Reconhecimento dos Conhecimentos Tradicionais em Saúde. Andes, Antioquia 2019: Abordagem qualitativa

Introduction: revaluing and re-signifying the identity of traditional health knowledge is challenging in a culture mediated by industrialization, surviving with a historical past, cultural and symbolic heritage, from a mixed identity that is conjugated in a territorial syncretism, which persists through physical and cultural traces of magical-religious traditions. Objective: to recognize the ethnographic particularities of the agents who carry popular knowledge in health that allows them to strengthen their practices in the Andes-Antioquia municipality. To re-signify these practices to recover their identity and symbolic ritual environments, in the configuration of their identity as an organic body in social spaces. Methodology: qualitative, descriptive type research, with ethnographic perspective (micro-ethnographic), systematized through in-depth interviews, accompanied by photographic records and participant observations. Results: 48 social agents between 30 and 70 years old, most of them settled in rural areas, were identified. Among them: sobanderos with secret, sobanderos with pain or componedores, hierbateros and rezanderos. Their diverse identity is recognized from a magical religious emergence and the characteristics of their inherited knowledge are exposed, in an enveloping rituality that recreates and vitalizes them in social spaces. Discussion: the results are analyzed within the framework of social, multidimensional and complex spaces, through its three elements: social structures, social relations and spatial forms. Conclusions: spatial forms transfer symbolism to the physical social space with characteristics that strengthen the exercise of their knowledge and identity. The gap between western knowledge and traditional knowledge is closing more and more due to the strength of its realities in the daily life of a globalized society. How to cite this article: Jaramillo Delgado Gonzalo Hernando, Agudelo Arias Mariana, Jaramillo Vargas Juliana, Moreno Villa Francia Elena. Reconocimiento de Saberes Tradicionales en Salud. Andes, Antioquia 2019: Aproximación Cualitativa. Revista Cuidarte. 2021;12(3):e1307. http://dx.doi.org/10.15649/cuidarte.1307Introducción: revalorizar y resignificar la identidad de los saberes tradicionales en salud es retador, en una cultura mediada por la industrialización, perviviendo con un pasado histórico, patrimonial cultural y simbólico, desde una identidad mixturada que se conjuga en un sincretismo territorial, que persiste a través de huellas físicas y culturales de tradiciones mágico religiosas. Objetivo: reconocer las particularidades etnográficas de los agentes portadores de saberes populares en salud que les permite afianzar sus prácticas en el municipio de Andes- Antioquia. Y resignificar estas prácticas para recuperar sus entornos identitarios y rituales simbólicos, en la configuración de su identidad como cuerpo orgánico en los espacios sociales. Metodología: investigación cualitativa, de tipo descriptivo, con perspectiva etnográfica (microetnográfica), sistematizada a través de entrevistas a profundidad acompañadas de registros fotográficos y observaciones participantes. Resultados: se reconocen 48 agentes sociales entre 30 y 70 años, la mayoría asentados en la ruralidad. Entre ellos: sobanderos con secreto, sobanderos con dolor o componedores, hierbateros y rezanderos. Se reconoce su identidad diversa desde una emergencia mágica religiosa y se exponen las características de sus saberes heredados, en una ritualidad  envolvente que los recrea y vitaliza en los espacios sociales. Discusión: se analizan los resultados en el marco del espacio social, multidimensional y complejo, a través de sus tres elementos: estructuras sociales, relaciones sociales y formas espaciales. Conclusiones: las formas espaciales trasladan el simbolismo al espacio social físico con características que afianzan el ejercicio de su saber y su identidad. La brecha entre los conocimientos occidentales y los saberes tradicionales se cierra cada vez más por la fuerza de sus realidades en la vida cotidiana, de una sociedad globalizada. Como citar este artículo:Jaramillo Delgado Gonzalo Hernando, Agudelo Arias Mariana, Jaramillo Vargas Juliana, Moreno Villa Francia Elena. Reconocimiento de Saberes Tradicionales en Salud. Andes, Antioquia 2019: Aproximación Cualitativa. Revista Cuidarte. 2021;12(3):e1307. http://dx.doi.org/10.15649/cuidarte.1307  Introdução: revalorizar e resignificar a identidade dos conhecimentos tradicionais em saúde é um desafio em uma cultura mediada pela industrialização, sobrevivendo com um passado histórico, cultural e simbólico, a partir de uma identidade mista de sincretismo territorial, que persiste através de traços físicos e culturais de tradições mágico-religiosas. Objetivo: reconhecer as particularidades etnográficas dos agentes portadores de conhecimentos populares em saúde que lhes permitam fortalecer suas práticas no município de Andes, Antioquia. E resignificar estas práticas a fim de recuperar seus espaços de identidade e rituais simbólicos, na configuração de sua identidade como um corpo orgânico em espaços sociais. Metodologia: pesquisa qualitativa, descritiva, com uma perspectiva etnográfica (microetnográfica), sistematizada através de entrevistas em profundidade acompanhadas de registros fotográficos e observações dos participantes. Resultados: Foram identificados 48 agentes sociais entre 30 e 70 anos de idade, a maioria deles instalados em áreas rurais. Entre eles: sobanderos com secreto, sobanderos com dor ou componedores, herboristas e curandeiros. Sua identidade diversificada é reconhecida a partir de uma emergência mágica religiosa e as características de seus conhecimentos herdados são expostas, em um ritual envolvente que os recria e os vitaliza nos espaços sociais. Discussão: os resultados são analisados no âmbito do espaço social, multidimensional e complexo, através de seus três elementos: estruturas sociais, relações sociais e formas espaciais. Conclusões: As formas espaciais traduzem o simbolismo em espaço social físico com características que fortalecem o exercício de seu conhecimento e identidade. A distância entre o conhecimento ocidental e o conhecimento tradicional está se fechando cada vez mais devido à força de suas realidades na vida cotidiana em uma sociedade globalizada. Como citar este artigo: Jaramillo Delgado Gonzalo Hernando, Agudelo Arias Mariana, Jaramillo Vargas Juliana, Moreno Villa Francia Elena. Reconocimiento de Saberes Tradicionales en Salud. Andes, Antioquia 2019: Aproximación Cualitativa. Revista Cuidarte. 2021;12(3):e1307. http://dx.doi.org/10.15649/cuidarte.130

Tratamiento normativo al status de beligerancia y terrorismo dentro del conflicto armado en Colombia

For about 50 years there has been an armed conflict in Colombia, but recently acknowledged by the government, leaving as a result huge social gaps, economic and devastating consequences and noticeable cultural changes in the national imaginaries of life and development. Terms as belligerency, terrorism, and armed conflict are now part of our lexicon. The pretension for this research is to address the issue of the regulatory treatment given by Colombian legislation to the status of belligerence, terrorism and armed conflict without neglecting of course that in this regard, our regulations have adopted those from the International Law through the Constitutionality cluster.En Colombia desde hace aproximadamente cincuenta años ha tenido lugar un conflicto armado, recientemente reconocido por el gobierno, que ha dejado como resultado grandes brechas sociales, consecuencias económicas devastadoras y cambios culturales notables en los imaginarios nacionales de vida y desarrollo. Términos como beligerancia, terrorismo y conflicto armado, hacen parte ahora de nuestro léxico. Es entonces como desde esta investigación se pretende abordar el tratamiento que desde la normativa se le ha dado al status de beligerancia, terrorismo y conflicto armado en la legislación colombiana, sin dejar de lado, por supuesto, que nuestra reglamentación ha adoptado normativas al respecto desde el Derecho Internacional mediante el bloque de constitucionalidad

El SECOP II y su implementación en la gobernación del departamento de Caldas

El gobierno de Colombia fijó mediante el Documento Conpes 3249, la política pública a seguir en materia de contratación del Estado. Para ello, entre otros criterios, estableció la creación de un sistema electrónico de contratación que se concretó mediante la expedición del Decreto 3485 (2011), sistema al que se le denominó SECOP (Sistema electrónico para la contratación pública), y está compuesto por tres plataformas: la Tienda Virtual del Estado Colombiano, el Secop I y el SECOP II.Por lo anterior, el semillero de investigación Contratación Estatal del Programa de Derecho de la Universidad Católica Luis Amigó, sede Manizales, decidió realizar un análisis sobre la preparación e implementación del SECOP II en la Gobernación del departamento de Caldas, con el fin de determinar si tal entidad cuenta con un grado o nivel óptimo de preparación jurídica, tecnológica, de infraestructura y de talento humano que le permita poner en funcionamiento esta plataforma de acuerdo con los parámetros dados por Colombia Compra Eficiente (CCE) como ente administrador de dicho sistema.El resultado expuesto es producto de un proceso de investigación jurídico-dogmática que desarrollaron los autores en cinco (5) fases mediante la aplicación de un método mixto con enfoque empírico-analítico

La renovación de una sede regional del Museo del Oro: el Museo del Oro Nariño

Las personas que trabajan en las diferentes secciones del Museo del Oro del Banco de la República de Colombia presentan y comparten sus buenas prácticas, procedimientos y metodologías para la renovación de la exposición permanente de un museo. El proceso, que integra colecciones patrimoniales, investigación arqueológica y participación de los públicos, se ilustra con la renovación de la exposición regional del Museo del Oro Nariño, en Pasto, reinaugurado en diciembre de 2016. Abstract Professionals from the different offices of the Banco de la República Gold Museum of Colombia present and share their best practices, procedures, and methodologies for the renovation of a museum's permanent exhibition. The process, which integrates heritage collections, archaeological research, and community participation, is illustrated with the renewal of the regional exhibition of the Nariño Gold Museum, in Pasto, reopened in December 2016

Taking the pulse of Earth's tropical forests using networks of highly distributed plots

Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests.Additional co-authors: Susan Laurance, William Laurance, Francoise Yoko Ishida, Andrew Marshall, Catherine Waite, Hannsjoerg Woell, Jean-Francois Bastin, Marijn Bauters, Hans Beeckman, Pfascal Boeckx, Jan Bogaert, Charles De Canniere, Thales de Haulleville, Jean-Louis Doucet, Olivier Hardy, Wannes Hubau, Elizabeth Kearsley, Hans Verbeeck, Jason Vleminckx, Steven W. Brewer, Alfredo Alarcón, Alejandro Araujo-Murakami, Eric Arets, Luzmila Arroyo, Ezequiel Chavez, Todd Fredericksen, René Guillén Villaroel, Gloria Gutierrez Sibauty, Timothy Killeen, Juan Carlos Licona, John Lleigue, Casimiro Mendoza, Samaria Murakami, Alexander Parada Gutierrez, Guido Pardo, Marielos Peña-Claros, Lourens Poorter, Marisol Toledo, Jeanneth Villalobos Cayo, Laura Jessica Viscarra, Vincent Vos, Jorge Ahumada, Everton Almeida, Jarcilene Almeida, Edmar Almeida de Oliveira, Wesley Alves da Cruz, Atila Alves de Oliveira, Fabrício Alvim Carvalho, Flávio Amorim Obermuller, Ana Andrade, Fernanda Antunes Carvalho, Simone Aparecida Vieira, Ana Carla Aquino, Luiz Aragão, Ana Claudia Araújo, Marco Antonio Assis, Jose Ataliba Mantelli Aboin Gomes, Fabrício Baccaro, Plínio Barbosa de Camargo, Paulo Barni, Jorcely Barroso, Luis Carlos Bernacci, Kauane Bordin, Marcelo Brilhante de Medeiros, Igor Broggio, José Luís Camargo, Domingos Cardoso, Maria Antonia Carniello, Andre Luis Casarin Rochelle, Carolina Castilho, Antonio Alberto Jorge Farias Castro, Wendeson Castro, Sabina Cerruto Ribeiro, Flávia Costa, Rodrigo Costa de Oliveira, Italo Coutinho, John Cunha, Lola da Costa, Lucia da Costa Ferreira, Richarlly da Costa Silva, Marta da Graça Zacarias Simbine, Vitor de Andrade Kamimura, Haroldo Cavalcante de Lima, Lia de Oliveira Melo, Luciano de Queiroz, José Romualdo de Sousa Lima, Mário do Espírito Santo, Tomas Domingues, Nayane Cristina dos Santos Prestes, Steffan Eduardo Silva Carneiro, Fernando Elias, Gabriel Eliseu, Thaise Emilio, Camila Laís Farrapo, Letícia Fernandes, Gustavo Ferreira, Joice Ferreira, Leandro Ferreira, Socorro Ferreira, Marcelo Fragomeni Simon, Maria Aparecida Freitas, Queila S. García, Angelo Gilberto Manzatto, Paulo Graça, Frederico Guilherme, Eduardo Hase, Niro Higuchi, Mariana Iguatemy, Reinaldo Imbrozio Barbosa, Margarita Jaramillo, Carlos Joly, Joice Klipel, Iêda Leão do Amaral, Carolina Levis, Antonio S. Lima, Maurício Lima Dan, Aline Lopes, Herison Madeiros, William E. Magnusson, Rubens Manoel dos Santos, Beatriz Marimon, Ben Hur Marimon Junior, Roberta Marotti Martelletti Grillo, Luiz Martinelli, Simone Matias Reis, Salomão Medeiros, Milton Meira-Junior, Thiago Metzker, Paulo Morandi, Natanael Moreira do Nascimento, Magna Moura, Sandra Cristina Müller, Laszlo Nagy, Henrique Nascimento, Marcelo Nascimento, Adriano Nogueira Lima, Raimunda Oliveira de Araújo, Jhonathan Oliveira Silva, Marcelo Pansonato, Gabriel Pavan Sabino, Karla Maria Pedra de Abreu, Pablo José Francisco Pena Rodrigues, Maria Piedade, Domingos Rodrigues, José Roberto Rodrigues Pinto, Carlos Quesada, Eliana Ramos, Rafael Ramos, Priscyla Rodrigues, Thaiane Rodrigues de Sousa, Rafael Salomão, Flávia Santana, Marcos Scaranello, Rodrigo Scarton Bergamin, Juliana Schietti, Jochen Schöngart, Gustavo Schwartz, Natalino Silva, Marcos Silveira, Cristiana Simão Seixas, Marta Simbine, Ana Claudia Souza, Priscila Souza, Rodolfo Souza, Tereza Sposito, Edson Stefani Junior, Julio Daniel do Vale, Ima Célia Guimarães Vieira, Dora Villela, Marcos Vital, Haron Xaud, Katia Zanini, Charles Eugene Zartman, Nur Khalish Hafizhah Ideris, Faizah binti Hj Metali, Kamariah Abu Salim, Muhd Shahruney Saparudin, Rafizah Mat Serudin, Rahayu Sukmaria Sukri, Serge Begne, George Chuyong, Marie Noel Djuikouo, Christelle Gonmadje, Murielle Simo-Droissart, Bonaventure Sonké, Hermann Taedoumg, Lise Zemagho, Sean Thomas, Fidèle Baya, Gustavo Saiz, Javier Silva Espejo, Dexiang Chen, Alan Hamilton, Yide Li, Tushou Luo, Shukui Niu, Han Xu, Zhang Zhou, Esteban Álvarez-Dávila, Juan Carlos Andrés Escobar, Henry Arellano-Peña, Jaime Cabezas Duarte, Jhon Calderón, Lina Maria Corrales Bravo, Borish Cuadrado, Hermes Cuadros, Alvaro Duque, Luisa Fernanda Duque, Sandra Milena Espinosa, Rebeca Franke-Ante, Hernando García, Alejandro Gómez, Roy González-M., Álvaro Idárraga-Piedrahíta, Eliana Jimenez, Rubén Jurado, Wilmar López Oviedo, René López-Camacho, Omar Aurelio Melo Cruz, Irina Mendoza Polo, Edwin Paky, Karen Pérez, Angel Pijachi, Camila Pizano, Adriana Prieto, Laura Ramos, Zorayda Restrepo Correa, James Richardson, Elkin Rodríguez, Gina M. Rodriguez M., Agustín Rudas, Pablo Stevenson, Markéta Chudomelová, Martin Dancak, Radim Hédl, Stanislav Lhota, Martin Svatek, Jacques Mukinzi, Corneille Ewango, Terese Hart, Emmanuel Kasongo Yakusu, Janvier Lisingo, Jean-Remy Makana, Faustin Mbayu, Benjamin Toirambe, John Tshibamba Mukendi, Lars Kvist, Gustav Nebel, Selene Báez, Carlos Céron, Daniel M. Griffith, Juan Ernesto Guevara Andino, David Neill, Walter Palacios, Maria Cristina Peñuela-Mora, Gonzalo Rivas-Torres, Gorky Villa, Sheleme Demissie, Tadesse Gole, Techane Gonfa, Kalle Ruokolainen, Michel Baisie, Fabrice Bénédet, Wemo Betian, Vincent Bezard, Damien Bonal, Jerôme Chave, Vincent Droissart, Sylvie Gourlet-Fleury, Annette Hladik, Nicolas Labrière, Pétrus Naisso, Maxime Réjou-Méchain, Plinio Sist, Lilian Blanc, Benoit Burban, Géraldine Derroire, Aurélie Dourdain, Clement Stahl, Natacha Nssi Bengone, Eric Chezeaux, Fidèle Evouna Ondo, Vincent Medjibe, Vianet Mihindou, Lee White, Heike Culmsee, Cristabel Durán Rangel, Viviana Horna, Florian Wittmann, Stephen Adu-Bredu, Kofi Affum-Baffoe, Ernest Foli, Michael Balinga, Anand Roopsind, James Singh, Raquel Thomas, Roderick Zagt, Indu K. Murthy, Kuswata Kartawinata, Edi Mirmanto, Hari Priyadi, Ismayadi Samsoedin, Terry Sunderland, Ishak Yassir, Francesco Rovero, Barbara Vinceti, Bruno Hérault, Shin-Ichiro Aiba, Kanehiro Kitayama, Armandu Daniels, Darlington Tuagben, John T. Woods, Muhammad Fitriadi, Alexander Karolus, Kho Lip Khoon, Noreen Majalap, Colin Maycock, Reuben Nilus, Sylvester Tan, Almeida Sitoe, Indiana Coronado G., Lucas Ojo, Rafael de Assis, Axel Dalberg Poulsen, Douglas Sheil, Karen Arévalo Pezo, Hans Buttgenbach Verde, Victor Chama Moscoso, Jimmy Cesar Cordova Oroche, Fernando Cornejo Valverde, Massiel Corrales Medina, Nallaret Davila Cardozo, Jano de Rutte Corzo, Jhon del Aguila Pasquel, Gerardo Flores Llampazo, Luis Freitas, Darcy Galiano Cabrera, Roosevelt García Villacorta, Karina Garcia Cabrera, Diego García Soria, Leticia Gatica Saboya, Julio Miguel Grandez Rios, Gabriel Hidalgo Pizango, Eurídice Honorio Coronado, Isau Huamantupa-Chuquimaco, Walter Huaraca Huasco, Yuri Tomas Huillca Aedo, Jose Luis Marcelo Peña, Abel Monteagudo Mendoza, Vanesa Moreano Rodriguez, Percy Núñez Vargas, Sonia Cesarina Palacios Ramos, Nadir Pallqui Camacho, Antonio Peña Cruz, Freddy Ramirez Arevalo, José Reyna Huaymacari, Carlos Reynel Rodriguez, Marcos Antonio Ríos Paredes, Lily Rodriguez Bayona, Rocio del Pilar Rojas Gonzales, Maria Elena Rojas Peña, Norma Salinas Revilla, Yahn Carlos Soto Shareva, Raul Tupayachi Trujillo, Luis Valenzuela Gamarra, Rodolfo Vasquez Martinez, Jim Vega Arenas, Christian Amani, Suspense Averti Ifo, Yannick Bocko, Patrick Boundja, Romeo Ekoungoulou, Mireille Hockemba, Donatien Nzala, Alusine Fofanah, David Taylor, Guillermo Bañares-de Dios, Luis Cayuela, Íñigo Granzow-de la Cerda, Manuel Macía, Juliana Stropp, Maureen Playfair, Verginia Wortel, Toby Gardner, Robert Muscarella, Hari Priyadi, Ervan Rutishauser, Kuo-Jung Chao, Pantaleo Munishi, Olaf Bánki, Frans Bongers, Rene Boot, Gabriella Fredriksson, Jan Reitsma, Hans ter Steege, Tinde van Andel, Peter van de Meer, Peter van der Hout, Mark van Nieuwstadt, Bert van Ulft, Elmar Veenendaal, Ronald Vernimmen, Pieter Zuidema, Joeri Zwerts, Perpetra Akite, Robert Bitariho, Colin Chapman, Eilu Gerald, Miguel Leal, Patrick Mucunguzi, Miguel Alexiades, Timothy R. Baker, Karina Banda, Lindsay Banin, Jos Barlow, Amy Bennett, Erika Berenguer, Nicholas Berry, Neil M. Bird, George A. Blackburn, Francis Brearley, Roel Brienen, David Burslem, Lidiany Carvalho, Percival Cho, Fernanda Coelho, Murray Collins, David Coomes, Aida Cuni-Sanchez, Greta Dargie, Kyle Dexter, Mat Disney, Freddie Draper, Muying Duan, Adriane Esquivel-Muelbert, Robert Ewers, Belen Fadrique, Sophie Fauset, Ted R. Feldpausch, Filipe França, David Galbraith, Martin Gilpin, Emanuel Gloor, John Grace, Keith Hamer, David Harris, Tommaso Jucker, Michelle Kalamandeen, Bente Klitgaard, Aurora Levesley, Simon L. Lewis, Jeremy Lindsell, Gabriela Lopez-Gonzalez, Jon Lovett, Yadvinder Malhi, Toby Marthews, Emma McIntosh, Karina Melgaço, William Milliken, Edward Mitchard, Peter Moonlight, Sam Moore, Alexandra Morel, Julie Peacock, Kelvin Peh, Colin Pendry, R. Toby Pennington, Luciana de Oliveira Pereira, Carlos Peres, Oliver L. Phillips, Georgia Pickavance, Thomas Pugh, Lan Qie, Terhi Riutta, Katherine Roucoux, Casey Ryan, Tiina Sarkinen, Camila Silva Valeria, Dominick Spracklen, Suzanne Stas, Martin Sullivan, Michael Swaine, Joey Talbot, James Taplin, Geertje van der Heijden, Laura Vedovato, Simon Willcock, Mathew Williams, Luciana Alves, Patricia Alvarez Loayza, Gabriel Arellano, Cheryl Asa, Peter Ashton, Gregory Asner, Terry Brncic, Foster Brown, Robyn Burnham, Connie Clark, James Comiskey, Gabriel Damasco, Stuart Davies, Tony Di Fiore, Terry Erwin, William Farfan-Rios, Jefferson Hall, David Kenfack, Thomas Lovejoy, Roberta Martin, Olga Martha Montiel, John Pipoly, Nigel Pitman, John Poulsen, Richard Primack, Miles Silman, Marc Steininger, Varun Swamy, John Terborgh, Duncan Thomas, Peter Umunay, Maria Uriarte, Emilio Vilanova Torre, Ophelia Wang, Kenneth Young, Gerardo A. Aymard C., Lionel Hernández, Rafael Herrera Fernández, Hirma Ramírez-Angulo, Pedro Salcedo, Elio Sanoja, Julio Serrano, Armando Torres-Lezama, Tinh Cong Le, Trai Trong Le, Hieu Dang Tra

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Tratamiento normativo al status de beligerancia y terrorismo dentro del conflicto armado en Colombia

For about 50 years there has been an armed conflict in Colombia, but recently acknowledged by the government, leaving as a result huge social gaps, economic and devastating consequences and noticeable cultural changes in the national imaginaries of life and development. Terms as belligerency, terrorism, and armed conflict are now part of our lexicon. The pretension for this research is to address the issue of the regulatory treatment given by Colombian legislation to the status of belligerence, terrorism and armed conflict without neglecting of course that in this regard, our regulations have adopted those from the International Law through the Constitutionality cluster.En Colombia desde hace aproximadamente cincuenta años ha tenido lugar un conflicto armado, recientemente reconocido por el gobierno, que ha dejado como resultado grandes brechas sociales, consecuencias económicas devastadoras y cambios culturales notables en los imaginarios nacionales de vida y desarrollo. Términos como beligerancia, terrorismo y conflicto armado, hacen parte ahora de nuestro léxico. Es entonces como desde esta investigación se pretende abordar el tratamiento que desde la normativa se le ha dado al status de beligerancia, terrorismo y conflicto armado en la legislación colombiana, sin dejar de lado, por supuesto, que nuestra reglamentación ha adoptado normativas al respecto desde el Derecho Internacional mediante el bloque de constitucionalidad

El aprendizaje de los estudiantes de enfermería en la interacción con el docente experto

Objective: To describe the learning process of nursing students in the interaction with the expert teacher. Methodology: Qualitative investigation, using ethnographic tools. One teacher was identified as an expert teacher. The field work was done in two phases. In the first, two observations were made during the classes; and 23 think aloud interviews were conducted with six students. In the second phase, eight in-depth interviews were conducted with six students. Descriptive analysis and categorization was carried out using the Atlas Ti computer program. Results: From the student-teacher interaction emerged two categories describing the learning process. The first is “the interaction between students and the expert teacher: a process of dos”, which is developed through explanation, spontaneous interventions by students and recapitulation exercises. The second one is about “apprenticeships: for life”, which are shown through the identification of different ways of learning, apprenticeships to learn and tacit apprenticeships. Conclusions: The learning process in the interaction between the expert teacher and the students is dynamic, flexible and open. It is a space where the students and the teacher build an active, flexible and bidirectional relationship that helps the professional training processes in Nursing, making it possible for the students to obtain significant learnings.Objetivo: Descrever o processo de aprendizagem dos estudantes de enfermagem na interação com o professor especialista. Materiais e métodos: Pesquisa qualitativa, utilizando ferramentas da etnografia. Um educador foi identificado como professor especialista. A coleta de informações foi realizada em duas fases. Na primeira, realizaram-se observações de duas aulas e 23 entrevistas think aloud com 6 alunos. Na segunda fase, foram realizadas oito entrevistas em profundidade com seis alunos. A análise descritiva e a categorização foram realizadas no programa Atlas Ti. Resultados: Emergiram duas categorias da interação aluno-professor que descrevem o processo de aprendizagem. A primeira é “a interação entre os alunos e o professor especialista: um processo de dois”, desenvolvido por meio de explicações, intervenções espontâneas dos alunos e exercícios de recapitulação. A segunda trata do “aprendizado: permanece a vida toda”, o qual se evidencia na identificação dos diferentes modos de aprender, aprendizagens para aprender e o aprendizado implícito. Conclusões: O processo de aprendizagem na interação entre o professor especialista e os alunos é dinâmico, flexível e aberto. É um espaço onde os alunos e o professor constroem uma relação ativa, proativa e bidirecional que favorece os processos de ensino em Enfermagem, fazendo com que os alunos obtenham aprendizados significativos.Objetivo: Describir el proceso de aprendizaje de los estudiantes de enfermería en la interacción con el docente experto. Materiales y Métodos: Investigación cualitativa, utilizando herramientas de la etnografía. Se identificó un docente reconocido como docente experto. La recolección de la información se hizo en dos fases. En la primera de realizaron observaciones durante dos clases y 23 entrevistas think aloud a 6 estudiantes. En la segunda fase se realizaron 8 entrevistas a profundidad a seis estudiantes. Se realizó el análisis descriptivo y la categorización en el programa Atlas Ti. Resultados: A Partir de la interacción estudiante-docente emergieron dos categorías que describen el proceso de aprendizaje. La primera es “la interacción entre los estudiantes y el docente experto: un procesos de dos”, que se desarrolla mediante la explicación, las intervenciones espontáneas de los estudiantes y los ejercicios de recapitulación. La segunda trata sobre “los aprendizajes: se quedan para la vida”, los cuales se evidencian en la identificación de las diversas formas de aprender, los aprendizajes para aprender y los aprendizajes implícitos. Conclusiones: El proceso de aprendizaje en la interacción entre el docente experto y los estudiantes es dinámico, flexible y abierto. Es un espacio donde los estudiantes y el docente construyen una relación activa, propositiva y bidireccional que favorece los procesos formativos en Enfermería, haciendo que los estudiantes obtengan aprendizajes significativos

Ecohotel Los Balcones de Darién

El ecohotel se dedica a promover el turismo ecológico de la región del Valle del Cauca, prestando servicios de hotelería, educación en temas ecológicos, turismo, y apoyo en eventos especiales

Intravascular lymphoma, the great simulator: Case report

Introducción El linfoma intravascular representa un subtipo de linfoma B muy poco común, sus síntomas diversos lo hacen un reto diagnóstico. Caso clínico Presentamos un caso de una paciente con síntomas desde hace un año, dados por compromiso cognitivo y de la marcha, con presencia de múltiples lesiones en la resonancia magnética. Su estado neurológico empeoró rápidamente, progresando a la muerte. La necropsia reportó la presencia de células tumorales en la luz de los vasos, compatible con linfoma intravascular. Conclusión Este linfoma no tiene síntomas específicos. Se debe sospechar rápidamente, ya que su mortalidad es del 90% sin tratamiento.Introduction Intravascular lymphoma is a very uncommon subtype of B-Cell lymphoma, it has many clinical manifestations which makes it a diagnostic challenge. Case report We present a patient who had cognitive deterioration and gait disturbance for over a year, with multiple lesions evidenced on MRI. Her neurological condition worsened rapidly, progressing to death. Necropsy reported the presence of tumor cells in the lumen of vessels compatible with intravascular lymphoma. Conclusion This lymphoma has no specific symptoms. It should be suspected quickly since their mortality is 90% without treatment