Description and analysis of pulmonary rehabilitation care programs current state in four cities of Colombia

Purpose: there are many studies reporting the benefits of pulmonary rehabilitation, but few of them exhibit the behavior and activities of these services. This article presents the characteristics of services, parts management and training level of team members, in addition to the variables or instruments used to measure the effectiveness and impact in these programs. Method: it was made a cross sectional convenience sample which included seven pulmonary rehabilitation services in four Colombian cities (Bogotá, Medellín, Manizales and Cali), selected by the coverage, for having at least one year of experience and for being formally established and recognized nationwide. The interdisciplinary team of each service answered a survey that was validated through a pilot test and expert consensus. Participation was voluntary. Results: labor onset pulmonary rehabilitation services correspond to an average of a decade, with COPD and asthma pathologies of attention. The programs are characterized by an outpatient treatment with an average duration of eight to twelve weeks, with a frequency of an hour three times a week. Also, the director of the service is regularly a pulmonologist and the coordinator a physiotherapist (57.14%). The posgradual training of these professionals is notable, and they report to have procedural, administrative and communicative skills, but qualify regular there research skills. The physical and technological resources are well tested. 71.42% have done impact studies, but only 28.57% have been published. All have in common training in upper limbs, lower limbs, respiratory muscles, counseling, functional assessment and quality of life. The effectiveness and impact of programs is measured by the walking test, quality of life questionnaires and activities of daily living.

The Integrated Mass Transit Systems Program in Colombia: an Example of Recentralization of the Cities�� Management?

The Integrated Mass Transit Systems are an initiative of the Colombian Government to replicate the experience of Bogota’s Bus Rapid Transit System —Transmilenio— in large urban areas of the country, most of them over municipal perimeters to provide transportation services to areas undergoing a metropolization process. Management of these large scale metropolitan infrastructure projects involves complex setups that present new challenges in the interaction between stakeholders and interests between municipalities, tiers of government and public and private sectors. This article presents a compilation of the management process of these projects from the national context, based on a document review of the regulatory framework, complemented by interviews with key stakeholders at the national level. Research suggests that the implementation of large-scale metropolitan projects requires a management framework orientated to overcome the traditional tensions between centralism and municipal autonomy.

Assessment of conditions that make habitable the public space of Colombian cities

This paper presents the assessment that inhabitants of some Colombian cities did on the conditions that contribute to the livability of public space. Seven hundred and forty people, inhabitants of Yopal, Villavicencio, Valledupar, Popayán, Pereira, Pasto, Neiva, Montería, Medellín, Fusagasugá, Cúcuta, Cartagena, Cali and Bogotá participated in the study. The assessment of the conditions that contribute to the livability of public space was carried out using an instrument composed of 48 items that inquired about the level of contribution that can have different conditions on the quality of public space, from a scale five points ranging from: Does not contribute at all (-2) to: Contribute significantly (+2). The results show the conditions that most affect the habitability of public space in Colombia, as well as the differences between cities according to the assessment made by participants about the general state of public space in cities. Multidimensional analysis (SSA) evidence a structure that reflects the function that public space plays in people’s assessment on Colombian cities. It is discussed the implications of the findings for urban planning and management and the designed instrument is proposed as a tool to assess the quality of urban public space.

The municipality and neighborhood associative entities in argentine cities: its resignification after the decentralization of the ‘80s A case study: The municipality of Río Cuarto and their neighborhood associations

In Argentina, the restructuring of the State initially raised as a public policy in the 1980s and in-depth in the ‘ 90s under the neoliberal model accentuated - between other processes, of the administrative  decentralization, which also resulted in new roles awarded to municipalities. That’s how various actors in society charged leadership. The local and urban were the subject of renewed interpretations,  scenarios where practices more fully participatory citizen could be settled. In the neighborhoods  of cities, grass-roots organizations cultivated his role as space intermediation. This article discusses  and reflects on these new roles that launched from the changes in articulation with the municipality  since the mid-’ 80s and ‘ 90s, and problematizes particularly about the contents and scope of participatory practices inside and outside of organizations of civil society in the neo-liberal situation.

Alcances y desafíos del proceso de hermanamiento “Sister Cities" desarrollado por la ciudad de Santa Marta en el marco de su proceso de internacionalización: 1978- 2013.

La evolución de los enfoques de la cooperación internacional y de los procesos de internacionalización de las ciudades han contribuido activamente al desarrollo territorial. Los hermanamientos como una herramienta clave para el intercambio social, político, económico, técnico y académico entre ciudades, se han convertido en uno de los métodos más utilizados para el accionar internacional. Bajo ese contexto, se analizará la influencia del proceso de internacionalización de Santa Marta en la implementación del hermanamiento “Sister Cities��� con Miami Beach. Lo anterior, pretende demostrar que el proceso de internacionalización de la ciudad de Santa Marta, desde 1989 hasta la actualidad, ha influido directamente en el hermanamiento entre las dos ciudades, obviando oportunidades y beneficios. Finalmente, a partir del resultado de la investigación se sugerirá una alternativa de solución para la optimización del acuerdo entre las dos ciudades.

Horizontal Inequity in Access to Health Care in Four South American Cities

The objective of this paper is compare socioeconomic inequalities in the use of healthcare services in four South-American cities: Buenos Aires, Santiago, Montevideo, and San Pablo. We use secondary data from SABE, a survey on Health, Well-being and Aging administered in 2000 underthe sponsorship of the Panamerican Health Organization, and representative of the elderly population in each of the analyzed cities. We construct concentration indices of access to and quality of healthcare services, and decompose them in socioeconomic, need, and non-need contributors. Weassess the weight of each contributor to the overall index and compare indices across cities. Our results show high levels of pro-rich socioeconomic inequities in the use of preventive services in all cities, inequities in medical visits in Santiago and Montevideo, and inequities in quality of access to care in all cities but Montevideo. Socioeconomic inequality within private or public health systems explains a higher portion of inequalities in access to care than the fragmented nature of health systems. Our results are informative given recent policies aimed at enforcing minimum packages of services and given policies exclusively focused on defragmenting health systems.