Dignificando la vivienda en contextos de emergencia

Habit.us is a multi-criteria emerging housing solution that arises from the need to generate decent and quality housing for communities at risk that have suffered any type of natural disaster or social conflict. Under the parameters of a decent home, which in many cases does not respond adequately to such situations, due to the lack of privacy and basic sanitation in many shelters for affected people. Currently it is clear that one of the main global problems is the forced displacement of people by emergency situations caused by natural disasters and social conflicts, taking into account that over time climate change makes these disasters occur more frequently and a greater impact of damage which drag the affected people towards a temporary homelessness and in some cases permanent with the total loss of the home. On many occasions, the wait is not carried out in a dignified way, carrying out multiple relocations in schools, stadiums, refugee camps, etc. Based on this, Habit.us proposes, through bioclimatic design, a new concept of emergent housing that adapts to both the specific needs of people and the topographic characteristics where it is implanted; thus generating greater adaptability to the new environment where they live. Understanding that the emergency does not obey specific points on the planet, the Habit.us model seeks not to be linked to a defined territory, on the contrary, it aims to be able to be implemented anywhere where it may be required.Habit.us es una solución multicriterio de vivienda emergente que nace de la necesidad de generar vivienda digna y de calidad a comunidades en situación de riesgo que hayan sufrido cualquier tipo de desastre natural o conflicto social. Bajo los parámetros de una vivienda digna, la cual en muchos casos no responde de manera adecuada ante dichas situaciones, debido a la carencia de intimidad y saneamiento básico en muchos refugios para las personas afectadas. Actualmente es claro que uno de los principales problemas mundiales es el desplazamiento de personas forzados por situaciones de emergencia provocadas por catástrofes naturales y conflictos sociales, teniendo en cuenta que con el pasar del tiempo el cambio climático hace que estas catástrofes se presenten con más frecuencia y un mayor impacto de daño las cuales arrastran a las personas afectadas hacia un sinhogarismo temporal y en algunos casos permanente con la pérdida total de la vivienda. En muchas ocasiones, la espera no se realiza de manera digna, realizando reubicaciones múltiples en colegios, estadios, campos de refugiados, etc. Con base en esto, Habit.us propone mediante el diseño bioclimático, un nuevo concepto de vivienda emergente que se adapte tanto a las necesidades específicas de las personas como a las características topográficas donde sea implantado; generando así una mayor adaptabilidad al nuevo entorno donde se habite. Entendiendo que la emergencia no obedece a puntos específicos en el planeta, el modelo Habit.us busca no estar ligado a un territorio definido, por el contrario, apunta a poder implementarse en cualquier sitio donde pueda ser requerido

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