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El presente proyecto de investigación consiste en el diseño y evaluación de una propuesta de mejora en el servicio de alimentación del ala hospitalaria de la Clínica Delgado mediante la aplicación de herramientas para la estandarización de procesos. La Clínica Delgado lleva más de 90 años ofreciendo el servicio de salud y se caracteriza por los grandes especialistas dentro de su staff, el servicio que brindan y la gran infraestructura con la que cuentan. En el 2019, se realizó una evaluación interna de los servicios que brindan para analizar la satisfacción de los pacientes con respecto a este. De esto se pudo reconocer ciertos problemas en el servicio de alimentación, siendo los principales el retraso en la entrega de alimentos y los errores en las bandejas. Al evaluar la situación actual del área de cocina, se encontró que existe mucho desorden en el área de trabajo, se improvisa las funciones de los trabajadores, lo que en ocasiones retrasa el flujo del proceso. Por ello, se optó por utilizar herramientas que permitan la estandarización de procesos, en específico el estudio de tiempos para determinar los horarios de cada operación y para definir los puestos necesarios y establecer los procesos críticos estandarizados. En lo que respecta a la evaluación económica, se estima que la inversión de la propuesta de mejora es 12 000 soles, obteniendo una VAN de 35 457,96, una TIR de 40,39% y un periodo de recupero de 7 meses y 23 días. This research consists of the design and evaluation of a proposal to improve the food service of the hospital wing in the Delgado Clinic through the application of tools for processes’ standardization. The Delgado Clinic has been offering health services for more than 90 years and it is characterized by the great specialists within its staff, the service they provide and the great infrastructure they have. In 2019, an internal evaluation of the food services they provide was conducted to analyze patient satisfaction. From this analysis, it was possible to recognize certain problems in the food service, the main ones being the delay in the delivery of food and errors in the trays. When evaluating the current situation of the kitchen area, it was found that there is a lot of disorder in the work area, the functions of the workers are improvised, which causes delays in the flow of the process. Therefore, it was decided to use tools that allow the standardization of processes, specifically a time study to determine the standard hours of each operation and to define the necessary positions and establish the standardized critical processes. Regarding the economic evaluation, it is estimated that the investment of this improvement project is 12 000 soles, obtaining a NPV of 36 457,96, TIR of 40,39% and a payback period of 7 months and 23 days.

The aim of this research was to evaluate the inflammatory and/or oxidative damage related to silver nanoparticles (AgNPs), which are responsible for negative effects on sperm physiology and metabolism. Thirty New Zealand White rabbit bucks were divided into 5 experimental groups (6 animals/group): Control, treated with 0.9% NaCl; AgNP, treated with a 5 mM AgNP solution; LPS, treated with 50 g/kg b.w. E. coli LPS; AgNPs + NSAID, treated with an anti-inflammatory drug at 0.2 mg/kg b.w. and 5 mM AgNPs; and AgNPs + Vit E, treated with 0.18 mg/kg b.w. vitamin E and 5 mM AgNPs. Sperm quality and oxidative and inflammatory status were assessed at different times (0-60 days). Two statistical models were built: the first evaluated the effects of AgNPs and LPS (vs. Control), whereas the second evaluated the protective effect of an NSAID and vitamin E against AgNP-induced damage. Three principal component analyses were performed: sperm traits (motility, volume), oxidative status (antioxidants, oxidative metabolites, and redox reactions), and cytokines (TNF-α, IL-8, and IL-6). A negative effect on reproductive traits resulted after NP administration. In particular, an inflammatory/oxidative response took place in the reproductive tract during the first 2-3 wks of AgNP administration (cytokine and oxidative metabolite generation); the inflammatory/oxidative thrust impaired the status of rabbit tissues (seminal plasma, sperm, and blood), inducing a response (increased antioxidant enzymes and redox reactions) at 4-7 wks; oxidative stress, if not totally counteracted, likely induced toxicity in the late phases of AgNP administration (8-9 wks). In conclusion, exposure to silver nanoparticles produced a similar but more persistent effect than that of LPS on rabbit reproductive tissues: AgNP administration triggered a proinflammatory response linked to oxidative thrust, worsening many sperm parameters. However, only anti-inflammatory treatment counteracted the negative effects of AgNPs, whereas vitamin E seemed to act as an adjuvant, attenuating the oxidative cascade.

In recent years, various studies and development using nanoparticles (NPs) have been carried out in the most diverse areas of knowledge. Although nanomaterials are widely employed by many sectors and some may have a fertilizing potential, little is known about their effects on the environment. This study aimed to evaluate the effect of applying, in tropical natural soil, different contents of nanoparticles of zinc oxide (NPs-ZnO) and non-nano zinc oxide (ZnO) on soil pH and on the survival and reproduction rates of earthworms ( Eisenia andrei ) and springtails ( Folsomia candida ) through standardized ecotoxicological tests. The tests used a tropical soil representative of Brazil, classified as Entisol ( Neossolo Quartzarênico órtico típico ) with no history of agricultural use, collected in the 0.00-0.20 m layer, previously sieved (2-mm mesh) and defaunated. The experimental design was completely randomized, and treatments consisted of two forms of zinc (Zn), NPs-ZnO and ZnO, at the following doses: 0, 50, 100, 200, 400, 800, 2,000, and 4,000 mg kg−1. Standardized ecotoxicological tests showed no toxicity of NPs-ZnO in terms of lethality of E. andrei and F. candida . In E. andrei reproduction tests, NPs-ZnO were toxic at doses higher than 400 mg kg−1 (EC50 of 1,021 mg kg−1). Tests with F. candida demonstrated that its reproduction rate was significantly affected by NPs-ZnO at a rate of 4,000 mg kg−1 (EC50 of 3,636 mg kg−1). When used in Entisol, the NPs-ZnO inhibit the reproduction of earthworms and springtails; earthworms are more sensitive to such an effect, it being demonstrate at lower contents than those found for springtails.