33 research outputs found

    La certificaci贸n digital y la gesti贸n administrativa eficiente en las Instituciones del Estado Peruano

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    El presente trabajo de investigaci贸n titulado 鈥淟a certificaci贸n digital y la gesti贸n administrativa eficiente en las instituciones del estado peruano鈥, presenta un estudio y an谩lisis de la relaci贸n existente entre la certificaci贸n digital y la gesti贸n administrativa que permitir铆a mejorar la eficiencia de los procesos administrativos a trav茅s de la certificaci贸n digital en las instituciones del estado. Para tal efecto dentro de la metodolog铆a de la investigaci贸n planteada, se utilizaron los siguientes m茅todos cient铆ficos: anal铆ticos, inductivos, deductivos y descriptivos, entre otros. Considerando en dicha metodolog铆a el tipo, nivel, dise帽o, m茅todo, poblaci贸n, muestra, e instrumentos de recopilaci贸n de datos. Despu茅s de realizar el an谩lisis e interpretaci贸n de la prueba de campo, en concordancia con el desarrollo de los objetivos y de acuerdo a las hip贸tesis planteadas, se lograron demostrar mediante la contrastaci贸n y convalidaci贸n de las hip贸tesis lo siguiente: Que la variable independiente, la certificaci贸n digital, se relaciona con la variable dependiente, la gesti贸n administrativa eficiente. La investigaci贸n ha podido determinar que el 75.15% de los encuestados realizan transacciones electr贸nicas bastante y regularmente. Asimismo, dedican semanalmente entre 4 a 6 horas de su tiempo en transacciones electr贸nicas (51.55%) Se ha logrado determinar que, el 84.47% de los encuestados manifiesta que siempre o casi siempre los mecanismos de protecci贸n de la certificaci贸n digital son seguros. Se estableci贸 que, los encuestados consideran que siempre o casi siempre la certificaci贸n digital, permitir铆a una gesti贸n administrativa eficiente, que incrementar铆an las transacciones electr贸nicas, y que difundir los mecanismos permitir铆a que m谩s usuarios utilicen la certificaci贸n digital. El estudio demuestra que, el 75.78% de los encuestados manifiesta que la certificaci贸n digital agilizar铆a los tr谩mites electr贸nicos que el sector privado realiza con el Estado. Asimismo, el 85.10% de los encuestados considera que la certificaci贸n digital reducir铆a los costos de las transacciones En conclusi贸n, luego de haber contrastado las hip贸tesis planteadas y analizadas las tablas y gr谩ficos elaborados en el cuestionario del trabajo de campo podemos afirmar que la certificaci贸n digital, permitir铆a una gesti贸n administrativa eficiente en las instituciones del estad

    Plan de negocio para la apertura de una sede comercial de la empresa quesera Primavera en el oriente antioque帽o

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    Colombia es un pa铆s que consume productos l谩cteos, en este caso espec铆fico el queso, de manera habitual, de tal forma que las personas demandan diferentes tipos de quesos y cada regi贸n tiene un consumo espec铆fico de cada producto. Hace parte de la canasta b谩sica de los colombianos y es un producto que tanto su producci贸n como su consumo est谩 en aumento a nivel nacional e internacional. El modelo de negocio que se plantea toma en consideraci贸n todas las variables claves relacionadas con la descripci贸n del servicio y el producto de un plan de negocio, presentando una propuesta de valor e identificando elementos que son clave para as铆 desarrollar todas las estrategias operativas y de mercado para la viabilidad del negocio. Se realizar谩n an谩lisis financieros, los cuales muestran una viabilidad y favorabilidad los primeros 5 a帽os proyectados, concluyendo as铆 que la implementaci贸n del negocio es recomendada para los due帽os o inversionistas de la empresa.Colombia is a country that consumes dairy milk based products, in this specific case cheese on a regular basis, they demand different types of cheese and each region has a specific consumption of each product. Cheese is part of the basic basket of colombians consumption, also its a product that botch its production and its consumption is increasing nationally and internationally talking. The business model that is proposed to be considered in this case, the approach of all the key variables related to the description of the service and the product, the value proposal identified are key for the development of all operational and market strategies for the viability of the business. Financial analyzes are carried out, which show a viability and favorability for the first five years projected, we can conclude that the implementation of this business model is highly recommended for the owners or investors of the company

    Los 鈥渄oce roles del docente de medicina鈥: un estudio piloto de tres universidades p煤blicas de Paraguay

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    Reconocer los m煤ltiples roles que tienen los docentes de medicina es importante para prepararlos para la compleja tarea de ense帽ar la ciencia m茅dica. El objetivo de este trabajo fue determinar la importancia que dan los docentes de medicina de 3 universidades p煤blicas de Paraguay a los 鈥淒oce roles de un docente de medicina鈥 planteados por Harden y Crosby. Fue un estudio observacional, descriptivo, de corte transversal, con muestreo por conveniencia. Los participantes fueron docentes de Medicina, de la Universidad Nacional de Asunci贸n, Nacional del Este y Nacional de Itap煤a, con al menos 2 a帽os de experiencia, que completaron un cuestionario que midi贸 la importancia que dan a los doce roles del docente de medicina. Para ese fin, se utiliz贸 una versi贸n en espa帽ol de la teor铆a de Harden y Crosby, traducida con autorizaci贸n de sus autores. Participaron del estudio 73 docentes. La mayor铆a percibi贸 su papel m谩s importante como proveedor de informaci贸n en las pr谩cticas o en la cl铆nica (4,68卤0,57), como modelo de rol en el 谩mbito laboral (4,53卤0,60) y en la ense帽anza (4,45卤0,67), y como planificador o participante en las evaluaciones del estudiante (4,41卤0,62). Estos resultados nos permiten afirmar que el docente de medicina de Paraguay se ve a s铆 mismo como m谩s que un instructor de clases te贸ricas o pr谩cticas cl铆nicas, sino cumpliendo muchos diferentes roles al mismo tiempo. Los docentes de medicina pueden desempe帽ar un papel importante en la realizaci贸n de estudios de investigaci贸n pedag贸gica que permitan mejorar las pr谩cticas de ense帽anza y aprendizaje de la medicina

    Lung cancer : changes in histology, gender, and age over the last 30 years in Brazil

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    Objective: To describe the trends in tumor histology, gender and age among patients with non-small cell lung cancer (NSCLC) treated with lung resection. The histology of lung cancer has changed in developed countries, and there is still little information available on the topic for developing countries. Methods: This was a retrospective study of 1,030 patients with NSCLC treated with lung resection between 1986 and 2015 at a university hospital in southern Brazil. Differences in histology, stage, and type of surgery were analyzed by gender and for three periods (1986-1995, 1996-2005, and 2006-2015). Results: Most (64.5%) of the patients were males, and the main histological types were squamous cell carcinoma (in 40.6%) and adenocarcinoma (in 44.5%). The mean age at surgery during the first period was 56.4 years for women and 58.9 years for men, compared with 62.2 for women and 64.6 for men in the third period (p < 0.001). The proportion of females increased from 26.6% in the first period to 44.1% in the third. From the first to the third period, the proportion of patients with squamous cell carcinoma decreased from 49.6% to 34.8% overall (p < 0.001), decreasing to an even greater degree (from 38.9% to 23.2%) among men. Among the NSCLC patients in our sample, females with adenocarcinoma accounted for 11.9% in the first period and 24.0% in the third period (p < 0.001). Conclusions: As has been seen in developed countries, the rates of lung cancer in females in southern Brazil have been rising over the last three decades, although they have yet to surpass those observed for males in the region. The incidence of squamous cell carcinoma has decreased in males, approaching adenocarcinoma rates, whereas adenocarcinoma has significantly increased among women

    Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019

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    "Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru鈥檚 healthcare system performance. Methods: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8鈥70.3) to 80.3 (77.2鈥83.2) years. This increase was driven by the decline in under-5 mortality (鈭80.7%) and mortality from infectious diseases in older age groups (+60鈥墆ears old). The number of DALYs in 1990 was 9.2 million (8.5鈥10.1) and reached 7.5 million (6.1鈥9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.

    Quality of life in the older adults: The protective role of self-efficacy in adequate coping in patients with chronic diseases

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    The purpose of the present study was to establish the association between self-efficacy, perception of disease, emotional regulation, and fatigue and the health-related quality of life in older adults living in the departments of Cesar and Atl谩ntico in Colombia and who have been diagnosed with a chronic disease. The participants were 325 older adults of both sexes, with literacy and no presence of cognitive impairment in the Mini-Mental State Examination (MMSE); A non-probabilistic sampling was carried out. We used the MOS-SF-36 questionnaire, the Brief Illness Perception Questionnaire scale for measuring the perception of disease, the Stanford Patient Education Research Center鈥檚 Chronic Disease Self self-efficacy questionnaire for chronic patients, the Difficulties in Emotional Regulation Scale, and the Fatigue Severity Questionnaire as measurement instruments. The design was non-experimental cross-sectional with a correlational scope. The results indicate that self-efficacy, disease perception, emotional regulation and severity of fatigue are variables that could impact the physical function of quality of life, confirming that self-efficacy would work as a factor that decreases the probability that a participant score low on this dimension of quality of life. On the other hand, both the perception of the disease and the severity of fatigue were identified as factors that probably negatively influence quality of life

    Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI : Results of the ISACS-STEMI COVID-19 Registry

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    Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March鈥揓une 2019 and 2020. Patients were divided according to age (< or 鈮75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. Results: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825鈥0.861, p < 0.0001). We found a significant agerelated reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24鈥1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05鈥1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic

    Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

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    Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (= 75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. Results: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic

    Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

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    Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March鈥揓une 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time 鈮 12 h and door-to-balloon 鈮 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825鈥0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31鈥2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96鈥1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655
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