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.

SBR technology for wastewater treatment: suitable operational conditions for a nutrient removal

Actualment, la legislació ambiental ha esdevingut més restrictiva pel que fa a la descàrrega d'aigües residuals amb nutrients, especialment en les anomenades àrees sensibles o zones vulnerables. Arran d'aquest fet, s'ha estimulat el coneixement, desenvolupament i millora dels processos d'eliminació de nutrients. El Reactor Discontinu Seqüencial (RDS) o Sequencing Batch Reactor (SBR) en anglès, és un sistema de tractament de fangs actius que opera mitjançant un procediment d'omplerta-buidat. En aquest tipus de reactors, l'aigua residual és addicionada en un sol reactor que treballa per càrregues repetint un cicle (seqüència) al llarg del temps. Una de les característiques dels SBR és que totes les diferents operacions (omplerta, reacció, sedimentació i buidat) es donen en un mateix reactor. La tecnologia SBR no és nova d'ara. El fet, és que va aparèixer abans que els sistema de tractament continu de fangs actius. El precursor dels SBR va ser un sistema d'omplerta-buidat que operava en discontinu. Entre els anys 1914 i 1920, varen sorgir certes dificultats moltes d'elles a nivell d'operació (vàlvules, canvis el cabal d'un reactor a un altre, elevat temps d'atenció per l'operari...) per aquests reactors. Però no va ser fins a finals de la dècada dels '50 principis del '60, amb el desenvolupament de nous equipaments i noves tecnologies, quan va tornar a ressorgir l'interès pels SBRs. Importants millores en el camp del subministrament d'aire (vàlvules motoritzades o d'acció pneumàtica) i en el de control (sondes de nivell, mesuradors de cabal, temporitzadors automàtics, microprocessadors) han permès que avui en dia els SBRs competeixin amb els sistemes convencional de fangs actius. L'objectiu de la present tesi és la identificació de les condicions d'operació adequades per un cicle segons el tipus d'aigua residual a l'entrada, les necessitats del tractament i la qualitat desitjada de la sortida utilitzant la tecnologia SBR. Aquestes tres característiques, l'aigua a tractar, les necessitats del tractament i la qualitat final desitjada determinen en gran mesura el tractament a realitzar. Així doncs, per tal d'adequar el tractament a cada tipus d'aigua residual i les seves necessitats, han estat estudiats diferents estratègies d'alimentació. El seguiment del procés es realitza mitjançant mesures on-line de pH, OD i RedOx, els canvis de les quals donen informació sobre l'estat del procés. Alhora un altre paràmetre que es pot calcular a partir de l'oxigen dissolt és la OUR que és una dada complementària als paràmetres esmentats. S'han avaluat les condicions d'operació per eliminar nitrogen d'una aigua residual sintètica utilitzant una estratègia d'alimentació esglaonada, a través de l'estudi de l'efecte del nombre d'alimentacions, la definició de la llargada i el número de fases per cicle, i la identificació dels punts crítics seguint les sondes de pH, OD i RedOx. S'ha aplicat l'estratègia d'alimentació esglaonada a dues aigües residuals diferents: una procedent d'una indústria tèxtil i l'altra, dels lixiviats d'un abocador. En ambdues aigües residuals es va estudiar l'eficiència del procés a partir de les condicions d'operació i de la velocitat del consum d'oxigen. Mentre que en l'aigua residual tèxtil el principal objectiu era eliminar matèria orgànica, en l'aigua procedent dels lixiviats d'abocador era eliminar matèria orgànica i nitrogen. S'han avaluat les condicions d'operació per eliminar nitrogen i fòsfor d'una aigua residual urbana utilitzant una estratègia d'alimentació esglaonada, a través de la definició del número i la llargada de les fases per cicle, i la identificació dels punts crítics seguint les sondes de pH, OD i RedOx. S'ha analitzat la influència del pH i la font de carboni per tal d'eliminar fòsfor d'una aigua sintètica a partir de l'estudi de l'increment de pH a dos reactors amb diferents fonts de carboni i l'estudi de l'efecte de canviar la font de carboni. Tal i com es pot veure al llarg de la tesi, on s'han tractat diferents aigües residuals per a diferents necessitats, un dels avantatges més importants d'un SBR és la seva flexibilitat.

Enhanced fault recovery methods for protected traffic services in GMPLS networks

Les noves tecnologies a la xarxa ens permeten transportar, cada cop més, grans volums d' informació i trànsit de xarxa amb diferents nivells de prioritat. En aquest escenari, on s'ofereix una millor qualitat de servei, les conseqüències d'una fallada en un enllaç o en un node esdevenen més importants. Multiprotocol Lavel Switching (MPLS), juntament amb l'extensió a MPLS generalitzat (GMPLS), proporcionen mecanismes ràpids de recuperació de fallada establint camins, Label Switch Path (LSPs), redundants per ser utilitzats com a camins alternatius. En cas de fallada podrem utilitzar aquests camins per redireccionar el trànsit. El principal objectiu d'aquesta tesi ha estat millorar alguns dels actuals mecanismes de recuperació de fallades MPLS/GMPLS, amb l'objectiu de suportar els requeriments de protecció dels serveis proporcionats per la nova Internet. Per tal de fer aquesta avaluació s'han tingut en compte alguns paràmetres de qualitat de protecció com els temps de recuperació de fallada, les pèrdues de paquets o el consum de recursos. En aquesta tesi presentem una completa revisió i comparació dels principals mètodes de recuperació de fallada basats en MPLS. Aquest anàlisi inclou els mètodes de protecció del camí (backups globals, backups inversos i protecció 1+1), els mètodes de protecció locals i els mètodes de protecció de segments. També s'ha tingut en compte l'extensió d'aquests mecanismes a les xarxes òptiques mitjançant el pla de control proporcionat per GMPLS. En una primera fase d'aquest treball, cada mètode de recuperació de fallades és analitzat sense tenir en compte restriccions de recursos o de topologia. Aquest anàlisi ens dóna una primera classificació dels millors mecanismes de protecció en termes de pèrdues de paquets i temps de recuperació. Aquest primer anàlisi no és aplicable a xarxes reals. Per tal de tenir en compte aquest nou escenari, en una segona fase, s'analitzen els algorismes d'encaminament on sí tindrem en compte aquestes limitacions i restriccions de la xarxa. Es presenten alguns dels principals algorismes d'encaminament amb qualitat de servei i alguna de les principals propostes d'encaminament per xarxes MPLS. La majoria dels actual algorismes d'encaminament no tenen en compte l'establiment de rutes alternatives o utilitzen els mateixos objectius per seleccionar els camins de treball i els de protecció. Per millorar el nivell de protecció introduïm i formalitzem dos nous conceptes: la Probabilitat de fallada de la xarxa i l'Impacte de fallada. Un anàlisi de la xarxa a nivell físic proporciona un primer element per avaluar el nivell de protecció en termes de fiabilitat i disponibilitat de la xarxa. Formalitzem l'impacte d'una fallada, quant a la degradació de la qualitat de servei (en termes de retard i pèrdues de paquets). Expliquem la nostra proposta per reduir la probabilitat de fallada i l'impacte de fallada. Per últim fem una nova definició i classificació dels serveis de xarxa segons els valors requerits de probabilitat de fallada i impacte. Un dels aspectes que destaquem dels resultats d'aquesta tesi és que els mecanismes de protecció global del camí maximitzen la fiabilitat de la xarxa, mentre que les tècniques de protecció local o de segments de xarxa minimitzen l'impacte de fallada. Per tant podem assolir mínim impacte i màxima fiabilitat aplicant protecció local a tota la xarxa, però no és una proposta escalable en termes de consum de recursos. Nosaltres proposem un mecanisme intermig, aplicant protecció de segments combinat amb el nostre model d'avaluació de la probabilitat de fallada. Resumint, aquesta tesi presenta diversos mecanismes per l'anàlisi del nivell de protecció de la xarxa. Els resultats dels models i mecanismes proposats milloren la fiabilitat i minimitzen l'impacte d'una fallada en la xarxa.

The potential of digital interactive television for the provision of healthcare and wellness services

The potential of digital interactive television (iDTV) to promote original services, formats and contents that can be relevant to support personal health care and wellness of individuals, namely elderly people, has not been yet fully explored in the past. Therefore, in a context of rapid change of the technological resources, in which the distribution and presentation of content comes associated with new platforms (such as digital terrestrial TV and IPTV), it is important to perceive the configurations that are being developed for interactive digital TV (iDTV) that may result in relevant outcomes within the field of healthcare and wellness, with the aim of offering complementarity to the existing services and contents made available today via the traditional means and media. This article describes and discusses the preliminary results of the first part of the research project iDTV-HEALTH: Inclusive services to promote health and wellness via digital interactive television. These first results suggest that iDTV solutions may represent a real contribution to delivery healthcare and wellness to the target population, namely as a supplement to health services provision.

Museums and quality, from the concept of the museum that carries out functions to the museum that provides services

Quality management Self-evaluation of the organisation Citizens/customers satisfaction Impact on society evaluation Key performance evaluation Good practices comparison (Benchmarking) Continuous improvement In professional environments, when quality assessment of museums is discussed, one immediately thinks of the honourableness of the directors and curators, the erudition and specialisation of knowledge, the diversity of the gathered material and study of the collections, the collections conservation methods and environmental control, the regularity and notoriety of the exhibitions and artists, the building’s architecture and site, the recreation of environments, the museographic equipment design. We admit that the roles and attributes listed above can contribute to the definition of a specificity of museological good practice within a hierarchised functional perspective (the museum functions) and for the classification of museums according to a scale, validated between peers, based on “installed” appreciation criteria, enforced from above downwards, according to the “prestige” of the products and of those who conceive them, but that say nothing about the effective satisfaction of the citizen/customers and the real impact on society. There is a lack of evaluation instruments that would give us a return of all that the museum is and represents in contemporary society, focused on being and on the relation with the other, in detriment of the ostentatious possession and of the doing in order to meet one’s duties. But it is only possible to evaluate something by measurement and comparison, on the basis of well defined criteria, from a common grid, implicating all of the actors in the self-evaluation, in the definition of the aims to fulfil and in the obtaining of results.

What is wrong with the global support facility for small-scale mining?

The World Bank, United Nations and UK Department for International Development (DfID) have spearheaded a recent global drive to regularize artisanal and small-scale mining (ASM), and provide assistance to its predominantly impoverished participants. To date, millions of dollars have been pledged toward the design of industry-specific policies and regulations; implementation of mechanized equipment; extension; and the launch of alternative livelihood (AL) programmes aimed at diversifying local economies. Much of this funding, however, has failed to facilitate marked improvements, and in many cases, has exacerbated problems. This paper argues that a poor understanding of artisanal, mine-community dynamics and operators’ needs has, in a number of cases, led to the design and implementation of inappropriate industry support schemes and interventions. The discussion focuses upon experiences from sub-Saharan Africa, where ASM is in the most rudimentary of states.

'A load too heavy': Critical reflections on the child labor problem in Africa's small-scale mining sector

This paper provides an extended analysis of the child labor problem in the artisanal and small-scale mining (ASM) sector, focusing specifically on the situation in sub-Saharan Africa. In recent years, the issue of child labor in ASM has garnered significant attention from the International Labor Organization (ILO), which has been particularly active in raising public awareness of the problem; and, has proceeded to implement policies and collaborative project work aimed at Curtailing children's participation in ASM activities in a number of African countries. The analysis concludes with a critical appraisal of an ILO project recently launched in the Talensi-Nabdam District in the Upper East Region of Ghana, which sheds light on how the child labor problem is being tackled in practice in ASM communities in sub-Saharan Africa. (c) 2008 Elsevier Ltd. All rights reserved.

Mercury: An agent of poverty in Ghana's small-scale gold-mining sector?

There is consensus worldwide that the artisanal and small-scale mining (ASM) sector is comprised of individuals who are trapped in a vicious cycle of poverty, lacking the necessary financial and technological means to improve their standards of living. Minimal work, however, has been undertaken to identify the very factors behind miners' plight, which inevitably vary from country to country. This paper uses a case study of Ghana to argue that an increased dependence upon mercury for amalgamation In artisanal gold-mining communities is one such-albeit overlooked-"agent of poverty". There is mounting empirical evidence which suggests that dealings with the monoponistic middlemen who supply mercury, purchases of costly medicines to remedy ailments caused by mercury poisoning, and a lack of appropriate safeguards and alternatives to amalgamation, are preventing gold miners from improving their practices and livelihoods. The solution to the problem lies in breaking this cycle of dependency, which can be achieved by providing miners with robust support services, mercury-free technologies and education. (c) 2006 Elsevier Ltd. All rights reserved.

Challenges with minimising mercury pollution in the small-scale gold mining sector: Experiences from the Guianas

This paper examines the barriers to mitigating mercury pollution at small-scale gold mines in the Guianas (Guyana, French Guiana and Suriname), and prescribes recommendations for overcoming these obstacles. Whilst considerable attention has been paid to analysing the environmental impacts of operations in the region, minimal research has been undertaken to identify appropriate policy and educational initiatives for addressing the mounting mercury problem. Findings from recent fieldwork and selected interviews with operators from Guyanese and Surinamese gold mining regions reveal that legislative incapacity, the region's varied industry policy stances, various technological problems, and low environmental awareness on the part of communities are impeding efforts to facilitate improved mercury management at small-scale gold mines in the Guianas. Marked improvements can be achieved, however, if legislation, particularly that pertaining to mercury, is harmonised in the region; educational seminars continue to be held in important mining districts; and additional outlets for disseminating environmental equipment and mercury-free technologies are provided.

The use of information technology by the quantity surveying professionals in Hong Kong

This paper introduces the findings of a recent study on the use of information technology (IT) among the quantity surveying (QS) organisations in Hong Kong. The study was conducted through a structured questionnaire survey among 18 QS organisations registered in Hong Kong, representing around 53% of the total number of organisations in the profession. The data set generated from this study provided rich information about what information technology the QS profession used, what the perceived benefits and barriers experienced by the users in the industry were. The survey concluded that although IT had been widely used in QS organisations in Hong Kong, it is mainly used to support various individual tasks of the QS services at a basic level, rather than to streamline the production of QS services as a whole through automation. Most of the respondents agreed that IT plays an important role in the QS profession but they had not fully taken advantage of IT to improve their competitive edge in the market. They usually adopted a more passive “wait and see” approach. In addition, very few QS organisations in Hong Kong have a comprehensive policy in promoting the use of IT within the organisations. It is recommended that the QS profession must recognise the importance of IT and take appropriate actions to meet the challenges of ever-changing and competitive market place.

Innovative approach to building systems integration problems: Using systems theory, technological forecasting and scenario planning

Building services are worth about 2% GDP and are essential for the effective and efficient operations of the building. It is increasingly recognised that the value of a building is related to the way it supports the client organisation’s ongoing business operations. Building services are central to the functional performance of buildings and provide the necessary conditions for health, well-being, safety and security of the occupants. They frequently comprise several technologically distinct sub-systems and their design and construction requires the involvement of numerous disciplines and trades. Designers and contractors working on the same project are frequently employed by different companies. Materials and equipment is supplied by a diverse range of manufacturers. Facilities managers are responsible for operation of the building service in use. The coordination between these participants is crucially important to achieve optimum performance, but too often is neglected. This leaves room for serious faults. The need for effective integration is important. Modern technology offers increasing opportunities for integrated personal-control systems for lighting, ventilation and security as well as interoperability between systems. Opportunities for a new mode of systems integration are provided by the emergence of PFI/PPP procurements frameworks. This paper attempts to establish how systems integration can be achieved in the process of designing, constructing and operating building services. The essence of the paper therefore is to envisage the emergent organisational responses to the realisation of building services as an interactive systems network.

Can adapting the homes of older people and providing assistive technology pay its way?

Background: Adaptations and assistive technology (AT) have an important role in enabling older people to remain in their own homes. Objective: To measure the feasibility and cost of adaptations and AT, and the scope for these to substitute and supplement formal care. Design: Detailed design studies to benchmark the adaptability of 82 properties against the needs of seven notional users. Setting: Social rented housing sector. Main outcome measures: Measures of the adaptability of properties, costs of care, adaptations and AT, and relationships between these costs. Results: The adaptability of properties varies according to many design factors and the needs of occupiers. The most adaptable properties were ground floor flats and bungalows; the least were houses, maisonettes and flats in converted houses. Purpose-built sheltered properties were generally more adaptable than corresponding mainstream properties but the opposite was the case for bungalows. Adaptations and AT can substitute for and supplement formal care, and in most cases the initial investment in adaptations and AT is recouped through subsequently lower care costs within the average life expectancy of a user. Conclusion: Appropriately selected adaptations and AT can make a significant contribution to the provision of living environments which facilitate independence. They can both substitute for traditional formal care services and supplement these services in a cost-effective way.

Application of integrated GPS and GIS technology for reducing construction waste and improving construction efficiency

This paper presents a study on applying an integrated Global Position System (GPS) and Geographacial Information System (GIS) technology to the reduction of construction waste. During the study, a prototype study is developed from automatic data capture system such as the barcoding system for construction material and equipment (M&E) management onsite, whilst the integrated GPS and GIS technology is combined to the M&E system based on the Wide Area Network (WAN). Then, a case study is conducted to demonstrate the deployment of the system. Experimental results indicate that the proposed system can minimize the amount of onsite material wastage.

Carbon reduction in buildings (CaRB) - Understanding the social and technical factors that influence energy use in UK buildings

Attempts to reduce the energy consumed in UK homes have met with limited success. One reason for this is a lack of understanding of how people interact with domestic technology – heating systems, lights, electrical equipment and so forth. Attaining such an understanding is hampered by a chronic shortage of detailed energy use data matched to descriptions of the house, the occupants, the internal conditions and the installed services and appliances. Without such information it is impossible to produce transparent and valid models for understanding and predicting energy use. The Carbon Reduction in Buildings (CaRB) consortium of five UK universities plans to develop socio-technical models of energy use, underpinned by a flow of data from a longitudinal monitoring campaign involving several hundred UK homes. This paper outlines the models proposed, the preliminary monitoring work and the structure of the proposed longitudinal study.