Autopercepción del estado de salud: una aproximación al los ancianos en México

OBJECTIVE: To evaluate health status of the elderly in Mexico through their self-perception and to describe social, organizational and health-related factors. METHODS: A study was carried out on secondary data from the 2000 National Health Survey in Mexico. Multiple logistic regression models were used. The dependent variable health status was measured through self-perception. The independent variables included were: sociodemographic characteristics, risk behaviors, accidents, disease diagnosis and clinical measures. RESULTS: A total of 7,322 adults aged 60 years and older were studied, which represents 7% of the total population in that age group in Mexico. Of them, 19.8% reported poor or very poor health status. Factors found to be associated to poor health were age, female sex, having no social security, being divorced, homemaker, disabled, unemployed, tobacco consumption, having a health condition, accidents and diagnosed with chronic diseases. CONCLUSIONS: The study allowed to identifying factors that may contribute to poor health status in the elderly. These findings could be taken into account in the development of actions and health care programs for this population in Mexico.OBJETIVO: Evaluar el estado de salud de los ancianos mexicanos a través de la autopercepción y analizar los factores sociales, de salud y organizacionales asociados. MÉTODOS: Estudio de datos secundarios de la Encuesta Nacional de Salud 2000 en México. Se realizó análisis de regresión logística múltiple. La variable dependiente fue el estado de salud medido a través de la autopercepción de salud. Las variables independientes seleccionadas fueron: características sociodemográficas, hábitos de riesgo, accidentes, diagnóstico de enfermedades y mediciones clínicas. RESULTADOS: Se analizó a 7,322 adultos de 60 años y mayores, que representan al total de la población (7%) en ese grupo de edad en México. De estos, 19.8% reportó estado de salud como malo o muy malo. Los factores asociados a mala salud fueron edad, sexo femenino, no tener seguro social, ser divorciado, dedicarse al hogar, estar incapacitado, no tener trabajo, consumo de tabaco, problema de salud, accidentes y diagnóstico de enfermedades crónicas. CONCLUSIONES: El análisis de factores asociados permitió determinar elementos que influyen en mal estado de salud de ancianos. Los hallazgos podrían considerarse en la formulación de acciones y programas de atención para esa población en México

Catastro y georreferenciación de la red de acueducto de la ciudad de Armenia

Dado que el país se encuentra en un proceso de mejoramiento de todas las entidades estatales, los servicios públicos domiciliarios se han convertido en una de las principales prioridades del gobierno nacional y es por esto que el PLAN MAESTRO DE ACUEDUCTO ha sido adoptado por las Empresas Públicas de Armenia (EPA), con el propósito de ser utilizado como una herramienta eficaz para la actualización de todas las redes de distribución de agua potable, ya que es un requisito de ley indispensable (Resolución 1096 noviembre 17 2000) para todas las empresas prestadoras de servicios públicos del estadoIntroducción 12 1. Tema 13 2. Problema 14 3. Justificación 15 4. Objetivos 16 4.1 Objetivos Generales 16 4.2 Objetivos Específicos 16 5. Empresas públicas de Armenia 17 5.1 Ambientación y reseña 17 5.2 Marco Referencial 17 5.3 Marco Legal 18 5.4 Marco Teórico 22 5.5 Especificaciones Técnicas 26 6. Metodología 28 7. Catastro y georreferenciación 29 7.1 Catastro de Redes 29 7.2 Georreferenciación 29 7.3 Fase de Inspección 32 7.4 Fase de Referenciación 33 7.5 Fase de Dibujo e Informe 33 7.6 Fase de Georreferenciación 34 7.7 Presentación Carteras de Campo 35 8. Consolidado 36PregradoTecnólogo en Topografí

Renal Sympathetic Denervation for Treatment of Resistant Hypertension

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The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial

Abstract Background: Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity. Objectives: To assess the effectiveness of a Primary Health Care (PHC) based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period. Research Design: Randomized controlled trial. Subjects: Three hundred and sixty-two (n = 362) inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD); 68.3 (8.8) years; 118 women) were randomly allocated to the physical activity program (IG). One hundred and seventy-nine patients (n = 179; 67.2 (9.1) years; 106 women) were allocated to the control group (CG). The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources. Measures: The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2) was assessed at baseline (month 0), at the end of the intervention (month 3), and at 12 months follow-up after the end of the intervention (month 15). Results: The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5). The CG remained about the same: 18.2 (11.1) (P = .002). Conclusions: Our findings indicate that a 3-month physical activity program linked to community resources is a shortduration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits. Trial Registration: ClinicalTrials.gov NCT0071483

Regulatory sites for splicing in human basal ganglia are enriched for disease-relevant information

Genome-wide association studies have generated an increasing number of common genetic variants associated with neurological and psychiatric disease risk. An improved understanding of the genetic control of gene expression in human brain is vital considering this is the likely modus operandum for many causal variants. However, human brain sampling complexities limit the explanatory power of brain-related expression quantitative trait loci (eQTL) and allele-specific expression (ASE) signals. We address this, using paired genomic and transcriptomic data from putamen and substantia nigra from 117 human brains, interrogating regulation at different RNA processing stages and uncovering novel transcripts. We identify disease-relevant regulatory loci, find that splicing eQTLs are enriched for regulatory information of neuron-specific genes, that ASEs provide cell-specific regulatory information with evidence for cellular specificity, and that incomplete annotation of the brain transcriptome limits interpretation of risk loci for neuropsychiatric disease. This resource of regulatory data is accessible through our web server, http://braineacv2.inf.um.es/

Identification of novel risk loci, causal insights, and heritable risk for Parkinson's disease: a meta-analysis of genome-wide association studies

Background Genome-wide association studies (GWAS) in Parkinson's disease have increased the scope of biological knowledge about the disease over the past decade. We aimed to use the largest aggregate of GWAS data to identify novel risk loci and gain further insight into the causes of Parkinson's disease. Methods We did a meta-analysis of 17 datasets from Parkinson's disease GWAS available from European ancestry samples to nominate novel loci for disease risk. These datasets incorporated all available data. We then used these data to estimate heritable risk and develop predictive models of this heritability. We also used large gene expression and methylation resources to examine possible functional consequences as well as tissue, cell type, and biological pathway enrichments for the identified risk factors. Additionally, we examined shared genetic risk between Parkinson's disease and other phenotypes of interest via genetic correlations followed by Mendelian randomisation. Findings Between Oct 1, 2017, and Aug 9, 2018, we analysed 7·8 million single nucleotide polymorphisms in 37 688 cases, 18 618 UK Biobank proxy-cases (ie, individuals who do not have Parkinson's disease but have a first degree relative that does), and 1·4 million controls. We identified 90 independent genome-wide significant risk signals across 78 genomic regions, including 38 novel independent risk signals in 37 loci. These 90 variants explained 16–36% of the heritable risk of Parkinson's disease depending on prevalence. Integrating methylation and expression data within a Mendelian randomisation framework identified putatively associated genes at 70 risk signals underlying GWAS loci for follow-up functional studies. Tissue-specific expression enrichment analyses suggested Parkinson's disease loci were heavily brain-enriched, with specific neuronal cell types being implicated from single cell data. We found significant genetic correlations with brain volumes (false discovery rate-adjusted p=0·0035 for intracranial volume, p=0·024 for putamen volume), smoking status (p=0·024), and educational attainment (p=0·038). Mendelian randomisation between cognitive performance and Parkinson's disease risk showed a robust association (p=8·00 × 10−7). Interpretation These data provide the most comprehensive survey of genetic risk within Parkinson's disease to date, to the best of our knowledge, by revealing many additional Parkinson's disease risk loci, providing a biological context for these risk factors, and showing that a considerable genetic component of this disease remains unidentified. These associations derived from European ancestry datasets will need to be followed-up with more diverse data. Funding The National Institute on Aging at the National Institutes of Health (USA), The Michael J Fox Foundation, and The Parkinson's Foundation (see appendix for full list of funding sources)

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Identification of candidate Parkinson disease genes by integrating genome-wide association study, expression, and epigenetic data sets

Importance Substantial genome-wide association study (GWAS) work in Parkinson disease (PD) has led to the discovery of an increasing number of loci shown reliably to be associated with increased risk of disease. Improved understanding of the underlying genes and mechanisms at these loci will be key to understanding the pathogenesis of PD. Objective To investigate what genes and genomic processes underlie the risk of sporadic PD. Design and Setting This genetic association study used the bioinformatic tools Coloc and transcriptome-wide association study (TWAS) to integrate PD case-control GWAS data published in 2017 with expression data (from Braineac, the Genotype-Tissue Expression [GTEx], and CommonMind) and methylation data (derived from UK Parkinson brain samples) to uncover putative gene expression and splicing mechanisms associated with PD GWAS signals. Candidate genes were further characterized using cell-type specificity, weighted gene coexpression networks, and weighted protein-protein interaction networks. Main Outcomes and Measures It was hypothesized a priori that some genes underlying PD loci would alter PD risk through changes to expression, splicing, or methylation. Candidate genes are presented whose change in expression, splicing, or methylation are associated with risk of PD as well as the functional pathways and cell types in which these genes have an important role. Results Gene-level analysis of expression revealed 5 genes (WDR6 [OMIM 606031], CD38 [OMIM 107270], GPNMB [OMIM 604368], RAB29 [OMIM 603949], and TMEM163 [OMIM 618978]) that replicated using both Coloc and TWAS analyses in both the GTEx and Braineac expression data sets. A further 6 genes (ZRANB3 [OMIM 615655], PCGF3 [OMIM 617543], NEK1 [OMIM 604588], NUPL2 [NCBI 11097], GALC [OMIM 606890], and CTSB [OMIM 116810]) showed evidence of disease-associated splicing effects. Cell-type specificity analysis revealed that gene expression was overall more prevalent in glial cell types compared with neurons. The weighted gene coexpression performed on the GTEx data set showed that NUPL2 is a key gene in 3 modules implicated in catabolic processes associated with protein ubiquitination and in the ubiquitin-dependent protein catabolic process in the nucleus accumbens, caudate, and putamen. TMEM163 and ZRANB3 were both important in modules in the frontal cortex and caudate, respectively, indicating regulation of signaling and cell communication. Protein interactor analysis and simulations using random networks demonstrated that the candidate genes interact significantly more with known mendelian PD and parkinsonism proteins than would be expected by chance. Conclusions and Relevance Together, these results suggest that several candidate genes and pathways are associated with the findings observed in PD GWAS studies

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Formulación de medidas preventivas y/o correctivas para la estabilización del talud ubicado en la vereda charco rico- ibague

El presente trabajo se enfoca en establecer un método preventivo el cual permita la estabilización de un talud ubicado en la vía que comunica la vereda Charco Rico con el municipio de Ibagué; para el desarrollo del mismo fue necesario realizar una revisión de los documentos otorgados por parte de la Universidad Cooperativa de Colombia en el trabajo formulado por (Portela, 2020), como los antecedentes, la topografía y las condiciones geomecánicas del suelo donde se trabajará, para luego con estos datos realizar el cálculo del factor de seguridad con diferentes métodos de análisis. Para determinar el factor de seguridad fue necesario implementar el uso del software SLIDE y determinar una serie de variables necesarias para su correcto análisis de estabilidad, entre las cuales, se determinó por cartografía básica la litología en la zona la cual se define tres tipos de rocas ígneas las cuales son el balolito de Ibagué, rocas hipoabisales y depósitos piroclasticos, las cuales registran presencia en la zona. Adicional, en base a la zonificación sísmica se evidencia que el talud se encuentra ubicado en una zona de amenaza alta, debido al riesgo de una posible ocurrencia de liberación de energía por fallas cercanas. También, se realizó el estudio hidrológico en la zona de estudio, con el análisis y la condensación de los datos históricos pluviométricos extraídos de la estación La Martinica, en donde se obtuvo valores máximos de precipitación registrados en los años los años 2014 y 2015, con valores de 59.4 mm y 52.6 mm, respectivamente, con una intensidad de lluvia de 21.88 mm/h lo que deja evidencia la altas precipitaciones en la zona y determina un caudal máximo de drenaje el cual es de 2.01 LP*S, dicho caudal es importante para el diseño de obras de complementarias. Tomando como referencia los resultados obtenidos con el software SLIDE, se plantea tres métodos de estabilización para el talud en estudio, en donde se determinó en base a la simulación que el método de bioingeniería a base de trincho de guadua, fue el que obtuvo mayor factor de seguridad estando por encima de 1, valor que define el grado de estabilidad en función del riesgo de pérdidas humanas.The present work focuses on establishing a preventive method which allows the stabilization of a slope located on the road that connects the Charco Rico village with the municipality of Ibagué; For its development, it was necessary to carry out a review of the documents granted by the Cooperative University of Colombia in the work formulated by (Portela, 2020), such as the background, the topography and the geomechanical conditions of the soil where it will be worked, to Then, with these data, calculate the safety factor with different analysis methods. To determine the safety factor, it was necessary to implement the use of the SLIDE software and determine a series of variables necessary for its correct stability analysis, among which, the lithology in the area was determined by basic cartography, which defines three types of rocks. igneous which are the Ibagué balolith, hypoabyssal rocks and pyroclastic deposits, which register presence in the area. Additionally, based on seismic zoning, it is evident that the slope is located in a high hazard zone, due to the risk of a possible occurrence of energy release by nearby faults. Also, the hydrological study was carried out in the study area, with the analysis and condensation of the historical pluviometric data extracted from the La Martinica station, where maximum precipitation values recorded in the years 2014 and 2015 were obtained, with values of 59.4 mm and 52.6 mm, respectively, with a rainfall intensity of 21.88 mm/h, which shows the high rainfall in the area and determines a maximum drainage flow which is 2.01 LP*S, this flow is important for the design of complementary works. Taking as reference the results obtained with the SLIDE software, three stabilization methods are proposed for the slope under study, where it was determined based on the simulation that the bioengineering method based on guadua tricho, was the one that obtained the highest factor. of security being above 1, a value that defines the degree of stability based on the risk of human losses.Glosario -- Resumen -- Introducción -- 1.Descripción del problema. --2.Justificación.-- 3.Objetivos. -- 3.1. Objetivo general. -- 3.2. Objetivos específicos. -- 4. Marco teórico. -- 4.1. Análisis De Riesgo, Amenaza Y Vulnerabilidad. -- 4.2. Talud. -- 4.2.1. Partes de un Talud -- 4.3. Eventualidades de falla -- 4.3.1. Clasificación de Movimientos de Masas. -- 4.3.1.1. Movimiento con predominio de la trayectoria vertical. -- 4.4. Métodos para la estabilidad de un talud. -- 4.4.1 Excavación y/o relleno. -- 4.4.2. Pantallas. -- 4.4.3 Gaviones. -- 4.4.4 Muros de contención. -- 4.4.5 Mallas y mantas y orgánicas. -- 4.4.6 Trinchos en guadua. -- 5. Localizacion y georreferenciación. -- 6. metodología. -- 6.1. Visita de campo. -- 6.1.1 Percepción del Riesgo. -- 6.1.1.1. Muestra. -- 6.2. Análisis de información secundaria. -- 6.3. Estudios de amenaza, vulnerabilidad y riesgo por movimientos remoción en masa -- 6.3.1. Zonificación de amenazas por sismo. -- 6.3.2. Amenaza por eventos de remoción en masa. -- 6.3.3. Análisis Hidrológico. -- 6.3.3.1. Precipitaciones de lluvia de la zona. -- 6.3.3.1.1. Cálculo de curvas IDF por el método simplificado. -- 6.4. Caudal de drenaje. -- 6.4.1. Periodo de Retorno. -- 6.4.2. Tiempo de Concentración -- 6.4.3. Coeficiente de Escorrentía. -- 6.5. Caracterización de talud. -- 6.6. Metodo de estabilización. -- 6.6.1. Modelación del talud con Nivel freático y Sismo. -- 6.6.2.1. Método de estabilización con muro de contención, terraceo y geotextil. -- 6.6.3. Método de estabilización en pantallas ancladas en Concreto. -- 6.6.4. Método de estabilización con trinchos de guadua. -- 6.7. Diseño del sistema desagüé -- 7. Resultados. -- 7.1. Visita de campo. -- 7.1.1. Percepción del riesgo. -- 7.2. Análisis de información secundaria. -- 7.3. Variables geoambientales -- 7.3.1. Zonificación de amenazas por sismo. -- 7.3.2. Litología de sector. -- 7.3.2.2. Análisis de la cartografía de amenaza por remoción en masa. -- 7.3.3. Análisis Hidrológico. -- 7.3.3.1. Precipitaciones de Lluvia. -- 7.3.3.2. Cálculo de curvas IDF por el método simplificado. -- 7.4. Caudal de diseño. -- 7.4.1. Tiempo de Concentración. -- 7.4.2. Periodo de Retorno. -- 7.4.3. Intensidad de Lluvia. -- 7.4.4. Área drenada. -- 7.4.5. Coeficiente de Escorrentía. -- 7.5. Formato de caracterización de talud. -- 7.6. Método de estabilización. -- 7.6.1. Determinación del factor de seguridad. -- 7.6.2.1. Métodos de estabilización combinado muro de contención, terraceo y geotextil. -- 7.6.2.2 Método de estabilización en pantallas ancladas en Concreto. -- 7.6.2.3. Método de estabilización con trinchos de guadua. -- 7.7. Diseño del sistema desagüé -- 8. Conclusiones. -- 9. Recomendaciones. -- Bibliografía -- [email protected]@[email protected]