La crisis de la garantía hipotecaria en las corporaciones de ahorro y vivienda, la crisis del UPAC y estudios sobre la ley 546 de 1999

El tema de la vivienda en los últimos años, con sus múltiples componentes, comenzando por el UPAC, se convirtió en la pesadilla más tormentosa para los colombianos, sin importar su condición social: muchos empresarios quebraron en la construcción

Propuesta del plan de desarrollo cultural para el Departamento del Meta

formular un Plan de Desarrollo Cultural para el Departamento, donde se comprometa a las empresas productivas, entidades administrativas del gobierno y la población en general

Inmunoterapia en pacientes con cáncer de pulmón de células no pequeñas versus terapia convencional. Revisión sistemática

RESUMEN Antecedentes y Justificación: El cáncer de pulmón es la principal causa de muerte relacionada con Cáncer en el mundo. El cáncer pulmonar de células no pequeñas (Non-Small-cell lung cancer NSCLC) representa el 85% de todos los cánceres de pulmón y en un 40% es diagnosticado tardíamente y con los tratamientos disponibles actualmente (cirugía, radioterapia y quimioterapia) presenta una supervivencia a 5 años entre el 10 y el 15%. En los últimos años han surgido nuevos tratamientos basados en la inmunoterapia que prometen mejorar la supervivencia de estos pacientes. Objetivo: Determinar la eficacia de la inmunoterapia en el tratamiento del cáncer de pulmón de células no pequeñas (NSCLC) con el fin de integrar la información disponible para su posterior uso en la clínica. Metodología: Se realizó búsqueda exhaustiva de la literatura disponible del 1 de Enero de 2003 al 31 de Diciembre de 2013. Se examinaron las siguientes bases de datos: Pubmed, Scielo, Medline, Lilacs, EMBASE, Bandolier, peDRO y Cochrane. Se utilizaron los términos MeSH de búsqueda: immunotherapy, NSCLC, clinical trials. Resultados: de 163 referencias identificadas en las bases de datos, 12 fueron seleccionadas para la revisión. Se identificaron 11 estrategias inmunoterapéuticas que fueron complementarias al uso de quimioterapia, radioterapia o ambas. No se encontró diferencia significativa entre la supervivencia global de los grupos de intervención y controles con excepción de 1 artículo. La mayoría de efectos secundarios fueron de leves a moderados y no hubo diferencias significativas entre los grupos. Discusión: no se evidenció un aumento significativo de la supervivencia global con la utilización de inmunoterapias, a excepción de la que emplea células asesinas inducidas por citocinas junto a células dendríticas. Sin embargo es necesario esperar resultados de estudios fase III en curso.

Desarrollo indígena y cooperación internacional: una aproximación a la intervención de la AECID en la recuperación del cordón ambiental de la Sierra Nevada de Santa Marta (2011-2014)

El objetivo del presente estudio de caso es analizar de qué forma la participación de la Agencia Española de Cooperación Internacional para el Desarrollo en el proyecto Cordón ambiental y Tradicional de la Sierra Nevada de Santa Marta (2011- 2014) aporta nuevos elementos a las dinámicas de cooperación internacional para el desarrollo indígena. Se contextualiza la situación de derechos indígenas en términos de desarrollo. Se hace una reflexión de los resultados institucionales y los elementos recogidos del diálogo directo con indígenas arhuacos, resaltando el valor cultural y formas de pensar indígena que ponen a consideración temas coyunturales como la situación de los Objetivos del Desarrollo del Milenio y nuevos protagonismos conceptuales como el Buen Vivir

Diabetes relacionada a la fibrosis quística (DRFQ)

Importancia: el paciente con fibrosis quística después de las complicaciones gastrointestinales y pulmonares debe enfrentar otras comorbilidades como la diabetes relacionada a su condición . Dado el aumento en la esperanza de vida y el hecho de que virtualmente todas los pacientes con esta enfermedad pueden desarrollar alteración en el metabolismo de los carbohidratos, se requiere una sensibilización frente al tema que posibilite una detección temprana de esta entidad y un tratamiento óptimo que evite las complicaciones microvasculares e impacte entre otros el crecimiento pondo-estatural en pacientes en desarrollo y la función pulmonar. Objetivo : realizar una revisión actualizada de la literatura sobre la diabetes relacionada a la fibrosis quística, destacando las indicaciones de tamización y tratamiento. Conclusión : la FQ dentro de su abordaje requiere la detección temprana de la alteración del metabolismo de los carbohidratos con una prueba de tolerancia a la glucosa , el daño del islote pancreático , la disfunción inmune, la resistencia a la insulina, el estrés oxidativo entre otros elementos fisiopatológicos conllevan a un estado de depleción de insulina que producirán un efecto negativo microvascular así como a una reducción marcada de la función pulmonar, mayores tasa de infección e incremento de la mortalidad. La piedra angular del tratamiento en pacientes con o sin hiperglicemia es la insulina que mejora tanto el estado nutricional como la función pulmonar ; nuevos antidiabéticos orales con efecto incretinas y fármacos modificadores de la enfermedad se vislumbran como alternativas al corto plazo

Plotino y Grosseteste: El neoplatonismo en la cosmología medieval

En este trabajo se estudia el caso de la cosmología del filósofo y científico Robert Grosseteste como un ejemplo de la notable influencia del neoplatonismo en la ciencia medieval. Uno de los propósitos de la cosmología de Grosseteste consistió en explicar la secuencia efectiva de la creación del cosmos. Sostengo que la explicación que ofrece Grosseteste acerca de la creación es una expresión renovada de algunas ideas de Plotino a propósito de cómo el Uno engendra lo múltiple. Me interesa resaltar tres aspectos de la estrecha relación entre el sistema cosmológico de Grosseteste y el sistema metafísico de Plotino: (1) Unidad de principio, (2) Mecanismos de generación y (3) Unidad del sistema.

English language modular packs : for ESO. 'Módulos de inglés : para ESO'.

Contiene : Modular Pack 1, Planificación (vol I, II, Preparando las clases) - Modular Pack 2, Integración (vol III, IV, V, Beyond the linguistic skills) - Modular Pack 3, Evaluación ( vol. VI, VII, Una asignatura pendiente). Este trabajo ha sido financiado por el MEC al amparo del Concurso Nacional para la elaboración de materiales curriculares, convocado por la Secretaría de Estado de Educación, según resolución 31 de enero de 1990

Integración : beyond the linguistic skills.

Contiene: Vol. III. Modules A, C, D - Vol. IV. 1er. ciclo ESO: Modules B - Vol. V. 2o. ciclo ESO: Modules B. Trabajo financiado por el MEC al amparo del Concurso Nacional para la elaboración de materiales curriculares

El test guestáltico visomotor en el diagnóstico de las dificultades en lectura y escritura.

Observar si el test guestáltico visomotor como medida de la coordinación visomotora diferencia entre buenos y malos lectores de diferente sexo y edad, y entre buenos y malos escritores de diferente sexo y edad. 256 sujetos seleccionados en varios colegios públicos de la provincia de Murcia y en el departamento de Psicología Clínica de la Ciudad Sanitaria Vírgen de la Arrixaca. Para cubrir los objetivos básicos de la investigación se ha hecho un diseño experimental con seis variables independientes intersujetos, tres referidas a la lectura: 1. Nivel lector; 2. Sexo; 3. Edad y tres referidas a la escritura: 1. Nivel escritor; 2. Sexo; 3. Edad, para observar que efectos diferenciales ejercen en relación a la coordinación visomotora referida a la escritura. La variable dependiente la conforman las puntuaciones obtenidas en las diferentes categorías: forma; contigüidad separación; orientación general; orientación precisa; alineaciones; dimensiones y número. Cuestionario de observación 'ad hoc' para los profesores de tercero, cuarto y quinto de EGB de Cervera y Toro para evaluar el nivel lector y escritor, y seleccionar la muestra. WISC y TEA-1 para evaluar el CI de los sujetos de la muestra. Cinco dibujos en cartulina (10 x 15) y ordenados I, II, III, IV, V, correspondientes con los modelos A, II, IV, III, VII de Bender. Folio blanco, lápiz número 2 y otro de reserva, una hoja de anotación, siete mallas de corrección y tres hojas de puntuación. Análisis cuantitativo de las variables independientes. Análisis cualitativo de las variables, muy utilizado con el Test Guestáltico Visomotor (TGV), para referirse al estudio de ciertos fracasos en la ejecución de los modelos. Para el análisis de significación estadística se realizaron las siguientes contrastaciones: lectura: análisis de varianza factorial de tipo 2x2x4 para los 16 grupos. Escritura: análisis de varianza factorial de tipo 2x2x4 para los surgidos. Edad: contraste de significación para los cuatro niveles de la variable, tanto en lectura como en escritura. Para el análisis cualitativo referido a lectura, se utilizó un análisis de varianza factorial 2x4 para cada categoría; lo mismo en lo referente a escritura. En los análisis estadísticos se han seguido las pautas de Glass & Stanley (1974) y Arnau (1978,1981). En relación a las hipótesis planteadas se observan diferencias de ejecución del Bender entre los buenos y malos lectores y escritores; con lo que ambas hipótesis quedan confirmadas. En relación a las hipótesis de las diferencias por el sexo, se confirma que no existe diferente ejecución en el TGV. En relación con la edad si se observan diferencias, por lo que al TGV se le puede considerar como un test madurativo. El TGV tiene una utilidad clínica manifiesta. Parece adecuado afirmar que entre los muchos factores relacionados con las dificultades de lectura y escritura el factor 'coordinación visomotriz' es un factor importante.

Estudo in vivo sobre a influência do fototipo na resposta da pele humana ao contacto com lauril sulfato de sódio

O Lauril Sulfato de Sódio (LSS) é um tensioactivo aniónico utilizado em muitas formas farmacêuticas, que apresenta, no entanto, algum potencial de irritação. Também por esse motivo o LSS é utilizado como agente provocador em diversos micrométodos de exploração in vivo da fisiopatologia da pele. Factores como a idade, sexo, hidratação da pele, região anatómica, afectam a resposta da pele ao contacto com LSS, O objectivo deste estudo foi estudar a influência do fototipo na recuperação da integridade da pele humana ao contacto com LSS. Após selecção dos voluntários (n=12) com base nos seus fototipos (Grupo I : Fototipo III-IV e Grupo II: Fototipo V-VI) foi aplicado um penso contendo uma solução de LSS a 2% no antebraço, durante 24h(D0. Após remoção do penso, os voluntários foram sujeitos (D1,D2,D7) a exame dermatológico e à medição das variáveis biométricas: perda de água trans-epidermica, hidratação (por 2 métodos complementares) grau de eritema e fluxo sanguíneo local. Os resultados mostram que existem diferenças entre os dois grupos para a PTEA, LDF e grau de eritema, sugerindo uma maior susceptibilidade para os fototipos mais claros e uma maior rapidez de recuperação para os fototipos mais elevados.

Nitric oxide detection in cell culture exposed to LPS after Er:YAG laser irradiation

P>Aim To evaluate in vitro the effect of calcium hydroxide [Ca(OH)(2)] and Er:YAG laser on bacterial endotoxin [also known as lipopolysaccharide (LPS)] as determined by nitric oxide (NO) detection in J774 murine macrophage cell line culture. Methodology Samples of LPS solution (50 mu gmL-1), Ca(OH)(2) suspension (25 mg mL-1) and LPS suspension with Ca(OH)(2) were prepared. The studied groups were: I - LPS (control); II - LPS + Ca(OH)(2); III - LPS + Er:YAG laser (15 Hz 140 mJ); IV - LPS + Er:YAG laser (15 Hz 200 mJ); V - LPS + Er:YAG laser (15 Hz 250 mJ), VI - Pyrogen-free water; VII - Ca(OH)(2). Murine macrophage J774 cells were plated and 10 mu L of the samples were added to each well. The supernatants were collected for NO detection by the Griess reaction. Data were analysed statistically by one-way anova and Tukey`s test at 5% significance level. Results The mean and SE (in mu mol L-1) values of NO release were: I - 10.48 +/- 0.58, II - 6.41 +/- 0.90, III - 10.2 +/- 0.60, IV - 8.35 +/- 0.40, V - 10.40 +/- 0.53, VI - 3.75 +/- 0.70, VII - 6.44 +/- 0.60; and the values for the same experiment repeated after 1 week were: I - 21.20 +/- 1.50, II - 9.10 +/- 0.60, III - 19.50 +/- 1.00, IV - 18.50 +/- 0.60, V - 21.30 +/- 0.90, VI - 2.00 +/- 0.20, VII - 6.80 +/- 1.70. There was no significant difference (P > 0.05) between the control and the laser-treated groups (III, IV and V), or comparing groups II, VI and VII to each other (P > 0.05). Group I had significantly higher NO release than group II (P < 0.05). Groups II and VI had similar NO release (P > 0.05). Conclusions Calcium hydroxide inactivated the bacterial endotoxin (LPS) whereas none of the Er:YAG laser parameter settings had the same effectiveness.

Low levels of methylmercury induce DNA damage in rats: protective effects of selenium

In this study we examined the possible antigenotoxic effect of selenium (Se) in rats chronically exposed to low levels of methylmercury (MeHg) and the association between glutathione peroxidase (GSH-Px) activity and DNA lesions (via comet assay) in the same exposed animals. Rats were divided into six groups as follows: (Group I) received water; (Group II) received MeHg (100 mu g/day); (Group III) received Se (2 mg/L drinking water); (Group IV) received Se (6 mg/L drinking water); (Group V) received MeHg (100 mu g/day) and Se (2 mg/L drinking water); (Group VI) received MeHg (100 mu g/day) and Se (6 mg/L drinking water). Total treatment time was 100 days. GSH-Px activity was determined spectrophotometrically and DNA damage was determined by comet assay. Mean GSH-Px activity in groups I, II, III, IV, V and VI were, respectively: 40.19 +/- A 17.21; 23.63 +/- A 6.04; 42.64 +/- A 5.70; 38.50 +/- A 7.15; 34.54 +/- A 6.18 and 41.39 +/- A 11.67 nmolNADPH/min/gHb. DNA damage was represented by a mean score from 0 to 300; the results for groups I, II, III, IV, V and VI were, respectively: 6.87 +/- A 3.27; 124.12 +/- A 13.74; 10.62 +/- A 3.81; 13.25 +/- A 1.76; 86.87 +/- A 11.95 and 76.25 +/- A 7.48. There was a significant inhibition of GSH-Px activity in group II compared with group I (P < 0.05). Groups V and VI did not show a difference in enzyme activity compared with groups III and IV, showing the possible protective action of Se. Comet assay presented a significant difference in DNA migration between group II and group I (P < 0.0001). Groups V and VI showed a significant reduction in MeHg-induced genotoxicity (P < 0.001) when compared with group II. A negative correlation (r = -0.559, P < 0.05) was found between GSH-Px activity and DNA lesion, showing that the greater the DNA damage, the lower the GSH-Px activity. Our findings demonstrated the oxidative and genotoxic properties of MeHg, even at low doses. Moreover, Se co-administration reestablished GSH-Px activity and reduced DNA damage.

Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Existential issues in surgical care : Nurses’ experiences and attitudes in caring for patients with cancer

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

Physiological demands of competitive elite cross-country skiing

Introduction Researchers have, for decades, contributed to an increased collective understanding of the physiological demands in cross-country skiing; however, almost all of these studies have used either non-elite subjects and/or performances that emulate cross-country skiing. To establish the physiological demands of cross-country skiing, it is important to relate the investigated physiological variables to the competitive performance of elite skiers. The overall aim of this doctoral thesis was, therefore, to investigate the external validity of physiological test variables to determine the physiological demands in competitive elite cross-country skiing. Methods The subjects in Study I – IV were elite male (I – III) and female (III – IV) cross-country skiers. In all studies, the relationship between test variables (general and ski-specific) and competitive performances (i.e. the results from competitions or the overall ski-ranking points of the International Ski Federation (FIS) for sprint (FISsprint) and distance (FISdist) races) were analysed. Test variables reflecting the subject’s general strength, upper-body and whole-body oxygen uptake, oxygen uptake and work intensity at the lactate threshold, mean upper-body power, lean mass, and maximal double-poling speed were investigated. Results The ability to maintain a high work rate without accumulating lactate is an indicator of distance performance, independent of sex (I, IV). Independent of sex, high oxygen uptake in whole-body and upper-body exercise was important for both sprint (II, IV) and distance (I, IV) performance. The maximal double-poling speed and 60-s double-poling mean power output were indicators of sprint (IV) and distance performance (I), respectively. Lean mass was correlated with distance performance for women (III), whereas correlations were found between lean mass and sprint performance among both male and female skiers (III). Moreover, no correlations between distance performance and test variables were derived from tests of knee-extension peak torque, vertical jumps, or double poling on a ski-ergometer with 20-s and 360-s durations (I), whereas gross efficiency while treadmill roller skiing showed no correlation with either distance or sprint performance in cross-country skiing (IV). Conclusion The results in this thesis show that, depending on discipline and sex, maximal and peak oxygen uptake, work intensity at the lactate threshold, lean mass, double-poling mean power output, and double-poling maximal speed are all externally valid physiological test variables for evaluation of performance capability among elite cross-country skiers; however, to optimally indicate performance capability different test-variable expressions should be used; in general, the absolute expression appears to be a better indicator of competitive sprint performance whereas the influence of body mass should be considered when evaluating competitive distance performance capability of elite cross-country skiers.