Perioperative transfusion analysis and blood ordering schedule update for total knee arthroplasty / 中国输血杂志

【Objective】 To investigate the perioperative rate of allogeneic red blood cell (RBC) transfusion in patients who underwent total knee arthroplasty (TKA) and its risk factors, and to identify its cross-match to transfusion ratio (C∶T ratio). 【Methods】 Anesthetic data of patients who underwent TKA from January 2014 to October 2019 in Peking Union Medical College Hospital were collected and analyzed retrospectively. Perioperative allogeneic RBC transfusion rate was calculated, and binary Logistic regression analysis was performed to identify its risk factors in these patients. The overall C∶T ratio was calculated and divided into subgroups based on surgery type and age group. 【Results】 The study enrolled 2 903 patients. The perioperative rate of allogeneic RBC transfusion in TKA patients was 10.9% (95% CI 9.8%~12.0%) and overall C∶T ratio was 5.6∶1. The independent risk factors leading to perioperative allogeneic RBC transfusion included advanced age(OR=1.025, 95% CI 1.009~1.042, P<0.01), preoperative hemoglobin level(OR=0.966, 95% CI 0.954~0.978, P<0.001), preoperative anemia(OR=3.543, 95% CI 2.052~6.119, P<0.001), hematological diseases(OR=6.462, 95% CI 2.479~16.841, P<0.001), bilateral surgery(OR=7.681, 95% CI 5.759~10.245, P<0.01) and revision surgery(OR=9.584, 95% CI 4.360~21.065, P<0.001). 【Conclusion】 The risk factors for perioperative allogeneic RBC transfusion in TKA patients included advanced age, preoperative low hemoglobin level, preoperative anemia, hematological diseases, bilateral surgery and revision surgery. Only type and screen tests are recommended if patients receiving unilateral primary TKA surgery are less than 75 years old without anemia and hematological diseases, while at least one to four units of blood should be cross-matched if patients are with preoperative anemia and hematological diseases or will receive bilateral and revision arthroplasty.

Establishment of the maximum surgical blood order schedule for cesarean sections / 中国输血杂志

【Objective】 To establish the catalog of maximum surgical blood order schedule(MSBOS) for cesarean sections with different obstetric complications, so as to guide the doctors of clinical and Blood Transfusion Department to prepare blood reasonably. 【Methods】 The blood transfusion data during cesarean sections from January to October 2021 in our hospital were collected via medical record information system and blood bank system.The blood recipients were classified according to the main obstetric complications. The incidence of blood transfusion, per capita RBC transfusion units, blood transfusion index (TI) and other indicators were calculated, the literature and the risk of massive hemorrhage were referred, and the actual situation of Obstetrics Department was considered to formulate the obstetric MSBOS of our own. 【Results】 1) The blood recipients during cesarean sections were mainly diagnosed as placental abruption, placental implantation, central placenta previa and severe preeclampsia; the incidence of blood transfusion of them was 17.9%(20/112), 17.7%(15/85), 16.8% (27/161)and 5.2%(9/173), respectively, and TI indexes was 0.9, 1.3, 1.0 and 0.3, respectively. 2) The MSBOS of Obstetrics Department in our hospital had been established, and the blood preparation for obstetric surgery was divided into three categories: T(blood typing)/S(antibody screening), T(blood typing)/S(antibody screening)/C(crossmatch) 2 U, and T/S/C 4 U. 【Conclusion】 The establishment of MSBOS in Obstetrics Department of our hospital provides references for preparing blood reasonably.

Incidence of Medication Errors in King Fahad Hospital Madina Saudi Arabia

Abstract This study aimed to evaluate the incidence of medication errors over a period of one year in King Fahad Hospital Madina Saudi Arabia. This retrospective, cross-sectional study was conducted over a period of one year from 2018 January to 2018 December using patient's records. King Fahad Hospital in Madina was selected for the study center. Data collected include the number and types of errors, severity, location of errors, errors by profession, and errors occurred in the medical wards. Statistical analysis was carried out using statistical package for social science version22. A total of twenty- six hundred and fifty-eight medication errors were reported during the study period. Among the reports 2567(96.5%) of the errors were due to near misses, followed by transcribing errors 1597(60%), ordering errors 928(34.9%), duplicative therapy 765(28.7%), wrong dose 454(%). The most common procedures involve medication errors were wrong documentation 442(16.6%), duration 168(6.3%) wrong quantity 162(6.4%). Majority of the medication errors were contributed by physicians (99.2%) and 0.7% of them were due to the pharmacist. In conclusion study findings reported that yet some kind of medication errors has been under reported and it was common in most hospital, further studies with intervention programs needed to control the incidence of medication errors in a Saudi hospital

Current situation of surgical blood ordering and value of optimizing preoperative blood ordering / 中国输血杂志

【Objective】 To retrospectively analyze the situation of surgical blood ordering in our hospital and explore the value of optimizing preoperative blood ordering. 【Methods】 Surgical blood ordering and utilization data of West China Hospital of Sichuan University from 2012 to 2018 were gathered to evaluate the rationality of preoperative blood ordering by calculating the indicators including transfusion rate, transfusion probability, transfusion index etc. and recommend preoperative blood ordering guided by transfusion index ≥ 0.3, the transfusion rate ≥ 5%, and the transfusion index ≥ 0.5 respectively to calculate the cost saved. 【Results】 1) The preoperative blood ordering of Department of Cardiac Surgery and Burn Plastic Surgery were relatively rational, while other Surgery Departments was excessive, especially the Thoracic Surgery; 2) Among the top fifteen surgeries ranked by blood ordering rate, the blood ordering was rational for mitral valve replacement, ventricular septum (repair/occlusion), and aortic valve replacement, while excessive for other 12 surgeries, especially for lung resection surgery; 3) The surgical blood ordering guided by the three indicators can reduce 19% ~80% theoretically, saving 0.39~1.28 million yuan per year. 【Conclusion】 Preoperative blood ordering of the Department of Cardiac Surgery and Burn Plastic Surgery in our hospital is relatively rational. While excessive blood ordering exists in other surgical departments, especially for thoracic surgery. The establishment of Maximum Surgical Blood Order Schedule can reduce unnecessary blood ordering and improve blood utilization, and save manpower and material resources, and reduce the costs of patients.

Analysis of cross matching to transfusion ratio of blood components in blood bank SKIMS, Soura: a prospective one year study

Background: Blood requisitions received in blood bank for elective and emergency procedures from surgery, trauma, Obstetrics and Gynaecology Department are often associated with excessive demand for cross matching of blood which is often more than the required blood and blood components. In this study, our goal was to use the blood stocks more efficiently and reduction in the wastage due to over dating and to prevent injudicious pre-operative cross-matching and utilization of blood.Methods: This was a prospective study conducted in the Department of Blood Transfusion and Immunohematology of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar over a period of one year with effect from September 2017 to August 2018. Source was requisition forms and blood bank records of patients who underwent elective procedures in the hospital. For the purpose of analysis, departments were categorized into surgical and allied branches i.e Cardiovascular Surgery (CVTS), Neurosurgery, General Surgery and Obstetrics and Gynaecology. Department wise utilization of blood Components cross matching to Transfusion ratio (C/T), transfusion probability (T%) and Transfusion Index (TI) were calculated. Data was entered and analyzed using Microsoft excel window 2010. The obtained data was evaluated and presented in the tabular and diagrammatic forms.Results: A total of 3940 requests for cross matching of blood and its components were received for 3072 patients. Out of these, 2048 units were transfused. The total C/T Ratio, Transfusion Probability (T%) and Transfusion Index (TI) was 1.92, 42.5% and 0.6 respectively.Conclusions: To reduce the injudicious usage of blood, blood transfusion services need to adopt blood conserving policies. Efforts should be made to adopt more conservative transfusion thresholds, periodic feedback to improve blood ordering, conduct regular auditing, handling, distribution and utilization practices of this scarce resource.

Influence of Ordering Kiosk Nutrition Information Transparency and Information Quality on the Customer Behavioral Intention in Fast Food Restaurants

This study examined the perception and behavior of fast food restaurant customers toward ordering kiosk nutrition information. Specifically, the influence of nutrition information transparency and information quality on behavioral intention and revisit intention were identified. In addition, the difference in the nutrition information transparency and information quality was analyzed according to the health consciousness of the customers. The study employed a self-administered survey that was distributed both online and offline from November 8~22, 2018. The sample of the study was customers who had experienced ordering from the kiosk in a fast food restaurant in the six months prior to taking the survey. A total of 250 (98.0%) respondents completed the survey, which was used for data analysis. As a result, there was a significant relation between transparency and nutrition information quality (P<0.001). The higher the visibility and inferability of the nutrition information, the better the nutrition information quality. Nutrition information quality has a significant impact on the levels of customer satisfaction and revisit intention (P<0.001). For the differences in the transparency and nutrition information quality by health consciousness of customers, the results indicated that groups with high health consciousness (3.74 or higher) perceived a higher transparency and nutritional information quality than those with a lower health consciousness. These findings can form the basis of a strategy in developing nutrition information of ordering kiosks in restaurants. In addition, it can be applied to academia and industry.

Study on the characteristics of major birth defects in 1.69 million cases of fetus in Guangxi Zhuang Autonomous Region / 中华流行病学杂志

Objective@#Tracking the information on 1.69 million fetal cases across Guangxi Zhuang Autonomous Region (Guangxi) so as to study the occurrences of total and major birth defects in order to evaluate the ability on related prevention and control programs in Guangxi.@*Methods@#Using the self-developed "Gui Women’s System" to establish a database of 1.69 million fetal cases in Guangxi and to analyze the distribution of time, space and population, as well as the outcomes of pregnancy, using the big data.@*Results@#During the 29 months of observation, the overall live birth rate was 99.25%, with stillbirth rate during pregnancy as 0.44%, stillbirth rate during birth as 0.02%, and the 0-6 days mortality rate as 0.14%. The total detection rate on birth defects was 197.63/10 000; the incidence rate was 103.04/10 000, the birth rate was 102.55/10 000. The overall discovery rate of major birth defects was 48.33/10 000, with the incidence rate as 783 000, the birth rate as 0.58/10 000. The discovery rates of major birth defects in 14 cities were between 35 and 68/10 000, and the birth rate dropped significantly to less than 1.00 in 10 000. Nationalities showed that the number of pregnant women with birth defects more than 50 000 would include Hui (9.68/10 000), Yao (9.57/10 000), and Jing (9.37/10 000). With the increasing age of gestation, number of birth defects, incidence of major birth defects also increased. Ninety-five percent of the major birth defects were found within <28 weeks and with the top 5 kinds of major birth defects as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). The top 5 major birth defects appeared as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000).@*Conclusion@#Programs leading to increase the rate on discovery of major birth defects were fundamental in effectively reducing the major birth defects.

Prueba de patrones de frecuencia y patrones de duración: evaluación del ordenamiento auditivo temporal / Frequency pattern and duration pattern test: assessment of auditory temporal ordering

Los aspectos temporales de la audición se consideran unos de los mecanismos claves del procesamiento auditivo, ya que resultarían críticos para el adecuado funcionamiento del resto de los procesos auditivos centrales. El ordenamiento auditivo temporal es una de las cuatro habilidades de los aspectos temporales de la audición y se refiere al procesamiento de dos o más estímulos auditivos según su orden de aparición u ocurrencia en el dominio temporal. Ha sido uno de los procesos más ampliamente estudiados debido a sus implicancias en el resto de las habilidades auditivas, así como también en numerosas actividades de la vida diaria, incluyendo la percepción y la discriminación de los sonidos del habla. Históricamente se han utilizado dos pruebas para evaluarlo: la prueba de patrones de frecuencia y la prueba de patrones de duración. Ambas pruebas cuentan con buena sensibilidad y especificidad para detectar lesiones del sistema nervioso auditivo central, incluyendo el hemisferio derecho, izquierdo y cuerpo calloso. En la actualidad, ambas pruebas son utilizadas con frecuencia debido a su eficiencia, su facilidad para ser administrada y la disponibilidad de valores normativos para un amplio rango de población. Se recomienda ampliamente su utilización en la práctica clínica considerando la obtención de valores normativos locales.

The temporal aspects of audition are considered one of the key mechanisms of auditory processing, as they would be critical for the proper functioning of the rest of the central auditory processes. The auditory temporal ordering is referred to one of the four skills of the temporal aspects of audition and refers to the processing of two or more auditory stimuli in their order of appearance or occurrence in the time domain. It has been one of the most widely studied processes due to its implications for the rest of listening skills, as well as in numerous activities of daily life, including perception and discrimination of speech sounds. Historically, two test has been used to evaluate: the frequency pattern and duration pattern tests. Both tests have good sensitivity and specificity to detect lesions at the central auditory nervous system, such as right and left hemisphere and corpus callosum dysfunctions. Currently, both tests are commonly used clinically due to its efficiency, ease of administration and the availability of normative data in wide range of population. Their use is strongly recommended in clinical practice considering obtaining local normative values.

Reveal of the 374th Clause of Treatise on Febrile Disease / 浙江中医药大学学报

[bjective]This paper is about to expound the true meaning of the 374th clause of Treatise on Febrile Diseases. [Methods] Under the guidance of dynamic thinking of Treatise on Febrile Diseases, with the help of other clauses about Zaoshi syndrome, Small Decoction for Ordering the Qi, Gardenia and Prepared Soybean Decoction, to understand the 374th clause.[Results] The 374th clause is not alone, it should be combined with the 375th clause, they tell us when we treat the combination of Shi and Re syndrome of Yangming disease, we should use Small Decoction for Ordering the Qi first, then use Gardenia and Prepared Soybean Decoction. At the same time if we want to understand the 374th clause, we should combine it with the 368th clause to 375th clause, it tells us the treatment and difference between the diarrhea of cold, wet heat, Shi and Re, deficient heat etc. [Conclusion]This clause institutes the principle of the treatment for Shi and Re syndrome of Yangming disease, completing the system of treating diarrhea. It also tells us how to combine two decoctions.

Medicine Procurement and Inventory Control Strategies Based on Inventory Model Approach / 中国药房

OBJECTIVE:To work out the optimal inventory levels in zero inventory management mode through model predic-tion and control strategy,by using the inventory upper & lower limits settings generally available in the information management system of health care institutions. METHODS:Multi-varieties joint ordering modelwas constructed by referring to operations management,time series analysis and quantitative approach to decision-making,that is,to make a prediction of upper&lower lim-its on medicine inventory based on historical data and applicable mathematical models(fixed order interval model and re-order mod-el,i.e. FOI and ROP),and compared with real results;based on above,specific medicine procurement and inventory control strat-egies would be developed and an evaluation of the application effects would be made. RESULTS:The error test and reproducibility test exhibited that the out-of-stock ratio remained under 3.36%,of which 71.24% could be effectively alarmed;under computer simulation and practical operation,the instant replenishment rate reduced by 9.33% and 13.03%,OOS ratio down by 11.11% and 27.45%,and average daily inventory turnover rate up by 30.19% and 15.85% respectively,all showing remarkable improvements compared to before the implementation of the mode. CONCLUSIONS:This model is of favorable accuracy and operability,there-fore it can lay foundation for rational and well-founded decisions in medicine procurement and inventory control in zero inventory management mode.

Las unidades de planificación y gestión territorial como directriz para la zonificación urbana / Planning units and land management as guidelines for urban zoning

El presente artículo, derivado de investigación, presenta el marco conceptual y metodológico resultados del estudio de las Unidades de Planificación Territorialy de Gestión como Instrumento Operativo para la toma de Decisiones Urbano Rural, los POTs y PDM, instrumentos de planteamiento en el corto, mediano y largo plazo, en este orden la zonificación del territorio se convierte en la alternativa para plantear y fortalecer las Unidades de Gestión y Planificación Territorial donde se debe fortalecer la institucionalidad a partir de la incorporación de los actores y sectores público, privado y sociedad civil.

This current article, derived from a piece of research, introduces in the theoretical and methodological frameworks, the results of a study of the Land Planning Units and of Management as an Operational Instrument for the Rural-Urban decisionmaking, the Territorial Ordering Plan –TOP– and Municipal Development Plan –MDP–, instruments of approach in the short, medium and long terms; in this order, the zoning of the territory becomes an alternative to raise and to strengthen the Management Units and the Territorial Planning, where the institutional framework must be consolidated from the incorporation of public, private actors and sectors, and the civil society.

Servicios públicos domiciliarios: ¿derechos humanos o productos para la venta? Caso Medellín / Home utilities: are they human rights or products for sale? The Medellin Case

El presente artículo presenta los resultado de investigación encaminada a demostrar y visibilizar, en la ciudad de Medellín, las múltiples afectaciones a personas por la ausencia de servicios públicos domiciliarios en sus viviendas, aún y la capacidad técnica, operativa y financiera de la empresa prestadora de servicios en la ciudad: Empresa Públicas de Medellín (Epm E.S.P), lo que supone una inadecuada lectura de la realidad de la ciudad, principalmente en las zonas periféricas y zonas de alto riesgo. Esta situación lleva a que los ciudadanos recurran a las vías judiciales o a las vías de hecho para proveerse del servicio y en cualquiera de las dos vías se termina por generarle una serie de dificultades de orden jurídico, social y económico al Municipio que es, según la Ley 142 de 1994, el responsable de garantizar el derecho a los servicios públicos domiciliarios; situaciones que pudiesen contar con una solución más adecuada en tanto que ajustada a las realidad de la ciudad.

This current paper introduces the research results aiming at demonstrating and identifying, in the city of Medellin, the multiple effects to people by the lack of home utilities, still and the technical, operational, and financial capacities of the company providing services in the city: Public Companies of Medellin (EPM -ESP), which supposes an inadequate reading of the reality of the city, mainly on the outskirts and high-risk areas. This situation makes the citizens resort to the judicial routes or assault and battery in order for them to provide with the service, and in either of the two routes, a series of legal, social, and economic difficulties are derived, which becomes a problem to the Municipality, which according to the Law 142 as of 1994, is responsible for ensuring the people the right to home utilities, situations which could have a moreadequate solution to the extent that it can be adjusted to the reality of the city.

A survey on the sodium content of customers' orderings at three restaurants in Beijing / 中华流行病学杂志

Objective To survey the mean sodium content of menu offering and customers' orderings on sodium when eating out.Methods All weights of ingredients of menu offerings at three Chinese restaurants with Wenzhou,Shandong,and Yunnan cuisines,in Beijing,were collected and their sodium values were estimated based on data from the Chinese Food Composition.All records from customers' orders were collected in a certain period of time from year 2011 to 2013.The mean sodium content of ordering per person and the proportion of all orders exceeding the recommended daily sodium limit that applicable to most native Chinese,were estimated.Results Of all the menu offerings,hot dishes (1 728.6 mg; P25,P75:1 198.7,2 482.8) and soup dishes (2 101.5 mg;P25,P75:1 467.8,2 291.2) had the highest sodium contents,followed by cold dressed dishes (790.7 mg; P25,P75:128.1,1 472.9) staple foods (802.9 mg; P25,P75:115.1,1 563.2) while the beverages having the lowest sodium contents (17.0 mg;P25,P75:2.0,19.5) (P＜0.05).Meat dishes (1 796.3 mg;P25,P75:1 303.9,2 670.3) contained more sodium than vegetable dishes (1 105.5 mg; P25,P75:423.6,1 628.6)(P＜0.001).The median sodium contents in per person orderings were 2 325.6 mg (P25,P75:1 700.7,3 213.8) for lunch and 2 542.5 mg (P25,P75:1 857.5,3 498.1) for dinner.Current dietary guideline recommended for Chinese adults was:in general,the amount of consumption should not exceed 2 400 mg of sodium per day.Based on the recornmended optimal daily calories intake ratio as 3 ∶ 4 ∶ 3for breakfast,lunch,and dinner,we would suggest that the sodium intake should follow the amount as 960 mg for lunch and 720 mg for dinner.Our data indicated that 97.5％ of the ordered meals appeared that they were over the recommended sodium limit and 76,5％ of the tables showed two times more than the limit of recommendation.Conclusion Soup and hot dishes provided at these three restaurants contained more sodium contents.People ordered dishes at restaurants would contain more sodium than the recommended Chinese daily sodium intake.

Instalando pré-requisitos de leitura para dois alunos com deficiência intelectual / Reading prerequisite installation in two students with intellectual deficiencies / Al instalar los requisitos previos para la lectura de dos alumnos con discapacidad intelectual

A recombinação silábica para formar novas palavras tem se mostrado uma alternativa promissora no ensino de leitura generalizada para indivíduos com desenvolvimento atípico. No entanto, organizar as letras que constituem as palavras é um conceito básico indispensável para que se instalem os rudimentos da leitura, ainda que sejam palavras simples compostas por uma ou duas sílabas. O presente estudo teve por objetivo instalar os pré-requisitos do comportamento de ordenação dos símbolos gráficos do alfabeto romano para indivíduos com deficiência intelectual. Participaram do estudo dois alunos matriculados na escola da Apae. Formas não representacionais apresentadas em quatro tamanhos foram inicialmente utilizadas, e a resposta requerida foi selecioná-las para formar três sequências. Seguindo o mesmo procedimento, foram utilizadas letras como estímulos para formar palavras dissílabas. Os resultados mostraram que os alunos foram capazes de ordenar as letras formando as palavras após aprenderem a organizar os estímulos não representacionais, utilizados como pré-requisito.

The syllable recombination to form new words has been shown as a promising alternative to teach generalized reading to individuals with atypical development. However, letter organization to form words is a basic concept necessary to install the rudiments of reading, even if the words are simple with one or two syllable. The present study had the goal of installing the pre-requisites behavioral of graphic symbol ordination of the Roman alphabet in individuals with intellectual deficiencies. Two students from Apae School participated of the study. Non-representational shapes presented in four sizes were initially used and the required response was to select them to form three sequences. Using the same procedure, letters were used as stimuli to form two-syllable words. The results showed that the students were capable of ordering the letters to form words after learning to organize the non-representational stimuli as a prerequisite.

La recombinación silábica para formar nuevas palabras se ha mostrado como una alternativa prometedora en la enseñanza de lectura generalizada en los individuos con desarrollo atípico. Sin embargo, organizar las letras que constituyen las palabras es un concepto básico esencial para instalar los rudimentos de la lectura, aunque sean palabras sencillas de una o dos sílabas. El propósito de este estudio fue instalar los requisitos previos para el comportamiento de la coordinación de símbolos gráficos del alfabeto romano para las personas con discapacidad intelectual. Participaron en el estudio, dos estudiantes matriculados en la escuela de Apae. Formas no representacionales presentadas en cuatro tamaños fueron originalmente utilizadas y la respuesta necesaria fue seleccionarlas para formar tres secuencias. Siguiendo el mismo procedimiento se utilizaron las letras como palabras bisilábicas. Los resultados mostraron que los estudiantes fueron capaces de ordenar las letras que forman las palabras después de aprender a organizar los estímulos no representacionales, utilizados como un requisito previo.

Integración territorial de Palestina caldas a través de los macroproyectos de importancia regional / Territorial iteggration in Palestina, caldas trhough macroprojects of regional imprrtance

El desarrollo de estrategias y mecanismos para la integración territorial es de gran importancia para el municipio de Palestina y otros similares que ostentan la categoría más baja dentro de la clasificación municipal, condicionada por algunas características de desarticulación física y funcional en el territorio. Asimismo, es relevante y extrapolable a otros municipios que han sido objeto de la implantación de macroproyectos de importancia regional, sin la planeación adecuada, ni una articulación al contexto y a las características municipales. La primera contribución de esta investigación consiste en la elaboración de la caracterización regional del territorio y de la unidad de análisis, desde las dimensiones del desarrollo y sus atributos, estableciendo los desequilibrios en la ocupación del territorio, pero también sus potencialidades y oportunidades de desarrollo. Posteriormente se establecen los escenarios prospectivos posibles para el territorio analizado, desde la espacialización de los determinantes de ordenamiento territorial que en la actualidad orientan los usos del suelo y su confrontación con las perspectivas generales de desarrollo y se determinan los escenarios propuestos, los cuales simulan una forma de ocupación de las áreas de expansión de la microrregión, considerando las oportunidades, posibilidades y limitantes que genera el establecimiento de los macroproyectos. Seguidamente se establecen las líneas de acción derivadas de los escenarios prospectivos y la construcción de los macroproyectos con incidencia subregional, micro-regional y municipal, en los modelos de ocupación territoriales, desequilibrios regionales, usos del suelo, conectividad vial, reconversión de usos y solución de déficits, recuperación de áreas ambientalmente sensibles, relocalización de asentamientos y en la articulación modal, entre otros factores. Por último se formulan los lineamientos de política y objetivos que permitirán el desarrollo de un proyecto de ciudad, dirigidos a influir profundamente en la red urbano regional, promoviendo la adopción de los modelos de desarrollo sostenible, endógeno, local y regional, enfoques que originen de manera específica y en forma complementaria, modelos centrados en logros cualitativos como la urbanización compacta, variada, multipolar, equilibrada, limpia y eficiente energéticamente.

Developing strategies and mechanisms for regional integration is of great importance to the municipality of Palestina and other similar municipalities which hold the lowest category in the municipal influenced classification becaue of some physical and functional disruption characteristics in the territory. It is also relevant and applicable to other municipalities where large scale projects of regional importance, have been implementing without either proper planning or an articulation with the context and municipal characteristics. The first contribution of this research is the development of the regional characterization of the territory and the unit of analysis, from the dimensions of development and its attributes, and setting the imbalances in land use, but also its potential and development opportunities. Subsequently, the possible prospective scenarios for the analyzed area are established from the spatial determinants of land that currently guide land use and its confrontation with the overall development perspectives and the proposed scenarios are determined, which simulate a form of occupation of the mirco-region expansion areas, considering the opportunities, possibilities and constraints generated by the establishment of the macro projects. Afterwards, the lines of action arising from the prospective scenarios and the construction of the macroprojects with a sub-regional, microregional and municipal impact in the models of territorial occupation, regional imbalance, land use, road connectivity, use conversion and deficits solution, recovery of environmentally sensitive areas, relocation of settlements and modal articulation, among other factors, are established. Finally, the policy guidelines and objectives which allow the development of a city project are formulated, directed to influence profoundly the regional urban network, promoting the adoption of sustainable development models, endogenous, local and regional approaches that originate in an specific and complementary way originate, qualitative achievement centered models such as, varied, multi-polar, balanced, clean and energy efficient compact urbanization.

Dimeric and dipolar ground state orders in colloidal molecular crystals

A two dimensional colloidal suspension subject to a periodic substrate evolves into a colloidal molecular crystal under situationsofstrongconfinement. Wefocusonthelongrangeorientationalordertherebyemerging, inthegroundstate. We study by simulations the situations where in each trap lies a pair of identical colloids, or alternatively a pair of oppositelychargedmacroions. We consider square or triangular geometries for the periodic confinement, together with less symmetric distorted lattices.

Uma suspensão bidimensional coloidal sujeita a um substrato periódico evolui para um cristal coloidal molecular em situações de forte confinamento. Nós focamos na ordem de orientação emergindo a partir do estado fundamental. Fazendo uso de simulações, estudamos as situações onde em cada armadilha reside um par de colóides idênticos ou, alternativamente, um par de macro-íons de cargas opostas. Consideramos geometrias quadradas ou triangulares para o confinamento periódico com arranjos simétricos com menor distorção.

A Validation Study of the Korean-version of Symmetry, Ordering and Arranging Questionnaire / 신경정신의학

OBJECTIVES: The Symmetry, Ordering and Arranging Questionnaire (SOAQ) has been reported as a valid tool for the assessment of symmetry, ordering and arranging compulsive behaviors of patients with obsessive compulsive disorder. It was introduced by Radomsky and Rachman in 2004. The aim of this study was to assess the reliability, validity and psychometric properties of the Korean-version of the SOAQ (K-SOAQ). METHODS: Two hundreds twenty eight under-graduate college students were enrolled in this study. They were assessed with K-SOAQ, Obsessive-Compulsive Inventory-Revised (OCI-R), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: There were no significant differences in sex, education, and total scores of BDI and BAI. The Cronbach's alpha coefficient of K-SOAQ was high, Cronbach's alpha=0.96. There was strong evidence for a one-factor solution, accounting for 60.3% of the variance. Convergent validity was examined through correlations between the SOAQ and the OCI-R (r=0.61). Divergent validity was examined through correlations between the SOAQ and two self report measures; BDI (r=0.12) and BAI (r=0.19). CONCLUSION: The K-SOAQ showed good reliability and validity for the assessment of severity of compulsive characteristics regarding symmetry, ordering and arranging. The K-SOAQ is a useful instrument for assessing compulsive symptoms related with symmetry, ordering and arranging in Korea.

Escritores-fantasma e comércio de trabalhos científicos na internet: a ciência em risco / Ghostwriters and commerce of scientific papers on the internet: science at risk

Fraudes na produção científica não são situações raras, mesmo na área da saúde. Entre elas incluem-se alguns tipos de má conduta em autoria, como o plágio e a prática de ghostwriting (escrever um artigo com o nome de outro autor) patrocinada pela indústria farmacêutica. Um outro tipo particularmente nocivo para a ciência é o comércio de trabalhos científicos, que tem crescido na internet e tem sido freqüentemente noticiado na imprensa. OBJETIVOS: Analisar o comércio de trabalhos científicos na internet e o modo como são oferecidos esses serviços. MÉTODOS:Foram selecionadas 18 páginas eletrônicas nacionais que oferecem serviços de elaboração de artigos científicos, monografias, dissertações e teses. Para cada uma foi enviada mensagem solicitando informações sobre a elaboração de uma monografia de conclusão de um curso de especialização fictício. A pesquisa já havia sido realizada, de forma que suas características técnicas, éticas e bibliográficas já eram conhecidas pela autora. RESULTADOS: Dez empresas aceitaram a encomenda e, exceto por uma delas, não se opuseram às condições impostas: pesquisa de campo, aprovação por comitê de ética em pesquisa e utilização das normas de Vancouver. Seis não responderam e duas não aceitaram a encomenda alegando não ter colaboradores disponíveis. CONCLUSÃO: O comércio de trabalhos científicos é uma realidade que pode interferir negativamente na formação ética, científica e profissional de graduandos e pós-graduandos, bem como na produção científica, falseando dados e informações da literatura. Recomenda-se uma nova abordagem principalmente na avaliação de trabalhos de conclusão de cursos e monografias.

Frauds in scientific production are not a rare phenomenon, even in the medical field. Among these frauds are some types of authorship misconduct, such as plagiarism and ghostwriting sponsored by pharmaceutical industries. Another type of misconduct, which is particularly detrimental to science, is the ecommerce of scientific works, which has been growing and frequently shown in the press. OBJECTIVE: To analyze the e-commerce of scientific papers and the means by which these services are offered. METHODS: Eighteen Brazilian web sites that offer elaboration of scientific papers were selected. A request for the elaboration of a final essay for a forged post-graduatie course was sent to each of them. The research requested had already been completed, consequently technical, ethical and bibliographical characteristics were already known to the author. RESULTS: Ten enterprises accepted the order and, except for one, they have not objected to the conditions imposed: Field research, approval by an ethics committee on research and use of the Vancouver norms. Six have not replied and two have not accepted the order alleging that they had no co-workers available for the task. CONCLUSIONS: E-commerce of scientific papers is a fact which can negatively interfere in the ethical, scientific and professional development of graduate and post-graduate students, as well as in scientific production by adulterating data and information found in literature. A new approach is recommended, especially when evaluating final essays.

Avaliação da necessidade da solicitação de exames complementares para pacientes internados em unidade de terapia intensiva de hospital universitário / Laboratory exams necessity for patients admitted to an university hospital intensive care unity

JUSTIFICATIVA E OBJETIVOS: O aumento progressivo nos recursos diagnósticos tem aumentado a qualidade e a quantidade dos exames de laboratório realizados nas Unidades de Terapia Intensiva (UTI). A influência deste aumento sobre a morbidade e mortalidade não está bem definida. O objetivo deste estudo foi avaliar a freqüência da solicitação de exames na UTI do HU e verificar se houve ou não relação entre a quantidade de exames solicitados e a idade dos pacientes, o seu desfecho e a gravidade das doenças. MÉTODO: Coorte prospectiva, com abordagem quantitativa. Foram analisados os exames dos pacientes internados na UTI, dos meses de julho a dezembro, 2005. Foram coletados dados clínicos e demográficos dos pacientes e quantificados diariamente os exames mais freqüentemente solicitados na UTI. Seqüencialmente a média diária de exames foi calculada para todo o período de internação. Para fins de análise os pacientes foram divididos obedecendo três critérios: faixa etária, desfecho de saída da UTI e gravidade. Para a análise estatística foram utilizados os testes Exato de Fisher, Qui-quadrado e ANOVA. RESULTADOS: Foram admitidos 113 pacientes durante o período de estudo. A taxa média foi de 11,5 exames por dia de internação. Estes valores não apresentaram diferença estatística quando comparados entre os pacientes com idade acima ou abaixo de 60 anos, entre os que sobreviveram e os que foram a óbito e entre aqueles que tiveram taxa de óbito estimada em menos que 50 por cento ou mais que 50 por cento. CONCLUSÕES: Os exames solicitados não guardam correlação clínica e prognóstica com sua solicitação. Não houve estatística significativa quando a taxa diária média de exames foi relacionada à idade do paciente, ao desfecho e à gravidade.

BACKGROUND AND OBJECTIVES: The progressive increasing diagnostic resources had influenced the quality and quantity of laboratory exams. It is not clear if the amount of exams performed influence the morbidity and mortality in the ICU patients. The purpose of this study was to appraise the frequency of the most ordering tests in the ICU of HU-UFSC and to check if there was connection between them and the age, the destiny until the ICU discharge and the estimate severity of their diseases. METHODS: Prospective cohort study with qualitative approach. The blood samples of admitted patients were analyzed, from July to December 2005. Clinical and demographic features were collected and the most frequently blood-samples were quantified per day. In the sequence the daily rate of exams were calculated during all the admission period. The patients were analyzed according to three criterions: age, destiny until the ICU discharge and estimate severity according to APACHE II index. Data were analyzed using Fisher Exact, Chi-square and ANOVA tests. RESULTS: One hundred and thirteen patients were enrolled to this study. The average test-ordering was 11.50 per day. These numbers didn't have statistical difference when they were compared between survivor and non-survivor patients, and between those whose the death estimated tax was bigger or smaller than 50 per cent. CONCLUSIONS: The test-ordering didn't show clinical and prognostic relation to its request. There were no statistic relation between the patient's age, ICU discharge and the estimate severity.

Integrated Pharmaceutical Supply Chain Management based on B2B Collaboration and Information Sharing / 대한의료정보학회지

OBJECTIVE: The objective of this research is to design and develop an integrated pharmaceutical supply chain management(SCM) system for optimizing inventory control and reducing material handling costs based on B2B collaboration and information sharing. METHODS: We have analyzed business processes of material handling in hospitals and reviewed system requirements for efficient supply chain management. VMI(Vendor-Managed Inventory), which is one of important applications of SCM, has been adopted. Online procurement system and Web-based information sharing system are developed for the integration of the SCM. RESULTS: The SCM system composed of VMI, CAO(Computer Aided Ordering), and Web-based information sharing system enables hospitals to optimize the procurement processes and inventory control of pharmaceutical products. By sharing information with hospitals, the wholesaler can get information more timely and use exact data about inventory status and drug usage volumes of hospitals, so that it can forecast future demand more accurately, which facilitates needed products to be supplied timely and cost-effectively. CONCLUSION: By the B2B collaborations and information sharing among SCM participants, the SCM system have been implemented successfully in the medical center. It improves material handling of hospitals, reducing inventory management costs and ultimately improving quality of patient care.