Playas de Rosarito: Propuesta para una optimización territorial de las prácticas turísticas y recreativas

Tesis dirigida por Fernando Vera Rebollo, tutor Onésimo Cuamea Velázquez. Se centra en el Municipio de Rosarito, B.C., como campo de trabajo en pos de encontrar e intentar potenciar este sitio y hacer frente, no solo a cuestiones de competencia y satisfacer las nuevas exigencias del turista de hoy, sino que también permita una disminución en los impactos ambientales que son generados por el turismo en el litoral municipal, una creación de nuevas fuentes de empleo en las zonas marginadas del municipio, un combate a la deserción en las zonas rurales y el ofrecimiento de una perspectiva de mejora en la calidad de vida de los pobladores que se encuentran fuera de la zona urbana. Se centra en conocer el problema desde la perspectiva de la oferta, concluyendo con una contextualización territorial y funcional del área de trabajo y un análisis de potencialidades turísticas y recreativas de las áreas del interior del municipio que fueron encontradas y estudiadas en el trabajo de campo. Realiza un análisis de motivaciones del turista ante las actividades recreativas susceptibles de realizarse en los lugares del interior del municipio, seguido de una valoración de la planta turística desde la dimensión empresarial e institucional del municipio, y culminando con un diagnóstico integrado. Se plantean las propuestas relativas a la ordenación de los sitios del estudio, a la gestión territorial y ambiental de los sitios, a los productos, su imagen y configuración y a la promoción y comercialización de los productos una vez configurados

La integración del territorio interior como incentivador de desarrollo turístico: caso Playas de Rosarito (México)

Playas de Rosarito es el municipio de más reciente creación y con mayor vocación turística de Baja California. Alrededor de su principal atractivo, el sol y la playa, opera una creciente oferta de servicios de hospedaje, alimentación y espacios para la recreación y el esparcimiento, y últimamente un importante crecimiento de turismo de segunda residencia; sin embargo, la proliferación de discotecas ha propiciado la afluencia de un turismo juvenil con poca capacidad de gasto que se interesa más en diversión nocturna. Un turismo joven con poca sensibilidad ambiental, que aunada a la falta de escrúpulos de algunos servidores turísticos, está provocando una alta concentración y aglomeración de usuarios en espacios específicos y el gradual deterioro de su principal atractivo, la “playa”, así como la disminución de la afluencia del turismo familiar que recibe anualmente. Considerando lo anterior, el presente artículo expone la importancia de identificar y caracterizar nuevas alternativas turísticas recreativas como estrategia de planificación y de desarrollo, para integrar la región interior del municipio rosaritense a la dinámica económica y de desarrollo del espacio costero y evitar así, o disminuir al menos, la sobre-explotación de su principal recurso turístico (la playa), preservar la afluencia del turismo familiar, diversificar la oferta turística municipal y promover la afluencia de turistas con intereses diferentes al tradicional sol y playa. La detección e identificación de recursos naturales susceptibles de aprovechamiento turístico se llevó a cabo mediante visitas de reconocimiento y observación directa en la zona rural interior del municipio, y mediante un análisis de debilidades, amenazas, fortalezas y oportunidades se procedió a su selección y caracterización, que a partir de una planificación territorial permitiera una explotación de sus recursos de manera sustentable y con beneficios directos para la población local. Entre los sitios naturales visitados se seleccionaron tres, con potencial para prácticas de campismo, senderismo, motocross, ciclismo de montaña, alpinismo para principiantes y rappel, etc.; es decir, en general se detecta la viabilidad de realizar actividades turísticas y recreativas de bajo impacto. Los sitios seleccionados en general, no requieren grandes inversiones sino más bien del interés y voluntad de quienes se beneficiarían con su explotación; propietarios de los suelos en donde se encuentran los sitios, servidores turísticos y autoridades responsables de la planificación y promoción turística. Dentro de este contexto, el estudio dirige su mirada hacia la zona del interior del municipio como campo de trabajo en pos de encontrar e intentar potenciar estos sitios y hacer frente, no solo a cuestiones de competencia y satisfacer las nuevas exigencias del turista de hoy, sino que también permita una disminución en los impactos ambientales que son generados por el turismo en el litoral, una creación de nuevas fuentes de empleo en las zonas marginadas, un combate a la deserción en las zonas rurales y el ofrecimiento de una perspectiva de mejora en la calidad de vida de los pobladores de la zona rural de Rosarito; entendiendo que la integración del interior a la dinámica turística costera sea el resultado de una planeación territorial y desarrollo sustentable controlado.Peer Reviewe

El Enoturismo en México: comportamiento de viaje y patrones de consumo en la ruta del vino, Baja California

En su origen, la Región del Vino en el norte del municipio de Ensenada, México, se orientó al cultivo e industrialización de la uva, así como la producción y comercialización de vino; posteriormente, a partir de la década de los noventa, se combinó con el entonces incipiente crecimiento de servicios relacionados con el turismo. Se iniciaron ofertas de servicios tales como la degustación de vinos de la región, restaurantes (servicios de restauración); venta de artesanías, souvenirs (recuerdos) y curious (curiosidades); entre otros artículos de interés para los visitantes, los cuales fueron creciendo en volumen y en demanda. Es a partir del inicio del presente siglo, que las políticas públicas se enfocaron en impulsar la Región del Vino (o Valle de Guadalupe, como también se le conoce), iniciando un proceso de consolidación para lo que hoy se oferta al turismo enológico como Ruta del Vino (El COLEF, 2013). Sin embargo, el desarrollo de la nueva oferta de servicios turísticos en dicha región se ha basado más en decisiones intuitivas por parte de los empresarios (tanto vitivinicultores como turísticos) sin considerar las necesidades, gustos y preferencias de los visitantes.Fil: Morgan Medina, Jorge Carlos. Universidad Autónoma de Baja California Sur; MéxicoFil: Cuamea Velázquez, Onésimo. Universidad Autónoma de Baja California Sur; MéxicoFil: Minaverry, Clara María. Universidad Nacional de Luján; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Use and Perception of Digital Marketing Tools for Micro-Enterprises in Tijuana

In modern world, big changes are occurring in short time frames, business are dealing with information and communication technologies adaptation and updating problems, being such as Internet and Web 2.0. There are different tools that allow efficiency in internal and external communications of the company; when it comes to external communication, digital marketing is gaining more ground and an increasing number of companies invest more in that kind of strategies. Digital marketing as a tool for business is a great advantage that not all recognize, even much less number of companies use it, in particular microenterprises. There are many factors that influence the decision to adopt digital marketing strategies and activities. The present paper presents the scores for the different digital marketing activities as perceived and implemented by micro-enterprises in the city of Tijuana. The main reasons why they do not perform digital marketing activities are: they do not believe it necessary, training outdates and price. Companies mainly perform activities in social networks, in the company website, emailing and online advertising, while they qualify email, website, Facebook and Google Maps as the most useful digital marketing activities. This information can be used both by microenterprises as by suppliers to generate profitable strategic alliances

La integración del territorio interior como incentivador de desarrollo turístico: caso Playas de Rosarito (México)

Playas de Rosarito es el municipio de más reciente creación y con mayor vocación turística de Baja California. Alrededor de su principal atractivo, el sol y la playa, opera una creciente oferta de servicios de hospedaje, alimentación y espacios para la recreación y el esparcimiento, y últimamente un importante crecimiento de turismo de segunda residencia; sin embargo, la proliferación de discotecas ha propiciado la afluencia de un turismo juvenil con poca capacidad de gasto que se interesa más en diversión nocturna. Un turismo joven con poca sensibilidad ambiental, que aunada a la falta de escrúpulos de algunos servidores turísticos, está provocando una alta concentración y aglomeración de usuarios en espacios específicos y el gradual deterioro de su principal atractivo, la “playa”, así como la disminución de la afluencia del turismo familiar que recibe anualmente. Considerando lo anterior, el presente artículo expone la importancia de identificar y caracterizar nuevas alternativas turísticas recreativas como estrategia de planificación y de desarrollo, para integrar la región interior del municipio rosaritense a la dinámica económica y de desarrollo del espacio costero y evitar así, o disminuir al menos, la sobre-explotación de su principal recurso turístico (la playa), preservar la afluencia del turismo familiar, diversificar la oferta turística municipal y promover la afluencia de turistas con intereses diferentes al tradicional sol y playa. La detección e identificación de recursos naturales susceptibles de aprovechamiento turístico se llevó a cabo mediante visitas de reconocimiento y observación directa en la zona rural interior del municipio, y mediante un análisis de debilidades, amenazas, fortalezas y oportunidades se procedió a su selección y caracterización, que a partir de una planificación territorial permitiera una explotación de sus recursos de manera sustentable y con beneficios directos para la población local. Entre los sitios naturales visitados se seleccionaron tres, con potencial para prácticas de campismo, senderismo, motocross, ciclismo de montaña, alpinismo para principiantes y rappel, etc.; es decir, en general se detecta la viabilidad de realizar actividades turísticas y recreativas de bajo impacto. Los sitios seleccionados en general, no requieren grandes inversiones sino más bien del interés y voluntad de quienes se beneficiarían con su explotación; propietarios de los suelos en donde se encuentran los sitios, servidores turísticos y autoridades responsables de la planificación y promoción turística. Dentro de este contexto, el estudio dirige su mirada hacia la zona del interior del municipio como campo de trabajo en pos de encontrar e intentar potenciar estos sitios y hacer frente, no solo a cuestiones de competencia y satisfacer las nuevas exigencias del turista de hoy, sino que también permita una disminución en los impactos ambientales que son generados por el turismo en el litoral, una creación de nuevas fuentes de empleo en las zonas marginadas, un combate a la deserción en las zonas rurales y el ofrecimiento de una perspectiva de mejora en la calidad de vida de los pobladores de la zona rural de Rosarito; entendiendo que la integración del interior a la dinámica turística costera sea el resultado de una planeación territorial y desarrollo sustentable controlado.Peer Reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe