Factores asociados a complicaciones post quirúrgicas en pacientes adultos con obstrucción intestinal mecánica en Bogotá, Colombia, período 2008 - 2014

Introducción: La obstrucción intestinal es una patología de alta prevalencia e impacto en los servicios de cirugía general a nivel mundial. El manejo de esta entidad puede ser médico o quirúrgico. Cuando se requiere intervención quirúrgica, se busca evitar el desarrollo de isquemia intestinal y resecciones intestinales; durante el postoperatorio, pueden existir complicaciones. El objetivo de este estudio es identificar los factores asociados al desarrollo de complicaciones post operatorias en un grupo de pacientes con obstrucción intestinal mecánica llevados a manejo quirúrgico. Metodología: Estudio analítico tipo casos y controles en un grupo de pacientes con diagnóstico de obstrucción intestinal mecánica llevados a manejo quirúrgico de su patología. Los casos corresponden a los pacientes con complicaciones postoperatorias y los controles aquellos que no presentaron complicaciones. Se identificaron factores asociados a complicación post operatoria mediante modelos estadísticos bivariados y multivariados de regresión logística para factores como edad, sexo, antecedente quirúrgico, presentación clínica, paraclínica y diagnóstico postoperatorio de malignidad, entre otras. Resultados: Se identificaron un total de 138 pacientes (54 casos y 129 controles). Los rangos de edad entre 55-66 años y mayor de 66 años fueron asociados con complicaciones postoperatorias (OR 3,87 IC95% 1,58-9,50 y OR 3,62 IC95% 1,45-9,08 respectivamente). El déficit de base inferior a 5 mEq/litro se relaciona con complicaciones postoperatorias (OR 2,64 IC95% 1.33-5,25) Otras pruebas de laboratorio, características radiológicas, hallazgos de malignidad en el postoperatorio y la evolución de los pacientes no fueron asociados con complicaciones. Conclusiones: Las disminución de las complicaciones durante el manejo quirúrgico de obstrucción intestinal mecánica continúa siendo un reto para la cirugía general. Factores no modificables como edad avanzada y modificables como el equilibrio ácido base deben ser tenidos en cuenta dada su correlación en el desarrollo de complicaciones postoperatorias.

Implementación de programas de cooperación internacional en el área de la empleabilidad de los jóvenes y su inseción laboral en América Latina, programa "Entra 21" Colombia y Chile periodo 2001-2007

INTRODUCCIÓN La presente Monografía pretende describir la participación de la Cooperación Internacional en los programas de Inserción Laboral Juvenil en América Latina, se hará una focalización especifica en el Programa Entra 21 creado por la International Youth Fundation y financiado por el Banco Interamericano de Desarrollo, el cual fue implementado para dar apoyo a 17 países de América Latina con el fin de aportar a la inserción laboral de más de 18 mil jóvenes. Los objetivos del presente trabajo son en primer lugar describir la situación laboral y educativa de los jóvenes y su inserción laboral en Colombia y Chile; posteriormente se hará una descripción de la importancia de los Programas de Cooperación internacional en la inserción laboral juvenil en Colombia y Chile, se realizara una descripción de la estrategia y el impacto del programa Entra 21 en Colombia y Chile periodo 2001 -2007, así mismo se realizará un análisis en base en la teoría sobre Desarrollo a Escala Humana por Manfred Max Neef tomando sus principales apartados y postulaciones para fines de esta investigación.

Calificando el desempeño institucional: índices internacionales y su descripción de Colombia

El presente documento busca hacer un recuento del surgimiento y utilización de los índices internacionales como un mecanismo para evaluar la eficiencia institucional de los países. Durante la década de los noventa, organismos internacionales, centros académicos y organizaciones no gubernamentales coincidieron en el interés de elaborar índices de desempeño con el fin de caracterizar los países y establecer escalas internacionales comparativas de desempeño. En esta perspectiva, surgen algunos temas de interés como la gobernabilidad, la competitividad, la corrupción y el estado de las libertades civiles y políticas. En este sentido, el documento da una explicación de las razones académicas y coyunturales para el surgimiento de los índices y los temas de interés en calificar. Luego, hace una descripción de los índices de competitividad, gobernabilidad, corrupción y libertades económicas y políticas; se explica su metodología y establece las convergencias y divergencias entre índices del mismo tema. También presenta una revisión de la literatura nacional e internacional sobre los índices. Por último, se presenta el desempeño del país de acuerdo con las escalas internacionales. Al final concluimos que los índices internacionales han permitido una revisión comparada del desempeño institucional. Sin embargo, por problemas de acceso a la información y existencia de estadísticas, estos índices aún son prematuros para permitir una comparación real y objetiva entre los distintos países.

Utilização de modelos farmacocinéticos de base fisiológica no desenvolvimento de novos fármacos

Nas últimas décadas tem-se verificado um aumento bastante acentuado da utilização de modelos in vitro e in silico para a obtenção de dados que permitem aumentar a eficácia de programas de desenvolvimento de novos fármacos. Actualmente são utilizados dois tipos de modelos para descrever a farmacocinética de compostos químicos em função do tempo: modelos empíricos farmacocinéticos e modelos farmacocinéticos baseados na fisiologia (PBPK). Modelos PBPK assumem que o corpo humano interage com os compostos químicos como um sistema integrado, pelo que um evento que ocorre numa zona do corpo poderá influenciar um evento a ocorrer noutra zona, aparentemente distinta. Estes modelos assumem que o organismo humano é constituído por “compartimentos” que representam fisiologicamente os órgãos, tecidos e outros espaços fisiológicos. Para a correcta utilização destes modelos é necessário determinar a estrutura do modelo e as suas características, escrever equações que o caracterizem, bem como definir e estimar os parâmetros deste. Estes modelos têm vindo a ser usados no campo toxicológico e farmacêutico cada vez com maior frequência. No futuro poder-se-ão transformar numa ferramenta universal.

Surveillance and data retention in Poland

The object of analysis in the present text is the issue of operational control and data retention in Poland. The analysis of this issue follows from a critical stance taken by NGOs and state institutions on the scope of operational control wielded by the Polish police and special services – it concerns, in particular, the employment of “itemized phone bills and the so-called phone tapping.” Besides the quantitative analysis of operational control and the scope of data retention, the text features the conclusions of the Human Rights Defender referred to the Constitutional Tribunal in 2011. It must be noted that the main problems concerned with the employment of operational control and data retention are caused by: (1) a lack of specification of technical means which can be used by individual services; (2) a lack of specification of what kind of information and evidence is in question; (3) an open catalogue of information and evidence which can be clandestinely acquired in an operational mode. Furthermore, with regard to the access granted to teleinformation data by the Telecommunications Act, attention should be drawn to a wide array of data submitted to particular services. Also, the text draws on the so-called open interviews conducted mainly with former police officers with a view to pointing to some non-formal reasons for “phone tapping” in Poland. This comes in the form of a summary.

Teoría de la interpretación y legitimidad del Tribunal Constitucional (Tema Central)

En este artículo se reflexiona acerca de la posibilidad de establecer la existencia, en la actividad hermenéutica de los Tribunales Constitucionales, de unas directrices o guías interpretativas que una vez especificadas puedan ser utilizadas como parámetro para controlar la juridicidad de la reconducción de la vida constitucional efectiva a las reglas de la Constitución. Todo ello pasando, en primer lugar, por el estudio de dos problemáticas: el papel de la jurisprudencia en el sistema de fuentes y los criterios de interpretación como instrumentos aptos para impedir o facilitar que dicha jurisprudencia pueda ser considerada fuente del Derecho, y, en segundo lugar, de los diferentes instrumentos hermenéuticos que se configuran como enlace entre disposición y norma y sus resultados interpretativos. Todo para llegar a demostrar que la utilización de los diferentes criterios de interpretación no puede ser evaluada por medio de un parámetro externo, como el de la teoría dogmática de la interpretación, sino que ellos se controlan por sí mismos, es decir, que el único control posible es un control de coherencia de su aplicación.

Seed survival in Chilean Nothofagus in response to desiccation and storage

Nothofagus alpina, N. obliqua, N. glauca, N. leonii, N. dombeyi and N. pumilio seeds exhibited consistent, albeit slight, sensitivity to extreme desiccation, but nevertheless maintained viability at low moisture contents and cool temperatures (-10 degrees to -20 degrees C) over 2 years. Nothofagus alpina, N. obliqua, N. glauca, N. leonii and N. dombeyi conformed to the seed viability equation of Ellis and Roberts; sensitivity of longevity to temperature was quantitatively similar to that of crop seeds, sensitivity to moisture was somewhat less, and a low-moisture-content limit to the equation was detected at 4.8% moisture content in hermetic storage at 65 degrees C, and possibly similar moisture contents at 30-40 degrees C. These five species show orthodox seed storage behaviour. Therefore, ex-situ conservation of these Nothofagus species in seed banks is possible, but the quality of seed lots collected requires attention. Seed storage behaviour was not defined in N. pumilio: initial seed quality was poor and loss of viability was detected over 2 years at 0 degrees, -10 degrees and -20 degrees C at 2.7% moisture content, but not at 5.2%. The results confirm that the economy of nature in seed storage physiology extends to forest tree seeds, but the repeated observation of reduced sensitivity of longevity to moisture in forest tree seeds requires further investigation.

Mixed Logit Model Performance and Distributional Assumptions: Preferences and GM foods

Using mixed logit models to analyse choice data is common but requires ex ante specification of the functional forms of preference distributions. We make the case for greater use of bounded functional forms and propose the use of the Marginal Likelihood, calculated using Bayesian techniques, as a single measure of model performance across non nested mixed logit specifications. Using this measure leads to very different rankings of model specifications compared to alternative rule of thumb measures. The approach is illustrated using data from a choice experiment regarding GM food types which provides insights regarding the recent WTO dispute between the EU and the US, Canada and Argentina and whether labelling and trade regimes should be based on the production process or product composition.

T testing the immune system

Amid the flurry of grant writing and experimentation, statistical analysis sometimes gets less attention than it requires. Here, we describe fully the considerations that should go into the employment of the statistical two-sample t test.

A novel scheme for human-friendly and time-delays robust neuropredictive teleoperation

A novel Neuropredictive Teleoperation (NPT) Scheme is presented. The design results from two key ideas: the exploitation of the measured or estimated neural input to the human arm or its electromyograph (EMG) as the system input and the employment of a predictor of the arm movement, based on this neural signal and an arm model, to compensate for time delays in the system. Although a multitude of such models, as well as measuring devices for the neural signals and the EMG, have been proposed, current telemanipulator research has only been considering highly simplified arm models. In the present design, the bilateral constraint that the master and slave are simultaneously compliant to each other's state (equal positions and forces) is abandoned, thus obtaining a simple to analyzesuccession of only locally controlled modules, and a robustness to time delays of up to 500 ms. The proposed designs were inspired by well established physiological evidence that the brain, rather than controlling the movement on-line, programs the arm with an action plan of a complete movement, which is then executed largely in open loop, regulated only by local reflex loops. As a model of the human arm the well-established Stark model is employed, whose mathematical representation is modified to make it suitable for an engineering application. The proposed scheme is however valid for any arm model. BIBO-stability and passivity results for a variety of local control laws are reported. Simulation results and comparisons with traditional designs also highlight the advantages of the proposed design.

Dietary monounsaturated fatty acids and haemostasis

Diets high in monounsaturated fatty acids (MUFA) are increasingly being recommended as a highly-effective cholesterol-lowering strategy in populations at risk of CHD. However, the need for a re-appraisal of the benefits of diets rich in MUFA became apparent as a result of recent studies showing that meals high in olive oil cause greater postprandial activation of blood coagulation factor VII than meals rich in saturated fatty acids. The present review evaluates the evidence for the effects of MUFA-rich diets on fasting and postprandial measurements of haemostasis, and describes data from a recently-completed long-term controlled dietary intervention study. The data show that a background diet high in MUFA has no adverse effect on fasting haemostatic variables and decreases the postprandial activation of factor VII in response to a standard fat-containing meal. Since the same study also showed a significant reduction in the ex vivo activation of platelets in subjects on the high-MUFA diet, the overall findings suggest that there is no reason for concern regarding adverse haemostatic consequences of high-MUFA diets.

High resolution Northern Hemisphere wintertime mid-latitude dynamics during the Last Glacial Maximum

Hourly winter weather of the Last Glacial Maximum (LGM) is simulated using the Community Climate Model version 3 (CCM3) on a globally resolved T170 (75 km) grid. Results are compared to a longer LGM climatological run with the same boundary conditions and monthly saves. Hourly-scale animations are used to enhance interpretations. The purpose of the study is to explore whether additional insights into ice age conditions can be gleaned by going beyond the standard employment of monthly average model statistics to infer ice age weather and climate. Results for both LGM runs indicate a decrease in North Atlantic and increase in North Pacific cyclogenesis. Storm trajectories react to the mechanical forcing of the Laurentide Ice Sheet, with Pacific storms tracking over middle Alaska and northern Canada, terminating in the Labrador Sea. This result is coincident with other model results in also showing a significant reduction in Greenland wintertime precipitation – a response supported by ice core evidence. Higher-temporal resolution puts in sharper focus the close tracking of Pacific storms along the west coast of North America. This response is consistent with increased poleward heat transport in the LGM climatological run and could help explain “early” glacial warming inferred in this region from proxy climate records. Additional analyses shows a large increase in central Asian surface gustiness that support observational inferences that upper-level winds associated with Asian- Pacific storms transported Asian dust to Greenland during the LGM.

Metaphors in complexity theory and planning

This article reviews the use of complexity theory in planning theory using the theory of metaphors for theory transfer and theory construction. The introduction to the article presents the author's positioning of planning theory. The first section thereafter provides a general background of the trajectory of development of complexity theory and discusses the rationale of using the theory of metaphors for evaluating the use of complexity theory in planning. The second section introduces the workings of metaphors in general and theory-constructing metaphors in particular, drawing out an understanding of how to proceed with an evaluative approach towards an analysis of the use of complexity theory in planning. The third section presents two case studies – reviews of two articles – to illustrate how the framework might be employed. It then discusses the implications of the evaluation for the question ‘can complexity theory contribute to planning?’ The concluding section discusses the employment of the ‘theory of metaphors’ for evaluating theory transfer and draws out normative suggestions for engaging in theory transfer using the metaphorical route.

The Haptic Aesthetic in Samuel Beckett's Drama

In their sparse and isolated spaces, Samuel Beckett's figures imagine the touch of a lost love or dream of the comfort and care that the hands of a dear one might bring. Applying philosophical writings that feature sensation, particularly touch, this study examines how Beckett's later work for stage and screen dramatizes moments of contact between self and self, self and world, and self and other. With implications for how gender and ethics can be approached within Beckett's aesthetic, this study explores the employment of haptic imagery as an alternative to certain dominant codes of visual representation.

All for the good

The Guise of the Good thesis has received much attention since Anscombe's brief defence in her book Intention. I approach it here from a less common perspective - indirectly, via a theory explaining how it is that moral behaviour is even possible. After setting out how morality requires the employment of a fundamental test, I argue that moral behaviour involves orientation toward the good. Immoral behaviour cannot, however, involve orientation to evil as such, given the theory of evil as privation. There must always be orientation to good of some kind for immorality even to be possible. Evil can, nevertheless, be intended, but this must be carefully understood in terms of the metaphysic of good and evil I set out. Given that metaphysic, the Guise of the Good is a virtual corollary.