COLOMBIA COFFEE SECTOR STUDY.

El presente documento analiza la evolución del sector cafetero colombiano en la última década, periodo en el cual ha perdido valor. Se hace un diagnóstico de las causas que han generado el retroceso del sector y propone unas estrategias de política para que vuelva a ser competitivo en los mercados internacionales. De las conclusiones se destaca la necesidad de mejorar la eficiencia en la producción para poder competir a precios cada día mas bajos en el mercado mundial, se propone una estrategia para desarrollar negocios en los nichos de los llamados cafés especiales a los que se les reconocen primas superiores por parte de los compradores, y en el plano regulatorio se recomienda que la parafiscalidad que afecta al sector sea reformulada para que el impuesto que tributan los cafeteros sea bajo, estable y fijo en el tiempo. Con los recursos que se generen por esta contribución se deberán financiar los programas prioritarios para beneficio de los caficultores. Programas que de manera individual no pueden ser acometidos (Investigación o promoción). El rol de la institucionalidad cafetera deberá ser reformulado. Los recursos del café no deben seguir suplantando los recursos del Estado en obras públicas en las regiones cafeteras, pero la organización cafetera regional puede convertirse en un ejecutor importante de proyectos de inversión con recursos del presupuesto general de la Nación.Economía Agrícola, Comercio Internacional, Economía Institucional

A Snapshot of How Entry-Level Occupational Therapy Programs Collect and Use Doctoral Capstone Outcomes

Entry-level occupational therapy doctorate (OTD) programs are required to gather program evaluation data regarding the doctoral capstone for accreditation purposes. This study aims to describe the processes used by a sample of OTD programs to gather doctoral capstone outcome data and to determine the type of data collected in order to understand the perspectives regarding doctoral capstone outcomes by doctoral capstone coordinators (DCCs) within the United States. The investigators used purposeful sampling to recruit DCCs at accredited entry-level OTD programs in the United States. The most common outcome data collected included information about the doctoral capstone experience from students, student performance outcomes, employment and scholarship outcomes from alumni and employers, and various outcomes from site/expert/faculty mentors. Results highlight the need to disseminate doctoral capstone outcomes as few participants in this study used the data they were collecting outside of their program. By sharing and reporting outcomes of the doctoral capstone, OTD programs, and the profession can collectively benefit. Development of common outcomes, collected across programs, can help to provide data large enough to draw meaningful conclusions regarding the value of the doctoral capstone in occupational therapy education and in strengthening the knowledge of the profession among the public

Dancing Between Two Worlds: Training Experiences of Dual Credentialed Counselors

Several challenges exist in the implementation of integrated care given that SUD/Addiction treatment has historically been segregated from the broader health care system (Office of the Surgeon General, 2016). One expression of the gap that persists is that for counselors who want to administer SUD/Addiction and mental health counseling, or co-occurring services, in Washington State they are required to satisfy state requirements for two separate credentials. The purpose of this study was to conduct an in-depth exploration into the training experiences of Dual Credentialed Counselors (DCCs) in Washington State where two separate credentials are required to administer co-occurring counseling. In this Interpretive Phenomenological Analysis, six participants agreed to share their training experiences. Two semi-structured interviews were conducted with each participant. Research study findings illuminated themes that reflected how participants made sense of their training experience given the segregation, features, and conditions that were part of the ecosystem within which they trained, and elucidated how they navigated the divisions that persist between SUD/Addiction and mental health counseling. Ultimately, the study revealed that there are several opportunities to develop training resources. The dearth of supervision models which specifically address the nuances and complexity of administering co-occurring counseling is a conspicuous gap to fill. Further research studies focused on the development of resources and supervision models, which address the training needs of DCCs, could contribute to the implementation of integrated care. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu)

Role of District Co-ordination Committee in Nepalese Federalism

The main objective of this paper is to explore the significance of role of District Co-ordination Committee in Nepalese Federalism. The paper seeks to identify and critically analyze the role of district Co-ordination committee. This study makes a brief description and analysis of the role of District Co-ordination Committee in Nepal. It is a descriptive and analytical paper. The present Constitution of Nepal has added two new tiers in ruling structure of the country. They are province and local levels. Province government is completely new in Nepalese history. Local level has been in existence long before now as an administrative unit but this is a new practice as constitutionally recognized unit. In this new restructuring and distribution of power, duties and responsibilities,  District Development Committee (DDC) in the previous system is removed, the administrative unit is removed, the role of District Administrative Office is also minimized to maintaining peace, security and acting as a representative of the federal government and in their places there is a new mechanism, created constitutionally - District Co-ordination Committee to undertake coordination between the rural municipalities and Municipalities within the district. DCC also monitors development and construction works to make a balance of such works. District Co-ordination Committee carries out coordination between the Federal and the State Government offices and rural municipalities and Municipalities in the district

The influence of day care centres designed for people with dementia on family caregivers : a qualitative study

Dementia is one of the most challenging age-related illnesses for family caregivers, whose care-related burden is well known. Research indicates that day care centres (DCCs) can reduce the caregiver burden and help family caregivers to cope with demands; however, the current body of knowledge is still tentative and inconsistent, and more research is recommended. The aim of this study is to provide an extended understanding of the situation of family caregivers and to examine to what extent DCCs can meet their need for support and respite.publishedVersio

The impact of initial antibiotic treatment failure: Real-world insights in patients with complicated, health care-associated intra-abdominal infection

Purpose: The RECOMMEND study (NCT02364284; D4280R00005) assessed the clinical management patterns and treatment outcomes associated with initial antibiotic therapy (IAT; antibiotics administered ≤48 hours post-initiation of antibiotic therapy) for health care-associated infections across five countries. Patients and methods: Data were collected from a retrospective chart review of patients aged ≥18 years with health care-associated complicated intra-abdominal infection (cIAI). Potential risk factors for IAT failure were identified using logistic regression analyses. Results: Of 385 patients with complete IAT data, bacterial pathogens were identified in 270 (70.1%), including Gram-negative isolates in 221 (81.9%) and Gram-positive isolates in 92 (34.1%). Multidrug-resistant (MDR) pathogens were identified in 112 patients (41.5% of patients with a pathogen identified). IAT failure rate was 68.3% and in-hospital mortality rate was 40.8%. Multivariate regression analysis demonstrated three factors to be significantly associated with IAT failure: patients admitted/transferred to the intensive care unit during index hospitalization, isolation of an MDR pathogen and previous treatment with β-lactam antibiotics. Conclusion: We reveal the real-world insights into the high rates of IAT failure and mortality observed among patients with cIAI. These data highlight the challenges associated with choosing IAT, the impact of MDR pathogens on IAT outcomes and the importance of tailoring IAT selection to account for local epidemiology and patient history