Funcionamiento de los discursos de equidad, centralización, descentralización, evaluación de los aprendizajes y privatización en relación con la constitución de subjetividades, desde la teoría de Michel Foucault, en la Universidad del Tolima entre 1990 y 2012

353 PáginasRecurso ElectrónicoEl discurso de la calidad de la educación superior en la Universidad del Tolima se trabajará a partir de cuatro categorías de calidad: Equidad (Claudia Milena Daza Gómez), Centralización/Descentralización (María Camila Horta Blandón, Diana Carolina Padilla Sánchez y Karen Melissa Lozano Castañeda), Evaluación de los aprendizajes (Juan Sebastián Nieto Serrate) y Privatización (Harold Ernesto Pabón Cortés y Wolfang Camilo Pineda Devia), las cuales son objeto de investigación; por ello, se hace necesario y pertinente tomar como autor principal al francés Michel Foucault y su obra El Orden del Discurso (1970), puesto que en su teoría se aborda un modelo de discurso diferente y más completo en relación con otros autores que también lo han estudiado. Foucault engloba en su teoría tres aspectos principales que son de vital importancia, tales como: el sujeto (lo subjetivo), la realidad (lo objetivo) y la sociedad (lo intersubjetivo); esta triada nos permite hacer una ubicación de las problemáticas dentro del discurso; de igual manera, remonta arqueológicamente y genealógicamente nuestro objeto de estudio a la actualidad y nos muestra cómo a través de los juegos de poder se generan los diversos procedimientos de control de los discursos, ejercidos tanto desde el exterior como desde el interior de la institución.ABSTRACT. The discourse of quality in higher education at the University of Tolima will work from four quality categories: Equity (Claudia Milena Daza Gómez), Centralization / Decentralization (Maria Camila Horta Blandon, Diana Carolina Padilla Sánchez and Karen Melissa Lozano Castañeda), Learning assessment (Juan Sebastian Nieto Serrate) and Privatization (Harold Ernesto Pabón Cortés and Wolfang Camilo Pineda Devia), which are under investigation; therefore, it is necessary and appropriate to take as principal French Michel Foucault and his work The Order of Discourse (1970), since in his theory more fully in relation to other authors model different discourse and addresses that also have been studied. Foucault in his theory encompasses three main aspects that are of vital importance, such as: the subject (the subjective) reality (objective) and society (intersubjectivity); this allows us to make a triad location problem within the discourse; similarly, archaeologically and genealogically back our object of study to the present and shows how through the power plays various control procedures speeches, exercised both from outside and from inside the institution are generated.INTRODUCCIÓN 18 1. PLANTEAMIENTO DEL PROBLEMA 19 1.1. ANTECEDENTES 21 1.1.1. Equidad 22 1.1.2. Centralización/Descentralización 24 1.1.3. Evaluación de los aprendizajes 26 1.1.4. Privatización 29 1.2. ÁMBITO TEÓRICO 33 1.2.1. Michel Foucault 33 1.2.2. Alberto Martínez Boom 37 1.2.3. Marcelo Fabián Vitarelli 41 1.2.4. Mariano Narodowski 44 1.3. OBJETIVOS 47 1.3.1. Objetivo General 47 1.3.2. Objetivos Específicos 47 1.4. CONJETURA O SUPUESTO INVESTIGATIVO 48 2. DISEÑO METODOLÓGICO 49 3. MATRICES DE INTERPRETACIÓN 55 4. INTERPRETACIONES. DISERTACIÓN SOBRE LA CALIDAD EDUCATIVA DE LA UNIVERSIDAD DEL TOLIMA EN LA ACTUALIDAD 128 4.1 LOGRO DE OBJETIVOS ESPECÍFICOS 128 4.2 EQUIDAD. BAJO LA AURORA DE “PENSAR DE OTRO MODO” 129 4.3 CENTRALIZACIÓN/DESCENTRALIZACIÓN 137 4.4 EVALUACIÓN DE LOS APRENDIZAJES 143 4.5 PRIVATIZACIÓN 155 5. PROPUESTAS CRÍTICO CREATIVAS 170 5.1 EQUIDAD 170 5.2 CENTRALIZACIÓN/DESCENTRALIZACIÓN 173 5.3 EVALUACIÓN DE LOS APRENDIZAJES 181 5.4 PRIVATIZACIÓN 182 6. CONCLUSIONES 183 6.1 PREGUNTAS ESPECÍFICAS DE LA INVESTIGACIÓN 183 6.2 EQUIDAD 183 6.3 CENTRALIZACIÓN/DESCENTRALIZACIÓN 184 6.4 EVALUACIÓN DE LOS APRENDIZAJES 184 6.5 PRIVATIZACIÓN 185 7. RECOMENDACIONES 187 8. REFERENCIAS 189 ANEXOS 19

Obstetricia integral siglo XXI. Tomo II

El libro Obstetricia Integral siglo XXI, Tomo II, es una publicación virtual de la Facultad de Medicina, se trata de la continuación sobre el análisis detallado de los principales tópicos en el área de la obstetricia, realizada por un grupo interdisciplinario de investigadores comprometidos con el mejoramiento de la calidad en el cuidado de la salud de la mujer gestante. Se ha procurado un balance entre los aspectos básicos de fisiopatología y las guías de atención clínica soportadas en evidencias científicas, con el ánimo de brindarle al lector un equilibrio entre las bases biopsico-sociales de la salud y la enfermedad y los aspectos prácticos de la atención clínica.Vargas Fiesco, Diana Carolina and Rubio Romero, Jorge Andrés and Ruiz Parra, Ariel Iván and Rodríguez, Luis Martín and Aragón, Miguel Eduardo and Arteaga Díaz, Clara Eugenia and Riaño, Jorge Enrique and Arenas Gamboa, Jaime and Ramírez Martínez, Javier Andrés and Amaya Guío, Jairo and Gaitán , Magda Alexandry and Gallego Arbeláez, Jaime and Cortés Díaz, Daniel Otálvaro and Ángel Müller, Edith and Bracho Ch., Alcides C. and Bautista Charry, Alejandro and Rodríguez Ramos, Marcela and Navarro Milanés, Alfonso and Díaz Cruz, Luz Amparo and Mercado Pedroza, Manuel Esteban and Gaitán Duarte, Hernando and Gómez Sánchez, Pio Iván and Peña, Diana Marcela and Calvo Gómez, José Manuel and Parra Pineda, Mario Orlando and Cárdenas Muñoz, María Luisa (2010) Obstetricia integral siglo XXI. Tomo II. Facultad de Medicina, Universidad Nacional de Colombia, Bogotá. ISBN 978958447618

Drug-induced anaphylaxis, elicitors, risk factors, and management in Latin America

Nonsteroidal anti-inflammatory drugs were the most frequent triggers of drug-induced anaphylaxis in Latín America, whereas antibiotics elicited faster onset and more scvere reactions. An improvement was observed in epinephrinc use and adherence to guidelines in the emergency department treatment of anaphylaxis in Latín America compared with our last report.Facultad de Ciencias Médica

Large scale multifactorial likelihood quantitative analysis of BRCA1 and BRCA2 variants: An ENIGMA resource to support clinical variant classification

The multifactorial likelihood analysis method has demonstrated utility for quantitative assessment of variant pathogenicity for multiple cancer syndrome genes. Independent data types currently incorporated in the model for assessing BRCA1 and BRCA2 variants include clinically calibrated prior probability of pathogenicity based on variant location and bioinformatic prediction of variant effect, co-segregation, family cancer history profile, co-occurrence with a pathogenic variant in the same gene, breast tumor pathology, and case-control information. Research and clinical data for multifactorial likelihood analysis were collated for 1,395 BRCA1/2 predominantly intronic and missense variants, enabling classification based on posterior probability of pathogenicity for 734 variants: 447 variants were classified as (likely) benign, and 94 as (likely) pathogenic; and 248 classifications were new or considerably altered relative to ClinVar submissions. Classifications were compared with information not yet included in the likelihood model, and evidence strengths aligned to those recommended for ACMG/AMP classification codes. Altered mRNA splicing or function relative to known nonpathogenic variant controls were moderately to strongly predictive of variant pathogenicity. Variant absence in population datasets provided supporting evidence for variant pathogenicity. These findings have direct relevance for BRCA1 and BRCA2 variant evaluation, and justify the need for gene-specific calibration of evidence types used for variant classification

Large scale multifactorial likelihood quantitative analysis of BRCA1 and BRCA2 variants: An ENIGMA resource to support clinical variant classification

Abstract The multifactorial likelihood analysis method has demonstrated utility for quantitative assessment of variant pathogenicity for multiple cancer syndrome genes. Independent data types currently incorporated in the model for assessing BRCA1 and BRCA2 variants include clinically calibrated prior probability of pathogenicity based on variant location and bioinformatic prediction of variant effect, co-segregation, family cancer history profile, co-occurrence with a pathogenic variant in the same gene, breast tumor pathology, and case-control information. Research and clinical data for multifactorial likelihood analysis were collated for 1395 BRCA1/2 predominantly intronic and missense variants, enabling classification based on posterior probability of pathogenicity for 734 variants: 447 variants were classified as (likely) benign, and 94 as (likely) pathogenic; 248 classifications were new or considerably altered relative to ClinVar submissions. Classifications were compared to information not yet included in the likelihood model, and evidence strengths aligned to those recommended for ACMG/AMP classification codes. Altered mRNA splicing or function relative to known non-pathogenic variant controls were moderately to strongly predictive of variant pathogenicity. Variant absence in population datasets provided supporting evidence for variant pathogenicity. These findings have direct relevance for BRCA1 and BRCA2 variant evaluation, and justify the need for gene-specific calibration of evidence types used for variant classification. This article is protected by copyright. All rights reserved.Peer reviewe

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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat