Modelado experimental de un sistema de e-Salud aplicado en cooperación al desarrollo

Los Objetivos de Desarrollo del Milenio comprometieron a los países con una nueva alianza mundial de alcanzar gradualmente una cobertura universal de los niveles mínimos de bienestar en los países en desarrollo (reducir la pobreza y el hambre y dar respuesta a problemas como la mala salud, las desigualdades de género, la falta de educación, el acceso a agua salubre y la degradación ambiental). Para dar continuidad a esta iniciativa, recientemente en septiembre de 2015, la ONU promulgó la declaración de los Objetivos de Desarrollo Sostenible. Los ODM sitúan la salud en el corazón del desarrollo y establecen un novedoso pacto mundial que vincula a los países desarrollados y los países en desarrollo por medio de obligaciones claras y recíprocas. En este sentido, diversos organismos de cooperación a través de sus programas de cooperación internacional, tratan de mejorar el acceso a la asistencia sanitaria, especialmente a la población vulnerable que vive en zonas rurales de países en desarrollo. Con el fin de ayudar a cumplir los ODM que apoyan los temas de salud en dicha población, estos organismos desarrollan proyectos que despliegan sistemas de e-salud. Las intervenciones se enfrentan a múltiples retos: condicionantes de los países en desarrollo, las necesidades y demandas de los sistemas sanitarios y la complejidad de implantar las TIC en entornos complejos y altamente dinámicos como son los países en desarrollo. Estos condicionantes ocasionan la mayoría de proyectos fallidos que terminan convirtiéndose en soluciones aisladas, que anteponen la tecnología a las necesidades de la población y no generan el impacto esperado en su desarrollo. En este contexto tuvo origen esta tesis doctoral, que persigue como objetivo analizar, planificar, diseñar, verificar y validar un marco arquitectónico de implantación de sistemas de e-salud en áreas rurales de países en desarrollo, que promueva el mejoramiento de la calidad de vida de la población vulnerable de estas regiones y la efectividad de las intervenciones de e-salud en el marco de proyectos de cooperación al desarrollo. Para lograrlo, tomé como punto de partida, diversas estrategias, modelos, metodologías de implantación de e-salud, modelos de gestión de proyectos propuestos por distintos organismos internacionales y propuse una instanciación de estos modelos a proyectos de implantación de sistemas de e-salud en países en desarrollo. Apliqué la metodología action research y los enfoques twin track, middle out y design thinking que me permitieron el refinamiento iterativo del modelo propuesto en la tesis doctoral mediante el trabajo de campo realizado en dos zonas rurales de países de Centroamérica: Jocotán (Guatemala) y San José de Cusmapa (Nicaragua). Como resultado obtuve un modelo experimental basado en cuatro componentes: un modelo de referencia tipo, un modelo conceptual de e-salud, los procesos de gestión y de implantación de sistemas de e-salud en países en desarrollo y una arquitectura de referencia. El modelo experimental resultante aporta herramientas importantes para el despliegue de sistemas de e-salud en países en desarrollo. Se ha propuesto un modelo de referencia que proporciona una visión holística del contexto del país en desarrollo donde se desarrollarán las intervenciones. Un modelo conceptual de e-salud que representa los principales conceptos involucrados en un sistema de e-salud. Los procesos ii- de gestión del proyecto y de implantación del sistema que proporcionan a los grupos de cooperación, herramientas para el análisis, diseño, desarrollo y despliegue de los sistemas de e-salud en áreas rurales de países en desarrollo. Y finalmente la arquitectura de referencia que sienta las bases para la aplicación de estos procesos a un contexto en particular. Las líneas futuras de trabajo sugieren extender el modelo a más casos de estudio que permitan su refinamiento y evaluar los futuros usos que pueden surgir de los sistemas de e-salud resultantes. ABSTRACT Millennium Development Goals (MDGs) committing the countries with a new global partnership to achieve universal coverage of minimum levels of well-being in Developing Countries (for addressing extreme poverty in its many dimensions-income poverty, hunger, disease, lack of adequate housing, and exclusion-while promoting gender equality, education, and environmental sustainability). From September 2015, these goals are replaces with Sustainable Development Goals (SDGs). The MDG place health at the heart of development and establish a novel global compact, linking developed and developing countries through clear, reciprocal obligations. Many public and private institutions promote international cooperation programs to support in achieving the MDGs. Some of these cooperation programs deal improving access to healthcare to poor people living in isolated areas from developing countries. In order to accomplish this goal organizations perform projects (interventions or cooperation projects) that deploy e-health systems in these zones. Nevertheless, this kind of projects face multiple challenges that dismiss the effectiveness of the projects results. In particular, cooperation teams face issues such as constraints in developing countries, lack of electrical and ICT infrastructure, scarce transport, extreme climate conditions, lack ICT capacity, lack of access to healthcare and inefficient delivery methods, etc. Hence, these issues increase the complexity of implementing e-health in developing countries and then causes the most projects fail. In other words, the solutions do not meet population needs and do not generate the expected impact on development. This context is the starting point of this doctoral thesis, which deals with analysing, planning, designing, testing and validating an architectural framework in order to implement e-health systems in rural areas from developing countries, promote development of the population in these regions, and thus improve the impact of interventions of development cooperation projects. To achieve this goal, I took as a starting point the strategies, models, e-health implementation methodologies and projects management models proposed by various international agencies. Then I proposed an instantiation of these models to manage the intervention and implement e-health systems in developing countries. I applied the action research methodology and the approaches twin track, middle out and design thinking which allowed me the iterative refinement of the model proposed in this doctoral thesis. The proposed framework was validated by running two cases studies in rural areas of Central America: Jocotán (Guatemala) and San José de Cusmapa (Nicaragua). As a result, I obtained an experimental model based on four components: a Type reference model, an e-health conceptual model, both process management and implementation e-health systems in developing countries and a reference architecture. The resulting experimental model provides important tools for the deployment of e-health systems in developing countries. The model become as reference model that provides a holistic view of the developing countries context where the interventions will be running. The conceptual model of e-health represents the main concepts involved into an e-health system. The project management and implementation processes of the iv- system provide to the cooperation teams with tools for analysing, designing, developing and deploying e-health systems in rural areas from developing countries. Finally, the reference architecture provides the basis for the implementation of these processes into a particular context. The future research suggest the extension the model to other cases studies in order to refine and evaluate the viability the model.

A Tele-Health Communication and Information System for Underserved Children in Rural Areas of Nicaragua

Millennium Development Goals point out the necessity of actively promoting maternal-child health care status, especially in underserved areas. This article details the development actions carried out between 2008 and 2011 in some rural communities of Nicaragua with the aim to provide a low-cost tele-health communication service. The service is managed by the health care center of Cusmapa, which leads the program and maintains a communication link between its health staff and the health brigades of 26 distant communities. Local agents can use the system to report urgent maternal-child health care episodes to be assessed through WiMAX-WiFi voice and data communications attended by two physicians and six nurses located at the health care center. The health and nutritional status of the maternal-child population can be monitored to prevent diseases, subnutrition, and deaths. The action approach assumes the fundamentals of appropriate technology and looks for community- based, sustainable, replicable, and scalable solutions to ensure future deployments according to the strategies of the United Nations.

Social development benefits of hydroelectricity CDM projects in Brazil

In recent years, the concept of sustainable development has become increasingly recognized and important. Within organizations, sustainable development is often portrayed as a balancing act, and requires a combination of three elements to be considered: economy, environment, and society. Traditionally, organizational management research has been focused on economical and environmental fronts. However, social aspects are also important for organizations, especially those in emerging and developing countries. The goal of this paper is to investigate the potential of Clean Development Mechanism (CDM) projects to deliver social benefits in Brazil?s hydroelectricity sector. The investigation involved the assessment of 46 registered hydro CDM projects under the Kyoto Protocol in terms of their potential impact on the envisaged social development goals. Two case studies were also examined. Results indicate that organizations managing hydroelectric initiatives in Brazil can provide the pathway towards achieving a number of important social benefits. Successful projects were found to have good community involvement and were managed by both cooperative ventures and money making corporations. The research also identified several challenges that are hindering hydro CDM projects from delivering more social benefits, and enabled a number of recommendations to be extracted for the organizations facing these challenges.

ESP in Spain: goals, achievements and prospects

This paper aims to describe the development of English for Specific Purposes (ESP) as specialised language study and research at tertiary level in Spain over the past twenty years. The year 1992 is chosen as a starting point because AELFE, the Association of Languages for Specific Purposes, was founded in Madrid at the time. As more members from other countries have joined in, this Association has served as an academic landmark for the development of ESP within the umbrella of applied linguistics. ESP has reflected the social changes, educational shifts, linguistic trends, and technological innovations involved in academic and professional contexts. The evolution of the specialised language practitioner’s scenarios and communicative situations has turned ESP into a lively and stimulating action, though not lacking in controversy, e.g., a general increase in the ESP teacher’s workload. Different lines of work and research have been followed from the inception of AELFE until the implementation of the Bologna agreement in our universities. The examination of such variables is conducted in the light of some quantitative and qualitative findings.

UER technique: conceptualisation for agent oriented development

The problem of conceptualisation is the first step towards the identication of the functional requirements of a system. This article proposes two extensions of well-known object oriented techniques: UER (User-Environment-Responsibility) technique and enhanced CRC (Class-ResponsibilityCollaboration) cards. UER technique consists of (a) looking for the users of systems and describing the ways the system is used; (b) looking for the objects of the environment and describing the possible interactions; and (c) looking for the general requirements or goals of the system, the actions that it should carry out without explicit interaction. The enhanced CRC cards together with the internal use cases technique is used for dening collaborations between agents. These techniques can be easily integrated in UML (Unied Modelling Language) [2], dening the new notation symbols as stereotypes.

The impact of sustainable construction and knowledge management on sustainability goals. A review of the venezuelan renewable energy sector

The recognition of the relevance of energy, especially of the renewable energies generated by the sun, water, wind, tides, modern biomass or thermal is growing significantly in the global society based on the possibility it has to improve societies′ quality of life, to support poverty reduction and sustainable development. Renewable energy, and mainly the energy generated by large hydropower generation projects that supply most of the renewable energy consumed by developing countries, requires many technical, legal, financial and social complex processes sustained by innovations and valuable knowledge. Besides these efforts, renewable energy requires a solid infrastructure to generate and distribute the energy resources needed to solve the basic needs of society. This demands a proper construction performance to deliver the energy projects planned according to specifications and respecting environmental and social concerns, which implies the observance of sustainable construction guidelines. But construction projects are complex and demanding and frequently face time and cost overruns that may cause negative impacts on the initial planning and thus on society. The renewable energy issue and the large renewable energy power generation and distribution projects are particularly significant for developing countries and for Latin America in particular, as this region concentrates an important hydropower potential and installed capacity. Using as references the performance of Venezuelan large hydropower generation projects and the Guri dam construction, this research evaluates the tight relationship existing between sustainable construction and knowledge management and their impact to achieve sustainability goals. The knowledge management processes are proposed as a basic strategy to allow learning from successes and failures obtained in previous projects and transform the enhancement opportunites into actions to improve the performance of the renewable energy power generation and distribution projects.

Guidance for the development of accessibility evaluation tools following the Unified Software Development Process

Automated and semi-automated accessibility evaluation tools are key to streamline the process of accessibility assessment, and ultimately ensure that software products, contents, and services meet accessibility requirements. Different evaluation tools may better fit different needs and concerns, accounting for a variety of corporate and external policies, content types, invocation methods, deployment contexts, exploitation models, intended audiences and goals; and the specific overall process where they are introduced. This has led to the proliferation of many evaluation tools tailored to specific contexts. However, tool creators, who may be not familiar with the realm of accessibility and may be part of a larger project, lack any systematic guidance when facing the implementation of accessibility evaluation functionalities. Herein we present a systematic approach to the development of accessibility evaluation tools, leveraging the different artifacts and activities of a standardized development process model (the Unified Software Development Process), and providing templates of these artifacts tailored to accessibility evaluation tools. The work presented specially considers the work in progress in this area by the W3C/WAI Evaluation and Report Working Group (ERT WG)

Development of a fuzzy control based self-adaptive system for energy saving in constrained networks for the Internet of Things

Las redes del futuro, incluyendo las redes de próxima generación, tienen entre sus objetivos de diseño el control sobre el consumo de energía y la conectividad de la red. Estos objetivos cobran especial relevancia cuando hablamos de redes con capacidades limitadas, como es el caso de las redes de sensores inalámbricos (WSN por sus siglas en inglés). Estas redes se caracterizan por estar formadas por dispositivos de baja o muy baja capacidad de proceso y por depender de baterías para su alimentación. Por tanto la optimización de la energía consumida se hace muy importante. Son muchas las propuestas que se han realizado para optimizar el consumo de energía en este tipo de redes. Quizás las más conocidas son las que se basan en la planificación coordinada de periodos de actividad e inactividad, siendo una de las formas más eficaces para extender el tiempo de vida de las baterías. La propuesta que se presenta en este trabajo se basa en el control de la conectividad mediante una aproximación probabilística. La idea subyacente es que se puede esperar que una red mantenga la conectividad si todos sus nodos tienen al menos un número determinado de vecinos. Empleando algún mecanismo que mantenga ese número, se espera que se pueda mantener la conectividad con un consumo energético menor que si se empleara una potencia de transmisión fija que garantizara una conectividad similar. Para que el mecanismo sea eficiente debe tener la menor huella posible en los dispositivos donde se vaya a emplear. Por eso se propone el uso de un sistema auto-adaptativo basado en control mediante lógica borrosa. En este trabajo se ha diseñado e implementado el sistema descrito, y se ha probado en un despliegue real confirmando que efectivamente existen configuraciones posibles que permiten mantener la conectividad ahorrando energía con respecto al uso de una potencia de transmisión fija. ABSTRACT. Among the design goals for future networks, including next generation networks, we can find the energy consumption and the connectivity. These two goals are of special relevance when dealing with constrained networks. That is the case of Wireless Sensors Networks (WSN). These networks consist of devices with low or very low processing capabilities. They also depend on batteries for their operation. Thus energy optimization becomes a very important issue. Several proposals have been made for optimizing the energy consumption in this kind of networks. Perhaps the best known are those based on the coordinated planning of active and sleep intervals. They are indeed one of the most effective ways to extend the lifetime of the batteries. The proposal presented in this work uses a probabilistic approach to control the connectivity of a network. The underlying idea is that it is highly probable that the network will have a good connectivity if all the nodes have a minimum number of neighbors. By using some mechanism to reach that number, we hope that we can preserve the connectivity with a lower energy consumption compared to the required one if a fixed transmission power is used to achieve a similar connectivity. The mechanism must have the smallest footprint possible on the devices being used in order to be efficient. Therefore a fuzzy control based self-adaptive system is proposed. This work includes the design and implementation of the described system. It also has been validated in a real scenario deployment. We have obtained results supporting that there exist configurations where it is possible to get a good connectivity saving energy when compared to the use of a fixed transmission power for a similar connectivity.

Development of a tool for designing tests based on statistics and metadata

Background: This project’s idea arose derived of the need of the professors of the department “Computer Languages and Systems and Software Engineering (DLSIIS)” to develop exams with multiple choice questions in a more productive and comfortable way than the one they are currently using. The goal of this project is to develop an application that can be easily used by the professors of the DLSIIS when they need to create a new exam. The main problems of the previous creation process were the difficulty in searching for a question that meets some specific conditions in the previous exam files; and the difficulty for editing exams because of the format of the employed text files. Result: The results shown in this document allow the reader to understand how the final application works and how it addresses successfully every customer need. The elements that will help the reader to understand the application are the structure of the application, the design of the different components, diagrams that show the workflow of the application and some selected fragments of code. Conclusions: The goals stated in the application requirements are finally met. In addition, there are some thoughts about the work performed during the development of the application and how it improved the author skills in web development.