Revocatoria directa de los actos del tribunal medico laboral del Ministerio de Defensa Nacional

El presente escrito se origina en la preocupación que le genera a dos profesionales del derecho, uno en su calidad de litigante y otro en su calidad de funcionario, los dos ante el Tribunal Médico Laboral de Revisión Militar y de Policía del Ministerio de Defensa Nacional, en cuanto a que las decisiones de está organismo médico laboral no son susceptibles de ser modificadas, por el carácter de irrevocabilidad con que el artículo 22 del decreto 1796 de 2000 revistió a dichos pronunciamientos, en vista de que se trata de actos administrativos preparatorios. Al efecto se realiza una síntesis del entorno normativo de la situación.The present essay is originated on the worry felt by two lawyers, one on it´s private practice and the other on it´s public service, both at the National Defense Ministry´s Laboral Medical Court, because the decisions of this laboral medical organism are not capable to be modified, also because it´s not reversible characteristic given by the 22th article of the 1796/00 law, attending that those decisions are preparatory administrative acts. On this purpose a synthesis of the legal surrounding of the situation is done

Indicadores de gestión de los Programas Académicos de Campo (PAC) de la Universidad del Rosario

En el marco del Proyecto Educativo Institucional (PEI) de la Universidad del Rosario, los Programas Académicos de Campo (PAC) hacen parte fundamental del proceso de formación de los estudiantes y se incluyen dentro de los programas de proyección social y extensión que tiene la Universidad. Con estos se pretende que el estudiante adquiera un conocimiento de la realidad social del país, actuando en beneficio de la misma con gran sentido de responsabilidad. En este sentido, los PAC se consideran como una fuerte estrategia de extensión mediante la cual los Programas enfrentan académicamente problemas de contexto, llegando a la comunidad con diferentes estrategias de acuerdo al nivel de atención en el que se desarrollan. A través de esta experiencia, estudiantes y profesores interactúan con la realidad social del país para fortalecer el desarrollo de competencias profesionales en el abordaje de problemas del entorno desde una mirada intersectorial e interdisciplinaria

INDICADORES DE GESTÃO NOS PROGRAMAS ACADÊMICOS DE CAMPO (PAC) DO PROGRAMA DE FISIOTERAPIA DA UNIVERSIDAD DEL ROSARIO PARA O PERÍODO 2004-2007

Introducción: El programa de Fisioterapia de la Universidad del Rosario, en su responsabilidad social de generar un impacto positivo en la comunidad y en su propósito de formar profesionales, cuenta con los Programas Académicos de Campo (PAC) que se consideran una fuerte estrategia de extensión de la Universidad. Los PAC contribuyen a la adquisición de competencias para el desarrollo de procesos de acción-actuación-creación en los estudiantes para que resuelvan problemas en un espacio real de ejercicio profesional. Bajo esta perspectiva los PAC del programa de Fisioterapia muestran su comportamiento a través de la medición de indicadores de proceso y resultados propuestos desde el Programa con el fin de proveer información útil para la reorientación y permanente actualización de los contenidos programáticos en las asignaturas y en los mismos PAC. Materiales y métodos: En el siguiente artículo se presenta un análisis de los indicadores de demanda por género, régimen de Seguridad Social en Salud, procedimiento y morbilidad de los Programas Académicos de Campo Integral Pediátrico, Integral de Adultos y Rehabilitación cardíaca y/o pulmonar, con el fin de establecer las características de la población objeto de la prestación de los servicios y procurar información verificable que dé soporte para la construcción de procesos de cambio dentro de la dinámica de mejoramiento continuo que debe tener cualquier institución. Este seguimiento es útil para la toma de decisiones de planeación académica que contribuye a mejorar los procesos de planeación y a facilitar el cumplimiento de los propósitos de formación para cada práctica, y de esta manera ayuda a ser elemento de análisis para directivas, instructores y estudiantes en la orientación del proceso de gestión académico-administrativo, y a retroalimentar los procesos de planeación y programación académica. Resultados: Los resultados arrojados en el análisis de los datos de la morbilidad en los programas académicos de campo muestran el siguiente comportamiento durante los años 2004, 2005, 2006 y 2007. Conclusiones: En el PAC pediátrico la mayor incidencia es de asma con un 37,2% y la más baja incidencia es para luxación congénita de cadera y enfermedad mental de origen central con un 0,1%. El 58% de los usuarios es de género masculino, y el 81% del total pertenece al régimen contributivo. En la morbilidad del PAC de adultos la mayor incidencia es de EPOC, con un 23,2%, y la menor incidencia es de lumbalgia, con un 2,4%. La mayoría de usuarios atendidos (58%) son hombres, y el 58% de los usuarios pertenece al régimen contributivo. En el PAC de rehabilitación cardíaca y/o pulmonar la mayor incidencia fue de EPOC, con un 40%; seguido de neumonía, con 17%; y con una menor incidencia para asma, con un 2%. El 54% de los usuarios son hombres y el 91% del total pertenece al régimen subsidiado.Introduction: The Physical Therapy program at Universidad del Rosario has Field Academic Programs (FAP) which are basically aimed at training professionals. FAPs contribute to the acquisition of skills for the development of acting-doing-creating processes in students in order to solve problems in a real practice setting. The purpose of this work is to describe the process indicators to provide useful information for the continuous updating of the courses' program contents. Methods and materials: An analysis of demand indicators by gender, health social security affiliation, procedure and morbidity of Integral Pediatric, Integral Adult, and Cardiac/Pulmonary Rehabilitation Field Academic Programs, is presented with the purpose of establishing the characteristics of the service target population and providing verifiable information. Results: The results obtained in the analysis of morbidity data in the field's academic programs show the following behavior during the years 2004 to 2007: In the pediatric FAP, the highest incidence was asthma (37.2%) and the lowest was congenital hip dislocation and mental disease of central origin. 58% of users were male and 81% of users belonged to the contributory social security regime. In adults FAP morbidity, the highest incidence was of COPD (23.2%), and the lowest incidence corresponded to lower back pain (2.4%). Most treated users were male (58%), and 58% of users belonged to the contributory social security regime. In the cardiac/pulmonary rehabilitation FAP, the highest incidence was of COPD (40%), followed by pneumonia with 17% and with a lower incidence to asthma with 2%. 54% of users were male, and 91% of users beloned to the subsidized social security regime. Conclusion: The assessment was able to establish the behavior of the proposed indicators, which will support the continuous change plan for the classes and the orientation of the field programs.Introdução: o programa de fisioterapia da Universidad del Rosario, em sua responsabilidade social de gerar um impacto positivo na comunidade e em seu propósito de formar profissionais, conta com os Programas Acadêmicos de Campo (PAC) que se consideram uma forte estratégia de extensão da universidade. Os PAC contribuem à aquisição de competências para o desenvolvimento de processos de ação - atuação - criação nos estudantes para que resolvam problemas em um espaço real de exercício profissional. Sob esta perspectiva os PAC do programa de Fisioterapia mostram seu comportamento através da medição de indicadores de processos e resultados propostos desde o Programa com o fim de prover informação útil para a reorientação e permanente atualização dos conteúdos programáticos nas disciplinas e nos mesmos PAC. Materiais e métodos: No seguinte artigo se apresenta uma análise dos indicadores de demanda por gênero, regime de Segurança Social em Saúde, procedimento e morbidade dos Programas Acadêmicos de Campo Integral Pediátrico, Integral de Adultos e Reabilitação cardíaca e/ou pulmonar, com o fim de estabelecer as características da povoação objeto da apresentação dos serviços e procurar informação verificável que dê suporte para a construção de processos de mudança dentro da dinâmica de melhoramento contínuo que deve ter qualquer instituição. Este seguimento é útil para a tomada de decisões de planejamento acadêmico que contribuem a melhorar os processos de planejamento e a facilitar o cumprimento dos propósitos de formação para cada prática, e desta forma ajuda a ser elemento de análise para diretivas, instrutores e estudantes na orientação do processo de gestão acadêmico-administrativo, e a retroalimentar os processos de planejamento e programação acadêmica. Resultados: Os resultados produzidos na análise dos dados da morbidade nos programas acadêmicos de campo mostram o seguinte comportamento durante os anos 2004, 2005, 2006 e 2007. Conclusões: No PAC pediátrico a maior incidência é de asma com um 37,2% e a mais baixa incidência é para luxação congênita de quadril e enfermidade mental de origem central com um 0,1%. O 58% dos usuários é de gênero masculino, e o 81% do total pertence ao regime contributivo. Na morbidade do PAC de adultos, a maior incidência é de EPOC, com um 23,2%, e a menor incidência é de lombalgia, com um 2,4%. A maioria de usuários atendidos (58%) são homens, e o 58% dos usuários pertencem ao regime contributivo. No PAC de reabilitação cardíaca e/ou pulmonar a maior incidência foi de EPOC, com um 40%; seguido de pneumonia, com 17%; e com uma menor incidência para asma, com um 2%. O 54% dos usuários são homens e o 91% do total pertencem ao regime subsidiado.

Cáncer renal metastásico, respuesta histopatológica completa posterior a sunitinib

ResumenAproximadamente el 25% de los pacientes se presentan con cáncer de células renales metastásico (CCRm) al momento del diagnóstico. Los inhibidores con actividad cinasa multitirosina han revolucionado el tratamiento del CCRm desplazando la terapia con citocinas. El sunitinib, inhibidor de la tirosina cinasa, ha mostrado eficacia en términos de supervivencia libre de progresión y supervivencia global, con tasas de respuesta completa de alrededor del 3%. Presentamos la remisión histológica completa posterior de sunitinib en CCRm.Masculino 65 años, hipertenso, inicia en 2013 con pérdida ponderal de peso, dolor en hipocondrio derecho, y aumento de volumen abdominal ipsilateral; hallazgo tomográfico tumor en riñón derecho de 24×13.8×10cm, realce 98UH, conglomerado ganglionar perihiliar; tórax con imagen única heterogénea con centro hiperdenso en segmento apical del pulmón izquierdo. Biopsia renal percutánea con reporte de carcinoma de células renales Fuhrman I. Inicia sunitinib 50mg vo/24h, 4 semanas, descansando 2 semanas, 3 ciclos. Al termino la tomografía muestra tumor de 10.2×8.1×5.1cm hipodenso en centro, calcificaciones periféricas, realce difuso, tórax sin lesiones. Se realiza nefrectomía radical derecha con reporte histopatológico de infiltrado inflamatorio, necrosis, sin evidencia de tumor.Actualmente la integración de cirugía y terapia sistémica representa la mejor opción de tratamiento para muchos pacientes con enfermedad avanzada.El tratamiento del CCRm se ha revolucionado a partir de la era de la terapia blanco, con respuestas parciales de hasta un 30-40%, y respuesta completa en casos aislados. La terapia neoadyuvante ha demostrado disminuir el tamaño tumoral y permitir la cirugía posterior en pacientes seleccionados.AbstractApproximately 25% of with renal cell carcinoma have already reached the metastatic phase of disease (mRCC) at the time of diagnosis. Multi-targeted tyrosine kinase inhibitors have revolutionised the treatment of mRCC, replacing cytokine therapy. Sunitinib, a tyrosine kinase inhibitor has shown to be effective in terms of progression free survival and overall survival, with complete response rates of around 3%. A case is presented of a complete histological response after sunitinib in mRCC.A 65 year-old hypertensive man, who in 2013 began with a considerable loss of weight, pain in the right hypochondrium, and an increase in ipsilateral abdominal volume. The computed tomography found a tumour of 24×13.8×10cm in the right kidney, with 98HU enhancement and a peri-hilar lymph node conglomerate. The thorax showed a single heterogeneous image with a hyperdense centre in the apical segment of the left lung. The percutaneous renal biopsy reported a Fuhrman grade I renal cell carcinoma. Sunitinib was started at 50mg orally every 24hours for 4 weeks, resting for 2 weeks, for 3 cycles. At the end of the treatment the tomography showed a tumour of 10.2×8.1×5.1cm hyperdense in the centre, peripheral calcifications, diffuse enhancement, and the thorax with no lesions. A right radical nephrectomy was performed, with the histopathology reporting an inflammatory infiltrate, necrosis, and with no evidence of a tumour.The combination of surgery and systemic therapy is currently the best treatment option for many patients with advanced disease.The treatment of mRCC has been revolutionised from the era of blanket therapy, with up to 30% - 40% partial responses, and a complete response in isolated cases. Neoadjuvant therapy has been shown to decrease tumour size and enables surgery to be performed in selected patients

Relevance of the Glutathione System in Temporal Lobe Epilepsy: Evidence in Human and Experimental Models

Oxidative stress, which is a state of imbalance in the production of reactive oxygen species and nitrogen, is induced by a wide variety of factors. This biochemical state is associated with diseases that are systemic as well as diseases that affect the central nervous system. Epilepsy is a chronic neurological disorder, and temporal lobe epilepsy represents an estimated 40% of all epilepsy cases. Currently, evidence from human and experimental models supports the involvement of oxidative stress during seizures and in the epileptogenesis process. Hence, the aim of this review was to provide information that facilitates the processing of this evidence and investigate the therapeutic impact of the biochemical status for this specific pathology

Transcription factor TFIIEβ interacts with two exposed positions in helix 2 of the Antennapedia homeodomain to control homeotic function in Drosophila

Abstract Homeoproteins contain the conserved homeodomain (HD) and have an important role determining embryo body plan during development. HDs increase their DNA-binding specificity by interacting with additional cofactors outlining a Hox interactome with a multiplicity of protein-protein interactions. In Drosophila, the first link of functional contact with a general transcription factor (GTF) was found between Antennapedia (Antp) and BIP2 (TFIID complex). Hox proteins also interact with other components of Pol II machinery such as the subunit Med19 from Mediator (MED) complex, TFIIEβand transcription-pausing factor M1BP. All these interactions clearly demonstrate Hox-driven transcriptional regulation, but the precise molecular mechanism remains unclear. In this paper, we focused on the Antp-TFIIEβ protein-protein interface to establish the specific contacts as well as its functional role. Using Bimolecular Fluorescence Complementation (BiFC) in cell culture and in vivo we found that TFIIEβinteracts with Antp through the HD independently of the YPWM motif and the direct physical interaction is at helix 2, specifically aminoacidic positions I32 and H36 of Antp. We also found, through ectopic assays, that these two positions in helix 2 are crucial for Antp homeotic function in head involution, and thoracic and antenna-to tarsus transformations. Interestingly, overexpression of Antp and TFIIEβin the antennal disc showed that this interaction is required for the antenna-to-tarsus transformation. In conclusion, interaction of Antp with TFIIEβis important for the functional specificity of Antennapedia, and amino acids 32 and 36 in Antp HD helix 2 are key for this interaction. Our results open the possibility to more broadly analyze Antp-TFIIEβinteraction on the transcriptional control for the activation and/ or repression of target genes in the Hox interactome during Drosophila development

Combined direct-sun ultraviolet and infrared spectroscopies at Popocatépetl volcano (Mexico)

Volcanic plume composition is strongly influenced by both changes in magmatic systems and plume-atmosphere interactions. Understanding the degassing mechanisms controlling the type of volcanic activity implies deciphering the contributions of magmatic gases reaching the surface and their posterior chemical transformations in contact with the atmosphere. Remote sensing techniques based on direct solar absorption spectroscopy provide valuable information about most of the emitted magmatic gases but also on gas species formed and converted within the plumes. In this study, we explore the procedures, performances and benefits of combining two direct solar absorption techniques, high resolution Fourier Transform Infrared Spectroscopy (FTIR) and Ultraviolet Differential Optical Absorption Spectroscopy (UV-DOAS), to observe the composition changes in the Popocatépetl’s plume with high temporal resolution. The SO2 vertical columns obtained from three instruments (DOAS, high resolution FTIR and Pandora) were found similar (median difference <12%) after their intercalibration. We combined them to determine with high temporal resolution the different hydrogen halide and halogen species to sulfur ratios (HF/SO2, BrO/SO2, HCl/SO2, SiF4/SO2, detection limit of HBr/SO2) and HCl/BrO in the Popocatépetl’s plume over a 2.5-years period (2017 to mid-2019). BrO/SO2, BrO/HCl, and HCl/SO2 ratios were found in the range of (0.63 ± 0.06 to 1.14 ± 0.20) × 10−4, (2.6 ± 0.5 to 6.9 ± 2.6) × 10−4, and 0.08 ± 0.01 to 0.21 ± 0.01 respectively, while the SiF4/SO2 and HF/SO2 ratios were found fairly constant at (1.56 ± 0.25) × 10−3 and 0.049 ± 0.001. We especially focused on the full growth/destruction cycle of the most voluminous lava dome of the period that took place between February and April 2019. A decrease of the HCl/SO2 ratio was observed with the decrease of the extrusive activity. Furthermore, the short-term variability of BrO/SO2 is measured for the first time at Popocatépetl volcano together with HCl/SO2, revealing different behaviors with respect to the volcanic activity. More generally, providing such temporally resolved and near-real-time time series of both primary and secondary volcanic gaseous species is critical for the management of volcanic emergencies, as well as for the understanding of the volcanic degassing processes and their impact on the atmospheric chemistry.We acknowledge financial support from grants UNAM-PAPIIT IA101620 and IN111521. NT and TBo also thank the stipend given by the Mexican Foreign Affairs Department (Secretaría de Relaciones Exteriores) and its AMEXCID program. Financial support from Conacyt-AEM through grant No. 275239 is acknowledged

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Municipios Jamundí, Santiago de Cali y San Juan de Pasto

El presente trabajo aborda el tema de violencia, fenómeno que por años se ha hecho presente en Colombia, llegando a convertirse en protagonista y parte intrínseca de su historia. Aunque sus manifestaciones son diversas; la violencia generada en el marco del conflicto armado interno, toma especial relevancia si se tiene en cuenta que por más de cincuenta años los grupos armados han promovido y justificado el uso de las distintas formas de violencia; como único instrumento y medio valido para presuntamente combatir la desigualdad y transformar la sociedad; cuando lo que se buscan son intereses particulares. El análisis al relato 1: Modesto Pacayà, un padre y esposo que fue reclutado y obligado a separarse de su familia; es un claro ejemplo del rigor del conflicto armado y la guerra en Colombia; aunque logró realizar su proceso de desmovilización con éxito, recuperar a su familia y reintegrarse a la sociedad con una actitud resiliente, no es ajeno a los impactos psicosociales que se derivan de la experiencia de violencia y que se hacen extensivos a su familia. Así mismo, la revisión y análisis del caso de Peñas Coloradas, permiten conocer las realidades de las comunidades olvidadas por el Estado durante años; que cuando son “reconocidas” corren el riesgo de ser estigmatizadas y explotadas; siendo impactadas negativamente en su identidad, cultura, tradición y costumbres. A partir de un abordaje psicosocial se proponen estrategias que permitan mitigar el impacto de violencia. Finalmente, el ejercicio de foto voz, llevado a cabo en contextos cercanos, permite reconocer la manifestación de la violencia en las comunidades; a partir de imágenes de los escenarios, las cuales reflejan los impactos psicosociales, factores de riesgo, pero también los procesos transformadores de impacto positivo para las comunidades. Palabras claves: Violencia, Víctima, Sobreviviente, Conflicto Armado, Desplazamiento.This work addresses the issue of violence, a phenomenon that has been present in Colombia for years, becoming a protagonist and an intrinsic part of its history. Although its manifestations are diverse; The violence generated within the framework of the internal armed conflict takes on special relevance if one takes into account that for more than fifty years armed groups have promoted and justified the use of different forms of violence; as the only valid instrument and means to presumably combat inequality and transform society; when what is sought are particular interests. The analysis of story 1: Modesto Pacayá, a father and husband who was recruited and forced to separate from his family; It is a clear example of the rigor of the armed conflict and war in Colombia; Although he managed to carry out his demobilization process successfully, recover his family and reintegrate into society with a resilient attitude, he is not immune to the psychosocial impacts that derive from the experience of violence and that extend to his family. Likewise, the review and analysis of the case of Peñas Coloradas, allow us to know the realities of the communities forgotten by the State for years; that when they are “recognized” they run the risk of being stigmatized and exploited; being negatively impacted on their identity, culture, tradition and customs. From a psychosocial approach, strategies are proposed to mitigate the impact of violence. Finally, the photo-voice exercise, carried out in close contexts, makes it possible to recognize the manifestation of violence in the communities; from images of the scenarios, which reflect the psychosocial impacts, risk factors, but also the transformative processes of positive impact for the communities. Key words: Violence, Victim, Survivor, Armed Conflict, Displacement

Formaldehyde total column densities over Mexico City: comparison between multi-axis differential optical absorption spectroscopy and solar-absorption Fourier transform infrared measurements

Formaldehyde (HCHO) total column densities over the Mexico City metropolitan area (MCMA) were retrieved using two independent measurement techniques: multi-axis differential optical absorption spectroscopy (MAX-DOAS) and Fourier transform infrared (FTIR) spectroscopy. For the MAX-DOAS measurements, the software QDOAS was used to calculate differential slant column densities (dSCDs) from the measured spectra and subsequently the Mexican MAX-DOAS fit (MMF) retrieval code to convert from dSCDs to vertical column densities (VCDs). The direct solar-absorption spectra measured with FTIR were analyzed using the PROFFIT (PROFile FIT) retrieval code. Typically the MAX-DOAS instrument reports higher VCDs than those measured with FTIR, in part due to differences found in the ground-level sensitivities as revealed from the retrieval diagnostics from both instruments, as the FTIR and the MAX-DOAS information do not refer exactly to the same altitudes of the atmosphere. Three MAX-DOAS datasets using measurements conducted towards the east, west or both sides of the measurement plane were evaluated with respect to the FTIR results. The retrieved MAX-DOAS HCHO VCDs where 6 %, 8 % and 28 % larger than the FTIR measurements which, supported with satellite data, indicates a large horizontal inhomogeneity in the HCHO abundances. The temporal change in the vertical distribution of this pollutant, guided by the evolution of the mixing-layer height, affects the comparison of the two retrievals with different sensitivities (total column averaging kernels). In addition to the reported seasonal and diurnal variability of HCHO columns within the urban site, background data from measurements at a high-altitude station, located only 60 km away, are presented

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia. Municipios de Tunja, Sogamoso, Villa de Leyva y Soatá, Departamento de Boyacá

La violencia en Colombia ha sido un problema complejo durante décadas, con múltiples facetas, conflicto armado interno, grupos armados ilegales, narcotráfico y factores socioeconómicos. En las diferentes narrativas como la de Nelson “capítulo 4 historias que retornan” y el relato de Yurley sobre la masacre de El Salado dan cuentan de lo que el conflicto armado ha traído; víctimas civiles, desplazamientos internos y graves violaciones a los derechos humanos. Factores como la lucha por el control territorial, la producción de drogas ilícitas y las luchas políticas han contribuido a la persistencia de la violencia armada en muchas partes del país; través de las narrativas y la foto – voz logramos identificar eventos y experiencias que reflejan la realidad de manera coherente y que dan cuenta de situaciones que se han podido afrontar día a día y para las personas ha sido una forma de comunicar ideas, emociones y perspectivas vividas. Desde diferentes municipios del departamento de Boyacá se analizaron hechos que han surgido, en el norte del departamento entre Soatá y Boavita grupos armados derribaron el puente con explosivos dejando a las poblaciones incomunicadas, pérdidas económicas, dificultad para acceder a servicios médicos y educación. De igual forma en Villa de Leyva, Tunja y Sogamoso encontramos violencia de género y el uso de sustancias psicoactivas. A pesar de la devastación, los sujetos han encontrado fuerza en sus conexiones culturales y simbólicas, lo que les ha permitido demostrar su resiliencia, estos son factores fundamentales en su capacidad para superar los desafíos.Violence in Colombia has been a complex problem for decades, with multiple facets, internal armed conflict, illegal armed groups, drug trafficking and socioeconomic factors. In the different narratives such as Nelson's "chapter 4 stories that return" and Yurley's account of the El Salado massacre, they tell what the armed conflict has brought; civilian casualties, internal displacement and serious human rights violations. Factors such as the struggle for territorial control, illicit drug production and political strife have contributed to the persistence of armed violence in many parts of the country; Through narratives and photo-voice we manage to identify events and experiences that reflect reality in a coherent way and that account for situations that have been faced day by day and for people it has been a way of communicating ideas, emotions and perspectives lived. From different municipalities of the department of Boyacá were analyzed facts that have arisen, in the north of the department between Soatá and Boavita armed groups demolished the bridge with explosives leaving the populations incommunicado, economic losses, difficulty in accessing medical services and education. Similarly in Villa de Leyva, Tunja and Sogamoso we find gender violence and the use of psychoactive substances. Despite the devastation, the subjects have found strength in their cultural and symbolic connections, which has allowed them to demonstrate their resilience, these are fundamental factors in their ability to overcome challenges