Zonificación Ambiental Área de Recreación Alto del Rey del Municipio de Balboa Risaralda

La realización de la zonificación ambiental del Área de Recreación Alto del Rey del municipio de Balboa en el departamentos de Risaralda, respondió a dos razones principales, cómo primera medida el cambio en la categoría de manejo del área, antes Parque Municipal Natural, con la aplicación del Decreto 2372 de 2010, la segunda en respuesta a la gestión de la Corporación Autónoma Regional de Risaralda CARDER, la cual en sus procesos de mejoramiento y calidad, estableció plazos en tiempo para la actualización de los planes de manejo iguales a un período de Plan de Acción (cuatro años). Durante la ejecución de la zonificación ambiental del Área de Recreación Alto del Rey, se utilizó como base la metodología de superposición cartográfica a través de un Sistema de Información Geográfica “SIG”. Se obtuvo la zonificación ambiental para los medios bióticos, abióticos y sociales, determinando la sensibilidad de cada elemento según el diagnóstico de la línea base por cada medio, dicha sensibilidad fue representada por un valor numérico que varía de acuerdo a cada variable analizada, entre mayor valor de calificación, mayor sensibilidad. Palabras clave: Zonificación ambiental, Susceptibilidad, Restauración, Recuperación, Uso Sostenible.The environmental zoning of the Alto del Rey Recreation Area of the municipality of Balboa in the departments of Risaralda, responded to two main reasons, as a first measure the change in the category of management of the area, before Natural Municipal Park, with the application of Decree 2372 of 2010, the second in response to the management of the Regional Autonomous Corporation of Risaralda CARDER, which in its improvement and quality processes, established deadlines in time for updating management plans equal to a Plan period of Action (four years). During the execution of the environmental zoning of the Alto del Rey Recreation Area, the cartographic overlay methodology was used as a basis through a Geographic Information System “GIS”. The environmental zoning for biotic, abiotic and social environments was obtained, determining the sensitivity of each element according to the baseline diagnosis for each medium, said sensitivity was represented by a numerical value that varies according to each variable analyzed, the higher rating value, higher sensitivity. Keywords: Environmental Zoning, Susceptibility, Restoration, Recovery, Sustainable Use

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

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

Seminario de Investigación aplicada 2018-I

El programa de contaduría pública de la universidad piloto de Colombia seccional alto magdalena, precursor de la constante actualización de conocimientos contables, fiscales y financieros; entrega a la comunidad académica la siguiente recopilación de trabajos de grado, del periodo 2018-I, enfocados en la actualización de conceptos de las áreas anteriormente mencionadas y realizado por los estudiantes de último semestre en el marco del seminario de investigación aplicada. El mencionado seminario tuvo una duración de 160 horas asignadas de la siguiente manera: Gestión contable por parte del Contador público, especialista en gerencia de impuestos, revisoría fiscal y auditoria externa, con certificación internacional en normas internacionales de información financiera (NIIF) Argilio Acuña Gallego (40 horas), y el contador público con especialización en gerencia de proyectos y certificado internacionalmente en normas internacionales Jhon Wilson Castro Gaitán (40 horas), gestión fiscal dirigida por el contador público especialista en derecho tributario con diplomado en Normas internacionales (NIIF) Andrés Felipe Forero Gámez (40 Horas) y gestión financiera conducida por el contador público especialista en gerencia administrativa y financiera, gerencia de proyectos, certificado en normas internacionales (NIIF), con maestrías en auditoria y gestión, dirección estratégica, Carlos Armando Castaño Matallana (40 Horas). Teniendo en cuenta que el ámbito fiscal en Colombia es constantemente sometido a cambios, se presenta una guía práctica de reconocimiento, en la cual se aplican talleres teóricos – prácticos y se recopila distintos argumentos de los participantes, dando, así como resultado una monografía de conocimientos contables atreves de la investigación

Delaying surgery for patients with a previous SARS-CoV-2 infection

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