Documental Mindo una ventana al ecoturismo

In a changing and dynamic modern world, there is an urgent need to adapt to different scenarios, mainly learning about ourselves and our environment, to take full advantage of the situations. This is the case of Ecotourism, a new term emerges from the need to rethink the ways in which tourism is operated nowadays, where its value lays on the exploitation of the location and its resources are centered on the materialistic development of the area. Large touristic companies are taking the bulk of the profits and in most cases the hosts are being trampled socially, their culture unappreciated, their history ignored and the people abused. We do not have a sense of the real value for conservation as a means of developing a notion of sustainable, reliable and decent growth. Here is where ecotourism gives us the opportunity to create a more feasible and permanent environment for conservation in order to obtain a viable alternative from the output of classic tourism. Introducing new ways and methods for a more sustainable culture of tourism will give us over time the opportunity to set aside the actual norm of waste and abuse to the natural environment. We need to create ways for development based on the respect for all living things by raising awareness through education focusing on the need of maintaining a healthy nation. The development of techniques and strategies to aid the public on the necessary information and intellectual resources will be a key factor that will take us from a wasteful society to a more eco friendly existence. Starting in primary levels will allow us to set a value for the proper management of nature and its resources, where all the people involved will have a direct investment and active participation including various authorities as to benefit us all. From the parish to the entire world will enjoy the benefits of conservation and proper management of resources as it is crucial and increasingly required.En un mundo tan cambiante y dinámico como este, se ve la necesidad imperiosa de adaptarnos a los distintos escenarios, saber manejarnos y conocer nuestro entorno, para sacar el mayor provecho a las situaciones planteadas, este es el caso del Ecoturismo, un término nuevo que emerge de la necesidad de replantear las formas en que se hacía turismo, donde su valor era dado por la explotación del lugar, solo la mirada materialista de desarrollo, donde los grandes dueños de los medios de producción turística se llevaban el grueso de las ganancias, y en la mayoría de casos los lugares anfitriones eran pisoteados, su cultura su historia su gente eran menospreciados, no se tenía un valor real por la conservación como medio de desarrollo no se tiene la noción de un crecimiento sostenible, fiable y digno. Aquí es donde interviene el ecoturismo, dar esa salida al turismo clásico, implantando nuevas formas y métodos para hacer un turismo, sustentable y sostenible en el tiempo, dejar de lado un turismo arrasador del medio ambiente, depredador y traficante, dar paso a un desarrollo basado en el respeto por todos los seres vivos, concientizar mediante la educación sobre todo en la primaria el valor de la naturaleza de la conservación, del manejo equilibrado de los recursos, donde todos los actores que participan en esto tengan su injerencia directa, que sea participativo que involucre a las diversas autoridades, para de esta manera todos sean beneficiados, y que gane el sector, la parroquia, la provincia el país y el mundo, ya que la conservación del medio ambiente es primordial y cada vez más requerida, el tiempo se acorta y la lucha por encontrar el equilibrio es ardua, pero con una fuerte concientización y el apoyo de los nuevos medios de comunicación, se puede llegar a muchas más personas y esta es la idea que la sociedad conozca los problemas que existen fuera de su lugar, y que mejor para esto que un documental, donde contenga una introducción al problema, un desarrollo y finalmente las conclusiones sobre el estudio realizado de la parroquia de Mindo

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease