Determinantes de la gestión clínica en atención médica domiciliaria de personas con secuelas de enfermedad cerebro-vascular

La atención domiciliaria constituye hoy una modalidad de atención que permite solventar las dificultades derivadas de la sobreocupación hospitalaria y la cronicidad, los cuales constituyen un problema de interés en salud pública en los países desarrollados y que pueden ser manejados en el domicilio del paciente como una opción costo-efectiva y segura. Para lo cual es necesario buscar estrategias que permitan su desarrollo, gestión de riesgos y modelos de atención, logrando mejorar las condiciones de salud de la población. Uno de los principales retos de la gestión de programas de atención en salud, se encuentra en definir los aspectos donde intervenir para potenciar la eficacia y la calidad en la prestación del servicio, por lo que dichos aspectos se constituyen como determinantes de la atención del paciente y su familia. En este documento se abordan los principales determinantes en la atención de personas con secuelas de Enfermedad cerebrovascular, que reciben manejo medico domiciliario, con el objetivo de identificar las áreas prioritarias de intervención, garantizando una mejor gestión clínica en tres áreas específicas: sobrecarga del cuidador, Polimedicación y ulceras por decúbito.

Propuesta académica para la Universidad del Rosario: Maestría en Administración Deportiva

Consiste en la propuesta de un programa de maestría para la Universidad Del Rosario en Administración Deportiva. Esto teniendo en cuenta el espacio para la profesionalización de este campo en el país

Ús de qüestionaris en la docència d'ecologia i la seva anàlisi mitjançant la plataforma Moodle

Durant el curs 2009/10, la Universitat de Girona ha implantat la plataforma virtual interactiva Moodle, adaptada a la formació i emprada pel professorat com a suport a la tasca docent. Aquesta plataforma ofereix la possibilitat de crear nous recursos, alguns dels quals enfocats a l’avaluació de l’aprenentatge. Com qualsevol pràctica educativa, aquests recursos han de ser sotmesos a processos d’anàlisi i revisió orientats a la seva millora, processos de metaavaluació (avaluar les avaluacions) els quals han de permetre detectar contradiccions i introduir canvis que contribueixin la millora dels recursos produïts i, de retruc, del procés d’avaluació

Sistema web per al préstec de DVD en col·lectius tancats

Aquest projecte de final de carrera sorgeix com a resposta a una necessitat existent dins de col•lectius laborals i docents de compartir documents i recursos. Per tal d’estabilitzar un sistema d’intercanvi que funcioni, és important que els préstecs siguin àgils i estiguin gestionats per un bon sistema. El projecte “Sistema web per al préstec de DVD en col•lectius tancats” té la finalitat de permetre als membres d’un col•lectiu tancat d’utilitzar un servei de préstecs de DVD via web. Aquest sistema facilita i gestiona l’intercanvi de DVD entre els usuaris del col•lectiu que estiguin registrats. La base de dades del conjunt dels DVD la formen els DVD que els mateixos usuaris registrats posen a disposició dels altres membres. Pel que fa a la gestió, el sistema incorpora un sistema automàtic d’enviament de correus electrònics i un gestor de temps per evitar que els préstecs no s’allarguin en excés. També està dotat de mesures de seguretat que garanteixen la privacitat als usuaris.

Generador d'horaris d'un centre docent

El projecte intenta resoldre el problema que suposa organitzar l'horari escolar en els centres docents. S'usa el Visual Bàsic per aconseguir, omplir i mostrar el contingut d’una base de dades feta amb Microsoft Access. Per generar el resultat, s'utilitza el llenguatge de programació lògica Prolog, el qual en ser un llenguatge declaratiu i utilitzant una llibreria de restriccions que permet fer modificacions d’una forma molt versàtil, aconsegueix un entorn de programació ideal per atacar aquest tipus de problema. Amb una interacció del Visual Bàsic amb el Prolog es pot mostrar d’una manera elegant i fàcil d’entendre el resultat obtingut

Inferring population history with DIY ABC: a user-friendly approach to approximate Bayesian computation

Genetic data obtained on population samples convey information about their evolutionary history. Inference methods can extract part of this information but they require sophisticated statistical techniques that have been made available to the biologist community (through computer programs) only for simple and standard situations typically involving a small number of samples. We propose here a computer program (DIY ABC) for inference based on approximate Bayesian computation (ABC), in which scenarios can be customized by the user to fit many complex situations involving any number of populations and samples. Such scenarios involve any combination of population divergences, admixtures and population size changes. DIY ABC can be used to compare competing scenarios, estimate parameters for one or more scenarios and compute bias and precision measures for a given scenario and known values of parameters (the current version applies to unlinked microsatellite data). This article describes key methods used in the program and provides its main features. The analysis of one simulated and one real dataset, both with complex evolutionary scenarios, illustrates the main possibilities of DIY ABC.

In-service and pre-service teachers' opinion on the use of models in teaching chemistry

The presented study examined the opinion of in-service and prospective chemistry teachers about the importance of usage of molecular and crystal models in secondary-level school practice, and investigated some of the reasons for their (non-) usage. The majority of participants stated that the use of models plays an important role in chemistry education and that they would use them more often if the circumstances were more favourable. Many teachers claimed that three-dimensional (3d) models are still not available in sufficient number at their schools; they also pointed to the lack of available computer facilities during chemistry lessons. The research revealed that, besides the inadequate material circumstances, less than one third of participants are able to use simple (freeware) computer programs for drawing molecular structures and their presentation in virtual space; however both groups of teachers expressed the willingness to improve their knowledge in the subject area. The investigation points to several actions which could be undertaken to improve the current situation.

Jpowder: a Java-based program for the display and examination of powder diffraction data

The ability to display and inspect powder diffraction data quickly and efficiently is a central part of the data analysis process. Whilst many computer programs are capable of displaying powder data, their focus is typically on advanced operations such as structure solution or Rietveld refinement. This article describes a lightweight software package, Jpowder, whose focus is fast and convenient visualization and comparison of powder data sets in a variety of formats from computers with network access. Jpowder is written in Java and uses its associated Web Start technology to allow ‘single-click deployment’ from a web page, http://www.jpowder.org. Jpowder is open source, free and available for use by anyone.

Transdifferential and transintegral calculus

The set of transreal numbers is a superset of the real numbers. It totalises real arithmetic by defining division by zero in terms of three def- inite, non-finite numbers: positive infinity, negative infinity and nullity. Elsewhere, in this proceedings, we extended continuity and limits from the real domain to the transreal domain, here we extended the real derivative to the transreal derivative. This continues to demonstrate that transreal analysis contains real analysis and operates at singularities where real analysis fails. Hence computer programs that rely on computing deriva- tives { such as those used in scientific, engineering and financial applica- tions { are extended to operate at singularities where they currently fail. This promises to make software, that computes derivatives, both more competent and more reliable. We also extended the integration of absolutely convergent functions from the real domain to the transreal domain.

Transreal limits expose category errors in IEEE 754 floating-point arithmetic and in mathematics

The IEEE 754 standard for oating-point arithmetic is widely used in computing. It is based on real arithmetic and is made total by adding both a positive and a negative infinity, a negative zero, and many Not-a-Number (NaN) states. The IEEE infinities are said to have the behaviour of limits. Transreal arithmetic is total. It also has a positive and a negative infinity but no negative zero, and it has a single, unordered number, nullity. We elucidate the transreal tangent and extend real limits to transreal limits. Arguing from this firm foundation, we maintain that there are three category errors in the IEEE 754 standard. Firstly the claim that IEEE infinities are limits of real arithmetic confuses limiting processes with arithmetic. Secondly a defence of IEEE negative zero confuses the limit of a function with the value of a function. Thirdly the definition of IEEE NaNs confuses undefined with unordered. Furthermore we prove that the tangent function, with the infinities given by geometrical con- struction, has a period of an entire rotation, not half a rotation as is commonly understood. This illustrates a category error, confusing the limit with the value of a function, in an important area of applied mathe- matics { trigonometry. We brie y consider the wider implications of this category error. Another paper proposes transreal arithmetic as a basis for floating- point arithmetic; here we take the profound step of proposing transreal arithmetic as a replacement for real arithmetic to remove the possibility of certain category errors in mathematics. Thus we propose both theo- retical and practical advantages of transmathematics. In particular we argue that implementing transreal analysis in trans- floating-point arith- metic would extend the coverage, accuracy and reliability of almost all computer programs that exploit real analysis { essentially all programs in science and engineering and many in finance, medicine and other socially beneficial applications.

The use of ICT by adults with learning disabilities in day and residential services

The use of Information and Communication Technology (ICT) by adults with learning disabilities has been positively promoted over the past decade. More recently, policy statements and guidance from the UK government have underlined the importance of ICT for adults with learning disabilities specifically, as well as for the population in general, through the potential it offers for social inclusion. The aim of the present study was to provide a picture of how ICT is currently being used within one organisation providing specialist services for adults with learning disabilities and more specifically to provide a picture of its use in promoting community participation. Nine day and 14 residential services were visited as part of a qualitative study to answer three main questions: What kinds of computer programs are being used? What are they being used for? Does this differ between day and residential services? Computers and digital cameras were used for a wide range of activities and ‘mainstream’ programs were used more widely than those developed for specific user groups. In day services, ICT was often embedded in wider projects and activities, whilst use in houses was based around leisure interests. In both contexts, ICT was being used to facilitate communication, although this was more linked to within-service activities, rather than those external to service provision.

P-T-Fluid evolution and graphite deposition during retrograde metamorphism in Ribeira Fold Belt, SE Brazil: Oxygen fugacity, fluid inclusions and C-O-H isotopic evidence

Combined fluid inclusion (FI) microthermometry, Raman spectroscopy, X-ray diffraction, C-O-H isotopes and oxygen fugacities of granulites from central Ribeira Fold Belt, SE Brazil, provided the following results: i) Magnetite-Hematite fO(2) estimates range from 10(-11.5) bar (QFM + 1) to 10(-18.3) bar (QFM - 1) for the temperature range of 896 degrees C-656 degrees C, implying fO(2) decrease from metamorphic peak temperatures to retrograde conditions; ii) 5 main types of fluid inclusions were observed: a) CO(2) and CO(2)-N(2) (0-11 mol%) high to medium density (1.01-0.59 g/cm(3)) FI; b) CO(2) and CO(2)-N(2) (0-36 mol%) low density (0.19-0.29 g/cm(3)) FI; c) CO(2) (94-95 mol%)-N(2) (3 mol%)-CH(4) (2-3 mol%)-H(2)O (water phi(v) (25 degrees C) = 0.1) FI; d) low-salinity H(2)O-CO(2) FI; and e) late low-salinity H(2)O FI; iii) Raman analyses evidence two graphite types in khondalites: an early highly ordered graphite (T similar to 450 degrees C) overgrown by a disordered kind (T similar to 330 degrees C); iv) delta(18)O quartz results of 10.3-10.7 parts per thousand, imply high-temperature CO(2) delta(18)O values of 14.4-14.8 parts per thousand, suggesting the involvement of a metamorphic fluid, whereas lower temperature biotite delta(18)O and delta D results of 7.5-8.5 parts per thousand and -54 to -67 parts per thousand respectively imply H(2)O delta(18)O values of 10-11 parts per thousand and delta D(H2O) of -23 to -36 parts per thousand suggesting delta(18)O depletion and increasing fluid/rock ratio from metamorphic peak to retrograde conditions. Isotopic results are compatible with low-temperature H(2)O influx and fO(2) decrease that promoted graphite deposition in retrograde granulites, simultaneous with low density CO(2), CO(2)-N(2) and CO(2)-N(2)-CH(4)-H(2)O fluid inclusions at T = 450-330 degrees C. Graphite delta(13)C results of -10.9 to -11.4 parts per thousand imply CO(2) delta(13)C values of -0.8 to -1.3 parts per thousand suggesting decarbonation of Cambrian marine carbonates with small admixture of lighter biogenic or mantle derived fluids. Based on these results, it is suggested that metamorphic fluids from the central segment of Ribeira Fold Belt evolved to CO(2)-N(2) fluids during granulitic metamorphism at high fO(2), followed by rapid pressure drop at T similar to 400-450 degrees C during late exhumation that caused fO(2) reduction induced by temperature decrease and water influx, turning carbonic fluids into CO(2)-H(2)O (depleting biotite delta(18)O and delta D values), and progressively into H(2)O. When fO(2) decreased substantially by mixture of carbonic and aqueous fluids, graphite deposited forming khondalites. (C) 2010 Elsevier Ltd. All rights reserved.

Mineralogical and microthermometric studies and structural aspects of imperial topaz mineralization in Antonio Pereira, Ouro Preto District (Minas Gerais) - Brazil

The occurrences of imperial topaz in the Antonio Pereira mine, Ouro Preto, Minas Gerais, are associated with the metamorphic carbonate rocks of the Minas Supergroup. The crystals have densities varying from 3.46 to 3.58. The parameters of the unitary cells obtained were: 4.658 to 4.663 angstrom (ao), 8.823 to 8.832 angstrom (b(o)), 8.382 to 8.389 angstrom (c(o)), and 344.65 to 345.46 angstrom 3 (V). The refraction indices presented the following variations: 1.622 to 1.630 (nX), 1.624 to 1.632 (nY), 1.633 to 1.640 (nZ), and 0.008 to 0.011 (B). These properties are coherent with the low fluorine contents obtained (16,48%/17,05wt%). Infrared spectroscopy and microthermometry showed that the fluid inclusions, which represent the mineralizing fluids, are formed by H(2)O (with Ca(2+), Mg(2+) and Na(+)), and CO(2) +/- CH(4). The minimal trapping T-P conditions of 290/320 degrees C and 2,349/2,497bar were obtained for the primary fluid inclusions. The pseudo-secondary fluid inclusions were trapped at conditions of lower temperatures and variable pressures, during the deformation process under local alternating states of stress. The microthermometric studies, the structural analysis and the fluorine contents suggest that the mineralized veins were formed from hydrothermal fluids originated during the Brasiliano tectono-metamorphic event.

Análise dinâmica de vigas assimétricas em curva com parede fina e aberta submetidas a ação de carga móveis

Fundamentalmente, o presente trabalho faz uma análise elástica linear de pontes ou vigas curvas assimétricas de seção transversal aberta e de parede fina, com propriedades físicas, geométricas e raio de curvatura constantes ao longo do eixo baricêntrico. Para tanto, utilizaram-se as equações diferenciais de VLASOV considerando o acoplamento entre as deformações nas direções vertical, transversal, axial de torcão nal. Na solução do sistema de quatro equações com derivadas parciais foi utilizado um apropriado método numérico de integração (Diferenças Finitas Centrais). A análise divide-se, basicamente, em dois tipos: análise DINÂMICA e ESTATICA. Ambas são utilizadas também na determinação do coeficiente de impacto (C.M.D.). A primeira refere-se tanto na determinação das características dinâmicas básicas (frequências naturais e respectivos modos de vibração), como também na determinação da resposta dinâmica da viga, em tensões e deformações, para cargas móveis arbitrárias. Vigas com qualquer combinação das condições de contorno, incluindo bordos rotulados e engastados nas três direções de flexão e na torção, são consideradas. 0s resultados da análise teórica, obtidos pela aplicação de programas computacionais implementados em microcomputador (análise estática) e no computador B-6700 (análise dinâmica), são comparados tanto com os da bibliografia técnica como também com resultados experimentais, apresentando boa correlação.

A influência cultural na distância entre o discurso da qualidade total e a prática gerencial em instituições de ensino superior

O estudo procura identificar a influência cultural na distància entre o discurso do programa de Gestão pela Qualidade Total (GQT) e a prática gerencial de uma Instituição de Ensino Superior Caso (lESC), pois parecia haver uma incongruência entre os valores verbalmente expressos pela administração, compartilhados pelo conjunto dos colaboradores, e as práticas observadas na organização. Ou seja, havia uma lógica na articulação da prática gerencial que era incompatível com a lógica dos valores verbalmente expressos. Se acreditarmos, como Geertz (1989), que a análise do fenômeno cultural deve estar calcada sobre a observação do fluxo do comportamento, no qual cada ação é vista como uma ação simbólica, importa analisar fundamentalmente estas ações em seu contexto para compreender seu significado, e buscar então uma explicação para o fato destas práticas estarem incongruentes com o discurso. Para isto foram utilizados observações, entrevistas e questionários na instituição analisada, o que possibilitou verificar que sua relação com o ambiente legitimou práticas gerenciais convergentes com o estilo gerencial brasileiro, sendo possível constatar a intluência cultural na distància entre o discurso adotado pela lESC e sua prática gerencial