La justicia restaurativa como expresión del principio de última ratio de la pena en un marco de protección de los derechos humanos

Trabajo final de graduación de 94 páginas en formato pdfLa justicia restaurativa es una nueva forma de ver y de aplicar la justicia, que busca la humanización del sistema de administración de ésta, poniendo énfasis en la reparación efectiva del daño causado a la víctima, que va más allá de la reparación meramente civil, luchando por su participación activa, pero también en el alto control y alto apoyo que debe brindarse a la persona imputada. La importancia de este estudio radica en que, la aplicación de la justicia restaurativa, constituye un cambio de paradigma y una forma de expresión del principio de última ratio de la pena, como uno de los principios que debe formar parte sin duda alguna, de un sistema democrático que se caracterice por la protección de los derechos humanos. Se pretende a lo largo de esta investigación, definir que es la justicia restaurativa, así como precisar y desarrollar cuáles son sus formas de aplicación en las distintas etapas de un proceso penal. Aunado a ello, se pretende determinar si la aplicación de procesos restaurativos como alternativa ante la comisión de delitos y en las diversas etapas de un proceso penal judicial, genera una disminución considerable en el índice de delincuencia en una sociedad, haciendo una comparación con lo que ha sucedido en Perú, que es un país que lleva varios años poniendo en práctica, con mucho éxito, procesos de corte restaurativo en el ámbito penal juvenil, así como el éxito que ha tenido un proyecto piloto realizado en el Juzgado Penal Juvenil de Cartago, que si bien no es justicia restaurativa pura, contiene muchos principios de ésta, para así al final de la investigación tratar de demostrar si la aplicación de la justicia restaurativa para la resolución de los conflictos, en las distintas etapas del proceso penal costarricense, generará un bajo índice de reincidencia delincuencial en los imputados e imputadas que se sometan a estos procesos restaurativos y por tanto ayudará a una reducción de costos dentro del sistema del administración de justicia.Universidad Estatal a Distancia de Costa Ric

Patients with obstructive sleep apnea can favor the predisposing factors of periodontitis by the presence of P. melaninogenica and C. albicans, increasing the severity of the periodontal disease

Q2Q2Pacientes con PeriodontitisPacientes con Apnea obstructiva del sueñoObjective: The aim of this study was to analyze the cultivable oral microbiota of patients with obstructive sleep apnea (OSA) and its association with the periodontal condition. Methods: The epidemiology profile of patients and their clinical oral characteristics were determined. The microbiota was collected from saliva, subgingival plaque, and gingival sulcus of 93 patients classified into four groups according to the periodontal and clinical diagnosis: Group 1 (n = 25), healthy patients; Group 2 (n = 17), patients with periodontitis and without OSA; Group 3 (n = 19), patients with OSA and without periodontitis; and Group 4 (n = 32), patients with periodontitis and OSA. Microbiological samples were cultured, classified, characterized macroscopically and microscopically, and identified by MALDI-TOF-MS. The distribution of complexes and categories of microorganisms and correlations were established for inter- and intra-group of patients and statistically evaluated using the Spearman r test (p-value <0.5) and a multidimensional grouping analysis. Result: There was no evidence between the severity of OSA and periodontitis (p = 0.2813). However, there is a relationship between the stage of periodontitis and OSA (p = 0.0157), with stage III periodontitis being the one with the highest presence in patients with severe OSA (prevalence of 75%; p = 0.0157), with more cases in men. The greatest distribution of the complexes and categories was found in oral samples of patients with periodontitis and OSA (Group 4 P-OSA); even Candida spp. were more prevalent in these patients. Periodontitis and OSA are associated with comorbidities and oral conditions, and the microorganisms of the orange and red complexes participate in this association. The formation of the dysbiotic biofilm was mainly related to the presence of these complexes in association with Candida spp. Conclusion: Periodontopathogenic bacteria of the orange complex, such as Prevotella melaninogenica, and the yeast Candida albicans, altered the cultivable oral microbiota of patients with periodontitis and OSA in terms of diversity, possibly increasing the severity of periodontal disease. The link between yeasts and periodontopathogenic bacteria could help explain why people with severe OSA have such a high risk of stage III periodontitis. Antimicrobial approaches for treating periodontitis in individuals with OSA could be investigated in vitro using polymicrobial biofilms, according to our findings.https://orcid.org/0000-0003-0006-7822https://orcid.org/0000-0003-2528-9632https://orcid.org/0000-0002-1387-1935https://orcid.org/0000-0003-1011-4450https://orcid.org/0000-0002-4069-4719https://orcid.org/0000-0001-5576-9341https://orcid.org/0000-0002-9884-9242https://orcid.org/0000-0003-1803-9141https://orcid.org/0000-0003-1302-5429Revista Internacional - IndexadaA1N

Biomarkers for the severity of periodontal disease in patients with obstructive sleep apnea : IL-1 β, IL-6, IL-17A, and IL-33

Q2Q1Pacientes con Apnea obstructiva del sueñoObjective: This study aims to compare the salivary and gingival crevicular fluid (GCF) concentrations of five cytokines: IL-1β, IL-6, IL-17A, IL-33, and Tumor Necrosis Factor-alpha (TNF-α) in patients with OSA and their association with periodontitis. Methods: Samples of saliva and GCF were obtained from 84 patients classified into four groups according to periodontal and OSA diagnosis: G1(H) healthy patients, G2(P) periodontitis and non-OSA patients, G3(OSA) OSA and non-periodontitis patients, and G4(P-OSA) periodontitis and OSA patients. The cytokines in the samples were quantified using multiplexed bead immunoassays. Data were analyzed with the Kruskal-Wallis test, Dunn's multiple comparisons test, and the Spearman correlation test. Results: Stage III periodontitis was the highest in patients with severe OSA (69%; p=0.0142). Similar levels of IL-1β and IL-6 in saliva were noted in G2(P) and G4(P-OSA). The IL-6, IL-17A and IL-33 levels were higher in the GCF of G4(P-OSA). There was a significant positive correlation between IL-33 in saliva and stage IV periodontitis in G4(P-OSA) (rs = 0.531). The cytokine profile of the patients in G4(P-OSA) with Candida spp. had an increase of the cytokine's levels compared to patients who did not have the yeast. Conclusions: OSA may increase the risk of developing periodontitis due to increase of IL-1β and IL-6 in saliva and IL-6, IL-17A and IL-33 in GCF that share the activation of the osteoclastogenesis. Those cytokines may be considered as biomarkers of OSA and periodontitis.https://orcid.org/0000-0003-0006-7822https://orcid.org/0000-0003-2528-9632https://orcid.org/0000-0002-1387-1935https://orcid.org/0000-0003-1011-4450https://orcid.org/0000-0002-4069-4719https://orcid.org/0000-0001-5576-9341https://orcid.org/0000-0003-1803-9141https://orcid.org/0000-0003-1302-5429https://orcid.org/0000-0002-9884-9242Revista Internacional - IndexadaA1N

OPCML is hypermethylated in a subset of patients with metaplastic changes in their esophagus

Abstract OPCML hypermethylation is considered a promising cancer biomarker. We examined methylation levels in the first exon of OPCML in two patient cohorts within the esophageal adenocarcinoma and gastric adenocarcinoma cascades and in a range of cell-lines using a custom PyroMark CpG assay. Methylation levels were significantly higher in esophageal tissue with histologically confirmed glandular mucosa as compared to tissue from normal esophagi or gastro-esophageal reflux disease. Higher levels of OPCML methylation were absent in the adjacent normal esophageal tissue of patients with glandular mucosa. Higher levels of methylation were confirmed in cell-lines derived from patients with adenocarcinoma, but also detected in two cell-lines with signs of dysplasia. We validated our assay by showing no differences in methylation levels in DNA extracted from blood of patients within the gastric adenocarcinoma cascade. OPCML hypermethylation is present in a subset of patients with metaplastic changes in their esophagus

Educar en derechos humanos : un espacio para el juego

Proyecto Aula Activa: Juegos Cooperativos para la educación para la paz Guía didáctica Colección: Jugando para la paz Material didáctico gratuito Editora Evelyn Cerdas AgüeroEsta guía didáctica titulada “Educar en derechos humanos un espacio para el juego” forma parte del proyecto Aula activa: juegos educativos para la educación para la paz del Instituto de Estudios Latinoamericanos (IDELA). Este proyecto busca fomentar en el estudiantado un proceso de cambio en la aprehensión y vivencia de los derechos humanos de manera que logren reconstruir actitudes, aprender valores y desarrollar habilidades susceptibles de ejercitarse en su interacción diaria, por medio de conductas y actitudes coherentes con el respeto de los derechos humanos y la construcción de una cultura de paz. En este participan estudiantes del curso Espacios Lúdicos para la Educación en Derechos Humanos del Instituto de Estudios Latinoamericanos. Autores: Chacón Campos Stephanie González Camacho Ana Lucía Loría Cubillo Marco Oconitrillo Arce Yuliana Quesada Sancho Fabiola Adrián Barrantes Aguilar Karina Díaz Monge Edith Jiménez Venegas Valeria Moya Pereira Nicolás Salas Ruíz Ericka Sánchez Morera Raúl Hidalgo Perez Stephen Mekbel Ashley Pereira Mónica Cordero Ramírez Jennifer Matarrita Corrales Pamela Brenes Navarro Elvira Mena Brenes Daniela Murillo Orozco Susan Solano Monge Francisco Suarez Pérez Carlos González Leandro Priscilla López Rojas. Carolina Montero Iyara Vargas Lobo Evelyn Figueroa Elizondo Anne Hübner Jacqueline Valencia González Miriam Lizbeth Velázquez Ávila Valerie Calderón Jennifer Campos Jessica Ochoa Monserrath Navarro Ericka Lewis Carolina Rojas Jazmín Arroyo Calderón Melany Arroyo Calderón Mónica Brenes Luna María Sofía Haug Cordero María José Redondo Ríos Ayleen Cascante Zúñiga Marta Azofeifa Matamoros Melanie Guillén Miranda Scarleth Luca Brenes David Valverde Murillo María Castro Arce Natalia Chacón Muñoz Hazel Campos Hernández María José Garita Barahona Raquel González Hernández Laura Ramos Solórzano Gisselle Porras Víquez Pedro ChaverríThis didactic guide entitled "Educating in human rights, a space for play" is part of the project Active Classroom: educational games for peace education of the Institute of Latin American Studies (IDELA). This project seeks to foster in students a process of change in the understanding and experience of human rights so that they can rebuild attitudes, learn values and develop skills that can be exercised in their daily interaction, through behaviors and attitudes consistent with respect for human rights and the construction of a culture of peace. Students from the course Playful Spaces for Human Rights Education of the Institute of Latin American Studies participate in this one. Authors: Chacón Campos Stephanie González Camacho Ana Lucía Loría Cubillo Marco Oconitrillo Arce Yuliana Quesada Sancho Fabiola Adrian Barrantes Aguilar Karina Díaz Monge Edith Jimenez Venegas Valeria Moya Pereira Nicolás Salas Ruíz Ericka Sánchez Morera Raúl Hidalgo Perez Stephen Mekbel Ashley Pereira Mónica Cordero Ramírez Jennifer Matarrita Corrales Pamela Brenes Navarro Elvira Mena Brenes Daniela Murillo Orozco Susan Solano Monge Francisco Suarez Perez Carlos González Leandro Priscilla Lopez Rojas Carolina Montero Iyara Vargas Lobo Evelyn Figueroa Elizondo Anne Hübner Jacqueline Valencia González Miriam Lizbeth Velázquez Ávila Valerie Calderon Jennifer Campos Jessica Ochoa Monserrath Navarro Ericka Lewis Carolina Rojas Jazmin Arroyo Calderon Melany Arroyo Calderon Mónica Brenes Luna María Sofía Haug Cordero María José Redondo Ríos Ayleen Cascante Zúñiga Marta Azofeifa Matamoros Melanie Guillén Miranda Scarleth Luca Brenes David Valverde Murillo María Castro Arce Natalia Chacón Muñoz Hazel Campos Hernández María José Garita Barahona Raquel González Hernández Laura Ramos Solórzano Gisselle Porras Víquez Pedro ChaverríInstituto de Estudios Latinoamericano

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society