INVESTIGACIÓN TURÍSTICA

GUÍA PEDAGÓGIC

Socioeconomic and environmental vulnerability: Valle de Cuautitlan-Texcoco, State of Mexico

The multidimensional vulnerability Cuautitlan-Texcoco Valley is anchored in social tension motivated by exclusion, deprivation and poverty of the population, as well as the problem of air pollution and water supply. The vulnerability is linked intrinsically to the City of Mexico and structural determinants, systems of production of goods and services invasive, population growth and urban sprawl. The socioeconomic and environmental weaknesses, have multiplier effects on the quality of life minimizes the ability of people to respond to contingency and risk situations, and questions the resilience of the metropolis of central Mexico. Official information sources are used and analyze indicators of marginalization, social backwardness, poverty, welfare, air pollution and water supply.La vulnerabilidad multidimensional del Valle de Cuautitlán-Texcoco se afianza en la tensión social motivada por la exclusión, las carencias y la pobreza de la población, así como en la problemática de la contaminación del aire y abastecimiento de agua. La vulnerabilidad está ligada intrínsecamente a la Ciudad de México y los factores estructurales que la determinan, sistemas de producción de bienes y servicios invasivos, aumento demográfico y crecimiento urbano desordenado. Las debilidades socioeconómicas y medioambientales, tienen efectos multiplicadores en la calidad de vida, minimiza la capacidad de la población para responder a situaciones de contingencia y riesgo, y cuestiona la resiliencia de la metrópoli del centro de México. Se utilizan fuentes de información oficial y analizan indicadores de marginación, rezago social, pobreza, bienestar, contaminación del aire y provisión de agua.Universidad Autónoma del estado de México, Consejo Nacional de Ciencia y Tecnologí

Adaptación a los cambios ambientales y territoriales

En este libro se abordan temáticas que destacan la adaptación de los distintos sectores de población a los cambios ambientales y territoriales, la cual muestra las respuestas a la incidencia de los estímulos del entorno, económico, social y ambiental. Así, se destaca la exposición de la población a los efectos destructivos de las amenazas y peligros naturales, lo que ha despertado interés en conocer sus causas, prevenir y mitigar el daño. A través de la revisión de estudios se induce la aprehensión de un tema que adquiere importancia en el contexto de los impactos globales, regionales y locales que se producen como consecuencia de la vulnerabilidad estructural característica de los países en desarrollo.En este libro se proponen estrategias de prevención ante la ocurrencia periódica de inundación en San Mateo Atenco, Estado de México y se analizan los factores sociales que inciden en el deterioro del bosque templado en San Lorenzo Huitzitzilapan. También se exponen soluciones para que se mejoren la condición del bosque y la calidad de vida de la población.Proyecto realizado con financiamiento de la Secretaría de Educación Pública-Subsecretaría de Educación Superior-Dirección General de Educación Superior Universitaria. Número del convenio con la SEP: 2017-15-001-017

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Community organisation for tourism : A Mexican case study

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Reserva de carbono en biomasa forestal y suelos minerales en el Parque Nacional Malinche (México)

Las áreas naturales protegidas representan una de las estrategias para la mitigación del cambio climático. El objetivo de esta investigación consistió en estimar el contenido de carbono en biomasa forestal en suelos minerales y calcular las pérdidas de carbono por cambios de uso del suelo en el Parque Nacional Malinche (PNM). La superficie de bosque del PNM es de 17.496,34 ha y almacena 1.544.377,66 mg en bosque y 4.148.985,97 mg en suelos. Para estimar el contenido de biomasa forestal se aplicaron ecuaciones alométricas y se trabajó con la cartografía del Instituto Nacional de Estadística y Geografía (INEGI) en el análisis espacio-temporal de los cambios de uso de suelo. Para el carbono en suelos se aplicaron los valores del Panel Intergubernamental de Cambio Climático (IPCC)

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Anti-inflammatory effects of melatonin in multiple sclerosis

Melatonin is a hormone with complex roles in the pathogenesis of autoimmune disorders. Over the years, it has become clear that melatonin may exacerbate some autoimmune conditions, whereas it alleviates others such as multiple sclerosis. Multiple sclerosis is an autoimmune disorder characterized by a dysregulated immune response directed against the central nervous system. Indeed, the balance between pathogenic CD4+ T cells secreting IFN-γ (TH1) or IL-17 (TH17); and FoxP3+ regulatory T cells and IL-10+ type 1 regulatory T cells (Tr1 cells) is thought to play an important role in disease activity. Recent evidence suggests that melatonin ameliorates multiple sclerosis by controlling the balance between effector and regulatory cells, suggesting that melatonin-triggered signaling pathways are potential targets for therapeutic intervention. Here, we review the available data on the effects of melatonin on immune processes relevant for MS and discuss its therapeutic potential.Fil: Farez, Mauricio Franco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; ArgentinaFil: Calandri, Ismael L.. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; ArgentinaFil: Correale, Jorge. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; ArgentinaFil: Quintana, Francisco J.. Harvard Medical School; Estados Unidos. The Broad Institute; Estados Unido