Las empresas sociales del estado y el derecho fundamental a la salud. Estudio de caso hospital simón bolívar E.S.E (2002-2014)

El presente trabajo busca hacer un análisis sobre los arreglos institucionales introducidos con la ley 100 de 1993 a las Empresas Sociales del Estado (ESE), y cómo estos han afectado la prestación del servicio de salud y la garantía del derecho; para lo cual se escoge como ejemplo el Hospital Simón Bolívar E.S.E de Bogotá durante los años 2002 a 2014. Se explica como con la implementación de la descentralización, el modelo de aseguramiento y la autonomía financiera se afectó la prestación del servicio de salud, teniendo en cuenta la introducción de un eslabón dentro del sistema de salud: las Empresas Promotoras de Salud (EPS).

Campañas electorales y acción legislativa en el senado: un análisis del comportamiento de los partidos políticos durante el año 2014

La presente investigación tiene como objetivo examinar la incidencia de las estrategias de campaña ejecutadas por los partidos políticos colombianos, sobre el comportamiento legislativo tomando como referencia las elecciones senatoriales del año 2014. De esta manera, sostiene que las organizaciones partidistas que demostraron una mayor cohesión al momento electoral, se comportaron de manera disciplinada en el Senado. Por ello, se exponen las distintas estrategias que aplicaron los partidos políticos que lograron una curul en el Senado, con el fin de determinar el grado de cohesión de cada uno de ellos, utilizando como marco los dilemas organizacionales a los que los partidos se ven expuestos. Luego, se relaciona con el trabajo legislativo que tuvo lugar en el primer periodo de la primera legislatura y, se finaliza, con un análisis de la reforma política contenida en el proyecto de equilibrio de poderes.

M??sica para todos : desarrollo de la m??sica en el curr??culo de alumnos con necesidades educativas especiales

Este manual es fruto de un trabajo de colaboraci??n del Servicio de Artes en la Educaci??n de Norfolk (Inglaterra) y una secci??n de los Servicios de Inspecci??n, Asesoramiento y Formaci??n de la administraci??n educativa local. Es un conjunto de programas de formaci??n permanente para dar respuesta a las necesidades de maestros que trabajan en escuelas de educaci??n especial en Norfolk, denominado Proyecto EASE (Educating in the Arts in Special Education)

Interventions to promote healthy eating habits: evaluation and recommendations

Although in several EU Member States many public interventions have been running for the prevention and/or management of obesity and other nutrition-related health conditions, few have yet been formally evaluated. The multidisciplinary team of the EATWELL project will gather benchmark data on healthy eating interventions in EU Member States and review existing information on the effectiveness of interventions using a three-stage procedure (i) Assessment of the intervention's impact on consumer attitudes, consumer behaviour and diets; (ii) The impact of the change in diets on obesity and health and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality-adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology and economics disciplines. Particular attention will be paid to lessons that can be learned from private sector that are transferable to the healthy eating campaigns in the public sector. Through consumer surveys and workshops with other stakeholders, EATWELL will assess the acceptability of the range of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one-stop guide to methods and measures in interventions evaluation, and outline data collection priorities for the future.

Assessment of evaluations made to healthy eating policies in Europe: a review within the EATWELL Project

Objective: To identify and assess healthy eating policies at national level which have been evaluated in terms of their impact on awareness of healthy eating, food consumption, health outcome or cost/benefit. Design: Review of policy documents and their evaluations when available. Setting: European Member States. Subjects: One hundred and twenty-one policy documents revised, 107 retained. Results: Of the 107 selected interventions, twenty-two had been evaluated for their impact on awareness or knowledge and twenty-seven for their impact on consumption. Furthermore sixteen interventions provided an evaluation of health impact, while three actions specifically measured any cost/benefit ratio. The indicators used in these evaluations were in most cases not comparable. Evaluation was more often found for public information campaigns, regulation of meals at schools/canteens and nutrition education programmes. Conclusions: The study highlights the need not only to develop harmonized and verifiable procedures but also indicators for measuring effectiveness and success and for comparing between interventions and countries. EU policies are recommended to provide a set of indicators that may be measured consistently and regularly in all countries. Furthermore, public information campaigns should be accompanied by other interventions, as evaluations may show an impact on awareness and intention, but rarely on consumption patterns and health outcome.

Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programme's Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete.

Des liaisons dangereuses? Réseaux donnés, réseaux supposés et réseaux déguisés d’une nonne vénitienne au XVIIe siècle

This article deals with Tarabotti's own family, her religious family within her nunnery and her ideal family, the so-called "République des lettres". Despite her permanent denial about her parents and siblings, she has ties with them all: she benifitted from her sister Camilla's and her mother's wills, she had a friendly relationship with one of her brothers-in-law, she took pity of her two sisters who remained spinsters. The same occurred with her religious family, where she developed close friendships with at least two of them. Moreover, her sisters in religion often belonged to patrician, well-off families and it is possible to argue that Tarabotti managed to expand her relationships with very important people via her sisters in religion. But the family she truly cherished, was her family d'election, the one she had been free to choose and to pursue: her literary family. However, this latter one was not a very recomandable family for a nun: therefore she kept silent with the most relevant elements of it, namely with the French priest and astronomer Ismael Boulliau who acted as the go-between for her last book, published abroad two years after her death. The article provides evidence to such connections, ties and knots, explaining at least in part Tarabotti's extraordinary success in life as a proto-feminist and political writer.

Determination of the absolute accuracy of UK chamber facilities used in measuring methane emissions from livestock

Respiration chambers are one of the primary sources of data on methane emissions from livestock. This paper describes the results from a coordinated set of chamber validation experiments which establishes the absolute accuracy of the methane emission rates measured by the chambers, and for the first time provides metrological traceability to international standards, assesses the impact of both analyser and chamber response times on measurement uncertainty and establishes direct comparability between measurements made across different facilities with a wide range of chamber designs. As a result of the validation exercise the estimated combined uncertainty associated with the overall capability across all facilities reduced from 25.7% (k = 2, 95% confidence) before the validation to 2.1% (k = 2, 95% confidence) when the validation results are applied to the facilities’ data.

Prediction of metabolisable energy concentrations of fresh cut grass using digestibility data measured with non-pregnant non-lactating cows

Pasture-based ruminant production systems are common in certain areas of the world, but energy evaluation in grazing cattle is performed with equations developed, in their majority, with sheep or cattle fed total mixed rations. The aim of the current study was to develop predictions of metabolisable energy (ME) concentrations in fresh-cut grass offered to non-pregnant non-lactating cows at maintenance energy level, which may be more suitable for grazing cattle. Data were collected from three digestibility trials performed over consecutive grazing seasons. In order to cover a range of commercial conditions and data availability in pasture-based systems, thirty-eight equations for the prediction of energy concentrations and ratios were developed. An internal validation was performed for all equations and also for existing predictions of grass ME. Prediction error for ME using nutrient digestibility was lowest when gross energy (GE) or organic matter digestibilities were used as sole predictors, while the addition of grass nutrient contents reduced the difference between predicted and actual values, and explained more variation. Addition of N, GE and diethyl ether extract (EE) contents improved accuracy when digestible organic matter in DM was the primary predictor. When digestible energy was the primary explanatory variable, prediction error was relatively low, but addition of water-soluble carbohydrates, EE and acid-detergent fibre contents of grass decreased prediction error. Equations developed in the current study showed lower prediction errors when compared with those of existing equations, and may thus allow for an improved prediction of ME in practice, which is critical for the sustainability of pasture-based systems.

Prediction of nutrient digestibility and energy concentrations in fresh grass using nutrient composition

Improved nutrient utilization efficiency is strongly related to enhanced economic performance and reduced environmental footprint of dairy farms. Pasture-based systems are widely used for dairy production in certain areas of the world, but prediction equations of fresh grass nutritive value (nutrient digestibility and energy concentrations) are limited. Equations to predict digestible energy (DE) and metabolizable energy (ME) used for grazing cattle have been either developed with cattle fed conserved forage and concentrate diets or sheep fed previously frozen grass, and the majority of them require measurements less commonly available to producers, such as nutrient digestibility. The aim of the present study was therefore to develop prediction equations more suitable to grazing cattle for nutrient digestibility and energy concentrations, which are routinely available at farm level by using grass nutrient contents as predictors. A study with 33 nonpregnant, nonlactating cows fed solely fresh-cut grass at maintenance energy level for 50 wk was carried out over 3 consecutive grazing seasons. Freshly harvested grass of 3 cuts (primary growth and first and second regrowth), 9 fertilizer input levels, and contrasting stage of maturity (3 to 9 wk after harvest) was used, thus ensuring a wide representation of nutritional quality. As a result, a large variation existed in digestibility of dry matter (0.642-0.900) and digestible organic matter in dry matter (0.636-0.851) and in concentrations of DE (11.8-16.7 MJ/kg of dry matter) and ME (9.0-14.1 MJ/kg of dry matter). Nutrient digestibilities and DE and ME concentrations were negatively related to grass neutral detergent fiber (NDF) and acid detergent fiber (ADF) contents but positively related to nitrogen (N), gross energy, and ether extract (EE) contents. For each predicted variable (nutrient digestibilities or energy concentrations), different combinations of predictors (grass chemical composition) were found to be significant and increase the explained variation. For example, relatively higher R(2) values were found for prediction of N digestibility using N and EE as predictors; gross-energy digestibility using EE, NDF, ADF, and ash; NDF, ADF, and organic matter digestibilities using N, water-soluble carbohydrates, EE, and NDF; digestible organic matter in dry matter using water-soluble carbohydrates, EE, NDF, and ADF; DE concentration using gross energy, EE, NDF, ADF, and ash; and ME concentration using N, EE, ADF, and ash. Equations presented may allow a relatively quick and easy prediction of grass quality and, hence, better grazing utilization on commercial and research farms, where nutrient composition falls within the range assessed in the current study.

Evaluating nitrogen utilization efficiency of nonpregnant dry cows offered solely fresh cut grass at maintenance levels

The present study aimed to identify key parameters influencing N utilization and develop prediction equations for manure N output (MN), feces N output (FN), and urine N output (UN). Data were obtained under a series of digestibility trials with nonpregnant dry cows fed fresh grass at maintenance level. Grass was cut from 8 different ryegrass swards measured from early to late maturity in 2007 and 2008 (2 primary growth, 3 first regrowth, and 3 second regrowth) and from 2 primary growth early maturity swards in 2009. Each grass was offered to a group of 4 cows and 2 groups were used in each of the 8 swards in 2007 and 2008 for daily measurements over 6 wk; the first group (first 3 wk) and the second group (last 3 wk) assessed early and late maturity grass, respectively. Average values of continuous 3-d data of N intake (NI) and output for individual cows ( = 464) and grass nutrient contents ( = 116) were used in the statistical analysis. Grass N content was positively related to GE and ME contents but negatively related to grass water-soluble carbohydrates (WSC), NDF, and ADF contents ( < 0.01), indicating that accounting for nutrient interrelations is a crucial aspect of N mitigation. Significantly greater ratios of UN:FN, UN:MN, and UN:NI were found with increased grass WSC contents and ratios of N:WSC, N:digestible OM in total DM (DOMD), and N:ME ( < 0.01). Greater NI, animal BW, and grass N contents and lower grass WSC, NDF, ADF, DOMD, and ME concentrations were significantly associated with greater MN, FN, and UN ( < 0.05). The present study highlighted that using grass lower in N and greater in fermentable energy in animals fed solely fresh grass at maintenance level can improve N utilization, reduce N outputs, and shift part of N excretion toward feces rather than urine. These outcomes are highly desirable in mitigation strategies to reduce nitrous oxide emissions from livestock. Equations predicting N output from BW and grass N content explained a similar amount of variability as using NI and grass chemical composition (excluding DOMD and ME), implying that parameters easily measurable in practice could be used for estimating N outputs. In a research environment, where grass DOMD and ME are likely to be available, their use to predict N outputs is highly recommended because they strongly improved of the equations in the current study.