Modelo para la implementación de procesos de Eco Innovación en el sector industrial Colombiano

El objetivo de este trabajo es presentar un modelo de implementación, aplicación y medición de diferentes procesos de eco-innovación al interior de una empresa. Para lograr este fin, se presenta una estructura donde se evalúan los procesos productivos del sector industrial colombiano y su relación con la eco-innovación, esto para realizar un filtro dentro de la propuesta y poder dirigir el proyecto a empresas idóneas para adoptar un modelo eco-innovador. Este modelo está basado en diferentes métodos de desarrollo de conceptos como lo son la innovación, el desarrollo sostenible y un término que en los últimos tiempos ha venido tomando fuerza dentro del sector empresarial mundial, el término Eco-amigable. Este término será entonces una base para la relación de los procesos productivos con la adaptación de la eco-innovación para generar un desarrollo sostenible referente al ambiente y un posicionamiento empresarial industrial dentro de un mercado altamente competitivo.

La sanità mediata: il rapporto medico-paziente dentro e fuori lo schermo televisivo

L’obiettivo di questa tesi è rilevare se e quanto i medical dramas abbiano contribuito a ridefinire conoscenze, aspettative e pratiche dei telespettatori/pazienti rispetto a questioni concernenti la salute e il loro ruolo all’interno della relazione medico-paziente. Grazie ad un lavoro di campo, fatto di questionari e interviste con utenti, operatori della sanità di Centro e Nord Italia e studenti di Medicina, sono state poi registrate le modalità di interazione che i protagonisti della scena della cura dichiarano di sperimentare quotidianamente. Ciò ha permesso di rendere conto delle trasformazioni più recenti della professione medica e di come viene elaborato oggi il sapere sulla malattia da parte dei soggetti implicati, fra tecnicismi, atteggiamenti difensivi, sfiducia e affidamento. La tesi restituisce anche alcune modalità sperimentali di interazione fra pazienti e medici, messe in atto in contesti locali, che testimoniano l’esigenza di approdare a un sapere partecipato delle relazioni di cura. Infine, raccogliendo la sfida posta dalle medical humanities, immagina un utilizzo del medical drama nella formazione degli studenti di medicina per l’apprendimento di competenze narrative necessarie ad una pratica medica più umana e efficace.

Impact of a self-developed planning and self-constructed navigation system on skull base surgery: 10 years experience

CONCLUSION: Our self-developed planning and navigation system has proven its capacity for accurate surgery on the anterior and lateral skull base. With the incorporation of augmented reality, image-guided surgery will evolve into 'information-guided surgery'. OBJECTIVE: Microscopic or endoscopic skull base surgery is technically demanding and its outcome has a great impact on a patient's quality of life. The goal of the project was aimed at developing and evaluating enabling navigation surgery tools for simulation, planning, training, education, and performance. This clinically applied technological research was complemented by a series of patients (n=406) who were treated by anterior and lateral skull base procedures between 1997 and 2006. MATERIALS AND METHODS: Optical tracking technology was used for positional sensing of instruments. A newly designed dynamic reference base with specific registration techniques using fine needle pointer or ultrasound enables the surgeon to work with a target error of < 1 mm. An automatic registration assessment method, which provides the user with a color-coded fused representation of CT and MR images, indicates to the surgeon the location and extent of registration (in)accuracy. Integration of a small tracker camera mounted directly on the microscope permits an advantageous ergonomic way of working in the operating room. Additionally, guidance information (augmented reality) from multimodal datasets (CT, MRI, angiography) can be overlaid directly onto the surgical microscope view. The virtual simulator as a training tool in endonasal and otological skull base surgery provides an understanding of the anatomy as well as preoperative practice using real patient data. RESULTS: Using our navigation system, no major complications occurred in spite of the fact that the series included difficult skull base procedures. An improved quality in the surgical outcome was identified compared with our control group without navigation and compared with the literature. The surgical time consumption was reduced and more minimally invasive approaches were possible. According to the participants' questionnaires, the educational effect of the virtual simulator in our residency program received a high ranking.

TELMA: Technology enhanced learning environment for minimally invasive surgery

Background: Cognitive skills training for minimally invasive surgery has traditionally relied upon diverse tools, such as seminars or lectures. Web technologies for e-learning have been adopted to provide ubiquitous training and serve as structured repositories for the vast amount of laparoscopic video sources available. However, these technologies fail to offer such features as formative and summative evaluation, guided learning, or collaborative interaction between users. Methodology: The "TELMA" environment is presented as a new technology-enhanced learning platform that increases the user's experience using a four-pillared architecture: (1) an authoring tool for the creation of didactic contents; (2) a learning content and knowledge management system that incorporates a modular and scalable system to capture, catalogue, search, and retrieve multimedia content; (3) an evaluation module that provides learning feedback to users; and (4) a professional network for collaborative learning between users. Face validation of the environment and the authoring tool are presented. Results: Face validation of TELMA reveals the positive perception of surgeons regarding the implementation of TELMA and their willingness to use it as a cognitive skills training tool. Preliminary validation data also reflect the importance of providing an easy-to-use, functional authoring tool to create didactic content. Conclusion: The TELMA environment is currently installed and used at the Jesús Usón Minimally Invasive Surgery Centre and several other Spanish hospitals. Face validation results ascertain the acceptance and usefulness of this new minimally invasive surgery training environment.

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Purpose: Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to five tasks included in SINERGIA laparoscopic virtual reality simulator. Methods: Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1–R8) of the five mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of R1, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value <0.005. Results: In total, 84.38% of the metrics provided by SINERGIA and included in this study show significant differences when comparing R1 and R8. Metrics are mostly improved in the first session of training (75.00% when R1 and R4 are compared vs. 37.50% when R4 and R8 are compared). In tasks Coordination and Navigation and touch, all metrics are improved. On the other hand, Navigation just improves 60% of the analyzed metrics. Most learning curves show an improvement with better results in the fulfillment of the different tasks. Conclusions: Learning curves of metrics that assess the basic psychomotor laparoscopic skills acquired in SINERGIA virtual reality simulator show a faster learning rate during the first part of the training. Nevertheless, eight repetitions of the tasks are not enough to acquire all psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program.

Research-to-Practice (R2P) Tools for Improving Safety in Nighttime Highway Construction Work Zones

The safety of workers in nighttime roadway work zones has become a major concern for state transportation agencies due to the increase in the number of work zone fatalities. During the last decade, several studies have focused on the improvement of safety in nighttime roadway work zones; but the element that is still missing is a set of tools for translating the research results into practice. This paper discusses: 1) the importance of translating the research results related to the safety of workers and safety planning of nighttime work zones into practice, and 2) examples of tools that can be used for translating the results of such studies into practice. A tool that can propose safety recommendations in nighttime work zones and a web-based safety training tool for workers are presented in this paper. The tools were created as a component of a five-year research study on the assessment of the safety of nighttime roadway construction. The objectives of both tools are explained as well as their functionalities (i.e., what the tools can do for the users); their components (e.g., knowledge base, database, and interfaces); and their structures (i.e., how the components of the tools are organized to meet the objectives). Evaluations by the proposed users of each tool are also presented.

Estructura formal, textual y oral del discurso público

Estructura formal, textual y oral del discurso públicoExisten tres competencias comunicativas muy valoradas en la sociedad de la información. Primero, la búsqueda, selección y gestión de grandes cantidades de información. Segundo, la redacción de textos claros, concisos y rigurosos. Y en tercer lugar, la exposición y defensa oral de esta información en un discurso público. Tradicionalmente, los estudios de periodismo han abordado estas competencias de forma independiente. Pero actualmente, instituciones y empresas de ámbitos diferentes demandan un perfil profesional capaz de aplicarlas ante cualquier tipo de información y con objetivos diversos. Se propone un modelo integral en tres niveles estructurales basado en teorías, conceptos y estudios específicos de periodismo, oratoria, retórica… o comunicación, en los últimos años. Este modelo puede contribuir a encauzar las investigaciones de académicos y representa una herramienta de entrenamiento para profesionales.

Exercise training as a preventive tool for age-related disorders: a brief review

Aging populations are a worldwide phenomenon affecting both developed and developing countries. This issue raises serious concerns for both governments and the general population. Regular participation in physical activity and/or exercise training programs can minimize the physiological alterations that occur during aging and may contribute to improvements in health and well-being. The present review will discuss the role of regular exercise training in preventing age-related physiological decline and, consequently, associated chronic diseases. Compelling evidence that regular exercise and/or physical activity can improve quality of life, prevent or control the development of chronic disease and increase life expectancy is shown. In summary, regular exercise training and/or physical activity has an important influence on aging and may help to prevent age-related disorders.

Rating of perceived exertion as a tool for prescribing and self regulating interval training: a pilot study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a study protocol

BACKGROUND The Cochrane risk of bias (RoB) tool has been widely embraced by the systematic review community, but several studies have reported that its reliability is low. We aim to investigate whether training of raters, including objective and standardized instructions on how to assess risk of bias, can improve the reliability of this tool. We describe the methods that will be used in this investigation and present an intensive standardized training package for risk of bias assessment that could be used by contributors to the Cochrane Collaboration and other reviewers. METHODS/DESIGN This is a pilot study. We will first perform a systematic literature review to identify randomized clinical trials (RCTs) that will be used for risk of bias assessment. Using the identified RCTs, we will then do a randomized experiment, where raters will be allocated to two different training schemes: minimal training and intensive standardized training. We will calculate the chance-corrected weighted Kappa with 95% confidence intervals to quantify within- and between-group Kappa agreement for each of the domains of the risk of bias tool. To calculate between-group Kappa agreement, we will use risk of bias assessments from pairs of raters after resolution of disagreements. Between-group Kappa agreement will quantify the agreement between the risk of bias assessment of raters in the training groups and the risk of bias assessment of experienced raters. To compare agreement of raters under different training conditions, we will calculate differences between Kappa values with 95% confidence intervals. DISCUSSION This study will investigate whether the reliability of the risk of bias tool can be improved by training raters using standardized instructions for risk of bias assessment. One group of inexperienced raters will receive intensive training on risk of bias assessment and the other will receive minimal training. By including a control group with minimal training, we will attempt to mimic what many review authors commonly have to do, that is-conduct risk of bias assessment in RCTs without much formal training or standardized instructions. If our results indicate that an intense standardized training does improve the reliability of the RoB tool, our study is likely to help improve the quality of risk of bias assessments, which is a central component of evidence synthesis.

Minimally invasive surgical video analysis: a powerful tool for surgical training and navigation

Analysis of minimally invasive surgical videos is a powerful tool to drive new solutions for achieving reproducible training programs, objective and transparent assessment systems and navigation tools to assist surgeons and improve patient safety. This paper presents how video analysis contributes to the development of new cognitive and motor training and assessment programs as well as new paradigms for image-guided surgery.