Propuesta en supply chain management y logística en la empresa Alimentos y Carnicos

Por medio de este trabajo se realiza el Diplomado en Supply Chain Management y Logística correspondiente a la opción de grado del programa de Ingeniería Industrial de la Universidad Nacional Abierta y a Distancia. Para ello se escogió a la empresa Alimentos Cárnicos S.A.S, la cual hace parte del Grupo Nutresa y se dedica a la fabricación, distribución y comercialización de cárnicos y embutidos. Se escoge esta empresa por la facilidad en el acceso a la información y porque la misma cuenta con todos los procesos logísticos necesarios para la consecución del diplomado. Con la realización de este trabajo se espera obtener las bases para analizar y mejorar los procesos logísticos en cualquier tipo de organización, esto puesto que la rama de la logística hace parte del actuar profesional de la ingeniería industrial. El trabajo contiene 12 capítulos, los cuales se detallan a continuación • En el capítulo 1, se realiza la configuración de la red de la empresa. Para ello se realizó la identificación de los proveedores y clientes de la cadena logística, en todos sus niveles; estableciendo el nivel de jerarquía de cada uno. A su vez se elaboró un diagrama de la cadena, donde se observa la estructura horizontal y vertical de la empresa y se muestran los procesos que son administrados, monitoreados y no administrados. Finalmente, se muestra la estructura organizacional de la empresa, identificando las ramas y dependencias. • En el capítulo 2, se realiza la descripción de los ocho procesos del enfoque estratégico GSCF. Para ello se realizó la descripción de los procesos de: Administración de las Relaciones con el Cliente, Administración del Servicio al Cliente, Administración de la Demanda, Gestión de la Orden, Administración del Flujo Manufactura, Administración de las Relaciones con el Proveedor, Desarrollo y Comercialización de Productos y Administración del Retorno. • En el capítulo 3, se describen los procesos de enfoque APICS-SCOR dentro de la empresa Alimentos Cárnicos, y como se integran para desarrollar los objetivos planteados por la compañía, tomando como referencia el cumplimiento de cada uno de los procesos dentro de las áreas, zonas o sectores correspondientes. Para ello se realizó la descripción de los procesos de Planeación, Aprovisionamiento, Fabricación, Logística, Devolución y Activación. • En el capítulo 4 se analizan los diagramas de Flujo de Información, Flujo de Productos y Flujo de Dinero de la organización Alimentos Cárnicos S.A.S. • En el capítulo 5, se realiza un análisis comparativo de Colombia con otros países de Suramérica, Centroamérica, Norteamérica, Europa, Asia y África. • En el capítulo 6 se representa, por medio de un cuadro sinóptico el documento “Conpes 3547 Política Nacional Logística”. • En el capítulo 7, se analiza el concepto The Bullwhip Effect—Exploring Causes and Counter Strategies en la organización Alimentos Cárnicos y se explica cómo sucedería esta situación en la empresa, teniendo en cuenta las siguientes causas: Demand-forecast updating, Order batching, Price fluctuation y Shortage gaming. • En el capítulo 8, se identifica la forma para realizar los inventarios en la organización y con base a esa información se propone una estrategia de gestión para los inventarios; y se genera respuesta a unos interrogantes sobre: la centralización del inventario, el pronóstico de la demanda y la transferencia de inventario entre almacenes. • En el capítulo 9, se identifica el Layout actual de la organización y se genera una propuesta de un nuevo Layout, ya que se desea desarrollar un proceso productivo más eficiente y mejorar las condiciones de los trabajadores de la planta de producción. • En el capítulo 10, se propone una estrategia de aprovisionamiento para la empresa alimentos cárnicos S.A.S., para lograr una mejor selección y evaluación de sus proveedores; de tal manera que pueda apoyar la consecución de los objetivos estratégicos de la misma, como el plan de negocio y estrategia de producción. • En el capítulo 11, se detallan los procesos logísticos de distribución, identificando a través de mapas conceptuales los beneficios y desventajas de implementar estrategias de DRP y TMS en la empresa Alimentos Cárnicos S.A.S., para la distribución del portafolio que en este momento tiene en el mercado. A su vez se describe de manera detallada los diferentes modos y medios de transporte utilizados por una empresa en sus procesos de aprovisionamiento de materias primas y distribución de su producto terminado. • En el capítulo 12, se identifican las mega tendencias en Supply Chain Management y Logística por medio de un mapa conceptual y se discuten los factores críticos de éxito que dificultan la implementación de esas mega tendencias, en las empresas colombianas.Through this work, the Diploma in Supply Chain Management and Logistics corresponding to the degree option of the Industrial Engineering program of the National Open and Distance University is carried out. For this, the company Alimentos Cárnicos S.A.S was chosen, which is part of Grupo Nutresa and is dedicated to the manufacture, distribution and marketing of meat and sausages. This company is chosen for the ease of access to information and because it has all the logistical processes necessary to achieve the diploma. With the completion of this work, it is expected to obtain the bases to analyze and improve the logistics processes in any type of organization, this since the logistics branch is part of the professional act of industrial engineering. The work contains 12 chapters, which are detailed below • In Chapter 1, the company network setup is done. For this, the identification of the suppliers and customers of the logistics chain was carried out, at all levels; establishing the hierarchy level of each one. In turn, a chain diagram was drawn up, where the horizontal and vertical structure of the company is observed and the processes that are managed, monitored and unmanaged are shown. Finally, the organizational structure of the company is shown, identifying the branches and dependencies. • In Chapter 2, the description of the eight processes of the GSCF strategic approach is made. For this, a description of the processes of: Customer Relations Management, Customer Service Management, Demand Management, Order Management, Manufacturing Flow Management, Supplier Relations Management, Development and Product Marketing and Return Administration. In Chapter 3, the APICS-SCOR approach processes within the Alimentos Cárnicos company are described, and how they are integrated to develop the objectives set by the company, taking as a reference the fulfillment of each of the processes within the areas , zones or corresponding sectors. For this, the description of the Planning, Procurement, Manufacturing, Logistics, Return and Activation processes was carried out. • In Chapter 4, the Information Flow, Product Flow and Money Flow diagrams of the organization Alimentos Cárnicos S.A.S. are analyzed. • In Chapter 5, a comparative analysis of Colombia is carried out with other countries in South America, Central America, North America, Europe, Asia and Africa. • In Chapter 6 the document “Conpes 3547 National Logistics Policy” is represented by means of a synoptic table. • In Chapter 7, the concept The Bullwhip Effect — Exploring Causes and Counter Strategies in the Alimentos Cárnicos organization is analyzed and it is explained how this situation would happen in the company, taking into account the following causes: Demand-forecast updating, Order batching, Price fluctuation and Shortage gaming. • In Chapter 8, the way to carry out inventories in the organization is identified and based on this information a management strategy for inventories is proposed; and answers are generated to questions about: inventory centralization, demand forecasting and inventory transfer between warehouses. In Chapter 9, the current Layout of the organization is identified and a proposal for a new Layout is generated, since it is desired to develop a more efficient production process and improve the conditions of the workers in the production plant. • In chapter 10, a supply strategy is proposed for the company Alimentos Carne Meat S.A.S., to achieve a better selection and evaluation of its suppliers; in such a way that it can support the achievement of its strategic objectives, such as the business plan and production strategy. • In Chapter 11, the logistics distribution processes are detailed, identifying through concept maps the benefits and disadvantages of implementing DRP and TMS strategies in the company Alimentos Cárnicos SAS, for the distribution of the portfolio that it currently has in the market. At the same time, the different modes and means of transport used by a company in its processes of sourcing raw materials and distribution of its finished product are described in detail. • In Chapter 12, mega trends in Supply Chain Management and Logistics are identified by means of a concept map and the critical success factors that hinder the implementation of these mega trends in Colombian companies are discussed

El reencuentro con la naturaleza: voces femeninas en el tiempo

Este texto contribuye al análisis científico de diferentes áreas del conocimiento la filosofía social, la educación para el cuidado del medio ambiente mediante la sustentabilidad que incide en diversas unidades de aprendizaje en Educación para la Salud y de la Maestria en Sociología de la SaludEl relato de las voces femeninas que se escuchan en el tiempo, narran las luchas por defender un ideal, con frecuencia en la organización de las mujeres que pugnan por estabilizar el equilibrio de la naturaleza, por medio de tácticas educativas que van recorriendo el bachillerato, la normal y la universidad

Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake