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La Uchuva (Physalis peruvian) es una fruta tropical que ha ganado popularidad en Europa debido a su sabor dulce y ácido, así como a sus propiedades nutricionales, ya que es rica en vitamina C, antioxidantes y fibra. Las exportaciones de esta fruta desde Colombia han sido crecientes en los últimos años, al mismo tiempo que el mercado aumenta las exigencias en cuanto al cumplimiento de las normatividades, límites de agroquímicos en la fruta y calidad consistente en los productos que comercializa. El cultivo de esta fruta se ha caracterizado por ser realizado por pequeños y medianos productores, con poca asistencia técnica y en muchos casos sin cumplir la normatividad; a su vez la exportación la han realizado empresas intermediarias, que comercializan estas cosechas, algunas veces sin mucho control de las exigencias del mercado; esta situación viene generando espacios de oportunidad de negocios, especialmente con los clientes más exigentes, de los mercados más exigentes; que buscan proveedores respetuosos de la normatividad, que apoyen toda la cadena de valor y que ofrezcan productos de calidad consistente. El análisis financiero de un proyecto de empresa exportadora, que se abastezca de agricultores pequeños, con alta inversión en asistencia técnica, cumplimiento de la normatividad, pagos justos que les permitan mejorar su calidad de vida y alta atención e inversión al control de calidad, se presenta como viable, rentable y sostenible con ciertos riesgos que pueden mitigarse., Cape Gooseberry (Physalis peruvian) is a tropical fruit that has gained popularity in Europe due to its sweet and sour taste and nutritional properties, as it is rich in vitamin C, antioxidants, and fibre. Exports of this fruit from Colombia have been growing in recent years; at the same time, the market increases the demands in terms of compliance with regulations, limits of agrochemicals in the fruit and consistent quality of the products it sells. The cultivation of this fruit has been characterized by being carried out by small and medium producers, with little technical assistance and, in many cases, without complying with regulations; In turn, the export has been carried out by intermediary companies, which market these crops, sometimes without much control over the demands of the market; This situation has been generating spaces for business opportunities, especially with the most demanding clients, from the most demanding markets; who are looking for suppliers that comply with regulations, that support the entire value chain and that offer products of consistent quality. The financial analysis of an export company project, which is supplied by small farmers, with high investment in technical assistance, compliance with regulations, fair payments that allow them to improve their quality of life and great attention and investment in quality control, are presented as viable, profitable, and sustainable with certain risks that can be mitigated.

Las empresas de hoy en día otorgan un lugar muy importante a sus trabajadores dentro del contexto de seguridad y salud en el trabajo, los cuales a diario se exponen a distintos tipos de riesgos durante la ejecución de las tareas asignadas y se enfrentan a posibles condiciones inseguras por exceso de confianza o falta de conocimiento. Teniendo en cuenta lo anterior, el reto de las empresas es promover el bienestar físico, mental y social a todos sus trabajadores, además de suministrar las condiciones óptimas para el desarrollo de sus labores. El presente trabajo tiene como objetivo principal diseñar una estrategia pedagógica de prevención de incidentes, accidentes y enfermedades laborales que sea adoptada por la empresa JR INGENIEROS ELECTRICISTAS S.A.S. como herramienta de proceso de inducción y reinducción para nuevos y antiguos trabajadores. En esta investigación se aborda una metodología de carácter descriptivo a través de la observación directa, lo cual permitió identificar los principales peligros y riesgos a los que se exponen los trabajadores en sus labores diarias, con la estrategia planteada anteriormente se espera demostrar que la implementación de las prácticas de autocuidado puede tener un impacto positivo a la hora de ejecutar todas las labores diarias, las cuales atribuyan a la disminución del índice de incidentes, accidentes y enfermedades laborales. Today's companies give a very important place to their workers within the context of safety and health at work, who are daily exposed to different types of risks during the execution of assigned tasks and face possible unsafe conditions due to overconfidence or lack of knowledge. Considering the above, the challenge for companies is to promote the physical, mental and social well-being of all their workers, in addition to providing optimal conditions for the development of their work. The main objective of this work is to design a pedagogical strategy for the prevention of incidents, accidents and occupational diseases to be adopted by the company JR INGENIEROS ELECTRICISTAS S.A.S. as a tool for the induction and reinduction process for new and old workers. In this research a descriptive methodology is approached through direct observation, which allowed to identify the main hazards and risks to which workers are exposed in their daily work, with the strategy outlined above is expected to demonstrate that the implementation of self-care practices can have a positive impact when performing all daily tasks, which attribute to the decrease in the rate of incidents, accidents and occupational diseases.

Estrogen receptor-positive (ER+) breast tumours are often treated with anti- estrogen (AE) therapies but frequently develop resistance. Cancer Stem Cells (CSCs) with high aldehyde dehydrogenase (ALDH) activity (ALDH+ cells) are reported to be enriched following AE treatment. Here we perform in vitro and in vivo functional CSC assays and gene expression analysis to characterise the ALDH+ population in AE resistant metastatic patient samples and an ER+ cell line. We show that the IL1 signalling pathway is activated in ALDH+ cells and data from single cells reveals that AE treatment selects for IL1R1-expressing ALDH+ cells. Importantly, CSC activity is inhibited by Anakinra, a synthetic IL1R1 antagonist, in AE-resistant models. Moreover, we demonstrate that increased expression of IL1R1 is observed in the tumours of patients treated with AE therapy and predicts for treatment failure. Single-cell gene expression analysis revealed that at least 2 sub-populations exist within the ALDH+ population, one proliferative and one quiescent. Following AE therapy, the quiescent ALDH+IL1R1+ population is expanded, which suggests CSC dormancy as an adaptive strategy that facilitates treatment resistance. Supporting this, analysis of AE resistant dormant tumours reveals significantly increased expression of ALDH1A1, ALDH1A3 and IL1R1 genes. Thus, our work establishes that targeting of ALDH+IL1R1+ cells may reverse AE resistance in patients with minimal residual disease.

Introducción. La Cultura de Seguridad del Paciente (CSP) se funda a manera de elemento cardinal para instaurar la atención adecuada sin fallas idealmente cuando atendemos un paciente, se ha transformado en un argumento de utilidad general, que integra aspectos relacionados con la comprensión y las cualidades del aparato de salud hacia la atención segura de los usuarios con finalidad única de impedir o mermar el daño potencial prevenible producto de asistencia durante el proceso de atención en salud; además, promueve, en el personal que ofrece el servicio, la responsabilidad liderazgo y compromiso. Valorar la Cultura de Seguridad del Paciente (CSP) permite desarrollar acciones hacia la mejora de procesos para las instituciones de salud y convertirlas en organizaciones confiables y seguras. objetivo del estudio fue Conocer que opinan las personas involucradas directamente en el servicio quirúrgico del camino universitario Adelita de Char acerca de la aplicación de los conocimientos que pretenden brindar atención segura al paciente. Metodología. Se realizo un estudio de tipo cuantitativo, descriptivo, transversal; población y muestra que se escogió fueron 106 colaboradores que laboran en el servicio de cirugía o realizas sus prácticas con las diferentes corporaciones que tiene convenios entre los Criterios de inclusión: Personal de salud con contrato vigente, activo que labora en el servicio de quirúrgica, exprese su deseo de participar por voluntad en el estudio. Para la exclusión los criterios fueron: personal de salud sin vinculación ya sea laboral o educativa en este servicio, de vacaciones o licencia y aquellos que no desearon participar en la investigación; el instrumento que utilizamos fue el diseñado en la Agency for Health Care Research and Quality (AHRQ) de los Estados Unidos el cual fue adaptado al español; las respuestas del interrogatorio fueron recodificadas en 3 categorías: siendo la primera negativo, la segunda neutral y la tercera positivos; los resultados fueron estudiados por el SPSSS en su versión 20. Introduction. The Patient Safety Culture (CSP) is founded as a cardinal element to establish adequate care without failures ideally when we care for a patient, it has become a general utility argument, which integrates aspects related to the understanding and qualities of the patient. health apparatus towards the safe care of users with the sole purpose of preventing or reducing the potential damage that can be prevented because of assistance during the health care process; In addition, it promotes, in the personnel that offers the service, responsibility, leadership and commitment. Valuing the Patient Safety Culture (CSP) allows developing actions towards the improvement of processes for health institutions and turning them into reliable and safe organizations. The objective of the study was to know what the people directly involved in the surgical service of the Adelita de Char university path think about the application of knowledge that aims to provide safe patient care. Methodology. A quantitative, descriptive, cross-sectional study was carried out; Population and sample that was chosen were 106 collaborators who work in the surgery service or carry out their practices with the different corporations that have agreements between the Inclusion Criteria: Health personnel with a current contract, active who work in the surgical service, express their willingness to participate in the study. For exclusion, the criteria were: health personnel without employment or educational ties to this service, on vacation or leave, and those who did not wish to participate in the research; The instrument we used was the one designed by the Agency for Health Care Research and Quality (AHRQ) of the United States, which was adapted to Spanish; the responses to the interrogation were recoded into 3 categories: the first being negative, the second neutral, and the third positive; the results were studied by the SPSSS in its version 20.

De las grandes implicaciones que se generan en la contratación pública, se refiere a las reglas de subsanabilidad que se presentan cuando a consecuencia de la presentación de las ofertas existen discrepancias frente a los comités de evaluación ante una regla de subsanabilidad o una mejora de oferta bajo el vacío jurídico que presenta la normatividad y el pronunciamiento generado por el Consejo de Estado. Of the great implications generated in public contracting, it refers to the rectification rules that arise when as a result of the presentation of the offers there are discrepancies befare the evaluation committees befare a rectification rule oran improvement o f the offer under the legal vacuum presented by the regulations and the pronouncement generated by the Council of State Maestría Facultad Derecho::Magíster en Derecho de Estado con énfasis en Derecho Público - (Modalidad Investgación)

Estrogen receptor (ER) positive breast cancer is frequently sensitive to endocrine therapy. Multiple mechanisms of endocrine therapy resistance have been identified, including cancer stem-like cell (CSC) activity. Here we investigate SFX-01, a stabilised formulation of sulforaphane (SFN), for its effects on breast CSC activity in ER+ preclinical models. SFX‐01 reduced mammosphere formation efficiency (MFE) of ER+ primary and metastatic patient samples. Both tamoxifen and fulvestrant increased MFE and aldehyde dehydrogenase (ALDH) activity of patient-derived xenograft (PDX) tumors, which was reversed by combination with SFX‐01. SFX-01 significantly reduced tumor-initiating cell frequency in secondary transplants and reduced the formation of spontaneous lung micrometastases by PDX tumors in mice. Mechanistically, we establish that both tamoxifen and fulvestrant induce STAT3 phosphorylation. SFX-01 suppressed phospho‐STAT3 and SFN directly bound STAT3 in patient and PDX samples. Analysis of ALDH+ cells from endocrine-resistant patient samples revealed activation of STAT3 target genesMUC1andOSMR, which were inhibited by SFX-01 in patient samples. Increased expression of these genes after 3 months’ endocrine treatment of ER+ patients (n = 68) predicted poor prognosis. Our data establish the importance of STAT3 signaling in CSC-mediated resistance to endocrine therapy and the potential of SFX-01 for improving clinical outcomes in ER+ breast cancer.

SUMMARYEstrogen receptor-positive (ER+) breast tumours are often treated with anti-estrogen (AE) therapies but frequently develop resistance. Cancer Stem Cells (CSCs) with high aldehyde dehydrogenase (ALDH) activity (ALDH+ cells) are reported to be enriched following AE treatment. Here we perform in vitro and in vivo functional CSC assays and gene expression analysis to characterise the ALDH+ population in AE resistant metastatic patient samples and an ER+ cell line. We show that the IL1β signalling pathway is activated in ALDH+ cells and data from single cells reveals that AE treatment selects for IL1R1-expressing ALDH+ cells. Importantly, we demonstrate that increased expression of IL1R1 is observed in the tumours of patients treated with AE therapy and predicts for treatment failure. Single-cell gene expression analysis revealed that at least 2 sub-populations exist within the ALDH+ population, one proliferative and one quiescent. Following AE therapy, the quiescent ALDH+IL1R1+ population is expanded, which suggests CSC dormancy as an adaptive strategy that facilitates treatment resistance. Supporting this, analysis of AE resistant dormant tumours reveals significantly increased expression of ALDH1A1, ALDH1A3 and IL1R1 genes. Thus, we propose that targeting of ALDH+IL1R1+ cells will reverse AE resistance, including in patients with minimal residual disease.

Summary Estrogen-receptor-positive breast tumors are treated with anti-estrogen (AE) therapies but frequently develop resistance. Cancer stem cells (CSCs) with high aldehyde dehydrogenase activity (ALDH+ cells) are enriched following AE treatment. Here, we show that the interleukin-1β (IL-1β) signaling pathway is activated in ALDH+ cells, and data from single cells reveals that AE treatment selects for IL-1 receptor (IL1R1)-expressing ALDH+ cells. Importantly, CSC activity is reduced by an IL1R1 inhibitor in AE-resistant models. Moreover, IL1R1 expression is increased in the tumors of patients treated with AE therapy and predicts treatment failure. Single-cell gene expression analysis revealed that at least two subpopulations exist within the ALDH+ population, one proliferative and one quiescent. Following AE therapy the quiescent population is expanded, which suggests CSC dormancy as an adaptive strategy that facilitates treatment resistance. Targeting of ALDH+IL1R1+ cells merits testing as a strategy to combat AE resistance in patients with residual disease., Highlights • Anti-estrogen-resistant ALDH+ cells have increased CSC activity in ER+ tumors • The IL1R1-expressing ALDH+ CSC population expands after anti-estrogen treatment • IL1R1 expression predicts anti-estrogen treatment failure • Targeting of ALDH+IL1R1+ cells reverses anti-estrogen resistance, In this study, Simões, Clarke and colleagues show that anti-estrogen treatments select for ALDH+ breast cancer stem cells expressing IL1R1, which can be targeted by a specific inhibitor. Increased expression of IL1R1 is observed in the tumors of patients treated with anti-estrogen therapy, suggesting that targeting of ALDH+IL1R1+ cells will help combat therapy resistance.

La investigación en el campo educativo se define como un largo camino que intenta comprender el papel de los sujetos, la interacción entre las personas, experimentando la incertidumbre, la duda y la certeza, pero a través de sus hallazgos construye un mundo de conocimiento. La investigación cualitativa está asociada a explorar dentro de un mundo explicativo (positivista) o interpretativo o comprensivo (cualitativo social) y vivir construyendo los procedimientos de la investigación desde lo pedagógico, el conocimiento mismo de los procedimientos investigativos mediados por la etnografía, la hermenéutica, la fenomenología y la teoría fundada.Palabras Clave: Investigación cualitativa; campo pedagógico; investigación en educación.

Breast cancer specific mortality results from tumour cell dissemination and metastatic colonisation. Identification of the cells and processes responsible for metastasis will enable better prevention and control of metastatic disease, thus reducing relapse and mortality. To better understand these processes, we prospectively collected 307 patient-derived breast cancer samples (n = 195 early breast cancers (EBC) and n = 112 metastatic samples (MBC)). We assessed colony-forming activity in vitro by growing isolated cells in both primary (formation) and secondary (self-renewal) mammosphere culture, and tumour initiating activity in vivo through subcutaneous transplantation of fragments or cells into mice. Metastatic samples formed primary mammosphere colonies significantly more frequently than early breast cancers and had significantly higher primary mammosphere colony formation efficiency (0.9 % vs. 0.6 %; p < 0.0001). Tumour initiation in vivo was significantly higher in metastatic than early breast cancer samples (63 % vs. 38 %, p = 0.04). Of 144 breast cancer samples implanted in vivo, we established 20 stable patient-derived xenograft (PDX) models at passage 2 or greater. Lung metastases were detected in mice from 14 PDX models. Mammosphere colony formation in vitro significantly correlated with the ability of a tumour to metastasise to the lungs in vivo (p = 0.05), but not with subcutaneous tumour initiation. In summary, the breast cancer stem cell activities of colony formation and tumour initiation are increased in metastatic compared to early samples, and predict metastasis in vivo. These results suggest that breast stem cell activity will predict for poor outcome tumours, and therapy targeting this activity will improve outcomes for patients with metastatic disease.

El presente trabajo inició con la investigación bibliográfica sobre la discapacidad intelectual y el impacto familiar; se empleó la guía contextualizada “No estás solo”. Para medir el efecto que esta generó en los padres de adolescentes de la Unidad Educativa Especial Agustín Cueva Tamariz, se les aplicó una encuesta inicial, luego se socializó la guía a través de talleres brindándoles tácticas e información para afrontar esta discapacidad, finalmente se aplicó nuevamente la encuesta; con los datos y mediante análisis estadísticos se identificó un impacto favorable, la guía contribuyó de manera positiva en la situación emocional de los padres de adolescentes con discapacidad intelectual. Magíster en Educación Especial

Background: SFX-01 is a novel therapeutic comprising synthetic sulforaphane (SFN) stabilised within a-cyclodextrin. Breast cancer stem-like cells (CSCs) have been identified in all molecular subtypes and are likely drivers of breast cancer metastasis and treatment resistance. We recently established that CSC activity in ER+ BC, represent a source of therapeutic resistance (Simões et al, Cell Reports, 2015). Material and methods: We investigated SFX-01 effects on breast CSC activity using mammosphere formation efficiency (MFE) and aldehyde dehydrogenase (ALDH) activity using the ALDEFLUOR assay in patient samples and patient-derived xenograft (PDX) tumours. Cells from primary (n=12) and metastatic (n=15) samples were treated with SFX-01 (5 μM) or vehicle control.Using a 2 or 8 week in vivo treatment, early (HBCx34) and metastatic (BB3RC31) ER+ PDX tumours were treated with SFX-01 (300mg/Kg/day) alone or in combination with tamoxifen (TAM, 10 mg/kg/day) or fulvestrant (FULV, 200 mg/kg/week). Tumours were dissociated and MFE and ALDH activity assessed. Results: SFX-01 in vitro reduced MFE of both primary (0.19%±0.02 vs control 0.52%±0.06: p SFX-01 has been shown to be well tolerated in SAD and MAD studies in normal volunteers and clinical studies designed to test tolerability and efficacy in combination with the three major classes of endocrine therapy (AI, TAM and FULV) in advanced BC will begin in Q4 2016. Conclusions: Our data demonstrate the potential of SFX-01 for clinically meaningful improvements to endocrine therapy in ER+ breast cancer by reversing CSC mediated resistance. Citation Format: Howell SJ, Simoes BM, Alferez D, Eyre R, Spence K, Santiago-Gomez A, Sarmiento-Castro A, Tanaka I, Howat D, Clarke RB. SFX-01 targets Wnt signalling to inhibit stem-like cells in breast cancer patient-derived xenograft tumours [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD2-02.

Summary Breast cancers (BCs) typically express estrogen receptors (ERs) but frequently exhibit de novo or acquired resistance to hormonal therapies. Here, we show that short-term treatment with the anti-estrogens tamoxifen or fulvestrant decrease cell proliferation but increase BC stem cell (BCSC) activity through JAG1-NOTCH4 receptor activation both in patient-derived samples and xenograft (PDX) tumors. In support of this mechanism, we demonstrate that high ALDH1 predicts resistance in women treated with tamoxifen and that a NOTCH4/HES/HEY gene signature predicts for a poor response/prognosis in 2 ER+ patient cohorts. Targeting of NOTCH4 reverses the increase in Notch and BCSC activity induced by anti-estrogens. Importantly, in PDX tumors with acquired tamoxifen resistance, NOTCH4 inhibition reduced BCSC activity. Thus, we establish that BCSC and NOTCH4 activities predict both de novo and acquired tamoxifen resistance and that combining endocrine therapy with targeting JAG1-NOTCH4 overcomes resistance in human breast cancers., Graphical Abstract, Highlights • Anti-estrogen therapies selectively enrich for BCSCs and activate Notch signaling • Notch pathway activation and ALDH1 predict for anti-estrogen treatment failure • Targeting of Notch4 reduces the population of BCSCs • Notch inhibitors might prevent relapse or overcome resistance in ER+ tumors, Breast cancers frequently develop resistance to anti-estrogen treatment, which makes it imperative to understanding how therapy resistance develops. Here, Simões et al. show that combining standard anti-estrogen therapies with anti-Notch4 drugs targeting breast cancer stem cells should improve treatment of ER+ breast cancer patients by preventing relapse due to therapy resistance.

228 p. Cd, El referente teórico que soporte este proyecto de investigación es poder identificar el alcance de una evaluación de impacto determinando en que forma el proyecto, mejora las condiciones sociales de las comunidades beneficiadas, si responde a los objetivos propuestos en términos de eficacia, eficiencia y efectividad y poder tomar las decisiones de ajustarlo, mejorarlo o por el contrario terminarlo de acuerdo a los resultados que este genera. Es la academia un facilitador y articulador de procesos de análisis que da al Magister de Gestión Pública y Gobierno las Herramientas necesarias para poder hacer una análisis real del impacto de los programas asistencialista, como es el caso de Familias en Acción cuyo objeto es desde el año 2001, mejorar las condiciones de salud y educación de las familias vulnerables del estrato uno, siendo este programa, el objeto central del Proyecto de Invest igació n. Entre los referentes teóricos que sustenta el proyecto, se encuentra la escritora Irma Arriagada, asesora de la CEPAL y Blanca Esther Bonilla,las cuales en diversos artículos y libros abordan el tema de Familias, Políticas Públicas y Evaluaciones de Impacto, asimismo el Banco Mundial y Comité de Ayuda al Desarrollo (OCDE) define la evaluación de impacto como la medición de los cambios en el bienestar de los individuos que pueden ser atribuidos a un programa o a una política específica su realización y sus resultados; se consulto al Profesor Paulo Freire y Margaret Shuler que desde tiempos atrás plantearon los conceptos de empoderamiento, otro referente fue los estudios realizados por el DPN en los años 2006-2008, los cuales en resumen dan un aval positivo al programa familias en acción. Con la sustentación de una metodológica de una Investigación Cuantitativa tipo Descriptiva Transversal mediante la aplicación de instrumentos estructurados como la encuesta y lista de chequeo para la auditoria a Historias clínicas; se identifico y midió independientemente cada una de las variables, se logro determinar el nivel de empoderamiento que se da en forma natural frente al programa Familias en Acción, evidenciado entre otros aspectos, por el Estado Nutricional del niño beneficiario en comparación con niños no beneficiarios, analizando factores externos. Como alcance del proyecto se logra describir como las Políticas Públicas Sociales Asistencialista generan aspectos positivos o negativos en el pensamiento y comportamiento de las comunidades vulnerables a lo largo del tiempo, se dio cumplimiento a los objetivos porque se pudo medir y concluir que el nivel de empoderamiento de las mujeres referenciadas es un nivel bajo independiente si son o no beneficiarias asimismo se identifico que los niños no beneficiarios presentan una tendencia a tener un estado nutricional mejor frente a los niños beneficiarios, se encontró una relación directa entre el empoderamiento de la mujer frente al cuidado de su hijos más nos frente a los problemas de la comunidad o que el programa le haya generado tener pensamientos y deseos de superación y/o auto sostenibilidad. El aporte social de la Investigación se da en la medida en que las conclusiones y recomendaciones planteadas sean un sustento teórico para mejorar las estrategias de abordaje del problema de pobreza, se plantea, dando cumplimento al cuarto objetivo de la investigación, un Plan de Mejora, en la planeación del programa Familias en Acción desde las Fases de Estructura, Proceso y Resultados, que involucran una articulación y compromiso de las instituciones del Estado, partiendo de la base del logro de los objetivos de la investigación., The theoretical reference that supports this research project is to identify the extent of an impact assessment in determining how the project improves the social conditions of the communities served, if it meets the objectives in terms of effectiveness, efficiency and effectiveness and able to make decisions to adjust, improve or otherwise terminate according to the results it generates. Academy is a facilitator and coordinator of analysis processes giving the Master of Public Management and Government the tools needed to make an effective impact analysis of welfare programs , such as Families in Action which aims since 2001 , improving the health and education of vulnerable families in stratum one, being this program , the focus of the research project . Among the theoretical framework behind the project , is the writer Irma Arriagada, CEPAL adviser and Blanca Esther Bonilla , which in several articles and books address the issue of Families, and Public Policy Impact Assessments also the World Bank and Development Assistance Committee (OECD ) defines impact assessment as measuring changes in the welfare of individuals that can be attributed to a specific policy program or its implementation and results; were consulted Professor Paulo Freire and Margaret Shuler since time ago raised the concepts of empowerment , another reference was studies by the DPN in the years 2006-2008 , which in summary are given a positive endorsement families in Action program . With a methodological support a Descriptive Quantitative Research Transverse type by applying structured instruments such as the survey and checklist for audit of Medical Records , was identified and measured independently of each of the variables , is able to determine the level of empowerment that occurs naturally in front of the Families in Action program , as evidenced among other things, by the State child Nutrition beneficiary children compared to non-beneficiaries , analyzing external factors. As project scope is achieved described as Public Policy Social welfare generate positive or negative aspects of thought and behavior of vulnerable communities over time , he met the objectives that could be measured and concluded that the level of empowerment of women is a low level referenced independently whether or not they are also beneficiaries identify beneficiaries that children have a tendency to have a better nutritional status compared to children beneficiaries , we found a direct relationship between the empowerment of women against care of their children more we face the problems of the community or that the program has generated have thoughts and desires for improvement and / or self- sustainability . The social contribution of the research is given to the extent that the conclusions and recommendations made be a basis for improving strategies theoretical approach to the problem of poverty , arises , giving compliance to the fourth objective of the research, an Improvement Plan , in planning the Families in Action program from Phases Structure , Process and Outcomes , involving a joint and commitment of state institutions , on the basis of the achievement of the objectives of the research ., Maestría, Magister en Gestión en Servicios de Salud, INTRODUCCIÓN 21 1. PLANTEAMIENTO DEL PROBLEMA 23 1.1 TITULO DE LA PROPUESTA INVESTIGATIVA 23 1.1.1 Subtitulo 23 1.2 PROBLEMA DE INVESTIGACIÓN 23 1.2.1 Descripción del problema 23 1.3 HIPÓTESIS 34 1.4 JUSTIFICACIÓN 35 1.5 OBJETIVOS 38 1.5.1 Objetivo general 38 1.5.2 Objetivos específicos 38 2. MARCOS DE REFERENCIA 40 2.1 ANTECEDENTES 40 2.1.1 Antecedentes internacionales 40 2.1.2 Antecedentes departamentales 43 2.2 MARCO CONCEPTUAL 45 2.3 MARCO TEÓRICO 51 2.3.1 Conceptos teóricos sobre impacto 51 2.4 MARCO CONTEXTUAL 56 2.4.2 Contexto geográfico 60 2.5 MARCO LEGAL 61 2.5.1 Constitución política del 1991 61 2.5.2 Objetivos del milenio 2005 61 2.5.3 Decreto 1011 del 2006 62 2.5.4 Decreto 3039 del 2007 62 2.5.5 Ley 1283 del 2009 64 2.5.6 Decreto 2055 del 2009 64 2.5.7 Ley 1098 del 2010, de infancia y adolescencia 65 2.5.8 Ley 1438 del 2011 66 2.5.9. El plan Nacional de Salud pública 2011-2021 66 3. METODOLOGÍA Y PLAN DE TRABAJO 68 3.1 TIPO DE ESTUDIO 68 3.2 POBLACIÓN Y MUESTRA 69 3.2.1 Población 69 3.2.2 Muestra 69 3.3 ELABORACIÓN DE INSTRUMENTOS DE MEDICIÓN 70 3.3.1 Viabilidad del instrumento de medición 74 3.4 PLAN DE ANÁLISIS DE RESULTADOS 74 3.4.1 Variables 74 3.5 CRONOGRAMA DE ACTIVIDADES 75 3.6 ALCANCE 76 3.7 IMPACTO ESPERADO 76 3.8 RESULTADOS Y PRODUCTOS 77 3.8.1 A nivel formativo 77 3.8.2 A nivel de la sociedad 77 3.8.3 Indicadores de medición 78 3.9.1 Fuente de financiamiento 79 4. RESULTADOS DE LA INVESTIGACIÓN 80 4.1 INTRODUCCIÓN 80 4.2 OBJETIVOS 80 4.2.1 Objetivo general 80 4.2.1.1 Primer objetivo específicos 80 4.2.1.2 Segundo objetivo específico 84 4.2.1.3 Tercer objetivo específico 93 4.2.1.4 Cuarto objetivo específico 98 5. PRESENTACIÓN CUANTITATIVA DE RESULTADOS 121 5.1 Parte A. Preguntas de observación 121 5.1.1 Caracterización comparativa de las mujeres beneficiarias y no beneficiarias al programa familias en acción 121 5.2 PREGUNTAS DE SELECCIÓN 131 5.3 PARTE B. PREGUNTAS DE OPINIÓN 138 5.3.1 Comparativo del nivel de empoderamiento de las mujeres beneficiarias o no beneficiarias 138 5.4 Gráficos de tabulación de historias clínicas auditadas del crecimiento y desarrollo de los niños beneficiarios y no beneficiarios del programa familias en acción 149 5.4.1 Evaluación del estado de crecimiento y desarrollo de los niños menores de 7 años beneficiarios y no beneficiario. 150 5.4.2 Otros factores intervinientes en el crecimiento y desarrollo de los niños menores de 7 años beneficiarios y no beneficiarios 151 6. CONCLUSIONES 165 7. RECOMENDACIONES 171 BIBLIOGRAFÍA 173 ANEXOS 180, Ej. 1