ABSTRACT
Introduction: Public health risk management in Colombia is led by the Instituto Nacional de Salud. In the face of the COVID-19 emergency, response actions centered on the implementation of risk analysis rooms and the strengthening of surveillance at points of entry into the country. Objective: To analyze the implementation and maintenance phases of the COVID-19 risk analysis rooms in four border departments of Colombia. Materials and methods: We conducted a qualitative study of public health risk analysis rooms for COVID-19. We reviewed the documentation and data generated from March to June, 2020, in the departments of Amazonas, Vichada, Guainía, and Putumayo. We did semi-structured interviews with key actors and analyzed the answers using the NVivo plus version 11 application in three cycles: open coding, identification of emerging categories, and modeling by analyzing the identified strengths and weaknesses. Results: We identified the components of the incident command structure and the relationships between the public health areas. Strengths were evidenced in the integration of the areas: the management of information in real time, the border surveillance and the capabilities of rapid response teams, while weaknesses appeared in planning, community surveillance, and risk communication processes. Conclusions: Risk analysis rooms constitute a joint effort at the national and local levels which has promoted the articulated participation of all actors in the analysis of information and the optimization of an organized response during the COVID-19 pandemic.
Introducción. La gestión del riesgo de salud pública en Colombia es liderada por el Instituto Nacional de Salud. Ante la emergencia de la COVID-19, se articularon acciones de respuesta mediante salas de análisis del riesgo y se fortaleció la vigilancia en los puntos de entrada al país. Objetivo. Analizar las fases de implementación y mantenimiento de las salas de análisis del riesgo de COVID-19 en cuatro departamentos fronterizos de Colombia. Materiales y métodos. Se hizo un estudio cualitativo de salas de análisis del riesgo en salud pública para COVID-19. Se revisaron la documentación y los datos generados en el periodo de marzo a junio de 2020 en Amazonas, Vichada, Guainía y Putumayo, y se hicieron entrevistas semiestructuradas a personas clave, las cuales se analizaron con el aplicativo NVivo plus, versión 11, en tres ciclos: codificación abierta, establecimiento de categorías emergentes y modelación mediante el análisis de las debilidades y fortalezas detectadas. Resultados. Se determinaron los componentes de la estructura de comando de incidentes y las relaciones entre las áreas de salud pública. Se encontraron fortalezas en la integración de las áreas, el manejo de la información en tiempo real, la vigilancia en las fronteras y las capacidades de los equipos de respuesta inmediata. Se detectaron debilidades en los procesos de planeación, vigilancia comunitaria y comunicación del riesgo. Conclusiones. Las salas de análisis del riesgo constituyen un esfuerzo conjunto del nivel local y nacional que han promovido la participación articulada de los actores, para analizar la información y optimizar la respuesta organizada durante la pandemia de COVID-19.
Subject(s)
COVID-19 , COVID-19/epidemiology , Colombia/epidemiology , HumansABSTRACT
Background: It is imperative to identify drugs that allow treating symptoms of severe COVID-19. Respiratory failure is the main cause of death in severe COVID-19 patients, and the host inflammatory response at the lungs remains poorly understood. Methods: Therefore, we retrieved data from post-mortem lungs from COVID-19 patients and performed in-depth in silico analyses of single-nucleus RNA sequencing data, inflammatory protein interactome network, and shortest pathways to physiological phenotypes to reveal potential therapeutic targets and drugs in advanced-stage COVID-19 clinical trials. Results: Herein, we analyzed transcriptomics data of 719 inflammatory response genes across 19 cell types (116,313 nuclei) from lung autopsies. The functional enrichment analysis of the 233 significantly expressed genes showed that the most relevant biological annotations were inflammatory response, innate immune response, cytokine production, interferon production, macrophage activation, blood coagulation, NLRP3 inflammasome complex, and the TLR, JAK-STAT, NF-κB, TNF, oncostatin M signaling pathways. Subsequently, we identified 34 essential inflammatory proteins with both high-confidence protein interactions and shortest pathways to inflammation, cell death, glycolysis, and angiogenesis. Conclusion: We propose three small molecules (baricitinib, eritoran, and montelukast) that can be considered for treating severe COVID-19 symptoms after being thoroughly evaluated in COVID-19 clinical trials.
ABSTRACT
Introducción. La gestión del riesgo de salud pública en Colombia es liderada por el Instituto Nacional de Salud. Ante la emergencia de la COVID-19, se articularon acciones de respuesta mediante salas de análisis del riesgo y se fortaleció la vigilancia en los puntos de entrada al país. Objetivo. Analizar las fases de implementación y mantenimiento de las salas de análisis del riesgo de COVID-19 en cuatro departamentos fronterizos de Colombia. Materiales y métodos. Se hizo un estudio cualitativo de salas de análisis del riesgo en salud pública para COVID-19. Se revisaron la documentación y los datos generados en el periodo de marzo a junio de 2020 en Amazonas, Vichada, Guainía y Putumayo, y se hicieron entrevistas semiestructuradas a personas clave, las cuales se analizaron con el aplicativo NVivo plus, versión 11, en tres ciclos: codificación abierta, establecimiento de categorías emergentes y modelación mediante el análisis de las debilidades y fortalezas detectadas. Resultados. Se determinaron los componentes de la estructura de comando de incidentes y las relaciones entre las áreas de salud pública. Se encontraron fortalezas en la integración de las áreas, el manejo de la información en tiempo real, la vigilancia en las fronteras y las capacidades de los equipos de respuesta inmediata. Se detectaron debilidades en los procesos de planeación, vigilancia comunitaria y comunicación del riesgo. Conclusiones. Las salas de análisis del riesgo constituyen un esfuerzo conjunto del nivel local y nacional que han promovido la participación articulada de los actores, para analizar la información y optimizar la respuesta organizada durante la pandemia de COVID-19.
Introduction: Public health risk management in Colombia is led by the Instituto Nacional de Salud. In the face of the COVID-19 emergency, response actions centered on the implementation of risk analysis rooms and the strengthening of surveillance at points of entry into the country. Objective: To analyze the implementation and maintenance phases of the COVID-19 risk analysis rooms in four border departments of Colombia. Materials and methods: We conducted a qualitative study of public health risk analysis rooms for COVID-19. We reviewed the documentation and data generated from March to June, 2020, in the departments of Amazonas, Vichada, Guainía, and Putumayo. We did semi-structured interviews with key actors and analyzed the answers using the NVivo plus version 11 application in three cycles: open coding, identification of emerging categories, and modeling by analyzing the identified strengths and weaknesses. Results: We identified the components of the incident command structure and the relationships between the public health areas. Strengths were evidenced in the integration of the areas: the management of information in real time, the border surveillance and the capabilities of rapid response teams, while weaknesses appeared in planning, community surveillance, and risk communication processes. Conclusions: Risk analysis rooms constitute a joint effort at the national and local levels which has promoted the articulated participation of all actors in the analysis of information and the optimization of an organized response during the COVID-19 pandemic.
Subject(s)
Coronavirus Infections/epidemiology , Risk Management , Sanitary Control of Borders , PandemicsABSTRACT
El incremento de la práctica de diagnósticos genéticos preimplantacionales, en el contexto de las técnicas de reproducción asistida, genera nuevos ámbitos potenciales de responsabilidad. El riesgo de comportamientos negligentes en la práctica de este diagnóstico puede concretarse en cualquier momento y generar, consiguientemente, el planteamiento de una reclamación de indemnización por parte de los sujetos afectados por los daños derivados de ello. Este trabajo se centra en analizar la respuesta jurídica que ha de darse a estas reclamaciones cuando se fundamenten en un error en el diagnóstico por falso positivo
The increase in the practice of preimplantation genetic diagnosis, in the context of assisted reproductive technology, generates new potential areas of liability. Any moment can crystallize the risk of negligent behavior in the practice of this diagnosis and it can therefore generate a claim brought by the subjects who suffer the damages derived from it. This paper focuses on analyzing the legal response to be given to these claims when they are based on an error in the diagnosis by false positive
Subject(s)
Humans , Preimplantation Diagnosis/ethics , False Positive Reactions , Wrongful Life/ethics , Reproductive Techniques/legislation & jurisprudence , Selective Breeding/genetics , Genetic Diseases, Inborn/genetics , Cryopreservation/ethics , Malpractice/legislation & jurisprudenceABSTRACT
BACKGROUND: Health care institutions include workers who must operate in accordance with the requirements of the position, even though there are psychosocial influences that can affect the stability of the worker. AIMS: To analyze the organizational culture of the team of professionals who work in the mental health network. METHOD: A qualitative methodology was used to assess a sample of 55 mental health professionals who have been practicing for at least 5years. RESULTS: "Team" was the overall topic. The subtopics within "Team" were: getting along in the unit, getting along with the patient, personal resources for dealing with patients, adaptive resources of team members and, resources that the team uses in their group activities. CONCLUSION: It was observed that the team does not work with a common objective and needs an accepted leader to manage the group. The definition and acceptance of roles can result in conflict. By increasing the skill level of each worker, the multidisciplinary team would be more collaborative.
