Incidencia pronunciamientos de las altas cortes frente a la aplicación de la facultad discrecional en la fuerza pública

El presente trabajo permitirá conocer la posición jurisprudencial asumida por la Honorable Corte Constitucional y el Consejo de Estado frente a la aplicación de la medida de retiro de los uniformados por la facultad discrecional, por lo que se observa dentro del desarrollo del tema que fue necesario unificar al interior de las Fuerzas Militares y de Policía Nacional los criterios para su uso con el propósito que esta figura jurídica no desapareciera y cumpliera con los fines plasmados desde su creación mejorar el servicio , también es claro precisar que el Consejo Superior de la Judicatura, Sala Jurisdiccional Disciplinaria, ha procedido a respetar tanto los intereses de la institución como los derechos fundamentales de los accionantes, para finalizar se concreto que se debe motivar el acto administrativo que ocasionó el retiro del servicio activo, así como la recomendación emitida por a Junta de Evaluación, lo que ha permitido mayor credibilidad al interior de las filas castrense

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)