Advances, trends and challenges in the use of biochar as an improvement strategy in the anaerobic digestion of organic waste: a systematic analysis.

A recently strategy applied to anaerobic digestion (AD) is the use of biochar (BC) obtained from the pyrolysis of different organic waste. The PRISMA protocol-based review of the most recent literature data from 2011-2022 was used in this study. The review focuses on research papers from Scopus® and Web of Knowledge®. The review protocol used permits to identify 169 articles. The review indicated a need for further research in the following challenges on the application of BC in AD: i) to increase the use of BC in developing countries, which produce large and diverse amounts of waste that are the source of production of this additive; ii) to determine the effect of BC on the AD of organic waste under psychrophilic conditions; iii) to apply tools of machine learning or robust models that allow the process optimization; iv) to perform studies that include life cycle and technical-economic analysis that allow identifying the potential of applying BC in AD in large-scale systems; v) to study the effects of BC on the agronomic characteristics of the digestate once it is applied to the soil and vi) finally, it is necessary to deepen in the effect of BC on the dynamics of nitrogen and microbial consortia that affect AD, considering the type of BC used. In the future, it is necessary to search for new solutions in terms of the transport phenomena that occurs in AD with the use of BC using robust and precise mathematical models at full-scale conditions.

Optimization of lignocellulolytic bacterial inoculum and substrate mix for lignocellulose degradation and product quality on co-composting of green waste with food waste.

The present study evaluates the effect of the mixing ratio of substrates and inoculation with lignocellulolytic bacteria on green waste (GW) and food waste (FW) co-composting. A Box-Behnken design was used to simultaneously optimize the lignocellulose degradation (%LD) and end-product quality. The best operational conditions were 4.85*105 CFU g-1 of Bacillus sp. F3X3 and 1.44*106 CFU g-1 of Paenibacillus sp. F1A5 with a substrate mixture containing 50% GW, 32.5% unprocessed FW, 2.5% processed FW, 13% sawdust, and 2% phosphate rock; with a C/N ratio of 27. Under these conditions, the %LD was 33% and the end-product has pH 8.3, TOC 22,4%, TN 1,7%, and a germination index of 103%. Therefore, the product complies with quality standards for organic fertilizers. The results of this study allow the identification of appropriate strategies to optimize GW composting, increasing the degradation of lignocellulose and improving the end-product quality.

Hospital nurse staffing and patient outcomes in Chile: a multilevel cross-sectional study.

BACKGROUND: Unrest in Chile over inequalities has underscored the need to improve public hospitals. Nursing has been overlooked as a solution to quality and access concerns, and nurse staffing is poor by international standards. Using Chile's new diagnosis-related groups system and surveys of nurses and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals. METHODS: For this multilevel cross-sectional study, we used data from surveys of hospital nurses to measure staffing and work environments in public and private Chilean adult high-complexity hospitals, which were linked with patient satisfaction survey and discharge data from the national diagnosis-related groups database for inpatients. All adult patients on medical and surgical units whose conditions permitted and who had been hospitalised for more than 48 h were invited to participate in the patient experience survey until 50 responses were obtained in each hospital. We estimated associations between nurse staffing and work environment quality with inpatient 30-day mortality, 30-day readmission, length of stay (LOS), patient experience, and care quality using multilevel random-effects logistic regression models and zero-truncated negative binomial regression models, with clustering of patients within hospitals. FINDINGS: We collected and analysed surveys of 1652 hospital nurses from 40 hospitals (34 public and six private), satisfaction surveys of 2013 patients, and discharge data for 761 948 inpatients. Nurse staffing was significantly related to all outcomes, including mortality, after adjusting for patient characteristics, and the work environment was related to patient experience and nurses' quality assessments. Each patient added to nurses' workloads increased mortality (odds ratio 1·04, 95% CI 1·01-1·07, p<0·01), readmissions (1·02, 1·01-1·03, p<0·01), and LOS (incident rate ratio 1·04, 95% CI 1·01-1·06, p<0·05). Nurse workloads across hospitals varied from six to 24 patients per nurse. Patients in hospitals with 18 patients per nurse, compared with those in hospitals with eight patients per nurse, had 41% higher odds of dying, 20% higher odds of being readmitted, 41% higher odds of staying longer, and 68% lower odds of rating their hospital highly. We estimated that savings from reduced readmissions and shorter stays would exceed the costs of adding nurses by US$1·2 million and $5·4 million if the additional nurses resulted in average workloads of 12 or ten patients per nurse, respectively. INTERPRETATION: Improved hospital nurse staffing in Chile was associated with lower inpatient mortality, higher patient satisfaction, fewer readmissions, and shorter hospital stays, suggesting that greater investments in nurses could return higher quality of care and greater value. FUNDING: Sigma Theta Tau International, University of Pennsylvania Global Engagement Fund, University of Pennsylvania School of Nursing's Center for Health Outcomes, and Policy Research and Population Research Center. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.

Dotaciones, skillmix e indicadores laborales de enfermería en Hospitales Públicos chilenos

Background: International evidence shows that there are organizational factors and nurse job outcomes that may negatively affect healthcare quality. Aim: To measure and analyze associations between nurse organizational factors, such as staffing ratios and skill mix, and job outcomes in public hospitals in Chile. Material and Methods: An observational, cross-sectional study of 1,855 registered nurses working in medical-surgical units in 37 public hospitals was conducted. Data collection followed the RN4CAST research protocol. Inferential analyses used logistic regression models. Results: The survey was answered by 1,395 registered nurses in 34 hospitals. The average staffing ratio was 14 patients-per-nurse, and the average skill mix was 31% registered nurses. Of all nurses, 35% reported burnout, 22% were dissatisfied, and 33% intended to leave. Being burned out increased by 9 and 6% the odds of being dissatisfied and the intent to leave, respectively (Odds ratio (OR) 1.09, p < 0.01 and 1.06, p < 0.01). Being dissatisfied increased by five times the odds of intent to leave (OR 5.19, p < 0.01). Conclusions: Staffing levels, burnout, and intent to leave warrant healthcare and governmental authorities' attention. All these factors may be threatening healthcare quality and safety.

[Nurse staffing, skill mix and job outcomes in Chilean public hospitals]. / Dotaciones, skillmix e indicadores laborales de enfermería en Hospitales Públicos chilenos.

BACKGROUND: International evidence shows that there are organizational factors and nurse job outcomes that may negatively affect healthcare quality. AIM: To measure and analyze associations between nurse organizational factors, such as staffing ratios and skill mix, and job outcomes in public hospitals in Chile. MATERIAL AND METHODS: An observational, cross-sectional study of 1,855 registered nurses working in medical-surgical units in 37 public hospitals was conducted. Data collection followed the RN4CAST research protocol. Inferential analyses used logistic regression models. RESULTS: The survey was answered by 1,395 registered nurses in 34 hospitals. The average staffing ratio was 14 patients-per-nurse, and the average skill mix was 31% registered nurses. Of all nurses, 35% reported burnout, 22% were dissatisfied, and 33% intended to leave. Being burned out increased by 9 and 6% the odds of being dissatisfied and the intent to leave, respectively (Odds ratio (OR) 1.09, p < 0.01 and 1.06, p < 0.01). Being dissatisfied increased by five times the odds of intent to leave (OR 5.19, p < 0.01). CONCLUSIONS: Staffing levels, burnout, and intent to leave warrant healthcare and governmental authorities' attention. All these factors may be threatening healthcare quality and safety.

Evaluation of mixing ratio and frequency of turning in the co-composting of biowaste with sugarcane filter cake and star grass.

This work studied the effect of mixing ratio (MR) and turning frequency (TF) in biowaste composting (BW) with sugarcane filter cake (SFC) and star grass (SG), both on process performance (temperature, static respiration index, total organic carbon, total nitrogen and total phosphorus) and on product quality (pH, cation exchange capacity, electrical conductivity, organic matter, nutrients, stability, maturity, total coliforms and faecal coliforms), through the Principal Components Analysis (PCA). The Pearson correlation coefficients were calculated for all the quality parameters. A joint effect of mixing ratio and turning frequency was demonstrated, highlighting the importance of studying the operational parameters simultaneously. The results of the PCA showed that the best operating conditions and therefore higher product quality is achieved with a TF of twice a week and MR between 20 and 30% of SFC or SG. Additionally, it was found that a frequency of one turn per week generates the lowest product quality, regardless the co-substrate and the MR. The best treatment corresponded to BW composting with MR of 20% SFC and TF of two turnings per week. The obtained results allow to optimize the operation in composting facilities.

Proyecto colaborativo Chile-Paraguay en formación de postgrado / A Chile - Paraguay collaborative project for postgraduate education

Resumen:

Objetivo: este artículo da a conocer el proyecto colaborativo entre la Escuela de Enfermería de la Pontificia Universidad Católica de Chile (PUC) y la Escuela de Enfermería de la Universidad Católica “Nuestra Señora de la Asunción” de Paraguay. El objetivo es el de mejorar la calidad del cuidado de la salud que se otorga a la población, a través del perfeccionamiento de enfermeras y enfermeros a nivel de postgrado. Metodología: se revisan los principales aspectos considerados en la creación y puesta en marcha del postgrado, y su estado actual a junio de 2014. La participación de la Escuela de Enfermería de la PUC en este proyecto responde al llamamiento de la Santa Sede “de fortalecer la red de universidades católicas” y es considerado un deber de contribuir con su experiencia y experticia al desarrollo de la enfermería de un país amigo. Resultados: como resultado de este proyecto se creó y puso en marcha, en el año 2007, un programa de magister en Enfermería desa­rrollado en la ciudad de Asunción, que en el año 2014 ha graduado a 29 profesionales y que están contribuyendo al desarrollo de la enfermería de Paraguay. Conclusión: el modelo diseñado para el desarrollo de este magister ha demostrado ser exitoso, como también el establecimiento de alianzas y colaboración entre las universidades, lo que aporta beneficios a las instituciones involucradas tanto en los ámbitos académicos y profesionales como personales.

Abstract:

Purpose: A collaborative project by Nursing School, Pontificia Universidad Católica, Chile (PUC) and Nursing School, Universidad Católica “Nuestra Señora de la Asunción”, Paraguay is described. The project is aimed at improving healthcare quality provided to the community by means of an improved postgraduate education for nurses.

Methods: The main aspects taken into account to create and develop postgraduate courses, along with their present condition in June 2014, are reviewed. The involvement of PUC's Nursing School in this project results from the Holy See's calling for "strengthening the Catholic Universities network"; and offering its experience and expertise to help nursing development in a friend country is considered to be a duty. Results: As a result from the project, in 2007 a Master Program in Nursing was created and implemented in Asunción city, with 29 professionals having achieved graduation in it until 2014; such professionals are currently contributing to nursing development in Paraguay. Conclusion: The model that was designed in order to develop this Master course has proved successful. Alliances and collaboration between universities have also been satisfactory, with benefits being obtained by involved institutions at academic, professional, and personal levels.

Introduçao: trabalho colaborador entre a Escola de Enfermagem da Pontifícia Universidade Católica de Chile (PUC) e a Escola de Enfermagem da Universidade Católica “Nossa Senhora da Assunção”, Paraguai. Objetivo: melhorar a qualidade do cuidado de saúde que se outorga a população, usando como estratégia o aperfeiçoamento de enfermeiras e enfermeiros em nível de pós-graduação. Resultado: como resultado deste projeto se criou e pôs em marcha, o ano de 2007, um Programa de Mestrado em Enfermagem desenvolvido na cidade de Assunção, que até 2014 havia graduado 29 profissionais que estão contribuindo ao desenvolvimento da Enfermagem de Paraguai.

Conclusão: o modelo desenhado deste Mestrado tem demonstrado ser exitoso, bem como também o estabelecimento de alianças e colaborações entre as universidades o que oferece contribuições benéficas ás instituições envolvidas tanto nos âmbitos acadêmicos, profissionais como pessoais.

Evaluación de indicadores de proceso, resultado e impacto del programa de tuberculosis en Guantánamo / Assessment process indicators, outcome and impact of the tuberculosis program at Guantanamo

Se realizó un estudio con el objetivo realizar una evaluación táctica del programa de tuberculosis en el municipio Guantánamo durante el año 2012. El universo está constituido por los 25 pacientes diagnosticados. Las fuentes de información se tomaron de los registros estadísticos, controles del jefe de programa. Las variables estudiadas fueron los principales indicadores de proceso, resultados e impacto del programa. Se utilizaron como medidas de resumen, números absolutos, porcentajes, tasas y por ciento de variación. Se detectaron dificultades en los indicadores de proceso, resultado, impacto y en la ejecución de actividades claves para el funcionamiento adecuado del programa y en la capacitación del personal de salud. Los resultados se presentaron en tablas y gráficos. Se emitieron conclusiones y recomendaciones(AU)

Further study is done in order to perform a tactical assessment of the tuberculosis program in the Guantanamo in 2012. The universe is made up of the 25 patients diagnosed. The sources of information were taken from the statistical records, controls program manager. The variables were studied: the main indicators of process, results and impact of the program. They were used as measures of short, absolute numbers, percent ages, rates and percent variation. Difficulties in the process indicators, outcome, impact and implementation of key activities for the proper functioning of the program and the training of health personnel were detected. The results were presented in tables and graphs. Conclusions and recommendations were issued(AU)