Formulation of the public policy of sport and physical activity, from a participatory approach in a Colombian municipality

Introducción: el desarrollo constitucional y legal ha favorecido la participación de la ciudadanía en la formulación de políticas públicas. Sin embargo, el rol de los grupos de interés en contextos específicos es limitado, en especial, en el sector del deporte y la actividad física, por tanto, se desconocen sus etapas de formulación, desde lo local, debido al predominio de investigaciones desde lo nacional y la falta de una visión “bottom-up”. Objetivo general: describir la formulación de la política pública del deporte y la actividad física desde el enfoque participativo en un municipio colombiano. Materiales y métodos: se desarrolló una metodología cualitativa, teniendo como muestra un municipio colombiano. Resultados y discusión: se evidenció que con participación de los grupos de interés es factible formular una política pública para el sector que resuelva las problemáticas de una comunidad. Conclusión: para plantear alternativas de solución, es necesario tener en cuenta el enfoque y principio de participación activa de los grupos de interés del sector.Introduction: The constitutional and legal development has favored the participation of citizens in the formulation of public policies. However, the role of stakeholders in specific contexts is limited, especially in the sport and physical activity sector, therefore, their formulation stages are unknown, from the local level, due to the predominance of research from the national level and the lack of a "bottomup" vision. Objective: To describe the formulation of public policy on sport and physical activity from a participatory approach in a municipality of Colombia. Materials and methods: A qualitative methodology was developed, having as sample a municipality of Colombia. Results and discussion: It was shown that with the participation of stakeholders it is feasible to formulate a public policy for the sector that solves the problems of a community. Conclusion: In order to propose alternative solutions, it is necessary to take into account the approach and principle of active participation of the sector's stakeholdersIncluye referencias bibliográfica

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Frequency of gastrointestinal parasites in equipment intended for human consumption in a slaughterhouse plant in Antioquia, Colombia.

Existen pocos reportes de la frecuencia de parásitos gastrointestinales en equinos faenados para consumo humano en Colombia, por esta razón fueron muestreados 1050 equinos que ingresaron a una planta de beneficio en Antioquia, con el fin de determinar la frecuencia de parásitos gastrointestinales que más afecta a los équidos. La muestra fue tomada directamente del recto con todas las medidas higiénico sanitarias. A cada muestra de materia fecal se le realizó examen coprológico a través de la técnica de flotación con solución sobresaturada de NaCl. Del 100% de los animales evaluados no fue posible saber si contaban o no con plan sanitario ya que la gran mayoría de équidos ingresaban a la planta por mercaderes los cuales no registraban ninguno de estos datos, por lo que se registraron sin plan sanitario. Los parásitos encontrados con mayor frecuencia fueron: Strongylos sp (72,1%), seguido por Entamoeba histolytica (1,0%), Endolimax nana (0,9%), Parascaris sp (0,8%), Oxyuris sp (0,8%), Entamoeba coli (0,3%), y Blastocystis hominus (0,2%). Siendo la mayor cantidad de caballos provenientes de Córdoba (71%), seguido por Antioquia (23%), Bolívar (3,0%) y por último Sucre (2,7%). De la cantidad de animales muestreados 995 eran caballos y 55 asnales, además se evidenció que las hembras presentaban un mayor porcentaje 53.2% respecto a los machos 46.8%.There are few reports of the prevalence of gastrointestinal parasites in equines slaughtered for human consumption in Colombia, for this reason 1050 equines that entered a slaughter plant in eastern Antioquia were sampled, in order to determine the incidence of gastrointestinal parasites that most affects For equines, each stool sample underwent a stool examination accompanied by the floatation technique with supersaturated NaCl solution, as it is fast, provides good results and is also easy to prepare, in addition to being the most common , simple and cheap 100% of the animals evaluated did not present a health plan, the parasites most frequently found were: Strongylos sp (72.1%), followed by Entamoeba histolytica (1.0%), Endolimax nana (0.9%), Parascaris sp (0.8%), Oxyuris sp (0.8%), Entamoeba coli (0.3%), and Blastocystis hominus (0.2%). Being the largest number of horses from Córdoba (71%), followed by Antioquia (23%), Bolívar (3.0%) and finally Sucre (2.7%). Of the number of animals sampled, 995 were horses and 55 donkeys, and it was also shown that females presented a higher percentage of 53.2% compared to males, 46.8%. There are few reports of the prevalence of gastrointestinal parasites in equines slaughtered for human consumption in Colombia, for this reason 1050 equines that entered a slaughter plant in eastern Antioquia were sampled, in order to determine the incidence of gastrointestinal parasites that most affects For equines, each stool sample underwent a stool examination accompanied by the floatation technique with supersaturated NaCl solution, as it is fast, provides good results and is also easy to prepare, in addition to being the most common , simple and cheap 100% of the animals evaluated did not present a health plan, the parasites most frequently found were: Strongylos sp (72.1%), followed by Entamoeba histolytica (1.0%), Endolimax nana (0.9%), Parascaris sp (0.8%), Oxyuris sp (0.8%), Entamoeba coli (0.3%), and Blastocystis hominus (0.2%). Being the largest number of horses from Córdoba (71%), followed by Antioquia (23%), Bolívar (3.0%) and finally Sucre (2.7%). Of the number of animals sampled, 995 were horses and 55 donkeys, and it was also shown that females presented a higher percentage of 53.2% compared to males, 46.8%.Existen pocos reportes de la frecuencia de parásitos gastrointestinales en equinos faenados para consumo humano en Colombia, por esta razón fueron muestreados 1050 equinos que ingresaron a una planta de beneficio en Antioquia, con el fin de determinar la frecuencia de parásitos gastrointestinales que más afecta a los équidos. La muestra fue tomada directamente del recto con todas las medidas higiénico sanitarias. A cada muestra de materia fecal se le realizó examen coprológico a través de la técnica de flotación con solución sobresaturada de NaCl. Del 100% de los animales evaluados no fue posible saber si contaban o no con plan sanitario ya que la gran mayoría de équidos ingresaban a la planta por mercaderes los cuales no registraban ninguno de estos datos, por lo que se registraron sin plan sanitario. Los parásitos encontrados con mayor frecuencia fueron: Strongylos sp (72,1%), seguido por Entamoeba histolytica (1,0%), Endolimax nana (0,9%), Parascaris sp (0,8%), Oxyuris sp (0,8%), Entamoeba coli (0,3%), y Blastocystis hominus (0,2%). Siendo la mayor cantidad de caballos provenientes de Córdoba (71%), seguido por Antioquia (23%), Bolívar (3,0%) y por último Sucre (2,7%). De la cantidad de animales muestreados 995 eran caballos y 55 asnales, además se evidenció que las hembras presentaban un mayor porcentaje 53.2% respecto a los machos 46.8%

Governance and legitimacy in Colombian sports federations

Con base en la investigación que adelantó la Universidad de Ciencias Aplicadas y Ambientales y el Comité Olímpico Colombiano, se elaboró el presente artículo, en el que se determina el estado de la gobernanza y legitimidad de las federaciones deportivas colombianas. Los resultados evidencian la existencia de debilidades relacionadas con el desequilibrio de género, como también, sobre la solidaridad con atletas e instituciones de menor jerarquía; el estudio estableció la necesidad de estructurar la creación de un observatorio de buena gobernanza. La muestra estuvo determinada, por ocho federaciones deportivas colombianas, en una población total de 19, cuya participación está reflejada en dar a conocer a través de elementos puntuales como su página web, sus estatutos, sus planes de gobierno, entre otros, acciones indirectas que evidencian elementos de transparencia, democracia, separación de poderes y solidaridad, los cuales son fundamento de la buena gobernanza y la legitimidad. La investigación se centró en evaluar las federaciones deportivas nacionales, con base en un estudio adelantado por la organización internacional Play the Game que evalúo el estado de la gobernanza y la legitimidad de las federaciones deportivas internacionales, las cuales hacen parte del programa olímpico.Incluye referencias bibliográficas

Governance and legitimacy in sport: the democratic processes of sports clubs in Chía, Cundinamarca

Introducción: El NSGO, se refiere a la observación nacional de la gobernanza en el deporte de la organización Play the Game, permitiendo tener una perspectiva del estado de la gobernanza de las federaciones deportivas nacionales y ahora de los clubes deportivos, del municipio de Chía, Cundinamarca, en Colombia. Este escrito presenta los resultados de la dimensión de procesos democráticos de la investigación; la gobernanza en el deporte: la legitimidad en los clubes deportivos del municipio de Chía, Cundinamarca. Objetivo: Determinar el estado de gobernanza y legitimidad de los clubes deportivos del municipio de Chía, Cundinamarca, de acuerdo con el principio de procesos democráticos. Metodología: Es un estudio descriptivo de carácter mixto, dando como resultado el diagnóstico de una situación que se pretende analizar. La población estuvo determinada por 33 clubes deportivos de formación y de competición del municipio de Chía, de los cuales, se tomó la información de 19 de ellos, a partir de los criterios de inclusión y de exclusión, determinados en el mismo. Resultados: La dimensión de procesos democráticos obtuvo un puntaje del 53 %, considerado como nivel moderado y los 13 principios que la componen, generaron un comportamiento variado, que permitió implementar acciones de mejora, con el fin de contribuir al desarrollo del sector del deporte, a nivel municipal. Conclusión: Se determinó el estado de la gobernanza en los clubes deportivos del municipio de Chía y su nivel de desarrollo frente a los procesos democráticos, a través del NSGO. Este resultado fue determinante, permitiendo identificar fortalezas y aspectos de mejora para dichas organizaciones.Introduction: The NSGO refers to the national observation of the governance in sport of the organization Play the Game, allowing to have a perspective of the state of governance of the national sports federations and now of the sports clubs of the Municipality of Chía, Cundinamarca in Colombia. This writing presents the results of the dimension of democratic processes of the investigation; governance in sport: legitimacy in sports clubs in Chía, Cundinamarca. Objective: To determine the state of governance and legitimacy of the sports clubs of the Municipality of Chía, Cundinamarca, in accordance with the principle of democratic processes. Methodology: It is a descriptive study of a mixed nature, resulting in the diagnosis of a situation to be analyzed. The population was determined by 33 training and competition sports clubs of the Municipality of Chia, from which, first, the information was taken from 19 of them, based on the inclusion and exclusion criteria determined therein. Results: The dimension of democratic processes obtained a score of 53%, considered as a moderate level, and the 13 principles that compose it generated a varied behavior, which allowed to implement improvement actions, in order to contribute to the development of the sports sector to municipal level. Conclusion: The state of governance in the sports clubs of Chia and their level of development in the face of democratic processes was determined, through the NSGO. This result was decisive, allowing the identification of strengths and aspects of improvement for these organizations.Incluye referencias bibliográfica

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)