Sistema de gestión TO-BE: garantizar el derecho a la salud de pacientes con ITS en Perú / TO-BE management system: guaranteeing the right to health of patients with STIs in Peru

Se realizó una investigación de campo para conocer la gestión de los procesos de solicitud y admisión de citas médicas, considerando la estigmatización y discriminación de las personas ITS, con el fin de garantizar el derecho a la salud de estos pacientes en Perú. Se ejecutó la sistematización de la información sobre los procesos y mecanismos de exigibilidad, bajo los lineamientos y manuales de los cuatro procesos estratégicos del MINSA contemplados para el otorgamiento de citas médicas, siguiendo los lineamientos de Gob.Pe, Adicionalmente, mediante verificación de los procesos se construyeron la matriz entidad-relación de la gestión por procesos del SSP, y el flujograma del proceso de solicitud y otorgamiento de citas AS-ISS. Se consideraron aspectos tecnológicos-médicos-legales con la participación de 201 pacientes independientemente del motivo o patología a consultar, identificando incidentes en la eficiencia del proceso misional. Por último, se implementó el flujograma de procesos de reserva de citas médicas a través de la aplicación ejecutable para smartphones, tabletas y otros dispositivos móviles (APP) TO-BE la cual conlleva a 10 pasos desde el registro de usuario hasta la emisión de comprobante de otorgamiento de cita médica. Se analizaron las preferencias de los usuarios sobre las causas superables en el proceso misional, mediante una encuesta estructura a 170 usuarios de SSP(AU)

A field investigation was carried out to learn about the management of the processes of request and admission of medical appointments, considering the stigmatization and discrimination of STI people, in order to guarantee the right to health of these patients in Peru. The systematization of the information on the processes and mechanisms of enforceability was carried out, under the guidelines and manuals of the four strategic processes of the MINSA contemplated for the granting of medical appointments, following the guidelines of Gov. Pe, Additionally, through verification of the processes The entity-relationship matrix of the management by processes of the SSP, and the flowchart of the process of request and granting of appointments AS-ISS were constructed. Technological-medical-legal aspects were considered with the participation of 201 patients regardless of the reason or pathology to be consulted, identifying incidents in the efficiency of the missionary process. Finally, the flowchart of medical appointment reservation processes was implemented through the executable application for smartphones, tablets and other mobile devices (APP) TO-BE, which entails 10 steps from user registration to issuance of voucher of granting a medical appointment. Users' preferences regarding causes that can be overcome in the missionary process were analyzed through a structured survey of 170 SSP users(AU)

Asistencia sanitaria y servicios sociales: enseñanza y aprendizaje significativo en talleres técnicos por el método de proyecto / Healthcare and social services: meaningful teaching and learning in technical workshops by the project method

Los derechos humanos, incluyendo la concreción del derecho a la salud, en Perú, contempla el mandato dirigido a los poderes públicos para que organicen la asistencia sanitaria, como elemento causal, específico y adopten el conjunto de medidas necesarias para lograr la prevención de las enfermedades o la mejora de las condiciones sanitarias generales, mediante el método de proyecto en el proceso enseñanza-aprendizaje se abordan los principios rectores de la política social y económica, contenidos del Estado social, y los mecanismos de justiciabilidad y exigibilidad. Se estudió el proceso enseñanza y aprendizaje significativo sobre asistencia sanitaria y servicios sociales en los talleres técnicos, en la Facultad de Derecho y Ciencias Políticas, de la Universidad Peruana Los Andes, durante el periodo lectivo 2019-II. En el egresado conlleva la interacción entre los conocimientos y la información nueva que recibe, en este proceso se construye un nuevo conocimiento o profundiza en los ya existentes. Este conocimiento es organizado y sistemático con conexiones interdisciplinarias entre ideas, se promueve desde el trabajo en equipo y colaborativo, capaz de vencer ambigüedades, complejidades y a lo impredecible; y aprovecha los recursos o herramientas de la vida real, por lo que el método de proyecto es una herramienta pedagógica aplicable a la formación del abogado(AU)

Human rights, including the realization of the right to health, in Peru, contemplates the mandate directed to the public powers to organize health care, as a causal, specific element and adopt the set of measures necessary to achieve the prevention of diseases or the improvement of general sanitary conditions, through the project method in the teaching-learning process, the guiding principles of social and economic policy, contents of the social State, and the mechanisms of justiciability and enforceability are addressed. The teaching and meaningful learning process on health care and social services was studied in technical workshops at the Faculty of Law and Political Sciences, Universidad Peruana Los Andes, during the 2019-II school period. In the graduate, it involves the interaction between knowledge and the new information received, in this process a new knowledge is built or deepens existing ones. This knowledge is organized and systematic with interdisciplinary connections between ideas, it is promoted from team and collaborative work, capable of overcoming ambiguities, complexities and the unpredictable; and it takes advantage of the resources or tools of the real life, reason why the project method is a pedagogical tool applicable to the training of the lawyer(AU)

Cost-benefit analysis of drinking water fluoridation in 12-year-old children in the Biobío region, Chile / Análisis costo-ceneficio de la fluoración del agua potable en niños de12 años de la región del Biobío, Chile

Fluoridation has been shown to be an effective measure against caries in children. The present study evaluates the cost-benefit of the fluoridated water program for the reduction of dental caries in 12-year-old children in the Biobío Region, the only region in Chile that has not implemented this program. An economic cost-benefit evaluation was carried out, comparing two alternative interventions: non-fluoridated drinking water versus fluoridated drinking water. The prevalence of caries, direct and indirect costs of the treatments, the cost of implementing the programs and the benefits of both interventions were estimated. From this study it is concluded that the savings in oral health costs in 12-year-old children when using fluoridating drinking water in the Biobío region is significantly higher than the cost involved in implementing the water fluoridation program, resulting in total savings for the Chilean state of $129,861,645 (USD$ 152,833) as well as an estimated reduction of 15% in the history of caries in the study population.

Se ha demostrado que la fluoración es una medida efectiva contra disminución de la caries en la población infantil. La presente investigación buscó evaluar cual es el costo-beneficio del programa del agua fluorada para la disminución de caries dental en niños de 12 años de la Región del Biobío, única región de Chile que no adhiere a este programa. Se realizó una evaluación económica de costo-beneficio, comparando dos intervenciones alternativas: agua potable no fluorada versus agua potable fluorada. Para tal fin se estimó la prevalencia de caries, costos directos e indirectos de los tratamientos, el costo de implementación de los programas y el beneficio de ambas intervenciones. De este estudio se concluye que el ahorro en costos de salud bucal en niños de 12 años al fluorar el agua potable en la región del Biobío, es significativamente mayor al costo que implica la implementación del programa de fluoración de aguas, lográndose un ahorro total para el Estado de $129.861.645 (USD $152.833) así como una estimación de reducción del 15% en la historia de caries en la población de estudio.

Leukemia multiclass assessment and classification from Microarray and RNA-seq technologies integration at gene expression level.

In more recent years, a significant increase in the number of available biological experiments has taken place due to the widespread use of massive sequencing data. Furthermore, the continuous developments in the machine learning and in the high performance computing areas, are allowing a faster and more efficient analysis and processing of this type of data. However, biological information about a certain disease is normally widespread due to the use of different sequencing technologies and different manufacturers, in different experiments along the years around the world. Thus, nowadays it is of paramount importance to attain a correct integration of biologically-related data in order to achieve genuine benefits from them. For this purpose, this work presents an integration of multiple Microarray and RNA-seq platforms, which has led to the design of a multiclass study by collecting samples from the main four types of leukemia, quantified at gene expression. Subsequently, in order to find a set of differentially expressed genes with the highest discernment capability among different types of leukemia, an innovative parameter referred to as coverage is presented here. This parameter allows assessing the number of different pathologies that a certain gen is able to discern. It has been evaluated together with other widely known parameters under assessment of an ANOVA statistical test which corroborated its filtering power when the identified genes are subjected to a machine learning process at multiclass level. The optimal tuning of gene extraction evaluated parameters by means of this statistical test led to the selection of 42 highly relevant expressed genes. By the use of minimum-Redundancy Maximum-Relevance (mRMR) feature selection algorithm, these genes were reordered and assessed under the operation of four different classification techniques. Outstanding results were achieved by taking exclusively the first ten genes of the ranking into consideration. Finally, specific literature was consulted on this last subset of genes, revealing the occurrence of practically all of them with biological processes related to leukemia. At sight of these results, this study underlines the relevance of considering a new parameter which facilitates the identification of highly valid expressed genes for simultaneously discerning multiple types of leukemia.