Modelo de gestión para el cambio del clima laboral del área administrativa de la empresa CMI televisión Ltda.

Tablas, imágenesLa realización de este trabajo, utilizando la orientación recibida en el curso de Gerencia Estratégica Empresarial, ha permitido conocer, aprender e identificar normas, modelos, informes y demás herramientas que aplicadas según las falencias y problemas que se presentan en las empresas contribuyan a generar calidad en lo personal, social, ambiental, económico y político. La organización a la que se le aplicará un modelo de gestión tiene varios aspectos negativos especialmente relacionados con el clima laboral, y por tanto partiendo de esa necesidad, establecer acciones remédiales que contribuyan a la solución, haciendo énfasis en realizar evaluaciones frecuentemente de sus resultados para llegar a la excelencia.No Abstrac

Cuerpos Atómicos

RESUMEN: Elaboro un ambiente para los sentidos, creando un lugar lleno de color, texturas, comodidad e incomodidad, dispuesto para activar los sentidos, sobre todo el sentido del erotismo y no partiendo desde el punto de vista morboso, sino mas bien mórbido; un erotismo romántico. No busca la producción del placer sexual como lo es la pornografía; sino mas bien un erotismo personal, más propio; donde se esta uno con sus pensamientos y hay malicia; por un instante logro desconéctame de la cotidianidad. La relación del objeto con la comida nace de la armonía que encuentro entre el comer y el sentir, sin embargo, no busco la representación literal de las cosas, es mas bien una metáfora sensorial donde cada quien le da un sentido desde su experienciaABSTRACT: I develop an environment for the senses, creating a place full of color, textures, comfort and discomfort, ready to activate the senses, especially the sense of eroticism and not starting from the morbid point of view, but rather morbid; a romantic eroticism. It does not seek the production of sexual pleasure as is pornography; but rather a personal eroticism, more proper; where you are one with your thoughts and there is malice; for an instant I manage to disconnect from everyday life. The relationship of the object with food is born from the harmony that I find between eating and feeling, however, I do not seek the literal representation of things, it is rather a sensory metaphor where everyone gives it a meaning from their experienc

Introducing automation to the molecular diagnosis of Trypanosoma cruzi infection: A comparative study of sample treatments, DNA extraction methods and real-time PCR assays

Background Polymerase chain reaction (PCR) has become a useful tool for the diagnosis of Trypanosoma cruzi infection. The development of automated DNA extraction methodologies and PCR systems is an important step toward the standardization of protocols in routine diagnosis. To date, there are only two commercially available Real-Time PCR assays for the routine laboratory detection of T. cruzi DNA in clinical samples: TCRUZIDNA.CE (Diagnostic Bioprobes Srl) and RealCycler CHAG (Progenie Molecular). Our aim was to evaluate the RealCycler CHAG assay taking into account the whole process. Methodology/Principal findings We assessed the usefulness of an automated DNA extraction system based on magnetic particles (EZ1 Virus Mini Kit v2.0, Qiagen) combined with a commercially available Real-Time PCR assay targeting satellite DNA (SatDNA) of T. cruzi (RealCycler CHAG), a methodology used for routine diagnosis in our hospital. It was compared with a well-known strategy combining a commercial DNA isolation kit based on silica columns (High Pure PCR Template Preparation Kit, Roche Diagnostics) with an in-house Real-Time PCR targeting SatDNA. The results of the two methodologies were in almost perfect agreement, indicating they can be used interchangeably. However, when variations in protocol factors were applied (sample treatment, extraction method and Real-Time PCR), the results were less convincing. A comprehensive fine-tuning of the whole procedure is the key to successful results. Guanidine EDTA-blood (GEB) samples are not suitable for DNA extraction based on magnetic particles due to inhibition, at least when samples are not processed immediately. Conclusions/Significance This is the first study to evaluate the RealCycler CHAG assay taking into account the overall process, including three variables (sample treatment, extraction method and Real-Time PCR). Our findings may contribute to the harmonization of protocols between laboratories and to a wider application of Real-Time PCR in molecular diagnostic laboratories associated with health centers.Fil: Abras, Alba. Universidad de Barcelona; España. Universidad de Girona; España. Instituto de Salud Global de Barcelona; EspañaFil: Ballart, Cristina. Universidad de Barcelona; España. Instituto de Salud Global de Barcelona; EspañaFil: Llovet, Teresa. Universitat Autònoma de Barcelona; España. Hospital de la Santa Creu I Sant Pau; EspañaFil: Roig, Carme. Hospital de la Santa Creu I Sant Pau; EspañaFil: Gutiérrez, Cristina. Hospital de la Santa Creu I Sant Pau; EspañaFil: Tebar, Silvia. Universidad de Barcelona; España. Instituto de Salud Global de Barcelona; EspañaFil: Berenguer, Pere. Hospital de la Santa Creu I Sant Pau; EspañaFil: Pinazo, María-Jesús. Instituto de Salud Global de Barcelona; EspañaFil: Posada, Elizabeth. Instituto de Salud Global de Barcelona; EspañaFil: Gascón, Joaquim. Instituto de Salud Global de Barcelona; EspañaFil: Schijman, Alejandro Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Gállego, Montserrat. Instituto de Salud Global de Barcelona; España. Universidad de Barcelona; EspañaFil: Muñoz, Carmen. Hospital de la Santa Creu I Sant Pau; España. Universitat Autònoma de Barcelona; Españ

Las familias rurales en Colombia: discusiones en torno a las posturas familistas y no familistas

The purpose of this research is to contrast the familist and non-familist positions in publications about Colombian rurality in the period 2016 to 2021, taking into account the trajectory of both approaches in light of the changes in the conformation of rural families in the country. The study is of a qualitative nature, through the review of literature with a descriptive exploratory scope, resorting to techniques of inferential analysis of content in academic production. In this sense, postulates of gender studies are taken up and the contributions of social constructionism are taken into account. It is concluded that, despite the transformation in rural families, familist and non-familist conceptions coexist in research on rurality in Colombia, where gender, economic practices and social organization are the nodes that show the greatest variations and similarities between the two concepts.El propósito de esta investigación es contrastar las posturas familistas y no familistas en publicaciones en torno a la ruralidad colombiana en el periodo 2016 a 2021, teniendo en cuenta la trayectoria de ambos enfoques a la luz de los cambios en la conformación de las familias rurales en el país.  El estudio es de carácter cualitativo, a través de la revisión de literatura con un alcance exploratorio descriptivo, acudiendo a técnicas de análisis inferencial del contenido en la producción académica. En este sentido, se retoman postulados de los estudios de género y se tiene en cuenta los aportes del construccionismo social. Se concluye que, a pesar de la transformación en las familias rurales, las concepciones familistas y las no familistas coexisten en las investigaciones sobre ruralidad en Colombia, en donde el género, las prácticas económicas y la organización social son los nodos que muestran mayores variaciones y similitudes entre ambas concepciones

Factores asociados a mortalidad en pacientes con VIH en el Hospital San Juan de Dios de San Miguel durante el periodo comprendido entre enero del año 2016 a diciembre del año 2020

RESUMEN: En el Hospital Nacional San Juan de Dios de San Miguel se investigaron los factores asociados a mortalidad en pacientes con VIH desde enero de 2016 hasta diciembre de 2020. El Objetivo consistió en la revisión y recolección de información de expedientes clínicos, Sistema Único de Monitoreo y Evaluación de la Vigilancia Epidemiológica (SUMEVE), Sistema de Morbimortalidad en línea (SIMMOW) para enunciar las enfermedades crónicas no transmisibles y las infecciones oportunistas más frecuentes asociadas a la mortalidad en pacientes VIH; luego relacionar el conteo inicial de linfocitos T CD4 y la Carga Viral Plasmática inicial como factor predictivo de defunción en ellos(as). Metodología: Estudio descriptivo, retrospectivo, transversal y de campo, Muestreo no probabilístico, por conveniencia con muestra de 186 pacientes, que cumplieron los criterios de inclusión: con diagnostico serológico de VIH, fallecido entre el periodo del estudio, registrado en los sistemas SUMEVE o SIMMOW, mayor de 15 años, que tengan al menos un conteo de CD4 y Carga viral plasmática registrada en los sistemas de información en línea, con expediente clínico en el Hospital y accesible al momento del estudio. Las técnicas de obtención de la información fueron la revisión de expedientes clínicos y sistemas de información en línea. Resultados: La enfermedad crónica no transmisible más frecuente es la enfermedad renal crónica (9.7%), la oportunista más común es la histoplasmosis (9.7%), los pacientes VIH con conteo de linfocitos TCD4 menor de 200cels y los de carga viral plasmática elevada al momento de su diagnóstico tienen mayor riesgo de mortalidad. ABSTRACT: At the San Juan de Dios National Hospital in San Miguel, the factors associated with mortality in patients with HIV were investigated from January 2016 to December 2020. The objective consisted of reviewing and collecting information from clinical records, the Unique Monitoring System and Evaluation of Epidemiological Surveillance (SUMEVE), Online Morbidity and Mortality System (SIMMOW) to list the most frequent chronic noncommunicable diseases and opportunistic infections associated with mortality in HIV patients; then relate the initial count of CD4 T lymphocytes and the initial Plasma Viral Load as a predictive factor of death in them. Methodology: Descriptive, retrospective, cross-sectional and field study, non-probabilistic sampling, for convenience with a sample of 186 patients, who met the inclusion criteria: with a serological diagnosis of HIV, deceased between the study period, registered in the SUMEVE systems or SIMMOW, over 15 years of age, who have at least one CD4 count and plasma viral load registered in the online information systems, with a clinical file at the Hospital and accessible at the time of the study. The techniques for obtaining the information were the review of clinical records and online information systems. Results: The most common chronic non-communicable disease is chronic kidney disease (9.7%), the most common opportunistic is histoplasmosis (9.7%), HIV patients with TCD4 lymphocyte count less than 200 cells and those with high plasma viral load at time of diagnosis are at increased risk of mortalit

Socio-cultural aspects of Chagas disease: a systematic review of qualitative research.

BACKGROUND: Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries. METHODOLOGY/PRINCIPAL FINDINGS: Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking. CONCLUSIONS: The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach

Population pharmacokinetics of benznidazole in adult patients with Chagas disease

AIM: To build a population pharmacokinetic (PopPK) model to characterize benznidazole (BNZ) pharmacokinetics in adults with chronic Chagas disease. METHODS: Prospective, open-label, single-center clinical trial(EudraCT:2011-002900-34;CINEBENZclinicaltrials.govnumber:NCT01755403), approved by the local ethics committee. Patients received 2.5mg/kg/12h (Abarax(R), Elea Laboratory, Argentina) for 60 days. Plasma BZN samples were taken at several times along the study and analyzed by HPLC-UV. The PopPK analysis was done with NONMEMv.7.3. Demographic and biological data were tested as covariates. Intraindividual, interoccasion and residual variability were modeled. Internal and external validations were completed to assess the robustness of the model. Later on, simulations were performed to generate the BNZ concentration-time course profile for different dosage regimens. RESULTS: A total of 358 plasma BZN concentrations from 39 patients were included in the analysis. A one-compartment-PK-model characterized by clearance(CL/F) and apparent volume of distribution(V/F) with first order absorption(Ka) and elimination, adequately described the data (CL/F:1.73 L/h; V/F:89.6 L; Ka:1.15 h-1). No covariates were found to be significant for CL/F and V/F. Internal and external validation of the final model showed adequate results. Data from simulations revealed that a dose of 2.5mg/kg/12h might lead to overexposure in the most of the patients. A lower dose (2.5mg/kg/24h) was able to achieve trough BNZ plasma concentrations within the accepted therapeutic range of 3-6 mg/L. CONCLUSION: A population PK model for BNZ in adults with chronic Chagas disease has been developed. Dosing simulations showed that a BNZ dose of 2.5 mg/kg/24h would adequately keep BNZ trough plasma concentrations within the recommended target range concentrations for the majority of patients

Characterization of digestive involvement in patients with chronic T. cruzi infection in Barcelona, Spain

Background: Digestive damage due to Chagas disease (CD) occurs in 15-20% of patients diagnosed as a result of peristaltic dysfunction in some endemic areas. The symptoms of chronic digestive CD are non-specific, and there are numerous confounders. Diagnosis of CD may easily be missed if symptoms are not evaluated by a well trained physician. Regular tests, as barium contrast examinations, probably lack the necessary sensitivity to detect early digestive damage. Methods: 71 individuals with T. cruzi infection (G1) and 18 without (G2) coming from Latin American countries were analyzed. They were asked for clinical and epidemiological data, changes in dietary habits, and history targeting digestive and cardiac CD symptoms. Serological tests for T. cruzi, barium swallow, barium enema, an urea breath test, and esophageal manometry were requested for all patients. Principal findings: G1 and G2 patients did not show differences in lifestyle and past history. Fifteen (21.1%) of G1 had digestive involvement. Following Rezende criteria, esophagopathy was observed in 8 patients in G1 (11.3%) and in none of those in G2. Manometry disorders were recorded in 34 G1 patients and in six in G2. Isolated hypotensive lower esophageal sphincter (LES) was found in sixteen G1 patients (23.9%) and four G2 patients (28.8%). Achalasia was observed in two G1 patients. Among G1 patients, ineffective esophageal motility was seen in six (five with symptoms), diffuse esophageal spasm in two (one with dysphagia and regurgitation), and nutcracker esophagus in three (all with symptoms). There were six patients with hypertonic upper esophageal sphincter (UES) among G1. Following Ximenes criteria, megacolon was found in ten G1 patients (13.9%), and in none of the G2 patients. Conclusions: The prevalence of digestive chronic CD in our series was 21.1%. Dysphagia is a non-pathognomonic symptom of CD, but a good marker of early esophageal involvement. Manometry could be a useful diagnostic test in selected cases, mainly in patients with T. cruzi infection and dysphagia in whose situation barium swallow does not evidence alterations. Constipation is a common but non-specific symptom that can be easily managed. Testing for CD is mandatory in a patient from Latin America with constipation or dysphagia, and if diagnosis is confirmed, megacolon and esophageal involvement should be investigated

Perfil epidemiológico de la salud sexual y reproductiva de un grupo de adolescentes escolarizados: una perspectiva desde los derechos. Bello-Colombia. 2005-2008

Objetivo. Describir la situación de la SSR, y sus determinantes protectores y deteriorantes, en  los adolescentes de una institución de educación pública de Bello-Colombia. Método. Estudio  descriptivo  en  el  que  se  encuestaron  estudiantes entre los 10 y 19 años de una institución educativa de Bello (Colombia),  seleccionados  mediante  muestreo  aleatorio simple;  también  se  realizaron  grupos  de  discusión  con adolescentes, padres y profesores de la institución educativa. Resultados. Participaron 233 adolescentes, el 56% del sexo masculino, edad promedio de 14 años con una desviación estándar de 2.2 años. En  las variables sociales el 62% se encuentran en el estrato socioeconómico 2 y 3, en  la afiliación al SGSSS el 39% está afiliado al  régimen contributivo y el 34% al subsidiado; el resto no  lo sabía o no estaba carnetizado. En comportamiento  sexual  el  32%  había  experimentado  la sexarquia, y de éstos el 9% fue a una edad menor a los 10 años, el 28% entre los 10 y 13 años, el 55% entre los 14 y 16 años, y el resto a edad mayor de los 17 años; del total el 17% había  tenido menos  de  dos  compañeros  sexuales  el  año anterior  a  la  encuesta  y  el  14%  tres  o más  compañeros, solamente un hombre refirió más de 10 parejas diferentes el último año. El 11% de los encuestados tenía antecedentes de embarazo, y de éstos el 58%  terminó en aborto, y el 2.1% refirió antecedentes de infecciones de transmisión sexual; los derechos más  vulnerados  fueron el de  formación oportuna completa  e  imparcializada  en  el  tema  de  la  sexualidad,  la autonomía, la libre expresión de la sexualidad, la opción de reproducción,  la  intimidad  personal  y  el  buen  nombre. Conclusión.  Se  encontró  alto  porcentaje  de  adolescentes con experiencias sexuales en etapas  tempranas de  la adolescencia, así mismo falta de formación en temas de sexualidad, salud  sexual  y  reproductiva  en  los  padres  de  familia  y docentes de la institución educativa; la institución de salud no aporta a  la educación de  los adolescentes en estos  temas