Implementación de políticas públicas de seguridad ciudadana: el caso de los delitos contra el patrimonio en el Distrito Metropolitano de Quito (2004-2009)

The present research aims to examine if the disruption of the involved government agencies led to weak implementation of the citizen security policy, that faced crimes against property in the Metropolitan District of Quito, during the period 2004-2009. This research was developed using a qualitative content-analysis with a deductive approach of primary and secondary sources; and for a suitable understanding of the research, it has been divided into three chapters. The first chapter refers to the proposed analytical model for the research of the policy and the validity of the sequential model. It also details the proposed approaches to the analysis of the implementation of policy, and the appropiate approach of the top-down approach to conduct this research. The second chapter analizes the six-variable selected for the top-down model in order to determine if there was a disorganization of the government offices in charge of the implementation of the citizen security policy. Finally, the investigation concluded that none of the selected variables has given satisfactory results; consecuently, the disruption of the involved government agencies causes a weak implementation of the citizen security policy,that faced crimes against property in the Metropolitan District of Quito, during the period 2004-2009.La presente investigación tiene como objetivo examinar si la desorganización de las entidades estatales provocó una deficiente implementación de las políticas públicas de seguridad ciudadana para enfrentar los delitos contra el patrimonio en el Distrito Metropolitano de Quito, durante el período 2004-2009. El estudio está desarrollado mediante el análisis de contenido cualitativo con enfoque deductivo, de fuentes primarias y secundarias; y, para una adecuada comprensión está estructurado en tres capítulos. El primero hace referencia a los modelos analíticos propuestos para el estudio de las políticas públicas y la validez del modelo secuencial; se detallan también los enfoques propuestos para el análisis de la implementación de las políticas públicas, y finalmente la pertinencia del enfoque de top-down para llevar a cabo esta investigación. El segundo capítulo analiza las seis variables escogidas del modelo top-down, para determinar si existió o no desorganización de las entidades estatales encargadas de la implementación de las políticas públicas de seguridad ciudadana. El capítulo final concluye la investigación, determinando que ninguna de las variables tuvo resultados satisfactorios, demostrando que la desorganización de las entidades estatales provocó una deficiente implementación de las políticas públicas de seguridad ciudadana para enfrentar los delitos contra el patrimonio en la ciudad de Quito durante el 2004 al 2009

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