Negotiating Social Policies in Kenya: Aid, Ethnicity and Resource Struggles

Since independence, the Kenyan state claims to have pursued the principle of equal rights as an important part of its nation-building project. At the same time, Kenya’s population is differentiated economically and politically along ethnic lines with state resources benefiting mainly those communities close to the ruling elite. At the beginning of the 21st century, important political events took place that seemed to address these inequalities. Focusing on a ten-year period from 2000–2010, this thesis examines the nature of Kenyan state–society relations through the prisms of two social policies: free primary education and HIV/AIDS prevention and care. The thesis asks: what roles have the enactment of social policies and aid within decision-making arenas played in the configuration of the contemporary Kenyan state?; and how have ethnicities and local redistribution of resources shaped negotiations within the implementation arenas

Análisis sobre la competencia del sistema interamericano para conocer de los casos previamente resueltos por la Jurisdicción Especial para la Paz

La justicia transicional es una facultad estatal que encuentra límites fijados por el derecho internacional, los cuales deben ser respetados al momento de su implementación. La Jurisdicción Especial para la Paz, por su parte, es un mecanismo de justicia transicional creado bajo la observancia de estas limitaciones y con un enfoque de justicia reparadora a favor de las víctimas. El Sistema Interamericano de Derechos Humanos es el ámbito regional encargado de la promoción y protección de los derechos humanos. Teniendo en cuenta la reciente entrada en vigencia de la Jurisdicción Especial para la Paz, resulta importante analizar la eventual competencia que tendría el Sistema Interamericano de Derechos Humanos frente a los casos previamente resueltos por este tribunal. Si la JEP, como en derecho debe suceder, cumple con las normas de derecho internacional y el estándar interamericano, no se darían los supuestos para que el Sistema Interamericano de Derechos Humanos intervenga, en tanto el mismo Estado ya habría satisfecho el fin último de este ámbito internacional.Transitional justice is a normative concept created under international and national law that provides temporary regulations to achieve a peaceful transition from war to peace. Under the Colombian government Peace Agreement with the FARC-EP the Special Jurisdiction for Peace is the transitional justice mechanism created under the observance of these parameters and with a restorative justice approach in favor of the victims. The Inter-American Human Rights System is the regional mechanism responsible for the promotion and protection of human rights in the continent. Considering the recent entry into force of the Special Jurisdiction for Peace, it is important to analyze the eventual competence that the Inter-American Human Rights System would have in the cases previously resolved by this court. If the JEP, as in theory must happen, complies with the norms of international law and the inter-American standard, the competence of the Inter-American Human Rights System will be restricted, since the State itself would had already satisfied the main goal of the Inter-American field

Análise política do programa de controle da dengue em Morelos, México

OBJECTIVE: To analyze municipal measures implemented to control the dengue epidemic, giving priority to the functions of intersectoral coordination, policy strengthening and community participation. METHODS: The observational study was performed in Morelos, Mexico in 2007. Data collected in interviews and direct observations were submitted to contents analysis and policy mapping. Policy Maker software was used to evaluate the values assigned to the stakeholders' performance (i.e., high, medium and low criteria) and to their role (actions undertaken for surveillance, control or management). A strategic analysis of opportunities and challenges regarding public policies and dengue control was conducted. RESULTS: The legal framework indicates that the approach to the dengue epidemic should be an intersectoral response. However, the burden of activities in terms of financial and human resources tends to fall on local health services, which contrasts with the contribution of other sectors (e.g., water and sanitation) that do not recognize their responsibilities. A high degree of operational feasibility links, in terms of optimization of resources and objectives fulfillment was detected, particularly among health authorities at state, jurisdictional and municipal levels. CONCLUSIONS: A multidisciplinary approach and strengthening of policy stewardship may allow a more efficient response to dengue outbreaks, sustained by intersectoral coordination and the active participation of the affected population.OBJETIVO: Analizar medidas municipales implementadas para el control de la epidemia del dengue, sobretodo las de coordinación sectorial, gobernanza y participación de grupos sociales. MÉTODOS: Estudio de observación, realizado en Morelos, México, 2007. Los datos colectados en entrevistas y observaciones directas fueron sometidos a análisis de contenido y mapeo político. El software Policy Marker fue utilizado para evaluar los pesos atribuidos a los datos de desempeño (e.g. criterios alto, medio y bajo) y el papel de actores (acciones realizadas sean ellas de vigilancia, control o administrativas). Se realizó análisis estratégico de las oportunidades y desafíos en el cumplimiento de las políticas públicas y control del dengue. RESULTADOS: Las bases jurídicas indican que la respuesta a la epidemia es una tarea multisectorial. Sin embargo, la respuesta está centrada en actividades de los servicios de la salud, que están forzados a dar mayor apoyo financiero y derivar los recursos humanos necesarios, en contraste con la contribución de otros sectores (e.g. agua y saneamiento básico), que desconocen sus responsabilidades. El sector de la salud presenta alto nivel de factibilidad para la vinculación intra?institucional, en términos de optimización de recursos y cumplimiento de objetivos, particularmente entre autoridades de salud en los niveles estatal, jurisdiccional, municipal y local. CONCLUSIONES: El abordaje multidisciplinario y el fortalecimiento de las responsabilidades políticas permitirán la respuesta eficaz ante la epidemia del dengue, sustentada en la coordinación sectorial e involucramiento activo de la población afectada.OBJETIVO: Analisar medidas municipais implementadas para o controle da epidemia da dengue, sobretudo as de coordenação setorial, governança e participação de grupos sociais. MÉTODOS: Estudo observacional, realizado em Morelos, México, 2007. Os dados coletados em entrevistas e observações diretas foram submetidos a análise de conteúdo e mapeamento político. O software Policy Maker foi utilizado para avaliar os pesos atribuídos aos dados do desempenho (i.e., critérios alto, médio e baixo) e papel de atores (ações realizadas, sejam elas de vigilância, controle, sejam administrativas). Foi realizada análise estratégica das oportunidades e desafios no cumprimento das políticas públicas e controle da dengue. RESULTADOS: As bases jurídicas indicam que a resposta à epidemia é uma tarefa multissetorial. Porém, a resposta está centrada em atividades dos serviços da saúde, que estão forçados a dar o maior apoio financeiro e a derivar os recursos humanos necessários, em contraste com a contribuição de outros setores (e.g., água e saneamento básico), que desconhecem as suas responsabilidades. O setor da saúde apresenta alto nível de factibilidade para a vinculação intra-institucional, em termos de otimização de recursos e cumprimento de objetivos, particularmente entre autoridades de saúde nos níveis estatal, jurisdicional, municipal e local. CONCLUSÕES: A abordagem multidisciplinar e o fortalecimento das responsabilidades políticas permitirão a resposta eficaz perante a epidemia da dengue, sustentada na coordenação setorial e envolvimento ativo da população afetada

Uso de servicios de salud y enfermedades transmisibles de la población migrante y refugiada venezolana

Introduction: Colombia is the main receiving country of the Venezuelan migrant population. This has involved identifying health needs and responses, particularly those that most threaten the well-being of migrants and refugees, such as infectious diseases. Objective: to analyze the use of health services related to HIV/AIDS, malaria and viral hepatitis in Venezuelan migrants and refugees in Colombia during 2018 and 2019.  Methodology: Mixed research study. First, 12 focus groups were conducted with Venezuelan migrant and refugee women and men. Second, an analysis of the use of health services by HIV/AIDS, malaria and viral hepatitis diagnostics was conducted during 2018 and 2019 in six cities with a high migration flow: Barranquilla, Bogotá, Cartagena, Cúcuta, Santa Marta and Riohacha. Results: Health service use by HIV/AIDS, viral hepatitis and malaria events among Venezuelan migrants increased from 2018 (n=1,519) to 2019 (n=3,988). By sex, men used health services most for diagnoses associated with infectious diseases. The qualitative approach identified irregular migration status, deficiencies in primary health care, and limited access to specific protection and early detection of communicable diseases as the main barriers to health care for migrants and refugees. Conclusions: Migration exposes people to a higher risk of contracting infectious diseases such as malaria, viral hepatitis or HIV/AIDS; as well as to inequalities and social exclusion in access to health services for the control and treatment of infectious diseases. Therefore, in migration contexts, equity in health services should be strengthened and access to primary health care, supplies, diagnostic tests and treatment of infectious diseases should be ensured for migrants and refugees.Introducción: Colombia es el principal país receptor de población migrante venezolana. Esto ha implicado identificar las necesidades en salud de esta población, como la atención y tratamiento de enfermedades infecciosas. Objetivo: analizar el uso de servicios de salud relacionados con VIH/SIDA, malaria y hepatitis virales en migrantes y refugiados venezolanos en Colombia durante 2018 y 2019. Metodología: estudio de investigación mixto. Se desarrollaron 12 grupos focales con mujeres y hombres venezolanos y se realizó un análisis del uso de servicios de salud por diagnósticos de VIH/SIDA, malaria y hepatitis virales, durante 2018 y 2019, en seis ciudades con un alto flujo de migración: Barranquilla, Bogotá, Cartagena, Cúcuta, Santa Marta y Riohacha. Resultados: el uso de servicios de salud por enfermedades infecciosas en migrantes venezolanos aumentó de 2018 (n=1.519) a 2019 (n=3.988). Los hombres fueron los que más usaron los servicios de salud por estas enfermedades. Aun así, la situación irregular migratoria, deficiencias en la atención primaria y acceso limitado a protección y detección temprana de enfermedades transmisibles, constituyen las principales barreras para migrantes y refugiados respecto a la atención en salud. Conclusiones: la migración expone a las personas al riesgo de contraer enfermedades infecciosas; así como a desigualdades y exclusión social en el acceso a servicios de salud para el control y tratamiento de enfermedades infecciosas. Por ello, en contextos de migración se debe fortalecer la equidad en los servicios de salud con el fin de asegurar el acceso de las personas a atención primaria, insumos, pruebas diagnósticas y tratamiento de enfermedades infecciosas.Introducción: Colombia es el principal país receptor de población migrante venezolana. Esto ha implicado identificar necesidades y respuestas en salud, en particular, de aquellas que más amenazan el bienestar de migrantes y refugiados, como es el caso de las enfermedades infecciosas. Objetivo: analizar el uso de servicios de salud relacionados con VIH/SIDA, malaria y hepatitis virales en migrantes y refugiados venezolanos en Colombia durante 2018 y 2019. Metodología: estudio de investigación mixto. Primero, se llevaron a cabo 12 grupos focales con mujeres y hombres migrantes y refugiados venezolanos. Segundo, se realizó un análisis del uso de servicios de salud por diagnósticos de VIH/SIDA, malaria y hepatitis virales, durante 2018 y 2019, en seis ciudades con un alto flujo de migración: Barranquilla, Bogotá, Cartagena, Cúcuta, Santa Marta y Riohacha. Resultados: el uso de servicios de salud por eventos de VIH/SIDA, hepatitis virales y malaria en migrantes venezolanos aumentó de 2018 (n=1.519) a 2019 (n=3.988). Según sexo, los hombres fueron los que más usaron los servicios de salud por diagnósticos asociados a enfermedades infecciosas. El enfoque cualitativo permitió identificar que la situación irregular migratoria, deficiencias en la atención primaria en salud y acceso limitado a protección específica y detección temprana de enfermedades transmisibles, constituyen las principales barreras para migrantes y refugiados respecto a la atención en salud. Conclusiones: la migración expone a las personas a un mayor riesgo de contraer enfermedades infecciosas como la malaria, hepatitis virales o VIH/SIDA; así como a desigualdades y exclusión social en el acceso a servicios de salud para el control y tratamiento de enfermedades infecciosas. Por ello, en contextos de migración se debe fortalecer la equidad en los servicios de salud y asegurar el acceso de las personas migrantes y refugiadas a atención primaria en salud, insumos, pruebas diagnósticas y tratamiento de enfermedades infecciosas

Effectiveness of treatments in Neuromyelitis optica to modify the course of disease in adult patients. Systematic review of literature.

El trastorno del espectro de la neuromielitis óptica (NMOSD) es una enfermedad inflamatoria, que se manifiesta principalmente como episodios recurrentes de neuritis o mielitis óptica que causan una discapacidad importante. El diagnóstico temprano y el pronto inicio de la terapia inmunosupresora son cruciales para reducir las recaídas, la discapacidad y la mortalidad. Aunque hay pocos ensayos controlados aleatorios prospectivos, varios medicamentos han demostrado ser efectivos y seguros. La azatioprina y el rituximab representan el estándar de atención y se utilizan como agentes de tratamiento de primera línea en todo el mundo. Sin embargo, estudios recientes han revelado nuevas terapias, como los anticuerpos monoclonales. Para hacer recomendaciones de tratamiento y pautas de manejo, es imperativo definir un estándar de atención adecuado.Neuromyelitis Optica spectrum disorder (NMOSD) is an inflammatory disease, which manifests mostly as recurrent episodes of optic neuritis or myelitis that cause important disability. Early diagnosis and prompt initiation of immunosuppressive therapy are crucial in reducing relapses, disability, and mortality. Even though, there are few prospective randomized controlled trials, several drugs have proved to be both effective and safe. Azathioprine and Rituximab represent the standard of care and are used as first-line treatment agents worldwide. However, recent studies have unveiled new therapies, such as monoclonal antibodies. To make treatment recommendations and management guidelines, it is imperative to define an appropriate standard of care.N/

Structure, Process, and Mortality Associated with Acute Coronary Syndrome Management in Guatemala’s National Healthcare System: The ACS-GT Registry

Background: Acute coronary syndromes (ACS) include ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). The leading cause of mortality in Guatemala is acute myocardial infarction (AMI) and there is no established national policy nor current standard of care. Objective: Describe the factors that influence ACS outcome, evaluating the national healthcare system’s quality of care based on the Donabedian health model. Methods: The ACS-Gt study is an observational, multicentre, and prospective national registry. A total of 109 ACS adult patients admitted at six hospitals from Guatemala’s National Healthcare System were included. These represent six out of the country’s eight geographic regions. Data enrolment took place from February 2020 to January 2021. Data was assessed using chi-square test, Student’s t-test, or Mann-Whitney U test, whichever applied. A p-value < 0.05 was considered statistically significant. Results: One hundred and nine patients met inclusion criteria (80.7% STEMI, 19.3% NSTEMI/UA). The population was predominantly male, (68%) hypertensive (49.5%), and diabetic (45.9%). Fifty-nine percent of STEMI patients received fibrinolysis (alteplase 65.4%) and none for primary Percutaneous Coronary Intervention (pPCI). Reperfusion success rate was 65%, and none were taken to PCI afterwards in the recommended time period (2–24 hours). Prognostic delays in STEMI were significantly prolonged in comparison with European guidelines goals. Optimal in-hospital medical therapy was 8.3%, and in-hospital mortality was 20.4%. Conclusions: There is poor access to ACS pharmacological treatment, low reperfusion rate, and no primary, urgent, or rescue PCI available. No patient fulfilled the recommended time period between successful fibrinolysis and PCI. Resources are limited and inefficiently used

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio