Factores de riesgo asociados a hipoglucemia en personas con diabetes mellitus tipo 2, Hospital Dr. Humberto Alvarado Vasquez-Julio a Diciembre de 2014

La Hipoglicemia constituye una emergencia médica, siendo la complicación más frecuente de los pacientes con diabetes que reciben insulina y el principal factor limitante de la optimización del control de la diabetes mellitus. De no ser tratada oportunamente, puede ocasionar daño neurológico permanente e incluso la muerte. Esta problemática es una realidad frecuente en la vida de los diabéticos tipo 1 y de los tipo 2. La incidencia de hipoglucemias sintomáticas en diabéticos es de dos por semana y la de hipoglucemias graves y temporalmente invalidantes, de un episodio por año las cuales son responsables del 2-4% de las muertes en este grupo poblacional. Este promedio se triplica en pacientes mayores de 75 años, con ingresos hospitalarios recientes y que reciben múltiples fármacos. El estudio se llevó a cabo en el Hospital Humberto Alvarado Vásquez, es un estudio Analítico, observacional de casos y controles, de corte transversal; el universo constituido por 755 pacientes Diabéticos tipo 2 que estuvieron ingresados en el periodo en estudio, la muestra total de 120 pacientes diabéticos constituida por 40 Casos y 80 Controles. En el cual se obtuvieron resultados de gran importancia como la asociación en la aparición de los síntomas y la dosificación del fármaco, la adecuada administración del mismo y en cierto porcentaje su asociación con la situación socioeconómica de los pacientes en estudio. Por lo que recomendamos Informar a nuestros pacientes diabéticos tipo 2 sobre cuáles fueron los hallazgos encontrados y de esta manera mejorar su condición y calidad de vida, a través de la práctica correcta de cuidados generales en esta patologí

The economic performance of urban gardening in three European cities – examples from Ljubljana, Milan and London

Urban gardening is not a new phenomenon but it has received considerably more practical and academic interest in recent years. Studies on economic aspects such as crop yields, inputs and outputs of production, productivity, gross margins and the contribution to home economics are rare, especially in Europe. While urban gardening plays an important role in the Global South, its role in Western Europe for food productivity and home eco- nomics is currently under-researched. The aim of this study is to analyse European urban gardeners\u2019 economic performance and self-sufficiency on a household level, as well as to reach a better understanding of their con- tribution to food self-provision and food security in the metropolitan areas. In a study carried out in 2014 with on-site personal and with online questionnaires participated 180 urban gardeners from three case study cities (Ljubljana, Milan, and London). Results from the economic analysis showed that although for most urban gar- deners, profit is not their main motivation, the economic calculation shows that productivity in small urban plots can be comparable to market garden production. Urban gardeners are saving money, especially when, compared to retail prices for regular produce or organic produce, their input is included in the gross margin calculation. We conclude that, in the case-study cities, the self-provisional potential of urban gardeners\u2019 households to ade- quately cover the annual vegetable need of five-a-day servings can be met under three conditions: (1) sufficient garden size; (2) increased area productivity, and (3) sufficient labour-hour inputs

Dinámicas de Consumo de los Estudiantes de Pregrado de la Universidad de los Llanos 2017-II

117 h.Analizar las dinámicas de consumo de los estudiantes de pregrado de La Universidad de los Llanos durante el segundo periodo del 2017. 1. Caracterizar los estudiantes de pregrado de la Universidad de los Llanos. 2. Identificar la motivación de compra de los estudiantes de la Universidad de los Llanos. 3. Analizar las preferencias de compra de los estudiantes de la Universidad de los Llanos.Resultado para Obtener el Título de Profesional en Mercadeo, Tesis (Profesional en Mercadeo) Universidad de los Llanos. Facultad de Ciencias Económicas. Programa Mercadeo., 2017PregradoMercade

Los mecanismos de influencia en el liderazgo : un estudio de caso organizacional

Este trabajo investigativo busca aportar a la literatura sobre las tácticas de influencia en el liderazgo. Surge como una aplicación, a dos casos específicos, del proyecto de investigación “Los mecanismos de influencia en la relación de liderazgo”, desarrollado por el profesor Juan Javier Saavedra Mayorga e inscrito en la línea de investigación en Estudios Organizacionales del Grupo de Investigación en Dirección y Gerencia. La investigación tiene como objetivo fundamental identificar las tácticas de influencia que utilizan dos líderes organizacionales en su trato cotidiano con sus colaboradores, así como la reacción de estos últimos ante dichas tácticas. El proyecto parte de una revisión teórica sobre tres elementos: el liderazgo, la influencia y el poder, y las reacciones de los colaboradores frente a las tácticas de influencia utilizadas por el líder. La estrategia metodológica empleada es el estudio de caso. El trabajo de campo se desarrolló en dos organizaciones: Microscopios y Equipos Especiales S.A.S. y Tecniespectro S.A.S. La técnica de recolección de información es la entrevista semi estructurada, y el método de análisis de información es el análisis de contenido temático.This research work is seeking to provide to the literature knowledge about the influence tactics of leadership. This investigation performs as an application of two specific cases, from the research project “The mechanism of influence in the leadership relationship”, developed by Professor Juan Javier Saavedra Mayorga and subscribed to the research line in Organizational studies, from the Research group in Management and leadership. The investigation has as a fundamental objective to identify the tactics of influence that are used by two organizational leaders in their daily relationship with their workers, as well as the workers reactions, after using the tactics before mentioned. The project starts from a theoretical revision about three elements: leadership, influence and power, and the reactions from employees against the influence tactics used by the leader. The methodologic strategy apply, is the study of the cases. The field work was developed in two organizations: Microscopios y Equipos Especiales S. A. S. y Tecniespectro S. A. S. The data collection technique is a semi structured interview; and the method of analysis of information is the analysis of the thematic content

Índice del derecho a la educación colegio oficiales Bogotá D.C. 2022

182 p. material digitalEl índice del derecho a la educación es una herramienta de medición del nivel de garantía del derecho a la educación en Bogotá enfocada en cinco dimensiones: disponibilidad, accesibilidad, adaptabilidad aceptabilidad y gestión institucional.Introducción ................................................................................................................ 6 II. Marco conceptual ....................................................................................................... 8 A. Antecedentes respecto al concepto de Derecho a la Educación ............................. 8 B. El modelo de las 4A ................................................................................................ 9 C. Antecedentes de mediciones del Derecho a la Educación .................................... 11 D. Fundamentación conceptual para índice del Derecho a la educación –IDE- en Bogotá medición 2022 .................................................................................................. 14 1. Disponibilidad .................................................................................................... 15 2. Accesibilidad ...................................................................................................... 15 3. Aceptabilidad ..................................................................................................... 16 4. Adaptabilidad ..................................................................................................... 17 5. Gestión institucional ........................................................................................... 19 III. Metodología .......................................................................................................... 21 A. Cálculo del IDE ..................................................................................................... 21 B. Cambios metodológicos respecto a versiones anteriores ...................................... 24 IV. Resultados del IDE 2022 ....................................................................................... 25 A. Resultados generales para la ciudad .................................................................... 26 1. Bogotá y el IDE .................................................................................................. 26 2. Disponibilidad .................................................................................................... 30 3. Accesibilidad ...................................................................................................... 36 4. Aceptabilidad ..................................................................................................... 42 5. Adaptabilidad ..................................................................................................... 48 6. Gestión institucional ........................................................................................... 54 B. Resultados por localidad ....................................................................................... 60 Barrios Unidos .......................................................................................................... 60 Los Mártires .............................................................................................................. 63 Chapinero ................................................................................................................. 66 Santa Fe/La Candelaria ............................................................................................ 69 Puente Aranda .......................................................................................................... 72 Kennedy ................................................................................................................... 75 San Cristóbal ............................................................................................................ 78 Rafael Uribe Uribe .................................................................................................... 81 Bosa ......................................................................................................................... 84 Engativá ................................................................................................................... 87 Tunjuelito .................................................................................................................. 90 Ciudad Bolívar .......................................................................................................... 93 Usme ........................................................................................................................ 96 Fontibón ................................................................................................................... 99 Suba ....................................................................................................................... 102 Antonio Nariño ........................................................................................................ 105 Usaquén ................................................................................................................. 108 Sumapaz ................................................................................................................ 111 V. Sistemas de prácticas escolares y pedagógicas para la garantía del Derecho a la Educación ...................................................................................................................... 114 A. Prácticas para la Disponibilidad .......................................................................... 116 B. Prácticas de gestión escolar para la Accesibilidad .............................................. 119 C. Prácticas de gestión escolar para la Aceptabilidad y la Adaptabilidad ................. 122 D. Prácticas de gestión escolar para la Gestión Institucional................................ 125 VI. Caja de herramientas de políticas públicas para la promoción del Derecho a la Educación ...................................................................................................................... 129 A. Disponibilidad ...................................................................................................... 130 B. Accesibilidad ....................................................................................................... 133 C. Aceptabilidad....................................................................................................... 135 D. Adaptabilidad ................................................................................................... 138 E. Gestión Institucional ............................................................................................ 141 VII. Referencias ......................................................................................................... 144 VIII. Anexos ................................................................................................................ 148 A. Metodología detallada de cálculo del IDE ............................................................ 148 B. Fichas metodológicas de indicadores .................................................................. 154primera edicio

Estrategia de comunicación en salud como instrumento integral para fortalecer la salud mental en adolescentes entre 12 y a15 años de la localidad Barrios Unidos de la ciudad de Bogotá

Nota: Video educativo con imágenes y mensajes de prevención, tips informativos, entre otros; con temas que están relacionados a situaciones que afecta la salud mental. Tomada de (Cardozo, 2022), Nota: Infografía: La comunicación en salud un instrumento integral para fortalecer la salud mental de los adolescentes. Tomada de (Erazo, 2022), Nota: Video con fines educativos, 2 influencers que apoyan la juventud de la capital invitan al inicio del tour por los barrios y colegios de la ciudad de Bogotá, locación de barrios unidos y a hacer la actividad viral con el hashtag #cuidomisaludmental. Tomada de (Rodríguez, 2022), Nota: Inicio de talleres, charlas y actividades en el parque de los novios en la localidad de barrios unidos de la ciudad de Bogotá a partir del próximo 02 de agosto del presente año con el fin de prevenir y mitigar los problemas de salud mental en adolescentes de 12 a 15 años. Tomada de (Sánchez, 2022), Nota: Actividad específica nos acompañará y apoyará en las actividades y charlas la Psicóloga Maryuris Mendoza Echenique. Tomada de (Sánchez, Crea o recrea tu super héroe, 2022), Nota: Estrategia de comunicación en salud como instrumento integral para fortalecer la salud mental en una localidad y rango de edad definidos. Tomada de (Rodríguez, Estrategia de Comunicación en Salud Grupal, 2022)En el siguiente trabajo plasmaremos la intervención y fortalecimiento de la comunicación en un problema de salud que se refleja en una población, en este caso en Bogotá en la localidad de Barrios Unidos, en donde la problemática de salud mental, que actualmente ataca a todo tipo de personas, nos hemos enfocado en la población más vulnerable que es adolescencia en ambos géneros. Es aquí en donde se decide impactar en primer lugar desde las instituciones de educación siendo estos los sitios más adecuados para intervenir, con el apoyo de los entes gubernamentales ya que cuentan con las herramientas necesarias para indagar y entrar a actuar encasos tales como maltrato, bullying, violencia en el hogar entre otros tantos problemas que desencadenan en la salud mental de los adolescentes llevándolos a la depresión, trastornos y que en muchas ocasiones no son detectados a tiempo provocando que terminen en hechos traumáticos directamente tanto en los afectados como en sus familias. Interviniendo desde programas de promoción y prevención que permitan detectar afectaciones en la salud mental de sus habitantes y que se puedan empezar a manejar de manera efectiva, la intervención de los centros de salud, ips tanto privadas como públicas cumplen un papel de vital importancia. Y nuestro objetivo es que la comunicación sea tan eficiente que se trasmita de manera conjunta con los entes de salud, de manera oportuna, clara y eficaz mediante la utilización de la tecnología a través de videos, charlas interactivas, talleres lúdicos de participación directa que la comunidad sienta que su participación y finalmente su salud mental está siendo atendida de forma responsable y convenienteIn the following work we will capture the intervention and strengthening of communication in a problem of health that is reflected in a population, in this case in Bogotá in the town of Barrios Unidos, where the mental health problem, which currently attacks all kinds of people, we have focused on the most vulnerable population that is adolescence in both genders. It is here where it is decided to impact firstly from educational institutions, these being the most appropriate places to intervene, with the aim of support of government entities since they have the necessary tools to investigate and enter act in cases such as abuse, bullying, domestic violence among many other problems that trigger in the mental health of adolescents leading them to depression, disorders and that in many occasions are not detected in time, causing them to end in directly traumatic events both in those affected as well as their families. Intervening from promotion and prevention programs that allow detect affectations in the mental health of its inhabitants and that they can begin to be managed in a effective, the intervention of health centers, both private and public ips play a vital role importance. And our objective is that the communication is so efficient that it is transmitted in a jointly with health entities, in a timely, clear and effective manner through the use of the technology through videos, interactive talks, playful workshops of direct participation that community feel that their participation and finally their mental health is being taken care of responsible and convenient wa

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life