32 research outputs found

    Estudio de factibilidad para la creación de una empresa de producción y comercialización de gerberas, "Gerberas del Café" en la ciudad de Pereira

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    El estudio de factibilidad realizado para analizar la creación de GERBERAS DEL CAFE, Cultivo de flores ornamentales, permitió definir ciertos criterios. - El estudio de mercados infiere sobre la población objetivo de GERBERAS DEL CAFE, obteniendo como resultado demandas potenciales favorables, respaldadas por una penetración de mercado progresiva, lo que le da vía libre a las proyecciones de ventas realizadas y muestra factibilidad comercial. - La factibilidad técnica, comprendida por los estudios de tamaño, localización e ingeniería, muestra que la capacidad de la empresa cumple con las necesidades de producción, además de ajustarse al diseño requerido por las condiciones del cultivo y al lugar elegido para su implementación. - El estudio administrativo y legal, garantiza el correcto funcionamiento de la empresa a partir de direccionamientos estratégicos claramente definidos, manuales e instructivos de trabajo óptimo, y trámites legales y de reglamentación identificados, dando como resultado una empresa factible desde el punto de vista organizacional, reflejado en el excelente servicio al cliente que se presta. - El estudio de factibilidad financiera arroja resultados positivos que determinan la viabilidad de la creación de esta nueva unidad de negocio; los ingresos son suficientes para cubrir sus costos de inversión y sostenimiento. - El análisis de sensibilidad evaluado con el VPN, TIR y B/C refleja que se debe aceptar la inversión ya que todos los valores obtenidos son positivos - Como se establece en las políticas ambientales de GERBERAS DEL CAFE, el impacto al medio ambiente es positivo en todo momento a partir de procesos más limpios y campañas de protección ambiental implementadas en el proceso de producción y comercialización, respaldando las iniciativas de responsabilidad social y ambiental generadas alrededor de todo el planeta. - Finalmente, es importante resaltar la necesidad de creación de empresa con sentido social y de impacto positivo; se recomienda buscar la disminución al máximo de costos operativos para mejorar las expectativas en el proyectoThe feasibility study undertaken to examine the creation of GERBERAS Coffee Cultivation of ornamental flowers, possible to define certain criteria. - Market research on the target population inferred Gerbera COFFEE, resulting in favorable potential claims, backed by a progressive market penetration, which gives free rein to sales projections and shows commercial feasibility. - Technical feasibility, including studies by size, location and engineering, shows that the ability of the company meets the needs of production, and fit the design required by the conditions of cultivation and the site chosen for implementation. - The administrative and legal study, the proper functioning of the company from clearly defined strategic direction, manuals and work instructions optimum, and legal and regulatory procedures identified, resulting in an enterprise feasible organizational standpoint, reflected in the excellent customer service that is provided. - The financial feasibility study shows positive results to determine the feasibility of creating this new business unit, revenue sufficient to cover its investment costs and maintenance. - The sensitivity analysis evaluated the NPV, IRR and B / C shows that investment should be accepted and that all values obtained are positive. - As stated in the environmental policies of gerbera CAFE, the environmental impact is positive at all times from cleaner processes and environmental protection campaigns implemented in the production and marketing process, supporting social responsibility initiatives and generated environment around the planet. - Finally, it is important to highlight the need for setting up a business with a social and positive impact, they should get the maximum reduction of operating costs to improve the prospects in the project

    Knowledge networks in public health and the capacity for building up through collaborative strategies

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    ABSTRACT: This paper presents the experience of a thematic network on public health in Colombia, which focuses its development and contributions to the field of research in policy and health systems. It is recognized in the work of this network the revival of knowledge from the interactions of social actors who share experiences, data, information, approaches, state of art and research methodologies and intervention as well as possibilities of systematization and measures generating political and public opinion in order to advance social transformation processes. The reflection on the construction of this type of endogenous capacities in the field leads to the necessary dimension of the challenges of increased national and global interaction. It builds networks of knowledge must advance and mature in the development of different forms of cooperation that allow them to experience greater international integration to improve performance and territorial impact. We conclude by interpreting how the internationalization of academic and scientific relations is the foundation of a perspective for the work of knowledge networks in a globalized world.RESUMEN: Este ensayo presenta la experiencia de una red temática en salud pública para Colombia que orienta sus desarrollos y aportes hacia el campo de la investigación en políticas y sistemas de salud. Se reconoce en el trabajo de esta red el surgimiento de relaciones de conocimiento a partir de las interacciones de actores sociales que comparten experiencias, datos, información, enfoques, estados del arte y metodologías de investigación e intervención, así como posibilidades de sistematización y medidas de política y generación de opinión pública, con el objeto de avanzar en procesos de transformación social. La reflexión en torno a la construcción de este tipo de capacidades en el ámbito endógeno lleva a la necesaria dimensión de los retos de una mayor interacción nacional y global. Se sustenta que las redes de conocimiento deben avanzar y madurar en el desarrollo de diferentes modalidades de cooperación que les permitan experimentar una mayor inserción internacional para mejorar la actuación e incidencia territorial. Se concluye interpretando cómo la internacionalización de las relaciones académicas y científicas es la base de una perspectiva para el trabajo de redes de conocimiento en un mundo globalizado

    Reflexiones para la construcción de política pública con impacto en el componente bucal de la salud

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    ABSTRACT: The workshop on Oral Health by the interinstitutional cooperation “Management of Public Policies and Health” has the objective of promoting a reflection conducive to the formulation of public health proposals that have a positive effect on the general health and its oral component. There are precedents of such policies and the local and international levels that have gone unrecognized by the reform to the social security system in health; this has produced, in the specific case of Medellin, the dismantling of public health programs that have proven their efficiency and efficacy in previous years. Some examples that show this statement are presented and some basic enunciates are proposed which should be part of a public policy with impact on the oral component of health. It concluded that the political, economic and demographic changes experienced by our country in the past recent years have given place to a determined profile of health disease which should be attended by the organized management of society. The oral component of health has also been affected and the dental practice called to respond to the new or old needs that the population has in this field.RESUMEN: La Mesa de trabajo por la Salud Bucal del proyecto interinstitucional de cooperación “Gestión de Políticas Públicas y Salud”, tiene como propósito promover una reflexión que conduzca a la formulación de propuestas de política pública que afecten positivamente la salud general y su componente bucal. Existen en el ámbito mundial y nacional antecedentes de dicha política que han sido desconocidos por la reforma al sistema de seguridad social en salud, lo que ha provocado en el caso específico de Medellín el desmonte de programas de salud pública que en otros tiempos mostraron ser eficaces y eficientes. Se exponen algunos ejemplos que ilustran esta afirmación y se proponen algunos enunciados básicos que deben hacer parte de una política pública con impacto en el componente bucal de la salud. Se concluye que los cambios políticos, económicos y demográficos que el país ha experimentado en los últimos años, han dado lugar a un determinado perfil de salud enfermedad que debe ser atendido mediante la gestión organizada de la sociedad; el componente bucal de la salud también se ha visto afectado y la práctica odontológica convocada a responder a las necesidades nuevas o antiguas que en este campo tiene la población

    “Diseño de una estrategia pedagógica comunicativa, para una estudiante de 21 años con discapacidad neuromotora y discapacidad intelectual moderada asociada”

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    En su célebre frase Yadiar Julián “La mentalidad fuerte del ser humano, debe enfocarse en sus logros, no es sus limitaciones” Yadiar (2000), hace referencia a los provechos que los profesionales de la Educación Especial pueden alcanzar cuando en su actuar hacen énfasis en la búsqueda y potenciación de las capacidades de la persona con discapacidad, para un mejor desarrollo y provecho de las mismas en su vida cotidiana, con el fin de enfocar la labor docente no en el “mejoramiento” de sus déficits sino en el desarrollo de sus habilidades, permitiendo así que su discapacidad pase a ser vista desde la concepción de talentos diversos. De otra parte, la discapacidad como condición presente en nuestra sociedad, es una realidad a la que cualquier familia puede enfrentarse tras diversas situaciones tales como: el cambio brusco de las condiciones biológico-ambientales de un individuo por nacer, o en cualquier etapa de la vida posterior al nacimiento, adicionalmente la discapacidad de un miembro de la familia trae consigo situaciones nuevas, extrañas y difíciles de llevar, como el sentimiento de culpa y la inseguridad, ante las cuales ninguna familia o persona estará lo suficientemente preparada y consciente para asumir, aceptar y enfrentar las dificultades emocionales y físicas que trae consigo el día a día de un familiar con discapacidad. Lo anterior, genera inquietudes que al ir experimentando situaciones impensadas, confrontan directamente lo emocional, lo que puede afectar o no, el desarrollo de la familia y de la persona en condición de discapacidad, donde la discapacidad es entendida, como un “término general que abarca las deficiencias, las limitaciones de la actividad y las restricciones de la participación” (2000, OMS). Sin embargo, actualmente Brand y Pope proponen de manera asertiva que “la discapacidad puede ser mayor o menor en la medida que el entorno le ofrezca las herramientas, adaptaciones y recursos que la persona necesite, de tal 12 manera que pueda interactuar cómodamente con su ambiente y tener una calidad de vida”, lo cual en relación con el rol de la familia y la influencia de la sociedad, permite reconocer la importancia de las acciones de las mismas en el desarrollo del individuo, de forma que éstas lo beneficien o perjudiquen.In his famous phrase Yadiar Julián "The strong mentality of the human being, must focus on his achievements, not his limitations" Yadiar (2000), refers to the benefits that Special Education professionals can achieve when they emphasize in the search and empowerment of the person with disabilities, for a better development and benefit from them in their daily lives, in order to focus the teaching work not on the "improvement" of their deficits but on the development of their abilities, thus allowing their disability to be seen from the conception of diverse talents. On the other hand, disability as a present condition in our society, is a reality that any family can face after various situations such as: the abrupt change of the biological-environmental conditions of an unborn individual, or at any stage of the life after birth, additionally the disability of a family member brings with it new, strange and difficult situations, such as feelings of guilt and insecurity, before which no family or person will be sufficiently prepared and conscious to assume, Accept and face the emotional and physical difficulties that the daily life of a family member with disabilities brings. This generates concerns that, when experiencing unthinkable situations, directly confront the emotional, which may or may not affect the development of the family and the person with a disability, where the disability is understood as a “general term that it covers deficiencies, activity limitations and participation restrictions ”(2000, WHO). However, Brand and Pope are now assertively proposing that “the disability may be greater or less as the environment offers the tools, adaptations and resources that the person needs, in such a way 12 so that it can interact comfortably with its environment and have a quality of life ”, which in relation to the role of the family and the influence of society, allows us to recognize the importance of their actions in the development of the individual, of so that they benefit or harm you

    Physicochemical and functional characterization of trupillo flour (Prosopis juliflora (Sw.) DC) and its inclusion in a food matrix

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    Introduction: The high protein content has made legumes a raw material of interest in the formulation of different agro-industrial products; the trupillo (Prosopis juliflora) tree is an easily accessible, multipurpose, wild legume that can be used in all its composition, has a high protein value and little commercial level, which is currently being wasted as it is mistakenly considered a weed and that It could be seen as a new alternative that helps in the potentialization of the food sector. Objective: This research aims to functionally characterize trupillo flour (Prosopis juliflora), obtained from leaves and seeds, to include it in a food matrix as a protein extender. Methodology: The experimental design for this research required three phases, i) obtaining, bromatological and functional characterization of leaf flour and trupillo seeds, ii) standardization of formulations for artisan sausages using trupillo flour as a protein source, and iii) bromatological and sensory characterization of the processed sausages. Results: It was found that the flours obtained preserved the characteristic odor and color of each raw material. Particularly, the seed flour presented bromatologically and functionally better protein contents (27.7%), ash (8.04%), swelling capacity (16.7 ml water / g sample), water absorption (7.89 g water / g sample) and water retention capacity (27.9 g water/g sample), for which it was selected to be included in the sausages. In the three formulations made (C, CT and T), there were variations in the color and texture of the sausages, with Formulation T standing out for presenting higher protein content (13.7%). However, consumers preferred Formulation C. Conclusions: These results allow to propose the inclusion of sausage with trupillo flour in the human diet as an alternative to traditional products.Introduction: The high protein content has made legumes a raw material of interest in the formulation of different agro-industrial products; the trupillo (Prosopis juliflora) tree is an easily accessible, multipurpose, wild legume that can be used in all its composition, has a high protein value and little commercial level, which is currently being wasted as it is mistakenly considered a weed and that It could be seen as a new alternative that helps in the potentialization of the food sector. Objective: This research aims to functionally characterize trupillo flour (Prosopis juliflora), obtained from leaves and seeds, to include it in a food matrix as a protein extender. Methodology: The experimental design for this research required three phases, i) obtaining, bromatological and functional characterization of leaf flour and trupillo seeds, ii) standardization of formulations for artisan sausages using trupillo flour as a protein source, and iii) bromatological and sensory characterization of the processed sausages. Results: It was found that the flours obtained preserved the characteristic odor and color of each raw material. Particularly, the seed flour presented bromatologically and functionally better protein contents (27.7%), ash (8.04%), swelling capacity (16.7 ml water / g sample), water absorption (7.89 g water / g sample) and water retention capacity (27.9 g water/g sample), for which it was selected to be included in the sausages. In the three formulations made (C, CT and T), there were variations in the color and texture of the sausages, with Formulation T standing out for presenting higher protein content (13.7%). However, consumers preferred Formulation C. Conclusions: These results allow to propose the inclusion of sausage with trupillo flour in the human diet as an alternative to traditional products.&nbsp

    Epidemiología y la relación salud-ambiente : reflexiones sobre el cambio ambiental, desarrollo sustentable y salud poblacional

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    ABSTRACT: This essay presents a discussion on current environmental problems and their relationship to the health of populations. The limitations of the model of economic and social development are analyzed focusing on the augmentation of the capital and the industrial production and its negative impact on natural resources, the balance of ecosystems and human vulnerability. The methodological basics and the developments in environmental epidemiological approach are exposed analyzing their main potential application. Finally, options for solutions are formulated linking them to the premises of sustainable development and environmental justice. The responsibility of the academic environment is pointed out in the training of human and scientific resources in the field of environmental epidemiology, as well as the role of the community in terms of environmental awareness and active participation from a point of view that becomes critical, responsible and capable of defining proposals to make part of the solution.RESUMEN: Ensayo que presenta una discusión sobre la problemática ambiental actual y su relación con la salud de las poblaciones. Se analizan las limitaciones del modelo de desarrollo económico y social, centrado en el incremento del capital y la producción industrial, y su impacto negativo sobre los recursos naturales, el equilibrio de los ecosistemas y la vulnerabilidad humana. Se exponen los fundamentos metodológicos y los desarrollos del enfoque epidemiológico ambiental, analizando sus principales potenciales de aplicación. Por último, se formulan opciones de solución articuladas a las premisas del desarrollo sustentable y de la justicia ambiental, y se destaca la responsabilidad de la academia en la formación del recurso humano y científico en el área de epidemiología ambiental, así como el papel protagónico de la comunidad en la toma de conciencia ambiental y la participación activa desde una postura crítica, responsable y propositiva para hacer parte de la solución del problema

    The Research Journey as a Challenge Towards New Trends

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    The academic community of the department of Risaralda, in its permanent interest in evidencing the results of the research processes that are carried out from the Higher Education Institutions and as a product of the VI meeting of researchers of the department of Risaralda held in November 2021 presents its work: “The journey of research as a challenge towards new trends”, which reflects the result of the latest research and advances in different lines of knowledge in Agricultural Sciences, Health Sciences, Social Sciences and Technology and Information Sciences, which seek to solve and meet the demands of the different sectors. This work would not have been possible without the help of each of the teachers, researchers and authors who presented their articles that make up each of the chapters of the book, to them our gratitude for their commitment, dedication and commitment, since their sole purpose is to contribute from the academy and science to scientific and technological development in the search for the solution of problems and thus contribute to transform the reality of our society and communities. We also wish to extend our gratitude to the institutions of the Network that made this publication possible: UTP, UCP, UNAD, UNIREMINGTON; UNISARC, CIAF, Universidad Libre, Uniclaretiana, Fundación Universitaria Comfamiliar and UNIMINUTO, institutions that in one way or another allowed this work to become a reality, which we hope will be of interest to you.Preface............................................................................................................................7 Chapter 1. Technologies and Engineering Towards a humanization in Engineering using soft skills in training in Engineers.............................................................................................................11 Omar Iván Trejos Buriticá1, Luis Eduardo Muñoz Guerrero Innovative materials in construction: review from a bibliometric analysis....................................................................................................................27 Cristian Osorio Gómez, Daniel Aristizábal Torres, Alejandro Alzate Buitrago, Cristhian Camilo Amariles López Bibliometric review of disaster risk management: progress, trends, and challenges.........................................................................................................51 Alejandro Alzate Buitrago, Gloria Milena Molina Vinasco. Incidence of land coverage and geology, in the unstability of lands of the micro-basin of the Combia creek, Pereira, Risaralda....................................73 Alejandro Alzate Buitrago, Daniel Aristizábal Torres. Chapter 2. Arts, Humanities, and Social Sciences Training experience with teachers teaching mathematics using the inquiry methodology ...............................................................................................95 Vivian Libeth Uzuriaga López, Héctor Gerardo Sánchez Bedoya. Interpretation of the multiple representations of the fears associated to the boarding of limited visual patients in the elective I students’ written productions and low vision ...................................................................................113 Eliana Bermúdez Cardona, Ana María Agudelo Guevara, Caterine Villamarín Acosta. The relevance of local knowledge in social sciences............................................131 Alberto Antonio Berón Ospina, Isabel Cristina Castillo Quintero. Basic education students’ conceptions of conflict a view from the peace for the education....................................................................................................143 Astrid Milena Calderón Cárdenas,Carolina Aguirre Arias, Carolina Franco Ossa, Martha Cecilia Gutiérrez Giraldo, Orfa Buitrago. Comprehensive risk prevention in educational settings: an interdisciplinary and socio-educational approach ............................................................................163 Olga María Henao Trujillo, Claudia María López Ortiz. Chapter 3. Natural and Agricultural Sciences Physicochemical characterization of three substrates used in the deep bedding system in swine .......................................................................................175 Juan Manuel Sánchez Rubio, Andrés Felipe Arias Roldan, Jesús Arturo Rincón Sanz, Jaime Andrés Betancourt Vásquez. Periodic solutions in AFM models........................................................................187 Daniel Cortés Zapata, Alexander Gutiérrez Gutiérrez. Phenology in flower and fruit of Rubus glaucus benth. Cv. Thornless in Risaralda: elements for phytosanitary management .........................................199 Shirley Palacios Castro, Andrés Alfonso Patiño Martínez, James Montoya Lerma, Ricardo Flórez, Harry Josué Pérez. Socio-economic and technical characterization of the cultivation of avocado (Persea americana) in Risaralda..............................................................217 Andrés Alfonso Patiño Martínez, Kelly Saudith Castañez Poveda, Eliana Gómez Correa. Biosecurity management in backyard systems in Santa Rosa de Cabal, Risaralda................................................................................................................227 Julia Victoria Arredondo Botero, Jaiver Estiben Ocampo Jaramillo, Juan Sebastián Mera Vallejo, Álvaro de Jesús Aranzazu Hernández. CONTENTS Physical-chemical diagnosis of soils in hillside areas with predominance of Lulo CV. La Selva production system in the department of Risaralda.............241 Adriana Patricia Restrepo Gallón, María Paula Landinez Montes, Jimena Tobón López. Digestibility of three concentrates used in canine feeding....................................271 María Fernanda Mejía Silva, Valentina Noreña Sánchez, Gastón Adolfo Castaño Jiménez. Chapter 4. Economic, Administrative, and Accounting Sciences Financial inclusion in households from socioeconomic strata 1 and 2 in the city of Pereira ..................................................................................................285 Lindy Neth Perea Mosquera, Marlen Isabel Redondo Ramírez, Angélica Viviana Morales. Internal marketing strategies as a competitive advantage for the company Mobilautos SAS de Dosquebradas........................................................................303 Inés Montoya Sánchez, Sandra Patricia Viana Bolaños, Ana María Barrera Rodríguez. Uses of tourist marketing in the tourist sector of the municipality of Belén de Umbría, Risaralda.............................................................................................319 Ana María Barrera Rodríguez, Paola Andrea Echeverri Gutiérrez, María Camila Parra Buitrago, Paola Andrea Martín Muñoz, Angy Paola Ángel Vélez, Luisa Natalia Trejos Ospina. Territorial prospective of Risaralda department (Colombia), based on the SDGS...............................................................................................................333 Juan Guillermo Gil García, Samanta Londoño Velásquez. Chapter 5. Health and Sports Sciences Performance evaluation in times of pandemic. What do medical students think?.......................................................................................................353 Samuel Eduardo Trujillo Henao, Rodolfo A. Cabrales Vega, Germán Alberto Moreno Gómez. The relevance of the therapist’s self and self-reference in the training of psychologists.....................................................................................................371 Maria Paula Marmolejo Lozano, Mireya Ospina Botero. Habits related to oral health which influence lifestyle of elder people in a wellness center for the elderly in Pereira 2020. .............................................387 Isadora Blanco Pérez, Olga Patricia Ramírez Rodríguez, Ángela María Rincón Hurtado. Analysis of the suicide trend in the Coffee Region in Colombia during the years 2012-2018 ..............................................................................................405 Germán Alberto Moreno Gómez, Jennifer Nessim Salazar, Jairo Franco Londoño, Juan Carlos Medina Osorio. Hind limb long bone fractures in canines and felines...........................................419 María Camila Cruz Vélez, Valentina Herrera Morales, Alba Nydia Restrepo Jiménez, Lina Marcela Palomino, Gabriel Rodolfo Izquierdo Bravo. Prevalence of overweight and obesity in children in the rural and urban area of Risaralda....................................................................................................439 Angela María Álvarez López, Angela Liceth Pérez Rendón, Alejandro Gómez Rodas, Luis Enrique Isaza Velásquez. Chapter 6. Architecture, Design and Advertising The artisan crafts of Risaralda, characteristics, importance, and risks within the Colombian Coffee Cultural Landscape, CCCL....................................457 Yaffa Nahir Ivette Gómez Barrera, Javier Alfonso López Morales

    Vocabulario de la sociedad civil, la ruralidad y los movimientos sociales en América Latina

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    El Vocabulario de la Sociedad Civil, la Ruralidad y los Movimientos Sociales en América Latina tiene como objetivo desarrollar vocablos relacionados con temas de gran trascendencia para la vida colectiva de la población Latinoamericana; pretende introducir a estudiantes, personas del ámbito académico y activistas en la comprensión de estas categorías de análisis. A través de la mirada de 70 especialistas que participaron en este vocabulario, es posible comprender muchos de los términos que se utilizan dentro de la investigación social y áreas relacionadas con las ciencias políticas, ambientales y rurales, a partir de una mayor explicación y detalle. Es por ello que se inserta este trabajo desde una mirada colectiva y amplia de los conceptos que se exponen. En este libro podrá encontrar las ideas de varios autores y autoras de distintas universidades, con una visión multi, inter y transdisciplinaria. El esfuerzo que se realizó para conjuntar varios términos y analizar su compleja red de interpretaciones, permitirá que este manuscrito pueda ser consultado por estudiantes, personas del ámbito científico-académico, y ciudadanía; porque contiene el estado del arte, la historia del paulatino avance de múltiples conceptos y su vigencia en el contexto actual

    Anales del III Congreso Internacional de Vivienda y Ciudad "Debate en torno a la nueva agenda urbana"

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    Acta de congresoEl III Congreso Internacional de Vivienda y Ciudad “Debates en torno a la NUEVa Agenda Urbana”, ha sido una apuesta de alto compromiso por acercar los debates centrales y urgentes que tensionan el pleno ejercicio del derecho a la ciudad. Para ello las instituciones organizadoras (INVIHAB –Instituto de Investigación de Vivienda y Hábitat y MGyDH-Maestría en Gestión y Desarrollo Habitacional-1), hemos convidado un espacio que se concretó con potencia en un debate transdisciplinario. Convocó a intelectuales de prestigio internacional, investigadores, académicos y gestores estatales, y en una metodología de innovación articuló las voces académicas con las de las organizaciones sociales y/o barriales en el Foro de las Organizaciones Sociales que tuvo su espacio propio para dar voz a quienes están trabajando en los desafíos para garantizar los derechos a la vivienda y los bienes urbanos en nuestras ciudades del Siglo XXI

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

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    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
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