Recomendaciones para la institucionalización de una política pública: diagnóstico de la naturaleza de las políticas en educación superior en Colombia. 1992-2011

Este trabajo busca, en primer lugar, por medio de una investigación diagnóstica, demostrar por qué las políticas de autonomía universitaria, financiación y calidad constituyeron desde 1992 hasta 2011 una política de Estado en materia de educación superior. Y, en segundo lugar, con base en ese diagnóstico, brindar algunas herramientas para la institucionalización de políticas públicas en esa materia sustentadas en la construcción participativa de las mismas. Para su desarrollo se tomaron como marco los conceptos de políticas públicas, políticas de Estado e institucionalización planteados por diferentes autores, lo que permitió realizar un estudio transversal e integrado de los contextos, actores e instrumentos de las precitadas políticas.

Efectividad en redes Inter-Organizacionales : una aproximación al concepto y su medición

El concepto de efectividad en Redes Inter-organizacionales se ha investigado poco a pesar de la gran importancia en el desarrollo y sostenibilidad de la red. Es muy importante entender este concepto ya que cuando hablamos de Red, nos referimos a un grupo de más de tres organizaciones que trabajan juntas para alcanzar un objetivo colectivo que beneficia a cada miembro de la red. Esto nos demuestra la importancia de evaluar y analizar este fenómeno “Red Inter-organizacional” de forma más detallada para poder analizar que estructura, formas de gobierno, relaciones entre los miembros y entre otros factores, influyen en la efectividad y perdurabilidad de la Red Inter-organizacional. Esta investigación se desarrolla con el fin de plantear una aproximación al concepto de medición de la efectividad en Redes Inter-organizacionales. El trabajo se centrara en la recopilación de información y en la investigación documental, la cual se realizará por fases para brindarle al lector una mayor claridad y entendimiento sobre qué es Red, Red Inter-Organizacional, Efectividad. Y para finalizar se estudiara Efectividad en una Red Inter-organizacional.

Plan de ventas para el cumplimiento de metas y presupuestos de SUMARC TAT

La empresa SUMARC TATS.A.S se ha desempeñado desde su fundación como distribuidor de los productos de NUTRESA en el canal tradicional y durante los últimos ocho años se ha mantenido en el mercado enfrentando retos y desafíos que le permiten hoy en día tener un amplio conocimiento del canal. Sin embargo, en los últimos meses se han detectado falencias en términos de cumplimiento de metas y presupuestos, lo cual implica que la empresa debe diseñar un nuevo esquema comercial que le permita cumplir con sus metas y presupuestos teniendo en cuenta los requerimientos de su socio comercial, NUTRESA. El presente proyecto de aplicación práctica pretende entonces contribuir al mejoramiento de las estrategias comerciales y el esquema organizacional de la empresa para lograr el cumplimiento al 100% de las metas y presupuestos y así garantizar la rentabilidad y el desarrollo eficiente de todas las actividades de la empresa. Para lograr estos objetivos se trabajó en conjunto con la gerencia y el departamento comercial de la empresa, realizando un diagnóstico completo de la situación inicial a través de herramientas cuantitativas y cualitativas, para así focalizar los esfuerzos hacia la solución de las causas raíces del problema. Una vez identificadas las falencias se diseñó un plan de acción para sacar provecho de las fortalezas y oportunidades existentes y hacer frente a las debilidades y amenazas presentes, con el fin de lograr un impacto positivo en todas las áreas funcionales de la empresa, los indicadores de cumplimiento y rentabilidad del negocio y la perdurabilidad del mismo.

Perfil logístico del sector del cemento en Colombia

Este proyecto caracteriza la industria del cemento en Colombia a partir de la contextualización y descripción de esta actividad en el mundo y en el país, describiendo y analizando asuntos relacionados con la cadena de suministro de esta. Teniendo en cuenta los actores directos e indirectos que en esta interactúan y temas como el comercio internacional, el desempeño y la competitividad regional de la industria nacional, la percepción empresarial y factores como la responsabilidad social y las buenas prácticas. Además de la descripción de los factores nacionales que afectan a la industria como la infraestructura, el transporte y el desempeño logístico del país. En la contextualización mundial se presentan temas como la producción, oferta y demanda mundial de este producto y las principales tendencias y prácticas logísticas que caracterizan a esta industria internacionalmente; en el panorama nacional se caracteriza la competitividad y desempeño logístico del país y los factores que afectan a la industria del cemento. Se presentan los orígenes e historia de la industria en el país y se dan datos de la producción, despachos y comercio internacional de esta además de una breve descripción de su cadena de suministro y la caracterización de las relaciones entre sus eslabones. Finalmente se describen los entes con los cuales interactúa la industria, se describe lo más relevante en cuanto a políticas ambientales, responsabilidad social y buenas prácticas de los principales productores del país y se concluye con la caracterización de la competitividad general de la industria a nivel nacional y los retos y problemáticas que afronta el sector y que lo limitan para mejorar su desempeño a nivel regional.

Caminando entre médicos y chamanes. Un documental sobre la salud en el Amazonas colombiano

En el departamento de Amazonas el servicio de salud es precario pues no se tienen en cuenta las necesidades particulares de la región, las condiciones demográficas, geográficas y las tradiciones culturales y ancestrales que hacen parte de la medicina tradicional indígena.

Innovation care pathways and the healthcare built environment: An explanatory framework and research agenda

The built environment in which health and social care is delivered can have an impact on the efficiency and outcomes of care processes. The health-care estate is large and growing and is expensive to build, adapt and maintain. The design of these buildings is a complex, difficult and political process. Better use of care pathways as an input to the design and use of the built environment has the potential to deliver significant benefits. A number of variations on the idea of care pathways are already used in designing health-care buildings but this is under-researched. This paper provides a framework for thinking about care pathways and the health-care built environment. The framework distinguishes between five different pathway ‘types’ defined for the purpose of understanding the relationship between pathways and infrastructure. The five types are: ‘care pathways’, ‘integrated care pathways’, ‘patient pathways’, ‘patient journeys’ and ‘patient flows’. The built environment implications of each type are discussed and recommendations made for those involved in either building development or care pathway projects.

Care pathways and designing the healthcare built environment: an explanatory framework

The built environment in which health and social care is delivered can have an impact on the efficiency and outcomes of care processes. The health-care estate is large and growing and is expensive to build, adapt and maintain. The design of these buildings is a complex, difficult and political process. Better use of care pathways as an input to the design and use of the built environment has the potential to deliver significant benefits. A number of variations on the idea of care pathways are already used in designing health-care buildings but this is under-researched. This paper provides a framework for thinking about care pathways and the health-care built environment. The framework distinguishes between five different pathway ‘types’ defined for the purpose of understanding the relationship between pathways and infrastructure. The five types are: ‘care pathways’, ‘integrated care pathways’, ‘patient pathways’, ‘patient journeys’ and ‘patient flows’. The built environment implications of each type are discussed and recommendations made for those involved in either building development or care pathway projects.

Stromal-derived factor-1 alpha (CXCL12) levels increase in periodontal disease

Background: The CXC chemokine receptor 4 (CXCR4) and its ligand, stromal cell-derived factor-1 (SDF-1 alpha or CXC chemokine ligand 12) are involved in the trafficking of leukocytes into and out of extravascular tissues. The purpose of this study was to determine whether SDF-1 alpha secreted by host cells plays a role in recruiting inflammatory cells into the periodontia during local inflammation. Methods: SDF-1 alpha levels were determined by enzyme-linked immunosorbent assay in gingival crevicular fluid (GCF) of 24 individuals with periodontitis versus healthy individuals in tissue biopsies and in a preclinical rat model of Porphyromonas gingivalis lipopolysaccharide-induced experimental bone loss. Neutrophil chemotaxis assays were also used to evaluate whether SDF-1 alpha plays a role in the recruitment of host cells at periodontal lesions. Results: Subjects with periodontal disease had higher levels of SDF-1 alpha in their GCF compared to healthy subjects. Subjects with periodontal disease who underwent mechanical therapy demonstrated decreased levels of SDF-1 alpha. Immunohistologic staining showed that SDF-1 alpha and CXCR4 levels were elevated in samples obtained from periodontally compromised individuals. Similar results were observed in the rodent model. Neutrophil migration was enhanced in the presence of SDF-1 alpha, mimicking immune cell migration in periodontal lesions. Conclusions: SDF-1 alpha may be involved in the immune defense pathway activated during periodontal disease. Upon the development of diseased tissues, SDF-1 alpha levels increase and may recruit host defensive cells into sites of inflammation. These studies suggest that SDF-1 alpha may be a useful biomarker for the identification of periodontal disease progression.

Effect of a calcium hydroxide-based paste associated to chlorhexidine on RAW 264.7 macrophage cell line culture

Objective. The objective of this study was to evaluate the effect of a calcium hydroxide Ca(OH)(2)-based paste (Calen) associated or not to 0.4% chlorhexidine digluconate (CHX) on RAW 264.7 macrophage cell line culture. Study design. The cell viability (MTT assay), immunostimulating properties (NO dosage), and anti-inflammatory properties (NO, TNF-alpha, and IL-1 alpha dosage) were evaluated after cell exposure to the materials. Data were analyzed statistically by Kruskal-Wallis test at 5% significance level. Results. There was low immunostimulating activity of the Calen paste associated or not to 0.4% CHX in the different materials` concentrations evaluated (P > .05). Anti-inflammatory activity with inhibition of NO and cytokine (TNF-alpha and IL1-alpha) release was observed only with Ca(OH)(2) + CHX at the highest concentration (25 mu g/mL). Conclusion. As the Calen paste associated to 0.4% CHX did not alter cell viability or the immunostimulating and anti-inflammatory properties, the addition of CHX brought no benefits to the Ca(OH)(2)-based paste with regard to the tested parameters. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e44-e51)

Arrest of root formation in a permanent maxillary central incisor subsequent to trauma and pulp necrosis to the primary predecessor

This paper reports a case in which a previous traumatic injury at the age of 2 and pulp necrosis to a primary incisor resulted in a rare injury to the permanent successor tooth. The radiographic examination at the age of 9 showed the arrest of root formation of the permanent maxillary right central incisor, which did not erupt. Tooth 11 was extracted and a functional removable space maintainer was prepared. At the age of 17, the patient received an anterior fixed prosthesis for re-establishment of the esthetics, phonetics and deglutition.

Health surveys and use of maternal and child health care services in three municipalities within the Sao Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the Sao Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes. Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the Sao Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions. Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of Sao Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance. Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Sex and socioeconomic inequalities of lung cancer mortality in Barcelona, Spain and Sao Paulo, Brazil

The objective of this paper was to assess sex and socioeconomic inequalities in lung cancer mortality in two major cities of Europe and South America. Official information on mortality and population allowed the estimation of sex- and age-specific death rates for Barcelona, Spain and Sao Paulo, Brazil (1995-2003). Mortality trends and levels were independently assessed for each city and subsequently compared. Rate ratios assessed by Poisson regression analysis addressed hypotheses of association between the outcome and socioeconomic covariates (human development index, unemployment and schooling) at the inner-city area level. Barcelona had a higher mortality in men (76.9/100000 inhabitants) than Sao Paulo (38.2/100 000 inhabitants); although rates were decreasing for the former (-2%/year) and levelled-off for the [after. Mortality in women ranked similarly (9.1 for Barcelona, 11.5 for Sao Paulo); with an increasing trend for women aged 35-64 years (+ 7.7%/year in Barcelona and + 2.4%/year in Sao Paulo). The socioeconomic gradient of mortality in men was negative for Barcelona and positive for Sao Paulo; for women, the socioeconomic gradient was positive in both cities. Negative gradients indicate that deprived areas suffer a higher burden of disease; positive gradients suggest that prosmoking lifestyles may have been more prevalent in more affluent areas during the last decades. Sex and socioeconomic inequalities of lung cancer mortality reinforce the hypothesis that the epidemiologic profile of cancer can be improved by an expanded access to existing technology of healthcare and prevention. The continuous monitoring of inequalities in health may contribute to the concurrent promotion of well-being and social justice.

Paracoccidioidomycosis-related mortality trend, state of Sao Paulo, Brazil: a study using multiple causes of death

Objective. To investigate mortality in which paracoccidioidomycosis appears on any line or part of the death certificate. Method. Mortality data for 1985-2005 were obtained from the multiple cause-of-death database maintained by the Sao Paulo State Data Analysis System (SEADE). Standardized mortality coefficients were calculated for paracoccidioidomycosis as the underlying cause-of-death and as an associated cause-of-death, as well as for the total number of times paracoccidioidomycosis was mentioned on the death certificates. Results. During this 21-year period, there were 1950 deaths related to paracoccidioidomycosis; the disease was the underlying cause-of-death in 1 164 cases (59.69%) and an associated cause-of-death in 786 (40.31%). Between 1985 and 2005 records show a 59.8% decline in the mortality coefficient due to paracoccidioidomycosis as the underlying cause and a 53.0% decline in the mortality as associated cause. The largest number of deaths occurred among men, in the older age groups, and among rural workers, with an upward trend in winter months. The main causes associated with paracoccidioidomycosis as the underlying cause-of-death were pulmonary fibrosis, chronic lower respiratory tract diseases, and pneumonias. Malignant neoplasms and AIDS were the main underlying causes when paracoccidioidomycosis was an associated cause-of-death. The decision tables had to be adapted for the automated processing of causes of death in death certificates where paracoccidioidomycosis was mentioned. Conclusions. Using the multiple cause-of-death method together with the traditional underlying cause-of-death approach provides a new angle on research aimed at broadening our understanding of the natural history of paracoccidioidomycosis.

Physical and sensory properties of regular and reduced-fat pound cakes with added amaranth flour

The sum of wheat flour and corn starch was replaced by 10, 20, or 30% whole amaranth flour in both conventional (C) and reduced fat (RF) pound cakes. and the effects on physical and sensory properties of the cakes were investigated. RF presented 33% fat reduction. The increasing amaranth levels darkened crust and crumb of cakes, which decreased color acceptability. Fresh amaranth-containing cakes had similar texture characteristics to (he controls, evaluated both instrumentally and sensorially. Sensory evaluation revealed that replacement by 30% amaranth flour decreased C cakes overall acceptability scores, clue to its lower specific volume and darker color. Amaranth flour levels had no significant effect on overall acceptability of RF cakes. Hence, the sum of wheat flour and corn starch could be successfully replaced by up to 20% amaranth flour in C and up to 30% in RF pound cakes without negatively affecting sensory quality in fresh cakes. Moisture losses for all the cakes were similar, approximate to 1% per day during storage. After six days of storage, both C and RF amaranth-containing cakes had higher hardness and chewiness values than control cakes. Further experiments involving sensory evaluation during storage are necessary to determine the exact limit of amaranth flour replacement.