ABSTRACT This research study focuses on the business process reengineering of the dimensioning process of imported stock-keeping units (SKU) in a distribution center for a company that specializes in the sale of home improvement products and construction materials. The study involved a time and motion study of the process using the spaghetti diagram tool, which highlighted the factors that were impacting the process and those that may optimize it. This led to an increase in productivity and a decrease in idle time, allowing for quicker measurement of the SKU universe. The study also led to the configuration of a system using the correct data, which streamlined warehouse operations.

RESUMEN Esta investigación se centra en la implementación de la reingeniería del proceso de medición de los Stock Keeping Unit (SKU) importados por un centro de distribución de una empresa especializada en la venta de productos para la mejora del hogar y materiales de construcción. Para identificar los factores que influyen en el proceso y optimizarlo, se realizó un estudio de tiempos y movimientos del proceso utilizando la herramienta conocida como diagrama de espagueti. Como resultado, se incrementó la productividad y disminuyeron los tiempos muertos, lo que permitió medir en menos tiempo el universo de SKU. El estudio también condujo a la configuración del sistema utilizando datos correctos, lo que facilitó la operación dentro del almacén.

Resumo Actualmente, todos nós estamos enfrentando as circunstâncias imprevistas da doença do coronavírus 2019 (COVID-19) que desenvolveu um espectro de efeitos, que pode ser melhor compreendido em termos de problemas psicológicos, físicos e de imunidade entre as pessoas. Por esse motivo, estamos interessados sobre como a saúde mental fortalece o sistema imunológico em tempos de COVID-19. Quais são os factores de protecção que ajudam a manter e apoiar a boa saúde mental e o bem-estar de qualquer pessoa que enfrente situações extremas de pandemia? A pandemia teve impactos significativos na saúde mental e no sistema imunitário das pessoas. Qualquer família que enfrentou a pandemia, directa ou indirectamente, sentiu um controle parcial ou até nenhum sobre os seus pensamentos, emoções, acções e enfrentamento face ao COVID-19 e às mortes. Alcançar uma boa saúde mental e um forte sistema imunológico, mantendo a homeostase da mente e do corpo, envolvimento em conexão próxima, apoio social, uso de técnicas anti-estressor, proximidade com o meio ambiente, praticando ioga e meditação, promovendo positividade e seguindo um estilo de vida saudável são necessários para as pessoas. Além disso, há uma ênfase em várias abordagens aos 4 M’s, que incluem saúde mental, imunidade mental, mentalidade e estressores, para descartar todos os emaranhados de saúde mental e minimizar o impacto do COVID-19. Assim, a saúde mental e a imunidade podem ser restauradas controlando os pensamentos, emoções e acções avassaladores do COVID-19 por meio da inculcação de técnicas salvadoras de vidas e dos 4 M’s como parte da vida diária.

Abstract Currently, all of us are experiencing the unforeseen circumstances of the coronavirus disease 2019 (COVID-19) that have developed a spectrum of effects, which can be best understood in terms of psychological, physical, and immunity problems among people. For this reason, we are particularly interested in the role of mental health in strengthening the immune system in times of COVID-19. What protective factors help maintain and support the good mental health and well-being of any person who faces extreme pandemic-like situations? The Pandemic has had significant and variable impacts on people’s mental health and immunity system. Every family who faces the Pandemic directly or indirectly experiences partial or no control over their thinking, emotions, actions, and coping related to COVID-19 and deaths. To achieve good mental health and a strong immunity system, maintaining the homeostasis of mind and body, engagement in close connections, and social support, using low-stressor techniques, nearness to the environment, practicing Yoga and meditation, infusing positivity, and following healthy lifestyles are necessary for people. In addition, there is an emphasis placed on various approaches to the 4 M’s, which include mental health, mental immunity, mindset, and stressor, to jettison all mental health tangles and minimize the impact of the COVID-19 Pandemic. Thus, mental health and immunity can be restored by controlling the overwhelming thoughts, emotions, and actions of COVID-19 through the inculcation of life-savior techniques and the 4 M’s as a part of daily life.

ABSTRACT This project addressed the issue of the pumping system reeingineering and implementation of a SCADA for the supervision and automatic control of the fire fighting system in the Petróleos Paraguayos PETROPAR industrial plant. The main objective of the project was to implement a new modern automation system commanded by a PLC with SCADA system, soft starters for the two electric pumps. The methodological approach used for the research was qualitative-quantitative or mixed, with a descriptive scope and experimental design. PETROPAR officials from the Department of Projects and Works were taken as population, as a sample 10 officials from the sector were selected. The methods used to collect data from PETROPAR's current firefighting system were through technical visits, interviews and surveys to the officials of the Department of Projects and Works, the results of which were analyzed in tables and statistical graphs. For the demonstration and elaboration of this project, the TIA PORTAL V15 software was used, likewise with this project it was not only sought to benefit in the care of operating personnel and material goods within the company, but also to protect physical and material well-being both of close people as well as of other companies located in the perimeter of the same. In the work, it was concluded that the project has feasibility through NPV and TIR calculations, and can be applied by the state entity to improve its fire prevention system.

RESUMEN En este proyecto se abordó el tema de la reingeniería del sistema de bombeo e implementación de un SCADA para la supervisión y el control automático del sistema contra incendio en la planta industrial Petróleos Paraguayos PETROPAR. El objetivo principal del proyecto fue implementar un nuevo sistema moderno de automatización comandado por un PLC con sistema SCADA, arrancadores suaves para las dos electrobombas. El enfoque metodológico utilizado para la investigación fue el cuali-cuantitativo o mixto, de alcance descriptivo y diseño experimental. Se tomó como población a los funcionarios de PETROPAR del Departamento de Proyectos y Obras, como muestra fueron seleccionados 10 funcionarios del sector. Los métodos utilizados para la recolección de datos del actual sistema contra incendio de PETROPAR fueron mediantes visitas técnicas, entrevistas y encuestas a los funcionarios del Departamento de Proyectos y Obras, cuyos resultados fueron analizados en cuadros y gráficos estadísticos. Para la demostración y elaboración de este proyecto se utilizó el software TIA PORTAL V15, así mismo con este proyecto no solo se buscó beneficiar en el cuidado del personal operativo y los bienes materiales dentro de la empresa, sino también precautelar el bienestar físico y material tanto de las personas próximas como de otras empresas ubicadas en el perímetro de la misma. En el trabajo se concluyó que el proyecto posee factibilidad mediante los cálculos VAN y TIR, y puede ser aplicada por la entidad estatal para mejorar su sistema de prevención contra incendio.

Resumen El objetivo del artículo consiste en identificar y construir un sistema de necesidades que favorezcan a la inmersión de individuos en actividades terroristas, así mismo en establecer la mecánica del proceso teniendo en cuenta las influencias destructivas del entorno externo e interno. La metodología del estudio empleada partió de un análisis retrospectivo de las necesidades del individuo mediante la caracterización socio-psicológica de los militantes de las organizaciones terroristas. El enfoque holístico sistémico y complejo permitió justificar el contenido de los subsistemas económicos, políticos, sociales y espirituales del sistema de equilibrio integral de las necesidades. La ima gen sistemática del objeto y el análisis de la reali dad objetiva del terrorismo moderno permitieron revelar las relaciones entre las necesidades identificadas sobre la base de los resultados obtenidos, lo anterior permitió la creación de un sistema piramidal de necesidades del individuo que sirven para identificar a la persona que decide incursionar en la actividad asocial del terrorismo. Los principales resultados del estudio arrojaron subsistemas estructurados del sistema general de necesidades, el contenido de las necesidades, los componentes que contribuyen a la radicalización del individuo en actividades terroristas, la construcción de un modelo matemático que describe el funcionamiento del sistema de necesidades del individuo, y la identificación de los valores cuantitativos de las necesidades que llevan al individuo a una organización terrorista.

Abstract The purpose of the present article is to identify and build a system of individual needs that promote an individual’s taking the path of terrorist activity, and to consider the process of its functioning under the destructive influences of the external and internal environment. The research methodology is based on a retrospective analysis of individual needs and socio-psychological characteristics of terrorist organizations' fighters. The system-integrated holistic approach allowed substantiating the content of the economic, political, social, and spiritual subsystems of the integral balanced system of individual needs. The focus on a systematic reflection of the research object and subject in the context of analyzing the objective reality of contemporary terrorism made it possible to reveal the relationships of the identified needs and, based on the results obtained, uncover the process of reengineering the system of individual needs into a hierarchy of needs which lead to taking the antisocial path of terrorism. The main research results include structured subsystem of the integrated system of individual’s needs, the content of needs, their components, promoting the individual to joining terrorist activities, as well as the construction of mathematical model describing the operation of the system of individual’s needs, and identifying quantitative values of the median needs, bringing the individual into a terrorist organization.

RESUMO Objetivo: Determinar o número de leitos de UTI para pacientes adultos a fim de reduzir o tempo de espera na fila e propor políticas estratégicas. Métodos: Abordagem multimetodológica: (a) quantitativa, através de séries temporais e teoria de filas, para prever a demanda e estimar o número de leitos de terapia intensiva em diferentes cenários; (b) qualitativa, através do grupo focal e análise do conteúdo, para explorar o comportamento, atitudes e as crenças dos médicos nas mudanças da saúde. Resultados: As 33.101 solicitações de internação nos 268 leitos regulados de terapia intensiva, durante 1 ano, resultaram na admissão de 25% dos pacientes, 55% abandonos da fila e 20% de óbitos. Mantidas as taxas atuais de entrada e saída da unidade de terapia intensiva, seriam necessários 628 leitos para assegurar que o tempo máximo de espera fosse de 6 horas. A redução das atuais taxas de abandono, em razão de melhora clínica ou a redução do tempo médio de permanência na unidade, diminuiria o número de leitos necessários para 471 e para 366, respectivamente. Caso se conseguissem ambos os objetivos, o número chegaria a 275 leitos. As entrevistas geraram três temas principais: o conflito do médico: a necessidade de estabelecer prioridades justas, legais, éticas e compartilhadas na tomada de decisão; o fracasso no acesso: filas invisíveis e falta de infraestrutura; o drama social: deterioração das políticas públicas e desarticulação das redes de saúde. Conclusão: A fila deve ser tratada como um problema social complexo, de origem multifatorial e que requer soluções integradas. Redimensionar o número de leitos não é a única solução. Melhorar os protocolos e prover a reengenharia das enfermarias gerais podem reduzir o tempo de permanência na unidade. É essencial consolidar as centrais de regulação para organizar a fila e fornecer os recursos disponíveis em tempo adequado, usando critérios de prioridade e trabalhando em conjunto com as pessoas envolvidas para garantir a governança clínica e a organização da rede.

ABSTRACT Objectives: To determine the optimal number of adult intensive care unit beds to reduce patient's queue waiting time and to propose policy strategies. Methods: Multimethodological approach: (a) quantitative time series and queueing theory were used to predict the demand and estimate intensive care unit beds in different scenarios; (b) qualitative focus group and content analysis were used to explore physicians' attitudes and provide insights into their behaviors and belief-driven healthcare delivery changes. Results: A total of 33,101 requests for 268 regulated intensive care unit beds in one year resulted in 25% admissions, 55% queue abandonment and 20% deaths. Maintaining current intensive care unit arrival and exit rates, there would need 628 beds to ensure a maximum wait time of six hours. A reduction of the current abandonment rates due to clinical improvement or the average intensive care unit length of stay would decrease the number of beds to 471 and 366, respectively. If both were reduced, the number would reach 275 beds. The interviews generated 3 main themes: (1) the doctor's conflict: fair, legal, ethical and shared priorities in the decision-making process; (2) a failure of access: invisible queues and a lack of infrastructure; and (3) societal drama: deterioration of public policies and health care networks. Conclusion: The queue should be treated as a complex societal problem with a multifactorial origin requiring integrated solutions. Improving intensive care unit protocols and reengineering the general wards may decrease the length of stay. It is essential to redefine and consolidate the regulatory centers to organize the queue and provide available resources in a timely manner, by using priority criteria, working with stakeholders to guarantee clinical governance and network organization.

Abstract Abstract: The construction industry is undoubtedly one of the biggest generators of work risks; however, prevention programs do not make this situation evident. Workers in the construction industry work in precarious conditions, lack social security, and are completely unaware of their rights that are enshrined in them despite not signing a contract. It is imperative that both these workers and those responsible for their work, know the risk factors they are exposed to, but above all the serious health conditions they can cause, which go beyond the disabling musculoskeletal injuries so detailed in the bibliography. As the need for an adequate situational diagnosis within the industries is established, the prevention of pathologies considered merely general and whose origin is in the performance of the work, will lead the public health to the adoption of policies in improvement of the conditions thereof. Objectives: Identify the current diseases that are associated with the risk factors of the construction industry in Mexico. Material and Methods: Bibliographic review published from January 2000 to November 2016 in PUBMED, SciELO and Medline databases. Bibliographies were consulted in both English and Spanish. The keywords considered in the search included: construction industry, risk factors, work, diseases. Conclusions: The construction industry, presenting more ergonomic hazards in Mexico, should be one of the most closely monitored, epidemiologically speaking, because of it derives a large number of diseases that afflict the population and saturate daily the health system of Our country. It affects as well the economic development due to decreased performance and absenteeism of affected workers. The demand for such epidemiological surveillance by the labor authorities should result in improved conditions within the workplace, from equipping workers suitable and specific tools for their activity, provide them with protective equipment personnel according to their anatomy and with the specific characteristics for the types of factors and substances to which they are exposed, as well as the reengineering of obsolete or artisanal construction processes with technology. But above all, communicate and keep workers informed about the risks they are exposed to by the type of work activity they perform. It is essential that this commitment to oversee close and formal internal relationships between workers and employers, but it is also essential that a cross-sectoral commitment on legislation and regulations is created to truly implement and fulfill the obligations, duties and Rights that guarantee decent work for this sector of the population.

Resumen Resumen: La industria de la construcción es sin lugar a dudas una de las mayores generadoras de riesgos de trabajo, sin embargo, los programas de prevención no hacen evidente dicha situación. Los trabajadores de la industria de la construcción laboran bajo condiciones precarias, carecen de seguridad social, y desconocen por completo los derechos que les son consignados por ley pese a no firmar un contrato. Es imprescindible que dichos trabajadores y los responsables de su actividad laboral, conozcan los factores de riesgo a que se encuentran expuestos, pero sobre todo las graves afecciones a la salud que estos pueden provocar, que van más allá de las lesiones músculo-esqueléticas incapacitantes tan reconocidas en bibliografía. Conforme se establezca la necesidad de un adecuado diagnóstico situacional al interior de las industrias, la prevención de patologías que hoy se consideran meramente generales y cuyo origen se encuentra en el desempeño del trabajo, encaminará a la salud pública a la adopción de políticas en mejora de las condiciones del mismo. Objetivo: Identificar las enfermedades actuales que se asocian a los factores de riesgo de la industria de la construcción en México. Material y Métodos: Revisión bibliográfica publicada desde enero del 2000 hasta noviembre del 2016 en bases de datos: PUBMED, SciELO y Medline. Se consultaron bibliografías tanto en inglés como en español. Las palabras clave consideradas en la búsqueda incluyeron: industria de la construcción, factores de riesgo, trabajo, enfermedades. Conclusiones: La industria de la construcción al presentar mayor cantidad de riesgos ergonómicos en México, debería ser una de las más estrechamente vigiladas, epidemiológicamente hablando, pues de ella derivan un gran número de enfermedades que aquejan a la población y que saturan diariamente al sistema de salud de nuestro país además de que afecta al desarrollo económico debido a la disminución del rendimiento y el ausentismo de los trabajadores afectados. La exigencia de dicha vigilancia epidemiológica efectuada por las autoridades del trabajo tendrían que redundar en mejoras de las condiciones al interior de los centros de trabajo, es decir, desde equipar a los trabajadores de herramientas aptas y específicas para su actividad, dotarlos con equipo de protección personal acorde a su anatomía y con las características específicas para los tipos de factores y sustancias a las que se exponen, así como la reingeniería de los procesos de construcción, obsoletos o artesanales, con tecnología. Pero sobre todo comunicar y mantener informados a los trabajadores acerca de los riesgos a que están expuestos por el tipo de actividad laboral que desempeñan. Es fundamental que en este compromiso de vigilancia se tejan relaciones internas estrechas y formales entre los trabajadores y los patrones, pero también es fundamental que se genere un compromiso transectorial en materia de legislación y normatividad para que verdaderamente se apliquen y cumplan las obligaciones, deberes y derechos que garanticen un trabajo digno para este sector de la población.

The aim of this study was to identify both institutional and production constraints to the success of poultry-based poverty alleviation projects (PAPs) in Bushbuckridge Municipality of the Ehlanzeni District of Mpumalanga Province. A mixed methods research design was used. Purposive sampling was used to select 10 Chairpersons, 20 ordinary members, andfive extension officers of PAPs who served as respondents in the study. Face-to-face interviews were conducted using a semi-structured guide to collect qualitative data. The qualitative data was analysed using the Atlas ti 7.0.81 software. The results were used to develop a questionnaire employed to collect quantitative data from 116 respondents. The Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the latter data. The major institutional constraints identified, in descending order of severity, were: lack of regulation ofprices of poultry feed, lack of government start-up capital/subsidy, inadequate extension shows the poor support the PAPs receive. High price of poultry feeds force PAPs to stock fewer chickens was the major production constraint followed by diseases, in particular New Castle and Bronchitis are killing chickens and water supply is so erratic and unreliable that it affects effective running of poultry-based PAPs. It was concluded that despite the wide range of constraints facing them, PAPs were improving people's livelihoods. The need for revamping the local extension service in order to deal with the numerous challenges that the PAPs faced was highlighted. Central to this reengineering of the extension support system is the need for creating platforms and opportunities for the PAPs to co-learn and learn from each other, both of which are fundamental ingredients of sustainability.

Se presenta el diseño, implementación y pruebas de un sistema de monitoreo y supervisión para una máquina universal de ensayos ShimadzuUDH 50. Se desarrolló un plan de mejoramiento de la máquina, que arrojó el diagnóstico de funcionamiento de los componentes internos y externos de la misma, aplicando reingeniería se dibujaron planos hidráulicos y planos eléctricos de mando y potencia, se desarrollaron manuales de usuario y mantenimiento, se diseñó un software en Labview que funciona como panel de control de la máquina, para el diseño e implementación de la automatización se usan normas ISA junto con una metodología de proyectos de ingeniería integrando una tarjeta de adquisición de datos DAQ, una tarjeta acondicionadora de señales, una tarjeta de control y potencia y un computador. Se presentan tres pruebas de funcionamiento realizando ensayos de compresión, flexión y tracción con el sistema integrado para verificar la eficiencia del mismo; se obtiene un rendimiento total del sistema, al comparar los resultados obtenidos en la máquina y se obtuvo un error de precisión promedio de 0,8%.

This paper presents the design, implementation and testing of a monitoring and supervision system for universal testing machine Shimadzu UDH50. An improvement plan of the machine was developed, getting the operation diagnostic for internal and external components of the machine, and with applying reengineering were drawn electrical and hydraulic plans of control and power, user and maintenance manuals were developed, it was designed a software in Labview which works as a control panel of the machine, for the design and implementation of automation was used ISA standards and methodology of engineering projects integrating an acquisition card DAQ data, a signal conditioning board, a control card and power and a computer. There are presented three operation test doing compression, tensile and bending tests with the integrated system for verify the efficiency; a total performance is obtained, the results of the machine were compared, and obtained an average precision error of 0,8%.

El transformar un software secuencial en uno paralelo, es costoso y difícil, lo cual constituye solo dos de los muchos obstáculos técnicos y económicos que se tienen que enfrentar cuando se desea hacer uso de sistemas HPC. En este trabajo investigamos la posibilidad de mejorar de forma rápida y eficiente el desempeño de un código numérico secuencial que se encarga de realizar la simulación del comportamiento y transporte de un flujo de electrones en un dispositivo semiconductor MOSFET doble puerta y de escala nanométrico. Se introduce el modelo Drift-Diffusion-Schrödinger-Poisson (DDSP) y se estudia una estrategia de paralelización rápida del procedimiento numérico, óptimo específicamente para arquitecturas a memoria compartida.

The expensive reengineering of the sequential software and the difficult parallel programming are two of the many technical and economic obstacles to the wide use of HPC. We investigate the chance to improve in a rapid way the performance of a numerical serial code for the simulation of the transport of a charged carriers in a Double-Gate MOSFET. We introduce the Drift-Diffusion-Schrödinger-Poisson (DDSP) model and we study a rapid parallelization strategy of the numerical procedure on shared memory architectures.

Integrated and shared information systems allow obtaining a high degree of information about processes, costs and outcomes, and considerably reducing prescription errors. Assisted electronic prescription, in the setting of total parenteral nutrition, integrated with other hospital databases and with the hospital drugs management system, is a tool that allows increasing patient' safety (by reducing prescription errors), improving quality assistance, improving information systems and information management and the efficiency of used resources. In this work, implementation of an assisted electronic prescription system applied to parenteral nutrition in a hospital and processes reengineering performed in the nutrition setting are described. This implementation was performed by medical staff from the Nutrition and Diet Department and pharmacists from the Pharmacy Department of Ramón y Cajal Hospital using "Nutriwin" computer software. For two months prior and after its implementation, a follow-up of time consumed in the circuit prescription-validation-elaboration-dispensation of parenteral nutrition formulas has been performed. After implementation, treatment orders reach on average 1 h and 15 minutes sooner the Pharmacy Department; by avoiding transcription, a saving of 3 min per nutrition formula calculations is achieved, besides reducing potential errors; elaboration of nutrition formulas can be started on average 1 h and 20 minutes sooner as compared to manual prescription. Besides, the staff that writes down the prescription may know in real time the nutritional profile for each patient in the current episode and the patient's historic. Electronic prescription of treatment orders in this area has represented for our hospital an optimization of the employed resources, a reduction of potential errors that may occur, an improvement in consumption management, and an increase in the whole process quality.

Los sistemas de información integrados y compartidos permiten obtener un elevado nivel de información sobre los procesos, costes y resultados, y reducir considerablemente los errores de medicación. La prescripción electrónica asistida, en el área de nutrición parenteral total, integrado con otras bases de datos del hospital y con el sistema de gestión de medicamentos del hospital, es una herramienta que permite aumentar la seguridad del paciente (disminuyendo los errores de medicación), mejorar la calidad de la asistencia, mejorar los sistemas de información y la gestión de la misma y la eficiencia de los recursos empleados. En este trabajo se describe la implantación de un sistema de prescripción electrónica asistida aplicada a la nutrición parenteral en un hospital general, y la reingeniería de procesos llevado a cabo en el área de nutrición. Esta implantación se ha llevado a cabo por los facultativos médicos del servicio de Nutrición y Dietética y por farmacéuticos del Servicio de Farmacia del Hospital Ramón y Cajal utilizando para ello el programa informático "Nutriwin". Durante dos meses antes y después de su implantación, se ha realizado un seguimiento del tiempo empleado en el circuito prescripción-validación-elaboración-dispensación de las nutriciones parenterales. Tras la implantación las órdenes de tratamiento llegan, en promedio, 1 h 15 minutos antes al Servicio de Farmacia; al evitarse la trascripción se produce, además de la disminución de errores potenciales, un ahorro de 3 min/ nutrición en los cálculos a realizar; la elaboración de las nutriciones puede comenzarse como promedio 1h 20 minutos antes que si se realizara la prescripción manual. Así mismo los prescriptores pueden conocer en tiempo real el perfil nutricional de cada paciente en el episodio en curso así como su histórico. La prescripción electrónica de las órdenes de tratamiento en éste área ha supuesto para nuestro hospital una optimización de los recursos empleados, una disminución de los errores potenciales que se pueden producir, una mejora en la gestión de consumos, y un aumento en la calidad de todo el proceso.

Some decades ago, it was taken for granted that infectious diseases would be erradicated in 2000 by medicine and science. Reality has been different: the emergence and reemergence of infectious diseases show all the contrary. Microorganisms have globalized, modernized and adapted, as a result of human intervention on the environment and of the indiscriminate use of antibiotics. It was also considered that the extension of public health and the curative services was the answer to the health needs of the population. However, the fiscal crisis of the benefactor State makes more difficult the public system’s capacity to meet the health care requirements. On the other hand, the skyrocketing costs of modern medicine do not solve 90 % of the health problems and the private model has led to a strong privatization and to an increasing mercantilist conception of the health services. The ideological, political and economic bases of this model are the partial withdrawal of the State, the formation of a market for the private sector and the growth of the structures for the autonomy and income-yield capacity of the private sector in the health area. Health globalization faces a double and recurrent debate and dilemma: the first is of economic and managerial nature and it is related to the organization of the medical and health services, whereas the second is epistological, conceptual and of principles, which orientate the health policies. Health cannot be invulnerable to changes and should adapt itself with originality to the new global reality. Globalizing health about alternative policies in the dominant model requires to go beyond a revisionism of the benefactor State, or a reengineering of the curative and preventive services so as to democratize them and guarantee equity. The challenges are rather in the capacity of promoting paradigmatic changes allowing to implement policies in relation to a reconceptualization of health as an integrating part of the social and economic development, turning it into a value and ethical indicator of modernity

Hace algunas décadas se tenía la certeza que al año 2000, la medicina y la ciencia iban a erradicar las enfermedades infecciosas. La realidad ha sido otra: la emergencia y la reemergencia de enfermedades infecciosas, demuestran lo contrario. Los microorganismos se han globalizado y modernizado y adaptado, como consecuencia de la intervención humana sobre el medio ambiente y la utilización indiscriminada de antibióticos. También se tenía además la certeza que la extensión de salud pública y de los servicios curativos era la respuesta a las necesidades de salud de la población. Sin embargo, la crisis fiscal del estado benefactor hacen cada vez más difícil, la capacidad de respuesta del sistema publico a los requerimientos en atención de salud. Por otro lado los costos exorbitantes de la medicina moderna no logran resolver el 90 % de los problemas de salud y el modelo privado ha llevado a una fuerte privatización y a una concepción cada vez más mercantil de los servicios de salud. Las bases ideológicas y politico-económicas de este modelo son el retiro parcial del Estado, la formación de un mercado para el sector privado y el crecimiento de las estructuras para la autonomía y rentabilidad del sector privado en el área de la salud. La globalización de la salud se encuentra frente a un doble y recurrente debate y dilema: el primero es de naturaleza económica y de gestión, con relación a la organización de los servicios médicos y de salud; el segundo es de orden epistemológico, conceptual y de principios que orientan las políticas de salud. La salud no puede mantenerse invulnerable frente a los cambios y debe adaptarse, con originalidad a la nueva realidad global. Globalizar la salud en torno a políticas alternativas al modelo dominante requiere ir más allá de un revisionismo del estado benefactor o a una reingeniería de los servicios curativos y preventivos, para democratizarlos y garantizar equidad. Los desafíos se encuentran mas bien en la capacidad de promover cambios paradigmáticos que logren implementar políticas en torno a una reconceptualización de la salud, como parte integrante del desarrollo económico y social, transformándola en un indicador valórico y ético de la modernidad

Este artigo oferece uma contribuição para uma revisão das metodologías, e do horizonte teórico que tradicionalmente caracteriza a "Engenharia da informaçao". O artigo define as opções epistemológicas sobre as quais, se deve fundamentar uma metodología de desenvolvimento de projetos de sistemas da informação, e se individualizam as possíveis orientações estratégicas que caracterizam o desenvolvimento de projetos. A finalidade que se persegue é: 1) desenvolver modelos interpretativos e de suporte ao desenvolvimento de projetos, que permitam superar as simplificações próprias dos enfoques BRP dentro de uma visão comum, de acordo com os processos; 2) melhorar a compreensão das relações recíprocas entre os processos de desenvolvimento de projetos e os "processos projetados" assumindo, como ponto de partida, a natureza organizativa comum; 3) reforçar teórica e metodologicamente o desenvolvimento de sistemas da informação e dos sistemas ERP em particular.

This paper contributes to a re-examination of the methodologies and theoretical horizon that has traditionally characterised information engineering. The paper defines the epistemological choices that are the foundation for information system project development and individualises the possible strategic orientations that characterise project development. The objectives pursued are: 1) to develop interpretative models and support for project development with a process-based approach in order to overcome the simplifications inherent to BPR; 2) improve our understanding of the reciprocal relationships between project development processes and "processes projected", in the hypothesis of a common organizational nature; and 3) reinforce the development of information systems and particularly ERP from a theoretical and methodological standpoint.