Estrategias para la convergencia : condiciones, capacidades y mecanismos para la construcción de sinergias entre actores diversos en proyectos urbanos de escala barrial de iniciativa institucional o comunitaria

Descargue el texto completo en el repositorio institucional de la Universidad EAFIT: http://hdl.handle.net/10784/12533El presente trabajo nace de reconocer las dificultades, frecuentes a la hora de implementar un proyecto urbano, al momento de considerar las sinergias entre los diversos actores interesados e implicados en el mismo; dificultades que pueden volverse críticas cuando la sostenibilidad social de la población se pone en riesgo, o la implementación exitosa del proyecto se complica. No pretende ser una visión ingenua sobre la realidad de la gestión territorial comunitaria o el manejo público de la planificación urbana. Se trata más bien de una propuesta alternativa, basada en identificar las características mínimas que se requieren para la convergencia y la construcción colectiva de ciudad. Rutas que permitan aplicar aprendizajes, sistematizados bajo un propósito general: conseguir unas condiciones e implementar unas capacidades en los diversos actores que contribuyan a una verdadera y efectiva construcción colectiva de ciudad . Partiendo de considerar las complejas relaciones de cooperación y conflicto que surgen entre los diversos actores día a día en los contextos urbanos, este trabajo centra su atención de forma específica a la relación de dos actores en particular: instituciones públicas y comunidades locales. Y lo hace en aquellos contextos donde esta relación se vuelve tan crítica como necesaria: los ámbitos populares autoconstruidos en informalidad -entendiendo por informal aquellos territorios desarrollados al margen de los canales institucionales de planificación urbana- buscando mejorar las sinergias entre ambos en el desarrollo e implementación de las iniciativas, tanto institucionales como comunitarias, a la hora de abordar proyectos urbanos de escala barrial.Tesi

Estrategias para la convergencia. Condiciones, capacidades y mecanismos para la construcción de sinergias entre actores diversos en proyectos urbanos de escala barrial de iniciativa institucional o comunitaria

El presente trabajo nace de reconocer las dificultades, frecuentes a la hora de implementar un proyecto urbano, al momento de considerar las sinergias entre los diversos actores interesados e implicados en el mismo; dificultades que pueden volverse críticas cuando la sostenibilidad social de la población se pone en riesgo, o la implementación exitosa del proyecto se complica. No pretende ser una visión ingenua sobre la realidad de la gestión territorial comunitaria o el manejo público de la planificación urbana. Se trata más bien de una propuesta alternativa, basada en identificar las características mínimas que se requieren para la convergencia y la construcción colectiva de ciudad. Rutas que permitan aplicar aprendizajes, sistematizados bajo un propósito general: conseguir unas condiciones e implementar unas capacidades en los diversos actores que contribuyan a una verdadera y efectiva construcción colectiva de ciudad . Partiendo de considerar las complejas relaciones de cooperación y conflicto que surgen entre los diversos actores día a día en los contextos urbanos, este trabajo centra su atención de forma específica a la relación de dos actores en particular: instituciones públicas y comunidades locales. Y lo hace en aquellos contextos donde esta relación se vuelve tan crítica como necesaria: los ámbitos populares autoconstruidos en informalidad -entendiendo por informal aquellos territorios desarrollados al margen de los canales institucionales de planificación urbana- buscando mejorar las sinergias entre ambos en el desarrollo e implementación de las iniciativas, tanto institucionales como comunitarias, a la hora de abordar proyectos urbanos de escala barrial.Tesi

Calidad del pescado seco -salado en la región del Banco

Esta investigación se realiza teniendo en cuenta los datos de producción de pescado Seco - Salado que colocan a la población de El Banco en primer plano a nivel nacional. Se analiza detalladamente el proceso de elaboración realizado artesanalmente por los pescadores de la región y se efectúan varios análisis que determinan su calidad. Se preparan en forma tecnológica muestras de las mismas especies con el objeto de hacer comparaciones de calidad con las elaboradas artesanalmente. Se hace referencia a las normas vigentes en el Canadá, así como las que se han propuesto para la India y México, y se toman como marco de comparación por la importancia que se le da en estos países al contenido de sal y humedad. Por la importancia que presenta la composición química y la granulometría de la sal en el proceso de Seco- Salado, se realizan tanto para la sal empleada por los pescadores en la elaboración artesanal, como para la utilizada por los autores en el método tecnológico, los respectivos análisis para determinar el porcentaje de cloruro de sodio e impurezas presentes, así como el tamaño del grano. Según los análisis microbiológicos realizados al producto elaborado artesanalmente, nueve (9) de las quince (15) muestras presentan un contenido superior a cinco (5) millones de bacterias por gramo, lo que determina una mala calidad, pudiendo ser su causa una mala elaboración, mala calidad de sal, proporciones inapropiadas de la misma, escaso tiempo de secado y /o almacenamiento antihigiénico. Se encuentran muestras con un número significativo de estafilococos según normas microbiológicas de diferentes países para productos pesqueros Seco - Salados. El número de bacterias y los análisis físico- organolépticos, determinan si el proceso de elaboración se efectúa en la forma adecuada y también si han sido apropiadas las condiciones sanitarias durante esa elaboración y la manipulación subsiguiente. Se observa que la composición del pescado Seco - Salado elaborado artesanalmente es extremadamente variada. Sin embargo se puede notar que todas las muestras examinadas presentan un contenido de agua en base seca superior al 40% , el cual debería ser el máximo permisible según las normas establecidas en otros países. Se dan a conocer los factores más importantes que determinan la alteración del pescado Seco- Salado. Las muestras tratadas tecnológicamente, presentan comparativamente pocas bacterias aeróbicas y un número negativo de estafilococos que indican que el Seco - Salado constituye una forma muy eficiente para conservar el pescado, aunque también resulta evidente que tanto el proceso de secado como las condiciones sanitarias, deben ser objeto de cuidadosa atención

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.814.4 million) incident T2D cases, representing 70.3% (68.871.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.027.1%)), excess refined rice and wheat intake (24.6% (22.327.2%)) and excess processed meat intake (20.3% (18.323.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.487.7%)) and Latin America and the Caribbean (81.8% (80.183.4%)); and lowest proportional burdens were in South Asia (55.4% (52.160.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. (c) 2023, The Author(s)

Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the worlds child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 1519 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes. (c) 2023, The Author(s)

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015 : a novel analysis from the Global Burden of Disease Study 2015

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Diseño y construcción de un objeto virtual de aprendizaje, como estrategia para fortalecer la comprensión del concepto de fracción en los estudiantes de grado octavo del colegio saludcoop sur ied

Este proyecto de intervención tiene como finalidad diseñar y crear un OVA (Objeto Virtual de Aprendizaje), con apoyo de diferentes herramientas Web 2.0 que permita una verdadera mediación pedagógica, posibilitando que los estudiantes del grado octavo del Colegio Saludcoop Sur. I.E.D. desarrollen competencias, para solucionar situaciones cotidianas donde se involucre el concepto de fracción