176 resultados para Conjunción aunque


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Esta publicación obtuvo el "IX Premio de Investigación Fracisco Javier de Landaburu Universitas 2010"

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En la última década Mindfulness ha despertado gran interés como tratamiento terapéutico en la salud psicológica. Está inmerso en lo que ya se denominan Terapias de Tercera Generación, donde la aceptación es el concepto en cuál se centra. Existen varios programas en los que se aplica esta terapia y se han realizado estudios para numerosas aplicaciones clínicas, dando evidencia científica al respecto. El objetivo de esta revisión narrativa es la de conocer la eficacia de la aplicación de la terapia Mindfulness para reducir los síntomas de ansiedad en personas adultas de Atención Primaria. Para ello, se revisan los fundamentos teóricos y mecanismos de acción de Mindfulness, y de qué manera actúa en los trastornos de ansiedad. Dentro de este marco, se expone en la discusión la aplicación de la terapia en Atención primaria y la posibilidad de ser una herramienta para el profesional de Enfermería. Finalmente, se concluye que Mindfulness tiene un efecto moderado para reducir los niveles de ansiedad, aunque sin gran diferencia respecto a las Terapias Cognitivo Conductuales utilizadas hasta el momento. Se observa una necesidad de mayor evidencia científica que respalde la idoneidad de la aplicación de Mindfulness en personas adultas de Atención Primaria para reducir los niveles de ansiedad. Y siendo esta terapia una herramienta idónea para ofrecer por parte del personal de Enfermería, existen pocos estudios en los que Enfermer@s sean los que aplican Mindfulness

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Las sujeciones físicas son aquellos dispositivos unidos al cuerpo, que se utilizan para restringir la movilidad de las personas. El debate sobre la utilización de estos dispositivos ha sido controvertido desde hace unos años a ahora, y se estima que en los diferentes países, entre los que se incluye España, el ratio de utilización es muy superior al que debería. Las complicaciones asociadas a su uso son extensamente documentadas, y la legislación vigente sobre ellas está en proceso de normalización. Objetivos: identificar la necesidad de implantación de protocolos de sujeciones en centros psicogeriátricos, así cómo analizar el porqué del inicio de sujeciones, sus consecuencias, los principales puntos a contener de un protocolo de sujeciones, y los cambios que dicho protocolo generará en las unidades. Metodología: el trabajo realizado es una revisión narrativa, basada en diferentes búsquedas en bases de datos y paginas web. Se utilizan descriptores y boleanos en conjunción para organizar la búsqueda, y se aplican criterios de inclusión y exclusión. Conclusiones: Existe la necesidad de crear e implantar protocolos que guíen en la práctica de sujeciones a los profesionales de enfermería, ya que cada vez somos más conscientes de los eventos adversos que acarrea su utilización. Por otro lado, la utilización de sujeciones todavía se llega a instaurar como facilitador del trabajo de enfermería, y existe unanimidad en qué deberían contener dichos protocolos de sujeciones: existencia de una atención centrada en el paciente y difusión de una cultura alternativa a las sujeciones.

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[EN] This PhD work started in March 2010 with the support of the University of the Basque Country (UPV/EHU) under the program named “Formación de Personal Investigador” at the Chemical and Environmental Engineering Department in the Faculty of Engineering of Bilbao. The major part of the Thesis work was carried out in the mentioned department, as a member of the Sustainable Process Engineering (SuPrEn) research group. In addition, this PhD Thesis includes the research work developed during a period of 6 months at the Institut für Mikrotechnik Mainz GmbH, IMM, in Germany. During the four years of the Thesis, conventional and microreactor systems were tested for several feedstocks renewable and non-renewable, gases and liquids through several reforming processes in order to produce hydrogen. For this purpose, new catalytic formulations which showed high activity, selectivity and stability were design. As a consequence, the PhD work performed allowed the publication of seven scientific articles in peer-reviewed journals. This PhD Thesis is divided into the following six chapters described below. The opportunity of this work is established on the basis of the transition period needed for moving from a petroleum based energy system to a renewable based new one. Consequently, the present global energy scenario was detailed in Chapter 1, and the role of hydrogen as a real alternative in the future energy system was justified based on several outlooks. Therefore, renewable and non-renewable hydrogen production routes were presented, explaining the corresponding benefits and drawbacks. Then, the raw materials used in this Thesis work were described and the most important issues regarding the processes and the characteristics of the catalytic formulations were explained. The introduction chapter finishes by introducing the concepts of decentralized production and process intensification with the use of microreactors. In addition, a small description of these innovative reaction systems and the benefits that entailed their use were also mentioned. In Chapter 2 the main objectives of this Thesis work are summarized. The development of advanced reaction systems for hydrogen rich mixtures production is the main objective. In addition, the use and comparison between two different reaction systems, (fixed bed reactor (FBR) and microreactor), the processing of renewable raw materials, the development of new, active, selective and stable catalytic formulations, and the optimization of the operating conditions were also established as additional partial objectives. Methane and natural gas (NG) steam reforming experimental results obtained when operated with microreactor and FBR systems are presented in Chapter 3. For these experiments nickel-based (Ni/Al2O3 and Ni/MgO) and noble metal-based (Pd/Al2O3 and Pt/Al2O3) catalysts were prepared by wet impregnation and their catalytic activity was measured at several temperatures, from 973 to 1073 K, different S/C ratios, from 1.0 to 2.0, and atmospheric pressure. The Weight Hourly Space Velocity (WHSV) was maintained constant in order to compare the catalytic activity in both reaction systems. The results obtained showed a better performance of the catalysts operating in microreactors. The Ni/MgO catalyst reached the highest hydrogen production yield at 1073 K and steam-to-carbon ratio (S/C) of 1.5 under Steam methane Reforming (SMR) conditions. In addition, this catalyst also showed good activity and stability under NG reforming at S/C=1.0 and 2.0. The Ni/Al2O3 catalyst also showed high activity and good stability and it was the catalyst reaching the highest methane conversion (72.9 %) and H2out/CH4in ratio (2.4) under SMR conditions at 1073 K and S/C=1.0. However, this catalyst suffered from deactivation when it was tested under NG reforming conditions. Regarding the activity measurements carried out with the noble metal-based catalysts in the microreactor systems, they suffered a very quick deactivation, probably because of the effects attributed to carbon deposition, which was detected by Scanning Electron Microscope (SEM). When the FBR was used no catalytic activity was measured with the catalysts under investigation, probably because they were operated at the same WHSV than the microreactors and these WHSVs were too high for FBR system. In Chapter 4 biogas reforming processes were studied. This chapter starts with an introduction explaining the properties of the biogas and the main production routes. Then, the experimental procedure carried out is detailed giving concrete information about the experimental set-up, defining the parameters measured, specifying the characteristics of the reactors used and describing the characterization techniques utilized. Each following section describes the results obtained from activity testing with the different catalysts prepared, which is subsequently summarized: Section 4.3: Biogas reforming processes using γ-Al2O3 based catalysts The activity results obtained by several Ni-based catalysts and a bimetallic Rh-Ni catalyst supported on magnesia or alumina modified with oxides like CeO2 and ZrO2 are presented in this section. In addition, an alumina-based commercial catalyst was tested in order to compare the activity results measured. Four different biogas reforming processes were studied using a FBR: dry reforming (DR), biogas steam reforming (BSR), biogas oxidative reforming (BOR) and tri-reforming (TR). For the BSR process different steam to carbon ratios (S/C) from 1.0 to 3.0, were tested. In the case of BOR process the oxygen-to-methane (O2/CH4) ratio was varied from 0.125 to 0.50. Finally, for TR processes different S/C ratios from 1.0 to 3.0, and O2/CH4 ratios of 0.25 and 0.50 were studied. Then, the catalysts which achieved high activity and stability were impregnated in a microreactor to explore the viability of process intensification. The operation with microreactors was carried out under the best experimental conditions measured in the FBR. In addition, the physicochemical characterization of the fresh and spent catalysts was carried out by Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES), N2 physisorption, H2 chemisorption, Temperature Programmed Reduction (TPR), SEM, X-ray Photoelectron Spectroscopy (XPS) and X-ray powder Diffraction (XRD). Operating with the FBR, conversions close to the ones predicted by thermodynamic calculations were obtained by most of the catalysts tested. The Rh-Ni/Ce-Al2O3 catalyst obtained the highest hydrogen production yield in DR. In BSR process, the Ni/Ce-Al2O3 catalyst achieved the best activity results operating at S/C=1.0. In the case of BOR process, the Ni/Ce-Zr-Al2O3 catalyst showed the highest reactants conversion values operating at O2/CH4=0.25. Finally, in the TR process the Rh-Ni/Ce-Al2O3 catalyst obtained the best results operating at S/C=1.0 and O2/CH4=0.25. Therefore, these three catalysts were selected to be coated onto microchannels in order to test its performance under BOR and TR processes conditions. Although the operation using microreactors was carried out under considerably higher WHSV, similar conversions and yields as the ones measured in FBR were measured. Furthermore, attending to other measurements like Turnover Frequency (TOF) and Hydrogen Productivity (PROD), the values calculated for the catalysts tested in microreactors were one order of magnitude higher. Thus, due to the low dispersion degree measured by H2-chemisorption, the Ni/Ce-Al2O3 catalyst reached the highest TOF and PROD values. Section 4.4: Biogas reforming processes using Zeolites L based catalysts In this section three type of L zeolites, with different morphology and size, were synthesized and used as catalyst support. Then, for each type of L zeolite three nickel monometallic and their homologous Rh-Ni bimetallic catalysts were prepared by the wetness impregnation method. These catalysts were tested using the FBR under DR process and different conditions of BSR (S/C ratio of 1.0 and 2.0), BOR (O2/CH4 ratio of 0.25 and 0.50) and TR processes (at S/C=1.0 and O2/CH4=0.25). The characterization of these catalysts was also carried out by using the same techniques mentioned in the previous section. Very high methane and carbon dioxide conversion values were measured for almost all the catalysts under investigation. The experimental results evidenced the better catalytic behavior of the bimetallic catalysts as compared to the monometallic ones. Comparing the catalysts behavior with regards to their morphology, for the BSR process the Disc catalysts were the most active ones at the lowest S/C ratio tested. On the contrary, the Cylindrical (30–60 nm) catalysts were more active under BOR conditions at O2/CH4=0.25 and TR processes. By the contrary, the Cylindrical (1–3 µm) catalysts showed the worst activity results for both processes. Section 4.5: Biogas reforming processes using Na+ and Cs+ doped Zeolites LTL based catalysts A method for the synthesis of Linde Type L (LTL) zeolite under microwave-assisted hydrothermal conditions and its behavior as a support for heterogeneously catalyzed hydrogen production is described in this section. Then, rhodium and nickel-based bimetallic catalysts were prepared in order to be tested by DR process and BOR process at O2/CH4=0.25. Moreover, the characterization of the catalysts under investigation was also carried out. Higher activities were achieved by the catalysts prepared from the non-doped zeolites, Rh-Ni/D and Rh-Ni/N, as compared to the ones supported on Na+ and Cs+ exchanged supports. However, the differences between them were not very significant. In addition, the Na+ and Cs+ incorporation affected mainly to the Disc catalysts. Comparing the results obtained by these catalysts with the ones studied in the section 4.4, in general worst results were achieved under DR conditions and almost the same results when operated under BOR conditions. In Chapter 5 the ethylene glycol (EG) as feed for syngas production by steam reforming (SR) and oxidative steam reforming (OSR) was studied by using microchannel reactors. The product composition was determined at a S/C of 4.0, reaction temperatures between 625°C and 725°C, atmospheric pressure and Volume Hourly Space Velocities (VHSV) between 100 and 300 NL/(gcath). This work was divided in two sections. The first one corresponds to the introduction of the main and most promising EG production routes. Then, the new experimental procedure is detailed and the information about the experimental set-up and the measured parameters is described. The characterization was carried out using the same techniques as for the previous chapter. Then, the next sections correspond to the catalytic activity and catalysts characterization results. Section 5.3: xRh-cm and xRh-np catalysts for ethylene glycol reforming Initially, catalysts with different rhodium loading, from 1.0 to 5.0 wt. %, and supported on α-Al2O3 were prepared by two different preparation methods (conventional impregnation and separate nanoparticle synthesis). Then, the catalysts were compared regarding their measured activity and selectivity, as well as the characterization results obtained before and after the activity tests carried out. The samples prepared by a conventional impregnation method showed generally higher activity compared to catalysts prepared from Rh nanoparticles. By-product formation of species such as acetaldehyde, ethane and ethylene was detected, regardless if oxygen was added to the feed or not. Among the catalysts tested, the 2.5Rh-cm catalyst was considered the best one. Section 5.4: 2.5Rh-cm catalyst support modification with CeO2 and La2O3 In this part of the Chapter 5, the catalyst showing the best performance in the previous section, the 2.5Rh-Al2O3 catalyst, was selected in order to be improved. Therefore, new Rh based catalysts were designed using α-Al2O3 and being modified this support with different contents of CeO2 or La2O3 oxides. All the catalysts containing additives showed complete conversion and selectivities close to the equilibrium in both SR and OSR processes. In addition, for these catalysts the concentrations measured for the C2H4, CH4, CH3CHO and C2H6 by-products were very low. Finally, the 2.5Rh-20Ce catalyst was selected according to its catalytic activity and characterization results in order to run a stability test, which lasted more than 115 hours under stable operation. The last chapter, Chapter 6, summarizes the main conclusions achieved throughout this Thesis work. Although very high reactant conversions and rich hydrogen mixtures were obtained using a fixed bed reaction system, the use of microreactors improves the key issues, heat and mass transfer limitations, through which the reforming reactions are intensified. Therefore, they seem to be a very interesting and promising alternative for process intensification and decentralized production for remote application.

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En este Trabajo de Fin de Grado desarrollado en la empresa On4U, se ha implementado un módulo para Magento, cuya función principal es la generación dinámica de parrillas de productos en base al análisis del tiempo meteorológico, teniendo en cuenta la localización del cliente. Además, el módulo guarda automáticamente las compras efectuadas, junto con la información externa, para un posible análisis posterior que relacione los hábitos de compra con el tiempo meteorológico. Aunque se haya centrado en este caso de uso, se ha desarrollado con un enfoque modular, de tal manera que fuese fácil de integrar en el módulo el uso de otra fuente abierta de información. Para poder realizar el proyecto, se ha tenido que profundizar en varios conceptos relacionados con la plataforma de eCommerce Magento, entre ellos, el patrón Modelo-Vista-Controlador y el ciclo de vida de una petición.

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La primera idea de la realización de este proyecto, fue concebida por la necesidad de tener un sistema por el cual se pudieran cambiar datos de una aplicación, en un sistema móvil, a través de una página web. Sin embargo al conocer la potencia que tiene RDF para ser muy escalable terminó siendo un sistema de gestión de contenido general en RDF. Este sistema de gestión se ha realizado para ser lo más simple posible para un usuario, de tal manera que con solo 2 click en la página web y rellenando un formulario simple, pudiera tener una base de datos sin muchos conocimientos sobre la gestión de las mismas. Aunque claramente no es un sistema potente como si fuera una base de datos en Oracle, por citar un ejemplo, sirve para poder agregar, modificar y eliminar datos con sencillez. Así este sistema de gestión da una posibilidad muy sencilla de realizar tus propias bases de datos. Además aunque tiene un motor SQL para la gestión interna de almacenamiento, la salida de los datos es en RDF/XML con lo que podría ser compatible con un sistema más amplio como Oracle Database Semantic Technologies. Este CMS también tendrá un sistema de seguridad basado en usuario y contraseña. Para que la edición del contenido sea accesible solo a usuarios con acceso, mientras que la exportación de los datos será pública, y podrá ser accesible por cualquier usuario mediante una URI.

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170 p.

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Introducción: La depresión representa una alta carga para la sociedad afectando a 121 millones de personas en el mundo, convirtiéndose en la tercera causa de carga mundial de morbilidad entre todas las enfermedades. En el campo de la enfermería las tasas de depresión son aun menos prometedoras. Diversos estudios a nivel internacional han considerado a la enfermería como una profesión con altas prevalencias en trastornos depresivos dando lugar a un efecto negativo sobre la fuerza de trabajo en el sector sanitario. Factores como los turnos rotatorios, mal ambiente laboral, bajo de nivel de autonomía o estar soltero o divorciado son algunos de los muchos agentes que aumentan el riesgo de padecer depresión. Objetivos: Aunque la depresión ha sido ampliamente estudiada, en la literatura actual los estudios realizados entre la depresión y la enfermería son relativamente escasos. Por lo tanto, el presente estudio será un esfuerzo para abordar esta cuestión y tendrá un doble propósito: determinar los niveles de depresión existentes entre las enfermeras del Servicio de Urgencias y de Cirugía General del Hospital de Galdakao y comparar los niveles de depresión entre las unidades anteriormente citadas. Metodología: Para ello se realizará un estudio descriptivo observacional de prevalencia. La población a estudio estará formada por los profesionales de enfermería que trabajan en las unidades de Urgencias y Cirugía General del Hospital de Galdakao. El instrumento que se utilizara para la recogida de datos será el Inventario de Depresión Beck (BDI) y el análisis estadístico se llevará a cabo mediante el programa informático SPSS.

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La enfermedad de Crohn (EC) es un proceso inflamatorio crónico del aparato digestivo, principalmente de origen desconocido pero con factores genéticos y ambientales que aumentan el riesgo de padecerla. Algunas personas presentan períodos prolongados de remisión, que alternan con fases de actividad (brote), mientras que otros padecen síntomas continuos durante años a pesar de recibir un tratamiento adecuado. Los signos y síntomas comunes incluyen dolor abdominal, diarrea, fiebre y pérdida de peso, pudiendo afectar a personas de cualquier edad, aunque la mayoría de los pacientes son adultos jóvenes entre los 16 y los 40 años. No existe una “cura” para esta enfermedad, sin embargo, la terapia médica permite la remisión clínica de la patología y alivio de síntomas, aumentando la calidad de vida del paciente. Actualmente se recurre a un nuevo grupo de fármacos conocidos como agentes biológicos, ante pacientes que no responden a tratamiento médico convencional, que se utilizan para inducir y/o mantener la remisión. Siendo la EC una patología crónica que afecta a un número significativo de personas, cuya calidad de vida puede verse mermada profundamente, se propone un plan de cuidados individualizado (PCI) para un caso clínico de un paciente con la EC con el objetivo de fomentar la calidad de vida de estas personas. Este plan de cuidados se apoya en el modelo conceptual de Virginia Henderson (modelo de suplencia y ayuda) siguiendo una metodología enfermera (el proceso de atención de enfermería) y un lenguaje universal estandarizado mediante la interrelación de las taxonomías NANDA-I, NIC, NOC.