La amenaza de ISIS : una respuesta en la política exterior Francesa

La presente investigación tiene como objetivo principal comprender e interpretar los efectos de la Política Exterior francesa a partir de la amenaza sistémica y la estrategia de posicionamiento transnacional del Estado Islámico. El análisis toma en cuenta las diversas dinámicas en la Arena Internacional a través de las respuestas del Estado francés frente a la estrategia y las tácticas implementadas por el Estado IslámicoThe main objective of this research is to understand and interpret the effects of the French Foreign Policy based on the systemic threat and the strategy of transnational positioning of the Islamic State. The analysis takes into account the various dynamics in the International Arena through the responses of the French State to the strategy and tactics implemented by the Islamic StateInternacionalistaPregrad

Línea de investigación en Helicobacter pylori para la formación de recurso humano en ciencia, tecnología e innovación en el programa de microbiología

Este libro nace de la unión de un maestro altamente calificado y alumnos dedicados con unas creatividades activas y dispuestas a trabajar por resolver los problemas que trae una bacteria a la humanidad. Las investigaciones aquí consignadas son producto de los trabajos de grado de los estudiantes del programa de Microbiología, quienes además fueron miembros del semillero de investigación, MICROORGANISMOS DE IMPORTANCIA EN SALUD HUMANA Y ANIMAL “OBVIO-MICROBIO”. Apoyados y dirigidos por la doctora Adalucy Alvarez-Aldana, quien gracias a su amplio conocimiento en el microorganismo supo sembrar curiosidad sobre el mismo durante las sesiones del semillero, incentivando a muchos de sus alumnos a dedicar su trabajo de grado a resolver alguna pregunta que les surgiera en torno a este microorganismo. Aunque diferentes son las investigaciones, todas fueron trazadas con un fin común, entregarle a la humanidad un poco más de conocimiento sobre Helicobacter pylori, por esto la unión de estas investigaciones en una sola consigna, son importantes para entender más sobre todo lo que rodea esta bacteria y pretenden resolver muchos misterios que aún aquejan la epidemiología detrás de la misma. Estos trabajos son fruto de muchos esfuerzos, materiales y académicos, de personas grandiosas, de la unión de universidades, doctores y docentes de diferentes disciplinas, razón que demuestra una vez más que la unión hace la fuerza, porque solo llegarás más rápido, pero en compañía llegarás más lejos. Además, contamos con la fortuna de tener un capitulo invitado, cuyo tema no es sobre Helicobacter pylori, pero si un sobre un tópico de gran interes en la actualidad como es la resistencia bacteriana. Capitulo titulado: “Caracterización epidemiológica y microbiológica de las bacteriemias y su perfil de resistencia durante el periodo junio 2011 a junio 2015”

Recomendaciones para el dise\uf1o y ejecuci\uf3n de programas educativos en el marco del aprendizaje a lo largo de la vida. Experiencias de las universidades socias del Proyecto TRALL (programa ALFAIII de la Comisi\uf3n Europea).

The publication contains a compilation of lifelong learning innovations. Sharing of experiences and strategies on lifelong learnings integral to UIL\u92s mission and in line with this spirit, the three year TRALL project has shown the importance of promoting synergies instead of the usual dispersion of efforts in the Latin American region. Such projects as TRALL and the resulting publicationare an important way to add value to the many learning reforms different actors are conducting in the different countries in the Latin American region. Imparting and taking on board good practices lead to common understanding and convergence in outlook. At the same time, learning from different country contexts is considered to be relevant for promoting the idea of social diversity. The report Learning to Be commissioned by UNESCO in 1972 (Faure et al., 1972) advocated lifelong education in both developed and developing countries, recognising education as universal and lifelong, and open to all. The UNESCO Report Learning: the Treasure Within (Delors et al., 1996), acknowledged lifelong learning as one of the guiding and organising principles of educational action and reform that underlines the essential role learning plays for both society and individuals.Despite the integrative understanding lifelong learning promoted since 1972, today most education systems are still not in a position to offer quality lifelong learning opportunities for all. Making it a reality implies holistic and sector-wide educational reform involving all sub-sectors and education levels of the education system to ensure the creation of learning opportunities in all settings or delivery modalities (formal, non-formal and informal) for people of all ages, and meeting a wide range of learning needs. Recent developments have reinforced the relevance of lifelong learning. These include an increasingly globalised world, the need for maintain peace and security, the introduction of new technologies, the exponential growth and changing nature of information, demographic shifts and social transformations, climate change and sustainable development, and the need of citizens to upgrade competences to meet labour market, social and environmental demands. Lifelong learning policies in the Latin American region need to be supported by broad social consensus,legislative instruments and coordination mechanism. As lifelong learning activities no longer fall exclusively within the domain of Ministries of Education, a mechanism for facilitating collaboration among various sectors and stakeholder is indispensable. Certain support structures are needed to facilitate lifelong learning. These include on the one hand, a full range of provision of education and learning opportunities, including guidance and counselling; as well as effective information and communication tools, and conducive learning environments and resources. To facilitate lifelong learning and provide incentives for learners, a learning outcomes-based qualifications framework and a coordinated approach to assessment and recognition of learning outcomes in non-formal and informal settings are required

Revista Temas Agrarios Volumen 26; Suplemento 1 de 2021

1st International and 2nd National Symposium of Agronomic Sciences: The rebirth of the scientific discussion space for the Colombian Agro.1 Simposio Intenacional y 2 Nacional de Ciencias Agronómicas: El renacer del espacio de discusión científica para el Agro colombiano

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research