Tics y efectividad en la gobernanza para el desarrollo sostenible

This article aims to determine the influence of new information and communication technologies (ICTs) for effective governance, attending the convergence between political communication and participative planning with e-government techniques, to bring citizenship closer to institutionality and to influence decision-making through the case study of PPPs Mi Concejal (My Councilor) and Tico, el buen ciudadano (Tico, the good citizen) (social networks), and its application in planning instruments in Barranquilla district in order to achieve the vision of local-endogenous development that the territory and the communities requireEste artículo tiene por objeto determinar la influencia de las nuevas tecnologías de la información y la comunicación (TICs) para la efectividad en la gobernanza, abordando la convergencia entre comunicación política y planeación participativa con técnicas de gobierno electrónico, para acercar la ciudadanía a la institucionalidad e incidir en la toma de decisiones, a través del estudio de casos de las APPs Mi Concejal y Tico el buen ciudadano (redes sociales), y su aplicación en los instrumentos de planeación en el Distrito de Barranquilla, con el propósito de alcanzar la visión de desarrollo endógeno-local que requieren el territorio y las comunidade

No regresión y justicia ecológica: desafíos para la paz y sostenibilidad en Colombia

Colombia has areas of extremely high environmental relevance due to its megabiodiversity. Precisely in these territories, the armed conflict has been fought, almost completely, suffering devastating impacts in all areas. This has brought related problems that represent great challenges facing the construction of territorial peace and a sustainable post-conflict, and it is necessary to approach them for the democratization of the inherent rights of the social conglomerate close to the conflict and to achieve an effective endogenous-local development based in the principle of non-regression and ecological justice.Colombia cuenta con zonas de altísima relevancia ambiental por su megabiodiversidad. Precisamente en estos territorios se ha librado, casi que a cabalidad, el conflicto armado, sufriendo impactos devastadores en todo ámbito. Esto ha traído problemáticas conexas que representan grandes desafíos frente a la construcción de paz territorial y de un posconflicto sostenible, siendo necesario encararlas para la democratización de los derechos inherentes del conglomerado social cercano al conflicto y en efecto, a un efectivo desarrollo endógeno-local basados en el principio de no regresión y justicia ecológica

Deepening our Understanding of Quality in Australia (DUQuA): a study protocol for a nationwide, multilevel analysis of relationships between hospital quality management systems and patient factors.

INTRODUCTION: Despite the growing body of research on quality and safety in healthcare, there is little evidence of the association between the way hospitals are organised for quality and patient factors, limiting our understanding of how to effect large-scale change. The 'Deepening our Understanding of Quality in Australia' (DUQuA) study aims to measure and examine relationships between (1) organisation and department-level quality management systems (QMS), clinician leadership and culture, and (2) clinical treatment processes, clinical outcomes and patient-reported perceptions of care within Australian hospitals. METHODS AND ANALYSIS: The DUQuA project is a national, multilevel, cross-sectional study with data collection at organisation (hospital), department, professional and patient levels. Sample size calculations indicate a minimum of 43 hospitals are required to adequately power the study. To allow for rejection and attrition, 70 hospitals across all Australian jurisdictions that meet the inclusion criteria will be invited to participate. Participants will consist of hospital quality management professionals; clinicians; and patients with stroke, acute myocardial infarction and hip fracture. Organisation and department-level QMS, clinician leadership and culture, patient perceptions of safety, clinical treatment processes, and patient outcomes will be assessed using validated, evidence-based or consensus-based measurement tools. Data analysis will consist of simple correlations, linear and logistic regression and multilevel modelling. Multilevel modelling methods will enable identification of the amount of variation in outcomes attributed to the hospital and department levels, and the factors contributing to this variation. ETHICS AND DISSEMINATION: Ethical approval has been obtained. Results will be disseminated to individual hospitals in de-identified national and international benchmarking reports with data-driven recommendations. This ground-breaking national study has the potential to influence decision-making on the implementation of quality and safety systems and processes in Australian and international hospitals

Parental distress around supplementing breastfed babies using nasogastric tubes on the post-natal ward: a theme from an ethnographic study

‘The definitive version is available at: www3.interscience.wiley.com ' Copyright Blackwell Publishing. DOI: 10.1111/j.1740-8709.2008.00165.xThere is abundant evidence of the benefits of breastfeeding. In the UK, supplementation in hospital has consistently been shown to be associated with shortened duration of breastfeeding. This paper reports on a subset of the data from an ethnographic study that explored the expectations, beliefs and experiences of mothers and health professionals concerning supplementation, using a variety of methods, of breastfed babies in an English maternity unit in 2002. This paper aims to describe the expectations, beliefs and experiences of mothers and health professionals concerning supplementation by nasogastric (NG) tube on the post-natal ward. Participant observation was carried out on day and night shifts and at weekends over 9 months. Mothers, midwives, neonatal nurses, health care assistants and senior paediatricians were interviewed. Categories and themes were generated. The researchers' constructs of 'the essential method', when the tube was the method needed for medical reasons, and 'the chosen method', when other methods of oral feeding should have been possible, emerged. The latter included time pressures and the avoidance of any form of oral activity that might perhaps make return to the breast more difficult. The data concerning the use of NG tubes for supplementation yielded the specific theme of parental distress. In the absence of evidence that supplementation by NG tube on the post-natal ward is associated with greater breastfeeding success than other methods, the use of the tube to avoid any form of 'oral confusion' should be discontinued. Its use primarily to save time should not be considered acceptable.Peer reviewe

Enfoques alternativos de desarrollo en los instrumentos de planeación del Distrito de Barranquilla

The objective of this article is apply alternative approaches of development on the formulation of planning instruments for in Barranquilla: District Development Plan 2016 - 2019 and territorial arrangement planning 2012 - 2032, being assumed as the vision of development and vision of city respectively. Understanding the territory as the spatial scope of development, the latter is the result of a process of participation aimed at overcoming conflicts, therefore development involves being controversial, polysemic and dynamic, starting from the desired economic and social progress.Este artículo tiene por objeto un análisis de aplicación en los enfoques alternativos de desarrollo formulados en los instrumentos de planeación del distrito de Barranquilla: Plan Distrital de Desarrollo 2016 – 2019 y Plan de Ordenamiento Territorial 2012 – 2032, asumidos desde la visión de desarrollo y de ciudad, respectivamente. Al comprender el territorio como el ámbito de espacialidad del Desarrollo, este último puede tomarse como el resultado de un proceso de participación que tiene como finalidad la superación de conflictos, por tanto, el desarrollo tiende a ser polémico, polisémico y dinámico, partiendo del progreso económico y social deseado

The ‘Healthy Dads, Healthy Kids’ community effectiveness trial: study protocol of a community-based healthy lifestyle program for fathers and their children

Background: The \u27Healthy Dads, Healthy Kids\u27 program was designed to help overweight fathers lose weight and positively influence the health behaviors of their children. The aim of the current study was to evaluate the previously established program in a community setting, in a large effectiveness trial. Methods/Design: The Healthy Dads, Healthy Kids community trial consists of three stages: (i) Stage 1 - program refinement and resource development (ii) Stage 2 - community randomized controlled trial (iii) Stage 3 - community effectiveness trial. The program will be evaluated in five Local Government Areas in the Hunter Valley Region of NSW, Australia. For the community randomized controlled trial, 50 overweight/obese men (aged 18-65 years) from one Local Government Area with a child aged between 5-12 years of age will be recruited. Families will be randomized to either the program or a 6-month wait-list control group. Fathers and their children will be assessed at baseline, post-intervention (3-months) and 6-months. Inclusion criteria are: body mass index 25-40 kg/m2; no participation in other weight loss programs during the study; pass a health-screening questionnaire; and access to a computer with Internet facilities. In the community trial, the program will be evaluated using a non-randomized, prospective design in five Local Government Areas. The exclusion criteria is body mass index \u3c 25 kg/m2 or lack of doctor\u27s approval. Measures will be collected at baseline, 3-, 6- and 12-months. The program involves fathers attending seven face-to-face group sessions (three with children) over 3-months. Measures: The primary outcome is fathers\u27 weight. Secondary outcomes for both fathers and children include: waist circumference, blood pressure, resting heart rate, physical activity, sedentary behaviors and dietary intake. Father-only measures include portion size, alcohol consumption, parenting for physical activity and nutrition and parental engagement. Process evaluation will determine the fidelity, dose (delivered and received), reach, recruitment and context of the program. Discussion: As a unique approach to reducing obesity prevalence in men and improving lifestyle behaviours in children, our findings will provide important evidence relating to the translation of Healthy Dads, Healthy Kids, which will enable it to be delivered on a larger scale

A Century of Drought in Hawaiʻi: Geospatial Analysis and Synthesis across Hydrological, Ecological, and Socioeconomic Scales

Drought is a prominent feature of Hawaiʻi’s climate. However, it has been over 30 years since the last comprehensive meteorological drought analysis, and recent drying trends have emphasized the need to better understand drought dynamics and multi-sector effects in Hawaiʻi. Here, we provide a comprehensive synthesis of past drought effects in Hawaiʻi that we integrate with geospatial analysis of drought characteristics using a newly developed 100-year (1920–2019) gridded Standardized Precipitation Index (SPI) dataset. The synthesis examines past droughts classified into five categories: Meteorological, agricultural, hydrological, ecological, and socioeconomic drought. Results show that drought duration and magnitude have increased significantly, consistent with trends found in other Pacific Islands. We found that most droughts were associated with El Niño events, and the two worst droughts of the past century were multi-year events occurring in 1998–2002 and 2007–2014. The former event was most severe on the islands of O’ahu and Kaua’i while the latter event was most severe on Hawaiʻi Island. Within islands, we found different spatial patterns depending on leeward versus windward contrasts. Droughts have resulted in over $80 million in agricultural relief since 1996 and have increased wildfire risk, especially during El Niño years. In addition to providing the historical context needed to better understand future drought projections and to develop effective policies and management strategies to protect natural, cultural, hydrological, and agricultural resources, this work provides a framework for conducting drought analyses in other tropical island systems, especially those with a complex topography and strong climatic gradients

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Metagenomic Profile of the Bacterial Communities Associated with Ixodes ricinus Ticks

Assessment of the microbial diversity residing in arthropod vectors of medical importance is crucial for monitoring endemic infections, for surveillance of newly emerging zoonotic pathogens, and for unraveling the associated bacteria within its host. The tick Ixodes ricinus is recognized as the primary European vector of disease-causing bacteria in humans. Despite I. ricinus being of great public health relevance, its microbial communities remain largely unexplored to date. Here we evaluate the pathogen-load and the microbiome in single adult I. ricinus by using 454- and Illumina-based metagenomic approaches. Genomic DNA-derived sequences were taxonomically profiled using a computational approach based on the BWA algorithm, allowing for the identification of known tick-borne pathogens at the strain level and the putative tick core microbiome. Additionally, we assessed and compared the bacterial taxonomic profile in nymphal and adult I. ricinus pools collected from two distinct geographic regions in Northern Italy by means of V6-16S rRNA amplicon pyrosequencing and community based ecological analysis. A total of 108 genera belonging to representatives of all bacterial phyla were detected and a rapid qualitative assessment for pathogenic bacteria, such as Borrelia, Rickettsia and Candidatus Neoehrlichia, and for other bacteria with mutualistic relationship or undetermined function, such as Wolbachia and Rickettsiella, was possible. Interestingly, the ecological analysis revealed that the bacterial community structure differed between the examined geographic regions and tick life stages. This finding suggests that the environmental context (abiotic and biotic factors) and host-selection behaviors affect their microbiome