Análisis de la percepción de calidad en salud, aplicado al Hospital Universitario Mayor Méderi.

El presente trabajo nace del interés en las posibles diferencias que pueden llegar a presentarse dentro del Hospital Universitario Mayor Méderi, en torno a la calidad de servicio prestada por el centro médico, y la percepción de calidad percibida por el paciente.

Análisis de las implicaciones del ascenso chino en el escenario internacional

El presente trabajo nace del interés por la creciente influencia de China en el mundo, principalmente, gracias a su acelerado crecimiento económico de los últimos años y a un estricto sistema de regulación por parte del Estado. Teniendo en cuenta lo anterior, se decidió hacer un análisis de las diferentes esferas o el contexto en el que se ha desarrollado un país que pasaba desapercibido hasta hace poco y que en la actualidad es considerado como la próxima potencia mundial. Aquí se presentan características del territorio, la población, el idioma, la política, la economía y otros aspectos importantes para este estudio. Adicionalmente, se presentan cifras que permiten observar con mayor claridad su evolución a lo largo del tiempo, su contribución a la economía mundial, las acciones del gobierno, y su situación actual a nivel tecnológico, científico, militar, ambiental, entre otros. Es así como, después de recopilar información de fuentes diversas, se procede a analizar las principales fortalezas y amenazas del ascenso chino, para, de esta manera, presentar un panorama sobre el futuro del mundo y de este país, si la situación continúa como hasta ahora. Por último, se llega a una serie de conclusiones con relación a lo anteriormente analizado y se plantean algunas recomendaciones para sobrellevar de una mejor manera los aspectos negativos que se identificaron durante la investigación.

Functional studies of the deubiquitinating enzymes USP19, USP4 and UCH-L1

El marcaje de proteínas con ubiquitina, conocido como ubiquitinación, cumple diferentes funciones que incluyen la regulación de varios procesos celulares, tales como: la degradación de proteínas por medio del proteosoma, la reparación del ADN, la señalización mediada por receptores de membrana, y la endocitosis, entre otras (1). Las moléculas de ubiquitina pueden ser removidas de sus sustratos gracias a la acción de un gran grupo de proteasas, llamadas enzimas deubiquitinizantes (DUBs) (2). Las DUBs son esenciales para la manutención de la homeostasis de la ubiquitina y para la regulación del estado de ubiquitinación de diferentes sustratos. El gran número y la diversidad de DUBs descritas refleja tanto su especificidad como su utilización para regular un amplio espectro de sustratos y vías celulares. Aunque muchas DUBs han sido estudiadas a profundidad, actualmente se desconocen los sustratos y las funciones biológicas de la mayoría de ellas. En este trabajo se investigaron las funciones de las DUBs: USP19, USP4 y UCH-L1. Utilizando varias técnicas de biología molecular y celular se encontró que: i) USP19 es regulada por las ubiquitin ligasas SIAH1 y SIAH2 ii) USP19 es importante para regular HIF-1α, un factor de transcripción clave en la respuesta celular a hipoxia, iii) USP4 interactúa con el proteosoma, iv) La quimera mCherry-UCH-L1 reproduce parcialmente los fenotipos que nuestro grupo ha descrito previamente al usar otros constructos de la misma enzima, y v) UCH-L1 promueve la internalización de la bacteria Yersinia pseudotuberculosis.

Plan de negocio - Beep

Beep ofrece seis servicios: Beep Móvil, Beep PBX Virtual, Beep SMS Masivo, Beep Callblasting, Beep Email y Beep SIPtrunk. Cada uno de ellos busca llegarle a un mercado objetivo diferente, pero siempre buscando ofrecerle la mejor calidad al consumidor. Para efectos de profundización en los productos que a través del tiempo pueden brindarle un mayor valor agregado al cliente y que son diferenciables de la competencia, este Plan de Negocio solamente se centrará en los dos primeros productos, es decir, en Beep Móvil y Beep PBX Virtual.

La Evaluación en las enseñanzas procedimentales. El cuaderno como herramienta de evaluación continua en las enseñanzas de dibujo

El dibujo como actividad procedimental implica realizar una serie de acciones consecutivas que requieren condiciones más exigentes para su aprendizaje, tanto en cantidad de práctica como en su organización. La evaluación del aprendizaje de procedimientos tiene carácter continuado, procesual, contextual y estratégico, favoreciendo la autorregulación del alumno en su proceso de aprendizaje gracias a la ayuda que el profesorado le presta. La evaluación de un proceso que se adquiere en el tiempo conlleva a plantear el cuaderno como elemento de control de dicho proceso que ayuda en la evaluación continua del mismo

Estudi d'una metal·lotioneïna d'alzina surera (QsMT)

En aquest treball es caracteriza per primera vegada la capacitat de coordinació metàl·lica d'una metal·lotineïna (MT) de planta i es proposa un model de plegament per a les MTs de planta en general. Els resultat mostren que aquestes proteïnes poden tenir un paper molt important en la regulació de l'estat redox de les cèl·lules, probablement a través de la coordinació a Cu. Les MTs de planta són proteïnes molt desconegudes. Es postula que participen en l'homeòstasi del Cu i en la protecció contra l'estrès oxidatiu, però es desconeix la capacitat de coordinació metàl·lica i el plegament. En aquest treball s'han estudiat una metal·lotioneïna d'alzina surera, QsMT, aïllada d'una llibreria de cDNA de fel·lema. Els objectius concrets han estat: (1) estudiar l'expressió de QsMT i la resposta a l'estrès oxidatiu; (2) determinar la capacitat de coordinació metàl·lica i la funcionalitat in vivo; (3) fer una aproximació al plegament de les MTs de planta. L'expressió del gen s'ha estudiat mitjançant hibridació in situ en plàntules i en embrions d'alzina surera. QsMT s'expressa majoritàriament en cèl·lules amb fort estrès oxidatiu, associat a la síntesi de polifenols (suberització i lignificació) i a la senescència. També s'expressa en cèl·lules meristemàtiques, cèl·lules en divisió molt activa on la funció de les MTs podria estar relacionada amb el manteniment de l'estat redox. L'aplicació d'estrès oxidatiu exogen (H2O2 i paraquat) incrementa fortament l'expressió de QsMT en teixits amb expressió constitutiva, confirmant la regulació de l'expressió del gen per estrès oxidatiu. Per l'estudi de les propietats de coordinació metàl·lica es va expressar QsMT en cèl·lules d'E. coli en medi de cultiu suplementat amb Cu, Zn o Cd. Es van aïllar els agregats metàl·lics corresponents i es van analitzar mitjançant tècniques espectroscòpiques i espectromètriques (ICP-OES, ESI-MS i CD). Els resultats mostren que QsMT coordina de forma estable Cu (8 ions metàl·lics/molècula), Zn (4 ions de Zn/molècula) i Cd (6 ions de Cd/molècula), i adopta una estructura especialment quiral en coordinació a Cu. L'elevada capacitat quelant de la proteïna i la quiralitat de l'estructura indiquen que QsMT possiblement té preferència metàl·lica pel Cu i per tant una funció relacionada amb aquest metall in vivo. Estudis de complementació en llevat demostren que QsMT coordina Cu de forma funcional in vivo. En coordinació a Cd QsMT presenta una peculiaritat no observada fins ara en altres MTs: la participació d'ions sulfur en la formació de l'agregat metàl·lic incrementant la capacitat de coordinació metàl·lica (6 ions metàl·lics divalents de Cd enlloc de 4 ions de Zn). A més QsMT coordina Cd de forma funcional en llevat, i per tant la seva funció també podria estar relacionada amb la destoxicació de Cd en la planta. QsMT s'ha utilitzat com a model per fer una aproximació al plegament de les MTs de planta. Amb aquest objectiu vam dissenyar tres pèptids mutants derivats de QsMT: N25 corresponent a la zona rica en cisteïna en posició amino-terminal, C18 corresponent a la zona rica en cisteïna en posició carboxil-terminal, i N25-C18 corresponent a les dues zones riques en cisteïna enllaçades per 4 glicines substituint la zona central de 39 aminoàcids. Es van expressar i estudiar aquests pèptids per les mateixes tècniques utilitzades en l'estudi de QsMT. Els resultats indiquen que QsMT es plega formant un sol agregat metàl·lic per la interacció de les dues zones riques en cisteïna. En aquest model la zona central d'enllaç, típica de les MTs de planta, no participa en la coordinació metàl·lica però és imprescindible per a la funció de la proteïna. El paper de la zona central podria variar en funció del metall que coordina, participant en el plegament i estructura de la proteïna quan coordina Zn i Cd i en la seva regulació i estabilització quan coordina Cu.

Breeding Biology of Grassland Birds in Western New York: Conservation and Management Implications

Declining grassland breeding bird populations have led to increased efforts to assess habitat quality, typically by estimating density or relative abundance. Because some grassland habitats may function as ecological traps, a more appropriate metric for determining quality may be breeding success. Between 1994 and 2003 we gathered data on the nest fates of Eastern Meadowlarks (Sturnella magna), Bobolinks (Dolichonyx oryzivorous), and Savannah Sparrows (Passerculus sandwichensis) in a series of fallow fields and pastures/hayfields in western New York State. We calculated daily survival probabilities using the Mayfield method, and used the logistic-exposure method to model effects of predictor variables on nest success. Nest survival probabilities were 0.464 for Eastern Meadowlarks (n = 26), 0.483 for Bobolinks (n = 91), and 0.585 for Savannah Sparrows (n = 152). Fledge dates for first clutches ranged between 14 June and 23 July. Only one obligate grassland bird nest was parasitized by Brown-headed Cowbirds (Molothrus ater), for an overall brood parasitism rate of 0.004. Logistic-exposure models indicated that daily nest survival probabilities were higher in pastures/hayfields than in fallow fields. Our results, and those from other studies in the Northeast, suggest that properly managed cool season grassland habitats in the region may not act as ecological traps, and that obligate grassland birds in the region may have greater nest survival probabilities, and lower rates of Brown-headed Cowbird parasitism, than in many parts of the Midwest.

G-protein-coupled-receptor-mediated presynaptic inhibition in the cerebellum

Throughout the central nervous system a dominant form of inhibition of neurotransmitter release from presynaptic terminals is mediated by G-protein-coupled receptors (GPCRs). Neurotransmitter release is typically induced by action potentials (APs), but can also occur spontaneously. Presynaptic inhibition by GPCRs has been associated with modulation of voltage-dependent ion channels. However, electrophysiological recordings of spontaneous, AP-independent (so-called ‘miniature’) postsynaptic events reveal an additional, important form of GPCR-mediated presynaptic inhibition, distinct from effects on ionic conductances and consistent with a direct action on the vesicle release machinery. Recent studies suggest that such miniature events might be of physiological relevance not only in signalling but also in development. In the cerebellum, neurotransmitter release onto Purkinje cells occurs by AP-dependent and AP-independent pathways. Here, I focus on inhibitory synapses between interneurons and Purkinje cells, which are subject to strong, identifiable regulation by endogenous GPCR agonists, to consider mechanisms of GPCR-mediated presynaptic inhibition.

Microbial perchlorate reduction: A precise laboratory determination of the chlorine isotope fractionation and its possible biochemical basis

Perchlorate-reducing bacteria fractionate chlorine stable isotopes giving a powerful approach to monitor the extent of microbial consumption of perchlorate in contaminated sites undergoing remediation or natural perchlorate containing sites. This study reports the full experimental data and methodology used to re-evaluate the chlorine isotope fractionation of perchlorate reduction in duplicate culture experiments of Azospira suillum strain PS at 37 degrees C (Delta Cl-37(Cr)--ClO4-) previously reported, without a supporting data set by Coleman et al. [Coleman, M.L., Ader, M., Chaudhuri, S., Coates,J.D., 2003. Microbial Isotopic Fractionation of Perchlorate Chlorine. Appl. Environ. Microbiol. 69, 4997-5000] in a reconnaissance study, with the goal of increasing the accuracy and precision of the isotopic fractionation determination. The method fully described here for the first time, allows the determination of a higher precision Delta Cl-37(Cl)--ClO4- value, either from accumulated chloride content and isotopic composition or from the residual perchlorate content and isotopic composition. The result sets agree perfectly, within error, giving average Delta Cl-37(Cl)--ClO4- = -14.94 +/- 0.15%omicron. Complementary use of chloride and perchlorate data allowed the identification and rejection of poor quality data by applying mass and isotopic balance checks. This precise Delta Cl-37(Cl)--ClO4-, value can serve as a reference point for comparison with future in situ or microcosm studies but we also note its similarity to the theoretical equilibrium isotopic fractionation between a hypothetical chlorine species of redox state +6 and perchlorate at 37 degrees C and suggest that the first electron transfer during perchlorate reduction may occur at isotopic equilibrium between art enzyme-bound chlorine and perchlorate. (C) 2008 Elsevier B.V. All rights reserved.

Long-term response of the nematode community to elevated atmospheric CO2 in a temperate dry grassland soil

Long-term effects of the elevated atmospheric CO2 on biosphere have been in focus of research since the last few decades. In this experiment undisturbed soil monoliths of loess grassland were exposed to an elevated CO2 environment (two-times the ambient CO2 level) for a period of six years with the aid of the open top chamber method. Control without a chamber and CO2 elevation was applied as well. Elevated CO2 level had very little impact oil soil food web. It did not influence either root and microbial biomass or microbial and nematode community structure. The only significant response was that density of the bacterial feeder genus Heterocephalobus increased in the chamber with elevated CO2 concentration. Application of the open top chambers initiated more changes on nematodes than the elevated CO2 level. Open top chamber (OTC) method decreased nematode density (total and plant feeder as well) to less than half of the original level. Negative effect was found on the genus level in the case of fungal feeder Aphelenchoides, plant feeder Helicotylenchus and Paratylenchus. It is very likely that the significantly lower belowground root biomass and partly its decreased quality reflected by the increased C/N ratio are the main responsible factors for the lower density of the plant feeder nematodes in the plots of chambers. According to diversity profiles, MI and MI(2-15) parameters, nematode communities in the open top chambers (both on ambient and elevated CO2 level) seem to be more structured than those under normal circumstances six years after start of the experiment.

Influence of elevated CO2 on interspecific interactions at higher trophic levels

We report the results of a study investigating the influence of elevated CO2 on species interactions across three trophic levels: a plant (Brassica oleracea), two aphid herbivores (the generalist Myzus persicae and the specialist Brevicoryne brassicae), and two natural enemies (the coccinellid Hippodamia convergens (ladybird) and the parasitoid wasp Diaeretiella rapae). Brassica oleracea plants reared under elevated CO2 conditions (650 ppmv vs. 350 ppmv) were larger and had decreased water and nitrogen content. Brevicoryne brassicae reared on plants grown in elevated CO2 were larger and accumulated more fat, while there was no change in M. persicae traits. Fecundity of individual aphids appeared to be increased when reared on plants grown in elevated CO2. However, these differences were generally lost when aphids were reared in colonies, suggesting that such changes in plant quality will have subtile effects on aphid intraspecific interactions. Nevertheless, CO2 treatment did influence aphid distribution on plants, with significantly fewer M. persicae found on the shoots, and B. brassicae was only found on senescing leaves, when colonies were reared on plants grown in elevated CO2. We reared B. brassicae and M. persicae in competition on plants grown at both the CO2 concentration treatments. We found a significantly lower ratio of M. persicae: B. brassicae on plants grown under elevated CO2 conditions, strongly suggesting that increasing CO2 concentrations can alter the outcome of competition among insect herbivores. This was also reflected in the distribution of the aphids on the plants. While the CO2 treatment did not influence where B. brassicae were found, fewer M. persicae were present on senescing leaves under elevated CO2 conditions. Changes in plant quality resulting from the CO2 treatments did not appear to alter aphid quality as prey species, as the number consumed by the ladybird H. convergens, and the number parasitised by the parasitoid wasp D. rapae, did not change. To our knowledge, this study provides the first empirical evidence that changes in host plant quality mediated by increasing levels of CO2 can alter the outcome of interspecific competition among insect herbivores.

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

Physiological, biochemical and transcriptional analysis of onion bulbs during storage

Abstract: During the transition from endo-dormancy to eco-dormancy and subsequent growth, the onion bulb undergoes the transition from sink organ to source, to sustain cell division in the meristematic tissue. The mechanisms controlling these processes are not fully understood. Here, a detailed analysis of whole onion bulb physiological, biochemical and transcriptional changes in response to sprouting is reported, enabling a better knowledge of the mechanisms regulating post-harvest onion sprout development. Biochemical and physiological analyses were conducted on different cultivars ('Wellington', 'Sherpa' and 'Red Baron') grown at different sites over 3 years, cured at different temperatures (20, 24 and 28 degrees C) and stored under different regimes (1, 3, 6 and 6 1 degrees C). In addition, the first onion oligonucleotide microarray was developed to determine differential gene expression in onion during curing and storage, so that transcriptional changes could support biochemical and physiological analyses. There were greater transcriptional differences between samples at harvest and before sprouting than between the samples taken before and after sprouting, with some significant changes occurring during the relatively short curing period. These changes are likely to represent the transition from endo-dormancy to sprout suppression, and suggest that endo-dormancy is a relatively short period ending just after curing. Principal component analysis of biochemical and physiological data identified the ratio of monosaccharides (fructose and glucose) to disaccharide (sucrose), along with the concentration of zeatin riboside, as important factors in discriminating between sprouting and pre-sprouting bulbs. These detailed analyses provide novel insights into key regulatory triggers for sprout dormancy release in onion bulbs and provide the potential for the development of biochemical or transcriptional markers for sprout initiation. Evidence presented herein also suggests there is no detrimental effect on bulb storage life and quality caused by curing at 20 degrees C, producing a considerable saving in energy and costs.

Influence of temperature during grain filling on gluten viscoelastic properties and gluten protein composition

BACKGROUND The aim of this study was to investigate the effects of low to moderate temperatures on gluten functionality and gluten protein composition. Four spring wheat cultivars were grown in climate chambers with three temperature regimes (day/night temperatures of 13/10, 18/15 and 23/20 °C) during grain filling. RESULTS The temperature strongly influenced grain weight and protein content. Gluten quality measured by maximum resistance to extension (Rmax) was highest in three cultivars grown at 13 °C. Rmax was positively correlated with the proportion of sodium dodecyl sulfate-unextractable polymeric proteins (%UPP). The proportions of ω-gliadins and D-type low-molecular-weight glutenin subunits (LMW-GS) increased and the proportions of α- and γ-gliadins and B-type LMW-GS decreased with higher temperature, while the proportion of high-molecular-weight glutenin subunits (HMW-GS) was constant between temperatures. The cultivar Berserk had strong and constant Rmax between the different temperatures. CONCLUSION Constant low temperature, even as low as 13 °C, had no negative effects on gluten quality. The observed variation in Rmax related to temperature could be explained more by %UPP than by changes in the proportions of HMW-GS or other gluten proteins. The four cultivars responded differently to temperature, as gluten from Berserk was stronger and more stable over a wide range of temperature

Composition differences between organic and conventional meat: a systematic literature review and meta-analysis

Demand for organic meat is partially driven by consumer perceptions that organic foods are more nutritious than non-organic foods. However, there have been no systematic reviews comparing specifically the nutrient content of organic and conventionally produced meat. In this study, we report results of a meta-analysis based on sixty-seven published studies comparing the composition of organic and non-organic meat products. For many nutritionally relevant compounds (e.g. minerals, antioxidants and most individual fatty acids (FA)), the evidence base was too weak for meaningful meta-analyses. However, significant differences in FA profiles were detected when data from all livestock species were pooled. Concentrations of SFA and MUFA were similar or slightly lower, respectively, in organic compared with conventional meat. Larger differences were detected for total PUFA and n-3 PUFA, which were an estimated 23 (95 % CI 11, 35) % and 47 (95 % CI 10, 84) % higher in organic meat, respectively. However, for these and many other composition parameters, for which meta-analyses found significant differences, heterogeneity was high, and this could be explained by differences between animal species/meat types. Evidence from controlled experimental studies indicates that the high grazing/forage-based diets prescribed under organic farming standards may be the main reason for differences in FA profiles. Further studies are required to enable meta-analyses for a wider range of parameters (e.g. antioxidant, vitamin and mineral concentrations) and to improve both precision and consistency of results for FA profiles for all species. Potential impacts of composition differences on human health are discussed.