Latin American Unions and the Reform of Social Service Delivery Systems: Institutional Constraints and Policy Choice

Recent policy debates on the reform of social service delivery systems focus on the decentralization of services and the introduction of competition in order to improve the quality of services. Despite the common assumption that public sector unions oppose these reforms, their responses were diverse. This paper argues that the structure of union organization and the environment of party and union competition are fundamental for understanding union policy preferences and strategic choices regarding the reforms of social service delivery systems. Mexico and Argentina education and health reforms in the early 1990s are used to illustrate the influence of these institutional features on the policy preferences and strategic choices of public sector unions.

Reforma del sector social en América Latina y el papel de los sindicatos

(Disponible en idioma inglés únicamente) En este trabajo se analiza la reacción de los sindicatos magisteriales y los gremios médicos a una serie de reformas del sector social en la región, incluidos la descentralización, mecanismos de pago a los prestadores de servicios y la introducción de mecanismos de evaluación del desempeño y de prestación privada de servicios. Combina la obra publicada sobre Economía y Politología para comprender las condiciones que moldean diversos patrones de comportamiento de los sindicatos y sus efectos en la aplicación de las políticas. El trabajo sugiere que las principales condiciones que influyen en el comportamiento de los sindicatos en el sector de la salud tienen que ver con la estructura del mercado (tamaño y nivel de competencia), debido a la participación combinada del sector privado y el público en el empleo. En la educación, donde el sector público es la principal fuente de empleo, los alineamientos políticos y las características organizacionales de las asociaciones magisteriales también desempeñan un papel importante para explicar el comportamiento de las organizaciones prestadoras de esos servicios. Se concluye, tomando en cuenta la naturaleza exógena de la mayoría de estas variables, presentando algunas sugerencias de políticas para alinear los objetivos de los sindicatos y los de los diseñadores de políticas mediante reformas de la normativa.

The Economic Effects of Unions in Latin America: Teachers' Unions and Education in Argentina

This paper considers the effects of trade unions on the education sector in Argentina. We have provided a substantial amount of new information and we have found useful preliminary results on some of the channels of union influence on the performance of this crucial sector. We find that those provinces where teacher unionism is fragmented, where union density is higher and where political relations with the governor are more conflictual, have more strikes (fewer class days). Based on estimates of education production functions both in this paper and elsewhere, we expect this to translate into lower student performance. We then find a number of weak conclusions related to the impact that unions have on several variables that affect students’ performance (i. e. , teachers’ tenure, job satisfaction, class size, education budget and teachers’ salaries). Reviewing these results, we conclude that the impact of unions on students’ performance depends on the channel and kind of political market where unions operate, but not on the existence of unions per se.

Canales alternativos en las oficinas de atención al cliente de las zonas occidente, nordeste y magdalena medio de la Unidad Canales Regional de Empresas Públicas de Medellín E.S.P.

En el presente trabajo, se desarrolló la investigación sobre el uso de canales alternativos de atención en las zonas Occidente, Nordeste y Magdalena Medio de la Unidad Canales Regional de Empresas Públicas de Medellín E.S.P., se comienza estableciendo la problemática que se intenta resolver y la justificación para llevar a cabo la investigación, seguidamente, se realizó consulta en diferentes fuentes bibliográficas donde se encuentran dos investigaciones relacionadas, las cuales sirvieron como base para la construcción del marco teórico, posteriormente y a través de una metodología cualitativa y cuantitativa se diagnosticó la situación actual, realizando encuestas a los clientes de los municipios de las tres regiones en las cuales se desarrolla el proyecto y a los empleados de EPM, haciendo uso de la metodología PMBOK y con la ayuda de un juicio de expertos, se elaboró una propuesta para promover un mayor uso de los canales alternativos de atención en la oficinas de EPM, como son la línea gratuita, la página Web, asesor virtual y módulos de autogestión. Se pudo concluir que, aunque los canales están implementados y los clientes conocen su existencia, no hacen uso de estos, principalmente por desconocimiento de cómo funcionan, por esta razón, la primera recomendación es sensibilizar y socializar el uso de los canales, además, de implementar otros medios que puedan facilitar la comunicación de los clientes con la empresa, todo esto buscando la satisfacción con la atención que se brinda. Otro elemento importante encontrado en el diagnóstico realizado es que cerca de la mitad de los empleados no están convencidos de que algunos de los canales alternativos sean una buena alternativa de atención para los clientes. Finalmente, se dan las recomendaciones para que se puedan promover los canales alternativos de atención y se proponen dos nuevos, que faciliten la interacción de los clientes y la empresa.In the present work, there was an alternative investigation of care channels of attention in the West, Northeast and Magdalena Medio areas of Unidad Canales Regional of Empresas Públicas de Medellín ESP, The beginning was established the problems that are being solved and the justification In order to carry out the investigation, a consultation was carried out in different bibliographic sources where two related investigations are found, which served as the basis for the construction of the theoretical framework. Later, through a qualitative and quantitative methodology, the current situation was diagnosed. Carrying out surveys of the clients of the municipalities of the two regions in which the project is carried out and of EPM employees, using the PMBOK methodology and with the help of expert judges, a proposal was developed to promote greater use of alternative care channels in the EPM offices, such as a free line, website, virtual advisor and self-management modules. It was concluded that, although the channels are implemented and customers know of their existence, they do not use them, mainly due to ignorance of how they work, for this reason, the first recommendation is to sensitize and socialize the use of the channels, in addition, to implement other means that can facilitate customer communication with the company, all seeking satisfaction with the care provided. Another important element found in the diagnosis made is that nearly half of the employees are not convinced that some of the alternative channels are a good alternative of care for clients. Finally, the recommendations are given so that alternative care channels can be promoted and two new ones are proposed, which facilitate the interaction of customers and the compan

Hospitalización a Domicilio: ¿Un servicio exclusivamente hospitalario? Experiencia en un Centro Coordinador de Urgencias y Emergencias (CCU-112)

BASIC: Hospitalization at home (HaD) in Navarra depends on Internal Medicine. During the last years have tripled his beds.Objective: to know the impact of HaD in the CCU-112 and in the mobilization of resources from the Out-of-hospital Emergency Network.Material and methods: Descriptive study of incidents in the CCU-112 by HaD patients, from 01/01/2016 to 31/12/2017.Through SPSS.21, sex, age, day, time, location, reason for calling, alert and mobilized resources were analyzed.We value the association of variables by contrasting hypotheses using Pearson’s χ² (significance level 5%).Results: 369 incidents attended and 340 mobilized resources (the health team in 43.9%).Reasons: 57.25% clinical and 19.5% therapeutic procedures.In 67.5% the alertant was the patient or caregiver.In the morning, HaD alerted (52.8%) and the most mobilized resource was SAMU-SVB (47.2%). At night, they called from home (89.5%), sending 60.8% emergency team.There are statistically significant differences between alertant and mobilized resources (χ² = 86.55, p <0.001)) and between the reason for calling and resources (χ² = 177, p <0.001).Comparing between 2017 and 2016, there is an increase in matters (56.25%) and mobilized resources (51.51%).Conclusions: The expansion of HaD in Navarra means an increase in matters in the CCU-112-Navarra and mobilized resources.The HaD requires the participation of out-of-hospital emergencies to guarantee continuous and quality care.Fundamento: En Navarra la hospitalización a domicilio (HaD) depende de Medicina Interna. En los últimos años ha triplicado sus camas.Objetivo: conocer la repercusión de HaD en el CCU-112 y en movilización de recursos de la Red de Urgencias Extrahospitalarias.Material y metodos: Estudio descriptivo de incidentes en el CCU-112 por pacientes de HaD, del 01/01/2016 al 31/12/2017. Mediante SPSS.21, se analizaron sexo, edad, día, hora, localidad, motivo de llamada, alertante y recursos movilizados.Valoramos la asociación de variables mediante el contraste de hipótesis usando χ² de Pearson (nivel de significación 5%).RESULTADOS: 369 incidentes atendidos y 340 recursos movilizados (el equipo sanitario en 43,9%).Motivos: 57,25% clínicos y 19,5% procedimientos terapéuticos.En el 67,5% el alertante era el paciente o cuidador.Por la mañana, alertaba HaD (52,8%) y el recurso más movilizado fue SAMU-SVB (47,2%). Por la noche, llamaban del domicilio (89,5%), enviando el 60,8% equipo de urgencias.Existen diferencias estadísticamente significativas entre alertante y recursos movilizados (χ²= 86,55, p<0,001)) y entre motivo de llamadas y recursos (χ²=177, p<0,001).En 2017 existe incremento de asuntos (56,25%) y recursos movilizados (51,51%) respecto a 2016.Conclusiones: La expansión de HaD en Navarra supone un incremento de asuntos en el CCU-112-Navarra y de recursos movilizados.La HaD requiere de la participación de las de urgencias extrahospitalarias para garantizar una atención continuada y de calidad

Familial globular glial tauopathy linked to MAPT mutations: molecular neuropathology and seeding capacity of a prototypical mixed neuronal and glial tauopathy

Globular glial tauopathy (GGT) is a progressive neurodegenerative disease involving the grey matter and white matter (WM) and characterized by neuronal deposition of hyper-phosphorylated, abnormally conformed, truncated, oligomeric 4Rtau in neurons and in glial cells forming typical globular astrocyte and oligodendrocyte inclusions (GAIs and GOIs, respectively) and coiled bodies. Present studies centre on four genetic GGT cases from two unrelated families bearing the P301T mutation in MAPT and one case of sporadic GGT (sGGT) and one case of GGT linked to MAPT K317M mutation, for comparative purposes. Clinical and neuropathological manifestations and biochemical profiles of phospho-tau are subjected to individual variations in patients carrying the same mutation, even in carriers of the same family, independently of the age of onset, gender, and duration of the disease. Immunohistochemistry, western blotting, transcriptomic, proteomics and phosphoproteomics, and intra-cerebral inoculation of brain homogenates to wild-type (WT) mice were the methods employed. In GGT cases linked to MAPT P301T mutation, astrocyte markers GFAP, ALDH1L1, YKL40 mRNA and protein, GJA1 mRNA, and AQ4 protein are significantly increased; glutamate transporter GLT1 (EAAT2) and glucose transporter (SLC2A1) decreased; mitochondrial pyruvate carrier 1 (MPC1) increased, and mitochondrial uncoupling protein 5 (UCP5) almost absent in GAIs in frontal cortex (FC). Expression of oligodendrocyte markers OLIG1 and OLIG2mRNA, and myelin-related genes MBP, PLP1, CNP, MAG, MAL, MOG, and MOBP are significantly decreased in WM; CNPase, PLP1, and MBP antibodies reveal reduction and disruption of myelinated fibres; and SMI31 antibodies mark axonal damage in the WM. Altered expression of AQ4, GLUC-t, and GLT-1 is also observed in sGGT and in GGT linked to MAPT K317M mutation. These alterations point to primary astrogliopathy and oligodendrogliopathy in GGT. In addition, GGT linked to MAPT P301T mutation proteotypes unveil a proteostatic imbalance due to widespread (phospho)proteomic dearrangement in the FC and WM, triggering a disruption of neuron projection morphogenesis and synaptic transmission. Identification of hyper-phosphorylation of variegated proteins calls into question the concept of phospho-tau-only alteration in the pathogenesis of GGT. Finally, unilateral inoculation of sarkosyl-insoluble fractions of GGT homogenates from GGT linked to MAPT P301T, sGGT, and GGT linked to MAPT K317M mutation in the hippocampus, corpus callosum, or caudate/putamen in wild-type mice produces seeding, and time- and region-dependent spreading of phosphorylated, non-oligomeric, and non-truncated 4Rtau and 3Rtau, without GAIs and GOIs but only of coiled bodies. These experiments prove that host tau strains are important in the modulation of cellular vulnerability and phenotypes of phospho-tau aggregates

Expanding the stdpopsim species catalog, and lessons learned for realistic genome simulations

Simulation is a key tool in population genetics for both methods development and empirical research, but producing simulations that recapitulate the main features of genomic datasets remains a major obstacle. Today, more realistic simulations are possible thanks to large increases in the quantity and quality of available genetic data, and the sophistication of inference and simulation software. However, implementing these simulations still requires substantial time and specialized knowledge. These challenges are especially pronounced for simulating genomes for species that are not well-studied, since it is not always clear what information is required to produce simulations with a level of realism sufficient to confidently answer a given question. The community-developed framework stdpopsim seeks to lower this barrier by facilitating the simulation of complex population genetic models using up-to-date information. The initial version of stdpopsim focused on establishing this framework using six well-characterized model species (Adrion et al., 2020). Here, we report on major improvements made in the new release of stdpopsim (version 0.2), which includes a significant expansion of the species catalog and substantial additions to simulation capabilities. Features added to improve the realism of the simulated genomes include non-crossover recombination and provision of species-specific genomic annotations. Through community-driven efforts, we expanded the number of species in the catalog more than threefold and broadened coverage across the tree of life. During the process of expanding the catalog, we have identified common sticking points and developed the best practices for setting up genome-scale simulations. We describe the input data required for generating a realistic simulation, suggest good practices for obtaining the relevant information from the literature, and discuss common pitfalls and major considerations. These improvements to stdpopsim aim to further promote the use of realistic whole-genome population genetic simulations, especially in non-model organisms, making them available, transparent, and accessible to everyone

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe