Enhancing On-line Blended Learning Systems Using a New Human-Computer Interaction Educational Methodology

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One Hundred Years of Subnational Public Finances in Colombia

Usando series históricas de ingresos y gastos ejecutados por los distintos niveles de gobierno para el periodo 1923-2020, este documento describe la evolución de los desequilibrios fiscales verticales y horizontales entre el gobierno nacional, los departamentos y los municipios en Colombia. El análisis permite identificar cuatro grandes momentos de las finanzas públicas territoriales en Colombia. Las décadas de 1910 y 1920 constituyen un primer momento marcado por el fortalecimiento de la autonomía fiscal de los gobiernos subnacionales. Posteriormente, con la República Liberal en los treinta, inició un segundo periodo caracterizado por reformas centralizadoras que buscaron robustecer los ingresos del gobierno nacional central, y en menor medida los de municipios y departamentos. En el lapso de 1960-1990, los cambios se enfocaron en corregir los desbalances fiscales existentes a través del aumento de las transferencias a las regiones, la creación de institutos descentralizados y fondos territoriales, y la introducción de un nuevo estatuto tributario territorial en 1983. Finalmente, un último momento inicia con la Constitución Política de 1991, la cual dio un impulso final a la descentralización y abrió el camino hacia las reformas que construyeron el actual marco normativo de las finanzas públicas territoriales en Colombia.Using a novel database of historical series of revenues and expenses of different levels of government between 1923 and 2020, in this paper we describe the evolution of the vertical and horizontal imbalances between central government, states, and municipalities in Colombia. The analysis highlights four big moments of subnational public finances in Colombia. The decades of 1910 and 1920 represent an initial moment that was characterized by the strengthening of local fiscal autonomy. Subsequently, a second period started with the Liberal Republic in 1930 and was driven by centralized reforms that aimed at increasing the revenues of the central government, and to a lower extent of subnational governments. In the lapse 1960-1990, changes focused on correcting the existing fiscal imbalances through the increase in transfers, the creation of decentralized institutes and territorial funds, and the introduction of changes to the territorial tax system. Finally, the last period began with the Political Constitution of 1991, which gave a final boost to decentralization and opened the way to the reforms that built the actual regulatory framework of territorial public finances in Colombia.Enfoque La estructura de gobierno de cualquier país alrededor del mundo es un reflejo de su historia. En el caso de Colombia, la heterogeneidad que ha caracterizado a sus regiones, sumado a la tendencia a concentrar las fuentes de ingreso más lucrativas en el orden nacional se ha traducido en una historia de vaivenes entre descentralización y centralización. Solo en el último siglo, y específicamente en el campo fiscal, es posible identificar varios periodos de cambios en el grado de autonomía de los gobiernos territoriales frente al poder del gobierno nacional central. A pesar de los avances, las finanzas públicas territoriales, y en general la política fiscal colombiana, tienen aún un largo camino por recorrer con grandes retos y problemáticas por abordar. El estado colombiano continúa siendo relativamente pequeño. Según las estadísticas fiscales del Fondo Monetario Internacional (FMI), la carga tributaria y el gasto público del gobierno general como porcentaje del PIB en 2020 fueron 18,7% y 37,2%, respectivamente; comparado con un 33,5% y 47,6% observado en el promedio de los países de la OCDE. Además, por el lado de los ingresos y en el sector público en general, se destaca el bajo dinamismo de los tributos territoriales en los últimos cien años. Contribución Las particularidades de las finanzas territoriales en Colombia y los distintos procesos en los que se han visto enmarcadas a lo largo del tiempo, hacen que el estudio de su historia sea la evidencia más directa para contribuir a su comprensión y a la construcción de una agenda para avanzar en su fortalecimiento. Este documento presenta cien años de historia de finanzas públicas territoriales en Colombia, cubriendo el periodo 1923 - 2020. Específicamente, se estudia la evolución de las principales fuentes de ingresos y componentes de gasto de municipios y departamentos, en el marco de las principales transformaciones económicas y políticas del país y sus territorios a lo largo del siglo. Resultados Para cuantificar la situación fiscal territorial, se construyeron series de ingresos y gastos de municipios y departamentos consistentes metodológicamente durante los años señalados. A diferencia de trabajos previos, en este caso se desagregan las series de ingresos y gastos a través de sus principales componentes y por departamentos, permitiendo un análisis más profundo de la situación fiscal regional a lo largo del periodo estudiado. Los hallazgos de esta investigación indican que la administración del Estado colombiano ha tenido un movimiento pendular entre descentralización y centralización durante la vida republicana del país. Esos cambios se han originado por crisis económicas que fueron enfrentadas con el fortalecimiento de los tributos nacionales y el aumento de la presencia del Estado en las regiones rezagadas. Por otra parte, las condiciones geográficas, el escaso desarrollo y la limitada integración de los distintos territorios han hecho de Colombia un país de regiones aisladas y grandes divergencias en el acceso a bienes y servicios públicos básicos. Estas últimas circunstancias han sido enfrentadas con una mayor descentralización, entregando más autonomía a las entidades territoriales en las decisiones de asignación del gasto. Si se tienen en cuenta las mejoras en las condiciones de bienestar registradas en Colombia en el siglo XX, se podría afirmar que los vaivenes mencionados han permitido mejorar las condiciones de vida de los colombianos sin distinción de los esquemas fiscales particulares de cada periodo

Factores influyentes en el clima organizacional de la clínica Urocaq

GraficasEl clima organizacional se reconoce como un elemento importante en el crecimiento empresarial, ya que es clave para el cumplimiento de objetivos y actividades necesarias para la empresa. En este trabajo queremos hacer un estudio del clima organizacional de la Empresa Clínica UROCAQ, puesto que en esta se viene mostrando comportamientos y factores que alteran el clima laboral generando que los colaboradores no realicen adecuadamente sus actividades, para así poder conocer cuáles son las razones por las cuales este afectado. En el estudio que se realizó a la organización se asentara en un Modelo de Desarrollo de Clima organizacional donde se utilizaran el método analítico y sintético; el primero se basa en especificar los elementos de los fenómenos presentados mediante la revisión de cada uno por separado, para así determinar la relación que hay; el segundo método se basa en analizar los aspectos teóricos, todo esto para ayudar en la mejora de las relaciones de los colaboradores.The organizational climate is recognized as an important element in business growth, since it is key to the fulfillment of objectives and activities necessary for the company. In this work we want to make a study of the organizational climate of the UROCAQ Clinic Company, since it has been showing behaviors and factors that alter the work environment, causing employees not to carry out their activities properly, in order to know what are the reasons why which is affected. In the study that was carried out, the organization was based on an Organizational Climate Development Model where the analytical and synthetic method was used; The first is based on specifying the elements of the phenomena presented by reviewing each one separately, in order to determine the relationship that exists; The second method is based on analyzing the theoretical aspects, all this to help improve the relationships of the collaborators

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The SIB Swiss Institute of Bioinformatics' resources: focus on curated databases

The SIB Swiss Institute of Bioinformatics (www.isb-sib.ch) provides world-class bioinformatics databases, software tools, services and training to the international life science community in academia and industry. These solutions allow life scientists to turn the exponentially growing amount of data into knowledge. Here, we provide an overview of SIB's resources and competence areas, with a strong focus on curated databases and SIB's most popular and widely used resources. In particular, SIB's Bioinformatics resource portal ExPASy features over 150 resources, including UniProtKB/Swiss-Prot, ENZYME, PROSITE, neXtProt, STRING, UniCarbKB, SugarBindDB, SwissRegulon, EPD, arrayMap, Bgee, SWISS-MODEL Repository, OMA, OrthoDB and other databases, which are briefly described in this article

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Can a Learning Companion Be Used to Continue Teaching Programming to Children Even During the COVID-19 Pandemic?

Learning how to program in Primary Education has attracted significant research in recent years. It is unclear though how programming environments and languages should be adapted to children to achieve better learning and use, but one trend seems to be the use of Scratch. The question in this paper is what programming environment can be used to continue teaching programming to children who have already been taught Scratch for years. This paper's proposal is that students aged between 10 and 12 can benefit from interacting with a friendly learning companion using p-code such as Alcody. The hypothesis is that students (aged between 10 and 12) with a knowledge of Scratch will be able to significantly improve their scores by using a learning companion to teach them how to program even during the COVID-19 pandemic. To check the hypothesis, an experiment was carried out during the 2019/2020 academic year with 137 students in Ecuador. A significant improvement in the scores of the students was recorded together with high satisfaction