Calidad de la gestión del sistema de información de una IPS de tercer nivel. Bogotá D.C., Colombia

Artículo reporte de casoEl objetivo del presente estudio fue evaluar la Calidad de la Gestión del Sistema de Información de una IPS de tercer nivel, a partir de los avances en el grupo de Estándares de Gerencia de la Información del Sistema Único de Acreditación, de cara a los atributos de calidad definidos por la Institución. Se definió una muestra representativa de 198 usuarios del sistema elegidos al azar en los diferentes turnos de trabajo, a los cuales se les aplicó el primer instrumento de la Metodología de Gestión de la Mejora Continua elaborado para el estudio (encuesta) y simultáneamente se aplicó el segundo instrumento (lista de chequeo) al Sistema de Información Institucional. Los resultados evidenciaron un cumplimiento de 78% en la aplicabilidad de los atributos de calidad de la Información al Plan de Mejoramiento vigente, así como niveles de percepción de la calidad y la efectividad del Sistema de Información por encima del 82%, siendo la Calidad Perceptiva, con tan solo 59%, el factor determinante en los resultados menos favorables para la Calidad; en tanto que elementos como la simplificación del ejercicio profesional con 16,7%, y confiabilidad de la Información con 8,1% afectaron la Efectividad. El estudio concluyó que la evaluación de la Gestión del Sistema de Información a partir de los atributos de calidad definidos por la Institución y haciendo el abordaje desde la percepción del usuario del Sistema de Información, facilita la evaluación del alcance de la Gestión y la sostenibilidad de los logros evidenciados a través de las acciones de mejora, dado que permite precisar el atributo afectado, optimizar la toma de decisiones y orientar efectivamente las mejoras hacia a la brecha de calidad observada

Interdiszciplináris közösségfejlesztés és együttműködés izraeli és amerikai tapasztalatok és szaktudás alapján

A tanulmány az interdiszciplináris közösségfejlesztés és együttműködés fogalmi kereteit és gyakorlatát vizsgálja, amerikai és izraeli tapasztalatok alapján. Két interdiszciplináris szakmai csoport munkájára épül, melyek szociális munkások kezdeményezésére jöttek létre az USA-ban és Izraelben. A tanulmány bemutatja a téma főbb kérdéseit és fogalmait, így a mono-, multi-, inter-, transz-diszciplinaritás valamint a nézőpontok közötti megközelítés különbségeit. Emellett tárgyalja a különböző szakmai identitások kérdését, a közösségfejlesztés gyakorlatában részt vevő szakmák számára létrehozható közös tudásalap és készségek azonosítását, valamint a szervezetközi szempontok értelmezését. Bemutatja az interdiszciplináris közösségfejlesztésben és együttműködésben részt vevő szakemberek párbeszédeiből nyert adatok kvalitatív módszerekkel elvégzett tartalmi elemzését, illetve az izraeli és amerikai csoport eredményeinek összevetését. Az eredmények azt mutatják, hogy az eltérő célok, gyakoriság és intenzitás ellenére a két fórum között több a hasonlóság, mint a különbség. Az eredmények tükrözik a résztvevők megbeszélések fontosságába vetett hitét és a szakmaközi gyakorlat iránt érzett elkötelezettségét. Mindkét csoport meggyőződése volt, hogy a szervezetközi és szakmaközi kapcsolatok, valamint a szakmai-közösségi interakciók új modelljei mellett sokféle szaktudásra van szükség. A korábbi kutatásoktól eltérően a tanulmány a közösséget a közösségfejlesztési együttműködésekben külön diszciplínaként kezeli. Hasonlóan fontos a fejlesztés jövőbeli céljainak meghatározása, mely magába foglalja az alap és társszakmák, valamint a szociális munka képzésének és oktatásának, illetve más társadalomtudományi szakmák irányainak azonosítását. Az ajánlások az interdiszciplináris közösségfejlesztés és együttműködés további vizsgálatának szükségességére mutatnak rá

Aplicabilidad del proceso de consentimiento informado en fisioterapia

Introduction: Informed consent is an important procedure by which all the pertinent information about the procedures in health intervention area disclosed to the patient, and the individual expresses whether or not to participate. In physiotherapy it is not always applied properly due to factors as: lack of knowledge, lack of training about its realization or because of institutional policies of the different health organizations. Objective: To identify the relevant aspects of the implementation and conceptualization of the informed consent in Physiotherapy. Materials and methods: A review was conducted in databases such as Scielo, Lilacs, Cochrane and Redalyc, and in scientific journals. The information search was limited to the 2000-2013 period. The researchers established as key words: informed consent, physiotherapy and applicability of the process of informed consent. The researchers established an analysis matrix to record the data of the literature. Results: Fifty documents between articles and texts about the informed consent, from which fourteen corresponded to specific literature in physiotherapy were reviewed this information demonstrated the limitation on the approach from this discipline. However common elements were established from different health disciplines, in terms of definition and conditions of application of informed consent in the clinical practice and research. Conclusions: It exists a difficulty in the perception of the importance of the informed consent in Physiotherapy, which is reduced to the signing of a document; although its relevance is unknown as for the legal and ethical scope.Introducción. El consentimiento informado es un procedimiento importante en el cual se suministra al paciente la información adecuada de los procesos de intervención en salud y el individuo manifiesta estar o no de acuerdo con su realización. En fisioterapia, su aplicabilidad no se ejerce con diligencia, por factores como la falta de conocimiento, la deficiente capacitación al respecto o las políticas institucionales de las diferentes entidades de salud.  Objetivo. Identificar los aspectos relevantes de la aplicación y conceptualización del consentimiento informado en fisioterapia. Materiales y métodos. Se hizo una revisión en bases de datos tales como: Scielo, Lilacs, Cochrane y Redalyc, y en revistas especializadas; la búsqueda de información se limitó al período 2000-2013. Como palabras de referencia se utilizaron: consentimiento informado, fisioterapia y aplicabilidad del proceso de consentimiento informado. Se estableció una matriz de análisis para registrar los datos de la literatura científica consultada.  Resultados. Se revisaron 50 documentos entre artículos y textos en torno al consentimiento informado, de los cuales 14 corresponden a bibliografía específica sobre fisioterapia, demostrándose la limitación en el abordaje desde esta disciplina. Sin embargo, se establecen elementos comunes desde las diferentes disciplinas de salud, en cuanto a la definición y las condiciones de aplicación del consentimiento infomado en la práctica clínica y en la investigación.  Conclusiones. Existe dificultad en la percepción de la importancia del consentimiento informado en fisioterapia, el cual se reduce a la firma de un documento; se desconoce su relevancia en el ámbito legal y ético. Palabras clave: consentimiento informado, fisioterapia, bioética

Enfermedad Diarreica Aguda (EDA) En el departamento de San Andrés, Providencia y Santa Catalina entre el periodo 2005 a 2019

Este trabajo tiene como fin abordar la problemática de morbimortalidad por Enfermedad Diarreica Aguda en menores de 5 años que se presenta en el Departamento de San Andrés, Providencia y Santa Catalina por medio del diseño de una propuesta de intervención con estrategias de promoción y mantenimiento de la salud que se articulan con el Plan Decenal de Salud Publica vigente y los objetivos de desarrollo sostenibles.The purpose of this work is to address the problem of morbidity and mortality due to Acute Diarrheal Disease in children under 5 years of age that occurs in the Department of San Andrés, Providencia and Santa Catalina through the design of an intervention proposal with strategies for the promotion and maintenance of that are articulated with the current Ten-Year Public Health Plan and the sustainable development objectives

Metabolic profiling and antibacterial activity of Eryngium pristis Cham. & Schltdl. - prospecting for its use in the treatment of bacterial infections

Morbidity and mortality of the infected patients by multidrug-resistant bacteria have increased, emphasizing the urgency of fi ght for the discovery of new innovative antibiotics. In this sense, natural products emerge as valuable sources of bioactive compounds. Among the biodiversity, Eryngium pristis Cham. & Schltdl. (Apiaceae Lindl.) is traditionally used to treat thrush and ulcers of throat and mouth, as diuretic and emmenagogue, but scarcely known as an antimicrobial agent. With this context in mind, the goals of this study were to investigate the metabolic profi le and the antibacterial activity of ethanolic extract (EE-Ep) and hexane (HF-Ep), dichloromethane (DF-Ep), ethyl acetate (EAF-Ep) and butanol (BF-Ep) fractions from E. pristis leaves. Gas Chromatography-Mass Spectrometry (GC-MS) was performed to stablish the metabolic profi le and revealed the presence of 12 and 14 compounds in EAF-Ep and HF-Ep, respectively. β-selinene, spathulenol, globulol, 2-methoxy-4-vinylphenol, α-amyrin, β-amyrin, and lupeol derivative were some of phytochemicals identifi ed. The antibacterial activity was determined by Minimal Inhibitory Concentration (MIC) using the broth micro-dilution against eight ATCC® and fi ve methicillin-resistant Staphylococcus aureus (MRSA) clinical strains. HF-Ep was the most eff ective (MIC ≤ 5,000 μg/μL), being active against the largest part of tested Gram-positive and Gram-negative bacterial strains, including MRSA, with exception of Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 9027) and (ATCC 27853). These results suggest that E. pristis is a natural source of bioactive compounds for the search of new antibiotics which can be an interesting therapeutic approach to recover patients mainly infected by MRSA strains.info:eu-repo/semantics/publishedVersio

Very early surfactant without mandatory ventilation in premature infants treated with early continuous positive airway pressure : a randomized, controlled trial

Artículo especial137-142Background. Chronic lung disease is one of the most frequent and serious complications of premature birth. Because mechanical ventilation Is a major risk factor for chronic lung disease, the early application of nasal continuous positive airway pressure has been used as a strategy for avoiding mechanical ventilation in premature infants. Surfactant therapy improves the short-term respiratory status of premature infants, but its use is traditionally limited to infants being mechanically ventilated. Administration of very early surfactant during a brief period of intubation to infants treated with nasal continuous positive airway pressure may improve their outcome and further decrease the need for mechanical ventilation. objective. Our goal was to determine if very early surfactant therapy without mandatory ventilation improves outcome and decreases the need for mechanical ventilation when used in very premature infants treated with nasal continuous positive airway pressure soon after birth. design/methods. Eight centers in Colombia participated in this randomized, controlled trial. Infants born between 27 and 31** weeks' gestation with evidence of respiratory distress and treated with supplemental oxygen in the delivery room were randomly assigned within the first hour of life to intubation, very early surfactant, extubation, and nasal continuous positive airway pressure (treatment group) or nasal continuous airway pressure alone (control group). The primary outcome was the need for subsequent mechanical ventilation using predefined criteria. RESULTS. From January 1, 2004, to December 31, 2006, 279 infants were randomly assigned, 141 to the treatment group and 138 to the control group. The need for mechanical ventilation was lower in the treatment group (26%) compared with the control group (39%). Air-leak syndrome occurred less frequently in the treatment group (2%) compared with the control group (9%). The percentage of patients receiving surfactant after the first iiour of life was also significantly less in the treatment group (12%) compared with the control group (26%). The incidence of chronic lung disease (oxygen treatment at 36 weeks' postmenstrual age) was 49% in the treatment group compared with 59% in the control group. All other outcomes, including mortality, intraventricular hemorrhage, and periventricular leukomalacia were similar between tiie groups

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Genome-wide association analysis implicates dysregulation of immunity genes in chronic lymphocytic leukaemia

Several chronic lymphocytic leukaemia (CLL) susceptibility loci have been reported; however, much of the heritable risk remains unidentified. Here we perform a meta-analysis of six genome-wide association studies, imputed using a merged reference panel of 1,000 Genomes and UK10K data, totalling 6,200 cases and 17,598 controls after replication. We identify nine risk loci at 1p36.11 (rs34676223, P=5.04 × 10−13), 1q42.13 (rs41271473, P=1.06 × 10−10), 4q24 (rs71597109, P=1.37 × 10−10), 4q35.1 (rs57214277, P=3.69 × 10−8), 6p21.31 (rs3800461, P=1.97 × 10−8), 11q23.2 (rs61904987, P=2.64 × 10−11), 18q21.1 (rs1036935, P=3.27 × 10−8), 19p13.3 (rs7254272, P=4.67 × 10−8) and 22q13.33 (rs140522, P=2.70 × 10−9). These new and established risk loci map to areas of active chromatin and show an over-representation of transcription factor binding for the key determinants of B-cell development and immune response

Genome-wide association analysis implicates dysregulation of immunity genes in chronic lymphocytic leukaemia

Several chronic lymphocytic leukaemia (CLL) susceptibility loci have been reported; however, much of the heritable risk remains unidentified. Here we perform a meta-analysis of six genome-wide association studies, imputed using a merged reference panel of 1,000 Genomes and UK10K data, totalling 6,200 cases and 17,598 controls after replication. We identify nine risk loci at 1p36.11 (rs34676223, P=5.04 × 10−13), 1q42.13 (rs41271473, P=1.06 × 10−10), 4q24 (rs71597109, P=1.37 × 10−10), 4q35.1 (rs57214277, P=3.69 × 10−8), 6p21.31 (rs3800461, P=1.97 × 10−8), 11q23.2 (rs61904987, P=2.64 × 10−11), 18q21.1 (rs1036935, P=3.27 × 10−8), 19p13.3 (rs7254272, P=4.67 × 10−8) and 22q13.33 (rs140522, P=2.70 × 10−9). These new and established risk loci map to areas of active chromatin and show an over-representation of transcription factor binding for the key determinants of B-cell development and immune response

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages