La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Nariño y valle

Durante el diplomado de profundización y acompañamiento psicosocial en escenarios de violencia, se desarrollaron una serie de actividades y análisis de diferentes casos en donde hemos podido fortalecer nuestro aprendizaje en cuanto a la importancia del acompañamiento psicosocial en escenarios de violencia. Después de un análisis de diferentes relatos, decidimos trabajar el relato 4 de “Ana Ligia Higinio López”, del corregimiento de Aquitania, cerca del municipio de San Francisco, quien fue víctima del desplazamiento forzoso entre el 2003 y 2004 a causa de la guerra que se vivía en su pueblo A través de este ejercicio logramos profundizar en las afectaciones simbólicas y subjetivas y a su vez en técnicas que permiten tener un mejor abordaje psicosocial a la hora de trabajar con víctimas del conflicto armado. La segunda actividad se refiere al análisis del caso de Peñas Colorado en el cual podemos como futuros psicólogos, presentar una propuesta de trabajo comunitario por medio de una serie de acciones y estrategias de apoyo que permitan a las víctimas trabajar en su proceso de reconstrucción tanto individual como socialmente. Finalmente se presenta el trabajo analítico realizado en diferentes contextos en los departamentos de Nariño y Valle del Cauca, a través de la imagen y la narrativa como herramienta de abordaje psicosocial, por medio del Foto Voz, donde se tuvo la oportunidad de conocer los emergentes psicosociales, problemáticas y trabajar sobre oportunidades de mejora.During the course of the diploma course on deepening and psychosocial accompaniment in situations of violence, A series of activities and analysis of different cases were developed where we have been able to strengthen our learning regarding the importance of psychosocial accompaniment in violence scenarios. After an analysis of different stories, we decided to work the story 4 of "Ana Ligia Higinio López", from the district of Aquitaine, near the municipality of San Francisco, who was forcibly displaced between 2003 and 2004 because of the war in his village, Through this exercise, we were able to deepen our understanding of the symbolic and subjective effects and, at the same time, techniques that allow us to have a better psychosocial approach when working with victims of the armed conflict. The second activity concerns the analysis of the case of Peñas Colorado in which we can as future psychologists, submit a proposal for Community work by means of a series of actions and support strategies enabling victims to work on their reconstruction process both individually and socially. Finally, the analytical work carried out in different contexts in the departments of Nariño and Valle del Cauca is presented, through the image and narrative as a tool of psychosocial approach, through the Photo Voice, where you had the opportunity to get to know the emerging psychosocial problems and work on opportunities for improvement

Estudios actuales de literatura comparada. Teorías de la literatura y diálogos interdisciplinarios

Estos dos volúmenes constituyen una contribución al desarrollo de la comparatística que se realiza, principalmente, desde América Latina. El primer volumen está organizado en tres partes y consta de 22 artículos, mientras que el segundo reúne 24 capítulos.UCR::Vicerrectoría de Docencia::Artes y Letras::Facultad de Letras::Escuela de Filología, Lingüística y LiteraturaUCR::Vicerrectoría de Docencia::Ciencias Básicas::Sistema de Educación General::Escuela de Estudios GeneralesUCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Artes y Letras::Maestría Académica en Literatura FrancesaUCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Artes y Letras::Maestría Académica en Literatura LatinoamericanaUCR::Vicerrectoría de Docencia::Artes y Letras::Facultad de Letras::Escuela de Lenguas Moderna

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Morichales, cananguchales y otros palmares inundables de Suramérica. Parte II: Colombia, Venezuela, Brasil, Perú, Bolivia, Paraguay, Uruguay y Argentina

El libro está dividido en cuatro partes. En la primera sección se incluye un análisis muy completo sobre el estado del conocimiento, uso y conservación de Mauritia flexuosa en Suramérica. En la segunda parte se consideran varios casos de estudio (11) sobre comunidades de plantas asociadas, demografía, polinizadores, aves y mamíferos relacionados, así como temas de manejo y ecoturismo en palmares de Mauritia flexuosa. La tercera sección incluye aportes de varios países sobre otros palmares, principalmente de Astrocaryum jauari, Butia odorata, B. paraguayensis, Copernicia alba, C. tectorum, Euterpe oleracea, Manicaria saccifera, Mauritiella aculeata y Roystonea oleracea. También se aporta información de 25 especies adicionales de palmas, incluyendo los usos, dinámica de poblaciones, biología reproductiva, florística de humedales asociados y conservación, entre otros aspectos. Por último, en la cuarta parte se dan las conclusiones y recomendaciones para la conservación de los palmares inundables en Suramérica.Bogotá, D. C

ENGIU: Encuentro Nacional de Grupos de Investigación de UNIMINUTO.

El desarrollo del prototipo para el sistema de detección de Mina Antipersona (MAP), inicia desde el semillero ADSSOF perteneciente al programa de Administración en Seguridad y Salud en el trabajo de la UNIMINUTO, se realiza a partir de un detector de metales que emite una señal audible, que el usuario puede interpretar como aviso de presencia de un objeto metálico, en este caso una MAP. La señal audible se interpreta como un dato, como ese dato no es perceptible a 5 metros de distancia, se implementa el transmisor de Frecuencia Modulada FM por la facilidad de modulación y la escogencia de frecuencia de transmisión de acuerdo con las normas y resolución del Ministerio de Comunicaciones; de manera que esta sea la plataforma base para enviar los datos obtenidos a una frecuencia establecida. La idea es que el ser humano no explore zonas peligrosas y buscar la forma de crear un sistema que permita eliminar ese riesgo, por otro lado, buscar la facilidad de uso de elementos ya disponibles en el mercado

Revista Temas Agrarios Volumen 26; Suplemento 1 de 2021

1st International and 2nd National Symposium of Agronomic Sciences: The rebirth of the scientific discussion space for the Colombian Agro.1 Simposio Intenacional y 2 Nacional de Ciencias Agronómicas: El renacer del espacio de discusión científica para el Agro colombiano

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society