La rebelión campesina. Entrevista a la Asociación Nacional de Zonas de Reservas Campesinas (ANZORC)

In 2013, cries of protest echoed in Colombia. Peasant outrage was the epicenter of strong mobilizations, whose waves spread and made themselves felt throughout the country, making the ruling class stagger. Old-but not very current-claims, such as that the land belongs to the peasant who works it, were echoed in a country that showed solidarity with this and other causes that make up a complex agrarian problem. At a time when the Colombian government is negotiating peace with the FARC, the problem of land ownership in Colombia - the initial vertex of a conflict that has lasted more than half a century - is far from being resolved.En el 2013 los gritos de protesta retumbaron en Colombia. La indignación campesina fue el epicentro de fuertes movilizaciones, cuyas ondas se esparcieron e hicieron sentir a lo largo y ancho del país, haciendo tambalear a la clase gobernante. Antiguas -pero no poco actuales- reivindicaciones, como que la tierra es del campesino que la trabaja, tuvieron eco en un país que se solidarizó con esta y otras causas que componen una compleja problemática agraria. En tiempos en que el gobierno colombiano negocia la paz con las FARC, el problema de la posesión de la tierra en Colombia -vórtice inicial de un conflicto que ha durado más de medio siglo- se encuentra lejos de solucionarse

“Yo no parí hijos para una guerra”. Entrevista a Luz Marina Bernal, lideresa de las Madres de Soacha

In late 2008, during the administration of former President Álvaro Uribe, Colombian society was stunned by the cases of the so-called "false positives" (in military parlance the term "positive" is used to speak of enemy casualties). By then, a systematic plan of extrajudicial executions was uncovered. Colombian army soldiers kidnapped and killed innocent civilians, posing as insurgents killed in combat, in order to collect juicy rewards. Some calculations indicate more than 4,000 alleged cases of extrajudicial killings by the state security forces, most of them for false positives, in 31 of the 32 departments. Atrocities committed in the heat of a war in which everything goes and that has seen the worst of both sides, sometimes relativizing the line that divides the heroes from the villains. Luz Marina Bernal is the mother of a "false positive", killed by the ambition of those who had the duty to protect him. One more example of how far the enduring Colombian armed conflict has come, with more than half a century of existence. Coming from Soacha, one of the popular municipalities in the south of Bogotá, Luz Marina tells us the heartbreaking story of what happened with her 26-year-old son, Fair Leonardo Porras Bernal, and how she went from being a simple housewife who studied clothing and card company, a fierce human rights activist in Colombia, along with other mothers whose children were also unfairly taken from them.A finales de 2008, durante la administración del expresidente Álvaro Uribe,  la sociedad colombiana quedó atónita ante los casos de los llamados “falsos positivos” (en la jerga militar el término “positivo” es utilizado para hablar de las bajas enemigas). Para ese entonces, se destapó un sistemático plan de ejecuciones extrajudiciales. Soldados del ejército colombiano secuestraron y ultimaron civiles inocentes, a los cuales hacían pasar por insurgentes muertos en combate, para así cobrar jugosas recompensas. Algunos cálculos señalan más de 4 mil presuntos casos de asesinatos extrajudiciales por las fuerzas de seguridad del Estado, la mayoría de ellas por falsos positivos, en 31 de los 32 departamentos. Atrocidades cometidas al calor de una guerra en la que todo se vale y que ha visto lo peor de ambos bandos, relativizando en ocasiones la línea que divide a los héroes de los villanos. Luz Marina Bernal es madre de un “falso positivo”, asesinado por la ambición de quienes tenían el deber de protegerlo. Una muestra más de lo lejos que ha llegado el imperecedero conflicto armado colombiano, con más de medio siglo de existencia. Proveniente de Soacha, uno de los municipios populares al sur de Bogotá, Luz Marina nos cuenta la desgarradora historia de lo ocurrido con su hijo de 26 años, Fair Leonardo Porras Bernal, y cómo pasó de ser una simple ama de casa que estudiaba confección y tarjetería, a una férrea activista defensora de los derechos humanos en Colombia, junto con otras madres a las cuales también les fueron arrebatados sus hijos injustamente

Development and test of a decision support tool for hospital health technology assessment

Objective: To develop and test a decision-support tool for prioritizing new competing Health Technologies (HTs) after their assessment using the mini-HTA approac

Identification and selection of health technologies for assessment by agencies in support of reimbursement decisions in Latin America

OBJECTIVE: There is no health system that has the resources to evaluate all technologies. The presence of a clear process to prioritize health technologies for assessment by health technology assessment (HTA) agencies is a good practice principle recognized at the international level. The objective of Health Technology Assessment International's 2020 Latin American Policy Forum (LatamPF) was to explore how to improve the way HTA agencies in Latin America identify and prioritize technologies for assessment. METHODS: This paper is based on a background document, a survey, and the deliberations of the members of the LatamPF (forty-six participants from eleven countries) using a design thinking methodology. RESULTS: Participants agreed that a lack of clear prioritization mechanisms results in HTA processes and decisions that are perceived to be of low transparency and overly exposed to political or interest group pressures. The LatamPF identified barriers and recommended actions to improve HTA prioritization mechanisms in Latin America. The criteria identified as the most important to be taken into consideration by HTA agencies in the region when prioritizing a technology for assessment were: the burden of illness, the potential clinical benefit, the alignment with national health priorities, the potential impact on equity, a lack of treatment alternatives for patients, and the potential economic impact. CONCLUSIONS: Forum participants agreed that the establishment of transparent prioritization processes is a key element for all health systems. Improvements in these processes will strengthen HTA and provide greater legitimacy to decision making.Fil: Pichón-riviere, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: García Martí, Sebastián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Alcaraz, Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Alfie, Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Sampietro Colom, Laura. Hospital Clinic de Barcelona; Españ

Arte en los muros. El muralismo como expresión cultural y artística en el espacio público de la ciudad de Córdoba.

El presente registro corresponde a un trabajo final para obtener el grado de licenciatura en comunicación social. Incluye un producto audiovisualEl presente trabajo se propone narrar en formato audiovisual la actividad del muralismo en el espacio público de la ciudad de Córdoba, mediante un registro documental que dé cuenta la manera en la que se encuentra presente en la ciudad, y los actores que intervienen activa y pasivamente. Además, pretende demostrar cómo el muralismo ha ido avanzando y mutando desde el año 2013 hasta el 2016

Readmissions and the quality of care in patients hospitalized with heart failure

Objectives. Clinical practice guidelines based on the results of randomized clinical trials recommend that patients with heart failure due to left ventricular systolic dysfunction (LVSD) be treated with angiotensin-converting enzyme inhibitors (ACEI) at doses shown to reduce mortality and readmission. This study examined the relationship between ACEI use at discharge and readmission among patients with heart failure due to LVSD. Methods and results. Data were abstracted from the medical records of 2943 randomly selected patients hospitalized for heart failure in 50 hospitals. The outcome of interest was the number of readmissions occurring up to 21 months after discharge. Six-hundred and eleven patients were eligible for analysis. Compared with patients discharged at a recommended ACEI dose, patients not prescribed an ACEI at discharge had an adjusted rate ratio of readmission (RR) of 1.74 [95% confidence interval (CI) 1.22-2.48], while patients prescribed an ACEI at less than a recommended dose had an RR of 1.24 (95% CI 0.91-1.69) (P = 0.005 for the trend). Conclusion. Our results show that ACEI use at discharge in patients with LVSD is associated with decreased rate of readmission. These findings suggest that compliance with the ACEI prescribing recommendations listed in clinical practice guidelines for patients with heart failure due to LVSD confers benefi

Economic Impact of a New Rapid PCR Assay for Detecting Influenza Virus in an Emergency Department and Hospitalized Patients

Seasonal influenza causes significant morbidity and mortality and has a substantial economic impact on the healthcare system. The main objective of this study was to compare the cost per patient for a rapid commercial PCR assay (Xpert1 Flu) with an in-house real-time PCR test for detecting influenza virus. Community patients with influenza like-illness attending the Emergency Department (ED) as well as hospitalized patients in the Hospital Clínic of Barcelona were included. Costs were evaluated from the perspective of the hospital considering the use of resources directly related to influenza testing and treatment. For the purpose of this study, 366 and 691 patients were tested in 2013 and 2014, respectively. The Xpert1 Flu test reduced the mean waiting time for patients in the ED by 9.1 hours and decreased the mean isolation time of hospitalized patients by 23.7 hours. This was associated with a 103€ (or about $113) reduction in the cost per patient tested in the ED and 64€ ($70) per hospitalized patient. Sensitivity analyses showed that Xpert1 Flu is likely to be cost-saving in hospitals with different contexts and prices

An accelerated access pathway for innovative high-risk medical devices under the new European Union Medical Devices and health technology assessment regulations?:Analysis and recommendations

Introduction: The new European Union (EU) Regulations for medical devices (MDs) and health technology assessment (HTA) are welcome developments that will hopefully increase the quality of clinical evidence for MDs and reduce fragmentation in the EU market access process. To fully exploit anticipated benefits, their respective assessment processes should be closely coordinated, particularly for promising, highly innovative MDs. Accelerated approval is worth exploring for certain categories of high-risk MDs to keep the EU regulatory process competitive compared to ad-hoc accelerated MD approval processes elsewhere (e.g., US). Areas covered: Problems observed in worldwide accelerated drug and MD regulatory approval programs are reviewed, including greater uncertainty in pre-market clinical evidence generation and lack of oversight for post-approval evidence requirements. Implications for MD approval, HTA and coverage are explored. Expert opinion: Through analysis of two decades of drug and MD accelerated approval programs worldwide, recommendations for an Accelerated Access Pathway for select innovative, high-risk MDs are proposed that can fit the EU context, leverage the two new regulations, increase opportunities for Expert Panels to provide timely advice regarding manufacturers’ evidence generation plans along the MD lifecycle (pre-, post-market), and safely speed patient access while promoting increased collaboration among Member States on coverage decisions.</p

Demodicosis felina por Demodex Gatoi

Demodex gatoi es responsable de una dermatosis felina rara que, hasta hace escasos años, solo se diagnosticaba en EEUU, pero que desde 2001 está emergiendo en Europa, habiéndose comunicado casos esporádicos (1). En esta presentación se describe el primer caso en España