Variabilidad de la profundidad anestésica evaluada mediante el índice de entropía, en anestesia total endovenosa vs. anestesia balanceada, en pacientes llevados a cirugía ortopédica bajo anestesia regional de miembro superior e inferior

Introducción: En la actualidad, la anestesia total endovenosa (TIVA) y la anestesia balanceada son las técnicas más utilizadas para conseguir el mantenimiento de la profundidad anestésica durante la cirugía. Establecer la variación en dicha profundidad podría predecir cuál de esas dos técnicas es más segura y presenta menor riesgo de despertar intra-operatorio. Objetivo: Comparar la variabilidad de la profundidad anestésica de ambas técnicas en busca de diferencias que sugieran superioridad en cuanto a estabilidad y predicción de despertares durante el procedimiento quirúrgico. Métodos: Ensayo clínico aleatorizado, cruzado, controlado y simple ciego llevado a cabo en 20 pacientes programados para cirugía de ortopedia de extremidad superior o inferior. Los pacientes fueron asignados aleatoriamente a: a) infusión controlada por objetivo de propofol con el modelo de Schnider a una concentración en sitio de efecto de 2,5 ug/ml durante 15 minutos, 10 minutos de lavado, seguido de anestesia balanceada con Sevofluorane 0.8 CAM; o b) la secuencia inversa. La diferencia en variabilidad de profundidad anestésica fue evaluada mediante la comparación de registros de índices de entropía con una prueba «t» pareada. Resultados: No hubo evidencia de diferencias significativas de la varianza media en los índices de entropía espectral asociada a las diferentes técnicas. Conclusión: El estudio sugiere que ambas técnicas anestésicas son equivalentes en términos de estabilidad de profundidad anestésica. Es importante continuar estudiando la eficacia en diferentes tipos de población, dado que su comportamiento según características individuales de los pacientes podrían inclinar la balanza.Especialización en Anestesiología y Medicina PerioperatoriaEspecialista en Anestesiología y Medicina Perioperatori

Design of a methodology for the management of organizational improvement projects in Profamilia

En el presente trabajo se propone el diseño de una metodología para la gestión de proyectos de mejora organizacional en Profamilia, a partir de la realización de un diagnóstico de las prácticas actuales de gestión de proyectos internos, elaborando un plan para la implementación de la metodología en la organización. El diagnóstico se basó en la aplicación de instrumentos de tipo cuantitativo y cualitativo previamente validados a funcionarios de diferentes áreas de la organización, para recopilar información respecto a las prácticas, la efectividad y la madurez de la organización en la gestión de proyectos.In this document is proposes the design of a methodology for the management of organizational improvement projects in Profamilia, based on the realization of a diagnosis of current internal project management practices, developing a plan for the implementation of the methodology in the organization. The diagnosis was based on the application of quantitative and qualitative instruments previously validated to officials from different areas of the organization, to gather information regarding the practices, methodology and maturity of the organization in project management.Magíster en Gerencia de Proyecto

Orientaciones para la implementación de la Cátedra de Paz con enfoque de cultura ciudadana : lineamientos para la implementación de políticas, programas y proyectos educativos

La Secretaría de Educación del Distrito de Bogotá, D. C. (SED) presenta a los colegios estas Orientaciones para la implementación de la Cátedra de Paz con enfoque de cultura ciudadana, con las cuales se les invita a reflexionar y generar diálogos sobre por qué es importante una educación para la paz en el contexto particular de su escuela, de la ciudad y del país

Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol.

INTRODUCTION: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION: The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020177408

Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity.

INTRODUCTION: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups. METHODS AND ANALYSIS: Systematic searches of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2021 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index z-score at age 24±6 months using WHO Growth Standards, and effect differences will be explored among prespecified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events. ETHICS AND DISSEMINATION: Approved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations and media releases. PROSPERO REGISTRATION NUMBER: CRD42020177408

Marine Biodiversity in the Caribbean: Regional Estimates and Distribution Patterns

This paper provides an analysis of the distribution patterns of marine biodiversity and summarizes the major activities of the Census of Marine Life program in the Caribbean region. The coastal Caribbean region is a large marine ecosystem (LME) characterized by coral reefs, mangroves, and seagrasses, but including other environments, such as sandy beaches and rocky shores. These tropical ecosystems incorporate a high diversity of associated flora and fauna, and the nations that border the Caribbean collectively encompass a major global marine biodiversity hot spot. We analyze the state of knowledge of marine biodiversity based on the geographic distribution of georeferenced species records and regional taxonomic lists. A total of 12,046 marine species are reported in this paper for the Caribbean region. These include representatives from 31 animal phyla, two plant phyla, one group of Chromista, and three groups of Protoctista. Sampling effort has been greatest in shallow, nearshore waters, where there is relatively good coverage of species records; offshore and deep environments have been less studied. Additionally, we found that the currently accepted classification of marine ecoregions of the Caribbean did not apply for the benthic distributions of five relatively well known taxonomic groups. Coastal species richness tends to concentrate along the Antillean arc (Cuba to the southernmost Antilles) and the northern coast of South America (Venezuela – Colombia), while no pattern can be observed in the deep sea with the available data. Several factors make it impossible to determine the extent to which these distribution patterns accurately reflect the true situation for marine biodiversity in general: (1) highly localized concentrations of collecting effort and a lack of collecting in many areas and ecosystems, (2) high variability among collecting methods, (3) limited taxonomic expertise for many groups, and (4) differing levels of activity in the study of different taxa

Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity

Introduction Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of intervention-covariate interactions. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups

Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol

Introduction Little is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and behaviour change techniques (BCTs), 2) explore similarities and differences in BCTs used to target behaviours, and 3) explore effectiveness of intervention components in preventing childhood obesity

Platform for Plasmodium vivax vaccine discovery and development

Plasmodium vivax is the most prevalent malaria parasite on the American continent. It generates a global burden of 80-100 million cases annually and represents a tremendous public health problem, particularly in the American and Asian continents. A malaria vaccine would be considered the most cost-effective measure against this vector-borne disease and it would contribute to a reduction in malaria cases and to eventual eradication. Although significant progress has been achieved in the search for Plasmodium falciparum antigens that could be used in a vaccine, limited progress has been made in the search for P. vivax components that might be eligible for vaccine development. This is primarily due to the lack of in vitro cultures to serve as an antigen source and to inadequate funding. While the most advanced P. falciparum vaccine candidate is currently being tested in Phase III trials in Africa, the most advanced P. vivax candidates have only advanced to Phase I trials. Herein, we describe the overall strategy and progress in P. vivax vaccine research, from antigen discovery to preclinical and clinical development and we discuss the regional potential of Latin America to develop a comprehensive platform for vaccine development

Diseño de un modelo de abastecimiento para la Arrocera la Esmeralda S.A.S

Existen empresas cuyos costos de adquisición requieren ser revisados, buscando evaluar su rentabilidad y dónde sus leads times son elevados, tal como en la empresa objeto de estudio, compañía dedicada a la producción y comercialización de Arroz en el suroccidente colombiano y que, actualmente, se encuentra en expansión en el interior del país; Es por eso que el área de abastecimiento se vuelve protagonista, entendiendo que es un proceso estratégico que implica la planificación y gestión eficiente de la cadena de suministro de una organización dónde su objetivo principal es asegurar que los productos o servicios necesarios este disponibles en el momento adecuado, en la cantidad adecuada y al costo adecuado. Es por ello que, dado el impacto del proceso de abastecimiento, en este proyecto se diseñó un modelo de abastecimiento para el material de empaque para Arrocera La Esmeralda S.A.S. Con base a lo anterior, para esta investigación se sistematizó el proceso de abastecimiento de la Arrocera La Esmeralda SAS por medio del levantamiento de información realizado a través los manuales de función y procedimientos, así como la caracterización del proceso y los manuales del mismo, con el fin de realizar una evaluación inicial para, seguidamente, realizar el diagrama de flujo del proceso que permita identificar las actividades que generan valor, ello apoyado de la herramienta Value Stream Mapping dónde se evidencio que el ciclo de compra esta alrededor de los 30 días, desde que se realiza la solicitud de materia prima hasta que se entrega el material al área de producción. Seguido a esto, se realizó una caracterización de las prácticas de abastecimiento en empresas de consumo masivo dónde se seleccionó 3 aportes teóricos, para la planeación se utilizó MRP, para el diseño de procesos se recurrió a Lean buying management y para la optimización de costos se implementó la Matriz de Kraljic. Por último, se planteó un modelo que permitiera clasificar el material de empaque y diseñar estrategias de abastecimiento a partir de la metodología propuesta por Kraljic, además disminuir el ciclo de compra a 18 días gracias al VSM.There are companies whose acquisition costs need to be reviewed, seeking to assess their profitability and where their lead times are high, such as the company under study, a company dedicated to the production and marketing of rice in southwestern Colombia and which, currently, it is expanding in the interior of the country; That is why the supply area becomes the protagonist, understanding that it is a strategic process that implies the planning and efficient management of the supply chain of an organization where its main objective is to ensure that the necessary products or services are available at the moment. right, in the right amount, and at the right cost. That is why, given the impact of the supply process, in this project, a supply model was designed for the packaging material for Arrocera La Esmeralda S.A.S. Based on the above, for this investigation, the supply process of Arrocera La Esmeralda SAS was systematized through the gathering of information carried out through the function and procedures manuals, as well as the characterization of the process and the manuals of the same, with to carry out an initial evaluation to, subsequently, carry out the flowchart of the process that allows identifying the activities that generate value, this supported by the Value Stream Mapping tool where it was evidenced that the purchase cycle is around 30 days, from the time the request for raw material is made until the material is delivered to the production area. Following this, a characterization of the supply practices in mass consumption companies was carried out where 3 theoretical contributions were selected, MRP was used for planning, Lean buying management was used for process design and cost optimization was used. implemented the Kraljic Matrix. Finally, a model was proposed to classify the packaging material and design supply strategies based on the methodology proposed by Kraljic, in addition to reducing the purchase cycle to 18 days thanks to the VSM.Tesis (Magíster en Administración de Empresas)-- Universidad Autónoma de Occidente, 2023MaestríaMagíster en Administración de Empresa