Aplicación de la medicina ancestral en los usuarios del Centro de Salud Carlos Elizalde. Cuenca 2015

ANTECEDENTES: En gran parte del mundo la medicina tradicional es el pilar principal de la prestación de servicios de salud, por ello en algunos países suele denominarse medicina complementaria. La medicina tradicional ha sufrido transformaciones, y los valores de este tipo de medicina están desapareciendo con rapidez a pesar que la OMS dicta estrategias para su implementación y el MSP del Ecuador reconoce su valor. OBJETIVO GENERAL: Caracterización de la aplicación de la medicina ancestral en los usuarios y usuarias del Centro de Salud “Carlos Elizalde”. METODOLOGIA: Es un estudio cuantitativo descriptivo en el que caracteriza la aplicación de la medicina ancestral en los usuarios del Centro de Salud “Carlos Elizalde”. El método utilizado fue la entrevista previo consentimiento informado realizada, según criterios de inclusión y exclusión a un universo de 110 usuarios, en la tabulación de datos se utilizó el programa SPSS Windows y Excel, y estos fueron analizados en tablas simples y gráficos. RESULTADOS: Los resultados obtenidos han servido para identificar la aplicación la Medicina Ancestral en los usuarios que acuden al Centro de Salud “Carlos Elizalde” de la Parroquia Yanuncay, identificando a las personas que más acuden al tratamiento son adultos con 71% y adultos mayores con un 16%, la mayoría son amas de casa en un 38%, con instrucción de primaria incompleta, es las enfermedades más frecuentes son espanto con un 36%, mal aire 18% y 10% caída de zhungo; para el tratamiento utilizan plantas o hiervas en un 54%

Análisis de las actividades turísticas que se desarrollan en el Biocorredor Yanuncay para determinar su sostenibilidad

Esta investigación se centra en el análisis de las tres actividades turísticas principales que se desarrollan a lo largo del BiocorredorYanuncay, perteneciente a la parroquia San Joaquín, Cantón Cuenca, provincia del Azuay. La restauración, el cultivo de huertos orgánicos y la cestería, serán estudiadas desde el punto de vista de la sostenibilidad, considerando a esta como parte fundamental para la gestión de todo tipo de emprendimiento. La aplicación de la sostenibilidad al turismo ha contribuido para que los prestadores de servicios y los turistas opten por una mentalidad más consciente, no únicamente en el ámbito ambiental sino también en el sociocultural y económico, que unidos forman un modelo de desarrollo equilibrado en el cual todos resultan beneficiados. La guía de “Buenas Prácticas de Turismo Sostenible” elaborada por la organización RainforestAliance, ha sido primordial para realizar el análisis. Dentro de este documento se encuentran expuestas buenas prácticas que se relacionan a cada pilar de la sostenibilidad, las mismas que deben ser consideradas por todos los emprendimientos turísticos para que puedan permanecer en el tiempo. Al identificar las falencias de los prestadores de servicios turísticos del Biocorredor en el área de la sostenibilidad, se plantea trabajar en propuestas que ayuden a los emprendedores a mejorar la experiencia del turista, aprovechando los recursos culturales y naturales de la zona.

Collaborative Management of Intermodal Mobility

Part 21: Mobility and Logistics

Time-Reversal Massive Multipath Effect and Bandwidth Heterogeneity

The proliferation of new mobile communication devices, such as smartphones and tablets, has led to an exponential growth in network traffic. The demand for supporting the fast-growing consumer data rates urges the wireless service providers and researchers to seek a new efficient radio access technology, which is the so-called 5G technology, beyond what current 4G LTE can provide. On the other hand, ubiquitous RFID tags, sensors, actuators, mobile phones and etc. cut across many areas of modern-day living, which offers the ability to measure, infer and understand the environmental indicators. The proliferation of these devices creates the term of the Internet of Things (IoT). For the researchers and engineers in the field of wireless communication, the exploration of new effective techniques to support 5G communication and the IoT becomes an urgent task, which not only leads to fruitful research but also enhance the quality of our everyday life. Massive MIMO, which has shown the great potential in improving the achievable rate with a very large number of antennas, has become a popular candidate. However, the requirement of deploying a large number of antennas at the base station may not be feasible in indoor scenarios. Does there exist a good alternative that can achieve similar system performance to massive MIMO for indoor environment? In this dissertation, we address this question by proposing the time-reversal technique as a counterpart of massive MIMO in indoor scenario with the massive multipath effect. It is well known that radio signals will experience many multipaths due to the reflection from various scatters, especially in indoor environments. The traditional TR waveform is able to create a focusing effect at the intended receiver with very low transmitter complexity in a severe multipath channel. TR's focusing effect is in essence a spatial-temporal resonance effect that brings all the multipaths to arrive at a particular location at a specific moment. We show that by using time-reversal signal processing, with a sufficiently large bandwidth, one can harvest the massive multipaths naturally existing in a rich-scattering environment to form a large number of virtual antennas and achieve the desired massive multipath effect with a single antenna. Further, we explore the optimal bandwidth for TR system to achieve maximal spectral efficiency. Through evaluating the spectral efficiency, the optimal bandwidth for TR system is found determined by the system parameters, e.g., the number of users and backoff factor, instead of the waveform types. Moreover, we investigate the tradeoff between complexity and performance through establishing a generalized relationship between the system performance and waveform quantization in a practical communication system. It is shown that a 4-bit quantized waveforms can be used to achieve the similar bit-error-rate compared to the TR system with perfect precision waveforms. Besides 5G technology, Internet of Things (IoT) is another terminology that recently attracts more and more attention from both academia and industry. In the second part of this dissertation, the heterogeneity issue within the IoT is explored. One of the significant heterogeneity considering the massive amount of devices in the IoT is the device heterogeneity, i.e., the heterogeneous bandwidths and associated radio-frequency (RF) components. The traditional middleware techniques result in the fragmentation of the whole network, hampering the objects interoperability and slowing down the development of a unified reference model for the IoT. We propose a novel TR-based heterogeneous system, which can address the bandwidth heterogeneity and maintain the benefit of TR at the same time. The increase of complexity in the proposed system lies in the digital processing at the access point (AP), instead of at the devices' ends, which can be easily handled with more powerful digital signal processor (DSP). Meanwhile, the complexity of the terminal devices stays low and therefore satisfies the low-complexity and scalability requirement of the IoT. Since there is no middleware in the proposed scheme and the additional physical layer complexity concentrates on the AP side, the proposed heterogeneous TR system better satisfies the low-complexity and energy-efficiency requirement for the terminal devices (TDs) compared with the middleware approach.

Banca Digital

Em plena quarta revolução industrial, todas as industrias se estão a transformar para se ajustar aos novos paradigmas de relação com os clientes, altamente influenciados pelos pioneiros digitais como a Uber, Netflix ou Amazon, porém no setor financeiro há desafios acrescidos, pois os clientes esperam juntar essas expectativas digitais com a manutenção da iteração humana, enquanto, do lados bancos, em simultâneo, necessitam de recuperar da crise da dívida soberana que impôs necessidades de ajustamento dos balanços. O momento de desenvolvimento tecnológico potenciado pelo forte crescimento do acesso à internet em mobilidade traz novos hábitos e expectativas na relação com as entidades, com dispositivos cada vez mais potentes a cada vez menor custo, o que criou a oportunidade perfeita para o surgimento de startups tecnológicas dispostas a transformar os modelos de negócio de intermediação clássica, dando origem, no setor financeiro, às fintechs – empresas de base tecnológica dedicadas à prestação de serviços financeiros - impondo uma disrupção na industria financeira, com destaque para mercados como os EUA e Reino Unido. Olhando aos últimos cinco anos do setor financeiro, será muito difícil antecipar como estará o setor financeiro dentro de cinco anos, mas sabemos que estará seguramente muito diferente do que conhecemos hoje, por esse fato este trabalho é assente essencialmente em referências bibliográficas dos últimos 5 anos, tendo sido feito utilizados estudos de investigação de empresas e documentos académicos para a caracterização do setor neste contexto de inovação permanente e em que medida este processo de “digitalização” do setor financeiro influencia a propensão dos clientes na contratação de mais produtos e serviços, sendo esse um fator central para os bancos em Portugal recuperarem economicamente. É também analisada a dimensão seguida pelas instituições de regulação e supervisão do setor financeiro com vista a potenciar a concorrência e inovação do setor financeiro, enquanto mantém a garantia de segurança, confiança e controlo de risco sistémico. É bastante escassa a literatura disponível para caracterizar a banca em Portugal numa ótica de inovação e transformação, porém este trabalho procura caracterizar o sistema financeiro português face à forma como está a responder aos desafios de transformação tecnológica e digital. Procurou-se estabelecer uma metodologia de investigação que permita caracterizar a perceção de valor acrescentado para os clientes da utilização de serviços digitais e em que medida estes se podem substituir aos balcões e à intervenção humana dos profissionais dos bancos, tendo-se concluído que estes dois elementos são ainda fatores centrais para os clientes.

Tourism Destination Management: A Collaborative Approach

Part 6: Engineering and Implementation of Collaborative Networks

Implementation and Operation of Collaborative Manufacturing Networks

Part 6: Engineering and Implementation of Collaborative Networks

Oral health quality of the workers of a telemarketing company and their satisfaction with the treatments provided by the corporative dental insurance plan

Aim: To evaluate the oral health quality of the workers of a telemarketing company and their satisfaction with the dental treatments provided by the corporative dental insurance plan. Methods: Data collection was by an online intranet questionnaire on dental service providers from Uberlândia/MG and Campinas/SP. It was addressed to 6000 associates, with objective and subjective questions, comprising the level of the telemarketing operators’ oral health, dental needs, satisfaction with dental care providers and the importance of having the laboral dental services provided by the company. Results: After analysis of the results, we observed that: 57.52% of the workers required improvement in their oral health and 56.03% mentioned prevention as the largest need, 66.70% use the dental providers’ services, but only 31.34% were satisfied with them. Conclusions: The results underscore that the workers have an intermediate level of dental needs, with prevention as top importance. Additionally, establishment of a basic attention program inside the company would increase the satisfaction and adhesion indexes of providers and the workers’ oral health.

Enhancing the Availability of Electronic Health Records for Secondary Purposes – A Case Study

Due to the sensitive nature of patient data, the secondary use of electronic health records (EHR) is restricted in scientific research and product development. Such restrictions pursue to preserve the privacy of respective patients by limiting the availability and variety of sensitive patient data. Current limitations do not correspond with the actual needs requested by the potential secondary users. In this thesis, the secondary use of Finnish and Swedish EHR data is explored for the purpose of enhancing the availability of such data for clinical research and product development. Involved EHR-related procedures and technologies are analysed to identify the issues limiting the secondary use of patient data. Successful secondary use of patient data increases the data value. To explore the identified circumstances, a case study of potential secondary users and use intentions regarding EHR data was carried out in Finland and Sweden. The data collection for the conducted case study was performed using semi-structured interviews. In total, 14 Finnish and Swedish experts representing scientific research, health management, and business were interviewed. The motivation for the corresponding interviews was to evaluate the protection of EHR data used for secondary purposes. The efficiency of implemented procedures and technologies was analysed in terms of data availability and privacy preserving. The results of the conducted case study show that the factors affecting EHR availability are divided to three categories: management of patient data, preservation of patients' privacy, and potential secondary users. Identified issues regarding data management included laborious and inconsistent data request procedures and the role and effect of external service providers. Based on the study findings, two secondary use approaches enabling the secondary use of EHR data are identified: data alteration and protected processing environment. Data alteration increases the availability of relevant EHR data, further decreasing the value of such data. Protected processing approach restricts the amount of potential users and use intentions while providing more valuable data content.

Avaliação de desempenho : estudo de caso da aplicação do balanced scorecard numa organização especializada na área do exercício, saúde e bem-estar

Atividade física, saúde e bem-estar são temas presentes no dia-a-dia das pessoas. O mercado do Fitness está dinâmico e ativo, quer na comunicação, através das novas tecnologias de informação, quer na especialização da oferta de produtos ou serviços. O Personal training surge como um produto feito á medida do cliente, importante numa sociedade onde a individualidade sobressai, as preferências e necessidades divergem de cliente para cliente. É solicitada uma boa performance constantemente ao profissional, que se pretende traduzida em altas taxas de angariação e retenção. O Balanced Scorecard (BSC), apresenta soluções válidas neste contexto de mercado, já que é uma ferramenta de apoio á gestão estratégica e simultaneamente um sistema de monitorização em tempo real dos indicadores de performance dos profissionais (Personal Trainer) e dos restantes níveis hierárquicos da Organização. Num mercado concorrencial, a valorização do recurso humano tem-se revelado crucial nos resultados alcançados e principal fator de criação de valor e vantagem competitiva, quando bem monitorizada e orientada pela Gestão da Organização. Surge como desafio maior, elaborar, posicionar, implementar, avaliar e medir através deste instrumento (BSC), num contexto laboral diferente (prestadores de serviços) onde já foi aplicado e apurar o nível de desempenho alcançado pela organização orientado nas respetivas visões: financeira, clientes, aprendizagem – crescimento e processos internos.

The personally controlled electronic health record (PCEHR) for adults with severe communication impairments: findings of pilot research.

To date, there is little information in the literature to guide the provision of supports for using the Personally Controlled Electronic Health Record (PCEHR) in populations with severe communication impairments associated with a range of disabilities. In this paper we will (a) outline the rationale for use of PCEHR in these populations by providing an overview of relevant research to date, and (b) present results of three integrated pilot studies aiming to investigate the barriers to and facilitators for PCEHR use by people with severe communication impairments and their service providers. Finally, we will present directions for future research on use of PCEHR by people with severe communication impairments.

End-of-life care in an Australian rehabilitation facility for older people: staff focus groups

A qualitative study of staff experiences of end-of-life care for older people in a subacute rehabilitation facility was undertaken using three focus groups with senior multidisciplinary staff (5), junior nurses (8), and junior allied health staff (7). Content analysis revealed four major themes: being a key contact person; the quality of end–of-life care; referring to off-site service providers; and differing perspectives. These data have implications for multidisciplinary practice including staff education and capacity to change focus of care in facilities for older people dedicated to rehabilitation rather than palliation or end-of-life care.

Understanding consumer participation in mental health: issues of power and change

Consumer participation occurs in all Victorian public mental health services. Area mental health services employ consumer consultants to enhance consumer participation across the network. Ongoing support of management is essential to the success of consumer participation. This project aimed to explore understandings of consumer participation from a manager's perspective. Semistructured interviews were conducted with seven participants in this qualitative, interpretive study. The thematic analysis revealed the complexities around defining consumer participation and demonstrated the difficulties and possible reasons as to why there is no real clarity between managers, service providers, and consumers as to what consumer participation should look like. Power and change were the primary themes. Power and the overwhelming consensus that the medical model and those working within it hold the most power was strongly represented in this study. Legislation and workplace settings were seen as considerable factors adding to the disempowerment of consumers within an already disempowering mental health system. Change was the other main theme that emerged, with culture and attitudes of the old ‘institutionalized’ thinking that still pervades some pockets of mental health services being seen as the major barriers to change. The role of the consumer consultant was a prominent subtheme, with their role in training and the education of workers seen as an essential and positive way to progress consumer participation. These findings demonstrate that managers consider there to be hope for consumers, brought about by collective action and lobbying, and through consumer participation in less-restrictive parts of the service (community settings).

Health literacy: applying current concepts to improve health services and reduce health inequalities

The concept of 'health literacy' refers to the personal and relational factors that affect a person's ability to acquire, understand and use information about health and health services. For many years, efforts in the development of the concept of health literacy exceeded the development of measurement tools and interventions. Furthermore, the discourse about and development of health literacy in public health and in clinical settings were often substantially different. This paper provides an update about recently developed approaches to measurement that assess health literacy strengths and limitations of individuals and of groups across multiple aspects of health literacy. This advancement in measurement now allows diagnostic and problem-solving approaches to developing responses to identified strengths and limitations. In this paper, we consider how such an approach can be applied across the diverse range of settings in which health literacy has been applied. In particular, we consider some approaches to applying health literacy in the daily practice of health-service providers in many settings, and how new insights and tools--including approaches based on an understanding of diversity of health literacy needs in a target community--can contribute to improvements in practice. Finally, we present a model that attempts to integrate the concept of health literacy with concepts that are often considered to overlap with it. With careful consideration of the distinctions between prevailing concepts, health literacy can be used to complement many fields from individual patient care to community-level development, and from improving compliance to empowering individuals and communities.

Time-series pattern based effective noise generation for privacy protection on cloud

Cloud computing is proposed as an open and promising computing paradigm where customers can deploy and utilize IT services in a pay-as-you-go fashion while saving huge capital investment in their own IT infrastructure. Due to the openness and virtualization, various malicious service providers may exist in these cloud environments, and some of them may record service data from a customer and then collectively deduce the customer's private information without permission. Therefore, from the perspective of cloud customers, it is essential to take certain technical actions to protect their privacy at client side. Noise obfuscation is an effective approach in this regard by utilizing noise data. For instance, noise service requests can be generated and injected into real customer service requests so that malicious service providers would not be able to distinguish which requests are real ones if these requests' occurrence probabilities are about the same, and consequently related customer privacy can be protected. Currently, existing representative noise generation strategies have not considered possible fluctuations of occurrence probabilities. In this case, the probability fluctuation could not be concealed by existing noise generation strategies, and it is a serious risk for the customer's privacy. To address this probability fluctuation privacy risk, we systematically develop a novel time-series pattern based noise generation strategy for privacy protection on cloud. First, we analyze this privacy risk and present a novel cluster based algorithm to generate time intervals dynamically. Then, based on these time intervals, we investigate corresponding probability fluctuations and propose a novel time-series pattern based forecasting algorithm. Lastly, based on the forecasting algorithm, our novel noise generation strategy can be presented to withstand the probability fluctuation privacy risk. The simulation evaluation demonstrates that our strategy can significantly improve the effectiveness of such cloud privacy protection to withstand the probability fluctuation privacy risk.