Calidad de atención percibida y calidad de vida relacionada con la salud en pacientes participantes de estudios clínicos de la ips idearg sas.

La presente investigación surge en el programa de Bienestar y Calidad de Vida suscrito a la Línea de Liderazgo en la Escuela de Administración de la Universidad del Rosario, con el objetivo de describir si las subdimensiones de la calidad de la atención percibida guardan relación con la calidad de vida relacionada con la salud en los pacientes participantes en Estudios Clínicos en la Institución Prestadora de Servicios de Salud IDEARG SAS, considerando si los factores sociodemográficos se constituyen en mediadores de esta relación. Esta investigación plantea un estudio descriptivo correlacional, en el que a partir de la utilización de los cuestionarios PECASUSS, Percepción de la Calidad según Usuarios del Servicio de Salud, y SF36 de Calidad de Vida Relacionada con la Salud, se lleve a cabo un procesamiento estadístico descriptivo en el software SPSS 21, y con ello se evidencie la correlación entre la calidad de atención percibida y la calidad de vida en salud. Para su desarrollo se abordaran cinco capítulos. El primero engloba el proyecto de trabajo de grado propuesto, el segundo capítulo refiere a la descripción de las subdimensiones que componen la Calidad de la Atención Percibida y de los índices y dominios que a la Calidad de Vida relacionada con la Salud atañen; en el tercer capítulo se evidencia la relación entre los datos sociodemográficos de los participantes y, por un lado, la Calidad de la Atención Percibida y, por otro lado, la Calidad de Vida Relacionada con la Salud; enseguida en el cuarto capítulo se describen las relaciones emergentes entre los dominios de la calidad de vida relacionados con la salud y las subdimensiones de la calidad de la atención en salud percibida; en un quinto capítulo se discuten las correlaciones que describen la existencia de relación entre la Calidad de la Atención Percibida y la Calidad de Vida Relacionada con la Salud; y finalmente se da cierre al trabajo con las conclusiones y recomendaciones.

Modelo de gestión del conocimiento para una empresa del sector de insumos químicos para la industria farmacéutica, cosmética y de alimentos: caso Disaromas S.A.

La creación de conocimiento al interior de las organizaciones es visible mediante la dirección adecuada del conocimiento de los individuos, sin embargo, cada individuo debe interactuar de tal manera que forme una red o sistema de conocimiento organizacional que consolide a largo plazo las empresas en el entorno en el que se desenvuelven. Este documento revisa elementos centrales acerca de la gestión de conocimiento visto desde varios autores y perspectivas e identifica puntos clave para diseñar un modelo de gestión de conocimiento para una empresa del sector de insumos químicos para la industria farmacéutica, cosmética y de alimentos de la ciudad de Bogotá.

Factores perinatales para riesgo de sobrepeso y obesidad en niños de 4 a 5 años en Colombia 2010.

Introducción: La OMS revela que en 2010 alrededor de 43 millones de niños menores de 5 años presentan sobrepeso. En Colombia según la Encuesta Nacional de Situación Nutricional en Colombia en su versión 2005, mostraba una prevalencia general de sobrepeso de 3.1% niños de 0 a 4 años. Es una condición de salud de origen multifactorial en la que interviene factores genéticos, ambientales, maternos y perinatales. Objetivo: Establecer la asociación de riesgo entre el bajo peso al nacer y el desarrollo de sobrepeso y obesidad en niños de 4 a 5 años. Metodología: Se realizó un estudio observacional descriptivo retrospectivo de corte transversal con los datos nutricionales, maternos y perinatales de la Encuesta Nacional de Demografía en Salud del año 2010 en Colombia. Se analizó la asociación entre la variable independiente bajo peso al nacer con el desenlace sobrepeso y obesidad en menores de 4 a 5 años, usando como medida el IMC según la edad. Se realizaron análisis univariados, bivariados y de regresión logística con un modelo de riesgo según las variables que inciden en el desenlace y la variable independiente. Resultados: La muestra obtenida para el estudio fue de 2166 niños de 4 a 5 años de edad quienes cumplían los criterios de inclusión. La prevalencia de sobrepeso u obesidad en la primera infancia fue de 21.8% (472) y el bajo peso al nacer. Los resultados sugieren la asociación de bajo peso y sobrepeso u obesidad es de ORajustado= 0.560 (0.356 – 0.881). Conclusiones: Los resultados sugieren que existe una asociación como factor protector entre el bajo peso y el sobrepeso u obesidad en la primera infancia. Sin embargo, debido al comportamiento de las variables consideradas en la muestra no hay suficiente información para rechazar completamente la hipótesis nula.

Desempeño de las RISS en relación al acceso, coordinación y calidad de la atención en cáncer de mama y diabetes mellitus tipo 2 en Colombia

El objetivo de este capítulo es mostrar los resultados de investigación del desempeño de las redes de servicios de salud frente a diferentes dimensiones relacionadas al acceso, coordinación y calidad de la atención en dos enfermedades crónicas como es el cáncer de mama y la diabetes en Colombia, importantes patologías por su incidencia e impacto así como por la necesidad de la mecanismos efectivos de coordinación para la adecuada atención de los usuarios del sistema de salud. Por tanto, se realiza el análisis del desempeño de dos redes de servicios de salud en la atención de usuarias con diagnostico confirmado de cáncer de mama, vinculadas unas a redes pertenecientes al régimen contributivo y otras al régimen subsidiado. Redes que también fueron consideradas para el análisis del desempeño en la atención de usuarios con diagnostico confirmado de diabetes, en el que de manera adicional participó otra red perteneciente al régimen subsidiado con área de operación en el municipio de Soacha, puesto que las dos anteriores tiene influencia en la ciudad de Bogotá. La fuente primaria de los datos fue la historia clínica y éstos fueron extraídos de acuerdo a ciertos indicadores seleccionados por el equipo investigador a través de un previo proceso de validación y a partir de su importancia para evidenciar el desempeño de las redes de servicios de salud en las dimensiones enunciadas anteriormente. Se muestran los resultados del estudio, a partir de los cuales se propone una breve discusión y conclusiones.

Gestión de la cadena de suministros desde la dinámica de sistemas. Aproximación al mejoramiento de la toma de decisiones

El objetivo de este trabajo es hacer un estudio sobre la cadena de suministros en organizaciones empresariales desde la Dinámica de Sistemas y como esta puede aportar al desempeño y el control de las cadenas de suministros. Se buscará Abordar el cocimiento sobre tres perspectivas de Supply Chain y su relación con la dinámica de sistemas. También se buscará identificar los tipos de integración en las actividades de la gestión en la cadena de suministros y sus horizontes de planeación. Por último, se pretende analizar las aplicaciones de Supply Chain Management que se han basado en el uso de la metodología de dinámica de sistemas. Para esto, la investigación empezará por definir la problemática alrededor de unir estas dos áreas y definirá el marco teórico que fundan estas dos disciplinas. Luego se abordará la metodología usada por la Dinámica de Sistemas y los diferentes aspectos de la cadena de suministros. Se Ahondará en el acercamiento de las dos disciplinas y como convergen ayudando la SD a la SCM (Supply Chain Management). En este punto también se describirán los trabajos en los diferentes enfoques que se han hecho a partir de uso de la dinámica de sistemas. Por último, presentaremos las correspondientes conclusiones y comentarios acerca de este campo de investigación y su pertinencia en el campo de la Supply Chain. Esta investigación abarca dos grandes corrientes de pensamiento, una sistémica, a través de la metodología de dinámica de sistemas y la otra, lógico analítica la cual es usada en Supply Chain. Se realizó una revisión de la literatura sobre las aplicaciones de dinámica de sistemas (SD) en el área de Supply Chain, sus puntos en común y se documentaron importantes empleos de esta metodología que se han hecho en la gestión de la cadena de suministros.

Autoavaliação de um agrupamento : um percurso de melhoria da qualidade de gestão e do serviço educativo da escola

Com o propósito de acompanhar a mudança da sociedade, em Portugal decorre a implementação de várias reformas entre as quais a da Administração Pública. Melhorar o serviço educativo prestado pelas escolas é condição essencial para o aumento da qualificação dos alunos. A Avaliação e a Auto Avaliação (AA) do desempenho da escola tornam-se cada vez mais importantes no sentido de acompanhar e garantir a evolução e o progresso do sistema educativo. Desta forma, torna-se imprescindível uma reflexão sobre os procedimentos desenvolvidos que visam suprir as necessidades das escolas. Este projeto de investigação, no âmbito do Mestrado em Ciências da Educação, especialização em Administração Escolar, tem como finalidade dar o seu contributo para esse debate, através da apresentação e discussão dos resultados de dois ciclos avaliativos, tendo sido aplicado, o modelo CAF (Common Assessment Framework). Neste sentido, pretendeu-se averiguar de que forma a AA (Auto Avaliação) contribui para o processo global de gestão da escola. Fazendo recurso à metodologia de estudo de caso, num Agrupamento de Escolas no interior do país, utilizou-se o paradigma qualitativo para a recolha de dados. Pela análise dos dados foi possível concluir que a aplicação do primeiro ciclo de avaliação, através do desenvolvimento de processos de melhoria da qualidade de serviço prestado, influenciou o segundo ciclo avaliativo. Esta influência foi evidente na melhoria dos planos de ação para colmatar pontos negativos detetados no ciclo avaliativo anterior contribuindo, consequentemente, para a melhoria do processo de gestão da escola. Desta forma, a experiência adquirida, as alterações introduzidas, a convição dos órgãos de gestão da escola e de quase todas as pessoas que nela exercem a sua atividade permitem concluir que é imprescindível a autorregulação e que a mesma proporcionou benefícios que levaram à melhoria da qualidade de gestão da escola.

Museums and quality, from the concept of the museum that carries out functions to the museum that provides services

Quality management Self-evaluation of the organisation Citizens/customers satisfaction Impact on society evaluation Key performance evaluation Good practices comparison (Benchmarking) Continuous improvement In professional environments, when quality assessment of museums is discussed, one immediately thinks of the honourableness of the directors and curators, the erudition and specialisation of knowledge, the diversity of the gathered material and study of the collections, the collections conservation methods and environmental control, the regularity and notoriety of the exhibitions and artists, the building’s architecture and site, the recreation of environments, the museographic equipment design. We admit that the roles and attributes listed above can contribute to the definition of a specificity of museological good practice within a hierarchised functional perspective (the museum functions) and for the classification of museums according to a scale, validated between peers, based on “installed” appreciation criteria, enforced from above downwards, according to the “prestige” of the products and of those who conceive them, but that say nothing about the effective satisfaction of the citizen/customers and the real impact on society. There is a lack of evaluation instruments that would give us a return of all that the museum is and represents in contemporary society, focused on being and on the relation with the other, in detriment of the ostentatious possession and of the doing in order to meet one’s duties. But it is only possible to evaluate something by measurement and comparison, on the basis of well defined criteria, from a common grid, implicating all of the actors in the self-evaluation, in the definition of the aims to fulfil and in the obtaining of results.

Birding 2.0: Citizen Science and Effective Monitoring in the Web 2.0 World

The amateur birding community has a long and proud tradition of contributing to bird surveys and bird atlases. Coordinated activities such as Breeding Bird Atlases and the Christmas Bird Count are examples of "citizen science" projects. With the advent of technology, Web 2.0 sites such as eBird have been developed to facilitate online sharing of data and thus increase the potential for real-time monitoring. However, as recently articulated in an editorial in this journal and elsewhere, monitoring is best served when based on a priori hypotheses. Harnessing citizen scientists to collect data following a hypothetico-deductive approach carries challenges. Moreover, the use of citizen science in scientific and monitoring studies has raised issues of data accuracy and quality. These issues are compounded when data collection moves into the Web 2.0 world. An examination of the literature from social geography on the concept of "citizen sensors" and volunteered geographic information (VGI) yields thoughtful reflections on the challenges of data quality/data accuracy when applying information from citizen sensors to research and management questions. VGI has been harnessed in a number of contexts, including for environmental and ecological monitoring activities. Here, I argue that conceptualizing a monitoring project as an experiment following the scientific method can further contribute to the use of VGI. I show how principles of experimental design can be applied to monitoring projects to better control for data quality of VGI. This includes suggestions for how citizen sensors can be harnessed to address issues of experimental controls and how to design monitoring projects to increase randomization and replication of sampled data, hence increasing scientific reliability and statistical power.

Sensitivity analysis of a catchment-scale nitrogen model

There are now considerable expectations that semi-distributed models are useful tools for supporting catchment water quality management. However, insufficient attention has been given to evaluating the uncertainties inherent to this type of model, especially those associated with the spatial disaggregation of the catchment. The Integrated Nitrogen in Catchments model (INCA) is subjected to an extensive regionalised sensitivity analysis in application to the River Kennet, part of the groundwater-dominated upper Thames catchment, UK The main results are: (1) model output was generally insensitive to land-phase parameters, very sensitive to groundwater parameters, including initial conditions, and significantly sensitive to in-river parameters; (2) INCA was able to produce good fits simultaneously to the available flow, nitrate and ammonium in-river data sets; (3) representing parameters as heterogeneous over the catchment (206 calibrated parameters) rather than homogeneous (24 calibrated parameters) produced a significant improvement in fit to nitrate but no significant improvement to flow and caused a deterioration in ammonium performance; (4) the analysis indicated that calibrating the flow-related parameters first, then calibrating the remaining parameters (as opposed to calibrating all parameters together) was not a sensible strategy in this case; (5) even the parameters to which the model output was most sensitive suffered from high uncertainty due to spatial inconsistencies in the estimated optimum values, parameter equifinality and the sampling error associated with the calibration method; (6) soil and groundwater nutrient and flow data are needed to reduce. uncertainty in initial conditions, residence times and nitrogen transformation parameters, and long-term historic data are needed so that key responses to changes in land-use management can be assimilated. The results indicate the general, difficulty of reconciling the questions which catchment nutrient models are expected to answer with typically limited data sets and limited knowledge about suitable model structures. The results demonstrate the importance of analysing semi-distributed model uncertainties prior to model application, and illustrate the value and limitations of using Monte Carlo-based methods for doing so. (c) 2005 Elsevier B.V. All rights reserved.

Development-led archaeology in north-west Europe

Many countries in northern Europe have seen a huge expansion in development-led archaeology over the past few decades. Legislation, frameworks for heritage management and codes of practice have developed along similar but different lines. The Valetta Convention has had considerable impact on spatial planning and new legislation on archaeological heritage management within EC countries as well as on the funding, nature and distribution of archaeological fieldwork. For the first time these 12 papers bring together data on developer-led archaeology in Britain, Ireland, France, the Low Countries, Germany and Denmark in order to review and evaluate key common issues relating to organisation, practice, legal frameworks and quality management.

New advances in aircraft MRO services: data mining enhancement

Aircraft Maintenance, Repair and Overhaul (MRO) agencies rely largely on row-data based quotation systems to select the best suppliers for the customers (airlines). The data quantity and quality becomes a key issue to determining the success of an MRO job, since we need to ensure we achieve cost and quality benchmarks. This paper introduces a data mining approach to create an MRO quotation system that enhances the data quantity and data quality, and enables significantly more precise MRO job quotations. Regular Expression was utilized to analyse descriptive textual feedback (i.e. engineer’s reports) in order to extract more referable highly normalised data for job quotation. A text mining based key influencer analysis function enables the user to proactively select sub-parts, defects and possible solutions to make queries more accurate. Implementation results show that system data would improve cost quotation in 40% of MRO jobs, would reduce service cost without causing a drop in service quality.

Adapted customer relationship management implementation framework:facilitating value creation in nursing homes

This paper proposes a framework to support Customer Relationship Management (CRM) implementation in nursing homes. The work extends research by Cheng et al. (2005) who conducted in-depth questionnaires to identify critical features (termed value-characteristics), which are areas identified as adding the most value if implemented. Although Cheng et al. did proposed an implementation framework, summary of, and inconsistent inclusion of value-characteristics, limits the practical use of this contribution during implementation. In this paper we adapt the original framework to correct perceived deficiencies. We link the value characteristics to operational, analytical, strategic and/or collaborative CRM solution types, to allow consideration in context of practical implementation solutions. The outcome of this paper shows that, practically, a 'one solution meets all characteristic' approach to CRM implementation within nursing homes is inappropriate. Our framework, however, supports implementers in identifying how value can be gained when implementing a specific CRM solution within nursing homes; which subsequently support project management and expectation management.

Capturing and sharing our collective expertise on climate data: the CHARMe project

For users of climate services, the ability to quickly determine the datasets that best fit one's needs would be invaluable. The volume, variety and complexity of climate data makes this judgment difficult. The ambition of CHARMe ("Characterization of metadata to enable high-quality climate services") is to give a wider interdisciplinary community access to a range of supporting information, such as journal articles, technical reports or feedback on previous applications of the data. The capture and discovery of this "commentary" information, often created by data users rather than data providers, and currently not linked to the data themselves, has not been significantly addressed previously. CHARMe applies the principles of Linked Data and open web standards to associate, record, search and publish user-derived annotations in a way that can be read both by users and automated systems. Tools have been developed within the CHARMe project that enable annotation capability for data delivery systems already in wide use for discovering climate data. In addition, the project has developed advanced tools for exploring data and commentary in innovative ways, including an interactive data explorer and comparator ("CHARMe Maps") and a tool for correlating climate time series with external "significant events" (e.g. instrument failures or large volcanic eruptions) that affect the data quality. Although the project focuses on climate science, the concepts are general and could be applied to other fields. All CHARMe system software is open-source, released under a liberal licence, permitting future projects to re-use the source code as they wish.

Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Background Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers (“biomarkers”) of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. Methods CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10–20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2–10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. Discussion From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research.

Stochastic Assessment Of Environmental Flows In Semiarid Environments

The regimen of environmental flows (EF) must be included as terms of environmental demand in the management of water resources. Even though there are numerous methods for the computation of EF, the criteria applied at different steps in the calculation process are quite subjective whereas the results are fixed values that must be meet by water planners. This study presents a friendly-user tool for the assessment of the probability of compliance of a certain EF scenario with the natural regimen in a semiarid area in southern Spain. 250 replications of a 25-yr period of different hydrological variables (rainfall, minimum and maximum flows, ...) were obtained at the study site from the combination of Monte Carlo technique and local hydrological relationships. Several assumptions are made such as the independence of annual rainfall from year to year and the variability of occurrence of the meteorological agents, mainly precipitation as the main source of uncertainty. Inputs to the tool are easily selected from a first menu and comprise measured rainfall data, EF values and the hydrological relationships for at least a 20-yr period. The outputs are the probabilities of compliance of the different components of the EF for the study period. From this, local optimization can be applied to establish EF components with a certain level of compliance in the study period. Different options for graphic output and analysis of results are included in terms of graphs and tables in several formats. This methodology turned out to be a useful tool for the implementation of an uncertainty analysis within the scope of environmental flows in water management and allowed the simulation of the impacts of several water resource development scenarios in the study site.