Modelo de imagen corporal y factores de riesgo en el desarrollo de trastornos alimentarios en una población universitaria.

[Resumen] Dado el estado actual de la investigación en el ámbito de los TCA (Trastornos de la C onducta A limentaria), se diseñó un estudio de naturaleza transversal para analizar las relaciones entre modelo de imagen corporal, hábitos de salud, hábitos alimentarios y estado de ánimo en estudiantes de instituto y de universidad de la provincia de A C oruña, que pueden ser factores de protección o vulnerabilidad frente a un TCA . N os interesaba estudiar particularmente la percepción que los estudiantes de C iencias de la Educación tenían respecto de estas cuestiones, habida cuenta de que su futuro profesional se orienta hacia la formación de las nuevas generaciones. A los 1164 sujetos de nuestra muestra se les aplicó un protocolo que permitía recabar información sobre determinados aspectos de la percepción de la imagen corporal, hábitos de salud, hábitos alimentarios y estado emocional. La mayoría de los participantes en el estudio mostraron puntuaciones bajas en cuanto a su preocupación por la imagen corporal y, por tanto, no se vieron alterados los patrones de alimentación y salud que son propios de los TCA . El hecho más destacable es que únicamente 17 de los sujetos habían recibido diagnóstico de un TCA. Los resultados obtenidos reflejan que las mujeres y los estudiantes universitarios son los que presentan una mayor preocupación por su imagen corporal y que las personas con mejor figura corporal tienen puntuaciones más elevadas en las escalas de ansiedad y depresión.[Abstract] Given the present state of research within the field of the TCA (Eating Disorders), an study was designed to analize the transverse nature of relationships between body image, eating habits and moods in school students and university students from the province of A C oruña. Factors that could act as protective or course vulnerability before a TCA .We are most interested in studying particularly the perception that science students had knowledge on these issues due to their profesional future being directed towards the formation of new generations. We applied a protocol to 1164 subjects allowing then to collect information on certain aspects of the perception of corporal image, i.e health habits, diet habits and emotional state. Most participants in the study showed low scores in their concern about body image and, therefore, were not altered eating patterns and health that are unique to the TCA . The most remarkable fact is that only 17 of the subjects had been diagnosed with an eating disorder. The results show that women and university students are those with a greater concern with body image and that people with better body shape have higher scores on scales of anxiety and depressio

Impacto de la innovación y la gestión de las organizaciones

En el presente libro se articulan diferentes temáticas que son ejes centrales de la investigación en Colombia. Algunas de ellas son desarrollo humano, ciencia y tecnología para las organizaciones, nuevos modelos de negocio y economías emergentes, retos y tendencias para el emprendimiento. Los capítulos se articulan en tres líneas, a saber, línea 1. Gestión en eje Centro-Bogotá; línea 2. Investigación en zonas colombianas; y línea 3. Impacto de la UNAD en la región. Es así como este libro muestra el resultado de diferentes investigaciones que buscan brindar soluciones a las problemáticas regionales en aras de construir un mejor país de forma colectiva desde la gestión de las organizaciones y el desarrollo regional, donde involucren los diferentes actores sociales y expertos de cada región en la construcción de los diferentes escenarios de los sectores económico, social, cultural, tecnológico, político y ambiental

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research