APROXIMACIÓN A LA INFORMALIDAD EN EL MERCADO LABORAL: UNA MODELACIÓN BASADA EN AGENTES

Este documento es un estudio del mercado laboral con particular énfasis en las actividades productivas de carácter informal que se evidencian al interior de ese mercado. Por medio de un Modelo Basado en Agentes (MBA) se establecen características propias de los agentes quienes, a lo largo de una serie de procesos, asumen uno de los cinco posibles roles que un agente puede tomar en el mercado de trabajo: desempleado, trabajador formal, trabajador informal, empresario formal o empresario informal. Las funciones de probabilidad de los agentes de pertenecer a uno de estos grupos están condicionadas igualmente por variables del mercado y del sistema político; algunas de estas variables cambian en el transcurso de la simulación del modelo por las acciones colectivas de los agentes. Los MBA permiten realizar un análisis de la informalidad laboral teniendo en cuenta características únicas de los agentes, además de posibilitar la comparación de diversos escenarios macroeconómicos e institucionalesSimulación Basada en Agentes, Informalidad Laboral, Economía evolucionista, Regulación Laboral.

Gobernanza de redes agroalimentarias alternativas: análisis de los mercados de productores con lógicas de transición agroecológica de la red Salsa

Alternative agri-food networks (AFNs) build distribution schemes, in which, as the number of intermediaries is reduced, those who produce have greater decision-making capacity and autonomy towards their products, as they approach the final consumers. In these networks, in addition to the closeness between actors, another alternative logic is incorporated into production from the agro-ecological perspective and the social and solidarity economy. Likewise, networks require mechanisms in the configuration of rules and decision-making, to the extent that they arise as processes of collective action from actors and organizations of civil society. All these elements give a political character to the AFNs; at the same time, it represents a challenge to promote their growth and their potential for transformation towards food sovereignty and, derived from it, towards guaranteeing the right to food. AFNs are analysed as collective actions with heterarchical governance processes, evaluating how this operates in a case study. Thus, the development of the theoretical framework and the conceptualization of heterarchical governance for the AFNs were carried out together with the participant observation in the study of the experience of the Regional Integration Committee for food sovereignty and autonomy - SALSA, Bogotá - Cundinamarca. Likewise, the results obtained from the different methodologies used were interpreted in the light of a participatory exercise with actors from the Comité Salsa and by the reflections of the people interviewed and surveyed. The experience of this network was described, with emphasis on the markets advanced by the organizations that comprise it. Based on fieldwork and literature review on AFNs (theories and cases), governance, and the social and solidarity economy, conceptual bases were established for the application of heterarchy in AFN governance, which is generated through horizontal and dynamic relationships. Subsequently, the behaviour of the relational dynamics around AFNs was deepened from the case study. Four types of relationships (peers, informants, interlocutors and co-operators) and three attributes of the relationships (cohesion, trust and synergy) were considered. The analysis of social networks was used, for whose interpretation the contextualization of the case configured from the fieldwork and the application of the net-map tool was essential. From this tool, it was possible to incorporate the reading made by some delegates of the Comité Salsa in front of the networks designed by themselves in the participatory mapping. The low dimension of the mapped networks is accompanied by a low density, warning of flaws in the cohesion of the networks. This is confirmed with the analysis of the attributes considered, as well as with the cohesion analysis by identifying subgroups. Nine organizations were found more closely linked and part of a subgroup in the network of cooperation. Among these organizations, six appear recurrently as those with the highest level of centrality, intermediation, and closeness. These elements must be considered to seek rapprochement with peripheral actors and to stimulate interactions within the Comité Salsa. In addition, a multi-criteria model was built for the analysis of heterarchical governance, considering the dimensions of sustainability, effectiveness, participation, legitimacy, and efficiency of AFNs as collective actions. The Network Analytical Process was used to establish the weight of the criteria associated with such dimensions, incorporating the value judgment of academic experts and participants from organizations related to alternative agri-food systems; the participation criteria obtained a higher weight, evidencing the horizontal and reflective nature of AFNs. Through a questionnaire applied to leaders of 16 organizations of the Comité Salsa, information was constructed to assess the four markets articulated to the network from the criteria of the model for the analysis of governance. The fieldwork was decisive to contribute to the interpretation of the estimation of the variables identified in the model. Markets show considerable variability among them, but generally, they have strengths in the dimensions of legitimacy and efficiency. These areas can be exploited to improve performance in the dimensions of sustainability and participation. Finally, the markets articulated to the Salsa Committee can be understood as transformation niches that still require greater dynamism to link actors of different profiles and sectors. However, to date they have managed to build a base to give continuity to alternative production projects and favour the recognition of producers. In this sense, some lines of future research are suggested at the end of this thesis, in terms of concepts to be explored and methodological aspects to be considered.Las redes agroalimentarias alternativas (AFN, por sus siglas en inglés) construyen esquemas de distribución, en los que, al reducirse el número de intermediarios y aproximarse a los consumidores finales, quienes producen poseen mayor capacidad de decisión y autonomía frente a sus productos. En esas redes, además de la cercanía entre actores, acá contemplada desde la economía social y solidaria, se incorpora otra lógica alternativa en la producción desde la agroecológica. Así mismo, las redes precisan de mecanismos particulares en la configuración de reglas y toma decisiones, en la medida que surgen como procesos de acción colectiva desde actores y organizaciones de la sociedad civil. Todos estos elementos dan un carácter político a las AFN, a la vez que supone un reto para fomentar su crecimiento y su potencial de transformación hacia la soberanía alimentaria y, derivado de esta, hacia la garantía del derecho a la alimentación. Se analizan las AFN como acciones colectivas con procesos de gobernanza heterárquica, evaluando cómo esta opera en un caso de estudio. Así, el desarrollo del marco teórico y la conceptualización de la gobernanza heterárquica para las AFN se realizaron a la par que la observación participante en el estudio de la experiencia del Comité de Integración regional para la soberanía y las autonomías alimentarias – SALSA, Bogotá – Cundinamarca. Igualmente, los resultados obtenidos desde las diferentes metodologías empleadas fueron interpretados a la luz de un ejercicio participativo con actores del Comité Salsa y por las reflexiones de las personas entrevistadas y encuestadas. Se describió la experiencia de red del Comité Salsa, con énfasis en los mercados adelantados por las organizaciones que lo integran. A partir del trabajo de campo y la revisión de literatura sobre las AFN (teorías y casos), la gobernanza y la economía social y solidaria, se establecieron unas bases conceptuales para la aplicación de la heterarquía en la gobernanza de AFN, la cual se genera mediante relacionamientos horizontales y dinámicos. Seguidamente se profundizó en el comportamiento de las dinámicas relacionales en torno a las AFN desde el caso de estudio. Se consideraron cuatro tipos de relacionamientos (compañeros, informantes, interlocutores y cooperantes) y tres atributos de las relaciones (cohesión, confianza y sinergia). Se empleó el análisis de redes sociales, para cuya interpretación fue fundamental la contextualización del caso configurada desde el trabajo de campo y la aplicación de la herramienta de net-map. Desde esta herramienta fue posible incorporar la lectura que hicieron algunos delegados del Comité frente a las redes diseñadas por ellos mismos en el mapeo participativo. La baja dimensión de las redes mapeadas se acompaña de una baja densidad, alertando sobre falencias en la cohesión de las redes. Esto es confirmado con el análisis de los atributos considerados, al igual que con el análisis de cohesión mediante la identificación de subgrupos. Se encontraron nueve organizaciones del Comité que en la red de cooperación se encuentran más vinculadas y conforman un subgrupo en la red; entre estas organizaciones, seis aparecen recurrentemente como las de mayor nivel de centralidad, intermediación y cercanía. Estos elementos deben ser tenidos en cuenta para buscar acercamientos con actores periféricos y para dinamizar las interacciones al interior del Comité. Se construyó un modelo multicriterio para el análisis de la gobernanza heterárquica, contemplando las dimensiones de sostenibilidad, efectividad, participación, legitimidad y eficiencia de las AFN como acciones colectivas. Se empleó el Proceso analítico en red para establecer el peso de los criterios asociados a tales dimensiones, incorporando el juicio de valor de expertos académicos y participantes de organizaciones relacionadas con los sistemas agroalimentarios alternativos; los criterios de participación obtuvieron una ponderación mayor, evidenciando el carácter horizontal y reflexivo de las AFN. Mediante un cuestionario aplicado a líderes de 16 organizaciones del Comité Salsa, se construyó información para valorar los cuatro mercados articulados al Comité desde los criterios del modelo para el análisis de la gobernanza. El trabajo de campo resultó determinante para aportar a la interpretación de la estimación de las variables identificadas en el modelo. Los mercados presentan una variabilidad considerable entre ellos, pero de manera general poseen fortalezas en las dimensiones de legitimidad y eficiencia. Estas son áreas que pueden aprovecharse para mejorar el desempeño en las dimensiones de sostenibilidad y participación. Finalmente, los mercados articulados al Comité Salsa pueden entenderse como nichos de transformación que aún requieren de un mayor dinamismo para vincular actores de distintos perfiles y sectores; sin embargo, a la fecha han logrado construir una base para dar continuidad a los proyectos de producción alternativa y favorecer el reconocimiento de los productores. En ese sentido se sugieren algunas líneas de investigación futura al final de esta tesis, en términos de conceptos por profundizar y de aspectos metodológicos a considerar.Convocatoria de proyectos de investigación conjuntos entre la Universidad de Cundinamarca y la Universidad Nacional de Colombia sede BogotáEvaluación de prácticas agroecológicas y el efecto de los procesos de gobernanza en la transformación de sistemas agrícolas de la provincia de SumapazLínea de Investigación: Desarrollo Rural.Maestrí

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research