The socio-cultural factors that might be influencing the normal psychomotor development of the undernourished infant are studied. The sample consisted of 32 mother-infant dyads: 16 having normal DQ (Group A) and 16 having a below normal DQ (Group B) according to Bailey's Test applied to infants who entered a Nutritional Recuperation Center. Results showed that there were some differences in the infants' backgrounds: infants of Group A were the product of a wished-for pregnancy (p less than .05), and were separated less from their mother's side (p less than .007) than was the case in Group B. No differences were found in the socio-cultural and demographic background of the mothers. The infants' external environment was different in aspects observed within the neighborhood: there were fewer negative aspects in Group A than in Group B (p less than .003) and more positive in Group A than in B (p less than .001). The infant's internal environment as related to the mother was also different. Mothers of Group A perceived more affection from their partner (p less than .008), were more sensitive (to feelings of joy and suffering) (p less than .003) and stimulated their infant (p less than .004) more than those of Group B. These results show that the internal and external environments in which the infant with normal and below normal DQ evolves were different between the two groups. This could explain the differences in psychomotor development among undernourished infants belonging to the lower socioeconomic strata.
Dentro del Proyecto de investigación "Evaluación del diseño curricular de Matemática en carreras de CienciasEconómicas", se propone autodiagnosticar los elementos disfuncionales y necesidades como paso previo a la toma dedecisiones para lograr mejores resultados en el aprendizaje de la Matemática en las carreras antes mencionadas.Atendiendo la propuesta de Madaus y Kellaghan (1992) en cuanto a los componentes del currículum que deben serevaluados, determinamos por un lado aspectos actitudinales hacia la Matemática y por otro los materiales curriculareselaborados en las asignaturas del área Matemática.En este trabajo se muestran algunos de los resultados obtenidos en este diagnóstico, efectuado en 2005, en las asignaturasdel área Matemática. Se consideró una muestra de 296 alumnos de Álgebra y otra de 290 alumnos de MatemáticaFinanciera, sobre un total de 1498 y 1352 alumnos respectivamente. Los datos se procesaron con el programaStatgraphic versión 4.0.Se trabajó en dos sentidos:1.- el análisis de la predisposición de los estudiantes hacia la Matemática (dificultades, temores, gusto, etc.).2.- la evaluación de los materiales curriculares elaborados especialmente para el proceso de enseñanza - aprendizaje encada asignatura mencionada.
BACKGROUND The number of knee replacement surgeries in OECD countries will continue rising due to the prevalence of osteoarthritis caused by aging and obesity. It is a cost-effective but expensive procedure. Consequently, decision-makers need accurate information on intervention outcomes and costs to manage the healthcare system efficiently. Literature proposed Time-Driven Based-Activity Costing (TDABC) as a cost measurement model that accounts for care cycle complexity, such as patient diversity and treatment variation. However, few studies show how to apply the TDABC model in a real context, considering the existing hospitals' information systems (IS). OBJECTIVE Our primary goal was to design a patient-centered digital cost simulator for assessing the provider's cost of care delivery that complemented the outcomes analysis in Knee Surgery. The secondary goal was to synthesize the learning experience of implementing the method in two Portuguese private hospitals of the same provider. METHODS The proof-of-concept study was designed based on the TDABC model. As the two hospitals had different care delivery chains for the same procedure, each hospital's study was independent. The unit cost of supplying capacity was calculated using data collected from interviews, literature reviews, and general ledger accounts. Both care delivery chains were defined using information from interviews with hospital staff and mapped using Visual Paradigm©. Time estimations were based on direct observation and data exported from hospitals' IS. The patient-centered digital cost simulator was created using Google Sheets. Through a focus group, the multidisciplinary team evaluated the model feasibility and generalisability. RESULTS A patient-centered digital cost simulator and the data structure that allows collecting the most relevant cost analysis data are presented. The main lessons learned are described through this paper and are based on practical application: (1) the patient journey must drive data collection, organization, and analysis for the TDABC implementation; (2) the implementation of TDABC in healthcare involves the commitment and dedication of the healthcare provider's teams; (3) breaking the activities into operations helps to obtain time estimations and allocate resources in the patient care pathway; (4) the listing of the used resources should follow the financial IS classification. CONCLUSIONS The simulator that was developed is still a proof-of-concept, but it enlightened the healthcare provider of future improvements in the existing IS infrastructure. The TDABC implementation requires that the hospitals' IS collect and interoperate different data sources (clinical, financial, and logistics) along the patient pathway. Therefore, future research should focus on developing effective and efficient interfaces to allow importing process, activity, resources, and time information from the existing IS and calculate the total costs of care per patient. Such data needs to be integrated with health outcomes measures in order to monitor healthcare interventions' value.
Resumen: Las instituciones públicas deben tener en cuenta, en sus campañas de comunicación, a todos los públicos posibles. Así, las entidades que desarrollan programas destinados a la infancia deben ser especialmente cuidadosas con las acciones que ponen en marcha. Para ello es importante hacer uso de los nuevos lenguajes que ofrece la sociedad de la información y buscar la fórmula apropiada para hacer efectivo el modelo comunicativo de cada ocasión. Algunas acciones se están desarrollando en este sentido. Uno de ellos es el que se analiza a continuación: el programa Andaluna de la
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