Search

PURPOSE: Access to health care is a long-standing concern for rural patients; however, administrative measures fail to capture the subjective patient experience of accessing health care. The purpose of this review was to synthesize the qualitative literature on patient and caregiver experiences of accessing health care services for chronic disease management among US residents of rural areas. METHODS: We searched Embase, MEDLINE, PsycInfo, CINAHL, and Scopus to identify qualitative studies published during 2010-2019. A thematic synthesis approach was used to analyze findings from included studies. RESULTS: A total of 62 studies involving 1,354 unique participants were included. The largest share of studies (24.2%) was focused on the experience of patients with cancer, followed by behavioral health (16.1%), HIV and AIDS (14.5%), and diabetes (12.9%). We identified 4 primary analytic themes of barriers and facilitators associated with the experience of accessing health care services for chronic disease management in rural areas: (1) navigating the rural environment, (2) navigating the health care system, (3) financing chronic disease management, and (4) rural life (ie, common elements of a distinct “rural” way of thinking and behaving). CONCLUSIONS: In this comprehensive review, we found that important cultural, structural, and individual factors influenced the rural patient’s experience of health care access and use, including barriers and facilitators posed by geographic and built environments, and distinct rural mores. Our findings can inform policies and programs that both facilitate structural aspects of access and include culturally appropriate interventions. VISUAL ABSTRACT

La presente tesis realiza un software libre para la administración y análisis de información de bases de datos relacionales y no relacionales en medianas y pequeñas empresas “MiPymes”. El software cuenta con la posibilidad de modificar y adecuar el código de acuerdo con las necesidades de cada empresa; así mismo, en la construcción del dashboard se da enfoque a la representación y visualización de datos mediante gráficos y diagramas para que brinden información de calidad a los usuarios con el propósito de generar una interfaz intuitiva mediante el framework de JavaScript VueJS. Cabe mencionar que, para el desarrollo del software libre, fue fundamental indagar acerca de conceptos y metodologías en diferentes fuentes con antecedentes en el tema para planificar y dar inicio con al flujo de desarrollo pertinente. Los resultados muestran la funcionalidad del dashboard configurado para que los usuarios puedan hacer consultas y visualicen graficas con la respectiva información en formato de vectores SVG, así mismo imágenes de alta calidad PNG y valores individuales CSV; por otro lado, cada componente grafico se le permite ser redimensionado y desplazado dentro del panel de visualización, con el fin de permitirle al usuario el total control de la información seleccionada. This thesis develops an open-source software for the administration and analysis of information from relational and non-relational databases in medium and small companies "MiPymes". The software has the possibility of modifying and adapting the code according to the needs of each company; Likewise, in the construction of the dashboard, focus is given to the representation and visualization of data through graphs and diagrams so that they provide quality information to users with the purpose of generating an intuitive interface through the VueJS JavaScript framework. It is worth mentioning that, for the development of open source software, it was essential to inquire about concepts and methodologies in different sources with background on the subject to plan and start the relevant development flow. The results show the functionality of the dashboard configured so that users can make queries and view graphs with the respective information in SVG vector format, as well as high-quality PNG images and individual CSV values; on the other hand, each graphic component is allowed to be resized and moved within the display panel, in order to allow the user full control of the selected information. Ingeniero de Telecomunicaciones http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado

Este proyecto artístico titulado El fin de la cosecha, está compuesto por trece fotogra-fías de 45x67’5 cm que revelan el impacto ambiental que tiene la producción agrícola intensiva bajo plástico. Dicha denuncia se hace a través de los residuos que provienen de la agricultura, creando una alegoría visual entre los desechos que se arrojan al pai-saje y la fisionomía de este, siendo elementos que se integran en la naturaleza y confi-guran un nuevo entorno. A partir de las imágenes captadas, se introduce al espectador en los aspectos sociales, económicos y culturales que derivan de esta situación para así concienciarlo y potenciar el desarrollo sostenible del entorno. Para ello, recorro diferentes zonas del Campo de Níjar, situado al Sur de la provin-cia de Almería, explorando la geografía y buscando los residuos que allí se hallan. Elijo esta localización por la vinculación familiar que me une a ella y por ser una de las mayores zonas de invernaderos del territorio nacional. El título se ha escogido por la ironía que refleja. Cuando parece que voy a mostrar el resultado de producción, la abundancia y el campo frondoso, lo que se ven son los restos que han quedado tras la recogida. Para finalizar, en esta memoria se exponen los desarrollos de investigación teórico-plástica a partir de los cuales se ha desarrollado el proyecto artístico que se presenta como Trabajo Fin de Grado.

Background Coastal ecosystems are prone to hydrocarbon pollution due to human activities, and this issue has a tremendous impact on the environment, socioeconomic consequences, and represents a hazard to humans. Bioremediation relies on the ability of bacteria to metabolize hydrocarbons with the aim of cleaning up polluted sites. Methods The potential of naturally occurring microbial communities as oil degraders was investigated in Sisal and Progreso, two port locations in the southeast Gulf of Mexico, both with a low level of hydrocarbon pollution. To do so, we determined the diversity and composition of bacterial communities in the marine sediment during the dry and rainy seasons using 16S rRNA sequencing. Functional profile analysis (PICRUTSt2) was used to predict metabolic functions associated with hydrocarbon degradation. Results We found a large bacterial taxonomic diversity, including some genera reported as hydrocarbon-degraders. Analyses of the alpha and beta diversity did not detect significant differences between sites or seasons, suggesting that location, season, and the contamination level detected here do not represent determining factors in the structure of the microbial communities. PICRUTSt2 predicted 10 metabolic functions associated with hydrocarbon degradation. Most bacterial genera with potential hydrocarbon bioremediation activity were generalists likely capable of degrading different hydrocarbon compounds. The bacterial composition and diversity reported here represent an initial attempt to characterize sites with low levels of contamination. This information is crucial for understanding the impact of eventual rises in hydrocarbon pollution.

Generalmente, el cultivo de la uva se utiliza para la elaboración de jugos o de vinos, la fabricación de aceites con la semilla de la misma es un proceso secundario, sin embargo, estudios revelan que la semilla que a menudo se desecha, forma parte integral de los beneficios existentes en la uva debido a su elevada cantidad de aceite con propiedades beneficiosas para la salud. El proyecto es enfocado en la elaboración de dicho aceite como insumo para las industrias cosmetológicas, usando como materia prima principal la pepa de uva que es desechada de los viñedos de la región boyacense,. Basically, the cultivation of grapes is used to make juices or wines, the making oils from the seed itself is a secondary process, however studies reveal that seed that is often discarded is an integral part of the benefits necessary in the grape due to its high amount of oil with beneficial properties for the The project is focused on the elaboration of this oil as an input for the industries cosmetology, using grape seed as the main raw material, which is discarded from vineyards of the boyacense region,. Profesional en Negocios Internacionales

Physical and geochemical characteristics of produced petroleum from the central region of the Llanos basin, Colombia, were analyzed to understand the petroleum charge history and alteration processes. Petroleum properties in the study area are the result of the complex charge history of the oil fields. The amount of gas in fluids is controlled by the migration distance from the late or, possibly, the current generation kitchen located beneath the foothill deformation zone. Gas influx decreases toward the foreland domain, as indicated by lower values of the gas–oil ratio and saturation pressure. The API gravity of the oil samples is mainly controlled by the intensity of biodegradation. Marine-sourced oils accumulated in shallow reservoirs of the foreland prior to the onset of Andean deformation. Those fluids were subjected to different levels of biodegradation, depending on the time they remained at reservoir temperatures lower than 80°C (176°F) and before being buried to their maximum depth. Geochemical data suggest multiple charge pulses from different source kitchens of two main types of source rocks, as well as different biodegradation levels. The proposed petroleum charge and alteration model allows prediction of the temperature history of a reservoir and the most likely physical properties of the petroleum at a specific location. The model can be used as an exploration tool to assess the risk of charge prior to drilling in unexplored areas of the basin.

Sign Language (SL) allows hearing and speech impaired people to communicate each other. Nevertheless, SL is not understood by most of common people. The development of a real-time Mexican Sign Language (MSL) translator could benefit the speech impaired community. In this work we propose a method capable of recognize in real-time a basic list of Mexican Sign Language (MSL) signs of 20 meaningful words and translate them into speech and text. The signs were collected from a group of 35 MSL signers executed in front of a Microsoft Kinect Sensor. The hand gesture recognition system use the RGB-D camera to store depth, color and skeleton tracking information. We propose a method to obtain the representative hand trajectory pat-tern information. A Dynamic Time Warping (DTW) algorithm is used to interpret the hand gestures. Finally, we use K-Fold Cross Validation method for testing stages. Our results achieve a mean accuracy of 99.1% using N-best strategy (N=5) after find the best-match approaches of our templates data-set. And a mean accuracy of 98.57% from real-time testing.

Sign Language (SL) is the basic alternative communication method between deaf people. However, most of the hearing people have trouble understanding the SL, making communication with deaf people almost impossible and taking them apart from daily activities. In this work we present an automatic basic real-time sign language translator capable of recognize a basic list of Mexican Sign Language (MSL) signs of 10 meaningful words, letters (A-Z) and numbers (1-10) and translate them into speech and text. The signs were collected from a group of 35 MSL signers executed in front of a Microsoft Kinect™ Sensor. The hand gesture recognition system use the RGB-D camera to build and storage data point clouds, color and skeleton tracking information. In this work we propose a method to obtain the representative hand trajectory pattern information. We use Euclidean Segmentation method to obtain the hand shape and Hierarchical Centroid as feature extraction method for images of numbers and letters. A pattern recognition method based on a Back Propagation Artificial Neural Network (ANN) is used to interpret the hand gestures. Finally, we use K-Fold Cross Validation method for training and testing stages. Our results achieve an accuracy of 95.71% on words, 98.57% on numbers and 79.71% on letters. In addition, an interactive user interface was designed to present the results in voice and text format.

The implementation of the Water Framework Directive requires a prior typology of aquatic ecosystems based on geographical features. The « Hydroecoregion» (HER) approach, previously developed in France, was extended ta Europe in the REBECCA project. This approach relies upon the concept of hierarchical ecosystem control. Primary determinants of the functioning of aquatic ecosystems are geology, relief and climate. The base data are geographicallayers describing these factors, compiled in a GIS. The common scale of the different layers is 1/1 000000. The geological map was interpreted according to the lithological structure and properties of the rocks (hardness, permeability, influence on water chemistry). A digital elevation model (DEM) with a pitch of 30 arc second (about 1km) was used ta characterize the altitude and the slopes. Hydrogeological maps were also consulted. The climatic factors refer ta precipitation (yearly average, seasonal variation) and temperature, interpreted with respect ta aquatic ecosystems functioning (water balance). The delimitation of the HER was carried out visually, seeking natural discontinuities for each of the parameters and regional concordances in their distribution. The basic principle was to minimize intra-regional variance and maximize inter-regional differences. A total of 133 HERs was identified at the most detailed level in Europe. These HER were further classified in 9 classes of relief, 21 categories combining relief and lithomorphology, and 9 climatic classes. The concepts, methodology, and the HER map, and the detailed characterisation of these HERs are presented in this report.

Extrait de document; For the implementation of the Water Framework Directive, the question is no longer what is the good ecological status?, but how to reach it? Managers need diagnostic methods and pressures/impacts models allowing to set priority actions. We present large scale models developed in the REBECCA project. PLS regressions were used to evaluate the relative impact of land cover (at the basin and riparian corridor scale) on invertebrate indices taken from national monitoring networks; data were stratified by hydro-ecoregions. Urbanisation appears always as a dominant pressure, while arable lands have generally a negative impact, less acute but extensive, and more variable according to regions. Forests in the river corridor have a strong positive effect. The hydro-ecoregion level seems more informative to identify regional pathologies of river ecosystems.

For the implementation of the Water Framework Directive, the question is no longer what is the good ecological status?, but how to reach it? Managers need diagnostic methods and pressures/impacts models allowing to set priority actions. We present large scale models developed in the REBECCA project. PLS regressions were used to evaluate the relative impact of land cover (at the basin and riparian corridor scale) on invertebrate indices taken from national monitoring networks; data were stratified by hydro-ecoregions. Urbanisation appears always as a dominant pressure, while arable lands have generally a negative impact, less acute but extensive, and more variable according to regions. Forests in the river corridor have a strong positive effect. The hydro-ecoregion level seems more informative to identify regional pathologies of river ecosystems.