Alianzas públicas, privadas y público-privadas para implementar Una Salud como acción contra la resistencia antimicrobiana en Colombia

[RESUMEN]. En este artículo se describe la importancia de las alianzas públicas y las alianzas privadas (APP) y de la articulación público-privada para hacer frente a la resistencia antimicrobiana (RAM) mediante el enfoque Una Salud. Estas alianzas se tejen entre actores gubernamentales, empresas privadas y organizaciones sociales para la construcción de agendas, la toma de decisiones y la gestión de proyectos de interés común. Se presenta un estudio de caso de Colombia, en el que se describen ejemplos del sector público ante la alerta de resistencia a la colistina que la Organización Mundial de la Salud (OMS) informó en el 2016, los sectores productores de proteína animal bajo una alianza intergremial para el uso racional de los antimicrobianos y, por último, una alianza público-privada del sector porcícola con instituciones gubernamentales y cooperación internacional para lograr la implementación de acciones que mitiguen el riesgo de RAM. En Colombia, el establecimiento de alianzas con las organizaciones que representan a los sectores de productores agropecuarios ha generado acciones de impacto, como estrechar canales de comunicación permanente entre el sector público y el privado, caracterizar las condiciones de la cadena de producción agropecuaria, establecer mecanismos de consulta y validación de las políticas de salud en RAM, obtener una línea base de patógenos indicado- res e identificación de los posibles flujos de propagación de RAM y, por último, lograr la transferencia de conocimiento y construcción de capacidades con expertos nacionales e internacionales, con acciones de concienciación de la problemática y su impacto en la salud pública. El modelo estratégico desarrollado en Colombia en colaboración público-privada puede inspirar a otros países de bajos y medianos ingresos para obtener resultados, con la optimización de recursos, que contribuyan al plan nacional de mitigación de la RAM.

[ABSTRACT]. This article describes the importance of public-private partnerships (PPPs) and public-private coordination to address antimicrobial resistance (AMR) through the One Health approach. These partnerships are developed between governmental actors, private companies, and social organizations to build agendas, decision- making, and the management of projects of common interest. A case study from Colombia is presented. It describes examples of response from the public sector when the World Health Organization (WHO) reported a colistin resistance alert in 2016; from the animal protein production sector under an industry partnership for the rational use of antimicrobials; and, finally, from a public-private partnership in the swine sector, with governmental institutions and international cooperation, to take action to mitigate the risk of AMR. In Colombia, the establishment of partnerships with organizations representing agricultural producers has generated impactful actions such as strengthening ongoing communication channels between the public and private sectors; characterizing the conditions of the agricultural production chain; establishing mechanisms for consultation and validation of health policies related to AMR; obtaining a baseline of indicator pathogens and identification of possible flows of AMR spread; and, finally, achieving knowledge transfer and capacity- building with national and international experts, with actions to raise awareness about the problem of AMR and its impact on public health. The strategic model developed in Colombia through public-private collaboration can inspire other low- and middle-income countries to optimize their use of resources to obtain results that contribute to the national AMR mitigation plan.

[RESUMO]. Este artigo descreve a importância das parcerias públicas e das parcerias privadas (PPP) e da articulação público-privada no enfrentamento da resistência a antimicrobianos (RAM) utilizando a abordagem de Saúde Única. Essas parcerias são formadas entre atores governamentais, empresas privadas e organizações sociais para elaborar agendas, tomar decisões e gerir projetos de interesse comum. Este artigo apresenta um estudo de caso da Colômbia, no qual são apresentados exemplos do setor público diante do alerta de resistência à colistina emitido pela Organização Mundial da Saúde (OMS) em 2016, a formação de uma aliança intersetorial pelos setores de produção de proteína animal para promover o uso racional de antimicrobianos e, por último, a formação de uma parceria público-privada composta pelo setor suinícola e por instituições governamentais e cooperação internacional para que a implementação de medidas de mitigação do risco de RAM. Na Colômbia, a criação de parcerias com organizações representantes dos setores de produção agropecuária geraram ações de impacto, como o fortalecimento de canais permanentes de comunicação entre os setores público e privado, a caracterização das condições da cadeia de produção agropecuária, o estabelecimento de mecanismos de consulta e validação das políticas de saúde voltadas para a RAM, a obtenção de uma linha de base de patógenos indicadores e identificação de possíveis fluxos de propagação de RAM e, por fim, a transferência de conhecimentos e capacitação envolvendo especialistas nacionais e internacionais, com ações de conscientização sobre o problema e seu impacto na saúde pública. O modelo estratégico desenvolvido na Colômbia por meio da colaboração público-privada pode inspirar outros países de baixa e média renda a obter resultados, pela otimização de recursos, que contribuam para o plano nacional de mitigação da RAM.

Evidencia epidemiológica acerca del rol de la hostelería en la transmisión de la COVID-19: una revisión rápida de la literatura / Epidemiologic evidence on the role of hospitality venues in the transmission of COVID-19: a rapid review of the literature

Objetivo: Revisar la literatura científica disponible para resumir la evidencia epidemiológica al respecto del impacto de la hostelería en la incidencia y la mortalidad de la COVID-19. Método: Se incluyeron estudios en cualquier población, que describieran tanto el impacto del cierre o la reapertura de la hostelería como la exposición a negocios de hostelería sobre la incidencia y la mortalidad de la COVID-19. Se empleó el método de búsqueda en bola de nieve, con búsqueda retrospectiva y prospectiva de citas y cocitaciones. Resultados: Se encontraron 20 estudios que investigaron el papel de la hostelería en la epidemiología de la COVID-19. Los estudios de modelaje evidencian que las intervenciones relacionadas con la disminución de los contactos sociales en el interior de los negocios tienen la capacidad para disminuir la velocidad de transmisión. Los estudios de inferencia estadística mostraron resultados similares, afirmando que el cierre de la hostelería es una de las medidas más efectivas para disminuir la incidencia y la mortalidad. Los estudios de brotes muestran la capacidad de los establecimientos de hostelería y restauración para generar eventos de supercontagio, a la vez que enfatizan la importancia de controlar las corrientes de aire y la correcta ventilación del interior de los establecimientos. Conclusiones: Se encuentra una gran consistencia en la literatura al señalar que el cierre de los locales de hostelería es una de las medidas más efectivas para disminuir la incidencia y la mortalidad de la COVID-19. Además, se señalan algunas medidas, como la limitación de aforos y la ventilación, como aspectos a monitorizar en los procesos de reapertura de estos locales. (AU)

Objective: To review the scientific epidemiologic evidence on the role of hospitality venues in the incidence or mortality from COVID-19. Method: We included studies conducted in any population, describing either the impact of the closure or reopening of hospitality venues, or exposure to these venues, on the incidence or mortality from COVID-19. We used a snowball sampling approach with backward and forward citation search along with co-citations. Results: We found 20 articles examining the role of hospitality venues in the epidemiology of COVID-19. Modeling studies showed that interventions reducing social contacts in indoor venues can reduce COVID-19 transmission. Studies using statistical models showed similar results, including that the closure of hospitality venues is amongst the most effective measures in reducing incidence or mortality. Case studies highlighted the role of hospitality venues in generating super-spreading events, along with the importance of airflow and ventilation inside these venues. Conclusions: We found consistent results across studies showing that the closure of hospitality venues is amongst the most effective measures to reduce the impact of COVID-19. We also found support for measures limiting capacity and improving ventilation to consider during the re-opening of these venues. (AU)

Audit of NZ COVID Tracer QR poster display and use in Dunedin.

AIMS: To assess how well the NZ COVID Tracer QR (Quick Response) code poster is displayed by Dunedin businesses and other venues in which groups of people gather indoors, and to calculate the proportions of visitors to those venues who scan the QR code poster. METHODS: We randomly selected 10 cafes, 10 restaurants, 10 bars, five churches, and five supermarkets and visited them at their busiest times. We evaluated the display of QR code posters using a six-item assessment tool that was based on guidance provided to businesses and services by the Ministry of Health, and we counted the number of people who entered each venue during a one-hour period and the number who scanned the QR code poster. RESULTS: All six criteria for displaying QR code posters were met at half of the hospitality venues, four of five churches, and all supermarkets. Scanning proportions were low at all venues (median 10.2%), and at 12 (30%) no visitors scanned; eight of these venues were bars. CONCLUSION: This audit provides a snapshot of the display and scanning of QR code posters in a city with no managed isolation and quarantine facilities and where no COVID-19 cases have been detected for 10 months.

Human Occupancy Detection via Passive Cognitive Radio.

Human occupancy detection (HOD) in an enclosed space, such as indoors or inside of a vehicle, via passive cognitive radio (CR) is a new and challenging research area. Part of the difficulty arises from the fact that a human subject cannot easily be detected due to spectrum variation. In this paper, we present an advanced HOD system that dynamically reconfigures a CR to collect passive radio frequency (RF) signals at different places of interest. Principal component analysis (PCA) and recursive feature elimination with logistic regression (RFE-LR) algorithms are applied to find the frequency bands sensitive to human occupancy when the baseline spectrum changes with locations. With the dynamically collected passive RF signals, four machine learning (ML) classifiers are applied to detect human occupancy, including support vector machine (SVM), k-nearest neighbors (KNN), decision tree (DT), and linear SVM with stochastic gradient descent (SGD) training. The experimental results show that the proposed system can accurately detect human subjects-not only in residential rooms-but also in commercial vehicles, demonstrating that passive CR is a viable technique for HOD. More specifically, the RFE-LR with SGD achieves the best results with a limited number of frequency bands. The proposed adaptive spectrum sensing method has not only enabled robust detection performance in various environments, but also improved the efficiency of the CR system in terms of speed and power consumption.

A System for the Detection of Persons in Intelligent Buildings Using Camera Systems-A Comparative Study.

This article deals with the design and implementation of a prototype of an efficient Low-Cost, Low-Power, Low Complexity-hereinafter (L-CPC) an image recognition system for person detection. The developed and presented methods for processing, analyzing and recognition are designed exactly for inbuilt devices (e.g., motion sensor, identification of property and other specific applications), which will comply with the requirements of intelligent building technologies. The paper describes detection methods using a static background, where, during the search for people, the background image field being compared does not change, and a dynamic background, where the background image field is continually adjusted or complemented by objects merging into the background. The results are compared with the output of the Horn-Schunck algorithm applied using the principle of optical flow. The possible objects detected are subsequently stored and evaluated in the actual algorithm described. The detection results, using the change detection methods, are then evaluated using the Saaty method in order to determine the most successful configuration of the entire detection system. Each of the configurations used was also tested on a video sequence divided into a total of 12 story sections, in which the normal activities of people inside the intelligent building were simulated.

Effects of mother related factors on perinatal outcomes-a study of mothers seeking antenatal care at public and non-public health facilities in Kisii County, Kenya

The study sought to determine client level and facility-level factors that affect perinatal outcomes among women attending comparable public (government owned) and non-public health facilities (non-government owned) in Kisii County-Kenya in the context of free maternity care. A total of 365 pregnant mothers recruited in 4 health facilities during their ANC visit and followed up to 2 weeks post-delivery but only 287 attended all follow-up visits. Study subjects were recruited proportionate to number of deliveries each of the facilities had conducted in the preceding 6 months. The dependent variable was perinatal outcome; independent variables were demographic and clinical factors. Analysis was done using χ2, logistic regression, paired t and McNemar's tests. Maternal BMI and a mother's parity were statistically correlated with perinatal outcome (χ2= 8.900, d.f =3, P=0.031 and (χ2= 13.232, d.f =4, P=0.039) respectively. Mothers with 1 parity were 4.5 times more likely to have normal perinatal outcomes (OR =4.5, 95% CI 2.25-14.29, P=0.012). There was a significant relationship between a mother's knowledge of pregnancy-related issues and the baby's weight (t=-67.8 d.f. 213 P<0.001). Mothers' knowledge on pregnancy issues and spousal involvement influences perinatal outcomes. Dietary Diversity Score (DDS) of a mother does not have a direct influence on the outcome of a pregnancy. There is need to focus on maternal factors that affect perinatal outcomes besides free maternity care

Cinco años de trabajo de redes compartido: centre català de solidaritat - San Juan de Dios / No disponible

No disponible

A nacionalização das associações esportivas em Porto Alegre (1937-1945) / The nationalization in the Porto Alegre city sports associations (1937-1945) / La nacionalización en las asociaciones deportivas de Porto Alegre (1937-1945)

As mudanças ocorridas no Brasil entre 1937 e 1945 atingiram os mais variados setores do país, inclusive o associativismo esportivo. O objetivo deste artigo é compreender como ocorreu o processo de nacionalização das associações esportivas "estrangeiras" em Porto Alegre durante o Estado Novo. Após a análise das fontes impressas evidenciou-se que estas associações foram alvejadas pelas medidas nacionalizadoras, as quais impuseram a mudança do nome original e a adoção da língua portuguesa nos documentos oficiais. Isto não significa que houve a perda de suas identidades culturais, mas sim um processo de resistência à nacionalização, através da recomposição de identidades

The occurred changes in Brazil between 1937 and 1945 reached the most varied sectors of the country and also the sports associations. This article's aim is to understand how in Porto Alegre occurred the nationalization's process of foreign sports associations during the New State. After the sources' printed analysis it was proved that these associations had been aimed by the nationalization measures, they have to change their original name as well as adopting the Portuguese language in the official documents. It does not mean there was the lost of their cultural identity, but on the order hand, there was a process of resistance to the nationalization, through the resetting of their identities

Los cambios ocurridos en Brasil entre 1937 y 1945 repercutieron en los más diversos sectores del país, inclusive en las asociaciones deportivas. El objetivo de este artículo es comprender como ocurrió el proceso de nacionalización de las asociaciones deportivas "extranjeras" en Porto Alegre durante el Estado Nuevo. Después de analizar las fuentes escritas se evidenció que estas asociaciones fueron alcanzadas por las medidas nacionalizadoras, teniendo que cambiar su nombre original así como adoptar la lengua portuguesa en los documentos oficiales. Esto no significa que hubo perdida de la identidad cultural, pero si, un proceso de resistencia a la nacionalización, a través de la recomposición de sus identidades