Intervención psicológica pre y post-quirúrgica para pacientes adultos con amputación de miembros superiores y/o inferiores

La presente revisión de la literatura tiene el objetivo de identificar las intervenciones psicológicas pre y postquirúrgicas para pacientes con amputación no traumática. Se identifica que las amputaciones por artropatía diabética son más frecuentes que las causadas por otras enfermedades aunque las amputaciones por cáncer, arterioesclerosis e infección también son prevalentes. La amputación es un evento altamente significativo en el sujeto y demanda un costoso reajuste que se ve influenciado por variables sociodemográficas y que tiene consecuencias psicosociales que requieren de la atención y acompañamiento de un equipo interdisciplinario. En la fase preoperatoria, al manifestarse ansiedad y temores subjetivos con respecto la amputación, las intervenciones se dirigen a favorecer la verbalización e identificación de recursos. En la fase postoperatoria se acompaña el proceso de adaptación y rehabilitación con el manejo de las consecuencias psicosociales más demandantes para el sujeto. La terapia cognitivo conductual en el proceso postoperatorio es la más frecuentemente utilizada.

Implementación de metodologías logísticas para la optimización de operaciones de adecuación y acondicionamiento de vehículos para el SITP en Bogotá

Hoy en día, Bogotá cuenta con aproximadamente 15800 buses de servicio público, no obstante, alrededor de un 45% de esta flota se encuentra en un estado crítico. La existencia de modelos de buses previos al 2003, la falta de revisiones periódicas, negligencias en el cumplimiento de los requisitos para la prestación del servicio, la resistencia al cambio por parte de los transportistas, y demás factores dificultan la labor de actualizar y unificar la flota en el actual plan del Sistema Integrado de Transporte de la ciudad. El Sistema integrado de transporte procura introducir un sistema confiable, eficaz, y rápido que se adapte a la creciente necesidad de movilidad en Bogotá. Este sistema tiene como propósito la integración del sistema Transmilenio con la estructura tradicional de transporte masivo; se pretende complementar, fortalecer e integrar todos los eslabones de transporte segmentado que existen en la ciudad. Las primeras fases del sistema pretenden cambiar la estructura de flota afiliadora a operadora como funciona en Transmilenio, crear un sistema organizado e integrado de buses de servicio público (Urbano, Especial, Complementario, Troncal y Alimentador), y asegurar la calidad en el servicio. El presente proyecto pretende evaluar, analizar y optimizar los procesos que permitirían la adecuación extensiva de la flota de transporte público para su introducción al Sistema Integrado de Transporte. Los procesos principales incluyen la adecuación de todos los vehículos antiguos (modelos anteriores al 2003 pasan por un proceso de reparación, mantenimiento, acondicionamiento) y la implementación de sistemas de tecnológicos. En adición, se plantea crear un sistema homogéneo que permite estándares de calidad y facilidad de mantenimiento.

Retos y alternativas de inversión para las compañías aseguradoras en Colombia

En este documento se explica el rol de las compañías aseguradoras colombianas dentro del sistema pensional y se busca, a través de la comprensión de la evolución del entorno macroeconómico y del marco regulatorio, identificar los retos que enfrentan. Los retos explicados en el documento son tres: el reto de la rentabilidad, el reto que plantean los cambios relativamente frecuentes de la regulación, y el reto del “calce”. El documento se enfoca principalmente en el reto de la rentabilidad y desarrolla un ejercicio de frontera eficiente que utiliza retornos esperados calculados a partir de la metodología de Damodaran (2012). Los resultados del ejercicio soportan la idea de que en efecto los retornos esperados serán menores para cualquier nivel de riesgo y sugiere que ante tal panorama, la relajación de las restricciones impuestas por el Régimen de inversiones podría alivianar los preocupaciones de las compañías aseguradoras en esta materia. Para los otros dos retos también se sugieren alternativas: el Algorithmic Trading para el caso del reto que impone los cambios en la regulación, y las Asociaciones Público-Privadas para abordar el reto del “calce”.

Caracterización de la gestión del mantenimiento de equipo biomédico en servicios de urgencia de clínicas y hospitales de Medellín en el período 2008-2009

La gestión de mantenimiento es una herramienta de gran impacto que apoya al personal de Ingeniería en el desarrollo, control y dirección de programas de mantenimiento para el equipo médico. Objetivo: caracterizar la gestión de mantenimiento en servicios de urgencia de clínicas y hospitales del área metropolitana de Medellín en el período 2008-2009. Materiales y métodos: se realizó una encuesta a jefes y técnicos de mantenimiento en once entidades prestadoras de servicios de salud, clasificadas en tercer nivel y pertenecientes a la red de salud del municipio de Medellín. Resultados: entre las instituciones encuestadas se encontró que la causa de falla más común en los equipos del servicio de urgencia es el mal manejo de los equipos (75%) por partede los operarios y que 70% del mantenimiento es realizado por personal con experiencia en el área (tecnólogos en mantenimiento de equipo biomédico e ingenieros biomédicos). En las once instituciones públicas y privadas encuestadas se halló que solo se contaban con cronogramas de mantenimiento y/o con información desactualizada concerniente a las hojas de vida de los equipos, planes de mantenimiento o adquisición y baja de equipos. Conclusión: el estudio muestra la existencia de debilidades en ciertos puntos de la gestión, incluyendo mala organización, poca disponibilidad de repuestos originales y falta de capacitación en el personal que maneja los equipos.

Limitaciones y obstáculos de MINUSTAH en materia de cooperación humanitaria y desarrollo en Haití (2000-2014)

Este estudio de caso pretende analizar las limitaciones y obstáculos a los que la misión de estabilización, MINUSTAH, se ha enfrentado en el proceso de reconstrucción de Haití antes, durante y después del terremoto de 2010. Además, busca identificar los elementos que han hecho de MINUSTAH una misión cuyo objetivo inicial de carácter político y estabilización se orientó hacia la asistencia humanitaria a causa de una catástrofe natural tal como el terremoto de 2010. En esta medida y bajo el marco de cooperación internacional para el desarrollo, este estudio de caso avanza por un proceso evaluativo del papel de MINUSTAH en la consolidación del Estado haitiano.

Living up to the value agenda: the empirical realities of through-life value creation in construction

Current research agendas are increasingly encouraging the construction industry to operate on the basis of 'added value'. Such debates echo the established concept of 'high value manufacturing' and associated trends towards servitization. Within construction, the so-called 'value agenda' draws heavily from the notion of integrated solutions. This is held to be especially appropriate in the context of PFI projects. Also relevant is the concept of service-led projects whereby the project rationale is driven by the client's objectives for delivering an enhanced service to its own customers. Such ideas are contextualized by a consideration of broader trends of privatization and outsourcing within and across the construction industry's client base. The current emphasis on integrated solutions reflects long-term trends within privatized client organizations towards the outsourcing of asset management capabilities. However, such trends are by no means uniform or consistent. An in-depth case study of three operating divisions within a major construction company illustrates that firms are unlikely to reorientate their business in response to the 'value agenda'. In the case of PFI, the tendency has been to establish specialist units for the purposes of winning work. Meanwhile, institutionally embedded operating routines within the rest of the business remain broadly unaffected.

Drivers of fund performance: a panel data analysis

The principle aim of this research is to elucidate the factors driving the total rate of return of non-listed funds using a panel data analytical framework. In line with previous results, we find that core funds exhibit lower yet more stable returns than value-added and, in particular, opportunistic funds, both cross-sectionally and over time. After taking into account overall market exposure, as measured by weighted market returns, the excess returns of value-added and opportunity funds are likely to stem from: high leverage, high exposure to development, active asset management and investment in specialized property sectors. A random effects estimation of the panel data model largely confirms the findings obtained from the fixed effects model. Again, the country and sector property effect shows the strongest significance in explaining total returns. The stock market variable is negative which hints at switching effects between competing asset classes. For opportunity funds, on average, the returns attributable to gearing are three times higher than those for value added funds and over five times higher than for core funds. Overall, there is relatively strong evidence indicating that country and sector allocation, style, gearing and fund size combinations impact on the performance of unlisted real estate funds.

Depreciation and its impact on the total return of UK commercial real estate, 1994-2003

Depreciation is a key element of understanding the returns from and price of commercial real estate. Understanding its impact is important for asset allocation models and asset management decisions. It is a key input into well-constructed pricing models and its impact on indices of commercial real estate prices needs to be recognised. There have been a number of previous studies of the impact of depreciation on real estate, particularly in the UK. Law (2004) analysed all of these studies and found that the seemingly consistent results were an illusion as they all used a variety of measurement methods and data. In addition, none of these studies examined impact on total returns; they examined either rental value depreciation alone or rental and capital value depreciation. This study seeks to rectify this omission, adopting the best practice measurement framework set out by Law (2004). Using individual property data from the UK Investment Property Databank for the 10-year period between 1994 and 2003, rental and capital depreciation, capital expenditure rates, and total return series for the data sample and for a benchmark are calculated for 10 market segments. The results are complicated by the period of analysis which started in the aftermath of the major UK real estate recession of the early 1990s, but they give important insights into the impact of depreciation in different segments of the UK real estate investment market.

Private property vehicles: the valuation of interests in limited partnerships

This paper examines the extent to which the valuation of partial interests in private property vehicles should be closely aligned to the valuation of the underlying assets. A sample of vehicle managers and investors replied to a questionnaire on the qualities of private property vehicles relative to direct property investment. Applying the Analytic Hierarchy Process (AHP) technique the relative importance of the various advantages and disadvantages of investment in private property vehicles relative to acquisition of the underlying assets are assessed. The results suggest that the main drivers of the growth of the this sector have been the ability for certain categories of investor to acquire interests in assets that are normally inaccessible due to the amount of specific risk. Additionally, investors have been attracted by the ability to ‘outsource’ asset management in a manner that minimises perceived agency problems. It is concluded that deviations from NAV should be expected given that investment in private property vehicles differs from investment in the underlying assets in terms of liquidity, management structures, lot size, financial structure inter alia. However, reliably appraising the pricing implications of these variations is likely to be extremely difficult due to the lack of secondary market trading and vehicle heterogeneity.

Liquidity in commercial property markets: deconstructing the transaction process

This paper draws from a wider research programme in the UK undertaken for the Investment Property Forum examining liquidity in commercial property. One aspect of liquidity is the process by which transactions occur including both how properties are selected for sale and the time taken to transact. The paper analyses data from three organisations; a property company, a major financial institution and an asset management company, formally a major public sector pension fund. The data covers three market states and includes sales completed in 1995, 2000 and 2002 in the UK. The research interviewed key individuals within the three organisations to identify any common patterns of activity within the sale process and also identified the timing of 187 actual transactions from inception of the sale to completion. The research developed a taxonomy of the transaction process. Interviews with vendors indicated that decisions to sell were a product of a combination of portfolio, specific property and market based issues. Properties were generally not kept in a “readiness for sale” state. The average time from first decision to sell the actual property to completion had a mean time of 298 days and a median of 190 days. It is concluded that this study may underestimate the true length of the time to transact for two reasons. Firstly, the pre-marketing period is rarely recorded in transaction files. Secondly, and more fundamentally, studies of sold properties may contain selection bias. The research indicated that vendors tended to sell properties which it was perceived could be sold at a ‘fair’ price in a reasonable period of time.

Can profitable trading strategies be derived from investment best-sellers?

A glance along the finance shelves at any bookshop reveals a large number of books that seek to show readers how to ‘make a million’ or ‘beat the market’ with allegedly highly profitable equity trading strategies. This paper investigates whether useful trading strategies can be derived from popular books of investment strategy, with What Works on Wall Street by James P. O'Shaughnessy used as an example. Specifically, we test whether this strategy would have produced a similarly spectacular performance in the UK context as was demonstrated by the author for the US market. As part of our investigation, we highlight a general methodology for determining whether the observed superior performance of a trading rule could be attributed in part or in entirety to data mining. Overall, we find that the O'Shaughnessy rule performs reasonably well in the UK equity market, yielding higher returns than the FTSE All-Share Index, but lower returns than an equally weighted benchmark

Low-cost momentum strategies

This paper analyses the impact of trading costs on the profitability of momentum strategies in the United Kingdom and concludes that losers are more expensive to trade than winners. The observed asymmetry in the costs of trading winners and losers crucially relates to the high cost of selling loser stocks with small size and low trading volume. Since transaction costs severely impact net momentum profits, the paper defines a new low-cost relative-strength strategy by shortlisting from all winner and loser stocks those with the lowest total transaction costs. While the study severely questions the profitability of standard momentum strategies, it concludes that there is still room for momentum-based return enhancement, should asset managers decide to adopt low-cost relative-strength strategies.

The role of rules-based compliance systems in the new EU regulatory landscape: perspectives of institutional change

Purpose The research objective of this study is to understand how institutional changes to the EU regulatory landscape may affect corresponding institutionalized operational practices within financial organizations. Design/methodology/approach The study adopts an Investment Management System as its case and investigates different implementations of this system within eight financial organizations, predominantly focused on investment banking and asset management activities within capital markets. At the systems vendor site, senior systems consultants and client relationship managers were interviewed. Within the financial organizations, compliance, risk and systems experts were interviewed. Findings The study empirically tests modes of institutional change. Displacement and Layering were found to be the most prevalent modes. However, the study highlights how the outcomes of Displacement and Drift may be similar in effect as both modes may cause compliance gaps. The research highlights how changes in regulations may create gaps in systems and processes which, in the short term, need to be plugged by manual processes. Practical implications Vendors abilities to manage institutional change caused by Drift, Displacement, Layering and Conversion and their ability to efficiently and quickly translate institutional variables into structured systems has the power to ease the pain and cost of compliance as well as reducing the risk of breeches by reducing the need for interim manual systems. Originality/value The study makes a contribution by applying recent theoretical concepts of institutional change to the topic of regulatory change uses this analysis to provide insight into the effects of this new environment

”En aktiemarknad för alla” : Integritet och marknadsomsorg i (själv)regleringen av den svenska värdepappersmarknaden

”A stock market for all”. Integrity and concern for the market in the (self-)regulation of the Swedish securities market This article deals with the transformation process that led to the substantial growth of the securities markets, and also led to a situation where Sweden became one of the leading countries when it comes to ordinary people investing in shares and mutual funds. The article discusses how social control and regulation of the market changed as a result of this process. A sudden and strong unanimity for knowledge tests in order for a stockbroker to be allowed to conduct brokerage, advisory services and asset management was the significant change in this transformation process. Knowledge tests were first introduced on a voluntary basis by the industry itself, but is now a mandatory requirement by the State. This article argues that the unanimity for knowledge tests best can be understood by studying the broadening of the financial markets. The broadening meant that more groups in society – with very varying capabilities – had started to place their assets in the security markets. They were encouraged to do so since this was considered to be the solution to the growing number of socioeconomic problems. This article is mainly based on market statistics and document analysis supplemented by interviews.

”Tacksamhet för att jag fick ett nytt liv” : En kvalitativ studie om återanpassningsstrategier efter avtjänat fängelsestraff

Intresset för kriminalitet och individerna bakom de kriminella handlingarna ökar i samhället och återges i media dagligen. Det är just individen bakom brottet, hen som fängslas och får avtjäna sitt straff som denna studie riktar sitt fokus på. När fängelsegrindarna öppnas och återinträdet till samhället blir ett faktum; Hur tar då dessa individer sig tillbaka till samhället för att åter bli en del av det? Syftet med denna studie är att undersöka vilka återanpassningsstrategier som frigivna använder sig av samt hur samhällets bemötande påverkar strategierna. Studien baseras på självbiografier skrivna av fyra författare som alla levt ett kriminellt liv och som sedermera avtjänat ett eller flera fängelsestraff. Resultatet visar att det finns flera anpassningsstrategier som tas i bruk. Däribland att söka hjälp och stöd hos familj, vänner eller andra sociala grupper. Vidare återfinns det i strävan efter en ”ny identitet” vilket ofta sker med hjälp av tro. Att sysselsätta sig, ge något tillbaka till samhället, visa sin kreativitet i syfte att återfå sin kredibilitet kan ses som strategier som leder fram till det slutliga målet, kredibiliteten. Slutligen kunde ett samband mellan samhällets bemötande och återanpassningsstrategierna utrönas. Ju mer negativt bemötandet är desto fler återanpassningsstrategier behövs och arbetet för att uppnå dem blir mer krävande. Givet blir då att ett bemötande som fyllts av uppmuntran till individens förändring medför att färre strategier behövs och risken för återfall blir mindre.