Análisis de las barreras para la unificación de una Historia Clínica Electrónica -HCE- en Colombia

Objetivo: Identificar las barreras para la unificación de una Historia Clínica Electrónica –HCE- en Colombia. Materiales y Métodos: Se realizó un estudio cualitativo. Se realizaron entrevistas semiestructuradas a profesionales y expertos de 22 instituciones del sector salud, de Bogotá y de los departamentos de Cundinamarca, Santander, Antioquia, Caldas, Huila, Valle del Cauca. Resultados: Colombia se encuentra en una estructuración para la implementación de la Historia Clínica Electrónica Unificada -HCEU-. Actualmente, se encuentra en unificación en 42 IPSs públicas en el departamento de Cundinamarca, el desarrollo de la HCEU en el país es privado y de desarrollo propio debido a las necesidades particulares de cada IPS. Conclusiones: Se identificaron barreras humanas, financieras, legales, organizacionales, técnicas y profesionales en los departamentos entrevistados. Se identificó que la unificación de la HCE depende del acuerdo de voluntades entre las IPSs del sector público, privado, EPSs, y el Gobierno Nacional.

Mapping spatial and temporal potassium balances in Brazilian soils of south-west Goias.

Introduction: Brazil, is one of the main agricultural producers in the world ranking 1st in the production of sugarcane, coffee and oranges. It is also 2nd as world producer of soybeans and a leader in the harvested yields of many other crops. The annual consumption of mineral fertilizers exceeds 20 million mt, 30% of which corresponds to potash fertilizers (ANDA, 2006). From this statistic it may be supposed that fertilizer application in Brazil is rather high, compared with many other countries. However, even if it is assumed that only one fourth of this enormous 8.5 million km2 territory is used for agriculture, average levels of fertilizer application per hectare of arable land are not high enough for sustainable production. One of the major constraints is the relatively low natural fertility status of the soils which contain excessive Fe and Al oxides. Agriculture is also often practised on sandy soils so that the heavy rainfall causes large losses of nutrients through leaching. In general, nutrient removal by crops such as sugarcane and tropical fruits is much more than the average nutrient application via fertilization, especially in regions with a long history of agricultural production. In the recently developed areas, especially in the Cerrado (Brazilian savanna) where agriculture has expanded since 1980, soils are even poorer than in the "old" agricultural regions, and high costs of mineral fertilizers have become a significant input factor in determining soybean, maize and cotton planting. The consumption of mineral fertilizers throughout Brazil is very uneven. According to the 1995/96 Agricultural Census, only in eight of the total of 26 Brazilian states, were 50 per cent or more of the farms treated "systematically" with mineral fertilizers; in many states it was less than 25 per cent, and in five states even less than 12 per cent (Brazilian Institute for Geography and Statistics; Censo Agropecuario1995/96, Instituto Brazileiro de Geografia e Estadistica; IBGE, www.ibge.gov.br). The geographical application distribution pattern of mineral fertilizers may be considered as an important field of research. Understanding geographical disparities in fertilization level requires a complex approach. This includes evaluation of the availability of nutrients in the soil (and related soil properties e.g. CEC and texture), the input of nutrients with fertilizer application, and the removal of nutrients by harvested yields. When all these data are compiled, it is possible to evaluate the balance of particular nutrients for certain areas, and make conclusions as to where agricultural practices should be optimized. This kind of research is somewhat complicated, because it relies on completely different sources of data, usually from incomparable data sources, e.g. soil characteristics attributed to soil type areas, in contrast to yields by administrative regions, or farms. A priority tool in this case is the Geographical Information System (GIS), which enables attribution of data from different fields to the same territorial units, and makes possible integration of these data in an "inputoutput" model, where "input" is the natural availability of a nutrient in the soil plus fertilization, and "output" export of the same nutrient with the removed harvested yield.

Australian waterfalls as tourism attractions

For a largely arid country with generally low relief, Australia has a remarkably large number and variety of waterfalls. Found mainly near the coast, close to where most of the population lives and near the major tourist resort areas, these landscape features have long been popular scenic attractions. As sights to see and places to enjoy a variety of recreational activities, waterfalls continue to play an important role in Australia’s tourism, even in seaside resort areas where the main attractions are sunshine, sandy beaches and surf. The aesthetic appeal of waterfalls and their value as recreational resources are recognized by the inclusion of many in national parks. Even here, demands of visitors and pressures from developers raise serious problems. This paper examines the way in which waterfalls have been developed and promoted as tourist attractions, demonstrating their importance to Australian tourism. It considers threats to the sustainable use of waterfall resources posed by power schemes and, particularly, by the tourist industry itself. Queensland’s Gold Coast is selected as a case study, and comparisons are made with other areas in which waterfalls have played important roles as tourist attractions, especially the Yorkshire coast of northeast England. The discussion draws largely on an examination of tourist literature from the nineteenth to the twenty-first century, including holiday brochures and guide books, as well as other published sources, together with field observation in various parts of the world

Destination Positioning Slogans - Analysis of Themes used by New Zealand Regional Tourism Organisations

A significant gap in the tourism and travel literature exists in the area of tourism destination branding. Although brands have been used as sources of differentiation in consumer goods markets for over a century, academic research attention towards destination branding has only been reported since the late 1990s. Three important components of the brand construct are brand identity, brand position and brand image. While interest in applications of brand theory to practise in tourism is increasing, there is a paucity of published research in the literature to guide destination marketing organisations (DMOs). In particular there have been few reported analyses of destination brand positioning slogans. The focus of this paper is on destination brand position slogans, which represent the interface between brand identity and brand image. Part of a wider investigation of DMO slogans worldwide, and in keeping with the conference location, the paper focuses on analysis of slogans used by New Zealand RTOs. The slogans are examined in terms of the extent to which they have been limited to ephemeral indifference. In other words, have they stood the test of time and do they effectively differentiate through a meaningful proposition? Analysis of the slogans indicates very few could be characterised as memorably distinctive. This reflects the complexity involved in capturing the essence of a multi-attributed destination in a succinct and focused positioning slogan, in a way that is both meaningful to the target audience and effectively differentiates the destination from competitors offering the same benefits.

Tourism Destination Preferences: A Longitudinal Analysis of Consumer Decision Sets

There have only been a small number of applications of consumer decision set theory to holiday destination choice, and these studies have tended to rely on a single cross sectional snapshot of research participants’ stated preferences. Very little has been reported on the relationship between stated destination preferences and actual travel, or changes in decision set composition over time. The paper presents a rare longitudinal examination of destination decision sets, in the context of short break holidays by car in Queensland, Australia. Two questionnaires were administered, three months apart. The first identified destination preferences while the second examined actual travel and revisited destination preferences. In relation to the conference theme, there was very little change in consumer preferences towards the competitive set of destinations over the three month period. A key implication for the destination of interest, which, in an attempt to change market perceptions, launched a new brand campaign during the period of the project, is that a long term investment in a consistent brand message will be required to change market perceptions. The results go some way to support the proposition that the positioning of a destination into a consumer’s decision set represents a source of competitive advantage.