Sistematización de las prácticas profesionales por emprendimiento Tenderos Seguros

Dimensionar la viabilidad e insuficiencia de un servicio como el planteado, divisar el panorama global de las necesidades de la comunidad del municipio de Anapoima – CundinamarcaA lo largo del proceso de aprendizaje de la carrera Administración en Salud Ocupacional y de las prácticas profesionales junto con la unidad de emprendimiento Centro Progresa EPE, en el periodo académico 2021 – 1, se realizó la propuesta y posterior desarrollo de la idea emprendedora llamada TENDEROS SEGUROS, que permitió dimensionar la viabilidad e insuficiencia de un servicio como el planteado, divisar el panorama global de las necesidades de la comunidad del municipio de Anapoima – Cundinamarca, el cual permitió afianzar la investigación y ejecutar un estudio de mercadeo en el que se identificó que las tiendas y/o establecimientos de comercio del municipio no cuentan con el Sistema de Gestión de Seguridad y Salud en el Trabajo o el cumplimiento de los estándares mínimos requeridos en la Resolución 0312 de 2019; razón por la que se genera la presente sistematización de experiencia y la implementación del emprendimiento dedicado a la oferta de asesorías enfocadas al área de Seguridad y Salud en el Trabajo personalizadas. Por medio de esta idea de negocio, se busca concientizar a la población comerciante acerca de la importancia y cumplimiento de los requisitos normativos en Seguridad y Salud en el Trabajo (SST), para generar ambientes laborales seguros que permitan la prevención de accidentes de trabajo o de enfermedades laborales. En el presente documento se plasma el conocimiento adquirido y la socialización de la experiencia durante el desarrollo de las prácticas profesionales, con el objetivo de mejorar y consolidar la idea de negocio TENDEROS SEGUROS con los tres servicios que se ofrecen (asesoría básica, asesoría avanzada y paquetes de asesorías), en relación a las exigencias estipuladas en el diseño de los Sistemas de Gestión Seguridad y Salud en el Trabajo el cual se reglamenta por medio del Reglamento Único Sector del Trabajo (RUST) Decreto 1072 de 2015 (2.2.4.6), así mismo, se debe tener en cuenta los lineamientos establecidos por la crisis de la pandemia del COVID -19, referente al control y seguimiento de los protocolos de bioseguridad dependiendo de la actividad económica y número de trabajadores de los establecimientos comerciales. (Ministerio del Trabajo, 2015)Throughout the learning process of the Occupational Health Administration career and the professional practices together with the Centro Progresa EPE entrepreneurship unit, in the academic period 2021 - 1, the proposal and subsequent development of the entrepreneurial idea called TENDEROS INSURANCE, which made it possible to measure the viability and insufficiency of a service such as the one proposed, to see the global panorama of the needs of the community of the municipality of Anapoima - Cundinamarca, which allowed to consolidate the research and carry out a marketing study in which it was identified that the shops and / or commercial establishments of the municipality do not have the Occupational Health and Safety Management System or compliance with the minimum standards required in Resolution 0312 of 2019; reason for which the present systematization of experience is generated and the implementation of the undertaking dedicated to offering advice focused on the area of Occupational Health and Safety. Through this business idea, it seeks to raise awareness among the business population about the importance of and compliance with the regulatory requirements in Occupational Safety and Health (OSH), to generate safe work environments that allow the prevention of occupational accidents or of occupational diseases. This document reflects the knowledge acquired and the socialization of the experience during the development of professional practices, with the aim of improving and consolidating the TENDEROS SEGUROS business idea with the three services offered (basic advice, advanced advice and advisory packages), in relation to the requirements stipulated in the design of the Occupational Health and Safety Management Systems, which is regulated through the Single Labor Sector Regulation (RUST) Decree 1072 of 2015 (2.2.4.6), Likewise, the guidelines established by the crisis of the COVID-19 pandemic must be taken into account, referring to the control and monitoring of biosafety protocols depending on the economic activity and number of workers in commercial establishments. (Ministry of Labor, 2015

Sistematización de las prácticas profesionales por emprendimiento Tenderos Seguros

Dimensionar la viabilidad e insuficiencia de un servicio como el planteado, divisar el panorama global de las necesidades de la comunidad del municipio de Anapoima – CundinamarcaA lo largo del proceso de aprendizaje de la carrera Administración en Salud Ocupacional y de las prácticas profesionales junto con la unidad de emprendimiento Centro Progresa EPE, en el periodo académico 2021 – 1, se realizó la propuesta y posterior desarrollo de la idea emprendedora llamada TENDEROS SEGUROS, que permitió dimensionar la viabilidad e insuficiencia de un servicio como el planteado, divisar el panorama global de las necesidades de la comunidad del municipio de Anapoima – Cundinamarca, el cual permitió afianzar la investigación y ejecutar un estudio de mercadeo en el que se identificó que las tiendas y/o establecimientos de comercio del municipio no cuentan con el Sistema de Gestión de Seguridad y Salud en el Trabajo o el cumplimiento de los estándares mínimos requeridos en la Resolución 0312 de 2019; razón por la que se genera la presente sistematización de experiencia y la implementación del emprendimiento dedicado a la oferta de asesorías enfocadas al área de Seguridad y Salud en el Trabajo personalizadas. Por medio de esta idea de negocio, se busca concientizar a la población comerciante acerca de la importancia y cumplimiento de los requisitos normativos en Seguridad y Salud en el Trabajo (SST), para generar ambientes laborales seguros que permitan la prevención de accidentes de trabajo o de enfermedades laborales. En el presente documento se plasma el conocimiento adquirido y la socialización de la experiencia durante el desarrollo de las prácticas profesionales, con el objetivo de mejorar y consolidar la idea de negocio TENDEROS SEGUROS con los tres servicios que se ofrecen (asesoría básica, asesoría avanzada y paquetes de asesorías), en relación a las exigencias estipuladas en el diseño de los Sistemas de Gestión Seguridad y Salud en el Trabajo el cual se reglamenta por medio del Reglamento Único Sector del Trabajo (RUST) Decreto 1072 de 2015 (2.2.4.6), así mismo, se debe tener en cuenta los lineamientos establecidos por la crisis de la pandemia del COVID -19, referente al control y seguimiento de los protocolos de bioseguridad dependiendo de la actividad económica y número de trabajadores de los establecimientos comerciales. (Ministerio del Trabajo, 2015)Throughout the learning process of the Occupational Health Administration career and the professional practices together with the Centro Progresa EPE entrepreneurship unit, in the academic period 2021 - 1, the proposal and subsequent development of the entrepreneurial idea called TENDEROS INSURANCE, which made it possible to measure the viability and insufficiency of a service such as the one proposed, to see the global panorama of the needs of the community of the municipality of Anapoima - Cundinamarca, which allowed to consolidate the research and carry out a marketing study in which it was identified that the shops and / or commercial establishments of the municipality do not have the Occupational Health and Safety Management System or compliance with the minimum standards required in Resolution 0312 of 2019; reason for which the present systematization of experience is generated and the implementation of the undertaking dedicated to offering advice focused on the area of Occupational Health and Safety. Through this business idea, it seeks to raise awareness among the business population about the importance of and compliance with the regulatory requirements in Occupational Safety and Health (OSH), to generate safe work environments that allow the prevention of occupational accidents or of occupational diseases. This document reflects the knowledge acquired and the socialization of the experience during the development of professional practices, with the aim of improving and consolidating the TENDEROS SEGUROS business idea with the three services offered (basic advice, advanced advice and advisory packages), in relation to the requirements stipulated in the design of the Occupational Health and Safety Management Systems, which is regulated through the Single Labor Sector Regulation (RUST) Decree 1072 of 2015 (2.2.4.6), Likewise, the guidelines established by the crisis of the COVID-19 pandemic must be taken into account, referring to the control and monitoring of biosafety protocols depending on the economic activity and number of workers in commercial establishments. (Ministry of Labor, 2015

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

Advancements in dementia research, diagnostics and care in Latin America : highlights from the 2023 Alzheimer's association international conference satellite symposium in Mexico City

While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics and care. In 2023, the Alzheimer’s Association hosted its eighth Satellite Symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. A wide range of topics were covered, including epidemiology, social determinants, dementia national plans, risk reduction, genetics, biomarkers, biobanks, and advancements in treatments. Large initiatives in the region including intra-country support showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care and implement affordable biomarkers in the region was highlighted

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Fall of the Angelus Novus: Beyond the Modern Game of Roots and Options

Sociology and social sciences in general have developed as part and parcel of the tension between social regulation and social emancipation that underlies the project of modernity. This tension seems to have vanished as social emancipation has become the double, rather than the opposite, of social regulation. Therefore, the reinvention of the social sciences presumes a new start for the social sciences focused on the generation of powerful interrogations and destabilizing images, made possible by the supersession of the modern equation of roots and options and by a shift from the conventional duality between structure and agency to a new, enabling duality between conformist action and action-with-clinamen

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Abstract Background Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). Methods In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care