Ventajas y aspectos que favorecen la atención domiciliaria de enfermería al paciente oncológico pediátrico en tratamiento

La atención domiciliaria de enfermería al paciente oncológico pediátrico promueve las actividades de educación sanitaria y representa un escenario ideal para educar al paciente y su familia en hábitos saludables y de auto cuidado, sugiere que parte de estas actividades a realizar en el hogar es el entrenamiento a cuidadores y pacientes sobre temas específicos como prevención de caídas, prevención de escaras, higiene, nutrición, curaciones. Los resultados indican que una de las condiciones que ameritan el cuidado domiciliario en el paciente oncológico pediátrico es la necesidad de preparar a los cuidadores para hacer frente a las actividades y posibles dificultades inherentes a la asistencia prestada y tratamiento en una situación que implica tantos cambios en el medio ambiente del paciente.Nursing home care to pediatric cancer patients promotes health education activities and represents an ideal setting to educate the patient and his family in healthy habits and self-care, suggests that some of these activities to do at home is the training caregivers and patients on specific topics such as fall prevention, pressure ulcer prevention, hygiene, nutrition, healing. The results indicate that one of the conditions warranting home care in pediatric cancer patients is the need to prepare caregivers to cope with the activities and potential difficulties inherent in the assistance and treatment in a situation involving so many changes in the patient's environment.Especialista en Enfermería OncológicaEspecializació

Fundación Parche de Amigos: planeación estratégica para la formación de liderazgos en jóvenes en el Municipio de Soacha

Fortalecer mediante una planeación estratégica a la Fundación Parche de Amigos en el componente de liderazgo, con el fin de beneficiar a los jóvenes en temas de participación comunitaria y planificación de sus proyectos de vida, en el Barrio Rincón del Lago de la Comuna 4 del Municipio de Soacha.Este trabajo propone una planeación estratégica para la Fundación Parche de Amigos encaminada al desarrollo de liderazgos juveniles orientados a la participación comunitaria y la planificación de proyectos de vida en el barrio Rincón del Lago del Municipio de Soacha, Cundinamarca. Debido a lo anterior, se realizó un recorrido sobre la manera en la que los jóvenes son líderes en sus comunidades y territorios en contextos de vulnerabilidad social, lo que demanda la intervención de organizaciones no gubernamentales que contribuyan al acompañamiento integral de los jóvenes. Para diseñar una propuesta de planeación estratégica desde el componente de liderazgo juvenil se realizaron diferentes abordajes conceptuales y una metodología de carácter cualitativo que involucró diferentes grupos de interés.The integrated project described in the following document contains the development of a strategic planning proposal for the Fundación Parche de Amigos, in such a way that its structure is strengthened from the youth leadership part. Due to the above, a tour was made of the situation of young people who are disadvantage due to the lack of guarantying their human rights, which requires the intervention of various institutions with the aim of contributing to the integral development of this population. The Foundation, in the midst of this identified reality, brings together efforts for the development of leadership oriented towards community participation and the planning of life projects in the Rincón del Lago neighborhood of the Municipality of Soacha, Cundinamarca

Fundación Parche de Amigos: planeación estratégica para la formación de liderazgos en jóvenes en el Municipio de Soacha

Fortalecer mediante una planeación estratégica a la Fundación Parche de Amigos en el componente de liderazgo, con el fin de beneficiar a los jóvenes en temas de participación comunitaria y planificación de sus proyectos de vida, en el Barrio Rincón del Lago de la Comuna 4 del Municipio de Soacha.Este trabajo propone una planeación estratégica para la Fundación Parche de Amigos encaminada al desarrollo de liderazgos juveniles orientados a la participación comunitaria y la planificación de proyectos de vida en el barrio Rincón del Lago del Municipio de Soacha, Cundinamarca. Debido a lo anterior, se realizó un recorrido sobre la manera en la que los jóvenes son líderes en sus comunidades y territorios en contextos de vulnerabilidad social, lo que demanda la intervención de organizaciones no gubernamentales que contribuyan al acompañamiento integral de los jóvenes. Para diseñar una propuesta de planeación estratégica desde el componente de liderazgo juvenil se realizaron diferentes abordajes conceptuales y una metodología de carácter cualitativo que involucró diferentes grupos de interés.The integrated project described in the following document contains the development of a strategic planning proposal for the Fundación Parche de Amigos, in such a way that its structure is strengthened from the youth leadership part. Due to the above, a tour was made of the situation of young people who are disadvantage due to the lack of guarantying their human rights, which requires the intervention of various institutions with the aim of contributing to the integral development of this population. The Foundation, in the midst of this identified reality, brings together efforts for the development of leadership oriented towards community participation and the planning of life projects in the Rincón del Lago neighborhood of the Municipality of Soacha, Cundinamarca

Beneficiarios efectivos y su efecto fiscal en Colombia

RESUMEN: El concepto de beneficiarios efectivos ha sido incluido en la legislación nacional a través de los convenios para evitar la doble imposición, sin embargo, su definición solo fue introducida en el Estatuto Tributario –E.T. a partir de la reforma estructural del año 2016. Dicha definición resulta compleja de interpretar, y por ende, realizar una identificación de los beneficiarios efectivos, puede resultar dificultosa para los contribuyentes y responsables de aplicar las normas relacionadas con el mismo. A lo largo de este trabajo se profundizan los conceptos claves relacionados con el término, de forma que se pueda obtener una mejor aproximación a la definición del concepto. Inicialmente, se hace necesario profundizar en el término “control” para lo cual se revisaron los criterios del Código de Comercio y del E.T, y se concluyó que es necesario para cada caso, examinar lo siguiente: el sometimiento del poder y las condiciones de toma de decisiones, las participaciones en el capital, las estructuras jurídicas, las relaciones de influencia, si se trata de sucursales o agencias, establecimientos permanentes, u otras relaciones de control por acuerdos y contratos; pues todas estas situaciones le son aplicables al concepto de beneficiarios efectivos para efectos tributarios. El análisis normativo y las conclusiones indican que, en la norma fiscal colombiana siempre se hace referencia a una persona natural, la cual puede, directamente, como propietario, o indirectamente, a través de una estructura jurídica o vehículo no societario, ostentar la capacidad de dirigir, decidir y disponer libremente de las utilidades de la entidad, o tener el control, por su poder de sometimiento e imposición de las decisiones sobre las operaciones y actividades, aun cuando no se beneficie directa o indirectamente de las utilidades de la misma, o ser beneficiaria de dichas operaciones y actividades aunque no tenga control. A lo largo de este documento se profundiza, investiga y caracterizan los conceptos claves relacionados con el término, las normas fiscales y sus efectos asociados al término, para proporcionar al lector elementos que le permitan identificar fácilmente los beneficiarios efectivos en las diversas operaciones fiscales. ABSTRACT: The concept of effective beneficiaries has been included in National Legislation through double taxation conventions; however, its definition was only introduced in the Tax Statute since the structural reform of 20161. This definition could be complex to interpret; hence, to identify actual beneficiaries may be difficult for taxpayers and those responsible for implementing the rules related to it. Throughout this work the key concepts related to the term are deepened, with the intention that a better approximation to the definition of the concept can be obtained. Initially, it was necessary to delve into the term “control”; thus, the criteria of the Commercial Code and the Colombia Tax Statute were analyzed and it was concluded that it is required for each case to examine the following: the subjection of power and the conditions of decision-making, equity participations, legal structures, relationships of influence; in the case of branches or agencies, permanent establishments, or other control relationships by agreements and contracts in view of the fact that all these situations apply to the concept of beneficial owners for tax purposes. The normative analysis and the conclusions indicate that, in the Colombian Tax Law always refers to a natural person who can directly, as owner, or indirectly, through a legal structure or non-corporate vehicle, hold the capacity to direct, decide and freely dispose of the Entity’s profits, or have control by its power to submit and impose decisions on operations and activities, even if it does not benefit directly or indirectly from its profits, or be a beneficiary of such operations and activities even if they have no control. Throughout this document, the key concepts related to the term, the tax rules and their effects associated with the term are deepened, researched and characterized to provide the reader with elements enabling them to easily identify beneficial owners in the various tax operations

Impacto del manejo del dolor en pacientes postquirúrgicos del Hospital San José centro de la ciudad de Bogotá

Actualmente la salud y la economía son conceptos que van anidados; vinculados principalmente por tres canales: las enfermedades prevenibles, las inversiones hechas en salud y los efectos de la enfermedad en el entorno; este último, teniendo en cuenta que las enfermedades tienen un efecto negativo sobre las iniciativas de inversión en salud y sus relacionados, pues si hay dolencia o enfermedad se ha visto disminuida. Así mismo, se considera que las enfermedades endémicas y epidémicas reducen la participación social y la estabilidad política y macroeconómica de un país. (Sachs, 2001). En Colombia esta regla no es la excepción, pues la salud es uno de los sectores más influyentes de la economía y las finanzas del país, por lo que ha pasado por múltiples transformaciones para cumplir con las exigencias económicas y sociales que requieren las poblaciones frente a la prestación de estos servicios. Desde la puesta en marcha de la Ley 100 en el año 1993, con la que se pasó de un Sistema Nacional de Salud a un Sistema General de Seguridad Social en Salud, se generó la entrada del concepto de calidad en la prestación de servicios en las empresas prestadoras de servicios de salud, creando un sistema altamente competitivo; así pues, se volvió fundamental la atención a los usuarios externos, la infraestructura y los costos del servicio, generando un alto impacto e influencia de la exigencias de los usuarios, los avances de la tecnología, la demanda, la competencia entre organizaciones y globalización de la economía sobre la llamada calidad, modificando sustancialmente las operaciones empresariales hacia estilos evaluadores y de estrategia, generando actividades como planeación, ejecución, control de costos de los servicios y evaluación, para hacer la atención en salud rentable y eficiente.EspecializaciónEspecialista En Gerencia De La Salu

Cocoa Pod Husk: A High‐Pectin Source with Applications in the Food and Biomedical Fields

Cocoa liquor, butter, and powder represent derived products from a small portion of the fruits, compared with the cocoa pod husk (CPH) which accounts for ∼ 70 % of fresh weight. CPH, improperly disposed in plantations, can cause diseases threatening worldwide chocolate production. However, this biomass can be a potential source of bioactive compounds aligned with the circular economy. An overview on the different methods for extracting pectin, resulting in variable extraction yields with a critical discussion on the obtained physicochemical characteristics, is presented. Additionally, the potential applications of the extracted pectin for food and biomedical application are discussed, including thickener, stabilizer, excipient, drug-release modifier, macrophage activator, etc. Despite these potential outputs, new extraction methods need to be considered for improving efficiency and sustainability. Finally, potential approaches are introduced that can help to minimize the environmental impact, making the extraction cost- and time-efficient, and, therefore, more sustainable for a further successful translation to industry

Differences in coping strategies among young adults and the elderly with cancer

Background: Coping with cancer and the oncologist-patient relationship can vary depending on the patient's age. Our aim is to examine and compare young and elderly adults with non‐metastatic, resected cancer. Methods: Two groups of patients were selected, young ( 70) with a diagnosis of non‐metastatic, resected cancer requiring adjuvant chemotherapy from a pre‐exiting, national database (NEOCOPING Study). Epidemiological variables were collected and subjects' emotional responses, perceptions of the physician-patient relationship, support network, fears, and regret about the decision to receive chemotherapy were assessed with questionnaires validated in previous studies: Mini‐Mental Adjustment to Cancer, Brief Summary Inventory (18 items), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire‐C30, Shared Decision‐Making Questionnaire‐Physician's version, Shared Decision‐Making Questionnaire‐Patient's version, and Informed Risk (physician and patient versions). Results: Data from 46 young and 46 elderly participants were collected. The most common neoplasms in both groups were breast (50%) and colorectal (22%). The younger adults had a higher level of education and were actively employed (72% vs. 7%). The leading coping strategy in the younger cohort was hope, and resignation among the elderly. Young adults sought more social support and the impact of diagnosis was more negative for them than for older individuals. No significant differences were detected in quality of life; both age groups demanded more time at their first visit with the doctor, while the older group exhibited greater satisfaction with shared decision‐making. At the end of adjuvant chemotherapy, neither age group regretted their decision to receive said treatment. Conclusion: Higher levels of education, greater demands of the labour market, and the advent of the age of information have entailed drastic changes in the physician-patient relationship paradigm. This is especially true in the younger cancer patient population, who require more information and active participation in decision‐making, can display more anxiety about their diagnosis, but also greater capacity to fight

Prediction of quality of life in early breast cancer upon completion of adjuvant chemotherapy

Quality of life (QoL) is a complex, ordinal endpoint with multiple conditioning factors. A predictive model of QoL after adjuvant chemotherapy can support decision making or the communication of information about the range of treatment options available. Patients with localized breast cancer (n = 219) were prospectively recruited at 17 centers. Participants completed the EORTC QLQC30 questionnaire. The primary aim was to predict health status upon completion of adjuvant chemotherapy adjusted for multiple covariates. We developed a Bayesian model with six covariates (chemotherapy regimen, TNM stage, axillary lymph node dissection, perceived risk of recurrence, age, type of surgery, and baseline EORTC scores). This model allows both prediction and causal inference. The patients with mastectomy reported a discrete decline on all QoL scores. The effect of surgery depended on the interaction with age. Women with ages on either end of the range displayed worse scores, especially with mastectomy. The perceived risk of recurrence had a striking effect on health status. In conclusion, we have developed a predictive model of health status in patients with early breast cancer based on the individual's profile

Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America : an analysis within the ESTAMPA study

Corresponding author. E-mail address: [email protected] (A.T. Ramírez).Background. Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study. Methods. Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings. 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively). Interpretation. The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America : the ESTAMPA screening study protocol

Q1Q1Introduction Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number NCT01881659Revista Internacional - Indexad