Percepciones de productores sobre el bienestar de bovinos doble propósito en los llanos Orientales de Colombia

The aim of this observational-cross-sectional study was to determine the attitudes of producers regarding the welfare (CW) of double-purpose (DP) cattle. A face-to-face survey was carried out with 20 DP producers from Meta, Colombia to quantify their perceptions (using 5-point Likert scales) on the level of impact that environmental, health and management aspects have on CW and on the level of importance of indicators (environmental, management, health and affective states) of CW evaluation. The average scores awarded to each aspect and indicator were calculated. The Kruskal-Wallis test was used to assess differences between categories of impact aspects and between categories of indicators. The health aspects were considered the ones with had the greatest impact (4.07/5), while the indicators of affective states were considered the least important (3.82). The key aspects categorized as 'Extreme Impact' factors were external parasite load (4.65), not checking colostrum intake (4.65), heat stress (4.55), myiasis (4.25) and disbudding/dehorning without anesthesia (4.25). Key indicators recognized as 'Essential' were access to shade (4.65), colostrum intake (4.55), staff skills (4.5), pup mortality (4.45) and drinking water (4.45). The results highlight the existing consensus between the impact of heat stress and the importance of the presence of shade as an indicator of CW, as well as between colostrum consumption and calf mortality. Likewise, there is evidence of a disagreement between the high impact of disbudding /dehorning without anesthesia and the low level of importance perceived as an essential indicator of CW.El objetivo de este estudio observacional-transversal fue determinar las actitudes de productores sobre el bienestar de bovinos (BB) doble-propósito (DP). Se realizó una encuesta presencial a 20 productores DP del Meta, Colombia, para cuantificar sus percepciones (utilizando escalas Likert de 5-puntos) sobre el nivel de impacto que tienen aspectos ambientales, de salud y de manejo en el BB y sobre el nivel de importancia de indicadores (ambientales, manejo, salud y estados afectivos) de evaluación del BB. Se calcularon las puntuaciones promedio otorgadas a cada aspecto e indicador. La prueba Kruskal-Wallis se utilizó para evaluar diferencias entre categorías de aspectos de impacto y entre categorías de indicadores. Los aspectos de salud fueron considerados como los de mayor impacto (4.07/5), mientras que los indicadores de estados afectivos fueron considerados como los de menor importancia (3.82). Los aspectos clave categorizados como factores de ‘Impacto extremo’ fueron carga parasitaria externa (4.65), no verificar consumo de calostro (4.65), estrés térmico (4.55), miasis (4.25) y topizar/descornar sin anestesia (4.25). Los indicadores clave reconocidos como ‘Esenciales’ fueron acceso a sombra (4.65), consumo de calostro (4.55), capacidades del personal (4.5), mortalidad de crías (4.45) y agua potable (4.45). Los resultados resaltan el consenso existente entre el impacto del estrés calórico y la importancia de la presencia de sombra como indicador de BB, así como entre el consumo de calostro y la mortalidad de crías. Asimismo, se evidencia un disenso entre el alto impacto que tiene topizar/descornar sin anestesia y el bajo nivel de importancia percibido como indicador esencial de BB

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort studyResearch in context

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017