Presupuesto participativo hospitalario por unidad de gestión clínica

En un entorno actual caracterizado por su volatilidad, incertidumbre, complejidad y ambigüedad, los prestadores privados de servicios de salud, se han visto obligados a desarrollar una capacidad de respuesta adaptativa para poder mantenerse en funcionamiento. Las características particulares de este tipo de instituciones como ser mano de obra intensiva, con requerimientos de insumos y productos médicos valuados en dólares, y con escasa participación en el establecimiento de precios, han hecho esta tarea todavía aún más difícil. Adicionalmente, el contexto inflacionario en el que están insertas, acompañado de la puja salarial por parte de los sindicatos, ha ejercido sobre los prestadores una presión que han podido soportar gracias al incremento en los niveles de actividad de sus prestaciones médicas. En este sentido el Planeamiento Estratégico visto como la proyección de ese escenario y los medios para alcanzarlo, es trascendental para delinear el rumbo que la misma ha de seguir. Este, a su vez, ha necesariamente de integrar en su proceso al Presupuesto, ya que el mismo se constituye como su expresión cuantificada y da cuenta de los fondos que serán requeridos para alcanzar las estrategias previstas. Este trabajo entonces, propone un recorrido por Planeamiento Estratégico, el Presupuesto y el Presupuesto Participativo Hospitalario por Unidad de Gestión Clínica siendo este último la forma de integrar al profesional sanitario en la gestión racional del recurso, desarrollando su sentido de pertenencia y el compromiso con los resultados de la Institución.Facultad de Ciencias Económica

Presupuesto participativo hospitalario por unidad de gestión clínica

En un entorno actual caracterizado por su volatilidad, incertidumbre, complejidad y ambigüedad, los prestadores privados de servicios de salud, se han visto obligados a desarrollar una capacidad de respuesta adaptativa para poder mantenerse en funcionamiento. Las características particulares de este tipo de instituciones como ser mano de obra intensiva, con requerimientos de insumos y productos médicos valuados en dólares, y con escasa participación en el establecimiento de precios, han hecho esta tarea todavía aún más difícil. Adicionalmente, el contexto inflacionario en el que están insertas, acompañado de la puja salarial por parte de los sindicatos, ha ejercido sobre los prestadores una presión que han podido soportar gracias al incremento en los niveles de actividad de sus prestaciones médicas. En este sentido el Planeamiento Estratégico visto como la proyección de ese escenario y los medios para alcanzarlo, es trascendental para delinear el rumbo que la misma ha de seguir. Este, a su vez, ha necesariamente de integrar en su proceso al Presupuesto, ya que el mismo se constituye como su expresión cuantificada y da cuenta de los fondos que serán requeridos para alcanzar las estrategias previstas. Este trabajo entonces, propone un recorrido por Planeamiento Estratégico, el Presupuesto y el Presupuesto Participativo Hospitalario por Unidad de Gestión Clínica siendo este último la forma de integrar al profesional sanitario en la gestión racional del recurso, desarrollando su sentido de pertenencia y el compromiso con los resultados de la Institución.Facultad de Ciencias Económica

RNA microarray analysis in prenatal mouse cochlea reveals novel IGF-I target genes: implication of MEF2 and FOXM1 transcription factors

Background: Insulin-like growth factor-I (IGF-I) provides pivotal cell survival and differentiation signals during inner ear development throughout evolution. Homozygous mutations of human IGF1 cause syndromic sensorineural deafness, decreased intrauterine and postnatal growth rates, and mental retardation. In the mouse, deficits in IGF-I result in profound hearing loss associated with reduced survival, differentiation and maturation of auditory neurons. Nevertheless, little is known about the molecular basis of IGF-I activity in hearing and deafness. Methodology/Principal Findings: A combination of quantitative RT-PCR, subcellular fractionation and Western blotting, along with in situ hybridization studies show IGF-I and its high affinity receptor to be strongly expressed in the embryonic and postnatal mouse cochlea. The expression of both proteins decreases after birth and in the cochlea of E18.5 embryonic Igf1(-/-) null mice, the balance of the main IGF related signalling pathways is altered, with lower activation of Akt and ERK1/2 and stronger activation of p38 kinase. By comparing the Igf1(-/-) and Igf1(+/+) transcriptomes in E18.5 mouse cochleae using RNA microchips and validating their results, we demonstrate the up-regulation of the FoxM1 transcription factor and the misexpression of the neural progenitor transcription factors Six6 and Mash1 associated with the loss of IGF-I. Parallel, in silico promoter analysis of the genes modulated in conjunction with the loss of IGF-I revealed the possible involvement of MEF2 in cochlear development. E18.5 Igf1(+/+) mouse auditory ganglion neurons showed intense MEF2A and MEF2D nuclear staining and MEF2A was also evident in the organ of Corti. At P15, MEF2A and MEF2D expression were shown in neurons and sensory cells. In the absence of IGF-I, nuclear levels of MEF2 were diminished, indicating less transcriptional MEF2 activity. By contrast, there was an increase in the nuclear accumulation of FoxM1 and a corresponding decrease in the nuclear cyclin-dependent kinase inhibitor p27(Kip1). Conclusions/Significance: We have defined the spatiotemporal expression of elements involved in IGF signalling during inner ear development and reveal novel regulatory mechanisms that are modulated by IGF-I in promoting sensory cell and neural survival and differentiation. These data will help us to understand the molecular bases of human sensorineural deafness associated to deficits in IGF-I

Escape the lion cage: Social networks by catch zones of small-scale fisheries in the oil settlement of Lobitos (Peru)

Artisanal fishing communities are often in conflict with the interests of the oil extraction industry, industrial fishing fleets and tourism. This paper considers Lobitos, a fishing enclave in northern Peru, where the oldest oil settlement in Latin America was established. The primary focus is community organization and development of the fisheries. Using a mixed methods approach, intensive ethnographic observation and analysis of the social networks of the skippers of small-scale fishing vessels was conducted by in-depth interviews with 30 artisanal fishermen, together with a social network survey involving 43 boat captains in Lobitos. The results showed the mistrust and negative attitudes of fishermen towards oil companies and the industrial fishing fleet. However, they expressed positive expectations regarding tourism development, as well as favorable attitudes towards the diversification of fishing activity through tourist services. The networks of acquaintances, social support and exchange of ecological information allowed us to identify three different groups of fishermen according to preferential fishing zones. The skippers of vessels that prefer to fish in intermediate zones have a prominent role, both in terms of local leadership and through the connection with boats belonging to other bays near Lobitos. This subgroup acts as an intermediary in the networks a whole and has an integrated vision of the coastal ecosystem. Network measures and preferential fishing zones can be used as indicators to assess the degree of availability and preparation for the implementation of new uses in the fisheries sector associated with tourism and heritage

Digital technology and teacher professional development: challenges and contradictions in compulsory education

The aim of this article is to explore the role of teacher professional development (TPD) in relation to two experiences involving digital technology. Both studies were conducted at a single combined primary and secondary school and involved a total of 727 students. The first study consisted of an ex post facto analysis of attempts to improve student perception of the risks associated with inappropriate use of technology, while the second examined the possible benefits of gamified learning on mathematical fluency using a pre-test/post-test approach. The results reveal the lack of TPD in relation to both experiences, with teachers unable to overcome problems related to technology use and risk perception in the first case, and relegated to the role of mere implementers of an automated learning software product in the second. The conclusions highlight the contradiction between the image of technological innovation in schools and the reality of stasis in teaching practice, as well as the need for further research to assess and promote more effective TPDS

Nutrigenomics and Atherosclerosis: The Postprandial and Long-Term Effects of Virgin Olive Oil Ingestion

Metals technology / metallurg

Intercalation processes and diffusion paths of lithium ions in spinel-type structured Li1+xTi2O4: density functional theory study

Intercalation processes and corresponding diffusion paths of Li ions into spinel-type structured Li1+xTi2O4 0 x 0.375 are systematically studied by means of periodic density functional theory calculations for different compositions and arrangements. An analysis of the site preference for intercalation processes is carried out, while energy barriers for the diffusion paths have been computed in detail. Our results indicate that the Li insertion is thermodynamically favorable at octahedral sites 16c in the studied composition range, and Li migration from tetrahedral sites 8a to octahedral sites 16c stabilizes the structure and becomes favorable for compositions x 0.25. Diffusion paths from less stable arrangements involving Li migrations between tetrahedral and octahedral sites exhibit the lowest energy barrier since the corresponding trajectories and energy profiles take place across a triangle made by three neighboring oxygen anions without structural modification. Theoretical and experimental diffusion coefficients are in reasonable agreemen

Motivos C-terminais do HIV-1 gp41 como Possíveis Determinantes da Patogênese Viral

Human immunodeficiency virus type 1 (HIV-1) is the etiological agent of acquired immunodeficiency syndrome (AIDS), a pandemic with high economic and social costs. The envelope glycoprotein (env) of the virus mediates the infectious process by binding to and entering the host cell, one of the main target components of studies since its discovery. Its endodomain or C-terminal tail (CTT) participates in late replicative cycle processes, such as intracellular trafficking, activation, and cell death, which occurs because it interacts with multiple cellular factors through motifs or signal sequences present throughout its structure. Although these interactions have not been fully understood at specific levels, studies over more than three decades leave no doubt that this domain plays a fundamental role in the biology of the virus and probably the development of the disease. This review describes the studies carried out to date that demonstrate the importance of the CTT, focusing on the motifs responsible for its interactions and its possible roles in the pathogenicity of the infection.El virus de la inmunodeficiencia humana tipo 1 (VIH-1) es el agente etiológico del síndrome de inmunodeficiencia adquirida (SIDA), una pandemia con altos costos económicos y sociales. La glicoproteína de la envoltura (env) del virus media el proceso infeccioso al unirse a la célula huésped y entrar en ella, uno de los principales componentes objetivo de los estudios desde su descubrimiento. Su endodominio o cola C-terminal (CTT) participa en procesos tardíos del ciclo replicativo, como tráfico intracelular, activación y muerte celular, lo que ocurre porque interactúa con múltiples factores celulares a través de motivos o secuencias señal presentes en toda su estructura. Aunque estas interacciones no se han entendido completamente a niveles específicos, los estudios durante más de tres décadas no dejan dudas de que este campo juega un papel fundamental en la biología del virus y probablemente en el desarrollo de la enfermedad. Esta revisión describe los estudios realizados hasta la fecha que demuestran la importancia de la CTT, centrándose en los motivos responsables de sus interacciones y sus posibles roles en la patogenicidad de la infección.O vírus da imunodeficiência humana tipo 1 (HIV-1) é o agente etiológico da síndrome da imunodeficiência adquirida (AUXILIA), uma pandemia com elevados custos económicos e sociais. A glicoproteína do envelope (env) do vírus media o processo infeccioso ligando-se e entrando na célula hospedeira, um dos principais componentes alvo dos estudos desde sua descoberta. Seu endo domínio ou cauda C-terminal (CTT) participa de processos do ciclo replicativo tardio, como tráfego intracelular, ativação e morte celular, que ocorre porque interage com múltiplos fatores celulares por meio de motivos ou sequências-sinal presentes em toda a sua estrutura. Embora essas interações não tenham sido totalmente compreendidas em níveis específicos, estudos ao longo de mais de três décadas não deixam dúvidas de que esse domínio desempenha um papel fundamental na biologia do vírus e provavelmente no desenvolvimento da doença. Esta revisão descreve os estudos realiza- dos até o momento que demonstram a importância da CTT, com foco nos motivos responsáveis por suas interações e seus possíveis papéis na patogenicidade da infecção