Turbulencia empresarial en Colombia : sector de seguros

En el año 2010, la Facultad de Administración de la Universidad del Rosario puso en marcha un proyecto de investigación donde se exploraba el fenómeno de la turbulencia empresarial. En este momento han sido publicados más de 15 documentos donde se realiza la descripción de lo ocurrido en igual número de sectores. En este número se realiza un análisis del sector asegurador, actividad empresarial que contribuye de manera significativa a la economía del país. El trabajo ha sido realizado de manera conjunta por los profesores Natalia Malaver y Hugo Rivera de la asignatura Estrategia de empresa I, con estudiantes del pregrado de la Facultad, quienes se motivaron por encontrar respuestas a la forma como algunas empresas del sector enfrentan la turbulencia sectorial. La estructura del documento incluye una breve descripción del sector; luego un análisis de la turbulencia, y un estudio sectorial realizado aplicando la metodología del Análisis Estructural de Sectores Estratégicos (AESE) desarrollada por el grupo de investigación en perdurabilidad empresarial de la Facultad de Aministración de la Universidad del Rosario

Respiratory viruses detected in Mexican children younger than 5 years old with community-acquired pneumonia: a national multicenter study

Background: Acute respiratory infections are the leading cause of mortality in children worldwide, especially in developing countries. Pneumonia accounts for 16% of all deaths of children under 5 years of age and was the cause of death of 935 000 children in 2015. Despite its frequency and severity, information regarding its etiology is limited. The aim of this study was to identify respiratory viruses associated with community-acquired pneumonia (CAP) in children younger than 5 years old. Methods: One thousand four hundred and four children younger than 5 years of age with a clinical and/or radiological diagnosis of CAP in 11 hospitals in Mexico were included. Nasal washes were collected, placed in viral medium, and frozen at �70 C until processing. The first 832 samples were processed using the multiplex Bio-Plex/Luminex system and the remaining 572 samples using the Anyplex multiplex RT-PCR. Clinical data regarding diagnosis, clinical signs and symptoms, radiographic pattern, and risk factors were obtained and recorded. Results: Of the samples tested, 81.6% were positive for viruses. Respiratory syncytial virus (types A and B) was found in 23.7%, human enterovirus/rhinovirus in 16.6%, metapneumovirus in 5.7%, parainfluenza virus (types 1–4) in 5.5%, influenza virus (types A and B) in 3.6%, adenovirus in 2.2%, coronavirus (NL63, OC43, 229E, and HKU1) in 2.2%, and bocavirus in 0.4%. Co-infection with two or more viruses was present in 22.1%; 18.4% of the samples were negative. Using biomass for cooking, daycare attendance, absence of breastfeeding, and co-infections were found to be statistically significant risk factors for the presence of severe pneumonia. Conclusions: Respiratory syncytial virus (types A and B), human enterovirus/rhinovirus, and metapneumovirus were the respiratory viruses identified most frequently in children younger than 5 years old with CAP. Co-infection was present in an important proportion of the children

Challenges for climate change adaptation in Latin America and the Caribbean region

The limited success of international efforts to reduce global warming at levels established in the Paris Agreement, and the increasing frequency and strength of climate impacts, highlight the urgent need of adaptation, particularly in developing countries. Unfortunately, current levels of adaptation initiatives are not enough to counteract the observed impacts and projected risks from climate change in Latin America and the Caribbean (LAC). In this paper, we review and highlight relevant issues that have limited the capacity to transform climate knowledge and parties’ ambitions into action in the region. Current vulnerabilities and climatic impact-drivers in LAC are diverse, complex, and region-specific and their effects are expected to be exacerbated by climate change. However, the advancement of regional and domestic climate agendas has been hindered by scientific gaps, political support, institutional capacity, and financial, technical, human, and economic limitations that are common to many LAC countries. Transforming climate data into multidimensional metrics with useful thresholds for different sectors and understanding their contribution for feasible adaptation strategies are delayed by regional and local conundrums such as lack of inclusive governance, data availability, equity, justice, and transboundary issues. We discuss ways to move forward to develop local and regional climate resilient development actions and a more sustainable future in LAC. The climate science community in LAC needs to strengthen its local, national, and international connections and with decision/policymakers and society to establish a three-way engagement by proposing suitable adaptation actions and international negotiations to reduce the risks and vulnerability associated with climate extremes, climate variability and climate change in the region. The discussions and insights presented in this work could be extrapolated to other countries in the Global South

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Hacinamiento estratégico, una enfermedad que erosiona la rentabilidad del sector: caso de la industria farmacéutica en Colombia

Las organizaciones en la última década se han enfrentado a un entorno turbulento, caracterizado por un aumento en la complejidad de las relaciones, cambios en las necesidades de los clientes e incremento de la incertidumbre en la toma de decisiones. Algunas empresas para responder a esta situación utilizan las mismas estrategias de los líderes de la industria, lo que lleva a un proceso de convergencia, que afecta la rentabilidad del sector. Este documento presenta una metodología que permite percibir de una mejor manera lo que ocurre en un sector y determinar el grado de convergencia

Contribución a la metalogenia de los yacimientos de Sn y W de la faja estanífera al SE del Perú y NW de Bolivia

Una gran variedad de yacimientos de Sn y W caracteriza a la faja estannífera andina norteña en la subprovincia plutónica del SE del Perú y NW Bolivia. Se presenta la geología de esta provincia metalogénica y se sus principales depósitos de tipo greisen, pegnotoide, veta y manto. Todos estos yacimientos están especialmente relacionados a rocas plutónicas granitoides del Perso-Triásico o Terciario. La metalización de Sn y W se produjo por procesos de fuerte diferenciación magmática y sus subsiguientes actividades hidrotermale