El matrimonio igualitario en Colombia : un diálogo con la convencionalidad

El objeto de esta investigación es determinar si el Estado colombiano, a través de sus diferentes operadores jurídicos, realizó un adecuado control de convencionalidad, al momento de definir si las parejas del mismo sexo tenían o no derecho a contraer nupcias. Para tal efecto, se expone la evolución que tuvo el reconocimiento de los derechos de los homosexuales en su ámbito individual y de pareja, así como también en el campo del matrimonio igualitario, análisis que se realiza tanto en el sistema colombiano, como en el interamericano. Finalmente, se hace un ejercicio descriptivo y analítico, para constatar si Colombia realizó una adecuada interpretación de las normas y principios de índole convencional, en las oportunidades en las que tuvo que pronunciarse sobre el derecho de las parejas gais a casarse.The subject of this investigation, is determine whether the Colombian Government through its different legal operators, performed a “conventionality control” at the time of define either the same-sex couples had or non-rights to married. To this end, will show the development of the gays rights recognition both individual and relationship scopes in the Colombian and Interamerican legal system and Thereafter the same analysis will be carried out with regard of equality marriage. Finally, an analytical and descriptive exercise it shall be done to establish if Colombia perform made an adequate interpretations of rules, conventional treaty principles, in the opportunities which had to rule about the right of the same-sex couples to married, in order to establish whether the Colombia state could be internationally responsible or by contrast will exceed the “Concentrated Conventionality Control” at present.MaestríaMagíster en Derecho del Estado con énfasis en Derecho Públic

Dynamic computerized-adaptive assessment of reading processes: Incremental validity on text comprehension

This study explores the predictive and incremental validity of the Dynamic Computerized Adaptive Reading Processes Assessment Device (EDPL-BAI). This battery has 38 tasks organized in 6 modules to assess different processes related to reading comprehension (e.g. phoneme-grapheme association, executive functions, metacognitive processes). Method: A total of 1336 Chilean students from 3rd to 6th grade (45% females) from 12 public urban and rural schools participated in a longitudinal study consisting of three assessment cycles. On the first cycle, the students were assessed with a standardized reading comprehension test (CL-PT), the Raven Progressive Matrices Test (PMR), and the complete poll of items were calibrated in a non-dynamic version of EDPL-BAI. On the second cycle, seven months after, a sub sample of 1068 students were administered the adaptive and dynamic version of the EDPL-BAI (graduated prompts were displayed after wrong responses), while the remainder 268 students were assessed with the non-dynamic version of EDPL-BAI, and for all the students a pre and post-test (using selected items from EDPL-BAI), CL-PT and PMR were administered. Finally, at the third cycle, four month after, the non-dynamic version of EDPL-BAI and CL-PT were administered to the complete sample. Results and Conclusions: Multiple CFAs were conducted to determine the factorial structure of the EDPL-BAI, and a final model of 6 factors was retained. Predictive and incremental validity of the EDPL-BAI was explored with SEM analysis. The dynamic and non-dynamic versions of the EDPL-BAI were good predictors of reading comprehension. The dynamic version showed incremental validity over the non-dynamic version. Furthermore, graduated prompts predicted reading comprehension performanc

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos Antioquía, Boyacá y Risaralda.

Colombia es un país que ha sido victimizado por eventos violentos desde hace décadas, diversas situaciones sociopolíticas y socioeconómicas han traído consigo pobreza, muerte, desplazamiento, desarraigo cultural y vulneración de múltiples derechos de individuos y comunidades dentro del contexto colombiano. Las víctimas de la violencia en Colombia sufren diversas afectaciones sociales, psicológicas, económicas y culturales que perturban significativamente el ciclo de desarrollo de cada una de ellas, por lo tanto, surge la necesidad de reconocerlas, escucharlas y visibilizarlas para así poder contribuir en el proceso de reparación y reconstrucción de nuevos estilos de vida, en las que la resiliencia es protagonista. Desde el enfoque conceptual de la metodología narrativa, aplicada desde la psicología y la sociología, se pretende velar por la salud mental y la restitución de derechos de los individuos y las comunidades que se reconocen como víctimas, desde un ejercicio de análisis de relatos para el abordaje de subjetividades inmersas en contextos violentos, con el fin de crear acciones psicosociales que contribuyan en la transformación social. Por lo tanto, en la selección del relato de Modesto Pacayá, se realizó un análisis en el que se especifican los esfuerzos personales, familiares, y comunitarios que en él se movilizan para romper ciclos de violencia e injusticia. Tomado del libro: Voces: relatos de violencia y esperanza, Banco Mundial, (2009). De la misma manera se realizó un abordaje crítico del caso de Peñas Coloradas, una comunidad que fue fundada en Caquetá y que sufrió un proceso de desarraigo cultural por parte del estado al ser estigmatizada y forzada al abandono de su territorio. Y se plantean 3 estrategias psicosociales con los pobladores, que faciliten la potenciación de recursos de afrontamiento a la situación expresada. Finalmente, y no menos importante se presenta un informe de una actividad realizada llamada “Foto Voz” en la que se usa la imagen y la narrativa como instrumentos para la identificación de variables psicosociales en escenarios de violencia, en tres departamentos colombianos. (Antioquia, Boyacá y Risaralda). Palabras Clave: Victimas, Resiliencia, Acción psicosocial, Narrativa e imagen.Colombia is a country that has been victimized by violent events for decades, various sociopolitical and socioeconomic situations have brought with them poverty, death, displacement, cultural uprooting and violation of multiple rights of individuals and communities within the Colombian context. The victims of violence in Colombia suffer various social, psychological, economic and cultural affectations that significantly affect the life cycle of each one of them, therefore, the need arises to recognize them, listen to them and make them visible in order to contribute to the reparation process. and reconstruction of new lifestyles, in which resilience is the protagonist. From the conceptual approach of the narrative methodology, applied from psychology and sociology, it is intended to ensure mental health and the restitution of rights of individuals and communities that recognize themselves as victims, from an exercise of story analysis for the approach to subjectivities immersed in violent contexts, in order to create psychosocial actions that contribute to social transformation. Therefore, the selection of the story of Modesto Pacayá taken from the book: Voices: stories of violence and hope, World Bank (2009). was made, and an analysis was carried out specifying the personal, family, collective and community efforts that in it they mobilize to break cycles of violence and injustice. In the same way, a critical approach was made to the case of Peñas Coloradas, a community that was founded in Caquetá and that suffered a process of cultural uprooting by the state when it was stigmatized and forced to abandon its territory. And 3 psychosocial strategies are proposed with the inhabitants, which facilitate the empowerment of coping resources to the expressed situation. Last but not least, a report is presented on an activity called "Photo Voice" in which images and narrative are used as instruments for the identification of psychosocial variables in scenes of violence, in three Colombian departments. (Antioquia, Boyacá and Risaralda). Key words: Victims, Resilience, Psychosocial action, Narrative and image

Aki associated with macroscopic glomerular hematuria: Clinical and pathophysiologic consequences

Hematuria is a common finding in various glomerular diseases. This article reviews the clinical data on glomerular hematuria and kidney injury, as well as the pathophysiology of hematuria-associated renal damage. Although glomerular hematuria has been considered a clinical manifestation of glomerular diseases without real consequences on renal function and long-term prognosis, many studies performed have shown a relationship between macroscopic glomerular hematuria and AKI and have suggested that macroscopic hematuria-associated AKI is related to adverse long-term outcomes. Thus, up to 25% of patients with macroscopic hematuria– associated AKI do not recover baseline renal function. Oral anticoagulation has been associated with glomerular macrohematuria–related kidney injury. Several pathophysiologic mechanisms may account for the tubular injury found on renal biopsy specimens. Mechanical obstruction by red blood cell casts was thought to play a role. More recent evidence points to cytotoxic effects of oxidative stress induced by hemoglobin, heme, or iron released from red blood cells. These mechanisms of injury may be shared with hemoglobinuria or myoglobinuria-induced AKI. Heme oxygenase catalyzes the conversion of heme to biliverdin and is protective in animal models of heme toxicity. CD163, the recently identified scavenger receptor for extracellular hemoglobin, promotes the activation of anti-inflammatory pathways, opening the gates for novel therapeutic approachesThis work was supported by FIS (Programa Miguel Servet) to J.A.M.; ISCIII and FEDER funds CP04/00060, PS09/00447, Sociedad Espa~nola de Nefrologia, ISCIII-RETIC REDinREN/RD06/ 0016, Comunidad de Madrid/FRACM/S-BIO0283/2006, Programa Intensificación Actividad Investigadora (ISCIII/) to A.O.; FIS 10/ 02668 and AITER (Asociación para el Estudio y Tratamiento de las Enfermedades Renales) to E.G. and M.P.; and ISCIII-Redes RECAVA (RD06/0014/0035) and ISCIII funds PI10/00072 and Fundacion Lilly to J.E

Integrating Curriculum-Based Dynamic Assessment in Computerized Adaptive Testing: Development and Predictive Validity of the EDPL-BAI Battery on Reading Competence

In recent decades there have been significant changes in the conceptualization of reading as well as in the perception of how this activity should be assessed. Interest in the analysis of reading processes has led to the emergence of new explanatory models based primarily on the contributions of cognitive psychology. In parallel, there have been notable advances in measurement procedures, especially in models based on Item Response Theory (IRT), as well as in the capacity and performance of specific software programs that allow data to be managed and analyzed. These changes have contributed significantly to the rise of testing procedures such as computerized adaptive tests (CATs), whose fundamental characteristic is that the sequence of items presented in the tests is adapted to the level of competence that the subject manifests. Likewise, the incorporation of elements of dynamic assessment (DA) as the prompts are gradually offered allows for obtaining information about the type and degree of support required to optimize the subject¿s performance. In this sense, the confluence of contributions from DA and CATs offers a new possibility for approaching the assessment of learning processes. In this article, we present a longitudinal research developed in two phases, through which a computerized dynamic adaptive assessment battery of reading processes (EDPL-BAI) was configured. The research frame involved 1,831 students (46% girls) from 13 public schools in three regions of Chile. The purpose of this study was to analyze the differential contribution on reading competence of dynamic scores obtained in a subsample composed of 324 (47% girls) students from third to sixth grade after the implementation of a set of adaptive dynamic tests of morpho-syntactic processes. The results achieved in the structural equation modeling indicate a good global fit. Individual relationships show a significant contribution of calibrated score that Frontiers in Psychology | www.frontiersin.org 1 August 2018 | Volume 9 | Article 1492 fpsyg-09-01492 August 25, 2018 Time: 10:59 # 2 Navarro et al. Curriculum-Based Dynamic Computerized-Adaptive Assessment reflects estimated knowledge level on reading competence, as well as dynamic scores based on the assigned value of graduated prompts required by the students. These results showed significant predictive values on reading competence and incremental validity in relation to predictions made by static criterion tests

Integrating Curriculum-Based Dynamic Assessment in Computerized Adaptive Testing: Development and Predictive Validity of the EDPL-BAI Battery on Reading Competence

In recent decades there have been significant changes in the conceptualization of reading as well as in the perception of how this activity should be assessed. Interest in the analysis of reading processes has led to the emergence of new explanatory models based primarily on the contributions of cognitive psychology. In parallel, there have been notable advances in measurement procedures, especially in models based on Item Response Theory (IRT), as well as in the capacity and performance of specific software programs that allow data to be managed and analyzed. These changes have contributed significantly to the rise of testing procedures such as computerized adaptive tests (CATs), whose fundamental characteristic is that the sequence of items presented in the tests is adapted to the level of competence that the subject manifests. Likewise, the incorporation of elements of dynamic assessment (DA) as the prompts are gradually offered allows for obtaining information about the type and degree of support required to optimize the subject’s performance. In this sense, the confluence of contributions from DA and CATs offers a new possibility for approaching the assessment of learning processes. In this article, we present a longitudinal research developed in two phases, through which a computerized dynamic adaptive assessment battery of reading processes (EDPL-BAI) was configured. The research frame involved 1,831 students (46% girls) from 13 public schools in three regions of Chile. The purpose of this study was to analyze the differential contribution on reading competence of dynamic scores obtained in a subsample composed of 324 (47% girls) students from third to sixth grade after the implementation of a set of adaptive dynamic tests of morpho-syntactic processes. The results achieved in the structural equation modeling indicate a good global fit. Individual relationships show a significant contribution of calibrated score that reflects estimated knowledge level on reading competence, as well as dynamic scores based on the assigned value of graduated prompts required by the students. These results showed significant predictive values on reading competence and incremental validity in relation to predictions made by static criterion tests

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes

Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week. Interpretation Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.Peer reviewe