Sarcoidosis como causa de fiebre de origen desconocido: reporte de caso.
Introducción: en el enfoque de los pacientes con fiebre de origen desconocido es importante tener en cuenta las etiologías inflamatorias no infecciosas, entre ellas enfermedades del tejido conectivo, vasculitis y granulomatosas. La sarcoidosis es inflamatoria, idiopática, crónica, multisistémica, granulomatosa y es una causa de fiebre de origen desconocido. Presentación del caso: se presenta el caso de un paciente con fiebre y manifestaciones cutáneas sugestivas de endocarditis y lesiones nodulares dolorosas en la región pretibial. Se descartó esta etiología por ecocardiografía transesofágica, con hemocultivos negativos y sin claro foco infeccioso ni respuesta a antibióticos de amplio espectro. Se le realizó una tomografía por emisión de positrones con evidencia de adenopatías en ambos hilios pulmonares y una biopsia de piel que evidenció granulomas sin necrosis, sin vasculitis, paniculitis con infiltrado septal. Conclusiones: por un cuadro clínico sugestivo y hallazgos radiológicos, se sospechó de sarcoidosis y se inició su manejo con posterior resolución del cuadro.
Compartir este contenido
Sarcoidosis como causa de fiebre de origen desconocido: reporte de caso.
Copia el enlace o compártelo en redes sociales
Factores socioafectivos y su influencia en la actividad sexual de adolescentes
Considering the increasing popularity of Social Media Marketing, strategists have begun to explore the ability of Brand Communities to enhance consumers’ emotional bonds and develop, in turn, higher levels of brand loyalty, trust, brand reputation and positive word-of-mouth. For this reason, the arising of Brand Love as a managerial construct seems to be deeply involved with the online consumer behaviour patterns within Brand Communities. In order to uncover the relationship between both phenomena, a quantitative empirical research was conducted on the basis of and online survey with 251 respondents.
The result of be-varied correlation analysis showed that social media based brand communities can directly influence the creation of positive emotional connection with the brand, as a constitutive component of Brand Love prototype. Furthermore, related analyses were run to determine the moderating effect of the level of participation within the brand community in the model’s overall performance. Finally, implications for marketing strategy and recommendation for further research are presented to conclude the investigation.
Compartir este contenido
Social media lovers in Colombia: the role of online brand communities in developing brand love
Copia el enlace o compártelo en redes sociales
El problema etiológico de los delirios psicóticos en la neuropsiquiatría actual
This dissertation project assesses the possibility of Colombia becoming an annex I country before 2020. This assessment assumes that the country will eventually have to define the year during which it will be required to start reducing its GHG emissions and by what amount. This project aims to answer the following questions; in which year Colombia should assume a GHG reductions cap? And how much GHG emissions should Colombia reduce?
These two questions were answered by first projecting the growth of future emissions of the country based on economic parameters, population growth and energy consumption and secondly by calculating the cost of undertaking the GHG reductions to meet the target. Three separate analyses were performed in order to answer those questions; first a comparative analysis of the country’s conditions when the protocol was signed, second the concept of the Environmental Kunznets Curve was used and confronted with the available Colombian data and third it was necessary to project when Colombia will be responsible for percent of the world’s emission.
The results showed that at least until the year 2020 Colombia will not be responsible for a share bigger than one percent of the world emissions; neither will it reach the peak of the EKC and lastly Colombia will not become a higher middle income country anytime before the year 2020. The main conclusion obtained in this dissertation is that Colombia should not undertake any GHG reduction targets under the continuation of the Kyoto protocol before the year 2020.
Compartir este contenido
Determining a GHG emission cap for Colombia under a continuation of the Kyoto protocol = Determinación de un nivel máximo de emisiones de GEI para Colombia bajo una continuación del protocolo de Kioto
Copia el enlace o compártelo en redes sociales
Protocolo de atención a usuarios/as/es trans del Servicio de Salud Talcahuano: características y relevancia
This paper is concerned with four aspects in the implementation of Article VI on domestic regulation in the General Agreement on Trade in Services (GATS). First, the need to reach a better understanding of the scope of the GATS existing disciplines, particularly, the national treatment and the transparency rule. Secondly, the feasibility of the necessity test to reach the Article VI objectives.
Third, the assessment of the international standard’s role in the facilitation of the trade. Fourth, the desirability to evaluate the sectoral testing exercises to determine whether the principles and disciplines developed are relevant and adaptable to other sectors. For GATS domestic regulation development, the mentioned factors are crucial accompaniment to future liberalization of services trade and to fulfil Article VI mandate. Whether this progress can be achieved within a time frame consistent with the duration of the current negotiations remains to be seen.
Compartir este contenido
Regulación Domestica en el ACGS: Algunos aspectos a futuro = Domestic Regulation in GATS: Some aspects from a prospective view
Copia el enlace o compártelo en redes sociales
Caracterización y factores de riesgo de caídas en un hospital de alta complejidad de Bogotá (Colombia)
Introducción
Las caídas intrahospitalarias están dentro de las prioridades nacionales e internacionales en cuanto a calidad asistencial. Aunque se reconocen elementos intrínsecos y extrínsecos al paciente con la presencia de caídas, en Colombia existe poca evidencia al respecto. El objetivo es caracterizar las caídas de pacientes ocurridas entre el 2013 y 2016, y sus factores asociados en un hospital de alta complejidad de Bogotá, Colombia.
Materiales y métodos
Estudio observacional retrospectivo basado en el registro de caídas que ocurrieron en el periodo de análisis en un hospital de alta complejidad de Bogotá, Colombia. Se utilizó estadística descriptiva y análisis de regresión logística binaria.
Resultados
De 951 caídas que ocurrieron entre el 2013 y 2016, el 63,1% se clasificaron como eventos adversos. Según la gravedad, el 54,2% fueron “moderados” y “severos”. De la muestra de pacientes, el 53,0% fueron hombres, el 65,5% tenía 65 o más años (mediana=71 años, mínimo=16 años, máximo=98 años), el 23,2% tenían enfermedad del sistema circulatorio. Se asoció con un mayor riesgo para una caída que culmina en evento adverso: ser mujer (IC95%OR=1,08–1,87), el turno laboral noche (IC95%=1,09-2,03) y las especialidades clínicas (IC95%=1,36-4,84) y quirúrgicas (IC95%=1,14-4,46).
Conclusión
Las caídas de pacientes son un evento adverso importante de intervenir en las instituciones hospitalarias. Se identificaron elementos intrínsecos, principalmente la edad, y extrínsecos, el turno laboral y la especialidad médica, relacionados con la probabilidad de generar un daño en el paciente ante una caída.
Compartir este contenido
Caracterización y factores de riesgo de caídas en un hospital de alta complejidad de Bogotá (Colombia)
Copia el enlace o compártelo en redes sociales
By giving our back to the River we cannot find our city’s future: planning for the future or the future demanding for planning? A case study of decision making around Parque del Río Medellín
The shift from government to governance has committed its goal to realize a more inclusive and plural way to govern contemporary societies. It has allowed the different actors to interrelate themselves in decision-making processes around strategic metropolitan projects. Citizen participation is also increasingly playing a role in the planning domain, as the traditional role of government as the main decision-maker, becomes challenged or accompanied by new and emerging participatory structures.
The recent literature on governance in the Latin American metropolitan context is just developing, as the term first appeared in the region in the 1990s. Although the region is advancing into the consolidation of governance structures, the metropolitan institutional framework is still deficient in the region for its short-lived background in democracy. By delving the context of the Aburrá Valley in Colombia, the present thesis is based on a single case study investigation which uses two frameworks: governance and citizen participation.
The thesis aims to answer the question: How have the different actors been interrelated in the decision-making process of Parque del Río Medellín and what were the policy outcomes? Parque del Río Medellín is a project that not only aims to enhance the deficit of public space in the city and improve mobility and quality of life conditions for its inhabit-ants, but also to challenge the current land use model which has saturated to an almost un-sustainable point the slopes of the valley.
The results of the investigation achieved through elite semi-structured interviews, show that public sector actors deploy enormous amounts of resources and decision-making capacity, while civil society actors mildly influence the decision-making process. On the other hand, the role of citizen participation around the project resembles classic ‘tokenism’ or symbolic participation achieved through ‘imaginary workshops’, ‘socializations’ or round tables. Finally, the investigation reveals the role of the municipal mayor and his ‘political’ will is crucial to understand the present and future a project, that while is strategic, paradoxically receives scarce attention on behalf of the citi-zens or other civil society actors.
Compartir este contenido
By giving our back to the River we cannot find our city’s future: planning for the future or the future demanding for planning? A case study of decision making around Parque del Río Medellín
Copia el enlace o compártelo en redes sociales
SEBEL value stream mapping analysis = SEBEL análisis del mapa de la cadena de valor
A feasibility study of one of the most complex and representative core products of Sebel Furniture (a well known furniture manufacturing company, based in Sydney, Australia) by comparing its current operations in a centralized model, to a future state in a de-centralized logistics model. The method for doing this was Value Stream Mapping, a Lean manufacturing methodology to identify non-value-added activities along the processes, and reduce Lead Time (LT) and costs by removing those wastes.
It is important to mention that, although most of the information in this report corresponded to real data, some assumptions were made, given constraints such as time and the fact that, by the time this report was written, the company was yet working on some of the projections for the future business model. Through the development of the project, Value Stream Maps (VSM) for the family product Postura Plus Shell range were documented on its centralized and de- centralized logistics, main wastes and non-value-added activities were identified, as well as considerations for improvement were raised.
This report also shows a basic simulation model of how the VSM would looks like in an improved state, and how each scenario differs from the others. Results showed risks of the future decentralized logistic model of the company regarding complexity of operations planning and inventory management, as well as it describes how successful could it be in terms of a shorter lead time, if an action plan were implemented.
Compartir este contenido
SEBEL value stream mapping analysis = SEBEL análisis del mapa de la cadena de valor
Copia el enlace o compártelo en redes sociales
Niche appliaction development for space based solar power = Desarrollo de aplicaciones de nicho para energía solar desde el espacio
The results of this report indicate how niche product developments for Space Based Solar Power (SBSP) can be easily achieved using present day technology, which markets need to be addressed, which niche configurations to pursue, and which organizations have the needed competencies to proceed. Classical SBSP concepts generally call for large rigid systems to be placed in orbit to collect and transmit several GW of energy down to Earth’s commercial electricity grid, and are still faced with many problems including system complexity, development, and costs. Smaller more specific niche applications of these concepts focus on different markets with lower complexity and barriers to entry while developing technologies and infrastructure needed for the classical SBSP.
Technical research was performed in order to identify potential system configurations as well as crucial competencies and technologies needed by the SBSP effort. A pair of unique technical configurations was proposed in an attempt to mitigate standard SBSP challenges such as construction, rigidity, and launch costs. A strategic evaluation tool was created to evaluate all potential system configurations in terms of risk and complexity; ideal configurations were chosen based on anticipated markets and the results from the strategic analysis.
Market research was performed in order to understand and valuate the utility of different niche configurations; these included the scientific, remote, green, space to space, and military markets. Very high value segments were observed in each of these market areas with a range of $0.37 to $1.88 USD per kwh for Terrestrial applications, and a range of $380.00 to $1200.00 per kwh for space applications. Exploration of the European Carbon Trading Exchange as a source of revenue is explored due to CO2 offsets. A unique satellite product is proposed and valuated which receives energy directly from an external on orbit source. The value of restoring functionality to damaged satellites is estimated in the millions of dollars.
Compartir este contenido
Niche appliaction development for space based solar power = Desarrollo de aplicaciones de nicho para energía solar desde el espacio
Copia el enlace o compártelo en redes sociales
Sustainable Transportation in Al-Buraimi (Sultanate of Oman), Analysis and concepts for the city of Al-Buraimi = Transporte Sostenible en Al Buraimi (Sultanato de Omán), Análisis y conceptos para la ciudad de Al Buraimi
The city of Al Buraimi, located in the northwest of the Sultanate of Oman, has experienced rapid urban growth characterized by patchy and unsustainable development over the last years. As a result of this process, the city is facing challenges in different dimensions of the urban structure. One of these problems is transportation, which is automobile dependent and road based.
Additionally, Al Buraimi presents segregated land use patterns, low densities, reduced travel choices, considerable occupation of land for car facilities and high accidents rates, amongst other issues. Thus the increasing transportation needs may lead to social, environmental and economic problems. Additionally, the transportation planning process is characterized by a lack of coordination among institutions and shortage of vision.
Car dependency can be attributed to different factors; firstly, the national transportation policy and legal framework are focused on roads development. Secondly, prices of cars and oil are relatively affordable in the Sultanate, and there is a car culture based on foreign automobile models.
Furthermore, the current strong top down approach does not facilitate the instruments necessary to implement a sustainable mode of transportation. A more balanced transportation system, achieved via a more holistically coordinated and inclusive planning approach would provide many benefits to the city.
This thesis has the aim of analyzing the current transportation system in Al Buraimi. Afterwards, this study intends to provide proposals which are based on criteria and concepts to adapt toward a more balanced/sustainable transportation system in Al Buraimi.
Compartir este contenido
Sustainable Transportation in Al-Buraimi (Sultanate of Oman), Analysis and concepts for the city of Al-Buraimi = Transporte Sostenible en Al Buraimi (Sultanato de Omán), Análisis y conceptos para la ciudad de Al Buraimi
Copia el enlace o compártelo en redes sociales
Applicability of the passivhaus standard for social housing in urban tropical climates (Colombia)
The Passivhaus Standard is a construction concept based on affordably achieving the best indoor conditions with the lowest energy demand. If adopted, it could contribute to fulfil the lack of regulations in energy and comfort performance in Colombian dwellings that the current sustainability laws mandate. The Standard has been applied in warm regions mostly throughout the Mediterranean.This work intended to study its applicability for social housing in tropical climates, specifically four Colombian cities with different average energy demands and number of occupants per household and diverse climatic conditions.
The work identified and described a reference building based on an average ‘good practice’ social housing project product of the current Building Regulations. It was modelled in the Passivhaus Planning Package (PHPP) to analyse its performance in the four cities. The results showed that the thermal performance of the building envelope is better than expected due to favourable climatic conditions in most of the cities, although it needs improvements. Even if primary energy demand is lower in the four cities than the maximum allowed by the Standard, it would be considerably high for dwellings without mechanical heating or cooling.
The improved models showed that adopting passive strategies according to local climates reduced daily temperature swings and increased indoor comfort. Applying energy efficiency measures such as solar thermal DHW and more efficient fridges and lighting decreased primary energy demand significantly to less than a half of the maximum allowed. The Standard would be applicable in tropical climates even within the budget limitations for social housing in Colombia, although not exactly in the same way as in central Europe. Local circumstances and passive strategies must be taken into account to feasibly achieve the Passivhaus Standard in Colombian social housing.
Compartir este contenido
Applicability of the passivhaus standard for social housing in urban tropical climates (Colombia)