Suchergebnisse

RESUMENSe expone un análisis centrado en la función del Estado en el contexto de la crisis sistémica desencadenada a partir de la irrupción de la pandemia global COVID-19, así como en los nuevos escenarios, las tendencias y las perspectivas que se vislumbran en un escenario postpandémico. Se presenta una valoración de las racionalidades hegemónicas de los poderes estatales antes de la pandemia; de la orientación y de los tipos de estrategias desplegadas para la gestión de la crisis; así como los escenarios geopolíticos y las lógicas de Estado que se prevén para el post COVID-19. El estudio se realizó sobre la base de una indagación documental mediada por una lectura histórico-geográfica de la coyuntura y una visión prospectiva a través de las dinámicas y las tendencias de actuación y de los sistemas de relaciones de los Estados. La conclusión fundamental de la reflexión, postula que en el tiempo histórico actual el poder estatal es un factor medular de la política, la economía y de las relaciones sociales. Esa situación era un hecho cierto antes de la irrupción del COVID-19, y con las contingencias dadas, ha adquirido mayor relieve y será crucial para el devenir de las sociedades en un contexto de profundas contradicciones sistémicas.

The document presents an analysis of the crisis of the Colombian-Venezuelan border, in its three most notable expressions: i) the human rights crisis; ii) the migration crisis; iii) the geopolitical conflict. Based on the historical-geographical materialism, the analysis of the functionality of the border areas in the current world, to identify the general trends and characterize the particular variables that have determined the concretion of said crisis. The reflection is based on a documentary review, on the valuation of official figures of multilateral organizations, and on the presence in the field of the researcher as a political and academic agent. Controversial perspectives are raised around the substantive topics of the analysis and a critical view of the problem is advocated. Finally, a set of recommendations addressed to the National States, the multilateral organisms and the scientific communities are enunciated. ; El documento expone un análisis de la crisis de la frontera colombo-venezolana, en sus tres expresiones más notables: i) la crisis de los derechos humanos; ii) la crisis migratoria; iii) el conflicto geopolítico. Con base en el materialismo histórico-geográfico, se parte del análisis de la funcionalidad de los espacios fronterizos en el mundo actual, para identificar las tendencias generales y caracterizar las variables particulares que han determinado la concreción de dicha crisis. La reflexión se sustenta en una revisión documental, en la valoración de cifras oficiales de organismos multilaterales, y en la presencia en campo del investigador como agente político y académico. Se plantean perspectivas polémicas en torno a los tópicos sustantivos del análisis y se propugna una visión crítica de la problemática. Por último se enuncian un conjunto de recomendaciones dirigidas a los Estados Nacionales, los organismos multilaterales y las comunidades científicas. ; O documento apresenta uma análise da crise da fronteira colombo-venezuelana, em suas três expressões mais notáveis: i) a crise dos direitos humanos; ii) a crise migratória; iii) o conflito geopolítico. Baseado no materialismo histórico-geográfico, a análise da funcionalidade das áreas de fronteira no mundo atual, para identificar as tendências gerais e caracterizar as variáveis particulares que determinaram a concretização da referida crise. A reflexão baseia-se em uma revisão documental, na valorização de figuras oficiais de organizações multilaterais e na presença no campo do pesquisador como agente político e acadêmico. Perspectivas controversas são levantadas em torno dos temas substantivos da análise e uma visão crítica do problema é defendida. Finalmente, um conjunto de recomendações dirigidas aos Estados Nacionais, aos organismos multilaterais e às comunidades científicas são enunciados.

BACKGROUND: Even though the WHO-endorsed, non-commercial MODS assay offers rapid, reliable TB liquid culture and phenotypic drug susceptibility testing (DST) at lower cost than any other diagnostic, uptake has been patchy. In part this reflects misperceptions about in-house assay quality assurance, but user convenience of one-stop procurement is also important. A commercial MODS kit was developed by Hardy Diagnostics (Santa Maria, CA, USA) with PATH (Seattle, WA, USA) to facilitate procurement, simplify procedures through readymade media, and enhance safety with a sealing silicone plate lid. Here we report the results from a large-scale field evaluation of the MODS kit in a government service laboratory. METHODS & FINDINGS: 2446 sputum samples were cultured in parallel in Lowenstein-Jensen (LJ), conventional MODS and in the MODS kit. MODS kit DST was compared with conventional MODS (direct) DST and proportion method (indirect) DST. 778 samples (31.8%) were Mycobacterium tuberculosis culture-positive. Compared to conventional MODS the sensitivity, specificity, positive, and negative predictive values (95% confidence intervals) of the MODS Kit were 99.3% (98.3-99.8%), 98.3% (97.5-98.8%), 95.8% (94.0-97.1%), and 99.7% (99.3-99.9%). Median (interquartile ranges) time to culture-positivity (and rifampicin and isoniazid DST) was 10 (9-13) days for conventional MODS and 8.5 (7-11) for MODS Kit (p<0.01). Direct rifampicin and isoniazid DST in MODS kit was almost universally concordant with conventional MODS (97.9% agreement, 665/679 evaluable samples) and reference indirect DST (97.9% agreement, 687/702 evaluable samples). CONCLUSIONS: MODS kit delivers performance indistinguishable from conventional MODS and offers a convenient, affordable alternative with enhanced safety from the sealing silicone lid. The availability in the marketplace of this platform, which conforms to European standards (CE-marked), readily repurposed for second-line DST in the near future, provides a fresh opportunity for improving equity of access to TB diagnosis and first and second-line DST in settings where the need is greatest.