Memorias, experiencias y transformaciones corporales en la guerra y en la reincorporación dentro de las FARC-EP en el ETCR de Icononzo

El acuerdo de paz entre el Estado colombiano y la extinta guerrilla de las Farc representa un gran reto para el país. La implementación del proceso de reincorporación, de largo aliento tanto para los excombatientes, el mismo Estado y para la población en general se reconoce como una oportunidad histórica de finalizar el conflicto armado con esta organización. Situada desde la ruta metodológica institucional DDR, la presente investigación es una invitación a abordar conceptos como el cuerpo, la colectividad y la cotidianidad en el contexto de la guerra, y hoy en la reincorporación a la civilidad para la población excombatiente. Las corporalidades configuradas para la guerra desde una colectividad imperante y hegemónica se enfrentan en los distintos espacios del proceso de paz a nuevas cotidianidades, nuevos quehaceres, nuevos retos y nuevas posibilidades. Desde el abordaje del cuerpo se analizará la relevancia y transformación de la colectividad Farc en el ingreso a la organización, durante el conflicto y en el período actual después de lo acordado en Cuba. Se pondrán en discusión esas nuevas cotidianidades a las que se enfrentan los excombatientes, y cómo desde el aspecto corporal se plantean espacios de memoria y expresión en la reincorporación.The peace agreement between the Colombian State and the extinct Farc guerrilla represents a great challenge for the country. The long-term implementation of the reincorporation process for ex-combatants, the State itself and for the population in general is recognized as a historic opportunity to end the armed conflict with this organization. Situated from the DDR institutional methodological route, this research is an invitation to approach concepts such as the body, the community and everyday life in the context of war, and today in the reincorporation to civility for the ex-combatant population. The corporality configured for war from a prevailing and hegemonic collectivity in the different spaces of the peace process face new dailyities, new tasks, new challenges and new possibilities. From the approach of the body, the relevance and transformation of the FARC community will be analyzed in the entrance to the organization, during the contlict and in the current period after the agreement in Cuba. These new dailyities that ex-combatants face will be put into discussion, and how, from the bodily aspect, spaces of memory and expression are raised in reincorporationAntropologo(a)Pregrad

Requalification of the river park: eco-houses in Elche

The city of Elche, the second most important town of Alicante’s province, thanks to its 230,000 inhabitants, has a lot of heritage values such as the Misteri and the Palmeral. In its urban structure, the relation between the original urban plot and the modern one is made from the location of the river Vinalopò. Its canal is dry most of the year and its slopes are residual spaces that are not integrated with the modern and the ancient existing urban plot. The city of Elche relationship with the Palmeral does not give added value to the numerous urban parks that are in many parts of the city. This research could organize a new building typology of flats. It has tried to build a relationship with the environment that would bring benefits for the relationship between the urban plot and the river. In this way it would encourage a revitalization of the existing river park in support of architectural proposals such as an equipped park. In addition, these houses have bioclimatic technology of cooling evaporating using the natural airstream produced in the park which is induced through the building’s structural system. Introduced by the chimney effect, the air is cooled by vegetal masses. The orientation to the West of glazing, that looks at the river park, causes a lot of energy problems. This research analyses a wrapped and protective solar system based on a vertical rotating panel formed by low thickness and large format ceramic tiles in various sceneries. With modelling and the simulation through the software Design Builder, energetic demands for different sceneries are obtained which allow us to draw conclusions about the most efficient system in terms of energy consumption

Immediate vs. deferred switching from a boosted protease inhibitor (PI/r) based regimen to a Dolutegravir (DTG) based regimen in virologically suppressed patients with high cardiovascular risk or Age ≥50 years: final 96 weeks results of NEAT 022 study

Background Both immediate and deferred switching from a ritonavir-boosted protease inhibitor (PI/r)–based regimen to a dolutegravir (DTG)–based regimen may improve lipid profile. Methods European Network for AIDS Treatment 022 Study (NEAT022) is a European, open-label, randomized trial. Human immunodeficiency virus (HIV)–infected adults aged ≥50 years or with a Framingham score ≥10% were eligible if HIV RNA was <50 copies/mL. Patients were randomized to switch from PI/r to DTG immediately (DTG-I) or to deferred switch at week 48 (DTG-D). Week 96 endpoints were proportion of patients with HIV RNA <50 copies/mL, percentage change of lipid fractions, and adverse events (AEs). Results Four hundred fifteen patients were randomized: 205 to DTG-I and 210 DTG-D. The primary objective of noninferiority at week 48 was met. At week 96, treatment success rate was 92.2% in the DTG-I arm and 87% in the DTG-D arm (difference, 5.2% [95% confidence interval, –.6% to 11%]). There were 5 virological failures in the DTG-I arm and 5 (1 while on PI/r and 4 after switching to DTG) in the DTG-D arm without selection of resistance mutations. There was no significant difference in terms of grade 3 or 4 AEs or treatment-modifying AEs. Total cholesterol and other lipid fractions (except high-density lipoprotein) significantly (P < .001) improved both after immediate and deferred switching to DTG overall and regardless of baseline PI/r strata. Conclusions Both immediate and deferred switching from a PI/r to a DTG regimen in virologically suppressed HIV-infected patients ≥50 years old or with a Framingham score ≥10% was highly efficacious and well tolerated, and improved the lipid profile

Towards a common vision of climate security in Guatamela

CGIAR’s Climate Resilience Initiative, also known as ClimBeR, is working to address these needs. On the 21st and 22nd of February, we ran in Guatemala City the first climate security workshop in Central America: Towards a common vision on the relationship between climate, conflict, and human security in Guatemala. The workshop was organized by the Alliance of Bioversity and CIAT along with the CGIAR’s Climate Resilience Initiative; the Fragility, Conflict, and Migration Initiative; the regional integrated initiative AgriLAC Resiliente; and the CGIAR FOCUS Climate Security and benefited from the participation of 45 individuals from 20 different organizations, including regional & local organizations, government institutions, UN agencies, and national universitie

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Hacia una visión compartida sobre la seguridad climática en Guatemala

Este infore explora las interconexiones entre el cambio climático, la seguridad humana y los conflictos en Guatemala basándose en el Taller sobre Seguridad Climática celebrado en Ciudad de Guatemala los días 21 y 22 de febrero de 2023. Las implicaciones del cambio climático para la seguridad, comúnmente conocidas como el nexo clima-seguridad, han sido ampliamente discutidas tanto en círculos políticos como académicos. La seguridad climática se refiere las amenazas y riesgos de seguridad a estados, sociedades e individuos causados directa o indirectamente por los efectos del cambio climático. Los riesgos de seguridad en este documento son entendidos de una manera amplia enfocándose no solo en los riesgos de seguridad nacional vistos desde el punto de vista de los estados sino, principalmente, en los riesgos de seguridad humana enfocados en los retos para la supervivencia y los medios de vida de la población que incluye la seguridad económica, alimentaria, sanitaria, medioambiental, personal, comunitaria y política (UNTFHS, 2016)

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Actas de las V Jornadas ScienCity 2022. Fomento de la Cultura Científica, Tecnológica y de Innovación en Ciudades Inteligentes

ScienCity es una actividad que viene siendo continuada desde 2018 con el objetivo de dar a conocer los conocimientos y tecnologías emergentes siendo investigados en las universidades, informar de experiencias, servicios e iniciativas puestas ya en marcha por instituciones y empresas, llegar hasta decisores políticos que podrían crear sinergias, incentivar la creación de ideas y posibilidades de desarrollo conjuntas, implicar y provocar la participación ciudadana, así como gestar una red internacional multidisciplinar de investigadores que garantice la continuación de futuras ediciones. En 2022 se recibieron un total de 48 trabajos repartidos en 25 ponencias y 24 pósteres pertenecientes a 98 autores de 14 instituciones distintas de España, Portugal, Polonia y Países Bajos.Fundación Española para la Ciencia y la Tecnología-Ministerio de Ciencia, Innovación y Universidades; Consejería de la Presidencia, Administración Pública e Interior de la Junta de Andalucía; Estrategia de Política de Investigación y Transferencia de la Universidad de Huelva; Cátedra de Innovación Social de Aguas de Huelva; Cátedra de la Provincia; Grupo de investigación TEP-192 de Control y Robótica; Centro de Investigación en Tecnología, Energía y Sostenibilidad (CITES

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines

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