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Mobile applications and Information and Communication Technologies (ICT) are widely used tools in various sectors such as business, health, and education, in the latter, mobile applications have an important role for teaching-learning methods. In Ecuador in 2021, there were low levels of acquired knowledge in the logical-mathematical approach in students from 3 to 10 years old, so it is required to innovate in effective teaching-learning methods for students at preschool level. The objective of the study was to evaluate preschool students through a mobile application designed based on gamification techniques for the improvement of logical-mathematical skills. For this study, the learning objectives standardized by the Ministry of Education of Ecuador (MINEDUC) were evaluated. In the results obtained, it was determined that a group of students is in a beginning stage to acquire skills to achieve knowledge and another in the process of acquiring knowledge. It is concluded that gamification is an alternative for the improvement of teaching-learning methods and an optimal mechanism for its application are mobile devices and ICT., Las aplicaciones móviles y las Tecnologías de la Información y Comunicación (TIC) son herramientas ampliamente utilizadas en diversos sectores como el empresarial, salud y educación, en este último, las aplicaciones móviles poseen un rol importante para los métodos de enseñanza-aprendizaje. En el Ecuador en 2021, se registró bajo niveles de conocimientos adquiridos en el enfoque lógico-matemático en estudiantes de 3 a 10 años, por lo que, se requiere innovar en métodos de enseñanza-aprendizaje eficaces para estudiantes a nivel preescolar. El objetivo del estudio fue evaluar a estudiantes de nivel preescolar mediante una aplicación móvil diseñada en base a técnicas de gamificación para el mejoramiento de destrezas lógico-matemáticas. Para este estudio, se evaluó los objetivos de aprendizaje estandarizados por el Ministerio de Educación del Ecuador (MINEDUC). En los resultados obtenidos, se determinó que un grupo de estudiantes se encuentra en una etapa de inicio para adquirir destrezas para lograr el conocimiento y otro en proceso de adquirir conocimientos. Se concluye que la gamificación es una alternativa para el mejoramiento de métodos de enseñanza-aprendizaje y un mecanismo óptimo para la aplicación de esta son los dispositivos móviles y las TIC.

Documento entregable del proyecto "SOSTENIBILIDAD EN EL USO DE LOS RECURSOS NATURALES Y CONSERVACIÓN DE LA BIODIVERSIDAD DE LA REGIÓN OCCIDENTAL DE PANAMÁ", CENPEN 012-18. PLAN ESTRATÉGICO DE MANEJO SOSTENIBLE DE LOS RECURSOS NATURALES DE LA PROVINCIA DE CHIRIQUÍ 2023-2027.&nbsp

BACKGROUND During the last 30 years, quality of care has been a major goal that public health aim to accomplish. In essence, policy-makers strive to improve their health systems by incorporating interventions where users get the care they need, and that the care they get is effective.(1) The challenge to define quality of care has hampered the development of specific policies or interventions and the research work conducted around frameworks to define it represent the most important contributions in the quality field. In 1980, Donabedian, one of the main contributors in the field defined care of high quality as “that kind of care which is expected to maximize an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts”(2) Acknowledging the differential nuances between the different definitions; all of them seem to contain two components that are important to people: the first component is providing care of high technical quality understanding technical care as the application of clinical medicine to a personal health problem where care should be appropriate and necessary. The second component is that all patients wish to be treated in a humane and culturally appropriate manner and be involved in their health decision-making.(3) Campbell et al. created a framework(1) to define quality of care where they identify three dimensions: the structure of health care, actual care given (process) and the consequences of the interaction between individuals and a health care system (outcome). For the purpose of this review we will be focusing in the process dimension. Process is the actual delivery and receipt of care. Processes of care involve interactions between users and the health care structure, i.e. what is done to or with users, hence the clinical encounter and what happens in these visits, plays an important role. Clinical visit is a pivotal part of healthcare, as is it this space that patients and clinicians collaborate to understand the clinical situation of the patient and the best step moving forwards. Clinical evidence suggest that the duration of clinical visits have remained stable during the last few decades, despite significant changes in the way healthcare is delivered (e.g. availability of electronic medical records). Although, both patients and clinicians, identify time for consultation as a barrier to high quality care, the extent to which the duration of clinical visits affects quality of care is unknown. Wilson and Childs work is focused on effectiveness of interventions aimed at changing the length of primary care physicians' consultations.(4–6) The Cochrane systematic review they published in 2016 included outcomes related with effectiveness and efficiency and concluded that they were unable to determine whether altering the length of consultation leads to changes in provider's performance nor the effect it has on referrals, examinations and prescriptions. The findings were based on very low‐certainty evidence. The review lacks of the inclusion of outcomes more related to other aspects of quality of care regarding the interaction in the encounter; such as patient-centeredness, equity, safety, legitimacy…, and limits this dimension to the outcome patient’s satisfaction- which they were also uncertain whether altering the length of consultation increases patient satisfaction. Other authors that also aim to evaluate time as a predictor of quality of care focused too on patient satisfaction.(7,8) There is a need for a contemporary assessment of clinical visit time as a predictor of quality care, and encompassing a broader definition of quality of care) that englobes a further understanding if the care given was needed and appropriate. The results of this systematic review will be of interest for patients, clinicians, policy makers and other stakeholders, as a better understanding of the relationship between clinical visit duration and quality of care can inform practice design that is supportive of care, by providing the time for patients and clinicians to work together. METHODS We will conduct a systematic review and will adhere to the applicable items of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. We registered this protocol in the open science framework registry:osf.io/svcwq. Any amendment to the protocol and the supporting rationale will be reported. Eligibility criteria We will include studies reporting on the duration of the outpatient visit of adult patients and its association to quality of care: 1. Population of interest: Adults visiting an outpatient clinic (in person or telemedicine). We wil exclude: encounters in the hospital, emergency department or urgent care center; children/pediatrics; and, simulated patients or visits. The kind of clinician is not an eligibility criterion: outpatient visits with a practice nurse or doctor, a pharmacist, or a therapist of any sort are eligible. 2. Independent variable: Measure of duration of the consultation. Encounter length must be used as an explanation or predictor of the quality care (meaning that the study is able to make inferences about the relationship between length of the consultation and quality of care (e.g., do shorter/ longer encounters impact on the quality of health care?). We would exclude articles in which encounter duration is an outcome of a practice change or intervention. Likewise, we would exclude articles in which the time measured is or includes time spent waiting for an appointment, traveling to an appointment, or waiting in an appointment. 3. Dependent variable: Measures of quality of care (examples of signaling questions): • Satisfaction: “did the care you received meet or exceed your expectations?”; but not just satisfaction with the duration of the visit or preference for longer/shorter visits. • Efficiency or value (impact on care per unit of time or money) • Effectiveness or efficacy (impact on health outcomes) • Patient-centeredness: “would a short visit impact on communication, preferences reported, involvement” • Safety: “would a short visit impact on how safe a treatment/intervention is” • Equity: “would a short visit differentially affect access, care, or outcomes by race, ethnicity, gender, or other marker of socioeconomic status” • Timeliness Information sources and search strategy We will design and execute a comprehensive search in multiple databases. We will search each database from their inception to June 23rd, 2021. The databases included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. The search strategy was designed and conducted by an experienced librarian (add initials), with input from the study's principal investigator (add initials). Controlled vocabulary supplemented with keywords will be used to search for studies of time factors in the clinical encounter and their effect on quality of care. The actual strategy listing all search terms used and how they are combined is available in the appendix. The leading search concepts will be:  Outpatient visits (consultation)  Time (duration, length, minutes); Quality of care (equity, patient-centeredness, effectiveness, efficiency, timeliness, safety, value, satisfaction). Selection of studies We will include quantitative primary studies (both experimental and observational studies) and primary qualitative studies, as well as those following a mixed-method or multiple methodology. Protocols, systematic reviews, editorials, commentaries, position papers, guideline documents, or narrative reviews will be excluded. We would review reference lists of included studies. We will manage references with Rayyan. Pairs of authors will conduct the screening of title and abstract references and selection of studies. Full-text appraisal would be also conducted in pairs and reasons for exclusion will be collected. Disagreements will be solved by discussion or, in the case discussion will not lead to consensus, with the help of a third author. Agreement will be measured using the kappa or phi statistics, as appropriate (the latter is appropriate when the distribution of agreement is extreme). Data extraction We will extract data using Google forms which uses an Excel format. We will design and pilot-test one form for each type of study (quantitative, qualitative or mixed methods). After initial calibration of 10% of the included studies between pairs of authors, one author will extract data from the included studies, and a second author will check the data against the full text for accuracy. We will solve disagreements by consensus or, if needed, with the help of a third author. We will collect the following information: • study characteristics (author, publication title, country and year of publication) • Justification for studying the association • Population/ Setting:  Type of patients: new or established; one or multiple diseases and type.  Type of clinicians: clinician gender; individual or group; specialist vs. generalist; trainee vs. faculty; type of practices; health care background  Setting: Primary or specialty care; healthcare was funded privately or publicly and took place in private/publicly funded institutions • Outcomes  Length of time spent in the visit: measures of time, patient reported measure, descriptive theme.  Measures and degree of quality (equity, patient-centeredness, effectiveness, efficiency, timeliness, safety, satisfaction, preferences, values) and instrument to collect the outcome; or descriptive theme. Data synthesis and reporting Quantitative evidence: To analyse and synthesize quantitative findings we will use narrative synthesis and will conduct metanalysis if applicable. We will perform descriptive statistics to characterize the length of consultation and quality of care measures (mean, SD for variables with a normal distribution and the median, interquartile range, for other distributions). For reporting, we will present results in summarized tables (grouping by relevant categories of outcomes). Comparative statistical tests will be used to look for differences in e.g. mean values, 95% confidence intervals and I2 statistic for heterogeneity (if pooled), or the range of mean values or other measures (if not pooled) across studies, the number of studies and the number of respondents for each outcome. We will perform statistical analyses using SPSS (IBM SPSS Statistics for Mac, Version 29.0. Armonk, NY: IBM Corp). Qualitative evidence. We will analyze and synthesize qualitative data using a thematic synthesis approach using NVivo 12. We will not specify any a priori theme and will generate free codes inductively. Quality assessment Two authors will independently assess the risk of bias of ultimately included studies to identify areas of strength and weakness of the existing evidence. Disagreements will be resolved through discussion. For quantitative studies: For randomized clinical trials we will be using RoB 2 tool (9)which provides a framework for considering the risk of bias in the findings of any type of randomized trial. The tool is structured into five domains which are: (1) bias arising from the randomization process; (2) bias due to deviations from intended interventions; (3) bias due to missing outcome data; (4) bias in measurement of the outcome; (5) bias in selection of the reported result. We will use ROBINS-I tool(10) for assessing risk of bias in non-randomized studies of interventions. This tool includes seven domains: The first two domains, covering confounding and selection of participants into the study, address issues before the start of the interventions that are to be compared (“baseline”). The third domain addresses classification of the interventions themselves. The other four domains address issues after the start of interventions: biases due to deviations from intended interventions, missing data, measurement of outcomes, and selection of the reported result. For qualitative research studies, we used the CASP Qualitative Checklist tool(11) to appraise the methodological quality of individual studies and will assess the certainty of the evidence according to GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) domains (methodological limitations, relevance, coherence, and adequacy). (12) For assessment of the full body of evidence, i.e., for each intervention and outcome, we will utilize the Grading of Recommendations Assessment (GRADE) approach. GRADE is a step-wise method to assess the certainty of evidence in the synthesis of scientific literature, such as reviews and guidelines, and is commonly used for the appraisal of effects found of health interventions in health care and the public health domain. The method is used to rate evidence per outcome and starts with a high rating for RCTs and low rating for all other study designs. Eight criteria, such as risk of bias or large magnitude of effect, are then used to either upgrade or downgrade the final rating to high, moderate, low, or very low quality of evidence. This way, the method can indicate how certain we can be of an effect and whether reliable recommendations for practice in health care can be made based on the evidence that is available.

Informe técnico del Bootcamp en Data Science y Data Mining.&nbsp

Informe técnico de proyecto "Sostenibilidad en el uso de los recursos naturales y conservación de la Biodiversidad de la Región Occidental de Panamá". Cenpen -18-012. Segunda Etapa

MEMORIA DEL SIMPOSIO BIODIVERSIDAD, SOSTENIBILIDAD, DESARROLLO ECONÓMICO Y SOCIAL DE LA REGIÓN OCCIDENTAL DE PANAMÁ.&nbsp

Informe semestral CIRN UNACHI Enero-Julio 2021&nbsp

Human African trypanosomiasis (HAT), or sleeping sickness disease, is an infection caused mainly by Trypanosoma brucei gambiense-human African trypanosomiasis (g-HAT) and is transmitted by tsetse flies. The disease goes through two stages: hemolymphatic and meningo-encephalic phases. The treatment for the second stage has changed from melarsoprol or eflornithine to nifurtimox-eflornithine combination therapy (NECT) and fexinidazole. We aimed to systematically review the literature on the efficacy and toxicity of fexinidazole and NECT. We used PubMed advanced strategy and Google Scholar databases, including clinical trials and observational studies on humans in the last 20 years in the English literature. Applying the inclusion/exclusion criteria, we reviewed eight studies. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) protocol. For assessing bias, we used the Cochrane Collaboration’s tool for risk assessment of the clinical trials and the Robins-I tool for the observational studies. Overall, the clinical trials showed that NECT was non-inferior to eflornithine. The proportion of patients discharged alive is higher in patients treated with NECT vs. patients treated with eflornithine. Gastrointestinal complaints are a common side effect of NECT therapy, while fearful but relatively rare convulsions can also occur. The main limitation among the studies of NECT was the lack of blinding because most of them were open-label. Fexinidazole, the new oral medication showed is effective and safe for the treatment of g-HAT infection. Because of their convenience, fexinidazole is preferred over NECT therapy, oral vs. IV infusion in the first and second stages of the disease. Compared to older therapies, fexinidazole and NECT are more effective and safer than eflornithine and melarsoprol monotherapy.

Virus mortales: ¿consecuencia de la alteración de la biodiversidad? Artículo de discusión de la relación entre la pérdida de biodiversidad y la aparición de virus letales para la humanidad.&nbsp

Los mercados financieros en los últimos años han sido duramente golpeados por una recesión mundial que no se veía desde el 2008. Claro, aunque no se está en un colapso, varios indicadores permiten ver el desaceleramiento global al que se debe prestar mucha atención. Con las potencias como China y EE. UU. en un estancamiento económico, la caída de precios de los commodities, que afectan la inversión y el desarrollo, los problemas de la zona euro, que cada vez vuelven inminente su ruptura, y el problema ecológico que sufre el mundo, nos hacen analizar y proponer nuevas estrategias financieras que permitan sostener la economía de la empresa en tiempos difíciles. En una vista más aislada, el Perú no ha sido indiferente a estos problemas, y más aún, cuando somos una economía dependiente del mundo, nuestra principal fuente de ingresos es la explotación responsable y formal de los recursos naturales. Este país tiene la ventaja de ser el primer o el segundo productor mundial de los principales metales necesarios para fabricar productos industriales y de consumo, lo que nos permite generar ingresos para invertir transmitiendo nuevas tecnologías, infraestructuras, insumos, inversiones y bienes de capital. La minería para el Perú representaba el 10% de su PBI en 2014. De esta manera, el PBI minero habría caído en 2.11%, pero la sorpresa se dio en diciembre 2015, donde el sector Minería e Hidrocarburos se expandió en 22.36%, impulsado por el dinamismo de la actividad minera metálica, que representa el 84% del peso del sector. Considerando esto, y siendo un país minero, el efecto mundial se ve reflejado en nuestra plaza local, por lo que, en el 2015, la bolsa limeña anotó su peor desempeño en siete años con un desplome del índice general en un 33.4% por el bajo valor de los metales; lo cual significó la mayor caída desde el 2008. No solo el problema en los mercados afecta la industria, sino también se convive con el problema de la minería informal que controla entre el 15% y 18% de la producción de oro en el Perú, lo que explica los movimientos migratorios al interior del país con relación al ciclo del precio del oro y otros factores que afectan el ciclo del negocio, como nuevas infraestructuras, problemas sociales, responsabilidad ecológica y decisiones políticas que exigen nuevas estrategias empresariales. Esto nos permite tener una idea de cuán difícil es mantener sólida un empresa del rubro minero. Por ello, decidimos elaborar un plan financiero para la Compañía de Minas Buenaventura, que se encuentra comprometida con la explotación, tratamiento y exploración de oro, plata y demás metales en minas que poseen el 100%, así como en aquellas en las que participa en sociedad con otras empresas minera. Este plan financiero realiza un análisis económico y un análisis estratégico, mediante herramientas y metodologías de investigación, para lograr evaluar correctamente la empresa, su sector y su entorno. De esta manera, se proponen estrategias financieras que le permitan al accionista maximizar su rentabilidad con una adecuada gestión de riesgos, potenciar la solidez económica de la empresa frente a los acreedores y confrontar futuros retos que pueden afectar el desarrollo de un país Financial markets in recent years have been hit hard by a global recession not seen again since 2008. Although we are not in a collapse, several indicators make us see the global slowdown that we must pay close attention, with powers like China and USA in economic stagnation, falling commodity prices, affecting investment and development, the problems of the Euro zone which increasingly imminent return to rupture, and the ecological problem afflicting the world, makes us analyze and propose new financial strategies to sustain the economy of the company in difficult times. In a more isolated view, Peru has not been indifferent to these problems, and even more, when we are an economy dependent to the world and our main source of income is responsible and formal exploitation of the natural resources, where we are blessed. Peru has the advantage of being the first or second largest producer of major metals needed to manufacture industrial and consumer products, this allows us to generate income to invest in bringing new technology, infrastructure, inputs and capital goods investment. Peru Mining accounts for 10% of GDP, in 2014 the mining GDP would have fallen 2.11%, but the surprise came in December 2015 when the mining and hydrocarbons sector expanded by 22.36%, driven by the dynamism of the metallic mining which is 84% of the weight of the sector. Considering this, and being a mining country, the global effect is reflected in our local market; in 2015 the Lima Stock Exchange posted its worst performance in seven years with a collapse of the overall index by 33.4% for the low value metals, being the biggest drop since 2008. Not only the problem in the markets affect the industry, but also with informal mining which controls between 15% and 18% of gold production in Peru, explaining migration within the country in relation to the gold price cycle and other factors affecting the business cycle, such as, new infrastructure, social, ecological responsibility and political decisions that require new business strategies. This allows us to get an idea of how difficult is to maintain a solid firm in the mining sector, that`s why we decided to develop a financial plan for Minera Buenaventura´s Company which is committed with the exploitation, processing, and exploration of gold, silver and other metal mines which owns 100%, as well as, in which participates in partnership with other mining companies. This financial plan carry out an economic analysis and strategic analysis, using tools and research methodologies in order to properly evaluate the company, its sector and its environment. In this way, we propose financial strategies that will allow the shareholder maximize profitability with adequate risk management, enhance the economic strength of the company from creditors, and confront future challenges that may affect the development of a country Tesis

Chimamanda Ngozi Adichie, the author of Americanah, portrays the hardships African immigrants have to undergo in adaptation and acculturation processes. She suggests that many people do not perceive themselves as blacks until they move into a cultural environment in which their "race" conditions their lives. In this paper I aim to disclose the different factors contributing to the development of the protagonist's self- image in her struggle for an identity as a woman and as a black person. These affecting factors are "race" and gender, two categories that, I claim, cannot be looked at separately Chimamanda Ngozi Adichie, l'autora d' Americanah ens mostra les dificultats que els immigrants Africans han de patir en processos d'adaptació a una cultura nova. L'autora suggereix que les persones no es perceben a sí mateixes com a 'negres' fins que marxen a viure a un entorn cultural diferent en el qual la seva 'raça' condiciona les seves vides. El meu objectiu es revelar quins són els factors que contribueixen en el desenvolupament de la pròpia imatge de la protagonista en la seva lluita d'identitat com a dona y com a persona negra. Aquests factors son 'raça' i gènere, dues categories que, sota el meu punt de vista, no es poden mirar per separat