La estrategia comunicacional y mediática de Rafael Correa

Rafael Correa’s rise to power in 2007 implied a series of changes in communication and journalism. The impact of Correa’s discourse in the mass media, along with transformations of the media map in Ecuador (a chronological/descriptive map of various government/media activities is included in this study), and an analysis of the communication strategy of the President are likewise provided, which use as a reference news events disseminated by the national press. The study highlights the various confrontations between the government and private media, which not only generated a tense political environment, but also led to legal proceedings and fiery debate. This subsequently led to changes in the journalism profession and in the restructuring of media companies in Ecuador.La llegada de Rafael Correa a la presidencia de Ecuador en el año 2007 supuso una serie de cambios en la comunicación y el ejercicio periodístico. Se realiza un mapeo cronológico/descriptivo de las diversas acciones gobierno/medios.Se estudia el impacto del discurso de Correa en los medios, las transformaciones del mapa mediático en Ecuador, y la estrategia comunicacional presidencial, tomando como referencia acontecimientos difundidos por la prensa nacional.Las confrontaciones entre gobierno y medios privados genera un ambiente tenso, lleno de procesos judiciales y discusiones sin tregua, que han modificado el quehacer periodístico y con el la estructura de la empresa periodística en el país

The impact of a medication review with follow-up service on hospital admissions in aged polypharmacy patients

© 2016 The British Pharmacological Society Aims: The aims were to assess the impact of a medication review with follow-up (MRF) service provided in community pharmacy to aged polypharmacy patients on the number of medication-related hospital admissions and to estimate the effect on hospital costs. Methods: This was a sub-analysis of a cluster randomized controlled trials carried out in 178 community pharmacies in Spain. Pharmacies in the intervention group (IG) provided a comprehensive medication review during 6 months. Pharmacists in the comparison group (CG) delivered usual care. For the purposes of this sub-analysis, an expert panel of three internal medicine specialists screened the hospitalizations occurring during the main study, in order to identify medication-related hospitalizations. Inter-rater reliability was measured using Fleiss's kappa. Hospital costs were calculated using diagnosis related groups. Results: One thousand four hundred and three patients were included in the main study and they had 83 hospitalizations. Forty-two hospitalizations (50.6%) were medicine-related, with a substantial level of agreement among the experts (kappa = 0.65, 95% CI 0.52, 0.78, P < 0.01). The number of medication-related hospitalizations was significantly lower in patients receiving MRF (IG 11, GC 31, P = 0.042). The probability of being hospitalized was 3.7 times higher in the CG (odds ratio 3.7, 95% CI 1.2, 11.3, P = 0.021). Costs for a medicine-related hospitalization were €6672. Medication-related hospitalization costs were lower for patients receiving MRF [IG: €94 (SD 917); CG: €301 (SD 2102); 95% CI 35.9, 378.0, P = 0.018]. Conclusion: MRF provided by community pharmacists might be an effective strategy to balance the assurance of the benefit from medications and the avoidance of medication-related hospitalizations in aged patients using polypharmacy

RESPUESTAS EDUCATIVAS PARA ALTAS CAPACIDADES, SEGÚN EL MODELO DE ENRIQUECIMIENTO ESCOLAR TIPO III DE RENZULLI: ESTUDIO DE CASO EN EDUCACIÓN INICIAL

Algunas investigaciones previas han mostrado efectividad en la aplicación de respuestas educativas a niños con altas capacidades. El objetivo de esta investigación fue diseñar, aplicar y evaluar, por medio de la educación en línea, un programa para un niño de cinco años con altas capacidades, utilizando el Modelo de Enriquecimiento Escolar tipo III según Renzulli, además de medir la efectividad de la intervención. Por medio de la plataforma zoom, se entrevistó a padres y docentes y se aplicó un Proyecto de Enriquecimiento tipo III, según el modelo de Renzulli. Finalmente se evaluaron los resultados del trabajo. El niño demostró, durante y después de la implementacióndel programa, una valiosa motivación por aprender y se pudo observar que se potenciaron los intereses detectados por este modelo y las destrezas. Esta intervención fue exitosa a pesar de que se llevó a cabo durante la etapa de confnamiento de la pandemiapor COVID-19. Palabras claveModelo de enriquecimiento, aprendizaje basado en proyectos, altas capacidades, estudio de caso, educación inicial. AbstractPrevious research has shown efectiveness in the application of educational responses to gifted children. The objective of this research was to design, apply and evaluate, through online education, a program for a fve-year-old gifted child by using the Type III School Enrichment Model according to Renzull in addition to measuring the efectiveness of the intervention.Through the zoom platform, parents and teachers were interviewed and a type III Enrichment Project was applied according to the Renzulli model. Finally, the results of the work were evaluated. The child demonstrated during and after the implementation of the program a valuable motivation to learn and it was observed that the interests detected by this model and the skills were enhanced. This intervention was successful despite the fact that it was carried out during the confnement stage of the COVID-19 pandemic. KeywordsEnrichment model, project based learning, high capacities, case study, initial education

Centering Community Voices in Mining Governance

Peru has shifted away from centralized mining management to governance among government, companies, and communities. Various mechanisms facilitate community participation, including the mining canon, dialogues, and corporate social responsibility programs. Even with these laws and mechanisms, mining pollution and conflicts continue. In this study, we ask: how do communities perceive and participate in mining governance? And what are some alternative ways, driven by community priorities, to address governance in mining contexts? We collected 53 semi-structured with agricultural actors in two Peruvian districts with mining activity and analyzed those perspectives through the lens of community-centered governance. Our analyses revealed how centering community priorities in data collection and analysis illuminates context-specific factors that shape community attitudes toward mining and highlights community-driven approaches to addressing mining governance. Such community driven approaches could include integrating understandings of local livelihoods and historical contexts, implementing transparent participatory processes, and improving laws to give communities decision-making power over mining development

Cost-Utility Analysis of a Medication Review with Follow-Up Service for Older Adults with Polypharmacy in Community Pharmacies in Spain: The conSIGUE Program

© 2015, Springer International Publishing Switzerland. Background: The concept of pharmaceutical care is operationalized through pharmaceutical professional services, which are patient-oriented to optimize their pharmacotherapy and to improve clinical outcomes. Objective: The objective of this study was to estimate the incremental cost-effectiveness ratio (ICER) of a medication review with follow-up (MRF) service for older adults with polypharmacy in Spanish community pharmacies against the alternative of having their medication dispensed normally. Methods: The study was designed as a cluster randomized controlled trial, and was carried out over a time horizon of 6 months. The target population was older adults with polypharmacy, defined as individuals taking five or more medicines per day. The study was conducted in 178 community pharmacies in Spain. Cost-utility analysis adopted a health service perspective. Costs were in euros at 2014 prices and the effectiveness of the intervention was estimated as quality-adjusted life-years (QALYs). In order to analyze the uncertainty of ICER results, we performed a non-parametric bootstrapping with 5000 replications. Results: A total of 1403 older adults, aged between 65 and 94 years, were enrolled in the study: 688 in the intervention group (IG) and 715 in the control group (CG). By the end of the follow-up, both groups had reduced the mean number of prescribed medications they took, although this reduction was greater in the IG (0.28 ± 1.25 drugs; p < 0.001) than in the CG (0.07 ± 0.95 drugs; p = 0.063). Older adults in the IG saw their quality of life improved by 0.0528 ± 0.20 (p < 0.001). In contrast, the CG experienced a slight reduction in their quality of life: 0.0022 ± 0.24 (p = 0.815). The mean total cost was €977.57 ± 1455.88 for the IG and €1173.44 ± 3671.65 for the CG. In order to estimate the ICER, we used the costs adjusted for baseline medications and QALYs adjusted for baseline utility score, resulting in a mean incremental total cost of −€250.51 ± 148.61 (95 % CI −541.79 to 40.76) and a mean incremental QALY of 0.0156 ± 0.004 (95 % CI 0.008–0.023). Regarding the results from the cost-utility analysis, the MRF service emerged as the dominant strategy. Conclusion: The MRF service is an effective intervention for optimizing prescribed medication and improving quality of life in older adults with polypharmacy in community pharmacies. The results from the cost-utility analysis suggest that the MRF service is cost effective

Cost-Utility Analysis of a Medication Adherence Management Service Alongside a Cluster Randomized Control Trial in Community Pharmacy.

Background: It is necessary to determine the cost utility of adherence interventions in chronic diseases due to humanistic and economic burden of non-adherence. Purpose: To evaluate, alongside a cluster-randomized controlled trial, the cost-utility of a pharmacist-led medication adherence management service (MAMS) compared with usual care in community pharmacies. Materials and Methods: The trial was conducted over six months. Patients with treatments for hypertension, asthma or chronic obstructive pulmonary disease (COPD) were included. Patients in the intervention group (IG) received a MAMS based on a brief complex intervention, whilst patients in the control group (CG) received usual care. The cost–utility analysis adopted a health system perspective. Costs related to medications, healthcare resources and adherence intervention were included. The effectiveness was estimated as quality-adjusted life years (QALYs), using a multiple imputation missing data model. The incremental cost–utility ratio (ICUR) was calculated on the total sample of patients. Results: A total of 1186 patients were enrolled (IG: 633; CG: 553). The total intervention cost was estimated to be € 27.33 ± 0.43 per patient for six months. There was no statistically significant difference in total cost of medications and healthcare resources per patient between IG and CG. The values of EQ-5D-5L at 6 months were significantly higher in the IG [IG: 0.881 ± 0.005 vs CG: 0.833 ± 0.006; p = 0.000]. In the base case, the service was more expensive and more effective than usual care, resulting in an ICUR of € 1,494.82/QALY. In the complete case, the service resulted in an ICUR of € 2,086.30/QALY, positioned between the north-east and south-east quadrants of the cost–utility plane. Using a threshold value of € 20,000/QALY gained, there is a 99% probability that the intervention is cost-effective. Conclusion: The medication adherence management service resulted in an improvement in the quality of life of the population with chronic disease, with similar costs compared to usual care. The service is cost-effective

Morphological and molecular studies on the Brazilian native red seaweed Laurencia oliveirana (Rhodomelaceae, Ceramiales)

Morphological and molecular studies were carried out on Laurencia oliveirana from the type locality (Arraial do Cabo, Rio de Janeiro, Brazil). This species is easily recognized by its small size, sub-erect habit forming intricate cushion-like tufts and unilateral pectinate branching. The species displays all the typical characters of the genus Laurencia, such as the production of the first pericentral cell underneath the basal cell of the trichoblast, tetrasporangia produced from particular pericentral cells, with the third and fourth pericentral cells becoming fertile, without production of additional pericentral cells, spermatangial branches produced from one of two laterals on the suprabasal cell of trichoblasts, and procarp-bearing segment with five pericentral cells. Details of tetrasporangial plants and development of procarp and male plants are described for the first time for the species. The phylogenetic position of L. oliveirana was inferred by analysis of the chloroplast-encoded rbcL gene sequences from 57 taxa. In all phylogenetic analyses, L. oliveirana grouped with L. caraibica, L. caduciramulosa, L. venusta and L. natalensis, forming a monophyletic clade within the Laurencia sensu stricto. The genetic divergence between L. oliveirana and the molecularly closest species, L. caraiba collected in Brazil, was 2.3%

Thermodynamic analysis of the Quantum Critical behavior of Ce-lattice compounds

A systematic analysis of low temperature magnetic phase diagrams of Ce compounds is performed in order to recognize the thermodynamic conditions to be fulfilled by those systems to reach a quantum critical regime and, alternatively, to identify other kinds of low temperature behaviors. Based on specific heat ($C_m$) and entropy ($S_m$) results, three different types of phase diagrams are recognized: i) with the entropy involved into the ordered phase ($S_{MO}$) decreasing proportionally to the ordering temperature ($T_{MO}$), ii) those showing a transference of degrees of freedom from the ordered phase to a non-magnetic component, with their $C_m(T_{MO})$ jump ($\Delta C_m$) vanishing at finite temperature, and iii) those ending in a critical point at finite temperature because their $\Delta C_m$ do not decrease with $T_{MO}$ producing an entropy accumulation at low temperature. Only those systems belonging to the first case, i.e. with $S_{MO}\to 0$ as $T_{MO}\to 0$, can be regarded as candidates for quantum critical behavior. Their magnetic phase boundaries deviate from the classical negative curvature below $T\approx 2.5$\,K, denouncing frequent misleading extrapolations down to T=0. Different characteristic concentrations are recognized and analyzed for Ce-ligand alloyed systems. Particularly, a pre-critical region is identified, where the nature of the magnetic transition undergoes significant modifications, with its $\partial C_m/\partial T$ discontinuity strongly affected by magnetic field and showing an increasing remnant entropy at $T\to 0$. Physical constraints arising from the third law at $T\to 0$ are discussed and recognized from experimental results