Protocolo para retiro de tratamiento vital en unidades de cuidado intensivo

En las unidades de cuidados intensivos, se participa en la toma de decisiones complejas y difíciles, haciendo reflexiones éticas sobre la gravedad y la muerte de los pacientes críticos ingresados allí . Por tanto, el mantener comunicación efectiva entre el equipo médico, los pacientes y las familias en determinadas situaciones críticas, permite la toma de decisiones complejas basadas en principios éticos, científicos y humanísticos. Lo cual hace que el equipo ético de las unidades de cuidados intensivos deba estar preparado para tomar dicha decisión, dado que existe controversia frente al tema entrando en juego problemas éticos y morales. Este es un hecho que cobra importancia en los estudios de pregrado, debido a su actual ausencia en los programas académicos tanto de medicina como de enfermería, es la razón por el cual se realiza este protocolo para retiro de tratamiento vital en las unidades de cuidado intensivo para que sea incluido en la formación.In the intensive care units (ICU), it is necessary to take part in the complex and difficult decision making process, doing ethical reflections about the seriousness and the death of the critical patients. Therefore, supporting an effective communication between the medical team, the patients as well as the families in certain critical situations, allows to develop accurate decisions based on ethical, scientific and humanistic principles. This fact, makes that the ethical intensive care unit team should be prepared to take this important decision, as it usually creates a controversy in which ethical and moral problems are exposed. Consequently, this matter becomes really important among several undergraduate university programs, especially due to its current absence in both, the medicine and nursing academic degrees. In this sense, the aim of this protocol is to include this important topic as a training course

La omisión legislativa frente a la adopción homoparental plena.

En Colombia, uno de los temas más polémicos es la adopción de menores por parte de las parejas homoparentales. Aunque el debate en esta materia es intenso, ha dejado de lado el interés superior del niño en situación de adoptabilidad y no ha dado mayor importancia a la deliberada falta de acción por parte del Legislativo respecto a la regulación del tema, aunque esta omisión ha influido de manera negativa en la posibilidad que podrían tener las parejas homoparentales para adoptar plenamente. Por ende, es importante analizar la omisión legislativa presente en la adopción por parte de parejas homoparentales, pues constituye un elemento fundamental para que la discusión se mantenga, desconociendo el interés superior del menor como componente importante en la ampliación del espectro de población adoptante en Colombia, y delegando la regulación del asunto a la Corte Constitucional. En este trabajo se realizará una breve aproximación a la figura de la adopción en Colombia, seguida por una descripción analítica del interés superior del niño, dando paso al concepto de familia y las categorías que, jurídicamente, existen en nuestro país, presupuesto relevante para analizar las posibilidades de adopción en Colombia con las dificultades y limitantes que se presentan en este proceso. Se hará especial énfasis en la negación de la adopción de menores por parejas homoparentales, centro de controversia y de contadas decisiones favorables otorgadas en el marco del activismo judicial de la Corte Constitucional y que se generaron por la preocupante omisión legislativa que se presenta en Colombia frente a la regulación de un asunto trascendente. (texto tomado de la fuente)In Colombia, one of the most controversial issues is the adoption of minors by homoparental couples. Although the debate on this matter is intense, it has left aside the best interests of the child in a situation of adoptability and has not given greater importance to the deliberate lack of action on the part of the Legislature regarding the regulation of the topic, although this omission has influenced in a negative way in the possibility that homoparental couples could have to adopt fully. Therefore, it is important to analyze the legislative omission present in the adoption by homoparental couples, since it constitutes a fundamental element for the discussion to remain, ignoring the best interests of the minor as an important component in the expansion of the spectrum of adopting population in Colombia and delegating the regulation of the matter to the Constitutional Court. Thus, there will be a brief approximation to the figure of adoption in Colombia, followed by an analytical description of the best interests of the child, giving way to the concept of family and the categories that, legally, exist in our country, relevant budget to analyze the possibilities of adoption in Colombia with the difficulties and limitations that arise in this process, with special emphasis on the denial of the adoption of minors by homoparental couples, controversy center and few favorable decisions, granted within the framework of the judicial activism of the Constitutional Court, generated by the disturbing legislative omission that is presented in Colombia against the regulation of a transcendent issue.MaestríaGénero y Justicia, Sistema Constitucional, Protecció

Caracterización de los casos de abuso sexual valorados en los servicios de urgencias y consulta externa de una institución hospitalaria de primer nivel en el Departamento del Cauca, 2007 - 2015

Introduction: Sexual abuse affects millions of children and adolescents and it impacts on their physical and mental health. Objective: To characterize the cases of sexual abuse valued in the emergency services and external consultation of a hospital institution of first level in the department of Cauca between 2007 and 2015. Materials and methods: A descriptive, retrospective study of victims of sexual abuse attended in external consultation/emergencies was made. Temporal and sociodemographic variables of the victim/aggressor and the context where the event occurred were selected. The analysis was done in Epi Info. Measures of central tendency, dispersion, proportions and reasons were calculated. The relationship between variables was assessed by using the Fischer test. Results: 77% of the victims were women, 23% men, at ages between 2 to 16 years and 100% were students. The act was committed by a single aggressor. Besides, in 93.0% of the cases, the act was perpetrated by acquaintances, of whom 42.9% were family members. Conclusions: Despite the control and regulation measures, the results suggest that sexual abuse takes place at very early ages. The aggressor is almost always a commonly known person with consanguineous bond, which facilitates the perpetuation of the act towards the family nucleus through deceit, blackmail or threat

Urban regeneration through retroftting social housing: the AURA 3.1 prototype

As a large proportion of housing stock does not meet the current demands for energy and comfort (leading to high levels of obsolescence and vulnerability), the annual rate of energy upgrades for the existing stock must be increased. The AURA Strategy is an intervention methodology which focuses on the regeneration of neighbourhoods or obsolete urban fabrics which sufer from high levels of architectural, urban and socioeconomic vulnerability. Within this context, the AURA 3.1 prototype was developed for the Solar Decathlon Europe 2019 Competition. The project was based around a sustainable construction strategy for the urban regeneration of obsolete residential neighbourhoods, through the reuse of existing buildings considering Mediterranean climate and energy. The Poligono San Pablo neighbourhood was chosen as the case study. This article presents the main retroft action: the juxtaposition on the existing building of a structural-architectural system which provides new technological and spatial features. Quantitative data regarding the validity and efectiveness of the AURA Strategy could be collected from the monitoring of the Pavilion prototype during the competition. Two frst prizes were won in contests with on-site measurements: Comfort conditions and House Functioning. Third place was also obtained in the Sustainability contest, thus confrming the enormous possibilities the AURA Strategy has for sustainable urban regeneration in retroftting social housing, within the limitations of the competition

Street sellers marketing strategies

Este artículo tiene como propósito, identificar las estrategias de mercadeo de los vendedores ambulantes de la ciudad de Medellín. Para lograr este objetivo se realizó una observación estructurada de las prácticas de intercambio y se hizo necesaria la revisión documental para identificar las características del sector, su relación con la economía popular y la diferencia entre microempresa e informalidad. El principal hallazgo de este ejercicio investigativo es que el pensamiento intuitivo de los vendedores ambulantes da lugar a sus prácticas de mercadeo. Si bien estos emprendedores no tienen una formación académica, su intuición les permite desarrollar acciones que configuran en sí un proceso de mercadeo.The main objective of this article is to identify marketing strategies used by street sellers in the city of Medellin. In order to reach this objective a structured observation was required for exchange practices,their relation with the popular economy and the difference between micro business and informality. The main finding of this research was that the intuitive thinking of the street sellers opens space to marketingpractices. And even though this entrepreneurs don´t count with academic education, their intuition allows them to develop actions that become a marketing processEste artigo tem como propósito, identificar as estratégias de marketing dos vendedores ambulantes da cidade de Medellín. Para conseguir este objetivo se realizou uma observação estruturada das práticas de intercâmbio e se fez necessária a revisão documental para identificar as características do setor, sua relação com a economia popular e a diferença entre microempresa e informalidade. O principal descoberta deste exercício investigativo é que o pensamento intuitivo dos vendedores ambulantes dá lugar a suas práticas de marketing. Se bem estes empreendedores não têm uma formação acadêmica, sua intuição lhes permite desenvolver ações que configuram em si um processo de marketing

Strategy to determine the foot plantar center of pressure of a person through deep learning neural networks

Some case studies treated by physiotherapists or orthopedists to measure the alignment of the lower extremities during a gait cycle are based on empirical methods of visual observation. This methodology does not guarantee total success, since it depends on the experience of the specialist, what can cause irreversible damage to patients, such as: hip displacement, wear and overload of the joints of a single lower limb. Although, this problem has been addressed in the investigation by means of devices implementation with sensors or methods of processing sequences of images and videos, this topic is still under investigation because the current methods depend on many external elements and data given by an expert in the area. Therefore, this paper proposes a partial solution to this problem by systematizing the experience of a specialist through a computational learning method

Smart Device for the Determination of Heart Rate Variability in Real Time

This work presents a first approach to the design, development, and implementation of a smart device for the real-time measurement and detection of alterations in heart rate variability (HRV). The smart device follows a modular design scheme, which consists of an electrocardiogram (ECG) signal acquisition module, a processing module and a wireless communications module. From five-minute ECG signals, the processing module algorithms perform a spectral estimation of the HRV. The experimental results demonstrate the viability of the smart device and the proposed processing algorithms.Fundación Pública Andaluza Progreso y Salud. Gobierno de Andalucía PI-0010-2013 y PI-0041-2014Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15 / 00306 y DTS15 / 00195CIBER-BBN INT-2-CAR

Recognition system for facial expression by processing images with deep learning neural network

The recognition systems of patterns in images are mechanisms that filter the information that provides an image to highlight the area of interest for the user. Usually, these mechanisms are based on mathematical transformations that allow the processor to perform interpretations based on the geometry or shape of the image. However, the strategies that implement mathematical transformations are limited, since the effectiveness of these techniques is reduced by changing the morphology or resolution of the image. This paper presents a partial solution to this limitation with a digital image processing technique based on a deep learning neural network (DNN). This technique incorporates a mechanism that allows the DNN to determine the facial expression of a person, based on the segmented information of the image of their face. By segmenting the image and processing its characteristics in parallel, the proposed technique increases the effectiveness of recognizing facial gestures in different images even when modifying their characteristics

Special Issue “Body Sensors Networks for E-Health Applications”

Body Sensor Networks (BSN) have emerged as a particularization of Wireless Sensor Networks (WSN) in the context of body monitoring environments, closely linked to healthcare applications. These networks are made up of smart biomedical sensors that allow the monitoring of physiological parameters and serve as the basis for e-Health applications. This Special Issue collects some of the latest developments in the field of BSN related to new developments in biomedical sensor technologies, the design and experimental characterization of on-body/in-body antennas and new communication protocols for BSN, including some review studies