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In contrast to the definition of metabolic syndrome (MetS) in adults, there is no standard definition of MetS in pediatric populations. We aimed to assess the differences in the prevalence of MetS in children and adolescents aged 9–17 years in the city of Bogota (Colombia) using four different operational definitions for these age groups and to examine the associated variables. A total of 673 children and 1,247 adolescents attending public schools in Bogota (54.4% girls; age range 9–17.9 years) were included. The prevalence of MetS was determined by the definitions provided by the International Diabetes Federation (IDF) and three published studies by Cook et al., de Ferranti et al., and Ford et al. The prevalence of MetS was 0.3%, 6.3%, 7.8%, and 11.0% according to the IDF, Cook et al., Ford et al., and de Ferranti et al. definitions, respectively. The most prevalent components were low high-density lipoprotein cholesterol and high triglyceride levels, whereas the least prevalent components were abdominal obesity and hyperglycemia. Overall, the prevalence of MetS was higher in obese than in non-obese schoolchildren. In conclusion, MetS diagnoses in schoolchildren strongly depend on the definition chosen. These findings may be relevant to health promotion efforts for Colombian youth to develop prospective studies and to define which cut-offs are the best indicators of future morbidity.

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El Estado colombiano tiene una capacidad de sanción que ha sido diseñada para ser ejercida por el presidente de la república. En algunas ocasiones gracias a la figura de la delegación se les entregan estas facultades de sanción a los gobernadores, los alcaldes de los distritos y los alcaldes de los municipios, quienes actúan como representantes legales de estas entidades territoriales que hasta la fecha son las únicas que existen en Colombia. El presente trabajo evaluará esa capacidad de sanción en un tema especifico como es el procedimiento sancionatorio de alimentos, procedimiento que es similar en su estructura legal en todas las entidades territoriales, pero que en su aplicación presenta características diferentes, estas diferencias permiten demostrar la hipótesis planteada que los procedimientos sancionatorios en alimentos en las entidades territoriales son débiles, no obstante contar con toda la facultad sancionadora delegada para ejercer esta actividad.

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Introducción: actualmente los trastornos músculo esqueléticos (TME) han sido reconocidos como la principal causa de morbilidad en el trabajo, dado el porcentaje de ausentismo laboral que representa, generando reducción en la productividad de las industrias. Una visión general de la prevalencia en TME puede conducir a métodos de prevención de morbilidad adecuados para cada tipo de proceso, y así proporcionar un ambiente más seguro y confortable. Objetivo: determinar la prevalencia de síntomas osteomusculares y su relación con factores individuales y laborales en personal de una empresa dedicada a prestar servicio de seguridad electrónica en Bogotá, en el 2013. Métodos: estudio de corte transversal, desarrollado a partir de fuentes de datos secundarios de una población de 199 trabajadores, con información sociodemográfica y síntomas osteomusculares en los distintos roles laborales (administrativo, soporte y de campo) de una empresa de servicios en seguridad electrónica. Se usaron métodos estadísticos para el cálculo de proporciones, se estimaron las prevalencias osteomusculares globales, realizando comparaciones por rol laboral. La revisión de la asociación entre factores sociodemográficos y laborales con síntomas de TME se hizo a través de la prueba Chi2 de asociación o prueba exacta de Fisher. Resultados: Los segmentos que mostraron la mayor frecuencia en morbilidad de TME fueron espalda, cuello, muñecas y manos. Se encontró asociación entre dolor de hombros y brazos con la edad, OR=0,54 (IC95%=0,30-0,95) y tiempo en el cargo, OR=1,855(IC 95%=1,043-3,297); entre dolor de cuello y edad OR=0,50 (IC95%=0,27-0,90) y entre dolor de muñecas y/o manos con tiempo en el cargo, OR=1,827(IC 95%=1,032-3,235). Conclusión: Se presenta morbilidad por TME en varios segmentos, derivados de factores (individuales y laborales), ratificando la importancia de hacer intervenciones integrales de control de riesgos para su prevención.

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The initial aim of the CareMan project was to develop a joint degree programme that combined and utilised the strengths of the five collaborating universities that were already involved in delivering social and health care management education. Because the project was to be implemented in collaboration between education- al institutions, the collaboration had to be based on a detailed understanding of the national and institutional specifics of each of the individual academic enti- ties. During this process it was recognised that, due to a number of regulation issues, achieving the original aim would not be possible; ultimately, following a series of analytical works, which are presented below, it was decided that a set of three master’s level modules should be developed. One of the reasons was that the Finnish law on master’s degrees at universities of applied sciences (UAS) stated that the requirement for entry to a UAS master’s programme was a bachelor degree from a UAS or equivalent, plus a minimum of three years of work experience in an appropriate field. The three years’ work experience is also required from international students. In practice this meant that the participating Finnish UASs, Lahti and HAMK, could not award a diploma for foreign students without this work experience. The other European universities do not have the work experience requirement, although some take it as a bonus for admission (FHS UK). There were also other differences in law (e.g., requirements for mini - mum standards in Social Work education at FHS UK) that could not have been overcome during the period of project realisation. Consequently, the outcome was the development of only three common educational modules, each for 10 ECTS, which were developed, delivered and assessed during the lifetime of the project. The intention was that these would be integrated into the current masters’ level provision in each of the universities

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The outcome of the inductive decision -making process of the leading project management group (PMG) was the proposal to develop three modules, Human Resource Management and Knowledge Management, Quality Management and Intercultural management, each for 10 ECTS credits. As a result of the theoretical and organisational framework and analytical phase of the project, four strategies informed the development and implemen- tation of the modules: 1. Collaboration as a principle stemming from EU collaborative policy and receiving it’s expression on all implementation levels (designing the modules, modes of learning, delivering the modules, evaluation process). 2. Building on the Bologna process masters level framework to assure ap- propriate academic level of outputs. 3. Development of value -based leadership of students through transforma- tional learning in a cross -cultural setting and continual reflection of theory in practice. 4. Continual evaluation and feedback among teachers and students as a strategy to achieve a high quality programme. In the first phase of designing the modules the collaborative strategy in particular was applied, as each module was led by one university, but members from all other universities participated in the discussions and development of the mod- ules. The Bologna process masters level framework and related standards and guidelines informed the form and method of designing the modules.

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This monograph outlines the process and results of development of a common educational programme at masters level in health and social care management, which was supported by the Erasmus Life Long Education project CareMan (Cul- ture and Care Management). The CareMan project brought together university partners actively involved in educating social and health care professionals in leadership and management at master’s level in Europe. The five partners of the consortium were Lahti University of Applied Sciences – Lahti UAS (administra- tive and academic coordinator, Finland), Charles University – CU (the Czech Republic), Edinburgh Napier University – ENU (Scotland), Hammeline University of Applied Sciences – HAMK (Finland), and University of Évora – UoE (Portugal). The objectives of the project were to achieve lower -level educational goals that included the development through education cultural and value -driven leadership, quality of care and quality management to effectively manage an integrated health and social care service. Through mapping the situation in the field and comparing curricula of all participating universities the overall aim was to develop a joint masters programme in social and healthcare management. After the detailed understanding of national and institutional specifics of each of the individual academic entities it was recognised that, due to a number of regulation issues, the original aim was not achievable. Following subsequent analytical work, it was decided to develop a set of three master’s level modules. At the end of the project it was intended that all created modules would be available virtually to the participating programmes and would contribute some added value to existing curricula. In the future these ready -to -use modules are intended to be taught in cooperation with the participating universities or as a separate module in each university. The chosen theoretical framework of the project that underpinned the devel- opment, management and evaluation of the inter -cultural educational provision relied on the combination of two learning theories – ‘cooperative collaborative and social learning’ and ’transformational’ (Mezirow, 2009). This theoretical framework helped to align with European collaborative policy and its application on all levels of implementation of the project.

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The purpose of this chapter is to enable registered health and social care prac - titioners to assume a clinical and/or a professional leadership role in quality management in the health and social care sectors. The contents in this chap - ter will strengthen the management competences of practitioners working in these sectors, including critical thinking, critical reflection, problem solving and decision -making, thus improving the quality in health and social care services.

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Globalization has increasingly brought permanent contact with people whose cultural background is different from what many would consider their ‘own’ culture. The area of intercultural management is of critical interest due to the impact of increased European and global migration, which has required health and social care leaders and managers to develop competency to respond to the diversity and changing needs of their workforce and service users. The communities within the European Union are now often characterised by significant diversity whether at cultural, social, or psychological levels. The purpose of this chapter is to enable health and social care practitioners to assume a clinical/ professional leadership role in quality intercultural management in the health and social care sector. This chapter will focus on developing health and social care practitioners’ knowledge and understanding in the area of intercultural management within contemporary health and social care organisations. It will focus on the critical application of knowledge to practice through the provision of underpinning knowledge, understanding and debates surrounding contemporary issues and practices in the areas of intercultural management. Many practitioners accessing this information may already work in the heath/social sector and this critical focus on intercultural and diversity management has the potential to improve the quality in health and social care services through the critical application to practice.

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Recibido 27 de julio de 2010 • Aceptado 31 de agosto de 2010 • Corregido 25 de noviembre de 2010  En el siglo XXI crece el interés por elevar la calidad de los sistemas educativos, lo que plantea la urgencia de profesionalizar el rol del docente, mientras se hace patente la necesidad de una superación apoyada en la autogestión del aprendizaje, por lo que se requiere que estas actividades constituyan modelos de la práctica pedagógica. Partiendo de los presupuestos que enfatizan el cambio hacia acciones de superación por consenso y no directivas, como generalmente se ha hecho, y desde el enfoque histórico cultural, es que se introduce un visón de la superación profesional del enfermero, el cual trasciende la trasmisión de conocimientos, hacia un desarrollo de sus necesidades educativas diagnosticadas.