Estrategias de integración sostenible para el diseño de un producto turístico, enfocado en el aspecto agroindustrial de la producción y uso del Aloe vera, determinando su relación con el turismo de bienestar en Santa Rosa de Cabal

El objetivo del presente trabajo es exponer la potencialidad del Aloe vera como producto turístico del turismo de bienestar en el Municipio de Santa Rosa de Cabal; Risaralda, diseñando un producto turístico que se base en criterios de sostenibilidad. Para lo cual se realiza una investigación teórico-práctica, investigando fuentes de información secundaria y realizando visitas de campo a la zona de estudio. Se evidencia que el municipio de Santa Rosa de Cabal tiene un gran potencial y expediente dentro del turismo de bienestar, pues alberga un importante complejo termal de alto reconocimiento turístico en la región y a nivel nacional, sin embargo, también se evidencia que el Aloe vera tiene unas connotaciones importantes de valor como factor cultural, natural y de múltiples beneficios para la salud. También se encontró la potencialidad del territorio para crear un clúster de turismo de bienestar, y este último sería el producto turístico diseñado en este trabajo. Por lo que se determina mediante un estudio de la demanda la acepción del producto turístico basado en uso y aprovechamiento del Aloe vera, y se enlaza la información consultada como bases de datos sobre turismo de bienestar en el municipio y sobre los productos y servicios asociados al aprovechamiento del Aloe vera o la sábila en Santa Rosa de Cabal etc. Para posteriormente crear una cadena de valor que pueda mostrar los factores de competitividad del municipio frente al producto turístico diseñado en este trabajo.The objective of this work is to expose the potential of Aloe vera as a tourist product of wellness tourism in the Municipality of Santa Rosa de Cabal; Risaralda, designing a tourism product that is based on sustainability criteria. For which a theoretical-practical investigation is carried out, investigating sources of secondary information, and making field visits to the study area. It is evident that the Municipality of Santa Rosa de Cabal has a great potential and expedient within wellness tourism, as it houses an important thermal complex of high tourist recognition in the region and at the national level, however, it is also evident that Aloe vera has some connotations important of value as a cultural, natural factor and of multiple health benefits. The potential of the territory to create a wellness tourism cluster was also found, and the latter would be the tourism product designed in this work. Therefore, the acceptance of the tourist product based on the use and exploitation of Aloe vera is determined through a demand study, and the information consulted as databases on wellness tourism in the municipality and on the products and services associated with it is linked. use of aloe or Aloe vera in Santa Rosa de Cabal, etc. To later create a value chain that can show the competitiveness factors of the municipality against the tourist product designed in this work.PregradoProfesional en Administración del Turismo SostenibleTabla de contenido 1. INTRODUCCIÓN .............................................................................................................................. 14 1.2. Importancia ...................................................................................................................................... 14 1.2. Descripción del problema ................................................................................................................ 15 1.3. Formulación del problema ............................................................................................................... 16 1.4. Antecedentes teóricos ...................................................................................................................... 16 1.5. Objetivos.......................................................................................................................................... 33 1.6. Alcances........................................................................................................................................... 34 1.7. Metodología ..................................................................................................................................... 34 1.8. Marco geográfico ............................................................................................................................. 35 1.9 Marco normativo............................................................................................................................... 37 2. CATEGORIZACIÓN DE LA OFERTA ASOCIADA AL TURISMO DE BIENESTAR EN SANTA ROSA DE CABAL..................................................................................................................................... 39 2.1. Turismo de bienestar en Santa Rosa de Cabal.................................................................................. 39 2.2. Productos y servicios asociados al aprovechamiento del Aloe vera en Santa Rosa de Cabal .......... 59 2.3. Prestadores de servicios asociados a la cadena de valor actual del turismo de bienestar en Santa Rosa de Cabal.......................................................................................................................................... 65 3. DISEÑO DE PRODUCTO TURÍSTICO ESPECIALIZADO ENFOCADO EN EL USO Y PRODUCCIÓN DEL ALOE VERA ............................................................................................................ 69 3.1. Identificación de atractivos y de las principales actividades que conforman el producto turístico de Santa Rosa de Cabal................................................................................................................................ 69 3.2. Criterios de sostenibilidad asociados al Producto Turístico............................................................. 84 3.3. Estudio de la demanda o público objetivo para el producto............................................................. 87 3.4. Criterios de selección de establecimientos para la conformación del Clúster de Turismo de Bienestar en Santa Rosa de Cabal........................................................................................................... 93 3.5. Estructuración de la cadena de valor del producto turístico de bienestar......................................... 94 3.6. Estrategias de Integración Sostenible para promover el turismo de bienestar en municipio de Santa Rosa de Cabal.......................................................................................................................................... 96 4. CONCLUSIONES .............................................................................................................................. 99 5. RECOMENDACIONES................................................................................................................... 103 6. BIBLIOGRAFÍA .............................................................................................................................. 106 7. ANEXOS .......................................................................................................................................... 11

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status