The Audit to Improve the Quality of Health Care in Colombia: Systematization Experience

El presente trabajo es una sistematización sobre las experiencias de la implementación del Programa de Auditoria para el Mejoramiento de la Calidad (PAMEC), en una IPS privada de mediana complejidad en la ciudad de Cali de enero a diciembre del año 2019. Este proceso de sistematización utilizó un enfoque metodológico cualitativo-participativo. Entre los principales resultados de la sistematización, se encontró que, dentro de la calidad observada, la mayoría de los estándares sobre la atención a usuarios estaban por encima de la media y algunas pocas áreas como Apoyo Diagnóstico y Terapéutico se encontraron por debajo de los estándares mínimos. Este documento socializa tanto las debilidades y fortalezas de los servicios habilitados a través de dicho programa.The present work is a systematization of the experiences of the implementation of the Audit Program for Quality Improvement (PAMEC), in a private IPS of medium complexity in the city of Cali from January to December of the year 2019. This systematization process used a qualitative-participatory methodological approach. Among the main results of the systematization, it was found that, within the observed quality, the majority of user care standards were above the average and a few areas such as Diagnostic and Therapeutic Support were below the minimum standards. This document socializes both the weaknesses and strengths of the services enabled through said program

Analysis of the Reform of the General Social Security Health System 2022 – 2026: a Look from the Ten-Year Public Health Plan

Introducción: en todo el mundo, los sistemas de salud han dado prioridad al rendimiento y la calidad de los servicios de salud mediante políticas públicas específicas. Esto requiere reformar los modelos de gestión actuales y lograr sistemas de salud de alta calidad, seguros y eficientes. Estas modificaciones a los sistemas de salud en un Estado están relacionadas con las estrategias a nivel social, político y económico que son principalmente solicitadas por la comunidad para abordar las ineficiencias presentes y futuras. Objetivo: analizar la propuesta de reforma al Sistema General de Seguridad Social en Salud (SGSSS) para el período 2022-2026 en Colombia, desde la perspectiva del Plan Decenal de Salud Pública. Metodología: Nos permitimos recopilar datos secundarios para responder a nuestra pregunta mediante un enfoque de investigación cualitativo de tipo descriptivo y un método interpretativo -hermenéutico. Resultados: se identificaron los actores del ecosistema de salud de Colombia, sus interrelaciones, las barreras de acceso de los usuarios como geográficas, económicas y sociales; y las posibles acciones para corregirlas en la reforma. Conclusión: los ajustes principales que se llevarían a cabo en la propuesta de reforma del SGSSS se centran en aspectos relacionados con la cobertura, el medio ambiente, los recursos y el aprendizaje. Asimismo, se enfocan en la intersectorialidad, la interculturalidad y la participación.Introduction: Around the world, health systems have prioritized the performance and quality of health services through specific public policies. This requires reforming current management models and achieving high-quality, safe and efficient health systems. These modifications to the health systems in a State are related to strategies at the social, political and economic level that are mainly requested by the community to address present and future inefficiencies. Objective: analyze the proposal to reform the General Social Health Security System (SGSSS) for the period 2022-2026 in Colombia, from the perspective of the Ten-Year Public Health Plan. Methodology: We allowed ourselves to collect secondary data to answer our question through a qualitative descriptive research approach and an interpretive-hermeneutic method. Results: the actors of the Colombian health ecosystem were identified, their interrelationships, the access barriers of users such as geographical, economic and social; and possible actions to correct them in the reform. Conclusion: the main adjustments that would be carried out in the SGSSS reform proposal focus on aspects related to coverage, the environment, resources and learning. Likewise, they focus on intersectorality, interculturality and participation

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Search for intermediate-mass black hole binaries in the third observing run of Advanced LIGO and Advanced Virgo

International audienceIntermediate-mass black holes (IMBHs) span the approximate mass range 100−105 M⊙, between black holes (BHs) that formed by stellar collapse and the supermassive BHs at the centers of galaxies. Mergers of IMBH binaries are the most energetic gravitational-wave sources accessible by the terrestrial detector network. Searches of the first two observing runs of Advanced LIGO and Advanced Virgo did not yield any significant IMBH binary signals. In the third observing run (O3), the increased network sensitivity enabled the detection of GW190521, a signal consistent with a binary merger of mass ∼150 M⊙ providing direct evidence of IMBH formation. Here, we report on a dedicated search of O3 data for further IMBH binary mergers, combining both modeled (matched filter) and model-independent search methods. We find some marginal candidates, but none are sufficiently significant to indicate detection of further IMBH mergers. We quantify the sensitivity of the individual search methods and of the combined search using a suite of IMBH binary signals obtained via numerical relativity, including the effects of spins misaligned with the binary orbital axis, and present the resulting upper limits on astrophysical merger rates. Our most stringent limit is for equal mass and aligned spin BH binary of total mass 200 M⊙ and effective aligned spin 0.8 at 0.056 Gpc−3 yr−1 (90% confidence), a factor of 3.5 more constraining than previous LIGO-Virgo limits. We also update the estimated rate of mergers similar to GW190521 to 0.08 Gpc−3 yr−1.Key words: gravitational waves / stars: black holes / black hole physicsCorresponding author: W. Del Pozzo, e-mail: [email protected]† Deceased, August 2020