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En este informe se presenta una situación real y objetiva, propia del E.S.E HOSPITAL SANTA MATILDE, centro hospitalario de Nivel I, situado en el municipio de Madrid, departamento de Cundinamarca, donde se ofrecen servicios generales y especializados incluyendo la utilización de equipos biomédicos para atender pacientes con diferentes patologías de nivel I, tanto del área urbana como rural. La investigación de este informe está fundamentada en la experiencia obtenida durante la realización de mis prácticas en el E.S.E HOSPITAL SAN MATILDE DE MADRID, relacionada con el uso y manejo del equipo biomédico existente, buscando el mejoramiento necesario para llegar a la excelencia al identificar dificultades que pueden superarse para ofrecer a los usuarios oportunidades tecnológicas acordes con la vida actual. Introducción 11 1.1 Descripción del problema 12 1.1.1 Formulación del problema 14 1.2 Justificación 14 1.3 Objetivos 15 1.3.1 Objetivo general. 15 1.3.2 Objetivos específicos. 16 2. Marco de referencia 17 2.1 Marco de estado actual 17 2.1.1 Misión 21 2.1.2 Visión 21 2.1.3 Lema 21 2.2 Marco Contextual 22 2.2.1 Informes institucionales 22 2.2.2 Organigrama 23 2.3 Marco conceptual 24 5 2.3.1 Hospital 26 2.3.2 Paciente 27 2.3.3 Términos especiales 27 2.3.3.1. POS, EPS, IPS, REPS, Telemedicina. 27 2.3.3.2 Dispositivo médico, Equipo biomédico, Servicio de soporte técnico 28 2.3.3.3. Equipo biomédico (original), Infraestructura, Dotación y Mantenimiento hospitalario 30 2.3.4 Niveles hospitalarios. Hospital de Nivel I 32 2.4 Marco legal 34 Metodología 37 3.1 Actividades desarrolladas durante la pasantía. 40 3.1.1 Investigación Cualitativa – descriptiva. Proceso Vivencial 40 3.2 Investigación Cuantitativa – Encuesta de Satisfacción. 45 3.2.1 Instrumento de medición – Encuesta. 45 3.2.2 Tipo de encuesta 45 3.2.3 Plan de análisis 46 3.2.4 Resultados 46 Conclusiones 56 Recomendaciones 58 Referencias 61

Supplemental Material, KocMichalska_online_appendix for From Online Political Posting to Mansplaining: The Gender Gap and Social Media in Political Discussion by Karolina Koc-Michalska, Anya Schiffrin, Anamaria Lopez, Shelley Boulianne and Bruce Bimber in Social Science Computer Review

Purpose: Breast cancer in women is the most commonly diagnosed cancer. Adjuvant endocrine therapy (AET) showed consistent improvements in recurrence and survival rates. Adherence to adjuvant endocrine therapy remains essential for improving overall survival in women with hormone receptor (HR) positive breast cancer. However, early discontinuation of medicine is reported to range from 20% to 50%. Poor adherence has been attributed to multiple factors including presence of adverse events. We aim to report the lived experience of breast cancer survivors specifically as regards to side effects, the most reported reason for lack of adherence., Methods: 35 breast cancer survivors on AET were interviewed. Qualitative iterative analysis was conducted using the grounded theory approach with the goal of identifying themes that emerge from the interviews and refining the question probes as needed. A codebook was developed and supplemented with interpretive codes generated through ongoing analysis of transcripts. All transcripts were coded using NVIVO qualitative data analysis software for data interpretations., Results: Reported side effects associated with AET medications include hot flashes, sexual side-effects, joint pain, stiffness, cognitive function, mood changes, bone mass density decrease and fertility concerns. Women who were on AET more than 6 months reported more side effect concerns. A variety of coping strategies using over the counter medications or alternative medicines and approaches were also discussed., Conclusion: Tailored and timely information on potential AET-induced side effects and strategies to manage them is needed. In particular, some side effects are more prevalent by medication (e.g., joint pain in those who were taking an aromatases inhibitor). Provision of information to prepare women for the potential side effects of type of AET they are prescribed for would be helpful., Implications for Cancer Survivors: As AET has been suggested for 10 years to improve surveillance and reduce recurrence, our results have implications for cancer survivors, especially the onsets of side effects and potential ways to manage them as they arise., Competing Interests: Competing interests No competing interests to declare