Health insurance as a strategy for access: streamlined facts of the colombian health care reform

The Colombian reform to the health system (Law 100 of 1993) established, as strategy to facilitate the access, the universality of a health insurance that is acquired by means of the quotation in the contributive regime or by means of the gratuitous affiliation to the subsidized regime, in order to cover all the population with a unique plan of benefits that includes services in all levels of complexity. In this paper we intend to cover the main streamlined facts of the reform as far as coverage and access of the insurance, by means of logit models, the determinants of the enrollment and the access are considered, using data from the Living Standards Surveys of 1997 and 2003. It stands out that the coverage rose from 20% of the population in 1993 to 60% in 2003, although it seems very difficult to reach the universality; the structure and evolution of the coverage show that both regimes complement each other, while the contributive one has greater presence in the cities and among the population with formal employment, the subsidized one has greater weight among the rural population and in those with low levels of income; on the other hand, the insurance has advantages for the subsidized population, with a greater probability for use of the services, although the plan offers less benefits than the contributive one there are some barriers for the access.health insurance, access, enrollment affiliation, social security, Colombia

Evaluating investments in future-proof retail buildings through the real options method

LAUREA MAGISTRALEIn un'era di digitalizzazione e di accelerazione nell'adozione della tecnologia nelle attività quotidiane e nel commercio tradizionale, l'e-commerce sta gradualmente sostituendo lo shopping tradizionale, affermandosi come settore in crescita che sta modificando il comportamento dei consumatori. Questa modifica ha un impatto sugli spazi fisici dei negozi al dettaglio nelle aree urbane. Il futuro delle vendite al dettaglio fisiche è incerto e sono necessarie alternative per il riutilizzo di questi spazi, il che rappresenta una sfida considerando la configurazione rigida della maggior parte di essi, difficili da adattare ad altri utilizzi senza demolizione e ricostruzione costose. In questa tesi magistrale, si valuta l'applicazione del Metodo Real Options (RO) per valutare il possibile cambio di utilizzo degli spazi commerciali al dettaglio attraverso progetti flessibili, considerando l'incertezza della domanda e gli interessi di tutti gli attori coinvolti. In due casi studio condotti a Milano, si sono analizzati il contesto socioeconomico, identificano gli stakeholder coinvolti e studiano le potenziali soluzioni per gli spazi. 400 scenari, sono stati generati con il metodo Monte Carlo tenendo conto dell'incertezza sulla domanda per stimare il Beneficio Netto su tutti gli stakeholder coinvolti. I risultati dell’analisi sui due casi studio dimostrano in modo quantitativo e rigoroso che l'implementazione di progetti flessibili negli spazi commerciali al dettaglio può offrire importanti vantaggi economici per tutti gli attori coinvolti, alla luce della forte incertezza sulla domanda futura. Il RO si rivela un metodo prezioso per valutare e sviluppare alternative concrete per l'adattamento e il riutilizzo degli spazi commerciali al dettaglio, introducendo flessibilità nel design e nelle decisioni per i professionisti responsabili di tali spazi.In an era of digitalization and accelerated adoption of technology in daily activities and commerce, e-commerce is gradually replacing traditional shopping, establishing itself as a growing sector that is changing consumer behaviour. This change has an impact on physical retail store spaces in urban areas. The uncertain future of physical retail stores necessitates the exploration of alternative uses for these spaces. However, the rigid configuration of most retail stores poses challenges for adaptation without costly demolition and reconstruction. This master's thesis evaluates the application of the Real Options Method (ROM) to assess the potential change of use in retail spaces through flexible designs, considering the uncertainty of the demand and the interests of all the actors involved. In two case studies conducted in Milan, the socio-economic context was analysed, the stakeholders involved were identified and potential solutions for the spaces were studied. 400 scenarios were generated with the Monte Carlo method taking into account the uncertainty on demand to estimate the Net Benefit for all the stakeholders involved. The analysis results of the two case studies demonstrate quantitatively and rigorously that implementing flexible projects in retail commercial spaces can offer important economic advantages for all the actors involved, in light of the strong uncertainty about future demand. The ROM emerges as a valuable method for assessing and developing real alternatives for the adaptation and reutilization of retail spaces, introducing flexibility in design and decision-making processes for professionals in charge of such spaces. This research contributes to addressing the challenges posed by the evolving retail properties market, enabling professionals to make informed decisions and effectively utilize existing spaces

A socio-ecological assessment of land-based contamination and pollution: The Magdalena delta, Colombia

River mouth systems, such as estuaries and deltas are important earth system transitional zones linking the land and coastal marine systems. They funnel anthropogenic contaminants and pollutants from the activities in the river catchment into the marine environment. The present study is focused on the Magdalena River-mouth at Bocas de Ceniza where land-based contamination and pollution are important issues. These were subsequently analysed using an expanded DPSIR framework (Drivers Pressures, State, Impacts Responses). Based on export coefficients and secondary information, the loads of BOD, TSS, Nutrients and solid waste from different sources were identified and compared to prioritize their management within the study area. Findings suggest that contaminants generated in the study area may be insignificant compared to the inputs from the Magdalena River, but they can have a significant impact on the state of local ecosystems. Of all the sources analysed, agriculture and livestock are theoretically the largest contributors of nitrogen (i.e., 14.84 t d(-1) and 48.99 t d(-1)) and phosphorus (i.e., 5.90 t d(-1) and 19.46 t d(-1)) in the basin 'Direct to the Caribbean' and 'Cienaga de Mallorquin' (that altogether are identified as DtC+) and the 'Western bank of the lower Magdalena' (DtM-LM), respectively. In the case of BOD, domestic and industrial wastewaters contribute about 5.10 t d(-1) and 98.43 t d(-1) in the same basins. Contributions of faecal coliforms were more than 4 orders of magnitude higher in untreated wastewater, being 4.86 x10(16) NMP d(-1) and 1.78 x10(16) NMP d(-1) in the lower Magdalena and Caribbean catchments, respectively. Inadequately managed waste and plastic represent a serious problem for the Caribbean Basin. Solid waste generated within the study area and coming from the Magdalena basin and the Caribbean Sea, reaches the coast and deteriorates its visual quality, affects mangrove ecosystems, and generates impacts on coastal populations. By basin, the DtM-LM is where the greatest pollutant loads are generated. However, in terms of impact on human well-being, it is the DtC+ that bears the brunt where pressures are translated in impacts such as increased maintenance and cleaning cost of beaches, reduction or loss of tourism revenue, adverse health effects to vulnerable groups, reduce protection against natural hazards, increased living costs and loss of cultural values.info:eu-repo/semantics/publishedVersio

Assessment of the Magdalena River delta socio-ecological system through the circles of coastal sustainability framework

River-mouth systems and deltas are hotspots where many of the coastal syndromes can be found. Moreover, these systems provide essential ecosystem services (e.g., recreation, food provisioning, protection against natural hazards). The present study focuses on the socio-ecological system at the delta of the Magdalena River in the central Caribbean Region in Colombia. This research seeks to assess the multidimensional sustainability of the Magdalena river-mouth system (MRm-SES) to improve the knowledge basis for its integrated management. To do so, an assessment tool named "Circles of Coastal Sustainability" (CCS) was used to evaluate the system splitting it into four domains (environmental, social, economic and governance) that were divided into 5 categories each. These domains were evaluated through a total of 52 indicators distributed like this: 16 for the Environmental domain, 16 for the Economic domain, 12 for the Social and Cultural domain and, 8 for the Governance domain. The results show that the overall sustainability of the MRm-SES is classified as "Satisfactory." None of the domains is in "Excellent" or "Bad" conditions. However, the evaluation of the categories shows that four (4) of them have "Poor" conditions (i.e., Social Benefits, Demographics, Economic Security, and Resources Management). Hence, it is recommended to put those categories at the centre of the discussion to define management strategies (e.g., Preserving and restoring habitats; tackling sources of pollution and excessive sediment; local reduction of net Greenhouse Gas and adaptation to climate change; participation of local communities in the management design and implementation), without disregarding the interrelation with the other categories and dimensions. Finally, it is argued that despite all the improvement opportunities, the CCS is a valuable tool to evaluate and communicate with different stakeholders (academic community, managers and decision-makers, local communities, etc.), to improve the sustainability of coastal systems in Colombia and the world.European Commission Joint Research Centre586596-EPP-1-2017-1-IT-EPPKA1-JMD-MOB, Fundação para a Ciência e a Tecnologia (FCT) LA/P/0069/2020,info:eu-repo/semantics/publishedVersio

Statistical modeling of ground motion relations for seismic hazard analysis

We introduce a new approach for ground motion relations (GMR) in the probabilistic seismic hazard analysis (PSHA), being influenced by the extreme value theory of mathematical statistics. Therein, we understand a GMR as a random function. We derive mathematically the principle of area-equivalence; wherein two alternative GMRs have an equivalent influence on the hazard if these GMRs have equivalent area functions. This includes local biases. An interpretation of the difference between these GMRs (an actual and a modeled one) as a random component leads to a general overestimation of residual variance and hazard. Beside this, we discuss important aspects of classical approaches and discover discrepancies with the state of the art of stochastics and statistics (model selection and significance, test of distribution assumptions, extreme value statistics). We criticize especially the assumption of logarithmic normally distributed residuals of maxima like the peak ground acceleration (PGA). The natural distribution of its individual random component (equivalent to exp(epsilon_0) of Joyner and Boore 1993) is the generalized extreme value. We show by numerical researches that the actual distribution can be hidden and a wrong distribution assumption can influence the PSHA negatively as the negligence of area equivalence does. Finally, we suggest an estimation concept for GMRs of PSHA with a regression-free variance estimation of the individual random component. We demonstrate the advantages of event-specific GMRs by analyzing data sets from the PEER strong motion database and estimate event-specific GMRs. Therein, the majority of the best models base on an anisotropic point source approach. The residual variance of logarithmized PGA is significantly smaller than in previous models. We validate the estimations for the event with the largest sample by empirical area functions. etc

Incidencia de la implementación de una estrategia pedagógica basada en el juego de roles y los trabalenguas para el mejoramiento de la pronunciación de los sonidos fricativos y africados que presentan los estudiantes del IV semestre del Programa de Licenciatura en Educación con Énfasis en Lenguas Extranjera de la Unidad Central del Valle del Cauca

ilustraciones, gráficos, tablasThe fricative and affricate sounds, are for the students one of the biggest difficulties for the pronunciation of English. Based on this problematic, the research carried out was aimed at "Determine Incidence of the implementation of a pedagogical strategy based on the Role play and Tongue twisters game for the improvement of the pronunciation of the fricative and affricate sounds that present the students of IV semester of the program of degree in Basic Education with Emphasis on Foreign Languages of the Unidad Central del Valle del Cauca ", which was achieved under a methodological design with qualitative and quantitative approach, a type of quasi-experimental research, of action and scope of explanatory type, which allowed through the use of data collection instruments, such as; the Lickert type survey, diagnostic entrance and exit evaluations to evaluate fricative and affricate sounds, pronunciation rubrics and the focal group technique, applied to a population of 28 students, initially obtain the necessary inputs for the intervention , which focused on the improvement of the pronunciation of the phonemes "/ tʃ / / dʒ // z /", which were improved trough an intervention based on the strategies of Role Play and Tongue Twister.Los sonidos fricativos y africados, resultan para los estudiantes una de las mayores dificultades para la pronunciación del inglés. Partiendo de esta problemática, el trabajo de investigación realizado tuvo como objetivo “ Determinar la incidencia de la implementación de una estrategia pedagógica basada en los sonidos fricativos y africados para el mejoramiento de la pronunciación que presentan los estudiantes de IV semestre del Programa de Licenciatura en Educación Básica con Énfasis en Lenguas Extranjeras de la Unidad Central del Valle del Cauca”, lo que se alcanzó bajo un diseño metodológico con enfoque cualitativo y cuantitativo, un tipo de investigación cuasi-experimental, de acción y un alcance de tipo explicativo, que permitieron mediante la utilización de instrumentos de recolección de datos, como; la encuesta tipo Likert, evaluaciones diagnósticas de entrada y de salida para evaluar sonidos y africados, rubricas de pronunciación y la técnica de grupo focal, aplicados a una población de 28 estudiantes, obtener inicialmente los insumos necesarios para la intervención, la cual se enfocó en el mejoramiento de la pronunciación de los fonemas “/tʃ/ /dʒ//z/”, los que se lograron mejorar por medio de una intervención basada en las estrategias del Role Play y el Tongue Twister.Licenciado (a) en Lenguas Extranjeras con énfasis en inglésPregrad

Aggregate particle size interrelations and case study in concrete using white ordinary Portland cement

The size distribution, the gradation and the type of aggregates are factors of great relevance for the design of mixtures in concrete and construction materials in general since these allow us to obtain information on the voids contents, module fineness, bulk density, and mechanical performance that certain aggregate mixtures will present. In the present work, different mixtures of aggregates were made using three types of raw materials: fine sand, coarse sand, and 3/8” aggregate, for which their mineralogical composition was evaluated using X-ray diffraction, the chemical composition using X-ray fluorescence, and its macroscopic structure using optical microscopy. Sixty-six mixture formulations were made, to which variables such as fineness modulus, particle size distribution, void content, and density were evaluated. These data were represented in ternary diagrams. From the gradation studies carried out, six formulations were selected based on the type of aggregate used and the content of voids. With this selection, concrete specimens were made, which were subjected to compression tests, finding that the mixture A 22, with 17 % of voids generated a compressive strength of 22 MPa. The results obtained can be used not only in applications such as zero-set concrete, concrete block masonry, or regular concretes, but also in asphalt pavements, ceramic materials obtained by sintering, and particle-reinforced composite materials.The size distribution, the gradation and the type of aggregates are factors of great relevance for the design of mixtures in concrete and construction materials in general since these allow us to obtain information on the voids contents, module fineness, bulk density, and mechanical performance that certain aggregate mixtures will present. In the present work, different mixtures of aggregates were made using three types of raw materials: fine sand, coarse sand, and 3/8” aggregate, for which their mineralogical composition was evaluated using X-ray diffraction, the chemical composition using X-ray fluorescence, and its macroscopic structure using optical microscopy. Sixty-six mixture formulations were made, to which variables such as fineness modulus, particle size distribution, void content, and density were evaluated. These data were represented in ternary diagrams. From the gradation studies carried out, six formulations were selected based on the type of aggregate used and the content of voids. With this selection, concrete specimens were made, which were subjected to compression tests, finding that the mixture A 22, with 17 % of voids generated a compressive strength of 22 MPa. The results obtained can be used not only in applications such as zero-set concrete, concrete block masonry, or regular concretes, but also in asphalt pavements, ceramic materials obtained by sintering, and particle-reinforced composite materials

Problemas de la investigación y las oportunidades para su desarrollo desde la Revista Médica de Risaralda

La crisis de la investigación en el país y el actual manejo de la Revista Medica de Risaralda resaltan las oportunidades del desarrollo de la investigación en pro de los impactos en salud publica