In-silico mechanistic analysis of adsorption of Iodinated Contrast Media agents on graphene surface.

The study aims at assessing the potential of graphene-based adsorbents to reduce environmental impacts of Iodinated Contrast Media Agents (ICMs). We analyze an extensive collection of ICMs. A modeling approach resting on molecular docking and Density Functional Theory simulations is employed to examine the adsorption process at the molecular level. The study also relies on a Quantitative Structure-Activity Relationship (QSAR) modeling framework to correlate molecular properties with the adsorption energy (Ead) of ICMs, thus enabling identification of the key mechanisms underpinning adsorption and of the key factors contributing to it. A collection of distinct QSAR-based models is developed upon relying on Multiple Linear Regression and a standard genetic algorithm method. Having at our disposal multiple models enables us to take into account the uncertainty associated with model formulation. Maximum Likelihood and formal model identification/discrimination criteria (such as Bayesian and/or information theoretic criteria) are then employed to complement the traditional QSAR modeling phase. This has the advantage of (a) providing a rigorous ranking of the alternative models included in the selected set and (b) quantifying the relative degree of likelihood of each of these models through a weight or posterior probability. The resulting workflow of analysis enables one to seamlessly embed DFT and QSAR studies within a theoretical framework of analysis that explicitly takes into account model and parameter uncertainty. Our results suggest that graphene-based surfaces constitute a promising adsorbent for ICMs removal, π-π stacking being the primary mechanism behind ICM adsorption. Furthermore, our findings offer valuable insights into the potential of graphene-based adsorbent materials for effectively removing ICMs from water systems. They contribute to ascertain the significance of various factors (such as, e.g., the distribution of atomic van der Waals volumes, overall molecular complexity, the presence and arrangement of Iodine atoms, and the presence of polar functional groups) on the adsorption process.

Probabilistic assessment of failure of infiltration structures under model and parametric uncertainty.

We focus on the quantification of the probability of failure (PF) of an infiltration structure, of the kind that is typically employed for the implementation of low impact development strategies in urban settings. Our approach embeds various sources of uncertainty. These include (a) the mathematical models rendering key hydrological traits of the system and the ensuing model parametrization as well as (b) design variables related to the drainage structure. As such, we leverage on a rigorous multi-model Global Sensitivity Analysis framework. We consider a collection of commonly used alternative models to represent our knowledge about the conceptualization of the system functioning. Each model is characterized by a set of uncertain parameters. As an original aspect, the sensitivity metrics we consider are related to a single- and a multi-model context. The former provides information about the relative importance that model parameters conditional to the choice of a given model can have on PF. The latter yields the importance that the selection of a given model has on PF and enables one to consider at the same time all of the alternative models analyzed. We demonstrate our approach through an exemplary application focused on the preliminary design phase of infiltration structures serving a region in the northern part of Italy. Results stemming from a multi-model context suggest that the contribution arising from the adoption of a given model is key to the quantification of the degree of importance associated with each uncertain parameter.

Mental health impacts of nurses caring for patients with COVID-19 in Peru: Fear of contagion, generalized anxiety, and physical-cognitive fatigue.

The health crisis caused by COVID-19 has resulted in the physical and emotional deterioration of health personnel, especially nurses, whose emotional state is affected by the high risk of contagion, the high demands of health services, and the exhausting working hours. The objective of this research was to determine the relationship between fear, anxiety, and fatigue of nurses caring for patients with COVID-19 in a second level public hospital in Peru. This study presents a quantitative approach and correlational level, cross-sectional, and non-experimental design. The sample consisted of 145 nurses who attended patients with COVID-19 in health care areas. The results show a significant relationship between fear of contagion and physical-cognitive fatigue (p < 0.001; r = 317) and a significant relationship between generalized anxiety and physical-cognitive fatigue (p < 0.001; r = 480). It is concluded that in this context, both fear of contagion and generalized anxiety are related to physical-cognitive fatigue.

Mental Health Projects for University Students: A Systematic Review of the Scientific Literature Available in Portuguese, English, and Spanish.

The mental health of college students has been the source of research, projects, and public policies involving education, health, and psychology professionals. Having as its axis the study of mental health and the phenomenon of psychological illness, this systematic review aims to characterize mental health programs directed to college students, as well as the forms of interventions offered to reduce the incidence of psychological disorders. From the proposal, a survey was conducted in the databases Scopus, Lilacs, and the repository Alicia, in the period between 2010 and 2021, choosing the search phrase "Programas de saúde mental para universitários" in Portuguese, "Mental health projects for university students" in English, and "Proyectos en salud mental para estudiantes universitarios" in Spanish. The research areas spanned humanities and social sciences, with peer-reviewed and open access articles. The questions that instigated the study were as follows: What are the mental health problems affecting college students? What type of strategy has been adopted to map the demands of university students in relation to mental illness? How can the university space reorganize itself to work on interventional-preventive aspects, according to the studies? Initially, 740 203 articles were obtained, and after sifting through 13 productions, using the PRISMA systematization. Despite several research interrelating mental health and university space, most were dedicated to data collection, using questionnaires, inventories, and scales, standardized and non-standardized. Only three studies described intervention projects and programs to reduce the problems of psychological distress in college students. Unanimously, the investigations emphasize the need for monitoring the higher education population regarding mental health and, in parallel, the implementation of institutional public policies to meet the students' demands and reduce the rates of problems in the educational field.

Factores mecánicos y químicos presentes en pacientes oncológicos hospitalizados con flebitis

RESUMEN Objetivo: Identificar los factores mecánicos y químicos presentes en pacientes oncológicos con flebitis, hospitalizados en un establecimiento público de alta complejidad, Lima-Perú; describir las técnicas invasivas más frecuentes practicadas en los procesos de hospitalización y las tendencias de los últimos 5 años. Material y Método: Enfoque cuantitativo, observacional, retrospectivo, con una población total de 295.151 (del 2016-2020), de los que 298 pacientes oncológicos tuvieron flebitis, pero solo 282 contaron con registros completos valorados por las enfermeras oncólogas según Escala de Maddox que consta de 16 ítems que miden factores mecánicos y químicos. El instrumento fue validado por expertos obteniéndose una validez binomial de 0,7 y una confiabilidad KR20 de 0,8. El análisis de datos se realizó mediante estadística descriptiva, prueba binomial y Chi cuadrado. Resultados: Estos muestran la mayor incidencia en los grados de flebitis II, III y I. Respecto al factor mecánico, se evidencia que el material no estéril, el lugar de inserción del catéter en zona Cubital, Radial y Cefálica y el tiempo de permanencia menor de 72 h se presentan con mayor frecuencia. El factor químico está asociado al uso de antibióticos como Vancomicina y la combinación del Meropenem/ Vancomicina, al uso de agentes citostáticos vesicantes-no vesicantes, así también el analgésico Ketoprofeno seguido con la combinación del Ketoprofeno con Tramadol y al uso de la Ranitidina como protector antiulceroso. Conclusión: Tanto los factores mecánicos y químicos afectan la zona de punción. Enfermería debe continuar capacitando en acciones preventivas para reducir o mitigar las complicaciones en el ámbito asistencial, siendo necesario promover buenas prácticas en la administración terapéutica en este tipo de paciente.

ABSTRACT Objective: To identify the mechanical and chemical factors present in oncological patients with phlebitis hospitalized in a high-complexity public facility, in Lima-Peru; describe the most frequent invasive techniques practiced in hospitalization processes and the trends of the last 5 years. Material and Method: Quantitative, observational, retrospective approach, with a total population of 295,151 (from 2016-2020), of which 298 cancer patients had phlebitis, but only 282 had complete records assessed by oncology nurses according to Maddox scale, which consists of 16 items containing mechanical and chemical factors. The instrument was validated by experts and had a binomial validity of 0.7 and a KR-20 reliability of 0.8. Data analysis was performed using descriptive statistics, binomial test and Chi-square. Results: Show the highest incidence in degrees of phlebitis II, III and I. Regarding the mechanical factor, non-sterile material, the place of insertion of the catheter in the ulnar, radial and cephalic areas and the permanence time of less than 72 h occur more frequently. The chemical factor is associated with the use of antibiotics such as Vancomycin and the combination of Meropenem/Vancomycin, the use of vesicant and non-vesicant cytostatic agents, as well as the analgesic Ketoprofen followed by the combination of Ketoprofen and Tramadol and the use of Ranitidine and an antiulcer protector. Conclusions: Both mechanical and chemical factors affect the insertion site. Nurses should receive training in preventive actions to reduce or mitigate complications in the healthcare setting. It is also necessary to promote good practices in the therapeutic administration with this type of patients.

RESUMO Objetivo: Identificar os fatores mecânicos e químicos presentes em pacientes oncológicos com flebite internados em um serviço público de alta complexidade na cidade de Lima, Peru; descrever as técnicas invasivas mais frequentes praticadas nos processos de hospitalização e as tendências dos últimos 5 anos. Material e Método: Abordagem quantitativa, observacional e retrospectiva, com uma população total de 295.151 (de 2016 2020), dos quais 298 pacientes com câncer apresentaram flebite, mas apenas 282 tiveram registros completos avaliados por enfermeiras oncológicas segundo a escala de Maddox entre 2016-2020. O cadastro é composto por 16 itens que contêm fatores mecânicos e químicos. O instrumento foi validado por especialistas, obtendo validade binomial de 0,7 e confiabilidade KR-20 de 0,8. A análise dos dados foi realizada por meio de estatística descritiva, teste binomial e Qui-quadrado. Resultados: Mostran a mayor incidência nos graus de flebite II, III e I. Em relação ao fator mecânico, fica evidente que o material não estéril, o local de inserção do cateter nas áreas ulnar, radial e cefálica e o tempo de permanencia inferior a 72 h ocorrem com mais freqüéncia. O fator químico está associado ao uso de antibióticos como a Vancomicina e a combinação de Meropenem/Vancomicina, ao uso de citostáticos vesicantes e não vesicantes, bem como ao analgésico Cetoprofeno seguido da combinação de Cetoprofeno com tramadol e uso de Ranitidina como protetor antiúlcera. Conclusão: Tanto fatores mecânicos como químicos afetam o local da inserção. O pessoal de enfermagem deve receber treinamento em ações preventivas para reduzir ou mitigar as complicações no ambiente de saúde, sendo necessário promover boas práticas de administração terapêutica com este tipo de paciente.

Experiencia docente en la aplicación de metodologías activas de aprendizaje en la educación superior enfermera / Teaching experience in the application of active learning methodologies in nursing higher education

Objetivo: Determinar la experiencia de los docentes sobre la aplicación de metodologías activas de aprendizaje en la formación académica del futuro profesional. Metodología: investigación cualitativa de tipo fenomenológico, descriptiva. Participaron 20 docentes cuyo muestreo fue por conveniencia y saturación de categorías, se utilizó la entrevista semiestructurada y grupo focal para obtener los datos. Resultados: emergieron seis categorías: docentes aplican metodologías activas de aprendizaje, estrategias para la sostenibilidad de las metodologías activas que aplican los docentes, elementos que fortalecen el desarrollo de las metodologías activas de aprendizaje, elementos que limitan el desarrollo de las metodologías activas de aprendizaje, estrategias metodológicas que muestran el areté en la formación del profesional de enfermería y aplicando deficientemente las metodologías activas en la formación profesional. Conclusión: La aplicación de las metodologías activas contribuyen al desarrollo de competencias integrales, favoreciendo la autonomía, confianza y el aprendizaje significativo crítico para su formación profesional.(AU)

Objective: To determine the experience of teachers on the application of active learning methodologies in the academic training of future professionals. Methodology: It was qualitative research of phenomenological, descriptive type. Twenty teachers participated, with a non-probabilistic sampling by convenience and saturation of categories; a semi-structured interview and focus group were used to obtain the data. Results: six categories emerged: teachers apply active learning methodologies, strategies for the sustainability of active methodologies applied by teachers, elements that strengthen the development of active learning methodologies, elements that limit the development of active learning methodologies, methodological strategies that show the areté in the training of the nursing professional and deficient application of active methodologies in professional training. Conclusion: The application of active methodologies contributes to the development of integral competences; favoring autonomy, confidence and critical significant learning for their professional training.(AU)

Humanized Care From the Nurse-Patient Perspective in a Hospital Setting: A Systematic Review of Experiences Disclosed in Spanish and Portuguese Scientific Articles.

Nowadays, humanized care is an essential component in the field of health because the professional work of nursing seeks to provide quality services to patients who are suffering and fear illness or the dying process. Nurses recognize the need to incorporate humanized care into their daily work, as supported by Jean Watson, who states that caring entails establishing an adequate nurse-patient therapeutic relationship, where health education is a tool that promotes self-care in the patient, family, and community. The main objective of this work was to find scientific evidence on humanized care from the perspectives of nurses and hospitalized patients. To meet those research objectives, an exploratory systematic review of articles published in high-quality scientific journals from 2016 to 2020 using the PRISMA methodology in the Scopus and Scielo databases was conducted, yielding 26 studies that were analyzed. The findings show that nurses and patients perceive the need to remove the barriers that limit the advancement of humanized care in hospital institutions because they urgently demand that health professionals in all settings, especially critical ones, strengthen their humanizing role by sharing cordial, empathetic health experiences, and respecting their customs and beliefs during the hospitalization process. As a conclusion of the findings, the nurse-patient professionals agree that health personnel training is critical to providing humanized attention with quality in the hospital context, emphasizing that professional training should develop in practice soft skills, communication, safety environment, and human values.

Formulation and probabilistic assessment of reversible biodegradation pathway of Diclofenac in groundwater.

We present a conceptual and mathematical framework leading to the development of a biodegradation model capable to interpret the observed reversibility of the Pharmaceutical Sodium Diclofenac along its biological degradation pathway in groundwater. Diclofenac occurrence in water bodies poses major concerns due to its persistent (and bioactive) nature and its detection in surface waters and aquifer systems. Despite some evidences of its biodegradability at given reducing conditions, Diclofenac attenuation is often interpreted with models which are too streamlined, thus potentially hampering appropriate quantification of its fate. In this context, we propose a modeling framework based on the conceptualization of the molecular mechanisms of Diclofenac biodegradation which we then embed in a stochastic context, thus enabling one to quantify predictive uncertainty. We consider reference environmental conditions (biotic and denitrifying) associated with a set of batch experiments that evidence the occurrence of a reversible biotransformation pathway, a feature that is fully captured by our model. The latter is then calibrated in the context of a Bayesian modeling framework through an Acceptance-Rejection Sampling approach. By doing so, we quantify the uncertainty associated with model parameters and predicted Diclofenac concentrations. We discuss the probabilistic nature of uncertain model parameters and the challenges posed by their calibration with the available data. Our results are consistent with the recalcitrant behavior exhibited by Diclofenac in groundwater and documented through experimental data and support the observation that unbiased estimates of the hazard posed by Diclofenac to water resources should be assessed through a modeling strategy which fully embeds uncertainty quantification.

Natural springs protection and probabilistic risk assessment under uncertain conditions.

The study introduces a comprehensive framework for natural springs' protection and probabilistic risk assessment in the presence of uncertainty associated with the characterization of the groundwater system. The methodology is applied to a regional-scale hydrogeological setting, located in Northern Italy and characterized by the presence of high-quality natural springs forming a unique system whose preservation is of critical importance for the region. Diverse risk pathways are presented to constitute a fault tree model enabling identification of all basic events, each associated with uncertainty and contributing to an undesired system failure. The latter is quantified in terms of hydraulic head falling below a given threshold value for at least one amongst all active springs. The workflow explicitly includes the impact of model parameter uncertainty on the evaluation of the overall probability of system failure due to alternative groundwater extraction strategies. To cope with conceptual model uncertainty, two models based on different reconstructions of the aquifer geological structure are considered. In each conceptual model, hydraulic conductivities related to the geomaterials composing the aquifer are affected by uncertainty. It is found that (a) the type of conceptual model employed to characterize the aquifer structure strongly affects the probability of system failure and (b) uncertainties associated with the ensuing conductivity fields, even as constrained through model calibration, lead to different impacts on the variability of hydraulic head levels at the springs depending on the conceptual model adopted. The results of the study demonstrate that the proposed approach enables one to (i) quantify the risk associated with springs depletion due to alternative strategies of aquifer exploitation; (ii) quantify the way diverse sources of uncertainty (i.e., model and parameter uncertainty) affect the probability of system failure; (iii) determine the optimal exploitation strategy ensuring system functioning; and (iv) identify the most vulnerable springs, where depletion first occurs.

[A cross-sectional study on the environmental culture and occupational health of informal waste pickers in Lima, Peru]. / Estudio transversal de la cultura ambiental y la salud ocupacional de recicladores informales de Lima, Perú.

PURPOSE: To determine the level of environmental culture of the informal sector waste pickers and compliance with occupational health standards of informal waste pickers. Specific objectives: to explore the relationship between the level of environmental culture and compliance with occupational health standards: exposure to physical, chemical, biological, and ergonomic agents in informal waste pickers in 2019. METHODS: Quantitative, correlational, cross-sectional, and non-experimental study. A sample of 400 informal waste pickers participated. Two questionnaires were applied: environmental culture and occupational health standards. RESULTS: There is a medium positive and weak positive relationship between the environmental culture variable and the different agents (physical, chemical, biological, and ergonomic). There is a significant positive correlation between environmental culture and occupational health. Likewise, there is a weak positive significant correlation between environmental culture and agents (physical, chemical, biological, and ergonomic), and a significant positive correlation between environmental culture and the social responsibility agent. CONCLUSIONS: Informal waste pickers do not have their basic needs and rights met. A lack of occupational health safety characterizes informal recycling, so it is necessary to create formal and safe work environments with health promotion and prevention practices.

OBJETIVOS: Determinar el nivel de cultura ambiental de los recicladores del sector informal y el cumplimiento de los estándares de salud ocupacional de los recicladores informales. Objetivos específicos: conocer la relación entre el nivel de cultura ambiental y cumplimiento de los estándares de salud ocupacional: exposición a los agentes físicos, químicos, biológicos y ergonómicos en los recicladores informales en 2019. METODOLOGÍA: Estudio cuantitativo, correlacional, corte transversal y no experimental. Participó una muestra de 400 recicladores informales. Se aplicaron dos cuestionarios: cultura ambiental y estándares de salud ocupacional. RESULTADOS: Existe relación entre positiva media y positiva débil entre la variable cultura ambiental y los diferentes agentes (físico, químico, biológico y ergonómico). Existe correlación significativa positiva media, entre la cultura ambiental y la salud ocupacional. Igualmente, existe correlación significativa positiva débil entre la cultura ambiental y los agentes (físico, químico, biológico y ergonómico), y correlación significativa positiva entre cultura ambiental y el agente responsabilidad social. CONCLUSIONES: Los recicladores informales no satisfacen sus necesidades básicas y derechos. El reciclaje informal se caracteriza por inseguridad en su salud ocupacional, por lo que es necesario crear entornos laborales formales y seguros, con prácticas de promoción y prevención sanitaria.

Estudio transversal de la cultura ambiental y la salud ocupacional de recicladores informales de Lima, Perú / A cross-sectional study on the environmental culture and occupational health of informal waste pickers in Lima, Peru

OBJETIVOS: Determinar el nivel de cultura ambiental de los recicladores del sector informal y el cumplimiento de los estándares de salud ocupacional de los recicladores informales. OBJETIVOS ESPECÍFICOS: conocer la relación entre el nivel de cultura ambiental y cumplimiento de los estándares de salud ocupacional: exposición a los agentes físicos, químicos, biológicos y ergonómicos en los recicladores informales en 2019. METODOLOGÍA: Estudio cuantitativo, correlacional, corte transversal y no experimental. Participó una muestra de 400 recicladores informales. Se aplicaron dos cuestionarios: cultura ambiental y estándares de salud ocupacional. RESULTADOS: Existe relación entre positiva media y positiva débil entre la variable cultura ambiental y los diferentes agentes (físico, químico, biológico y ergonómico). Existe correlación significativa positiva media, entre la cultura ambiental y la salud ocupacional. Igualmente, existe correlación significativa positiva débil entre la cultura ambiental y los agentes (físico, químico, biológico y ergonómico), y correlación significativa positiva entre cultura ambiental y el agente responsabilidad social. CONCLUSIONES: Los recicladores informales no satisfacen sus necesidades básicas y derechos. El reciclaje informal se caracteriza por inseguridad en su salud ocupacional, por lo que es necesario crear entornos laborales formales y seguros, con prácticas de promoción y prevención sanitaria.

PURPOSE: To determine the level of environmental culture of the informal sector waste pickers and compliance with occupational health standards of informal waste pickers. SPECIFIC OBJETIVES: to explore the relationship between the level of environmental culture and compliance with occupational health standards: exposure to physical, chemical, biological, and ergonomic agents in informal waste pickers in 2019. METHODS: Quantitative, correlational, cross-sectional, and non-experimental study. A sample of 400 informal waste pickers participated. Two questionnaires were applied: environmental culture and occupational health standards. RESULTS: There is a medium positive and weak positive relationship between the environmental culture variable and the different agents (physical, chemical, biological, and ergonomic). There is a significant positive correlation between environmental culture and occupational health. Likewise, there is a weak positive significant correlation between environmental culture and agents (physical, chemical, biological, and ergonomic), and a significant positive correlation between environmental culture and the social responsibility agent. CONCLUSIONS: Informal waste pickers do not have their basic needs and rights met. A lack of occupational health safety characterizes informal recycling, so it is necessary to create formal and safe work environments with health promotion and prevention practices.

Pore-scale velocities in three-dimensional porous materials with trapped immiscible fluid.

We study and document the influence of wetting and nonwetting trapped immiscible fluid on the probability distribution of pore-scale velocities of the flowing fluid phase. We focus on drainage and imbibition processes within a three-dimensional microcomputed tomographic image of a real rock sample. The probability distribution of velocity magnitude displays a heavier tail for trapped nonwetting than wetting fluid. This behavior is a signature of marked changes in the distribution and strength of preferential flow paths promoted by the wettability property of the trapped fluid. When the latter is wetting the host solid matrix, high-velocity areas initially present during single-phase flow conditions are mainly characterized by increased or decreased velocity magnitudes, and the velocity field remains correlated with its counterpart associated with the single-phase case. Otherwise, when the trapped fluid is nonwetting, features that are observed to prevail are appearance and disappearance of high-velocity areas and a velocity field that is less correlated to the one obtained under single-phase conditions.

Space-time mesh adaptation for solute transport in randomly heterogeneous porous media.

We assess the impact of an anisotropic space and time grid adaptation technique on our ability to solve numerically solute transport in heterogeneous porous media. Heterogeneity is characterized in terms of the spatial distribution of hydraulic conductivity, whose natural logarithm, Y, is treated as a second-order stationary random process. We consider nonreactive transport of dissolved chemicals to be governed by an Advection Dispersion Equation at the continuum scale. The flow field, which provides the advective component of transport, is obtained through the numerical solution of Darcy's law. A suitable recovery-based error estimator is analyzed to guide the adaptive discretization. We investigate two diverse strategies guiding the (space-time) anisotropic mesh adaptation. These are respectively grounded on the definition of the guiding error estimator through the spatial gradients of: (i) the concentration field only; (ii) both concentration and velocity components. We test the approach for two-dimensional computational scenarios with moderate and high levels of heterogeneity, the latter being expressed in terms of the variance of Y. As quantities of interest, we key our analysis towards the time evolution of section-averaged and point-wise solute breakthrough curves, second centered spatial moment of concentration, and scalar dissipation rate. As a reference against which we test our results, we consider corresponding solutions associated with uniform space-time grids whose level of refinement is established through a detailed convergence study. We find a satisfactory comparison between results for the adaptive methodologies and such reference solutions, our adaptive technique being associated with a markedly reduced computational cost. Comparison of the two adaptive strategies tested suggests that: (i) defining the error estimator relying solely on concentration fields yields some advantages in grasping the key features of solute transport taking place within low velocity regions, where diffusion-dispersion mechanisms are dominant; and (ii) embedding the velocity field in the error estimator guiding strategy yields an improved characterization of the forward fringe of solute fronts which propagate through high velocity regions.

Solute concentration at a well in non-Gaussian aquifers under constant and time-varying pumping schedule.

Our study is keyed to the analysis of the interplay between engineering factors (i.e., transient pumping rates versus less realistic but commonly analyzed uniform extraction rates) and the heterogeneous structure of the aquifer (as expressed by the probability distribution characterizing transmissivity) on contaminant transport. We explore the joint influence of diverse (a) groundwater pumping schedules (constant and variable in time) and (b) representations of the stochastic heterogeneous transmissivity (T) field on temporal histories of solute concentrations observed at an extraction well. The stochastic nature of T is rendered by modeling its natural logarithm, Y=lnT, through a typical Gaussian representation and the recently introduced Generalized sub-Gaussian (GSG) model. The latter has the unique property to embed scale-dependent non-Gaussian features of the main statistics of Y and its (spatial) increments, which have been documented in a variety of studies. We rely on numerical Monte Carlo simulations and compute the temporal evolution at the well of low order moments of the solute concentration (C), as well as statistics of the peak concentration (Cp), identified as the environmental performance metric of interest in this study. We show that the pumping schedule strongly affects the pattern of the temporal evolution of the first two statistical moments of C, regardless the nature (Gaussian or non-Gaussian) of the underlying Y field, whereas the latter quantitatively influences their magnitude. Our results show that uncertainty associated with C and Cp estimates is larger when operating under a transient extraction scheme than under the action of a uniform withdrawal schedule. The probability density function (PDF) of Cp displays a long positive tail in the presence of time-varying pumping schedule. All these aspects are magnified in the presence of non-Gaussian Y fields. Additionally, the PDF of Cp displays a bimodal shape for all types of pumping schemes analyzed, independent of the type of heterogeneity considered.

Cuidado humanizado de enfermería según la teor¡a de Jean Watson, servicio de medicina del Hospital Daniel Alcides Carrión. Lima - Callao 2015 / Humanized care of nursing according to the theory of Jean Watson, medical service of the hospital Daniel Alcides Carrión. Lima - Callao, 2015

El Cuidado Humanizado es una necesidad que urge en la práctica profesional y esto se evidencia en las políticas, disposiciones normativas establecidas por las entidades de salud que velan por el derecho de los pacientes y garantizan la calidad del servicio que se brinda. Objetivo: determinar el Cuidado Humanizado que brinda el profesional de Enfermería según la Teoría de Jean Watson, Servicio de Medicina del Hospital Daniel Alcides Carrión. Material y métodos: la población total estuvo conformada 46 profesionales de Enfermería que laboran en los Servicios de Medicina. Resultados: que el Cuidado Humano que ofrece los enfermeros es regular en un 52%, mientras que el 26%, es alto. Según las dimensiones: Satisfacción de necesidades: el cuidado humano e 59% ofrece regular, mientras que el 30% es alto; Habilidades, técnicas de enfermería el cuidado humano de regular 91%, y el nivel bajo 9%. Autocuidado de la profesional es el cuidado humano de regular un 57%, mientras 24% bajo. Aspectos éticos del cuidado el 65% en cuidado humano de regular y el 13% bajo. Relación enfermera- paciente el 65% en cuidado humano de regular, y el 20% Alto. Aspectos espirituales en un 87% en cuidado humano de regular, un 4% bajo. Conclusión: el cuidado humanizado es dado en forma regular y es necesario implementar estrategias, planes de mejoras y capacitación continua con la finalidad de generar la sensibilización del personal de enfermería para aplicar buen trato al paciente desde un abordaje basado en valores humanos.

Humanized care is an urgent need in professional practice and this is evidenced in policies, regulatory provisions established by health institutions that ensure the right of patients and guarantee the quality of service provided. Objectives: to determine the humanized care provided by the nursing professional according to the Theory of Jean Watson, Department of Medicine Daniel Alcides Carrion Hospital. Material and methods: total population consisted of 46 nursing professionals working in Medical Services. The results were that the human care offers regular nurses is 52%, while 26% is high. Depending on the dimensions: satisfaction of needs: human care and 59% with regular, while 30% is high; Skills, nursing techniques regular human care 91% and 9% low level. Self-care professional is the regular human care 57%, while 24% low. Ethical aspects of care 65% in regular human care and 13% low. Nurse patient ratio 65% in regular human care, and 20% is high. Spiritual aspects by 87% in regular human care, 4% lower. Conclusions: the humanized care is given regulary and is necessary to implement strategies, improvement plans and ongoing training in order to generate awareness of nurses to apply good treatment to the patient from a human values-based approach.

Spurious elevation of serum potassium concentration measured in samples with thrombocytosis.

BACKGROUND: Several factors that can lead to falsely elevated values of serum. Thrombocytosis is one of these factors, since breakage or activation of platelets during blood coagulation in vitro may lead to spurious release of potassium. The purpose of the study was to evaluate to which extent the platelet count may impact on potassium in both serum and plasma. METHODS: The study population consisted of 42 subjects with platelets values comprised between 20 and 750×109/L. In each sample potassium was measured in both serum and plasma using potentiometric indirect method on the analyzer Modular P800 (Roche, Milan, Italy). Platelet count was performed with the hematological analyzer Advia 120 (Siemens, Milano, Italy). RESULTS: Significant differences were found between potassium values in serum and in plasma. A significant correlation was also observed between serum potassium values and the platelet count in whole blood, but not with the age, sex, erythrocyte and leukocyte counts in whole blood. No similar correlation was noticed between plasma potassium and platelet count in whole blood. The frequency of hyperkalemia was also found to be higher in serum (20%) than in plasma (7%) in samples with a platelet count in whole blood >450×109/L. CONCLUSIONS: The results of this study show that platelets in the biological samples may impact on potassium measurement when exceeding 450×109/L. We henceforth suggest that potassium measurement in plasma may be more accurate than in serum, especially in subjects with thrombocytosis.

Prácticas de autocuidado y la adherencia al TARGA en personas que viven con VIH en un hospital nacional de Lima / Self-care practices and adherence to TARGA in people living with HIV at a national hospital Lima

Objetivo: determinar la relación entre las prácticas de autocuidado y la adherencia al TARGA en personas que viven con VIH de un hospital nacional. Material y métodos: estudio cuantitativo, correlacional, de corte transversal, la muestra estuvo compuesta de 288 personas que viven con VIH; se elaboró un cuestionario de 37 preguntas sobre prácticas de autocuidado y adherencia al TARGA, las cuales fueron validadas a través de una juicio de expertos y una prueba piloto; posteriormente, se obtuvo un listado de personas que viven con VIH de la historia clínica. Resultados: La recolección de datos permitió obtener los resultados que muestran que las prácticas son inadecuadas en su mayoría (99,7 por ciento), solo presentan prácticas de autocuidado adecuadas 0,3 por ciento. El perfil de adherencia, en su mayoría, también son no adherentes en un 70,1 por ciento, mientras que 29,9 por ciento son adherentes. El coeficiente de correlación rho de Spearman (R=0,445) muestra una correlación significativa (p=0,000), la cual resultó positiva y de nivel medio, lo que significa que niveles bajos de prácticas de autocuidado se corresponden con niveles bajos de adherencia, y viceversa. Conclusiones: las prácticas de autocuidado y la adherencia al tratamiento del TARGA se encuentran relacionadas con la decisión personal de lograr la madurez en su propio autocuidado, esto quiere decir que los patrones del comportamiento están interactuados seg£n su estilo de vida.

Objetive: To determine the relation between the practices of auto care and the adherence to the TARGA in persons who live with HIV of a National Hospital. Material and Methods: quantitative Study, correlacional, of transverse court, sample of 288 persons who live with HIV; there was elaborated a questionnaire of practices of auto care and adherence to the TARGA of 37 questions, which were validated across one expertsÆ and a pilot test was realized and later obtained a personsÆ list through that they live with HIV of the clinical history. Results: The compilation of information allowed to obtain the results that show us that the practices are inadequate in the main with 99.7 percent, only they present suitable practices of auto care 0.3 percent. The profile of adherence in the main also adherents are not in 70.1 percent and 29.9 percent adherents. The coefficient of correlation Rho de Spearman (R=0.445) shows a statistically significant correlation (p=0.000), which turned out to be positive and of average level, which means that low levels of practices of auto care correspond with low levels of adherence and vice versa. Conclusions. The practices of auto care and the adherence to the treatment of the TARGA are associated with the personal decision to achieve the maturity in his own auto care; this wants to say that the bosses of the behavior are interacted according to his way of life.

Relative importance of geostatistical and transport models in describing heavily tailed breakthrough curves at the Lauswiesen site.

We analyze the relative importance of the selection of (1) the geostatistical model depicting the structural heterogeneity of an aquifer, and (2) the basic processes to be included in the conceptual model, to describe the main aspects of solute transport at an experimental site. We focus on the results of a forced-gradient tracer test performed at the "Lauswiesen" experimental site, near Tübingen, Germany. In the experiment, NaBr is injected into a well located 52 m from a pumping well. Multilevel breakthrough curves (BTCs) are measured in the latter. We conceptualize the aquifer as a three-dimensional, doubly stochastic composite medium, where distributions of geomaterials and attributes, e.g., hydraulic conductivity (K) and porosity (phi), can be uncertain. Several alternative transport processes are considered: advection, advection-dispersion and/or mass-transfer between mobile and immobile regions. Flow and transport are tackled within a stochastic Monte Carlo framework to describe key features of the experimental BTCs, such as temporal moments, peak time, and pronounced tailing. We find that, regardless the complexity of the conceptual transport model adopted, an adequate description of heterogeneity is crucial for generating alternative equally likely realizations of the system that are consistent with (a) the statistical description of the heterogeneous system, as inferred from the data, and (b) salient features of the depth-averaged breakthrough curve, including preferential paths, slow release of mass particles, and anomalous spreading. While the available geostatistical characterization of heterogeneity can explain most of the integrated behavior of transport (depth-averaged breakthrough curve), not all multilevel BTCs are described with equal success. This suggests that transport models simply based on integrated measurements may not ensure an accurate representation of many of the important features required in three-dimensional transport models.