Aparcamiento subterráneo bajo el carrer del Capità Arenas

El barrio de Sarrià adolece de suficiente capacidad de estacionamiento debido a lo abigarrado de la trama urbana. En este caso se propone estudiar una solución en la zona norte del mismo aprovechando el espacio existente frente a la iglesia de Sant Miquel de Sarrià y eventualmente el Paseo de Sant Gervasi, buscando al mismo tiempo proporcionar servicio al Mercado municipal existente en las inmediaciones

Vicisitudes del protocolo de nagoya en colombia

La participación “justa y equitativa” de los beneficios que deriven la utilización de recursos genéticos no sólo es uno de los objetivos centrales del Protocolo de Nagoya, sino además es un reto para las comunidades de científicos, investigadores, comunidades indígenas ancestrales y en general, para la comunidad educativa. Por consiguiente, es esencial conocer cuáles son las implicaciones materiales y reales para la población, la ratificación del Protocolo de Nagoya, el cual a pesar de tener una justificación suficiente y argumentada, pone de manifiesto la necesidad de preparar las herramientas jurídicas, económicas, tecnológicas y educativas para su correcta y justa implementación

Propuesta para optimizar el manejo y control de inventarios en la distribuidora Merka Unión

203 páginas y anexosDistribuidora Merka Union, is a family business, founded 24 years ago in the city of Bogota in order to distribute and sell groceries, food, toiletries and pet food. The company has grown over the years, which is why the need to implement an inventory management policy has become apparent. Customer service is currently being affected because the company has a large number of shortages and over-stock in the inventory, avoiding the company's growth and profit, which, in the last two years, analyzed in different periods, it has lost on average $150,000,000 and, as it is a family business, represents a loss of significant magnitude. In this order of ideas it was necessary to raise the following general objective: to present a proposal for improvement in the management and administration of inventories to the Merka Union Distributor, based on models that apply to the nature of the businessDistribuidora Merka Unión, es una empresa familiar, fundada hace 24 años en la ciudad de Bogotá con el fin de distribuir y vender abarrotes, víveres, productos de aseo y comida para mascotas. La empresa ha crecido con el paso de los años, por lo que ha empezado a hacerse notoria la necesidad de implementar una política de administración de inventario. Actualmente se está afectando el servicio al cliente debido a que la empresa cuenta con gran cantidad de faltantes y sobre-stock en el inventario, evitando el crecimiento y utilidad de la compañía, que, en los últimos dos años, analizados en diferentes periodos, ha perdido en promedio$150,000.000 y, por tratarse de una empresa de carácter familiar, representa una perdida de magnitud importante. En este orden de ideas se hizo necesario plantear el siguiente objetivo general: presentar una propuesta de mejora en la gestión y administración de inventarios a la Distribuidora Merka Union, con base en modelos que aplican a la naturaleza del negocioEspecialista en Gerencia con Énfasis en Logística y Comercio InternacionalEspecializació

Mitigación del riesgo biomecánico del área operativa de la empresa Dígitos y Diseños industria gráfica SAS. un aporte desde el análisis ergonómico de puestos de trabajo.

189 p.770/5000 In Colombia, according to the I and II ENCSST, they identify the musculoskeletal risk factors as the most reported by workers, analyzing the company DIGITOS Y DISEÑOS INDUSTRIA GRAFICA SAS and the health diagnosis issued by the Health Service Provider Institution (IPS) in charge From the performance of the occupational medical examinations, it was evidenced that 35% of the workers referred pain of musculoskeletal origin, based on this, an analysis of these risk factors was carried out through the OCRA, RULA and GINSTH methods for repetitive movements, load postural and manual handling of loads respectively, finding as a result the need to redesign activities and jobs in the operational area.1. Título. 2. Problema de investigación. 3. Objetivos. 4. Justificación y delimitación. 5. Marcos referenciales. 6. Diseño metodológico. 7. Resultados. 8. Análisis financiero (costo-beneficio). 9. Conclusiones. 10. Referencias bibliográficas.En Colombia, según la I y II ENCSST identifican los factores de riesgo musculoesqueléticos como los más reportados por los trabajadores, Analizando la empresa DIGITOS Y DISEÑOS INDUSTRIA GRAFICA SAS y el diagnóstico de salud emitido por la Institución Prestadora de Servicios de Salud (IPS) encargada de la realización de los exámenes médicos ocupacionales se evidencio que el 35% de los trabajadores refirieron dolor de origen músculo esquelético, partiendo de esto se realizo análisis de estos factores de riesgo por medio de los métodos OCRA, RULA y GINSTH para movimientos repetitivos, carga postural y manipulación manual de cargas respectivamente encontrando como resultado la necesidad de realizar rediseño en actividades y puestos de trabajo del área operativa

Estigmatização e cuidado de doenças neurocognitivas e de saúde mental em idosos

The aging of the national and world population has awakened interest in documenting events related to older adults’ health and disease processes, which are prevalent in this population group. According to the World Health Organization, 20% of older people suffer from some form of mental illness resulting from the physical, psychological, and social processes of aging, as well as neurocognitive disorders. One resulting situation is the stigmatization of older people with mental illness or neurocognitive disease (Alzheimer-Parkinson’s). According to different authors, at least 40% of people with dementia feel excluded from society; their caregivers and family members are also concerned about social rejection. In order to identify the scientific literature related to stigmatization and care of neurocognitive and mental health conditions in the elderly, the following topic review was proposed.El envejecimiento poblacional nacional y mundial ha despertado el interés por evidenciar los eventos relacionados con el proceso de salud y enfermedad de la persona mayor que son prevalentes en este grupo poblacional. De acuerdo a la Organización Mundial de la Salud, el 20 % de las personas mayores presentan alguna enfermedad mental, derivada de los procesos físicos, psicológicos y sociales del envejecimiento, así como de las enfermedades neurocognitivas. Una situación derivada es la estigmatización de las personas mayores con enfermedad mental o con enfermedad neurocognitiva (Alzheimer-Parkinson). De acuerdo a diferentes autores se encuentra que por lo menos el 40 % de las personas con demencias consideran que son excluidas de la sociedad; también sus cuidadores y familiares se preocupan por situaciones de rechazo social. Con el fin identificar la literatura científica relacionada con la estigmatización y el cuidado de las enfermedades neurocognitivas y de la salud mental de la persona mayor se propuso realizar la siguiente revisión de tema.O envelhecimento populacional nacional e mundial tem despertado interesse em evidenciar os eventos relacionados ao processo de saúde e adoecimento dos idosos que são prevalentes neste grupo populacional. Segundo a Organização Mundial da Saúde, 20% dos idosos apresentam alguma doença mental, decorrente dos processos físicos, psicológicos e sociais do envelhecimento, além de doenças neurocognitivas. Uma situação derivada é a estigmatização de pessoas idosas com doença mental ou doença neurocognitiva (Alzheimer-Parkinson). De acordo com diferentes autores, verifica-se que pelo menos 40% das pessoas com demência consideram-se excluídas da sociedade; seus cuidadores e familiares também se preocupam com situações de rejeição social. A fim de identificar a produção científica relacionada à estigmatização e aos cuidados com as doenças neurocognitivas e saúde mental do idoso, propôs-se a realização da seguinte revisão temática

Associated factors for mortality in a COVID-19 colombian cohort : is the third wave relevant when Mu variant was predominant epidemiologically?

Q1Q1Pacientes con COVID-19Objectives: To evaluate the association between Colombia's third wave when the Mu variant was predominant epidemiologically (until 75%) in Colombia and COVID-19 all-cause in-hospital mortality. Methods: In this retrospective cohort, we included hospitalized patients ≥18 years with SARS-CoV-2 infection between March 2020 to September 2021 in ten hospitals from three cities in Colombia. Description analysis, survival, and multivariate Cox regression analyses were performed to evaluate the association between the third epidemic wave and in-hospital mortality. Results: A total of 25,371 patients were included. The age-stratified time-to-mortality curves showed differences according to epidemic waves in patients ≥75 years (log-rank test p = 0.012). In the multivariate Cox analysis, the third wave was not associated with increased mortality relative to the first wave (aHR 0.95; 95%CI 0.84–1.08), but there was an interaction between age ≥75 years and the third wave finding a lower HR for mortality (aHR 0.56, 95%CI 0.36–0.86). Conclusions: We did not find an increase in in-hospital mortality during the third epidemic wave in which the Mu variant was predominant in Colombia. The reduced hazard in mortality in patients ≥75 years hospitalized in the third wave could be explained by the high coverage of SARS-CoV-2 vaccination in this population and patients with underlying conditions.https://orcid.org/0000-0003-1833-1599https://orcid.org/0000-0001-5363-5729https://orcid.org/0000-0001-6964-2229https://orcid.org/0000-0003-3975-2835https://orcid.org/0000-0001-9441-4375Revista Internacional - IndexadaA1N

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival. (C) 2021 The Authors. Published by Elsevier Ltd