Prevalencia de riesgo psicosocial en personal civil y militar en una unidad militar de Bogotá Colombia 2014

El estudio se realizó en 2014 para establecer la prevalencia de los factores de riesgo psicosocial en el personal civil y militar en una unidad militar de Bogotá D.C. De una población universo de 632 funcionarios, se tomó por muestreo probabilístico aleatorio a 264 funcionarios a quienes se les aplicó los cuestionarios para la evaluación de Factores de Riesgo Psicosocial Intralaboral, extralaboral, síntomas de estrés y la ficha de datos sociodemográficos y ocupacionales, de la Batería de Instrumentos del Ministerio de Trabajo Colombia [1]. El estudio permitió establecer que los niveles de riesgo con síntomas de estrés son altos; el 61,74% presenta riesgo Muy alto y Alto, el 15,53% riesgo medio y 22.73% riesgo Bajo y Muy bajo. El riesgo más alto lo presentan los oficiales, seguido del personal civil y suboficiales. De mantenerse las condiciones actuales sin intervención fácilmente podrían incrementarse y de acuerdo con el modelo sistémico expuesto por Villalobos 2005, se podrían asociar a respuestas de estrés [2], por tanto se recomienda implementar un Sistema de Vigilancia Epidemiológica para riesgo psicosocial con base en los diagnósticos y sistema de gestión en seguridad y salud en el trabajo, donde se involucre personal con diagnóstico de patología mental.

Análisis predictivo de los eventos adversos relacionados con los indicadores de eficiencia hospitalaria de una IPS de Bogotá

En este estudio se realizó un análisis predictivo de la aparición de eventos adversos de los pacientes de una IPS de Bogotá, Mederi Hospital Universitario de Barrios Unidos (HUBU) durante el año 2013; relacionados con los indicadores de eficiencia hospitalaria (Porcentaje de ocupación hospitalaria, número de egresos hospitalarios, promedio de estancia hospitalaria, número de egresos de urgencias, promedio de estancia en urgencias). Los datos fueron exportados a una matriz de análisis de las variables cualitativas; fueron presentadas con frecuencias absolutas y relativas, las variables cuantitativas (edad, tiempos de estancia) fueron presentadas con media, desviaciones estándar. Se agruparon los datos de eventos adversos y de eficiencia hospitalaria en una nueva matriz que permitiera el análisis predictivo la nueva matriz fue exportada al software de modelación estadístico Eviews 6.5; se especificaron modelos predictivos multivariados para la variable número de eventos adversos, respecto de los indicadores de eficiencia hospitalaria y se estimaron las probabilidades de ocurrencia, análisis de correlación y multicolinealidad; los resultados se presentaron en tablas de estimación para cada modelo, se restringieron los eventos adversos prevenibles y no prevenibles información obtenida a través de un sistema de información que registra los factores relacionados con la ocurrencia de eventos adversos en salud, a través del sistema de reporte de eventos en salud, reporte en las historias clínicas, reporte individual, reporte por servicio, análisis de datos y estudios de caso, de la misma forma fueron extraídos los datos de eficiencia hospitalaria para el mismo periodo. El análisis y gestión de eventos adversos pretende establecer estrategias de mejoramiento continuo y análisis de resultados frente a los indicadores de eficiencia que permitan intervención de los factores de riesgo operativo de los servicios del Hospital Universitario de Barrios Unidos (HUBU), relacionados con eventos adversos en la atención de los pacientes en especial se debe enfocar en la gestión de los egresos de pacientes de acuerdo a los resultados obtenidos con el fin de alinearse y fortalecer las políticas de seguridad del paciente para brindar una atención integral con calidad y eficiencia, disminuyendo las quejas en la atención, las glosas, los riesgos jurídicos, de acuerdo al modelo predictivo estudiado.

Gestión tecnológica hospitalaria : Un enfoque sistémico

Este texto contribuirá a que la institución de salud se organice y prepare la información necesaria para emprender el largo y tortuoso camino de la determinación de la razón costo/beneficio y de la acreditación. Además, podrá ser muy útil para los estudiantes de los programas de pregrado y posgrado de ingeniería biomédica que se quieran especializar en la gestión de tecnologías del equipamiento biomédico y la ingeniería clínica. También podrá ser usado como guía de referencia por personas que estén directamente vinculadas al sector de la salud en departamentos de mantenimiento, ingeniería clínica o de servicios hospitalarios.

Determinación de las condiciones de trabajo y salud del personal de laboratorios universitarios como estrategia de intervención de riesgos laborales

Introducción: Las condiciones de trabajo y salud de la población trabajadora han sido estudiadas en los diferentes sectores económicos, y para esto se han aplicado diversos instrumentos para la identificación de los factores de riesgo. Sin embargo, el estudio en los trabajadores de las instituciones de educación superior, aún es escaso y limitado. Este trabajo de investigación abordó las condiciones de trabajo y salud y los factores de riesgo asociados de los empleados de laboratorios y de talleres de las diferentes unidades de una Universidad privada en Bogotá D.C. Objetivo: Determinar las condiciones de trabajo y salud del personal de laboratorios y de talleres en el 2014 de las diferentes unidades de una Universidad privada en Bogotá D.C. Métodos: Se realizó un estudio de corte transversal, en una muestra de 87 trabajadores de laboratorios y de talleres. En el análisis univariado se calcularon para las variables cualitativas frecuencias y proporciones, y para las variables cuantitativas medidas de tendencia central y dispersión acorde a la distribución de los datos. Para el análisis bivariado, se realizó la comparación de las prevalencias entre los factores de riesgo locativos, físicos, químicos, biológicos, biomecánicos y psicológicos de cada unidad y las condiciones de trabajo y salud; así como su asociación con los factores sociodemográficos y laborales, por medio de la prueba de asociación Chi-Cuadrado de Pearson. El nivel de significancia establecido fue p<0.05. Resultados: Se encontró que las variables respiración de sustancias y manipulación manual de cargas se encuentran asociadas al cargo de los trabajadores de laboratorios y de talleres. También de la muestra de trabajadores la mayoría infirió no tener una exposición significativa a los riesgos locativo, físico, biológico y psicosocial; mientras que para riesgo químico y biomecánico se encontraron frecuencias de más del 60% entre los participantes. Los hallazgos de este estudio corresponden únicamente a la percepción de los trabajadores frente a sus condiciones de trabajo y salud, puesto que no se realizaron mediciones higiénicas ni exámenes médicos a los participantes. Conclusiones: En este estudio se encontró que la exposición a riesgos locativo, físico, biológico y psicosocial es baja; mientras que es alta para riesgo químico debida a la manipulación e inhalación de sustancias químicas tóxicas, y a riesgo biomecánico a causa de las posturas prolongadas y mantenidas, la manipulación manual de cargas, los movimientos repetitivos y realizar fuerzas. En relación a las condiciones de salud mental, se encontró que la población no presenta algún estado emocional o psicológico que llame la atención, lo que en consecuencia se refleja en el buen estado de salud físico.

Papel das lideranças intermédias no processo de mudança organizacional : o caso das organizações de saúde em Portugal

A Gestão, como arte e experiência, tem sido infelizmente pouco solicitada para participar activamente no crucial e urgente processo de regeneração e reversão do Sistema Nacional de Saúde em Portugal. Perante a prevalência notória da perspectiva macroeconómica da economia da saúde, a gestão tem-se remetido quase ao serviço mínimo de repositório e subserviente cumpridor da norma emanada dos diversos e diversificados poderes da saúde, nomeadamente os político e burocrático. Sem querer com isto pretender ter encontrado a panaceia para a intervenção no processo, julga-se que sem um forte contributo da gestão jamais se atingirá o objectivo pretendido de flexão no andamento notoriamente negativo dos últimos anos. E isso passa por dois aspectos cruciais inerentes às organizações de saúde: acreditar verdadeiramente nas competências detidas pelas suas lideranças intermédias e apostar na respectiva delegação de poder e decisão. A contrapartida para isso será um sério, genuíno, forte, diferenciado e negociado processo de contratualização interna e avaliação de desempenho em excelência das unidades, serviços e centros nucleares da estrutura, em que de uma vez por todas se arrede a tradicional e já demonstradamente prejudicial posição negocial leonina dos diversos centralismos da saúde em Portugal.

Prevalence and determinants of Cryptosporidium spp. infection in smallholder dairy cattle in Iringa and Tanga Regions of Tanzania

The prevalence of Cryptosporidium spp. infection in a cross-sectional study of dairy cattle, from two contrasting dairying regions in Tanzania, were determined by staining smears of faecal samples with the modified Ziehl-Neelsen technique. Of the 1126 faecal samples screened, 19.7% were positive for Cr\yptosporidium spp. The prevalence was lower in Tanga Region than in Iringa Region. The prevalence of affected farms was 20% in Tanga and 21 % in Iringa. In both regions, the probability of detecting Cryptosporidium oocysts in faeces varied with animal class, but these were not consistent in both regions. In Tanga Region, Cryptosporidium oocysts were significantly more likely to be found in the faeces of milking cows. In Iringa Region, the likelihood that cattle had Cryptosporidium-positive faeces declined with age, and milking cattle were significantly less likely to have Cryptosporidium-positive faeces. In this region, 7% of cattle were housed within the family house at night, and this was marginally associated with a higher likelihood that animals had Ctyptosporidium-positive faeces. Our study suggests that even though herd sizes are small, Cryptosporidium spp. are endemic on many Tanzanian smallholder dairy farms. These protozoa may impact on animal health and production, but also on human health, given the close associations between the cattle and their keepers. Further studies are required to assess these risks in more detail, and understand the epidemiology of Cryptosporidium spp. in this management system.

Studies on weed infestation and tea growth under various weed management methods in a young Tea (Camellia sinensis [L.] kuntze) plantation

A field experiment was conducted in the low country of Sri Lanka, during the period 1994–1995 to investigate the severity of weed infestation and tea growth in relation to weed management methods in newly established tea (Camellia sinensis[L.] Kuntze). Manual weeding (hand and slash weeding) at various intervals was compared with various herbicides, with or without mulching. Weed control with herbicides was superior to that of hand weeding at 6-week intervals or more. Weed control with oxyfluorfen at 0.29 kg ai ha−1 + paraquat at 0.17 kg ai ha−1 or glyphosate at 0.99 kg ai ha−1 + kaolin at 3.42 kg ha−1 were superior. Plots unweeded for 12 weeks or more produced significantly greater (P < 0.05) weed biomass than plots unweeded for 6 weeks. Although the least weed dry weight (P < 0.05) and the greatest number of weed species were recorded with hand weeding at 2 week intervals, there was no particular benefit on tea growth when compared with hand weeding at 6 and 12 week intervals. Inter row mulching in chemically treated plots was more favorable for tea growth than no mulching, while living weed cover in unmulched slash weeded plots suppressed tea growth. A combination of mulching and herbicides, particularly oxyfluorfen and paraquat, followed by hand weeding at least every 6–8 weeks was considered the most appropriate weed management system for young tea.

A model of intelligent building energy management for the indoor environment

People's interaction with the indoor environment plays a significant role in energy consumption in buildings. Mismatching and delaying occupants' feedback on the indoor environment to the building energy management system is the major barrier to the efficient energy management of buildings. There is an increasing trend towards the application of digital technology to support control systems in order to achieve energy efficiency in buildings. This article introduces a holistic, integrated, building energy management model called `smart sensor, optimum decision and intelligent control' (SMODIC). The model takes into account occupants' responses to the indoor environments in the control system. The model of optimal decision-making based on multiple criteria of indoor environments has been integrated into the whole system. The SMODIC model combines information technology and people centric concepts to achieve energy savings in buildings.

Executive project management structure and the challenges acing its adoption in the Nigerian construction industry

Project management (PM) is a globally recognized discipline and has been widely adopted within the construction industry. Despite advancements in the PM discipline, the ineffective traditional management system, typical of the non-executive PM structure, is still widely used in the Nigerian construction industry. The aim of this paper is thus to explore the challenges facing the adoption of the executive PM structure in Nigeria. The paper first assesses the level of growth of PM in Nigeria using UK best practices as a benchmark and identifies the key PM characteristics in the two countries. Focus group interviews were used to collect the primary data for the study and content analysis was used to present the results in a thematic format. The study revealed the key barriers to the adoption of an executive PM structure in Nigeria as a lack of proper awareness, unfavorable policies, skill shortages, the traditional culture of stakeholders and the absence of a regulatory body. It is recommended that the government, as a major player/client in the Nigerian construction industry, should lead the campaign to change the traditional industry approach to project management. This is necessary if construction stakeholders in Nigeria are to be educated and encouraged towards adopting and putting into practice effective PM.

Linking alkaline phosphatase activity with bacterial phoD gene abundance in soil from a long-term management trial

Changes in land management practices may have significant implications for soil microbial communities important in organic P turnover. Soil bacteria can increase plant P availability by excreting phosphatase enzymes which catalyze the hydrolysis of ester-phosphate bonds. Examining the diversity and abundance of alkaline phosphatase gene harboring bacteria may provide valuable insight into alkaline phosphatase production in soils. This study examined the effect of 20 years of no input organic (ORG), organic with composted manure (ORG + M), conventional (CONV) and restored prairie (PRA) management on soil P bioavailability, alkaline phosphatase activity (ALP), and abundance and diversity of ALP gene (phoD) harboring bacteria in soils from the northern Great Plains of Canada. Management system influenced bioavailable P (P < 0.001), but not total P, with the lowest concentrations in the ORG systems and the highest in PRA. Higher rates of ALP were observed in the ORG and ORG + M treatments with a significant negative correlation between bioavailable P and ALP in 2011 (r2 = 0.71; P = 0.03) and 2012 (r2 = 0.51; P = 0.02), suggesting that ALP activity increased under P limiting conditions. The phoD gene abundance was also highest in ORG and ORG + M resulting in a significant positive relationship between bacterial phoD abundance and ALP activity (r2 = 0.71; P = 0.009). Analysis of phoD bacterial community fingerprints showed a higher number of species in CONV compared to ORG and ORG + M, contrary to what was expected considering greater ALP activity under ORG management. In 2012, banding profiles of ORG + M showed fewer phoD bacterial species following the second manure application, although ALP activity is higher than in 2011. This indicates that a few species may be producing more ALP and that quantitative gene analysis was a better indicator of activity than the number of species present.

Soil bacterial phoD gene abundance and expression in response to applied phosphorus and long-term management

Bacterial transformation of phosphorus (P) compounds in soil is largely dependent on soil microbial community function, and is therefore sensitive to anthropogenic disturbances such as fertilization or cropping systems. However, the effect of soil management on the transcription of bacterial genes that encode phosphatases, such as phoD, is largely unknown. This greenhouse study examined the effect of long-term management and P amendment on potential alkaline phosphatase (ALP) activity and phoD gene (DNA) and transcript (RNA) abundance. Soil samples (0–15 cm) were collected from the Glenlea Long-term Rotation near Winnipeg, Manitoba, to compare organic, conventional and prairie management systems. In the greenhouse, pots of soil from each management system were amended with P as either soluble mineral fertilizer or cattle manure and then planted with Italian ryegrass (Lolium multiforum). Soils from each pot were sampled for analysis immediately and after 30 and 106 days. Significant differences among the soil/P treatments were detected for inorganic P, but not the organic P in NaHCO3-extracts. At day 0, ALP activity was similar among the soil/P treatments, but was higher after 30 days for all P amendments in soil from organically managed plots. In contrast, ALP activity in soils under conventional and prairie management responded to increasing rates of manure only, with significant effects from medium and high manure application rates at 30 and 106 days. Differences in ALP activity at 30 days corresponded to the abundance of bacterial phoD genes, which were also significantly higher in soils under organic management. However, this correlation was not significant for transcript abundance. Next-generation sequencing allowed the identification of 199 unique phoD operational taxonomic units (OTUs) from the metagenome (soil DNA) and 35 unique OTUs from the metatranscriptome (soil RNA), indicating that a subset of phoD genes was being transcribed in all soils.

Barriers to interventions aimed at promoting the health of health care workers in Brazil

Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

Automated two-dimensional separation flow system with electrochemical preconcentration, stripping, capillary electrophoresis and contactless conductivity detection for trace metal ion analysis

This paper describes the automation of a fully electrochemical system for preconcentration, cleanup, separation and detection, comprising the hyphenation of a thin layer electrochemical flow cell with CE coupled with contactless conductivity detection (CE-C(4)D). Traces of heavy metal ions were extracted from the pulsed-flowing sample and accumulated on a glassy carbon working electrode by electroreduction for some minutes. Anodic stripping of the accumulated metals was synchronized with hydrodynamic injection into the capillary. The effect of the angle of the slant polished tip of the CE capillary and its orientation against the working electrode in the electrochemical preconcentration (EPC) flow cell and of the accumulation time were studied, aiming at maximum CE-C(4)D signal enhancement. After 6 min of EPC, enhancement factors close to 50 times were obtained for thallium, lead, cadmium and copper ions, and about 16 for zinc ions. Limits of detection below 25 nmol/L were estimated for all target analytes but zinc. A second separation dimension was added to the CE separation capabilities by staircase scanning of the potentiostatic deposition and/or stripping potentials of metal ions, as implemented with the EPC-CE-C(4)D flow system. A matrix exchange between the deposition and stripping steps, highly valuable for sample cleanup, can be straightforwardly programmed with the multi-pumping flow management system. The automated simultaneous determination of the traces of five accumulable heavy metals together with four non-accumulated alkaline and alkaline earth metals in a single run was demonstrated, to highlight the potentiality of the system.

Clustering Lab value working with medical data

Data mining is a relatively new field of research that its objective is to acquire knowledge from large amounts of data. In medical and health care areas, due to regulations and due to the availability of computers, a large amount of data is becoming available [27]. On the one hand, practitioners are expected to use all this data in their work but, at the same time, such a large amount of data cannot be processed by humans in a short time to make diagnosis, prognosis and treatment schedules. A major objective of this thesis is to evaluate data mining tools in medical and health care applications to develop a tool that can help make rather accurate decisions. In this thesis, the goal is finding a pattern among patients who got pneumonia by clustering of lab data values which have been recorded every day. By this pattern we can generalize it to the patients who did not have been diagnosed by this disease whose lab values shows the same trend as pneumonia patients does. There are 10 tables which have been extracted from a big data base of a hospital in Jena for my work .In ICU (intensive care unit), COPRA system which is a patient management system has been used. All the tables and data stored in German Language database.

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.