El conglomerado del azúcar del Valle del Cauca, Colombia

En el siglo XX surgió en el Valle del Cauca, Colombia, un cluster o conglomerado productivo en torno a la caña de azúcar. El conglomerado, compuesto por cientos de empresas dedicadas a una gran variedad de productos y servicios, constituye la columna vertebral del desarrollo económico y social de Cali y el Valle del Cauca. En muchos sentidos constituye un ejemplo de desarrollo exitoso. Es un caso tal vez poco conocido fuera de Colombia, tanto más interesante porque el cultivo de la caña no se asocia en general en otros países al desarrollo económico y social exitoso. La presente publicación pretende contar esta historia. Intenta trazar las grandes orientaciones estratégicas implícitas en el conjunto de acciones colectivas aunque probablemente nunca explicitadas como tales, así como los hitos principales que explican cien años de construcción social. Esta no es sólo una historia empresarial o productiva, sino sobre todo la historia de la construcción de un territorio, de una región cuya identidad se forja a partir del azúcar. La conclusión central es que el desarrollo no "sucede" de manera automática; efectivamente se construye a través de estrategias y acción colectivas. El texto fue elaborado por un equipo de investigadores coordinado por Felipe Millán del Centro de Nacional de Productividad en Cali. La investigación es parte del programa de investigación de la División de Desarrollo Productivo y Empresarial sobre clusters entorno a recursos naturales. Este trabajo contó con el patrocinio de la Sociedad Alemana de Cooperación Técnica (GTZ).

The Effect of Transfer of Care Protocol on the Rehospitalization Rates in Psychiatric Patients

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge. PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks? Evidence: The evidence from an extensive literature review supported the implementation of the Brief Critical Time Intervention (BCTI) tool to reduce psychiatric patient readmissions. Intervention: The intervention for this evidence-based practice change project was the implementation of the BCTI tool. The intervention included training of staff to incorporate the BCTI as part of the discharge process. Outcome: The BCTI tool revealed an effective clinical impact on readmissions as evidenced by a readmission rate of 8%, which was lower than the pre-intervention rate of 8.9%. The result of the two proportions z-test was significant (p = 0.002), which indicates a significant difference between pre and post intervention readmissions. Conclusion: The intent of the project was to evaluate the efficacy of using the BCTI tool to reduce the readmission of psychiatric patients and provided clinically significant outcomes by having positive impacts on patient care and outcomes as the patients received improved discharge planning

The Niger Delta wetland ecosystem: What threatens it and why should we protect it?

The Niger Delta wetland ecosystem is of high economic importance to the local dwellers and the nation in general. The region is rich in both aquatic and terrestrial biodiversity and serves as a main source of livelihood for rural dwellers as well as stabilizing the ecosystem. Tremendous changes have occurred recently in the Niger Delta wetlands due to anthropogenic activities, thus raising awareness on the need for effective monitoring, protection and conservation of the wetland ecosystem. A good knowledge of the services provided by wetland ecosystems is an important key for an effective ecosystem management. The aim of this paper therefore was to review the importance of wetland resources, their threats and the need to protect them. This review shows that the region is rich in biodiversity of high economic importance to national development, and has been under severe threat from human activities, especially pollution. It is recommended that effective monitoring be employed using modern techniques such as GIS and remote sensing in the conservation and management of this important ecosystem.Key words: Niger Delta, wetland, ecosystem

Advanced Practice Providers Recognized as Valuable Healthcare Resources: Increasing the Illinois PA’s Scope of Practice to Match Their NP Cohort

Abstract: Nurse practitioners (NPs) and physician assistants (PAs) represent a group of non-physician, advanced-practice providers (APPs) within our healthcare system. Non-physician providers are part of an inter-disciplinary team, working alongside physicians and a variety of allied healthcare providers. The purpose of this paper is to take a closer look at these two professions (NP and PA), with a focus on Illinois providers and the legislative strategies that guide their roles and abilities to practice. Illinois is a region where APP practices are inequitably regulated. Their Nurse Practice Act outlines a broad scope of practice for Advanced Practice Registered Nurses (APRNs). However, the Illinois PA Practice Act barely addresses the PA’s scope of practice, and also delineates certain restrictions, which limit practice in ways not paralleled for the NP. The goal of this paper was to construct an objective comparison between these two APP groups, in order to dispel the misconceptions that have led to these disparate Practice Acts. Specifically, the Master of Science in Nursing - Family Nurse Practitioner (MSN-FNP) training was compared to the Master of Science in Physician Assistant Studies (MSPA or MPAS) degree. Using these criteria, fifteen MSN-FNP programs were compared to nine MSPA programs among Illinois universities. Results revealed that NP and PA programs have similar educational objectives, all with demanding medical curricula, guided by strict accreditation standards. The data further revealed that Illinois PA educational training requires completion of more clinical practicum hours than does NP training: 704 (mean) hours for FNP students; compared to 2,108 (mean) hours for PA students. Furthermore, PA program accreditation requires that students complete practicum hours within seven medical fields, as well as elder care in long-term residential facilities, plus procedural skills training and proof of procedural skills competencies. Most NP programs are online and encourage concurrent nursing employment, thus supporting a part-time course load. NP programs are therefore designed to allow a flexible timeline for completion, some permitting five to six years. In comparison, all PA programs are full-time, in-person curricula, and discourage concurrent employment due to extensive course hours, and stringent requirements for advancement. The bottom line here is, NP and PA programs both have sound delivery methods and rigorous requirements, but longer chronological length should not be misinterpreted as greater in substance. Conclusion: This paper evaluated the highly advanced training programs of NPs and PAs in Illinois and found no data to support the differences in the Illinois Practice Acts governing these two groups. Despite the rigorous, highly advanced, and closely monitored training protocols of PA education, legislative bodies in Illinois do not fully recognize the PA provider’s significant potential. It is therefore, fair and reasonable to request these limitations be re-evaluated, in order to allow Illinois PAs to practice to the full potential of their professional training. In Illinois, NPs have achieved full provider status. Equal designation should be delegated to Illinois PAs

Centro virtual de coordinación del conocimiento en VIH / Sida: experiencia de gestión del conocimiento en políticas en salud

Knowledge management helps to capture and disseminate existing knowledge, creating new knowledge, communication and collaboration between people who have it. Many organizations in Peru which are committed in the fight against HIV-AIDS have contributed to improving society's response to the epidemic; To do this, they have developed various activities and the way they have learned many lessons. However, these had not been systematized much less shared. Network Knowledge Management (RGC) in HIV-AIDS emerges as a community of practice composed of organizations and governmental and non-governmental seeking systematize their best practices effectively and efficiently achieving a collective learning about the achievements and failures in the topic of interest. These experiences are presented on the platform called "Virtual Knowledge Coordination Centre in HIV-AIDS (HIV CVCC)". The National Institute of Health (NIH) in order to meet one of its priorities and research agenda, results of the Concerted Health and contribute to the national policy of modernization of public administration Plan, assumes responsibility for the joint administration and management Peru AIDS Network RGC and HIV CVCC

Measurement of the cross-section of high transverse momentum vector bosons reconstructed as single jets and studies of jet substructure in pp collisions at √s = 7 TeV with the ATLAS detector

This paper presents a measurement of the cross-section for high transverse momentum W and Z bosons produced in pp collisions and decaying to all-hadronic final states. The data used in the analysis were recorded by the ATLAS detector at the CERN Large Hadron Collider at a centre-of-mass energy of √s = 7 TeV;{\rm Te}{\rm V}$and correspond to an integrated luminosity of$4.6\;{\rm f}{{{\rm b}}^{-1}}$. The measurement is performed by reconstructing the boosted W or Z bosons in single jets. The reconstructed jet mass is used to identify the W and Z bosons, and a jet substructure method based on energy cluster information in the jet centre-of-mass frame is used to suppress the large multi-jet background. The cross-section for events with a hadronically decaying W or Z boson, with transverse momentum${{p}_{{\rm T}}}\gt 320\;{\rm Ge}{\rm V}$and pseudorapidity$|\eta |\lt 1.9$, is measured to be${{\sigma }_{W+Z}}=8.5\pm 1.7$ pb and is compared to next-to-leading-order calculations. The selected events are further used to study jet grooming techniques