411-470, y 1964, p. 143-149). Este es por consiguiente uno de los primeros antecedentes en el estudio de la economía campesina andina, hecha por un antropólogo que se interesó en esta región

A methodology for determining an effective subset of heuristics in selection hyper-heuristics

We address the important step of determining an effective subset of heuristics in selection hyper-heuristics. Little attention has been devoted to this in the literature, and the decision is left at the discretion of the investigator. The performance of a hyper-heuristic depends on the quality and size of the heuristic pool. Using more than one heuristic is generally advantageous, however, an unnecessary large pool can decrease the performance of adaptive approaches. Our goal is to bring methodological rigour to this step. The proposed methodology uses non-parametric statistics and fitness landscape measurements from an available set of heuristics and benchmark instances, in order to produce a compact subset of effective heuristics for the underlying problem. We also propose a new iterated local search hyper-heuristic usingmulti-armed banditscoupled with a change detection mechanism. The methodology is tested on two real-world optimisation problems: course timetabling and vehicle routing. The proposed hyper-heuristic with a compact heuristic pool, outperforms state-of-the-art hyper-heuristics and competes with problem-specific methods in course timetabling, even producing new best-known solutions in 5 out of the 24 studied instances

Effective learning hyper-heuristics for the course timetabling problem

Course timetabling is an important and recurring administrative activity in most educational institutions. This article combines a general modeling methodology with effective learning hyper-heuristics to solve this problem. The proposed hyper-heuristics are based on an iterated local search procedure that autonomously combines a set of move operators. Two types of learning for operator selection are contrasted: a static (offline) approach, with a clear distinction between training and execution phases; and a dynamic approach that learns on the fly. The resulting algorithms are tested over the set of real-world instances collected by the first and second International Timetabling competitions. The dynamic scheme statistically outperforms the static counterpart, and produces competitive results when compared to the state-of-the-art, even producing a new best-known solution. Importantly, our study illustrates that algorithms with increased autonomy and generality can outperform human designed problem-specific algorithms

A Methodology for Classifying Search Operators as Intensification or Diversification Heuristics

Selection hyper-heuristics are generic search tools that dynamically choose, from a given pool, the most promising operator (low-level heuristic) to apply at each iteration of the search process. The performance of these methods depends on the quality of the heuristic pool. Two types of heuristics can be part of the pool: diversification heuristics, which help to escape from local optima, and intensification heuristics, which effectively exploit promising regions in the vicinity of good solutions. An effective search strategy needs a balance between these two strategies. However, it is not straightforward to categorize an operator as intensification or diversification heuristic on complex domains. Therefore, we propose an automated methodology to do this classification. This brings methodological rigor to the configuration of an iterated local search hyper-heuristic featuring diversification and intensification stages. The methodology considers the empirical ranking of the heuristics based on an estimation of their capacity to either diversify or intensify the search. We incorporate the proposed approach into a state-of-the-art hyper-heuristic solving two domains: course timetabling and vehicle routing. Our results indicate improved performance, including new best-known solutions for the course timetabling problem

Effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal disease in people 60 years or older

<p>Abstract</p> <p>Background</p> <p>The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended in elderly and high-risk adults. However, its efficacy in preventing pneumococcal infections remains controversial. This study assessed the clinical effectiveness of vaccination against invasive pneumococcal disease (IPD) among people over 60 years.</p> <p>Methods</p> <p>Population-based case-control study that included 88 case patients over 60 years-old with a laboratory-confirmed IPD (bacteraemic pneumonia, meningitis or sepsis) and 176 outpatient control subjects who were matched by primary care centre, age, sex and risk stratum. Adjusted odds ratios (ORs) for vaccination were calculated using conditional logistic regression, controlling for underlying conditions. Vaccine effectiveness was estimated as (1 - OR) ×100.</p> <p>Results</p> <p>Pneumococcal vaccination rate was significantly lower in cases than in control subjects (38.6% <it>vs </it>59.1%; p = 0.002). The adjusted vaccine effectiveness was 72% (OR: 0.28; 95% CI: 0.15-0.54) against all IPD and 77% (OR: 0.23; 95% CI: 0.08-0.60) against vaccine-type IPD. Vaccination was significantly effective against all IPD in both age groups: 60-79 years-old (OR 0.32; 95% CI: 0.14-0.74) and people 80 years or older (OR: 0.29; 95% CI: 0.09-0.91). Vaccination appears significantly effective as for high-risk immunocompetent subjects (OR: 0.29; 95% CI: 0.11-0.79) as well as for immunocompromised subjects (OR: 0.12; 95% CI: 0.03-0.53).</p> <p>Conclusion</p> <p>These findings confirm the effectiveness of the 23-valent PPV against IPD, and they also support the benefit of vaccination in preventing invasive infections among high-risk and older people.</p

Demand energy forecasting using genetic algorithm to guarantee safety on electrical transportation system

Demand estimation models are used for energy planning activities. Their primary function is focused on securing energy supply to final users using available resources in generation, transport and interconnection. Long-term planning models typically use non-linear optimization techniques considering an error not exceeding 5%. The reference model used by UPME in Colombia is limited to an average error of 1.6% considering non-linear modeling estimation techniques. However, they are limited in their ability to anticipate uncharacteristic variations in curves or externalities, which increases the probability of an erroneous prediction. Therefore, this research proposes a model to forecast electricity demand using neural networks in order to anticipate non-characteristic variations. The study first documents current methodologies for the prediction of maximum power demand, as well as the current deficiencies in the used forecasts, A new model is then formulated with the application of neural networks using the algorithm Cascade-Forward Back propagation using MATLAB R2017a. During the model comparison process, it was identified that the data obtained reflects the characteristics of demand behavior with an acceptable margin error equal to 0.5%

Creación de Libros Colaborativos en el Marco de la Iniciativa LATIn

Creating text book is now a task that involves different stockholders participation. Working under a collaborative environment is not an easy labour to carry on. It is important to define, make plans and realize structured activities that lead to a treully collaboration among all working team. When writing books, such technique is utilized in order to generate high quality documents. On this paper, the authors are going to show the preferred model emplyed to créate books under collaborative environment, fremd upon the LATin iniciative (Latin-American Creation of Open Text Books).La creación de libros de texto es una tarea que involucra la participación de diversos actores. Trabajar colaborativamente es una labor que no es fácil de ejecutar. Se hace necesario definir, planear y estructurar actividades que conlleven una verdadera colaboración entre los integrantes de los grupos de trabajo. En la escritura de libros esta técnica se utiliza con el fin de producir documentos de alta calidad. En el presente trabajo, los autores presentan el modelo seguido para la creación de libros de forma colaborativa enmarcado dentro de la Iniciativa LATIn (Iniciativa Latinoamericana de Creación de Libros de Texto Abiertos)

Influence of a Concurrent Exercise Training Intervention during Pregnancy on Maternal and Arterial and Venous Cord Serum Cytokines: The GESTAFIT Project

The aim of the present study was to analyze the influence of a supervised concurrent exercise-training program, from the 17th gestational week until delivery, on cytokines in maternal (at 17th and 35th gestational week, and at delivery) and arterial and venous cord serum. Fifty-eight Caucasian pregnant women (age: 33.5 +/- 4.7 years old, body mass index: 23.6 +/- 4.1kg/m(2)) from the GESTAFIT Project (exercise (n = 37) and control (n = 21) groups) participated in this quasi-experimental study (per-protocol basis). The exercise group followed a 60-min 3 days/week concurrent (aerobic-resistance) exercise-training from the 17th gestational week to delivery. Maternal and arterial and venous cord serum cytokines (fractalkine, interleukin (IL)-1 beta, IL-6, IL-8, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha) were assessed using Luminex xMAP technology. In maternal serum (after adjusting for the baseline values of cytokines), the exercise group decreased TNF-alpha (from baseline to 35th week, p = 0.02), and increased less IL-1 beta (from baseline to delivery, p = 0.03) concentrations than controls. When adjusting for other potential confounders, these differences became non-significant. In cord blood, the exercise group showed reduced arterial IL-6 and venous TNF-alpha (p = 0.03 and p = 0.001, respectively) and higher concentrations of arterial IL-1 beta (p = 0.03) compared to controls. The application of concurrent exercise-training programs could be a strategy to modulate immune responses in pregnant women and their fetuses. However, future research is needed to better understand the origin and clearance of these cytokines, their role in the maternal-placental-fetus crosstalk, and the influence of exercise interventions on them