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The removal of three emerging pollutants: carbamazepine, ketoprofen, and bisphenol A, has been studied using the nanofiltration flat sheet membrane NF99HF. The removal efficiencies of the membrane have been evaluated by two system characteristic parameters: permeate flux and rejection coefficient. The influence of two operating variables has been analysed: operating pressure and feed concentration. Before and after the tests with emerging pollutants, the membrane has been characterized by determining its water permeability coefficient and its magnesium chloride rejection coefficient to find out if the removal of emerging pollutants causes membrane fouling. The results show that operating pressure has significant separation effects, obtaining the highest efficiencies at a pressure of 20 bar for pollutant concentrations between 5 and 25 mg/L. Moreover, rejection of ketoprofen was found to be dependent on electrostatic repulsion, while rejection of bisphenol A was significantly affected by adsorption onto the membrane. Finally, the experimental data have been fitted to the solution diffusion model and to the simplified model of Spiegler-Kedem-Katchalsky to predict the behaviour of the nanofiltration membrane in the removal of the tested pollutants. Good agreement between the experimental and predicted carbamazepine and bisphenol A data has been obtained with each model, respectively.
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Piezoelectric harvesters use the actuation potential of the piezoelectric material to transform mechanical and vibrational energies into electrical power, scavenging energy from their environment. Few research has been focused on the development and understanding of the piezoelectric harvesters from the material themselves and the real piezoelectric and mechanical properties of the harvester. In the present work, the authors propose a behavior real model based on the experimentally measured electromechanical parameters of a homemade PZT bimorph harvester with the aim to predict its Vrms output. To adjust the harvester behavior, an iterative customized algorithm has been developed in order to adapt the electromechanical coupling coefficient, finding the relationship between the harvester actuator and generator behavior. It has been demonstrated that the harvester adapts its elongation and its piezoelectric coefficients combining the effect of the applied mechanical strain and the electrical behavior as a more realistic behavior due to the electromechanical nature of the material. The complex rms voltage output of the homemade bimorph harvester in the frequency domain has been successfully reproduced by the proposed model. The Behavior Real Model, BRM, developed could become a powerful tool for the design and manufacturing of a piezoelectric harvester based on its customized dimensions, configuration, and the piezoelectric properties of the smart materials.
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New information technologies have transformed the way care is delivered within health services, permeating almost every aspect of health care. As the complexity of the system increases, it becomes more difficult to work optimally without the assistance of new technologies. Although its implementation represents a breakthrough, either because of the advancement involved in the proper use of any technology in health care, or because of the development of specific applications that improve patient safety, other factors such as incorrect design, implementation and poor maintenance, inadequate training, along with overconfidence and dependency, can make technologies compromise patient safety. This article describes the beneficial effects, and those that are not so, of the introduction in our country of the electronic medical record and the electronic prescription on the healthcare quality and safety.
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Registros Eletrônicos de Saúde , Qualidade da Assistência à Saúde , Atenção à Saúde , Humanos , Prescrições , Medição de RiscoRESUMO
The versatility of piezoelectric sensors in measurement techniques and their performance in applications has given rise to an increased interest in their use for structural and manufacturing component monitoring. They enable wireless and sensor network solutions to be developed in order to directly integrate the sensors into machines, fixtures and tools. Piezoelectric sensors increasingly compete with strain-gauges due to their wide operational temperature range, load and strain sensing accuracy, low power consumption and low cost. This research sets out the use of piezoelectric sensors for real-time monitoring of mechanical strength in metallic structures in the ongoing operational control of machinery components. The behaviour of aluminium and steel structures under flexural strength was studied using piezoelectric sensors. Variations in structural behaviour and geometry were measured, and the load and µstrains during operational conditions were quantified in the time domain at a specific frequency. The lead zirconium titanate (PZT) sensors were able to distinguish between material types and thicknesses. Moreover, this work covers frequency selection and optimisation from 20 Hz to 300 kHz. Significant differences in terms of optimal operating frequencies and sensitivity were found in both structures. The influence of the PZT voltage applied was assessed to reduce power consumption without signal loss, and calibration to µstrains and loads was performed.
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OBJECTIVE: The electronic prescription has meant an evolution in the quality of health care, but it has a series of deficiencies that compromise the adherence to treatments. The objective of this work was to collect and group these limitations and propose the changes that could solve them. METHODS: During 2017 and 2018, through dispensing and pharmacotherapeutic monitoring activities, incidents related to the electronic prescription were collected in a pharmacy in Santander and their causes were identified. A survey was conducted and sent to the Information Centers of the Medicines of the rest of the regions to know if the same problems were shared and the resulting data were treated by frequency distribution. RESULTS: We detected 1,500 incidents related to the way of access to the treatment and its activation period, with the availability of the medication when the patient requested it and those in which the assessment of the problem by the doctor was essential. The survey data showed that in 100% of the CCAA the patient must return to the doctor when there is an incidence, because there is no protocol to solve it from the pharmacy. CONCLUSIONS: These incidents compromise the adherence to treatments and the health of patients. To avoid them, we propose the elimination of the password that is necessary to access the treatment, the establishment of a minimum period of 30 days for its activation, the creation of protocols so that the pharmacist can solve problems and perform dispensations in special circumstances, and finally, the optimization of the communication between pharmacist and doctor.
OBJETIVO: La receta electrónica ha supuesto una evolución en la calidad de la asistencia sanitaria, pero presenta una serie de deficiencias que comprometen la adherencia a los tratamientos. El objetivo de este trabajo fue recopilar y agrupar estas limitaciones y proponer cambios que podrían resolverlas. METODOS: Durante los años 2017 y 2018, a través de las actividades de dispensación y seguimiento farmacoterapéutico, se recogieron en una farmacia de Santander las incidencias relacionadas con la dispensación de recetas electrónicas y se identificaron sus causas. Se realizó una encuesta que se envió a los Centros de Información de los Medicamentos del resto de comunidades autónomas para conocer si se compartían los mismos problemas y se trataron los datos resultantes mediante distribución de frecuencias. RESULTADOS: Se detectaron 1.500 incidencias relacionadas con el modo de acceso al tratamiento y su periodo de activación, con la disponibilidad de la medicación cuando el paciente lo solicitaba y aquellas en las que era indispensable la valoración del problema por parte del médico. Los datos de la encuesta mostraron que en el 100% de las comunidades autónomas el paciente debía volver al centro de salud para solucionar estas incidencias, al no existir ningún protocolo para resolverlas desde la farmacia. CONCLUSIONES: Estas incidencias comprometen la adherencia a los tratamientos y la salud de los pacientes. Para evitarlas, proponemos la eliminación del número de orden que es necesario para acceder al tratamiento, la instauración de un período mínimo de 30 días para su activación, la creación de protocolos para que el farmacéutico pueda solucionar problemas y realizar dispensaciones en circunstancias especiales, y por último, la optimización de la comunicación entre farmacéutico y médico.
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Prescrição Eletrônica , Adesão à Medicação/estatística & dados numéricos , Assistência Farmacêutica/organização & administração , Farmácias , Comunicação , Humanos , Qualidade da Assistência à Saúde , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The purpose of this study is to develop and test the validity and reliability of a questionnaire to evaluate dietary supplement use based on the Theory of Planned Behaviour (TPB). METHODS: The questionnaire has sections on demographics, physical activity, dietary supplements, and cognitive constructs based on the TPB. Three stages are followed. In Stage 1, elicitation interviews are conducted on five varsity athletes, five physically active non-athletes, and five physically inactive University of Guelph (UofG) students. In Stage 2, comments and ratings of the TPB-based statements are gathered from 10 subject matter experts to check for content validity. In Stage 3, Cronbach's α is calculated to determine the internal consistency of the cognitive constructs by a pilot test on 84 Applied Human Nutrition UofG students. RESULTS: Interviews assisted in the formulation of the cognitive constructs' statements, including intentions, attitudes, injunctive norms, descriptive norms, and perceived behavioural control. Content validity ensured that these constructs did not overlap. Few statements from the cognitive constructs were omitted based on findings from the reliability test, achieving acceptable Cronbach's α values across all constructs (≥0.70). CONCLUSIONS: This supplement use questionnaire will be used in a future study to investigate the use and determinants of dietary supplements among Canadian athlete and non-athlete UofG students.
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OBJETIVO: La receta electrónica ha supuesto una evolución en la calidad de la asistencia sanitaria, pero presenta una serie de deficiencias que comprometen la adherencia a los tratamientos. El objetivo de este trabajo fue recopilar y agrupar estas limitaciones y proponer cambios que podrían resolverlas. MÉTODOS: Durante los años 2017 y 2018, a través de las actividades de dispensación y seguimiento farmacoterapéutico, se recogieron en una farmacia de Santander las incidencias relacionadas con la dispensación de recetas electrónicas y se identificaron sus causas. Se realizó una encuesta que se envió a los Centros de Información de los Medicamentos del resto de comunidades autónomas para conocer si se compartían los mismos problemas y se trataron los datos resultantes mediante distribución de frecuencias. RESULTADOS: Se detectaron 1.500 incidencias relacionadas con el modo de acceso al tratamiento y su periodo de activación, con la disponibilidad de la medicación cuando el paciente lo solicitaba y aquellas en las que era indispensable la valoración del problema por parte del médico. Los datos de la encuesta mostraron que en el 100% de las comunidades autónomas el paciente debía volver al centro de salud para solucionar estas incidencias, al no existir ningún protocolo para resolverlas desde la farmacia. CONCLUSIONES: Estas incidencias comprometen la adherencia a los tratamientos y la salud de los pacientes. Para evitarlas, proponemos la eliminación del número de orden que es necesario para acceder al tratamiento, la instauración de un período mínimo de 30 días para su activación, la creación de protocolos para que el farmacéutico pueda solucionar problemas y realizar dispensaciones en circunstancias especiales, y por último, la optimización de la comunicación entre farmacéutico y médico
OBJECTIVE: The electronic prescription has meant an evolution in the quality of health care, but it has a series of deficiencies that compromise the adherence to treatments. The objective of this work was to collect and group these limitations and propose the changes that could solve them. METHODS: During 2017 and 2018, through dispensing and pharmacotherapeutic monitoring activities, incidents related to the electronic prescription were collected in a pharmacy in Santander and their causes were identified. A survey was conducted and sent to the Information Centers of the Medicines of the rest of the regions to know if the same problems were shared and the resulting data were treated by frequency distribution. RESULTS: We detected 1,500 incidents related to the way of access to the treatment and its activation period, with the availability of the medication when the patient requested it and those in which the assessment of the problem by the doctor was essential. The survey data showed that in 100% of the CCAA the patient must return to the doctor when there is an incidence, because there is no protocol to solve it from the pharmacy. CONCLUSIONS: These incidents compromise the adherence to treatments and the health of patients. To avoid them, we propose the elimination of the password that is necessary to access the treatment, the establishment of a minimum period of 30 days for its activation, the creation of protocols so that the pharmacist can solve problems and perform dispensations in special circumstances, and finally, the optimization of the communication between pharmacist and doctor
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Humanos , Prescrição Eletrônica , Adesão à Medicação/estatística & dados numéricos , Assistência Farmacêutica/organização & administração , Farmácias , Comunicação , Qualidade da Assistência à Saúde , Inquéritos e QuestionáriosRESUMO
Los pacientes mayores de 65 años con patologías crónicas, polimedicados y que se ven obligados a acudir a diferentes especialistas, son el colectivo más propenso a sufrir no sólo problemas relacionados con los medicamentos, sino también errores de prescripción. Estos errores son detectados por el farmacéutico comunitario, ya que suele ser el primer profesional sanitario con el que tienen contacto tras la consulta con el especialista. En este caso clínico, detectamos una duplicidad de antiespasmódicos urinarios en un paciente que había acudido a la farmacia preocupado por diversos problemas de salud y al que se le ofreció participar en nuestro servicio de seguimiento farmacoterapéutico. La incidencia fue solventada, pero consideramos que el tiempo de resolución podría ser menor con ligeras modificaciones en el sistema de comunicación entre el farmacéutico y otros profesionales sanitarios, aumentando así la calidad de la asistencia sanitaria y la eficiencia del sistema nacional de salud
Patients over 65 years old with chronic pathologies, polymedicated and who receive interdisciplinary care by different medical specialists, are the pronest ones to suffer problems related to medications as prescription errors that can be detected by the community pharmacist as the first healthcare professional with whom they have contact after a treatment modification by the specialist. In this clinical case, we detected a duplicity of urinary antispasmodics in the treatment of a patient who attended the pharmacy concerned about various health problems and who was offered to participate in our pharmacotherapy follow-up program. The incidence was solved. Nevertheless, we believe that the resolution time could be shorter with slight changes in the communication system between the pharmacist and other health professionals, increasing the quality of healthcare and the efficiency of the national health system
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Humanos , Feminino , Idoso de 80 Anos ou mais , Erros de Medicação/tendências , Farmácias , Tratamento Farmacológico/tendências , Assistência Farmacêutica/métodos , Prescrição Eletrônica , Polimedicação , IncidênciaRESUMO
he aim of the study was to evaluate the presence and characteristics of dental modifications in pre-Columbian populations from three archaeological sites in the Costa Rican territory (Nacascolo, Jícaro and La Cascabel) in order to describe them according to previous classification. Specimens were obtained from the collections of the National Museum of Costa Rica. All specimens were macroscopically analyzed and the pieces were classified. Photographic records were taken to each piece and a full description was done. Sixty one pieces with dental modifications were found. The types of dental modifications found were classified as A1, C2/C6, A2, C2, C1, E1 and A3 in order of prevalence. In conclusion, dental modifications were found in most of specimens. Particularly, C2/C6 modification was not reported by previous classifications.
l objetivo del estudio fue evaluar la presencia y características de las modificaciones dentales de las poblaciones precolombinas de tres sitios arqueológicos en el territorio Costarricense (Nacascolo, Jícaro y La Cascabel) con el fin de describirlas de acuerdo a una clasificación previa. Los especímenes fueron obtenidos de las colecciones del Museo Nacional de Costa Rica. Todos los especímenes fueron analizados macroscópicamente y las piezas fueron clasificadas. Cada pieza contó con un registro fotográfico y una descripción completa. Sesenta y un piezas fueron encontradas con modificaciones dentales. Los tipos de modificaciones dentales encontrados fueron clasificados como A1, C2/C6, A2, C2, C1 E1 y A3 en orden de prevalencia. En conclusión, en la mayoría de piezas dentales analizadas se encontraron modificaciones dentales. Particularmente, la modificación C2/C6 no ha sido reportada por clasificaciones previas.