Incidencia de la localización industrial en la expansión de las ciudades: la industria del tequila en Arandas y Tequila, Jal

El desarrollo y crecimiento de las ciudades se ve afectado por distintos factores, ya sea naturales o manipulados por el hombre, en el caso de este estudio la industria será el factor a analizar mediante una comparativa de dos poblaciones del estado de Jalisco que tienen como común denominador la industria del tequila: Arandas y Tequila. Por un lado la industria en Arandas parece haber encontrado su lugar fuera de la mancha urbana mientras que por su parte Tequila mantiene sus fábricas unidas a la ciudad, en parte para explotar la imagen de pueblo tequilero hacia el turismo, a pesar de que las teorías de la localización industrial dicen lo contrario en cuanto a productividad se refiere, lo que se pretende obtener al final del estudio es conocer cómo influye cada una de estas diferentes localizaciones a su respectiva ciudad.The development and growth of the cities are affected by different factors, they can be natural or manipulated by the man, in the case of this study the industry will be the factor to analyze by means of a comparative of two cities in the state of Jalisco that have like common denominator the industry of the tequila: Arandas and Tequila. On one hand the industry in Arandas seems to have found its place outside the urban areas and on the other hand Tequila maintains its factories together with the city, partly to operate the image of traditional town towards the tourism, although the theories of the industrial location say the opposite as far as productivity talks about, which is tried to obtain at the end of the study is to know how it influences each from these different locations from his respective city.Peer Reviewe

Incidencia de la localización industrial en la expansión de las ciudades: la industria del tequila en Arandas y Tequila, Jal

El desarrollo y crecimiento de las ciudades se ve afectado por distintos factores, ya sea naturales o manipulados por el hombre, en el caso de este estudio la industria será el factor a analizar mediante una comparativa de dos poblaciones del estado de Jalisco que tienen como común denominador la industria del tequila: Arandas y Tequila. Por un lado la industria en Arandas parece haber encontrado su lugar fuera de la mancha urbana mientras que por su parte Tequila mantiene sus fábricas unidas a la ciudad, en parte para explotar la imagen de pueblo tequilero hacia el turismo, a pesar de que las teorías de la localización industrial dicen lo contrario en cuanto a productividad se refiere, lo que se pretende obtener al final del estudio es conocer cómo influye cada una de estas diferentes localizaciones a su respectiva ciudad.The development and growth of the cities are affected by different factors, they can be natural or manipulated by the man, in the case of this study the industry will be the factor to analyze by means of a comparative of two cities in the state of Jalisco that have like common denominator the industry of the tequila: Arandas and Tequila. On one hand the industry in Arandas seems to have found its place outside the urban areas and on the other hand Tequila maintains its factories together with the city, partly to operate the image of traditional town towards the tourism, although the theories of the industrial location say the opposite as far as productivity talks about, which is tried to obtain at the end of the study is to know how it influences each from these different locations from his respective city.Peer Reviewe

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Cualificación en los Objetivos establecidos en la Agenda 2030 de estudiantes y profesores en el Máster Universitario en Profesor de Educación Secundaria Obligatoria y Bachillerato, Formación Profesional y Enseñanza de Idiomas (MUPES)

Memoria ID2022-157 Ayudas de la Universidad de Salamanca para la innovación docente, curso 2022-2023

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

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