Centro del Reciclador. A space for social articulation and recycling. C.R.E.A.S-RECYCLING

El proyecto se desarrolla sobre una problemática global causada por las actividades humanas en las ciudades, específicamente en el tratamiento de los residuos urbanos en Bogotá, en donde existe un grupo poblacional que tiene como oficio, reciclar. Los recicladores son indispensables en el desarrollo sostenible de la ciudad y lo han sido por años pero, actualmente, a pesar de sus esfuerzos por formalizar el oficio sigue siendo una población segregada, estigmatizada y desvalorizada con condiciones de vida y de trabajo desfavorables; Por lo tanto, el proyecto busca responder a las necesidades actuales de la comunidad desde el punto de vista social, cultural y económico con el fin de dignificar el oficio y replantear las actuales relaciones y estereotipos frente a los recicladores. Se propone entonces un equipamiento para el reciclador/reciclaje a nivel de anteproyecto, enfocado en el bienestar social, económico y educativo de los recicladores de Bogotá, teniendo como principal programa, una planta de clasificación y tratamiento de los residuos sólidos urbanos aprovechables de la ciudad y a su vez, espacios para su crecimiento educativo, interacción social, protección ambiental y su bienestar; tomando como principio de implantación la integración del río Tunjuelo, la restauración del humedal el Tunjo y la dignificación del oficio del reciclador.The project is developed on a global problem caused by human activities in cities, specifically in the treatment of urban waste in Bogotá, where there is a population group whose job is recycling. Waste pickers are essential in the sustainable development of the city and have been for years but, currently, despite their efforts to formalize the job, it continues to be a segregated, stigmatized and undervalued population with unfavorable living and working conditions; Therefore, the project seeks to respond to the current needs of the community from the social, cultural and economic point of view in order to dignify the trade and rethink the current relationships and stereotypes regarding waste pickers. Therefore, equipment for the recycler / recycling is proposed at the preliminary project level, focused on the social, economic and educational well-being of the recyclers of Bogotá, having as its main program, a plant for the classification and treatment of usable urban solid waste in the city and in turn, spaces for their educational growth, social interaction, environmental protection and their well-being; taking as a principle of implementation the integration of the Tunjuelo river, the restoration of the Tunjo wetland and the dignity of the recycler's job.Arquitecto (a)Pregrad

La delación en los procesos de compras públicas del Estado y sus efectos en la libre competencia

La presente Monografía Jurídica se sitúa en medio de dos regímenes jurídicos que interactúan y se complementan: la contratación estatal y la libre competencia. Se analiza el fenómeno de la colusión en las compras del Estado y, para combatirla, se estudia una herramienta propia del derecho de la competencia: la Delación. Sin embargo, se tiene que actualmente la figura presenta ciertos inconvenientes que impiden que delatar sea más beneficioso que coludir. Por ende, se desarrollará una propuesta integral que brinde los incentivos necesarios para evitar este tipo de conductas y garantizar los cometidos estatales.This thesis is situated in the middle of two legal regimes that interact and complement each other: public procurement and competition law. It also analyzes Leniency as an alternative to repress Collusive tendering in bid rigging. However, this figure is currently presenting certain drawbacks that makes being part of a cartel is more attractive than confessing this unlawful conduct. Therefore, a comprehensive proposal is developed, providing the necessary incentives to avoid this type of agreements and to guarantee the rule of law.Abogado (a)Pregrad

Centro de investigación y desarrollo marino costero sostenible – Paita, 2023

"El propósito del proyecto es diseñar un centro de investigación y desarrollo costero marino sostenible en la provincia de Paita; con el fin de ofrecer y enseñar la biodiversidad marina peruana e internacional. Actualmente la ciudad de Piura cuenta con una sede de investigación, sin embargo, la infraestructura es inadecuada para el seguimiento y control de las especies marinas. Por este motivo este proyecto ofrece una infraestructura sostenible para el crecimiento tecnológico y colectivo de la ciudad de Paita. Que cuente con espacios, laboratorios y talleres marinos que promuevan la investigación de los ecosistemas marinos y la acuicultura. Está diseñado en base al emplazamiento urbano y permite ser visible con sus ventanales y grandes espacios para el espectador. Para concluir esta edificación promueve el diseño sostenible y busca reducir el consumo de energético, brindando calidad al usuario y conservación de la biodiversidad marina"The purpose of the project is to design a sustainable marine coastal research and development center in the province of Paita; in order to offer and teach Peruvian and international marine biodiversity. Currently the city of Piura has a research headquarters, however, the infrastructure is inadequate for the monitoring and control of marine species. For this reason, this project offers a sustainable infrastructure for the technological and collective growth of the city of Paita. That it has spaces, laboratories and marine workshops that promote research into marine ecosystems and aquaculture. It is designed based on the urban location and allows it to be visible with its windows and large spaces for the viewer. To conclude, this building promotes sustainable design and seeks to reduce energy consumption, providing quality to the user and conservation of marine biodiversity.Tesi

Estrategias En Telepsicología Y Telemedicina Durante Pandemia Por COVID 19. Revisión Sistemática.

Since the year 2020, the necessity to provide remote healthcare services has increased due to the COVID-19 pandemic and the need to slow down the spread of this disease. Although these efforts have been valued, they have implied different challenges and still are insufficient from a global perspective. A review of the literature was found pertinent to identify in retrospect the strategies adopted, enabling a synthesis of their results, allowing, among other things, that future projects can work from what has been learned. Therefore, the objective was: to identify strategies for the promotion, prevention, and mental health care during and after confinement by COVID-19 from the literature review. For this, a systematic review was carried out that included four databases: PubMed, Scopus, EBSCO, and Science Direct. Among the most contrasted results, these strategies were found as opportune means that facilitate the streamlining of processes, results, and communications. Among its difficulties, the following stood out: the quality of care, diagnostic limitations, treatment adherence, and the lack of training, both for health personnel and for users/patients. La pandemia por COVID 19 ha impactado la población global perturbando la calidad de vida y su salud mental, afectaciones atribuidas tanto al contagio como a las medidas para mitigarlo. En respuesta a esta problemática viene en incremento la prestación de servicios de atención remota en salud. Aunque estos esfuerzos han sido valorados positivamente, también han implicado distintos retos, los cuales han sido objeto de discusión en materia de salud pública. De lo planteado parte la necesidad de identificar las estrategias adoptadas, posibilitando una síntesis de resultados y permitiendo que futuros proyectos puedan trabajar desde lo aprendido. El objetivo de este estudio fue: identificar las estrategias para la promoción, prevención y atención en salud mental durante y posterior al confinamiento por COVID 19. Se realizó una revisión sistemática acorde a la declaración PRISMA y la iniciativa STROBE.  Para ello se utilizaron cuatro bases de datos: PubMed, Scopus, EBSCO, y Science Direct. Entre Los resultados se evidenciaron la telepsicología y telemedicina como estrategias en telesalud oportunas para mejorar procesos, resultados y comunicaciones. Entre sus dificultades destacaron la calidad de la atención, limitaciones diagnósticas, adherencia al tratamiento, y falta de capacitación, tanto del personal en salud como la de los usuarios/pacientes

Clinical and Biomarker Responses to BI 655064, an Antagonistic Anti-CD40 Antibody, in Patients With Active Lupus Nephritis:A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial

Objective: To characterize its dose-response relationship, BI 655064 (an anti-CD40 monoclonal antibody) was tested as an add-on to mycophenolate and glucocorticoids in patients with active lupus nephritis (LN).Methods: A total of 121 patients were randomized (2:1:1:2) to receive placebo or BI 655064 120, 180, or 240 mg and received a weekly loading dose for 3 weeks followed by dosing every 2 weeks for the 120 and 180 mg groups, and 120 mg weekly for the 240 mg group. The primary endpoint was complete renal response (CRR) at week 52. Secondary endpoints included CRR at week 26.Results: A dose-response relationship with CRR at week 52 was not shown (BI 655064 120 mg, 38.3%; 180 mg, 45.0%; 240 mg, 44.6%; placebo, 48.3%). At week 26, 28.6% (120 mg), 50.0% (180 mg), 35.0% (240 mg), and 37.5% (placebo) achieved CRR. The unexpected high placebo response prompted a post hoc analysis evaluating confirmed CRR (cCRR, at weeks 46 and 52). cCRR was achieved in 22.5% (120 mg), 44.3% (180 mg), 38.2% (240 mg), and 29.1% (placebo) of patients. Most patients reported ≥1 adverse event (BI 655064, 85.7–95.0%; placebo, 97.5%), most frequently infections and infestations (BI 655064 61.9–75.0%; placebo 60%). Compared with other groups, higher rates of serious (20% vs. 7.5–10%) and severe infections (10% vs. 4.8–5.0%) were reported with 240 mg BI 655064.Conclusion: The trial failed to demonstrate a dose-response relationship for the primary CRR endpoint. Post hoc analyses suggest a potential benefit of BI 655064 180 mg in patients with active LN.</p

A systematic review of studies measuring health-related quality of life of general injury populations

Background. It is important to obtain greater insight into health-related quality of life (HRQL) of injury patients in order to document people's pathways to recovery and to quantify the impact of injury on population health over time. We performed a systematic review of studies measuring HRQL in general injury populations with a generic health state measure to summarize existing knowledge. Methods. Injury studies (1995-2009) were identified with main inclusion criteri

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019

Background: The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods: We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE). Results: In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for “HIV/AIDS and sexually transmitted diseases” and “transport injuries” (each -19%). “Diabetes and kidney diseases” showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, “mental disorders” showed an increasing age-standardised YLL rate (14.5%). Conclusions: There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease

Measurement invariance of six language versions of the post-traumatic stress disorder checklist for DSM-5 in civilians after traumatic brain injury

Traumatic brain injury (TBI) is frequently associated with neuropsychiatric impairments such as symptoms of post-traumatic stress disorder (PTSD), which can be screened using self-report instruments such as the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The current study aims to inspect the factorial validity and cross-linguistic equivalence of the PCL-5 in individuals after TBI with differential severity. Data for six language groups (n ≥ 200; Dutch, English, Finnish, Italian, Norwegian, Spanish) were extracted from the CENTER-TBI study database. Factorial validity of PTSD was evaluated using confirmatory factor analyses (CFA), and compared between four concurrent structural models. A multi-group CFA approach was utilized to investigate the measurement invariance (MI) of the PCL-5 across languages. All structural models showed satisfactory goodness-of-fit with small between-model variation. The original DSM-5 model for PTSD provided solid evidence of MI across the language groups. The current study underlines the validity of the clinical DSM-5 conceptualization of PTSD and demonstrates the comparability of PCL-5 symptom scores between language versions in individuals after TBI. Future studies should apply MI methods to other sociodemographic (e.g., age, gender) and injury-related (e.g., TBI severity) characteristics to improve the monitoring and clinical care of individuals suffering from PTSD symptoms after TBI.publishedVersio