Plan de mejoramiento del área administrativa de la empresa Todoterreno S.A.S.

T 658.401 2 G165; 141 p.El objetivo general es formular un Plan de Mejoramiento del Área Administrativa de la Empresa TODOTERRENO S.A.S., a través del análisis de las principales causas que generan ineficiencias en esta área, además de identificar oportunidades de mejora que permitan incrementar la productividad y la eficiencia de la misma. Como objetivos específicos, se pretende realizar un diagnóstico de las condiciones actuales de la empresa y posteriormente identificar los procesos que se deben analizar para proponer el mejoramiento.Universidad Libre de Pereir

DICER1-associated central nervous system sarcoma: A comprehensive clinical and genomic characterization of case series of young adult patients

Las alteraciones de DICER1 están asociadas con tumores intracraneales en la población pediátrica, incluidos el pineoblastoma, el blastoma hipofisario y el recientemente descrito " sarcoma primario del SNC asociado a DICER1 " (DCS). DCS es un tumor extremadamente agresivo con una firma de metilación distinta y una alta frecuencia de mutaciones concurrentes. Sin embargo, se sabe poco sobre su enfoque de tratamiento y los cambios genómicos que ocurren después de la exposición a la quimiorradioterapia.DICER1 alterations are associated with intracranial tumors in the pediatric population, including pineoblastoma, pituitary blastoma and the recently described "DICER1-associated primary CNS sarcoma" (DCS). DCS is an extremely aggressive tumor with a distinct methylation signature and a high frequency of concurrent mutations. However, little is known about its treatment approach and the genomic changes that occur after exposure to chemoradiotherapy

Uso del tape dinámico en el posicionamiento y fuerza muscular del hombro

Objective: To determine the acute effects of dynamic tape on scapular positioning and isometric muscle strength of the shoulder in swimmers with rounded shoulders. Methods: Randomized controlled trial on 40 active swimmers, 20 assigned to an experimental group with application of dynamic tape with tension and 20 to the control group with application without tension. Scapular positioning and isometric muscle strength measurements of the shoulder were made before (ST), immediately after (TA) and on the third day (T3D) after tape application. Results: There were no statistically significant differences in most of variables of study, only for lateral scapular slide test 30º and isometric muscle strength of rhomboids on dominant upper limb (p <0.05), no statistically significant difference between the experimental and control group were detected (p <0.05). Conclusion: The application of dynamic tape does not produce statistically significant changes in scapular positioning and isometric muscle strength of the shoulder in swimmers.Objetivo: Determinar los efectos agudos del tape dinámico en la estática escapular y fuerza muscular isométrica del hombro en nadadores con hombros redondeados. Materiales y métodos: Ensayo aleatorio controlado en 40 nadadores activos, 20 asignados a un grupo experimental con aplicación de tape dinámico con tensión y 20 a grupo control con aplicación de tape sin tensión. Se realizaron mediciones de estática escapular y fuerza muscular isométrica del hombro antes (ST), inmediatamente después (TA) y al tercer día (T3D) después de la aplicación. Resultados: No se presentaron diferencias estadísticamente significativas en la mayoría de las variables de estudio, con excepción del deslizamiento lateral escapular 30º y fuerza muscular isométrica de romboides del miembro superior dominante (p < 0,05). No se presentaron diferencias estadísticamente significativas entre el grupo  experimental y control (p < 0,05). Conclusión: La aplicación de tape dinámico no produce cambios estadísticamente significativos en el posicionamiento escapular y en la fuerza muscular isométrica del hombro en nadadores

Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework

Background: Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted a needs assessment to define short- and long-term needs and opportunities for hypertension services within the public health system. Methods: We conducted a multi-method, multi-level assessment of needs related to hypertension within Guatemala’s public system using the World Health Organization’s health system building blocks framework. We conducted semi-structured interviews with stakeholders at national (n = 17), departmental (n = 7), district (n = 25), and community (n = 30) levels and focus groups with patients (3) and frontline auxiliary nurses (3). We visited and captured data about infrastructure, accessibility, human resources, reporting, medications and supplies at 124 health posts and 53 health centers in five departments of Guatemala. We conducted a thematic analysis of transcribed interviews and focus group discussions supported by matrix analysis. We summarized quantitative data observed during visits to health posts and centers. Results: Major challenges for hypertension service delivery included: gaps in infrastructure, insufficient staffing and high turnover, limited training, inconsistent supply of medications, lack of reporting, low prioritization of hypertension, and a low level of funding in the public health system overall. Key opportunities included: prior experience caring for patients with chronic conditions, eagerness from providers to learn, and interest from patients to be involved in managing their health. The 5 departments differ in population served per health facility, accessibility, and staffing. All but 7 health posts had basic infrastructure in place. Enalapril was available in 74% of health posts whereas hydrochlorothiazide was available in only 1 of the 124 health posts. With the exception of one department, over 90% of health posts had a blood pressure monitor. Conclusions: This multi-level multi-method needs assessment using the building blocks framework highlights contextual factors in Guatemala’s public health system that have been important in informing the implementation of a hypertension control trial. Long-term needs that are not addressed within the scope of this study will be important to address to enable sustained implementation and scale-up of the hypertension control approach.Fil: Fort, Meredith P.. University of Colorado; Estados UnidosFil: Mundo, William. University of Colorado; Estados UnidosFil: Paniagua Avila, Alejandra. No especifíca;Fil: Cardona, Sayra. No especifíca;Fil: Figueroa, Juan Carlos. No especifíca;Fil: Hernández Galdamez, Diego. No especifíca;Fil: Mansilla, Kristyne. No especifíca;Fil: Peralta García, Ana. No especifíca;Fil: Roche, Dina. No especifíca;Fil: Palacios, Eduardo Alberto. No especifíca;Fil: Glasgow, Russell E.. University of Colorado; Estados UnidosFil: Gulayin, Pablo Elías. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: He, Jiang. University of Tulane; Estados UnidosFil: Ramirez Zea, Manuel. No especifíca

Quid: observatorio de medios

El informe está dividido en cuatro apartados: “Derecho a la información y transparencia”, “La televisión mexicana”, “Empresas y prácticas periodísticas” y “Los que se fueron”. En el primero de ellos se presenta un texto que ayuda a entender cuál es el momento en el que se encuentran las propuestas legislativas para regular a los medios y las telecomunicaciones en México, y una evaluación de los primeros cinco años del Instituto de Transparencia e Información Pública de Jalisco. El segundo apartado del informe es ecléctico, pues se compone de artículos que trabajan distintas temáticas de la televisión:la estructura y oferta de la televisión en nuestro país (en particular en la ciudad de Guadalajara), la televisión por cable (enfatizando el caso de Megacable), un recuento de cómo se gestó el Canal 44 y de sus prospectivas en 2011, y los mundiales de futbol. La tercera parte del informe documenta algunas de las situaciones más importantes que se viven en el periodismo local: estos trabajos presentan sistemas en crisis (alta vulnerabilidad de los periodistas mexicanos ante un clima de violencia que lejos de disminuir va en aumento, y la participación, por acción u omisión, del Estado mexicano en la sistemática violación de los derechos de quienes dedican su vida al trabajo periodístico. Los siguientes artículos tratan sobre las transformaciones de las empresas periodísticas, particularmente las del sector de la prensa escrita: la rápida e inexorable desaparición de los suplementos culturales, y una radiografía sobre las formas de producción de algunas secciones internacionales de los periódicos tapatíos. Al final se presentan las semblanzas de José Galindo, Raúl Mora Lomelí, S.J., Tomás Eloy Martínez y Juan Pablo Rosell.ITESO, A.C

Research advances in Risaralda. An overview of 8 experiences

I am honored to present to you this remarkable book, a testament to the invaluable research conducted in the fields of Health, Law, Engineering, and Administrative Sciences. Each chapter within these pages represents the culmination of extensive investigations carried out by dedicated scholars affiliated with the Red Universitaria de Risaralda (RUN), a network comprising 15 esteemed higher education institutions. Risaralda has emerged as a thriving hub for higher education, bolstered by its strategic geographical location, high quality of life, rich biodiversity, and competitive development. Today, Pereira ranks third in the index of university cities, with a student enrollment rate exceeding 63%. Close to 50,000 students pursue academic programs within the department. Notably, three institutions have achieved accreditation for their excellence in education, positioning Risaralda among the most competitive regions in terms of accredited academic programs. As we celebrate the 20th anniversary of the Red Universitaria de Risaralda in 2023, it is with great pride that we reflect on its pivotal role in fostering collaboration among public and private higher education institutions. Our mission has been twofold: attracting students to our region and supporting sustainable development and quality of life for our community. The mesa de investigación (research committee) has diligently coordinated the necessary actions to unite our researchers, facilitating an integrated approach to various disciplines and themes associated with the challenges faced in our region.CONTENT Introduction...................................................................................................................5 CHAPTER ONE. Tobacco Use and Social Skills in Children from Two Schools in Pereira, Colombia .......................................................................................................9 Angélica María Blanco Vanegas, Natalia Jeaneth Carmona Valencia and Ángela Liceth Pérez Rendón CHAPTER TWO. Lesbian visibility: between control and family silence.................................................35 Mireya Ospina Botero and Carolina Carmona Castilla CHAPTER THREE. New centralities in the city of Pereira, 1990-2019 .......................................................65 Cesar Augusto Castaño Galvis CHAPTER FOUR. Bibliometric analysis of scientific publications on the effect of roots on slope stability ...........................................................................................................95 Alejandro Alzate Buitrago, Raúl Alberto Gaviria Valencia, César Augusto Peñuela Meneses, Carlos Alberto Ospina Parra CHAPTER FIVE. Sustainability of local agri-food systems in a municipality of the Eje Cafetero, Colombia...............................................................................................131 Jaime Cardona Ocampo, Orlando Ospina Salazar and Julia Arredondo Botero CHAPTER SIX. Organizational strategies aimed at the Emberá Chamí unified indigenous reservation, Inamurcito community located in the municipality of Pueblo Rico, Risaralda............................................................................................................163 Carla Johana Martínez García and Yenny Marcela Vélez Herrera CHAPTER SEVEN. Psychomotor profile of children between 4 and 5 years old in the city of Pereira, Colombia ...................................................................................................199 Jhonatan Gonzalez-Santamaría and Claudia Jimena Lopez-Garcia CHAPTER EIGHT. Analysis of assembly tasks without the use of vision: an opportunity for the design of support technologies in manufacturing environments.....................217 Gustavo Adolfo Peña Marín, Carlos Andrés Quintero Diaztagle and Juan Diego Gallego Góme

The Caldera. No. 23

La pandemia, sin lugar a dudas, nos ha cambiado la vida a todos; un viernes nos fuimos para nuestros hogares, en el marco de una educación presencial; al lunes siguiente, después de dos días, estábamos iniciando el camino hacia una educación remota, una educación virtual, que se ha convertido en una gran alternativa para seguir contribuyendo con la formación de nuestros niños y jóvenes caldistas y al mejoramiento de nuestra calidad de vida que halla, en la educación, nuevamente la respuesta; han sido meses de cambios drásticos, inimaginables pero, cambios positivos que nos han permitido crecer como individuos, como familia, como escuela y como sociedad.Especial pandemia. Una generación Resiliente por promoción DINASTIA…06 VII Concurso Intercolegiado departamental de Oratoria. Ulibro 2020…51 Deporte en el Caldas…64 Expresiones Caldistas…71 Celebremos la palabra…93 Nuestros Maestros…102 Galería de Imágenes…107The pandemic, without a doubt, has changed the lives of all of us; One Friday we went to our homes, as part of a face-to-face education; The following Monday, after two days, we were starting the path towards a remote education, a virtual education, which has become a great alternative to continue contributing to the training of our children and young Caldistas and to the improvement of our quality of life. that finds, in education, the answer again; They have been months of drastic changes, unimaginable but positive changes that have allowed us to grow as individuals, as a family, as a school and as a society

Post-Franco Theatre

In the multiple realms and layers that comprise the contemporary Spanish theatrical landscape, “crisis” would seem to be the word that most often lingers in the air, as though it were a common mantra, ready to roll off the tongue of so many theatre professionals with such enormous ease, and even enthusiasm, that one is prompted to wonder whether it might indeed be a miracle that the contemporary technological revolution – coupled with perpetual quandaries concerning public and private funding for the arts – had not by now brought an end to the evolution of the oldest of live arts, or, at the very least, an end to drama as we know it

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline