Erros pré-analíticos em anatomia patológica : prevalência, caracterização e consequências para a segurança do doente

RESUMO - A literatura disponível revela que a maioria dos erros relacionados com os exames anatomopatológicos ocorre na fase pré-analítica. Existem alguns estudos que quantificam e caracterizam estes erros mas, não foram encontrados artigos publicados sobre o tema em hospitais portugueses. Foi objetivo deste estudo determinar qual a prevalência e características dos erros pré-analíticos em amostras anatomopatológicas e as suas consequências para a segurança do doente. Analisaram-se 10574 casos de exames anatomopatológicos, de cinco hospitais da região de Lisboa e Vale do Tejo. Os serviços de anatomia patológica registaram e caracterizaram, durante vinte dias, erros detetados nas amostras anatomopatológicas com origem nos serviços requisitantes. Posteriormente os hospitais foram caracterizados quanto aos procedimentos relativos à fase pré-analítica. A prevalência de erros aferida foi de 3,1% (n=330), com um intervalo de confiança a 95% compreendido entre os valores 2,8% e 3,5%. Para além destes resultados destacam-se os seguintes pontos: i. As amostras histológicas têm 4,1% de prevalentes e as de citologia 0,9%; ii. Foram registados erros em 2,6% das requisições e em 1,5% dos contentores com as amostras; iii. A aceitação dos casos com erro é a ação mais frequente (66,9%), seguida pela devolução (24,4%) e retenção (8,7%); iv. Os hospitais com sistemas de notificação de erros e normas escritas para aceitação de amostras têm menor prevalência de erros; v. O impacte dos erros detetados na segurança dos doentes é difícil de determinar, sendo que os mais críticos relacionam-se com amostras devolvidas a fresco, meio de colheita inadequado ou com amostras danificadas. Este estudo permitiu determinar a prevalência e caracterizar os erros pré-analíticos envolvendo amostras anatomopatológicas em hospitais portugueses. Reflete a dimensão atual do problema e efetua recomendações para a sua mitigação. A prevalência de erros encontrada é inferior às publicadas em estudos semelhantes.

Logoplaste: Internationalization to South Africa through flexible packaging

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Logoplaste: Implementation of flexible packaging technology and internationalization to Nigeria

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Strategy of Logoplaste in Mozambique's flexible plastic packaging industry

Logoplaste is a specialist in operating in-house industrial sites for manufacturing rigid plastic packaging containers. In developing countries, especially in Africa, the low income of consumers does not allow a widespread adoption of products typically sold in rigid plastic containers. In these countries the flexible packages are usually adopted as they allow for better ratios of cost/litter of product, particularly in smaller packages. Should Logoplaste offer this type of technology in order to expand into developing countries?

Viscofan SA: Equity research

UNL - NSBE

Daniel D. Tompkins letter to General Dearborn, June 28, 1812.

Transcript [original spelling and grammar retained]: Albany June 28 1812 Sir Your letter of the 23d has been received. I had anticipated your request by ordering the detachment from Washington, Essex, Clinton and Franklin Counties into service and have fixed the days and places of their Rendezvous. Upon application to the quarter master General I find there are but 139 tents & 60 camp kettles at this place & even those I take by a kind of stealth. The Deputy Quarter Master General declines giving an order for their delivery until he shall have a written order from the Quarter Master General, and the latter is willing I Shall take them but will not give the Deputy a written order for that purpose. Under Such circumstances I shall avail myself of the rule of Possession and by virtue of the Eleven Points of Law Send them tomorrow morning without a written order from anyone. You may remember that when you were Secretary of the war department I invited you to forward and deposit in our Frontier Arsenals, arms ammunition and camp equipage free of expense to be ready in case of war and the same invitation to the war department has been repeated some time, Since The United States have now from 5 to 600 regular troops at Plattsburgh, Rome, Canandaigua & c, where those arsenals are, and yet those recruits are now and must be for weeks to come unarmed and unequipped in every respect although within musket Shot of arsenals. The recruits at Plattsburgh are within 50 miles of two tribes of Canadian Indians. In case of an attack upon the Frontiers that portion of the United States army would be as inefficient and unable to defend the inhabitants or themselves even. The Militia Detachments on the Western Frontiers received the news of war with [cherafulness] and determined courage, and I am happy to find they are united late brothers, highly improved in Discipline & ready to devote themselves to any Service or danger which the good of the Country may require. But they are in barracks from which they cannot move a days march for the want of tents and other equipage, and they are in Separate and Independent Detachments without a General Officer to command them or combine their exertions for the accomplishment of any desirable and important object. The only officer of the United States here who can do anything is the Quarter Master General and he has not a tent Camp Kettle or Knapsack in this arsenal except what I have concluded to send off tomorrow morning as above mentioned to furnish men As to Cannon Muskets and Ammunition. I can find now one here who will exercise any authority over them or deliver a Single article upon my requisition. Neither can I find any Officer of the army who feel himself authorized to exercise any authority or do any act which will aid me in the all important object of protecting the Inhabitants of an extended Frontier exposed to the Cruelties of Savages and the depredations of the enemy. If I must rely upon the Militia Solely for Such protection I entreat you to give orders to your Officers to furnish upon my orders, for the use of the Militia Detachments , all needful weapons and articles with which the United States are Supplied and of which we are destitute . You may rely upon all the assistance which my talents, influence or authority can furnish in the active prosecution of the first & necessary way which has been declared by the Constituted Authorities of our beloved Country. I am, Sir, respectfully Your ob. Servt. Daniel D. Tompkins

Packaging materials for shrimp, fish and fish products, their properties, selection and effect of different packaging materials on their shelf life

Packaging is important not only in extending the shellife of fish and fishery products but also improving their marketability. In the recent years, significant development have taken place in the packaging industry. During the past decade in India, there is almost a packaging revolution with the availability of variety packaging materials, thus generating better packaging consciousness in other producer/manufacturing industries. But unfortunately, such realisation is not forthcoming in the fisheries sector and packaging techniques for local and export trade continues to be on traditional lines with their inherent drawbacks and limitations. Better packaging ensures improved quality and presentation of the products and ensures higher returns to the producer. Among several packaging materials used in fishery industry, ISI specifications had been formulated only for corrugated fibre board boxes for export of seafoods and froglegs. This standard was formulated before containersiation came into existance in the export of marine products. Before containerisation, the standards were stringent in view of the rough handling, transportation and storage. Two of the common defects reported in the master cartons exported from India are low mechanical strength and tendency to get wet. They are weakened by the deposits of moisture caused by temperature fluctuations during loading, unloading and other handling stages. It is necessary to rectify the above defects in packaging aquatic products and hence in the present study extensive investigations are carried out to find out the reasons for the damage of master cartons, to evolve code of practice for the packaging oi frozen shrimp for exports, development of alternative style of packaging for the shipping container, development of suitable consumer packaging materials for fish soup powder, cured dried mackeral, fish pickles in oil and frozen shrimp. For the development of suitable packaging materials, it is absolutely essential to know the properties of packaging materials, effect of different packaging materials on theirshelf life and their suitability for food contact applications.

Polypropylene/metal oxide nanocomposites: fiber spinning and evaluation”

PP has been getting much attention over the years because it is a very durable polymer commonly used in aggressive environments including automotive battery casings, fuel containers etc. They are used to make bottles, fibers for clothing, components in cars etc. However, it has some shortcomings such as low dimensional and thermal stability. Materials such as metal oxides with sizes of the order 1–50 nm have received a great deal of attention because of their versatile applications in polymer/ inorganic nanocomposites, optoelectronic devices, biomedical materials, and other areas. They are stable under harsh process conditions and also regarded as safe materials to human beings and animals. In the present investigation, PP is modified by incorporating metal oxide nanoparticles such as ZnO and TiO2 by simple melt mixing method. Melt spinning method was used to prepare PP/metal oxide nanocomposite fibers. Various studies have been carried out on these composites and fibers. In the first part of the study, ZnO nanoparticles were prepared from ZnCl2 and NaOH in presence of chitosan, PVA, ethanol and starch. This is a simple and inexpensive method compared to other methods. Change in morphology and particle size of ZnO were studied. Least particle size was obtained in chitosan medium. The particles were characterized by using XRD, SEM, TEM, TGA and EDAX. Antibacterial properties of ZnO prepared in chitosan medium (NZO) and commercial zinc oxide (CZO) were evaluated using a gram positive and a gram negative bacteria

‘Studies on some topics in product graphs’

For routing problems in interconnection networks it is important to find the shortest containers between any two vertices, since the w-wide diameter gives the maximum communication delay when there are up to w−1 faulty nodes in a network modeled by a graph. The concept of ‘wide diameter’ was introduced by Hsu [41] to unify the concepts of diameter and The concept of ‘domination’ has attracted interest due to its wide applications in many real world situations [38]. A connected dominating set serves as a virtual backbone of a network and it is a set of vertices that helps in routing. In this thesis, we make an earnest attempt to study some of these notions in graph products. This include, the diameter variability, the diameter vulnerability, the component factors and the domination criticality.connectivity

Cereal/legume rotation effects on rhizosphere bacterial community structure in West African soils

The increased use of cereal/legume crop rotation has been advocated as a strategy to increase cereal yields of subsistence farmers in West Africa, and is believed to promote changes in the rhizosphere that enhance early plant growth. In this study we investigated the microbial diversity of the rhizoplane from seedlings grown in two soils previously planted to cereal or legume from experimental plots in Gaya, Niger, and Kaboli, Togo. Soils from these legume rotation and continuous cereal plots were placed into containers and sown in a growth chamber with maize (Zea mays L.), millet (Pennisetum glaucum L.), sorghum (Sorghum bicolor L. Moench.), cowpea (Vigna unguiculata L.) or groundnut (Arachis hypogaea L.). At 7 and 14 days after sowing, 16S rDNA profiles of the eubacterial and ammoniaoxidizing communities from the rhizoplane and bulk soil were generated using denaturing gradient gel electrophoresis (DGGE). Community profiles were subjected to peak fitting analyses to quantify the DNA band position and intensities, after which these data were compared using correspondence and principal components analysis. The data showed that cropping system had a highly significant effect on community structure (p <0.005), irrespective of plant species or sampling time. Continuous cereal-soil grown plants had highly similar rhizoplane communities across crop species and sites, whereas communities from the rotation soil showed greater variability and clustered with respect to plant species. Analyses of the ammonia-oxidizing communities provided no evidence of any effects of plant species or management history on ammonia oxidizers in soil from Kaboli, but there were large shifts with respect to this group of bacteria in soils from Gaya. The results of these analyses show that crop rotation can cause significant shifts in rhizosphere bacterial communities.

Estudio de factibilidad de exportación de quinua elaborada como alimento

En el actual mundo cambiante, la forma de pensar y la cultura de las personas se transforman a gran velocidad. Dentro de estos cambios se incluye la cultura alimenticia de las personas, pues hoy en día se observa un creciente porcentaje de personas que se preocupan por tener una alimentación balanceada y muchos buscan mantener este equilibrio en productos que brinden la mayor cantidad de nutrientes para mantenerse bien física y saludablemente. Mediante ésta investigación se busca explorar las posibilidades de producción y exportación de la quinua con el fin de promocionar y fomentar el cuidado de la salud. Se busca producir quinua y transformarla en producto terminado en forma de barra de cereal, logrando reunir los requerimientos nutricionales que los consumidores buscan hoy en día y aprovechando al máximo las condiciones climáticas que tiene un país como Colombia que hace parte de la región Andina, terreno originario de la quinua.

Impacto del proceso de eliminación del doble conteo del material importado por Carbones del Cerrejón Limited en términos de eficiencia y efectividad en el proceso de nacionalización y liberación del material

La operación de mega minería que abarca CERREJON se desarrolla bajo lo más altos estándares de seguridad y calidad, con el compromiso de entregar al mercado un excelente producto y evitando el deterioro del entorno. Uno de los puntos más fuertes de la compañía se haya en la integración de los procesos productivos entre la mina de carbón, el ferrocarril y el puerto, logrando que la operación sea eficiente y que garantice niveles altos de óptimos resultados y que los porcentajes de falla no existan o cada vez sean menores en el proceso de explotación y transporte del carbón de Colombia hacia el mundo. El departamento de MATERIALES es el punto de origen para garantizar que se desarrolle la operación, dado que el departamento tiene la gran labor de adquirir y entregar los bienes y servicios requeridos por la Compañía al más bajo costo total evaluado, en el menor tiempo posible y bajo el marco de la legislación Colombiana en el proceso de nacionalización, con un alto énfasis en el desarrollo de relaciones fuertes y sinérgicas entre todos los eslabones de la cadena. Todo el proceso del departamento se enmarca dentro de un ciclo que debe encaminarse a ser cada vez más efectivo y eficiente; de allí que se busquen opciones de mejoramiento para afinar los procesos. Para que sea posible y factible manejar una mega operación como esta se requiere afinar al máximo la red que se establece en su cadena de abastecimiento, buscando lograr un flujo de producto, información y fondos que garanticen disponibilidad del producto, para así generar una rentabilidad alta a la compañía, y controlar los costos por la operación. Dado que la cadena de suministro es susceptible a mejoras, gracias a la interacción con los proveedores, colaboradores y clientes; se pretende sacar el mejor provecho de esto, a través del análisis de la cadena actual de CERREJON; presentando una opción de mejora en uno de los eslabones del proceso productivo, esta opción ha sido contemplada desde años anteriores, pero en esta ocasión gracias a la integración de afinamientos en los sistemas de información, y la participación activa de los proveedores, se encuentra una opción viable de la eliminación de un reproceso, que garantiza eficiencia y efectividad en la agilización del ciclo de producción en CERREJON. A través de la ejecución del proyecto de reforma del conteo, se presenta la oportunidad de mejoramiento en la cadena del departamento; el proceso de reconteo en la mina, realizado posteriormente al conteo inicial en Puerto Bolívar, de los materiales que llegan importados vía marítima. El proceso de afinamiento del recibo documental en el consolidador de carga y los mayores proveedores de entrega directa (HITACHI y MCA) al transportador, genera la opción del uso de terminales portátiles, que de la mano con los ajustes documentales, permitirán que la carga sea contada y separada por localización, para enviarla vía tren a LMN, reduciendo tiempo de entrega al cliente final, los costos de remanejo al volver a contar, y los costos asociados a las entregas no oportunas de devolución de contenedores.

Asignación estratégica de un modelo de logística inversa aplicado a los envases de pintura

El presente proyecto de investigación tuvo como principal objetivo resaltar la importancia de la responsabilidad social empresarial en el marco del desarrollo sostenible, unificando estrategias de logística inversa con modelos que permitirán cerrar el ciclo de vida útil de los envases de las mas prestigiosas compañías colombianas; líderes en el sector químico, mas exactamente de pinturas. Al ver la oportunidad del proyecto, en este se analizaron a grandes rasgos, los procesos inmersos en la producción, distribución y comercialización de las pinturas en el país para así poder llegar al cliente final quien se convirtió tanto en la fuente principal para la recolección de los residuos solidos generados como en el precursor de interrogantes y retos sobre cuales y como deberían ser atacadas las problemáticas sociales y ambientales que se originaban en la post-venta de dichos productos. De lo contrario, no se hubiera podido reflejar la importancia que tenia el proyecto en la búsqueda de soluciones a la problemática ambiental por la que atraviesa nuestro planeta. Problemática que debía ser atacada con iniciativas como estas que buscan disminuir y/o evitar la contaminación a recursos naturales existentes y en extinción. La recolección de envases contaminados y sus respectivas estrategias de reutilización, reciclaje y disposición final, acompañados de estrategias comerciales, ambientales y sociales de la empresa que seria creada para llevar a cabo esta tarea. Fueron los principales temas que se desarrollaron en el presente proyecto.

Modelo de gestión cultural para el arte itinerante con ciencia y tecnología

Diseñar un modelo de gestión cultural que busca llevar el arte, la ciencia y la tecnología a distintas regiones y ciudades del país, iniciando en la ciudad de Tunja, por medio de una exposición itinerante que vincule estos tres campos de una manera transversal con el fin de acercar a los distintos públicos a experiencias vivenciales de aprendizajes, interacción y exploración. Estas experiencias tendrán lugar por medio de contenedores.

Alternativa productiva para el aprovechamiento del residuo cachaza

Este trabajo de investigación, busca ofrecer al sector panelero de Colombia nuevas estrategias eco-eficientes y amigables con el medio ambiente, en pro de fortalecer las buenas prácticas agrícolas, que contribuyan con la gestión óptima de los residuos que se crean alrededor de la cadena de producción de la panela. Teniendo en cuenta que la obtención de desechos tanto orgánicos como inorgánicos, genera un impacto medioambiental negativo, se pudo identificar una de estas fuentes de contaminación, a través de un proceso de observación. Ésta es conocida como la Cachaza, la cual se genera dentro de un procedimiento denominado Limpieza del Dulce de Caña. Inicialmente, la caña se muele a través de una trituradora que exprime dulce sin tratamiento, el cual pasa por un ducto hasta regarse sobre una primera paila, donde se le aplica balso. Por medio del calor que produce una hornilla sobre la que se coloca dicha paila, se realiza un proceso de separación, el residuo consolidado en una espuma espesa, comienza a flotar por encima del dulce, siendo extraída a medida que va saliendo y depositada en otros recipientes. Considerando constantes prácticas como el vertimiento de la Cachaza sobre algunas fuentes hídricas (ríos, lagunas, etc.) y cultivos de caña ya fermentados (que elaboran nutrientes negativos sobre los mismos); se profundizará sobre los diferentes impactos ambientales que se originan en éste proceso agroindustrial. El objetivo principal del presente trabajo de investigación, consiste en la implementación de un proyecto de logística inversa, formulando estrategias para el procesamiento de la Cachaza a implementar en un trapiche de la zona de Rio negro a fin de reutilizar este residuo generando subproductos que aporten a la mitigación del impacto ambiental, dando así un valor agregado a toda la cadena. Mediante un análisis costo beneficio se evaluará qué tan fácil o difícil resulta la implementación de dicho proyecto, el cual al incluir un proceso adicional a la cadena de producción de la panela generara un suplemento alimenticio para los equinos y aprovechara el 100% de sus residuos a muy bajo costo.