Propuesta de mejora en el procedimiento de Evaluación del Desempeño Laboral en la empresa Eben-ezer “La Roca “S.A.S. de Tuluá Valle para el año 2021

Anexo A. Diseño del cuestionarioLa Evaluación del Desempeño Laboral (EDL) es un proceso muy importante que consiste en integrar los elementos más importantes para medir el desempeño individual de los empleados, alineando sus actividades diarias e identificando sus fortalezas y debilidades para tener un buen desempeño y productividad en el trabajo. Por tal motivo, se realiza una propuesta para mejorar este proceso en la empresa EBENEZER "La Roca" SAS de la ciudad de Tuluá, para este año 2021. Se usará métodos e instrumentos cualitativos como una encuesta a los empleados para conocer el nivel de satisfacción y cuánto es la aceptación frente a los procesos actuales en la empresa. Este proceso va a ayudar a los empleados a tener un desempeño óptimo en la empresa y a reconocer el logro de las metas organizacionales, promoviendo el desarrollo y la calidad de vida de los empleados.The Assessment of the Labor Performance (ALP) is a very important process that consists in integrate the most important elements for measuring the individual performance of employers, aligning their daily activities and identifying their strengths and weakness for having a good performance and productivity in the job. For this reason, it was created a proposal to improve this process in the company Electroingenieria SAS of Tuluá city, for this year 2020. It will be used methods and qualitative instruments such as a poll to employers to know the satisfaction level and how much is the acceptance in front of the current processes in the company. This process is going to help the employees to have an optimize performance in the company and recognize the attainment of the organizational goals, promoting the development and quality of life of the employees

Clinical Characteristics and Treatment Patterns of Children and Adults With IgA Nephropathy or IgA Vasculitis: Findings From the CureGN Study

Introduction: The Cure Glomerulonephropathy Network (CureGN) is a 66-center longitudinal observational study of patients with biopsy-confirmed minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, or IgA nephropathy (IgAN), including IgA vasculitis (IgAV). This study describes the clinical characteristics and treatment patterns in the IgA cohort, including comparisons between IgAN versus IgAV and adult versus pediatric patients. Methods: Patients with a diagnostic kidney biopsy within 5 years of screening were eligible to join CureGN. This is a descriptive analysis of clinical and treatment data collected at the time of enrollment. Results: A total of 667 patients (506 IgAN, 161 IgAV) constitute the IgAN/IgAV cohort (382 adults, 285 children). At biopsy, those with IgAV were younger (13.0 years vs. 29.6 years, P < 0.001), more frequently white (89.7% vs. 78.9%, P = 0.003), had a higher estimated glomerular filtration rate (103.5 vs. 70.6 ml/min per 1.73 m2, P < 0.001), and lower serum albumin (3.4 vs. 3.8 g/dl, P < 0.001) than those with IgAN. Adult and pediatric individuals with IgAV were more likely than those with IgAN to have been treated with immunosuppressive therapy at or prior to enrollment (79.5% vs. 54.0%, P < 0.001). Conclusion: This report highlights clinical differences between IgAV and IgAN and between children and adults with these diagnoses. We identified differences in treatment with immunosuppressive therapies by disease type. This description of baseline characteristics will serve as a foundation for future CureGN studies

Racial-ethnic differences in health-related quality of life among adults and children with glomerular disease

The final, published version of this article is available at https://doi.org/10.1159/000516832Introduction: Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships among race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. Methods: Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: (1) missed school or work due to kidney disease and (2) responses to Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. Results: Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than white or Asian participants. Black adults missed work or school most frequently due to kidney disease (30 vs. 16–23% in the other 3 groups, p = 0.04), and had the worst self-reported global physical health (median score 44.1 vs. 48.0–48.2, p < 0.001) and fatigue (53.8 vs. 48.5–51.1, p = 0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status was associated with HRQOL. Conclusions: Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.Funding for the CureGN consortium is provided by U24DK100845 (formerly UM1DK100845), U01DK100846 (formerly UM1DK100846), U01DK100876 (formerly UM1DK100876), U01DK100866 (formerly UM1DK100866), and U01DK100867 (formerly UM1DK100867) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Patient recruitment is supported by NephCure Kidney International. Dates of funding for the first phase of CureGN were from September 16, 2013 to May 31, 2019. Dr. Krissberg is a Tashia and John Morgridge Endowed Postdoctoral Fellow of the Stanford Maternal and Child Health Research Institute. Dr. Nestor reports support by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant No. TL1TR001875. Dr. Kopp is supported by the Intramural Research Program, NIDDK, NIH

Racial and Ethnic Disparities in Acute Care Utilization Among Patients With Glomerular Disease.

RATIONALE & OBJECTIVE: The effects of race, ethnicity, socioeconomic status, and disease severity on acute care utilization (ACU) in patients with glomerular disease (GD) are unknown. STUDY DESIGN: A prospective cohort study. SETTING: & Participants: 1,456 adults and 768 children with biopsy proven GD enrolled in the Cure Glomerulonephropathy cohort. EXPOSURE: Race and ethnicity as a participant-reported social factor. OUTCOME: ACU defined as hospitalizations or emergency department visits. ANALYTICAL APPROACH: Multivariable recurrent event proportional rate models were used to estimate associations between race and ethnicity and ACU. RESULTS: Black or Hispanic participants had lower socioeconomic status and more severe GD compared to White or Asian participants. ACU rates were 45.6, 29.5, 25.8, and 19.2 per 100 person-years in Black, Hispanic, White, and Asian adults, respectively, and 55.8, 42.5, 40.8, and 13.0, respectively, for children. Compared to White race (reference group): Black race was significantly associated with ACU in adults (rate ratio (RR) 1.76, 95% Confidence Interval (CI) 1.37-2.27), although this finding was attenuated after multivariable adjustment (RR 1.31, 95% CI 1.03-1.68). Black race was not significantly associated with ACU in children; Asian race was significantly associated with lower ACU in children (RR 0.32, 95% CI 0.14-0.70); no significant associations between Hispanic ethnicity and ACU were identified. LIMITATIONS: We used proxies for socioeconomic status and lacked direct information on income, household unemployment or disability. CONCLUSIONS: Significant differences in ACU rates were observed across racial and ethnic groups in persons with prevalent GD, although many of these difference were explained by differences in socioeconomic status and disease severity. Measures to combat socioeconomic disadvantage in Black patients, and more effectively prevent and treat glomerular disease, are needed to reduce disparities in ACU, improve patient wellbeing, and reduce healthcare costs

Association of COVID-19 Versus COVID-19 Vaccination With Kidney Function and Disease Activity in Primary Glomerular Disease: A Report of the Cure Glomerulonephropathy Study

Patients with glomerular disease (GN) may be at increased risk of severe COVID-19, yet concerns over vaccines causing disease relapse may lead to vaccine hesitancy. We examined the associations of COVID-19 with longitudinal kidney function and proteinuria and compared these to similar associations with COVID-19 vaccination. Observational cohort study from July 1, 2021 to Jan. 1, 2023. & Participants: A prospective observational study network of 71 centers from North America and Europe (CureGN) with children and adults with primary minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, or IgA nephropathy. COVID-19 and COVID-19 vaccination. Repeated measure of estimated glomerular filtration rate (eGFR); recurrent time-to-event outcome of GN disease worsening as defined by doubling of UPCR to at least 1.5g/g or increase in dipstick urine protein by two ordinal levels to 3+ (300mg/dL) or above. Interrupted time series analysis for eGFR. Prognostic matched sequential stratification recurrent event analysis for GN disease worsening. Among 2,055 participants, 722 (35%) reported COVID-19; of these, 92 (13%) were hospitalized and 3 died (<1%). eGFR slope pre-COVID-19 was -1.40ml/min/1.73m2 (SD 0.29), and -4.26ml/min/1.73m2 (SD 3.02) within 6 months post-COVID-19, which were not significantly different (p=0.34). COVID-19 was associated with increased risk of worsening GN disease activity (HR 1.35, 95% CI 1.01-1.80). Vaccination was not associated with change in eGFR (-1.34ml/min/1.73m2, SD 0.15 vs -2.16ml/min/1.73m2, SD 1.74; p=0.6) or subsequent GN disease worsening (HR 1.02, 95% CI 0.79–1.33) in this cohort. Infrequent or short follow-up. Among patients with primary GN, COVID-19 was severe for 1 in 8 cases and was associated with subsequent worsening of GN disease activity, as defined by proteinuria. In contrast, vaccination against COVID-19 was not associated with change in disease activity or kidney function decline. These results support COVID-19 vaccination for patients with GN. In this cohort study of 2,055 patients with minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, or IgA nephropathy, COVID-19 resulted in hospitalization or death for 1 in 8 cases and was associated with a 35% increase in risk for worsening proteinuria. In contrast, vaccination did not appear to adversely affect kidney function or proteinuria. Our data support vaccination for COVID-19 in patients with glomerular disease