Implementación de plataforma para mejorar gestión de proyectos de investigación en la subdirección de administración de proyectos de la UNALM

Universidad Nacional Agraria La Molina. Facultad de Economía y Planificación. Departamento Académico de Gestión EmpresarialEl presente trabajo, tiene como finalidad evaluar la implementación de una plataforma para la mejora de la gestión de proyectos en la Subdirección de Administración de Proyectos (SAP) de la Dirección de Gestión de la Investigación (DGI) del Vicerrectorado de Investigación (VRI) de la Universidad Nacional Agraria La Molina (UNALM), a nivel de tiempo, control y procesos. En el año 2016, el sector público presenta cambios en el procedimiento para realizar las transferencias entre instituciones, generándose la cuenta única del tesoro (CUT) público. En consecuencia, los requerimientos de los proyectos de investigación de la SAP tenían que vincularse con las transferencias recibidas sin embargo la plataforma de ese entonces no permitía dicho proceso teniéndose que registrar manualmente en el SIAF, lo que generaba un desfase de la información, sumado a las demoras en la ejecución presupuestal. Debido a las razones mencionadas, se solicitó la implementación de una nueva plataforma de gestión de proyectos. Este trabajo es monográfico, descriptivo, que muestra la experiencia en la incorporación de herramientas de gestión, tales como: control, sistemas integrados de gestión, indicadores de gestión ocurridos en el periodo 2019-2021. Este trabajo se compone de 3 partes. En la primera parte, se muestran las competencias profesionales adquiridas durante la carrera de Ingeniería en Gestión Empresarial, que se aplicó en el presente trabajo monográfico. En la segunda parte, se muestra la aplicación de las herramientas que mejoraron la gestión de los proyectos de investigación en el periodo 2019-2021. Y en la tercera parte, se presentan los resultados obtenidos de la implementación y mejora de la plataforma. Finalmente, se exponen las conclusiones y recomendaciones del presente trabajo.The purpose of the following work is to evaluate the implementation of a platform for the improvement of the project management within the Subdirection of Project Administration (SAP) of the Directorate of Research Management (DGI) of the Vice Presidency for Research (VRI) of the National Agrarian University of La Molina (UNALM), at the scale of time, control and processes. In 2016, the public sector presented changes in the procedure for making transfers among institutions, generating as a result the single public treasury account (CUT). As a consequence, the requirements of the SAP research projects had to be linked up to the transfers received, however the platform used at that time did not allow such process, having to be manually registered in the SIAF, which generated a gap in the information, generating delays in the budget execution. Due to the reasons mentioned previously, the implementation of a new project management platform was requested. This work is monographic, descriptive that shows the experience in the incorporation of management tools, such as: control, integrated management systems, management indicators that occurred in the 2019-2021 period. The work consists of 3 parts. In the first part, the professional skills acquired during the Business Management Engineering career are shown, which was applied in this monographic work. In the second part, the application of the tools that improved the management of research projects in the 2019-2021 period is shown. And in the third part, the results obtained from the implementation and improvement of the platform are presented. Finally, the conclusions and recommendations of this work are set fort

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

La revolución en el bicentenario : reflexiones sobre la emancipación, clases y grupos subalternos

La propuesta del Grupo de Trabajo de CLACSO "El Bicentenario Latinoamericano: dos siglos de revoluciones a la luz del presente" consiste en elaborar nuevas perspectivas sobre los dos últimos siglos de historia latinoamericana, problematizando, fundamentalmente, su trayectoria en torno al nudo temático de las revoluciones desde perspectivas interdisciplinarias al interior de las ciencias sociales. Un segundo eje del enfoque propuesto por el Grupo de Trabajo toma en cuenta el papel en esta historia y en este presente, de las clases y sujetos subalternos. Señalamos tres momentos principales: la denominada "primera independencia" (las luchas contra el dominio español), el período del llamado primer centenario y luego de las "revoluciones nacionales" (entre 1904 y 1950 aproximadamente) y los procesos revolucionarios o de lucha contra el dominio de los Estados Unidos, que comprende tanto la fase neoliberal actual y en proyección hacia el Bicentenario como la búsqueda de programa y proyecto latinoamericano y caribeño, comprendiendo incluso el del llamado "socialismo del siglo XXI". Algunas de las preguntas orientadoras de nuestra reflexión son: -¿Qué herencias históricas implicó la condición poscolonial del siglo XXI? -¿Qué determinaciones impuso la inscripción en el mercado capitalista? -¿Qué desafíos significó la presión de los Estados Unidos durane el siglo XX? -¿Cuáles fueron y son las características de los movimientos populares latinoamericanos? -¿Qué promesas y contradicciones singularizaron y singularizan a sus movimientos políticos de corte transformador? -¿Qué novedades políticas y sociales revela el inicio del nuevo siglo? -¿Qué balance es posible realizar del proceso en su conjunto? -¿Qué perspectivas están abiertas para el cambio social latinoamericano? -¿Qué nuevas situaciones supone la conformación de bloques económicos regionales? -¿Existe una forma propia de "revolución latinoamericana"? Esa última es una pregunta decisiva, porque su respuesta define la posibilidad de hablar de una historia y una realidad latinoamericanas. La respuesta puede ser plural e histórica. En este sentido, más que una forma única, investigamos la creación de formas específicas del cambio social, económico, político y cultural. Sin embargo, no es superfluo insistir sobre el interés por construir un enfoque comparativo de la historia latinoamericana. No se trata, entonces, de acumular trabajos monográficos sobre los diferentes países, sino de partir de estudios específicos para compartir preguntas, métodos y problemas para replantear una perspectiva renovada a la luz de las posibilidades actuales. De este modo la celebración del Bicentenario excederá el recuerdo o el festejo para avanzar en una reflexión que retome los proyectos seculares del subcontinente, contribuya a un balance crítico de dos siglos de historia y presente conocimientos para el futuro.Beatriz Rajland y María Celia Cotarelo Presentación | 9 Omar Acha La historia latinoamericana y los procesos revolucionarios: una perspectiva del Bicentenario (1870-2010) | 17 Juan Carlos Gómez Leyton La Revolución en la Historia. Refl exiones sobre el cambio político en América Latina | 39 Luis Suárez Salazar Las utopías Nuestramericanas de la Revolución Cubana: una aproximación histórica | 57 Gerardo Contreras El carácter de las relaciones internacionales: El caso Unión Europea Centroamérica de cara al acuerdo de asociación | 81 Mildred de la Torre Molina La revolución latinoamericana en el proceso nacional cubano (1790-1830) | 95 Daniel Kersffeld Entre evocaciones y desmemorias: México ante su propio Bicentenario | 115 Darío Sarah La construcción de la memoria colectiva del Paraguay: entre el cretinismo y la arcadia perdida | 133 Orietta Favaro y Graciela Iuorno Argentina. Un país a dos velocidades. Provincias y Territorios Nacionales. (1884-1991) | 151 Martha Ruffini El proceso formativo y de consolidación del Estado Argentino en perspectiva histórica. La exclusión política y sus diferentes itinerarios | 169 Ignacio Telesca Desde el revés de la trama: la independencia del Paraguay y los grupos subalternos | 189 J. Alberto Navas Sierra La Revolución atlántica, la independencia americana y La nueva Macro-historia | 209 Felipe de J. Pérez Cruz La educación y la pedagogía cubanas en el movimiento nacional liberador. Visión panorámica desde la revolución en el siglo XIX | 229 Pedro Canales Tapia Parece que no somos felices. Crisis del proyecto oligárquico y movilizaciones indígenas en Latinoamérica, (19001930) | 253 Carmen Rosa Rea Campos Luchas indias en Bolivia: un análisis socio-histórico de la constitución de la política | 273 María Celia Cotarelo La clase obrera en nuestra américa a comienzos del siglo XXI | 291 Steve Cushion Una sublevación de la clase obrera contra el imperio británico | 311 Nicolás Iñigo Carrera Emancipación social y emancipación nacional en el movimiento obrero argentino | 325 José Francisco Puello-Socarrás Revolución sin Guerrillas, ¿guerrillas sin revolución? La vigencia del concepto revolución en las guerrillas contemporáneas. El caso del Ejército de Liberación Nacional en Colombia | 345 Beatriz Rajland y Liliana B. Costante Los nuevos Poderes Constituyentes en la América Latina y Caribeña de hoy y su relación con los procesos de cambio | 367 Angelina Rojas Blaquier El proceso nacional liberador cubano entre 1923 y 1940. Apuntes esenciales | 39

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected