Apuntes para el debate ecuatoriano sobre medios

En los últimos años algunos países progresistas de América Latina han realizado cambios a sus leyes que regulan los medios de comunicación, con especial énfasis sobre los medios audiovisuales1 que explotan el espacio radioeléctrico. Una cuestión que comparten estas nuevas leyes de comunicación es el criterio de reorganizar las concesiones de radio y televisión, con el compromiso de entregar un tercio de estas frecuencias a los medios constituidos por organizaciones sin fines de lucro, que son denominados medios comunitarios. Además, en varios casos, como el ecuatoriano, también se reserva otro tercio de las frecuencias para medios de organismos públicos. Estos cambios posibilitarían que en el mediano plazo el sector comunitario y público posean, en conjunto, la mayor parte de las frecuencias de los medios audiovisuales en varios países de la región. En teoría tendríamos un conjunto de espacios antes acaparados por el sector privado, que deben pasar a manos de sectores fuera de unalógica estrictamente mercantil para la realización de sus producciones. En este marco nos preguntamos, ¿qué posibilidades existen para un relanzamiento de propuestas de comunicación orientadas, en un sentido amplio, hacia la educomunicación?2 Trataremos de ensayar respuestas a esta pregunta tomando como referencia el caso ecuatoriano y los desafíos, entendidos como logros y limitaciones, que plantea su nueva ley de comunicación.In the last few years, some progressive countries in Latin America have made changes to laws that regulate media, with a particular emphasis on audiovisual media that make use of radio broadcast ing space. A key feature shared by these new media laws is the criteria for reallocating radio and TV concessions, with a compromise of assigning a third of these frequencies to non-governmental organizations, referred to as community media. Moreover, in several cases, as in Ecuador, another third of the frecuencias are reserved for public institutions. These changes would allow, in the medium term, for community and public groups to own most of the range of audiovisual media frequencies in several countries in the region. In theory, we would have spaces that had been previously hoarded by the private sector, now in the hands of groups outside of the strictly commercial rationality used for their own benefit. In this context, we ask, what possibilities are there for a relaunch of communication proposals oriented, in the general sense, to “educommunication” (educational communication)? We will attempt to provide answers by using Ecuador as a reference for both challenges, learned successes, and limitations under the new Law of Communication

Appointing parties and OpenBIM in the context of ISO 19650

Dissertação de mestrado em Building Information ModellingThe architecture, engineering, construction, and operation (AECO) industry strives for a more integrated approach in the entire project life cycle. This new methodology of doing must include technology, process, and people. The urgency of change comes from the low productivity level in the AECO sector which impacts in different factors such as: time, cost, scope, and quality. The appointing party is one of the actors or stakeholders within the supply chain of the AECO industry. Also, it is the originator of the goals, objectives, purposes, and requirements that the project must fulfill to be considered successful. Then, a conscious appointing party about the necessity of innovation and a digital transformation can take the lead by implementing BIM. Nevertheless, it is not an easy path not only for the different dimensions to consider as it was mentioned technology, process and people, but also for the enormous guides, templates, books, papers existing that can create confusion in an appointing party for starting its BIM journey. This dissertation takes the perspective of an appointing party that intends to create a flow process aligned not only with ISO 19650 series but also with interoperability criteria coming from OpenBIM, and on top of that by adding some Lean Construction tools. Then, the first approach discussed in this document is the necessary steps that an appointing party needs to follow ISO 19650 series. The tangible result of this is the generation of thirteen different templates with alongside a technical guide that intends to pave the path of the appointing party in its BIM journey. The second step was the incorporation in the document of practical’s about interoperability through OpenBIM concepts such as IFC, MVD, BCF and IDS. As a third step it was included five tools from the Lean Construction community that pretend to boost the synergy between Lean and BIM. The validation process consisted of a series of semi-structured interviews and surveys to a panel of experts from the industry. This process helped to refine the proposed templates and technical guide aligned to ISO 19650 series, OpenBIM and Lean Construction tools. Some changes were included according to the answers and comments of the experts. The findings helped to improve and to consider the perspective of the industry that the expert panel brought to this research. It was found that necessity to improve the knowledge of practitioners about OpenBIM and Lean construction in the most practical aspects of the tools of each domain. Also, it was highlighted the convenience of having two complementary types of documents: templates and technical guide for helping appointing parties in its BIM implementation. Moreover, there was found doubts about the practicality and suitability of the level of information framework over other approach as LOD.A indústria de arquitetura, engenharia, construção e operação (AECO) tem-se esforçado por adotar uma abordagem mais integrada em todo o ciclo de vida do projeto. Esta nova metodologia deve incluir tecnologias, processos e pessoas. A urgência para esta mudança vem do baixo nível de produtividade no sector AECO que tem impacto em diferentes fatores, tais como: tempo, custo, âmbito e qualidade. O contratante é um dos atores ou partes interessadas dentro da cadeia de fornecimento da indústria AECO. Além disso, é o originador das metas, objetivos, propósitos e requisitos que o projeto deve cumprir para ser considerado bem-sucedido. Então, um contratante consciente sobre a necessidade de inovação e de transformação digital deve tomar a liderança, implementando o BIM. No entanto, não é um caminho fácil não só para as diferentes dimensões a considerar, tecnologias, processos e pessoas, mas também para os enormes guias, modelos, livros, artigos existentes que podem criar confusão num contratante para iniciar a sua viagem BIM. Esta dissertação assume a perspetiva de um contratante que pretende criar um processo de fluxo alinhado não só com a série ISO 19650 mas também com critérios de interoperabilidade vindos do OpenBIM, e ainda por cima acrescentando algumas ferramentas de Construção Lean. A primeira abordagem discutida neste documento são os passos necessários que uma parte nomeada necessita para seguir a série ISO 19650. O resultado tangível disto é a geração de treze modelos diferentes, com um guia técnico que pretende apontar o caminho do contratante na sua viagem BIM. O segundo passo foi a incorporação nos documentos de práticas sobre interoperabilidade através de conceitos OpenBIM tais como IFC, MVD, BCF e IDS. Como terceiro passo, foram incluídas cinco ferramentas da comunidade de Construção Lean que pretendem impulsionar a sinergia entre Lean e BIM. O processo de validação consistiu numa série de entrevistas e inquéritos semiestruturados a um painel de peritos da indústria. Este processo ajudou a refinar os modelos propostos e o guia técnico alinhado com a série ISO 19650, o OpenBIM e as ferramentas Lean Construction. Foram incluídas algumas alterações de acordo com as respostas e comentários dos peritos. Os resultados ajudaram a melhorar e a considerar a perspetiva da indústria que o painel de peritos trouxe para esta investigação. Foi constatada a necessidade de melhorar os conhecimentos dos profissionais sobre OpenBIM e construção Lean nos aspetos mais práticos das ferramentas de cada domínio. Também foi salientada a conveniência de ter dois tipos complementares de documentos: modelos e guia técnico para ajudar a designar as partes na sua implementação do BIM. Além disso, foram encontradas dúvidas sobre a praticabilidade e adequação do quadro de informação ao nível do quadro de informação em relação a outra abordagem como LOD

Current Status of New Anticoagulants in the Management of Venous Thromboembolism

Venous Thromboembolism, manifested as deep venous thrombosis and pulmonary embolism, is a common problem associated with significant morbidity, mortality, and resource expenditure. Unfractionated heparin, low-molecular-weight heparin, and vitamin K antagonists are the most common treatment and prophylaxis, and have demonstrated their efficacy in a vast number of previous studies. Despite their broad use, these agents have important limitations that have led to the development of new drugs in a bid to overcome the disadvantages of the old ones without decreasing their therapeutic effect. These novel medications, some approved and others in different stages of development, include direct thrombin inhibitors like dabigatran etexilate, and direct activated factor X inhibitors like rivaroxaban. The current paper will review the characteristics, clinical trial results, and current and potential therapeutic uses of these new agents with a focus on the categories of direct thrombin inhibitors and activated factor X inhibitors

Taking a Bite Out of Malnutrition

Purpose: In the United States, the literature suggests over the past decade that 30-50 % of patients admitted to the hospital are malnourished. Malnutrition is commonly overlooked and/or underre-ported in hospital settings. Some of the negative consequences of malnutrition are slower recovery, increased risk of hospital acquired pressure injuries (HAPI), mortality, postoperative infections, falls, and readmission rates. After hospital conversion to an electronic health record (EHR) and implementation of a malnutrition screening tool (MST) there was a high incidence of positive malnutrition screenings with referrals to the Dietitian for malnutrition consults. The readmission rate for under-weight malnourished elderly (≥65) patients was consistently higher than those who were 65 and old-er with a BMI ≤ 18.5. The primary aim of this project is to decrease the 30-day readmission rate of underweight, malnourished (BMI ≤ 18.5) patients 65 years of age and older. Method: An inter-professional team consisting of Dietitians, Nurses, Pharmacist, Social Worker and Physicians collaborated on a performance improvement initiative and applied evidence-based interventions for improvement of the patients’ nutritional status. The project consisted of early and accurate identification of malnourished patients with a BMI ≤ 18.5 and patients 65 years of age and older, early initiation of appropriate diet including oral nutritional supplements, nutritional resources upon discharge, and post discharge follow-up from registered dietitians. Findings: A total of 33 patients screened positive for underweight malnutrition and were ≥ 65 and agreed to participate in the performance improvement initiative. Six months post implementation of the project, the readmission rate for 100 patient days for the targeted population decreased by 61.5%. Whereas patients not included in the project (patients ≥ 65 with a BMI of \u3e18.5) had increase in readmission rate of 30.7%. Discussion: The collaborative effort and implementation of practical, evidence-based, low cost nutritional and educational interventions has shown to reduce the readmission rates for under-weight malnourished elderly patients. The reduction in readmission rates and the potential cost savings of implementing a project to monitor and reduce the incidence of malnutrition has proven effective when compared to patients ≥ 65 who did not participate in the project. Implications for Practice Implications for practice are to focus on evaluating current nutritional status assessments and to implement effective evidence-based validated screening tools and protocols that rapidly identify and treat all malnourished hospitalized patients along with aligning new evidence-based policies and procedures. Timely identification of malnutrition at any stage of the healthcare continuum could reduce unplanned admissions and improve overall patient outcomes while decreasing healthcare costs. Objectives: Describe the impact of rapid initiation of oral nutritional supplements with high protein, high calorie intake for the malnourished elderly inpatient. Summarize some of the adverse consequences of the unrecognized malnourished elderly inpatients (BMI ≤ 18.5) without nutritional interventions

Editorial

EditorialEl comité editor de ACTA NOVAsiente una profunda satisfacción alpresentar el primer número del cuartovolumen de esta revista, entregado aconsideración de quienes nos honrancon la lectura de nuestros artículos yvienen siguiendo nuestra labor desdehace nueve años

El choque anafiláctico y su posible influencia con las aguas radiactivas

Tesis inédita de la Universidad de Madrid, Facultad de Medicina, leída el 7-07-1962.Fac. de MedicinaTRUEProQuestpu

Doença de Chagas em uma comunidade do Sudeste do Brasil: I. Seguimento sorológico em uma área com controle vetorial

A prevalência da infecção pelo Trypanosoma cruzi foi avaliada no município de Berilo, Minas Gerais, Brasil, no período de janeiro a julho de 1997. Uma amostra de 2.261 indivíduos foi estudada sorologicamente mediante o teste de imunofluorescência indireta em sangue coletado em papel de filtro. A taxa de prevalência foi de 18% no total da população estudada e 50% em pessoas da área rural maiores de 30 anos. A percentagem de soropositividade foi 0,17% entre os menores de 10 anos estudados, o que sugere que a transmissão vetorial está controlada na área. Observamos uma diminuição na taxa de soroprevalência entre as pessoas nascidas após 1960 e 1970 o que teria relação com o início das ações de controle. Observou-se também uma redução na taxa de infecção pelo T. cruzi quando comparamos os nossos achados com as estimativas de infecção registradas em um estudo sorológico realizado em Berilo em 1983.The prevalence of Trypanosoma cruzi infection was evaluated in Berilo, Minas Gerais (MG), Brazil, from January to July 1997. A serological survey using the indirect immunofluorescence test (IFT) in dried blood collected on filter-paper was performed in a sample of 2,261 individuals. The overall prevalence rate of T. cruzi infection was 18%, and reached 50% in individuals older than 30 years from rural areas. The percentage of seropositivity was 0.17% among individuals younger than 10 years old, suggesting that vectorial transmission is controlled in the area. A decrease in prevalence rates among people born after 1960 and 1970 was observed and this appears to be correlated with the beginning of control programs. A reduction in T. cruzi infection rates was observed when comparing our results with the rates estimated in a serologic study carried out in Berilo in 1983(11)

El choque anafiláctico y su posible influencia con las aguas radiactivas

Tesis inédita de la Universidad de Madrid, Facultad de Medicina, leída el 7-07-1962.Fac. de MedicinaTRUEProQuestpu

Servicios de atención y cuidado para la familia en la zona metropolitana de Guadalajara

Trabajo en el que se presenta el plan de negocios para una empresa de servicios de cuidado y atención para la familia. Este servicio va dirigido a adultos que necesiten el apoyo de alguien externo capacitado para desarrollar diversas actividades en el hogar, a cualquier hora y en cualquier circunstancia

Targeted-pig trial on safety and immunogenicity of serum-derived extracellular vesicles enriched fractions obtained from Porcine Respiratory and Reproductive virus infections

The Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) is the etiological agent of one of the most important swine diseases with a significant economic burden worldwide. Unfortunately, available vaccines are partially effective highlighting the need of novel approaches. Previously, antigenic viral proteins were described in serum-derived extracellular vesicles (EVs) from pigs previously infected with PRRSV. Here, a targeted-pig trial was designed to determine the safety and immunogenicity of such extracellular vesicles enriched fractions. Our results showed that immunizations with EV-enriched fractions from convalescence animals in combination with montanide is safe and free of virus as immunizations with up-to two milligrams of EV-enriched fractions did not induce clinical symptoms, adverse effects and detectable viral replication. In addition, this vaccine formulation was able to elicit specific humoral IgG immune response in vaccinated animals, albeit variably. Noticeably, sera from vaccinated animals was diagnosed negative when tested for PRRSV using a commercial ELISA test; thus, indicating that this new approach differentiates vaccinated from infected animals. Lastly, after priming animals with EV-enriched fractions from sera of convalescence animals and boosting them with synthetic viral peptides identified by mass spectrometry, a distinctive high and specific IFN-γ response was elicited. Altogether, our data strongly suggest the use of serum EV-enriched fractions as a novel vaccine strategy against PRRSV.Anti-CD9, Anti-CD63 and anti-CD81 antibodies were kindly donated by Francisco Sánchez-Madrid and Maria Yañez-Mo, Hospital de la Princesa, Madrid, Spain. The authors wish to particularly thank Glòria Abella for her collaboration in conducting the field study and to Marta Alcobé, Miriam Moron Font and Paula Crego Mendez for technical assistance. This study received support from Innovex Therapeutics S.L., Pinsos del Segre SA, Granja Casanyé, Grup de Sanejament Porci (GSP, Lleida, Spain) and the FEDER project (COMRDI16-1-0035-03). Sergio Montanter-Tarbes is an industrial doctorate awarded by the Government of Catalonia, Spain (No. 2014 DI 044). ISGlobal and IGTP are members of the CERCA Programme, Generalitat de Catalunya