Un enfoque de gobernanza aplicado al análisis de una investigación sobre trabajadores cesantes en medellín, colombia

Objetivo Realizar un ejercicio académico de aplicación de las categorías analíticas del enfoque de gobernanza desarrollado por Marc Hufty para comprender el pro­ceso de relacionamiento de actores sociales en un proyecto de investigación e intervención que estudió las condiciones socioeconómicas y de aseguramiento en salud de los trabajadores cesantes-TC en la ciudad de Medellín-Colombia en los años 2004 y 2007 y que incorporó la propuesta de una política pública para garanti­zar la continuidad de su aseguramiento en salud. Metodología Se trató del examen como caso de un proceso de investigación e intervención, en el que los investigadores fueron uno de los actores involucrados. La caracterización de los actores involucrados incluyó: nivel de inser­ción/involucramiento en el problema; poder de decisión en la política pública pro­puesta; características, fuerza y dinámica de sus percepciones, expectativas y pro­puestas sobre el problema del desempleo y del aseguramiento en salud cuando alguien queda cesante; características de su interacción con otros actores. Resultados Se encontró que las dimensiones analíticas propuestas por Hufty (acto­res, normas sociales, puntos nodales y procesos) resultaron útiles para describir y comprender el proceso de interacción de actores sociales involucrados en la inves­tigación y la propuesta de intervención que sirvió como caso de estudio. Conclusiones El marco analítico de gobernanza propuesto por Hufty fue útil para entender cómo interactuaron los sujetos sociales, cuáles fueron las normas acogi­das para interactuar, cuáles nodos de actuación fueron más importantes y los pro­gresos alcanzados durante el proceso

Análisis del impacto administrativo y financiero de la implementación de la resolución 533 del 2015 en entidades del municipio de Armenia, Quindío

The objective of this article was to analyze the administrative and financial impact of the implementation of Resolution 533 of 2015 in government entities (Fomvivienda and Promotora de Vivienda). The methodological framework subscribes to a descriptive and inductive research, since it identifies particular characteristics of the entities in question, such as their legal, economic and social nature; In addition, the study was documentary, taking into account that the environment in which it was developed is public and therefore it was necessary to use official information for data collection and analysis; On the other hand, a cross-sectional analysis was made, because the data collection occurred at a specific time and responds to a particular problem, which for the case is the impact of the implementation of this Resolution on the financial situation of opening, in government entities. It was evidenced that the financial and administrative impact generated by the transition of the accounting regulations affected a large percentage of the equity of the entities (Fomvivienda and Promotora de Vivienda), which presented a reduction due to the recognition of the account impacts due to transition to the new Regulatory framework; caused by the adjustments and reclassifications resulting from said implementation and the adaptation of the accounting policy manual approved by the management of said entities. The implementation of Resolution 533 of 2015 generates benefits for government entities, as it provides tools such as internal control programs and recommendations that allow mitigating and preventing a series of difficulties that may arise due to lack of knowledge about the possible changes in both the accounting and administrative areas of these organizations.El objetivo de este artículo fue analizar el impacto administrativo y financiero de la implementación de la Resolución 533 de 2015 en entidades de gobierno (Fomvivienda y Promotora de vivienda). El marco metodológico se suscribe a una investigación descriptiva e inductiva, por cuanto identifica características particulares de las entidades en referencia, como lo es su naturaleza jurídica, económica y social; además, el estudio fue documental teniendo en cuenta que el entorno en el que se desarrolló es público y por lo tanto fue necesario el uso de información oficial para la recolección y análisis de datos; por otra parte, se hizo un análisis transversal, debido a que la recolección de datos se dio en un momento específico y responde a un problema particular, que para el caso es el impacto de la implementación de esta Resolución en el estado de situación financiera de apertura, en entidades de gobierno. Se evidenció que el impacto financiero y administrativo generado por la transición de la normativa contable, afectó en un gran porcentaje el patrimonio de las entidades (Fomvivienda y Promotora de vivienda), la cual presentó reducción por el reconocimiento de la cuenta impactos por transición al nuevo marco normativo; ocasionado por los ajustes y reclasificaciones resultantes de dicha implementación y la adecuación del manual de políticas contables aprobadas por la administración de dichas entidades. La implementación de la Resolución 533 de 2015 genera beneficios para las entidades del gobierno, ya que provee herramientas como programas y recomendaciones de control interno que permiten mitigar y prevenir una serie de dificultades que se pueden presentar por la falta de conocimiento, acerca de los posibles cambios tanto en el área contable como administrativa de estas organizaciones

Formulación de producto con potencial agroindustrial a base de cidra Sechium edule (Jacq) Swartz

La Asociación de Mujeres Multiétnicas(Asmufare) luego de un proceso de desplazamiento forzoso llegaron a habitar un territorio en la ciudad de Armenia, buscando reconstruir su cultura campesina. Actualmente cultivan y procesan cidra Sechium edule entre otros productos tradicionales. La cidra Sechium edule en Colombia es una materia prima con poco uso industrial y poco consumo doméstico, a pesar de tener gran potencial nutricional y funcional debido al potencial de protección de enfermedades; la cual puede ser empleada como materia prima para la formulación de una galleta para personas con celiaquía. El objetivo de esta investigación fue formular una galleta tipo colación a base de cidra Sechium edule como alternativa de negocio para la asociación de mujeres Asmufare, a partir de la caracterización y análisis de mercado del producto. Se realizó la formulación de la galleta, se caracterizó físico-químicamente teniendo en cuenta la normatividad y un análisis de mercado del producto. Se logró formular un producto de galletería tipo colación a base de harina y almidón de cidra Sechium edule, con adición de arroz Oryza sativa, para satisfacer las necesidades de la población con celiaquía; el cual cumple con los estándares de clasificación para este tipo de producto, siendo una alternativa para la población fitness, donde se obtuvo una aceptación del 87% de preferencia del consumidor potencial, con un posible precio de venta al público de $1.544,63 que se ajusta a las expectativas de estos consumidores; logrando vincularse como potencial producto para su venta por parte de la asociación Asmufare

Formulación de encurtido a base de cidra sechium edule para la asociación de mujeres asmufare

La cidra Sechium edule es un vegetal con un alto valor nutricional y poco uso por parte de la población, siendo una especie doméstica introducida por culturas precolombinas de América central de fácil cultivo; esta materia prima puede ser empleada para la formulación de encurtido, el cual es un producto preparado con frutas, hortalizas y/o legumbres, cuya conservación se da de una acidificación del medio; este producto es una alternativa para la asociación de mujeres campesinas desplazadas -Asmufare-, que junto con sus familias están construyendo un nuevo sueño, un eco-asentamiento en medio de la ciudad de Armenia; por este motivo se decidió incluir la cidra en el eco asentamiento con el propósito de enfocarlo en una economía diferente, planteando diversas formulaciones con el propósito de estandarizar una serie de productos, entre estos está el encurtido. Por lo tanto, el objetivo de esta investigación fue formular un encurtido a base de cidra Sechium edule como alternativa de negocio mediante la caracterización del producto y el análisis de mercado para la ciudad de Armenia Quindío. Se realizó la formulación y caracterización físico-química del producto cumpliendo con los estándares normativos, además del estudio de mercado para el municipio de Armenia. Los resultados de la caracterización físico-química del producto reportaron resultados adecuados para las variables de pH, porcentajes de cenizas, fibra y carbohidratos con valores de 3,49±0,06; 7,62±0,02; 1,41±0,02 y 3,4±0,00; respectivamente, cumpliendo con los estándares normativos de este tipo de producto; además de una aceptabilidad en el estudio de mercado de 80%. El producto formulado cumple con las características para este tipo de alimentos, con una aceptabilidad adecuada, siendo una alternativa potencial de comercialización para la asociación de mujeres -Asmufare- de la ciudad de Armenia

Burden of Respiratory Failure in Pediatric Patients: Analysis of a Prospective Multicenter Cohort in Bogotá, Colombia

BACKGROUND AND AIMS: The approach to the burden of disease is a demographic, economic, and a health problem, which requires the design and application of specific measures of cost of the disease, such as disability-adjusted life years (DALYs), to establish better public health policies in the pediatric population. The aim of this study is to approach the burden of disease in children with acute respiratory failure (ARF) through the calculation of DALYs. METHODS: This study was conducted in the framework of a prospective, multicenter cohort in Bogotá, Colombia. Inclusion criteria were all pediatric patients admitted to the emergency department, hospitalization, and intensive care unit with respiratory distress; eligible patients were all those who developed ARF between April 2020 and December 2021. They were followed-up during hospitalization, at 30 and 60 days after admission. The Infant/Toddler Quality of Life Questionnaire and KIDSCREEN quality of life scales were applied for follow-up according to the age group. The results were used to calculate DALYs. RESULTS: Six hundred and eighty-five eligible patients, 296 (43.08%) developed ARF, of these 22 (6.08%) patients died (mortality rate = 7.43%). The total DALYs was 277.164 years. For younger than 9 years, the DALYs were 302.64 years, while for older than 10 years were 40.49 years. CONCLUSION: ARF is one of the main causes of preventable mortality in pediatrics, its progression to respiratory failure is a highly prevalent condition in pediatric age, a condition that has a great impact on mortality, morbidity, and disability in our patients

Use of High-Flow Cannula in Pediatric Patients With Respiratory Failure: A Prospective Cohort Study in Three High-Altitude Hospitals

BACKGROUND AND AIMS: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals. METHODS: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management. RESULTS: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%. CONCLUSION: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies

First observations of oblique ionospheric sounding chirp signal in Mexico

The results of the first experiment of oblique ionospheric sounding (OIS) chirp signal reception in Mexico are reported. Maximal and Lowest Observed Frequencies variations were studied under the quiet Space Weather conditions. The diurnal ionospheric variations by OIS signal confirm the results based on GNSS data in the Mexican region. The best HF radio propagation conditions along the considered path are during morning and daytime hours. The multi-hop propagation is frequent. The interlayer propagation modes are present at nighttime

Detailed characterization of multiple myeloma circulating tumor cells shows unique phenotypic, cytogenetic, functional, and circadian distribution profile

[EN]Circulating myeloma tumor cells (CTCs) as defined by the presence of peripheral blood (PB) clonal plasma cells (PCs) are a powerful prognostic marker in multiple myeloma (MM). However, the biological features of CTCs and their pathophysiological role in MM remains unexplored. Here, we investigate the phenotypic, cytogenetic, and functional characteristics as well as the circadian distribution of CTCs vs paired bone marrow (BM) clonal PCs from MM patients. Our results show that CTCs typically represent a unique subpopulation of all BM clonal PCs, characterized by downregulation (P < .05) of integrins (CD11a/CD11c/CD29/CD49d/CD49e), adhesion (CD33/CD56/CD117/CD138), and activation molecules (CD28/CD38/CD81). Fluorescence in situ hybridization analysis of fluorescence-activated cell sorter-sorted CTCs also unraveled different cytogenetic profiles vs paired BM clonal PCs. Moreover, CTCs were mostly quiescent and associated with higher clonogenic potential when cocultured with BM stromal cells. Most interestingly, CTCs showed a circadian distribution which fluctuates in a similar pattern to that of CD34(+) cells, and opposite to stromal cell-derived factor 1 plasma levels and corresponding surface expression of CXC chemokine receptor 4 on clonal PCs, suggesting that in MM, CTCs may egress to PB to colonize/metastasize other sites in the BM during the patients' resting period

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe