20 research outputs found

    Una mirada interdisciplinar sobre los retos actuales de la infancia en un mundo globalizado (RETIN)

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    El concepto de infancia ha ido evolucionando a lo largo de la historia. En el siglo XX, especialmente en sus últimos años, se ha prestado mayor atención al desenvolvimiento de los seres humanos en esta etapa de la vida, atención que se ha concretado, entre otras cuestiones, en el interés creciente hacia los derechos de la infancia. En 1989 este proceso se ve reforzado por la aprobación de la Convención de las Naciones Unidas sobre los Derechos de los niños y las niñas, que reconoce a las personas menores de 18 años de edad derechos civiles, sociales, económicos, culturales y políticos, derechos de ciudadanía en suma para el colectivo infantil, considerado previamente como puro objeto de protección. En el ámbito de las ciencias sociales se ha producido también una transformación. Desde un enfoque sociológico se considera que la infancia es un espacio temporal en la trayectoria de vida de las personas, y también el espacio social definido para el desarrollo de la vida de los niños. Se reconoce que también los niños, como grupo social, no sólo pueden actuar, sino que actúan de hecho, y se relacionan con los demás grupos sociales, modificando, construyendo y contribuyendo a los cambios que se producen en la sociedad. En este marco, el objetivo del presente proyecto es la elaboración y difusión de materiales audiovisuales pedagógicos basados en entrevistas sobre los retos actuales de la infancia en un mundo globalizado, como son: cuidados en la ciudad, infancia migrante no acompañada, desigualdades socioeconómicas, nuevas tecnologías y género

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    How to address summer energy poverty in public policies

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    Este documento recoge las recomendaciones en materia de políticas públicas con incidencia en la pobreza energética de verano. Ha sido desarrollado por un consorcio de expertos pertenecientes al proyecto europeo COOLTORISE: Raising summer energy poverty awareness to reduce cooling needs
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