Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Marco comprensivo para el estudio de los procesos de formación de terapeutas

La indagación sobre la formación contempla las intencionalidades del proyecto educativo considerado como contexto de formación, las modalidades con las que éste opera y sus presupuestos básicos, lo que constituye el modelo educativo y el impacto del mismo tanto en los terapeutas como en sus consultantes. Los procesos de formación y terapia se estudian como procesos de modelización compleja concebidos como el métodoproyecto para construir conocimiento, que articula los sistemas académicos y terapéuticos bajo la noción de isomorfismo en el escenario pedagógico de supervisión. Corresponde a una investigación cualitativa que creó escenarios metaobservacionales y reflexivos, cuyas escenas preexistían en los contextos de supervisión y supervisión estructurados en la Maestría en Psicología Clínica y de Familia de la Facultad de Psicología de la Universidad Santo Tomás. Los resultados muestran un proceso formativo gradual, integrado en la modalidad de supervisión y supervisión conjunta. Entre formados se comparten modelizaciones de la experiencia formativa y entre formadores circulan muy diversas concepciones de las modalidades formativas. Su eficacia gana en impacto a lo largo del tiempo, de lo que dan cuenta los indicadores del proyecto educativo

PROCESOS Y PROCEDIMIENTOS DE ORIENTACIÓN VOCACIONAL / PROFESIONAL / LABORAL DESDE UNA PERSPECTIVA SISTÉMICA

Esta investigación buscó hacer una descripción de las comprensiones, estrategias y prácticas que identifican el proceso de orientación vocacional / profesional / laboral en la familia y la escuela. Para ello se identificaron los niveles de participación de cada uno de los actores de la organización escolar: estudiantes, docentes, orientadores y padres de familia, se evaluó el impacto de los procesos de orientación profesional, especificando las acciones que se realizan para ello y el papel de los profesionales que lideran el proceso de orientación vocacional / profesional / laboral en las organizaciones escolares. Mediante un estudio de tipo descriptivo, se aplicó como instrumento una encuesta a orientadores, estudiantes, docentes y padres de familia; las categorías a evaluar fueron: prácticas y nivel de participación en el proceso de orientación, comprensiones y puntuaciones sobre la orientación vocacional / profesional / laboral, efectos e impactos de la orientación, valoración del proceso de orientación, fuentes de influencia en el joven, valoración y recomendaciones de actividades de orientación. Con una muestra de 70 docentes, 35 orientadores, 130 padres de familia y 150 estudiantes de 35 colegios de Bogotá. Se encontró que los procesos y procedimientos realizados en la orientación vocacional / profesional / laboral están relacionados con presupuestos y acciones fundamentalmente dirigidas a la toma de decisión del estudiante sobre la elección de una carrera universitaria, desde sus intereses individuales, factores económicos e información sobre la oferta; no se observa que haya un acompañamiento para la movilización de los sistemas y contextos familiares, escolares y amplios que involucren procesos pedagógicos, psicológicos, sociales y culturales de los jóvenes con la escuela, la familia y el desarrollo del país

Escrituras de venta de tierras en Turmequé y Ventaquemada, Boyacá

70 ImágenesVentaquemada, constituida por Antonio Corredor y su esposa, en favor de Eusebia Torres Moreno; escritura de venta de Ignacio Cárdenas a Dionisio López; escritura de restitución de tierras a Tobías Leiva; escrituras de venta de tierras de Benedicto Simbaqueba, en la vereda de Rosales, jurisdicción de Ventaquemada, a Pedro Moreno y Pelegrino Huertas; escritura de venta de Fulgencio Moreno Cárdenas a Manuel Pineda; fragmento de escritura de venta de Adolfo Duarte a Dionisio López; fragmento de escritura de venta de Rumualdo Moreno a Dionisio López; escritura de venta de Eufrasio Velandia a Dionisio López; escritura de venta de Ignacio Cárdenas a Dionisio López y su esposa Anunciación Moreno; fragmento de la demanda de Valentina y Eustaquia Montaña por los derechos transmitidos a Facundo Corredor sobre unos terrenos de propiedad de Eustacio Moque en la vereda "La Mesa"; escritura de permuta de una casa y un lote de propiedad de Dionisio López comprados a Eustacio Moque, por tres terrenos y una casa de propiedad de Ludovino Torres; escritura de venta de Roso Martínez a Dionisio López; escritura de venta del terreno de propiedad de Vicenta, María, Petronila y Ricardo Duarte, en la vereda de Capellanía, jurisdicción de Padua, a Ricardo Cárdenas. Fechadas en Ventaquemada, Turmequé y Tunja

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings The highest globally observed HALE at birth for both women and men was in Singapore, at 75.2 years (95% uncertainty interval 71.9-78.6) for females and 72.0 years (68.8-75.1) for males. The lowest for females was in the Central African Republic (45.6 years [42.0-49.5]) and for males was in Lesotho (41.5 years [39.0-44.0]). From 1990 to 2016, global HALE increased by an average of 6.24 years (5.97-6.48) for both sexes combined. Global HALE increased by 6.04 years (5.74-6.27) for males and 6.49 years (6.08-6.77) for females, whereas HALE at age 65 years increased by 1.78 years (1.61-1.93) for males and 1.96 years (1.69-2.13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2.3% [-5.9 to 0.9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16.1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe