Determinacion de una metodologia de aplicacion de outsourcing en tecnologias de informacion

185 p.La investigación que se presenta a continuación, trata de Ias características, use y tendencias de los servicios de Outsourcing en Tecnologías de Información, entendiéndose por esto, la externalizacion de servicios informáticos, dejando en manos de terceros especializados el desarrollo de las aplicaciones que componen los mencionados servicios. Debido a la reciente incursión en esta nueva forma de administrar la informática, se genero como resultado de esta investigación, una Metodología de Aplicación de Outsourcing en Tecnologías de Información, que pretende ser una secuencia de actividades que organice y oriente el accionar de las empresas que se inicien en un proceso de Outsourcing. Esta metodología es el resultado de una serie de entrevistas con expertos en Outsourcing, señores como: Ignacio Niculcar, Jefe Proyecto Outsourcing ESVAL S.A.; Fedor Estrada, Gerente de Administración y Finanzas ESSBIO S.A.; Daniel García, Subgerente de Ingeniería se Software, Sonda Gestión Ltda.; Héctor Palma, Gerente de Sistemas, Compañía de Seguros Generales LE MANS ISE; Fernando Rossati, Jefe de Proyectos, Chilectra Metropolitana y Guillermo Toro, Gerente de Servicios, Synapsis. Además contribuye a la definición de esta metodología el análisis de casos específicos con Chilectra Metropolitana, Codelco, ESSBIO y ESVAL. Como parte fundamental en la conformación del resultado de esta tesis se presenta el análisis del proceso de Outsourcing llevado a cabo en ESSAM S.A., en la que se efectuó una consultoría, actuando como contraparte de dicha empresa el Ingeniero Civil y Gerente de Ingeniería y Planificación, Don Raúl Alcaíno Fuenzalida, como representante del comité de la empresa, conformado por las gerencias, quienes aprobaron nuestra propuesta de trabajo, facilitando el ingreso y acceso de información en ESSAM S.A.. La consultoría aplicada en la mencionada empresa se realizó en dos etapas. La primera representada por el diagnóstico y análisis de la situación de la empresa frente a la externalización de sus servicios; y la segunda etapa dada por la realización de una evaluación con respecto a la metodología obtenida, con el interés de validar en cierta forma el instrumento. La metodología involucrada para el desarrollo de esta investigación, consta de una primera etapa exploratoria y una segunda etapa descriptiva, detallando además, las tácticas a seguir para la verificación de hipótesis y logro de los objetivos planteados. Finalmente, considerando toda la información recopilada, se establecen los diagnósticos relacionados con la situación actual de la empresa analizada, en cuanto a manejo y administración de las Tecnologías de Información, donde a partir de la organización de éstos, se deducen las conclusiones respectivas, las cuales permiten establecer recomendaciones especificas para un adecuado desarrollo de la Metodología de Aplicación de Outsourcing en Tecnologías de Información y proponer, recomendaciones de carácter general para orientar acciones a seguir para empresas que se inicien en un proceso de externalizacion

Comunicación interna y desarrollo organizacional de la cooperativa de servicios especiales del C.C Túpac Amaru Ltda., San Juan de Lurigancho

La presente investigación “Comunicación interna y desarrollo organizacional de la cooperativa de servicios especiales del centro comercial Túpac Amaru Ltda., San Juan de Lurigancho”, tuvo como objetivo general determinar la relación que existe entre la comunicación interna y desarrollo organizacional de la cooperativa de servicios especiales del centro comercial Túpac Amaru Ltda., San Juan de Lurigancho. Para ello se tuvo una población conformada por 55 socios, datos recabados con la técnica de la encuesta, el cuestionario como instrumento y el censo como criterio ya que se tomó al total de los socios a los cuales se aplicaron las encuestas. El diseño de investigación es descriptiva correlacional. Además, se utilizó el coeficiente de correlación de Spearman para el cálculo de la correlación, llegando a la conclusión principal que la comunicación interna tiene una relación directa con el desarrollo organizacional de la cooperativa de servicios especiales del centro comercial Túpac Amaru Ltda. San Juan de Lurigancho

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Transformaciones y retos de la educación en las artes y los diseños (tomo 2)

394 páginas.Libro con diversas muestras de la labor, el pulso, las formas y caminos resolutivos que asumieron los docentes frente a contextos de complejidad en el marco de la educación superior en las artes y los diseños, que buscó la profesionalización de los estudiantes frente a la emergencia de la pandemia Covid-19 yendo más allá y proponiendo mecanismos de creatividad, flexibilidad académica, colaboración y motivación educativa. Aparecen en las investigaciones no solo respuestas y experiencias, sino nuevos planteamientos para una perspectiva futura, necesarios en las transformaciones para las próximas décadas que deberán vivirse en los planes y programas de estudio, los sistemas de evaluación, la formación docente, el perfil y las competencias digitales de los estudiantes, entre otros aspectos. Y a propósito de estas reflexiones, también se plantea un escenario sobre ¿a dónde queremos o debemos llegar en la educación en artes y diseño? Cabe señalar que los aportes de estos textos provienen del ámbito de la educación superior pública en México, que se rige bajo los principios generales de libertad de cátedra para los docentes, y este factor resulta fundamental para poder observar justamente la toma de decisiones, adecuaciones, movilidad y flexibilidad para las adecuaciones curriculares y también en los procesos de enseñanza- aprendizaje que se exponen, resultando un componente central para pensar en contextos de emergencia y complejidad y en los escenarios futuros de la educación en las artes, diseños y en todos los ámbitos del conocimiento.Coordinadoras: Alma Elisa Delgado Coellar, Juana Cecilia Angeles Cañedo & Daniela Velázquez Ruí

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (< 1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year agestandardised net survival for all lymphoid leukaemias combined ranged from 10.6% (95% CI 3.1-18.2) in the Chinese registries to 86.8% (81.6-92.0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52.4% (95% CI 42.8-61.9) in Cali, Colombia, to 91.6% (89.5-93.6) in the German registries, and for AML ranged from 33.3% (18.9-47.7) in Bulgaria to 78.2% (72.0-84.3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood survival

Lancet

BACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37.5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the USA, but international differences remain very wide, with levels as low as 66.1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68.9%), colon (71.8%), and rectum (71.1%); in Japan for oesophageal cancer (36.0%); and in Taiwan for liver cancer (27.9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), and for both lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49.8% in Ecuador to 95.2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28.9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)

Objective Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. Methods The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995â\u80\u932009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. Results During 2005â\u80\u932009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. Conclusions The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions

LA U INVESTIGA: Revista Científica. Facultad Ciencias de la Salud. Volumen 3. Número 1

Los ámbitos de investigación expuestos en este número corresponden a salud, educación, comunicación; temática relacionados íntimamente con la problemática social, que trata de visibilizarla a través de la difusión científica. Desde una visión de caso clínico, como son aquellos artículos investigados en los centros asistenciales del país; o de análisis colectivo evidente en los artículos elaborados por académicos de la Universidad Técnica del Norte.• Adenoma pleomorfo metastásico a mama y pulmón. • Evaluación clínica y atención temprana de la potencialidad cerebromotriz innata en los recién nacidos vivos con factores de riesgo neonatal del hospital general San Vicente de Paúl. • Embarazo ectopico cervical a proposito de un caso • Ganglio centinela en cáncer de mama uso de azul patente en unidades de segundo nivel. • Morbimortalidad en recién nacidos pretérminos menores de 36 semanas, hospital IESS Ibarra año 2014. • Ruptura esplénica asociada con preeclampsia severa presentacion de un caso. • Enfermedad de Addison de etiología tuberculosa: presentación de caso clínico. • Estado de la independencia funcional en personas con discapacidad del cantón Otavalo. • Síntesis analítica sobre las bondades medicinales de la jícama (smallanthus sonchifolius) 2015. • Prevención de infecciones puerperales con Churiyuyo (kalanchoe pinnata), una experiencia de las parteras tradicionales en Napo Ecuador. • Valoración de las habilidades comunicativas en la relación fisioterapeuta paciente. • Objeto de aprendizaje móvil en el aula, para estudiantes de la carrera de Nutrición y salud comunitaria, Universidad Técnica del Norte. • Infecciones de vías urinarias asociadas a catéter vesical en mujeres embarazadas. Hospital San Vicente de Paúl, 2015. • Proceso enfermero en la satisfacción de las necesidades básicas en usuario colecistectomizado. • Satisfacción laboral de los profesionales de enfermerí