Poverty and the destruction of food: hunger in the world and emerging foods. Towards a new humanity. Ongoing line of research

Edición bilingüe, español-inglésEl Congreso Internacional sobre “Pobreza y Denuncia de la destrucción de alimentos. Hambre en el mundo y alimentos emergentes: por una Nueva Humanidad”, se propone las siguientes líneas fundamentales: 1. Analizar el problema del hambre en el mundo, en toda su dimensión y profundidad, con nuevos parámetros y nuevos conceptos, desde una perspectiva multidisciplinar, para tomar conciencia de las dimensiones y las repercusiones de este grave problema. 2. Denunciar la destrucción de alimentos en el mundo a través de un trabajo cartográfico que identifique los lugares donde esto está sucediendo. Promovamos un cambio en nuestras estructuras socio-económicas, pero también en nuestros estilos de vida; mientras un solo hombre muera de hambre, debemos concienciarnos de la necesidad de vivir la austeridad. Compartir no es fácil, tenemos que capacitarnos para ello. 3. Descubrir las líneas de investigación de nuevos alimentos emergentes para descubrir nuevas fuentes de alimentación sostenibles y compatibles con el respeto a la dignidad de toda persona humana. Es vital trabajar y luchar por ello para erradicar el hambre y la pobreza en el mundo. 4. Promover el crowdfunding como técnica de ayuda para que muchos contribuyamos con poco a crear una nueva situación en el mundo. Tenemos que colaborar a crear nuevas estructuras de cooperación y nuevas fórmulas de financiación que promuevan la solidaridad y la fraternidad. No demos de lo que nos sobra, demos de lo que nos duela. 5. Crear un movimiento internacional de profesores, alumnos, universitarios y jóvenes en general, que luchen por un mundo nuevo con el lema de una Nueva Humanidad en la que los hombres se sientan más hermanos, una familia que posibilite que dentro de unos años veamos el problema del hambre como algo que ya no existe.Cátedra de la Caridad Santo Tomás de VillanuevaHumanidade

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London