Amenaza turística y vulnerabilidad de los sistemas de producción agrícola tradicional en Occidente Cercano, Antioquia Colombia

Se analiza el riesgo de pérdida de los sistemas de producción agrícola tradicional (SP) del Occidente cercano, Departamento de Antioquia, Colombia, debido a la actividad turística en la zona. Este análisis se realizó a partir de la identificación de los factores legales, infraestructura, atractivos y servicios presentes en el territorio, que promueven o facilitan el desarrollo del turismo como amenaza o factor de riesgo externo para los SP. También se evalúo la vulnerabilidad de los SP al turismo como un factor de riesgo interno del sistema, mediante la estimación de parámetros ambientales, económicos, sociales y técnicos. La investigación se realizó mediante el estudio de seis estudios de caso a escala predial. Los resultados obtenidos indican un riesgo bajo (Predio), una vulnerabilidad media de los seis SP ante el turismo (Predio).The risk of loss of traditional agricultural production systems (SP) of the nearby West, Department of Antioquia, Colombia, due to the tourist activity in the area is analyzed. This analysis was based on the identification of legal factors, infrastructure, attractions and services in the territory, that promote or facilitate the development of tourism as a threat or external risk factor for SP. SP vulnerability of tourism as an internal risk factor of the system is also evaluated by estimating environmental, economic, social and technical parameters. The research was conducted by studying six case studies at farm level. The results indicate a low risk, medium vulnerability of the six SP to tourism.Eje: A2: Paisajes, Territorios y AgroecologíaFacultad de Ciencias Agrarias y Forestale

Evaluación de sistemas de producción de frutales tradicionales asociados al turismo del Occidente Cercano Antioqueño, Colombia

Se evaluaron seis sistemas de producción de frutas y materias primas artesanales a escala predial, localizados en tres municipios ubicados a 50 km al occidente de la ciudad de Medellín, Dpto. de Antioquia, Colombia, mediante la generación de indicadores de sostenibilidad social, económica y ecológica. El objetivo fue visibilizar la importancia de estos sistemas locales de producción resaltando su aporte al desarrollo social, económico y ambiental de la población local y contribuir a su fortalecimiento, dar elementos para la formulación de políticas públicas y de transferencia de tecnología, en la perspectiva de mitigar los impactos y amenazas que representan las megas obras y el turismo en la región, contribuir al rescate y valoración de recursos fitogenéticos representados en los frutales nativos y al desarrollo del territorio con identidad cultural. Se identificó la multifuncionalidad de la agricultura tradicional, por medio de la gran diversidad de sistemas que rigen el proceso de producción de las frutas asociadas al turismo.Six systems of fruit production and handicraft of raw materials are examined at farm level. They are located in three municipalities 50 kilometers to the west of the city of Medellin, in the department of Antioquia, Colombia. These systems are examined by generating indicators of social, economical, and environmental sustainability. The aim was to visualize the significance of these local production systems by standing out its contribution to the social, economical, and environmental development of the local population, and their contribution to their strengthening. Furthermore, they give elements to the formulation of public policies and technology transfer, with a view to mitigate the impacts and threats that represent the megaprojects and tourism in the region. And also, these systems contribute to the recovery and assessment of the plant genetic resources represented in the native fruit trees, and in the territorial development with cultural identity. We identified the versatility of the traditional agriculture through the wide variety of systems that manage the production process of fruits associated with tourism.Eje A1 Sistemas de producción de base agroecológica (Trabajos científicos)Facultad de Ciencias Agrarias y Forestale

Evaluación de sistemas de producción de frutales tradicionales asociados al turismo del Occidente Cercano Antioqueño, Colombia

Se evaluaron seis sistemas de producción de frutas y materias primas artesanales a escala predial, localizados en tres municipios ubicados a 50 km al occidente de la ciudad de Medellín, Dpto. de Antioquia, Colombia, mediante la generación de indicadores de sostenibilidad social, económica y ecológica. El objetivo fue visibilizar la importancia de estos sistemas locales de producción resaltando su aporte al desarrollo social, económico y ambiental de la población local y contribuir a su fortalecimiento, dar elementos para la formulación de políticas públicas y de transferencia de tecnología, en la perspectiva de mitigar los impactos y amenazas que representan las megas obras y el turismo en la región, contribuir al rescate y valoración de recursos fitogenéticos representados en los frutales nativos y al desarrollo del territorio con identidad cultural. Se identificó la multifuncionalidad de la agricultura tradicional, por medio de la gran diversidad de sistemas que rigen el proceso de producción de las frutas asociadas al turismo.Six systems of fruit production and handicraft of raw materials are examined at farm level. They are located in three municipalities 50 kilometers to the west of the city of Medellin, in the department of Antioquia, Colombia. These systems are examined by generating indicators of social, economical, and environmental sustainability. The aim was to visualize the significance of these local production systems by standing out its contribution to the social, economical, and environmental development of the local population, and their contribution to their strengthening. Furthermore, they give elements to the formulation of public policies and technology transfer, with a view to mitigate the impacts and threats that represent the megaprojects and tourism in the region. And also, these systems contribute to the recovery and assessment of the plant genetic resources represented in the native fruit trees, and in the territorial development with cultural identity. We identified the versatility of the traditional agriculture through the wide variety of systems that manage the production process of fruits associated with tourism.Eje A1 Sistemas de producción de base agroecológica (Trabajos científicos)Facultad de Ciencias Agrarias y Forestale

Evaluación de sistemas de producción de frutales tradicionales asociados al turismo del Occidente Cercano Antioqueño, Colombia

Se evaluaron seis sistemas de producción de frutas y materias primas artesanales a escala predial, localizados en tres municipios ubicados a 50 km al occidente de la ciudad de Medellín, Dpto. de Antioquia, Colombia, mediante la generación de indicadores de sostenibilidad social, económica y ecológica. El objetivo fue visibilizar la importancia de estos sistemas locales de producción resaltando su aporte al desarrollo social, económico y ambiental de la población local y contribuir a su fortalecimiento, dar elementos para la formulación de políticas públicas y de transferencia de tecnología, en la perspectiva de mitigar los impactos y amenazas que representan las megas obras y el turismo en la región, contribuir al rescate y valoración de recursos fitogenéticos representados en los frutales nativos y al desarrollo del territorio con identidad cultural. Se identificó la multifuncionalidad de la agricultura tradicional, por medio de la gran diversidad de sistemas que rigen el proceso de producción de las frutas asociadas al turismo.Six systems of fruit production and handicraft of raw materials are examined at farm level. They are located in three municipalities 50 kilometers to the west of the city of Medellin, in the department of Antioquia, Colombia. These systems are examined by generating indicators of social, economical, and environmental sustainability. The aim was to visualize the significance of these local production systems by standing out its contribution to the social, economical, and environmental development of the local population, and their contribution to their strengthening. Furthermore, they give elements to the formulation of public policies and technology transfer, with a view to mitigate the impacts and threats that represent the megaprojects and tourism in the region. And also, these systems contribute to the recovery and assessment of the plant genetic resources represented in the native fruit trees, and in the territorial development with cultural identity. We identified the versatility of the traditional agriculture through the wide variety of systems that manage the production process of fruits associated with tourism.Eje A1 Sistemas de producción de base agroecológica (Trabajos científicos)Facultad de Ciencias Agrarias y Forestale

Amenaza turística y vulnerabilidad de los sistemas de producción agrícola tradicional en Occidente Cercano, Antioquia Colombia

Se analiza el riesgo de pérdida de los sistemas de producción agrícola tradicional (SP) del Occidente cercano, Departamento de Antioquia, Colombia, debido a la actividad turística en la zona. Este análisis se realizó a partir de la identificación de los factores legales, infraestructura, atractivos y servicios presentes en el territorio, que promueven o facilitan el desarrollo del turismo como amenaza o factor de riesgo externo para los SP. También se evalúo la vulnerabilidad de los SP al turismo como un factor de riesgo interno del sistema, mediante la estimación de parámetros ambientales, económicos, sociales y técnicos. La investigación se realizó mediante el estudio de seis estudios de caso a escala predial. Los resultados obtenidos indican un riesgo bajo (Predio), una vulnerabilidad media de los seis SP ante el turismo (Predio).The risk of loss of traditional agricultural production systems (SP) of the nearby West, Department of Antioquia, Colombia, due to the tourist activity in the area is analyzed. This analysis was based on the identification of legal factors, infrastructure, attractions and services in the territory, that promote or facilitate the development of tourism as a threat or external risk factor for SP. SP vulnerability of tourism as an internal risk factor of the system is also evaluated by estimating environmental, economic, social and technical parameters. The research was conducted by studying six case studies at farm level. The results indicate a low risk, medium vulnerability of the six SP to tourism.Eje: A2: Paisajes, Territorios y AgroecologíaFacultad de Ciencias Agrarias y Forestale

Amenaza turística y vulnerabilidad de los sistemas de producción agrícola tradicional en Occidente Cercano, Antioquia Colombia

Se analiza el riesgo de pérdida de los sistemas de producción agrícola tradicional (SP) del Occidente cercano, Departamento de Antioquia, Colombia, debido a la actividad turística en la zona. Este análisis se realizó a partir de la identificación de los factores legales, infraestructura, atractivos y servicios presentes en el territorio, que promueven o facilitan el desarrollo del turismo como amenaza o factor de riesgo externo para los SP. También se evalúo la vulnerabilidad de los SP al turismo como un factor de riesgo interno del sistema, mediante la estimación de parámetros ambientales, económicos, sociales y técnicos. La investigación se realizó mediante el estudio de seis estudios de caso a escala predial. Los resultados obtenidos indican un riesgo bajo (Predio), una vulnerabilidad media de los seis SP ante el turismo (Predio).The risk of loss of traditional agricultural production systems (SP) of the nearby West, Department of Antioquia, Colombia, due to the tourist activity in the area is analyzed. This analysis was based on the identification of legal factors, infrastructure, attractions and services in the territory, that promote or facilitate the development of tourism as a threat or external risk factor for SP. SP vulnerability of tourism as an internal risk factor of the system is also evaluated by estimating environmental, economic, social and technical parameters. The research was conducted by studying six case studies at farm level. The results indicate a low risk, medium vulnerability of the six SP to tourism.Eje: A2: Paisajes, Territorios y AgroecologíaFacultad de Ciencias Agrarias y Forestale

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

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

Riesgo de pérdida de los sistemas de producción agrícola tradicional por la amenaza turística en Occidente Cercano (Antioquia, Colombia)

El efecto del turismo sobre los sistemas de producción ( SP ) puede analizarse en términos de riesgo de pérdida y como producto de la amenaza y la vulnerabilidad. En el Occidente antioqueño el turismo es una actividad transformadora, por ello se evaluó si constituye una amenaza para los SP tradicionales y si estos están en riesgo. Se determinó la intensidad del turismo y la vulnerabilidad de seis SP tradicionales, considerando múltiples factores externos e internos. Se encontró que, efectivamente, el turismo representa un riesgo para los SP y que los más vulnerables son aquellos que usan tecnologías inadecuadas para las condiciones biofísicas, donde el operador no es propietario o donde falta relevo generacional. La investigación muestra que se requieren estrategias de planificación para promover un turismo con identidad cultural

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe