Sustainability strategies for the tangible cultural heritage of the historic center of Manizales based on its dynamics of social appropriation.

fotografías, graficas, tablasLa presente investigación tiene como objetivo proponer un marco estratégico para la sostenibilidad del patrimonio cultural material del Centro Histórico de Manizales a partir de sus dinámicas de apropiación; comprendiendo este como un sistema cultural en el que convergen actores, patrimonios e interrelaciones entre estos que determinan una identidad territorial. Analizando las diferentes configuraciones políticas territoriales, los productos y servicios culturales, los desafíos de sostenibilidad de los bienes de interés cultural, las diferentes políticas que permiten o excluyen la apropiación social del patrimonio, los fenómenos de transmisión y de patrimonialización de prácticas y saberes para tener una comprensión contemporánea de dicho territorio que permita desarrollar un ejercicio de orden prospectivo y con un carácter participativo para la sostenibilidad del centro histórico desde su patrimonio cultural material y las comunidades que configuran el sistema cultural de este. El desarrollo de la presente tuvo cuatro (4) momentos a partir de los cuales se recopilo la información, (1) revisión bibliográfica que permitió identificar las diferentes conceptualizaciones alrededor de los sistemas culturales, el patrimonio y sus dinámicas de apropiación, (2) construcción de la red socio espacial del Centro Histórico de Manizales que permitió identificar el sistema cultural de este a través del desarrollo de grupos focales (3) desarrollo de entrevistas a actores de los sectores público, privado y sociedad civil logrando identificar la diversidad de actores que desarrollan acciones dentro del sistema, así como los retos para la gestión del patrimonio. (4) construcción de un marco estratégico a partir de las visiones territoriales de los actores involucrados buscando una mirada holística e integral frentes a las complejidades y oportunidades que presente actualmente el patrimonio cultural material del Centro Histórico de Manizales. (Texto tomado de la fuente)The objective of this research is to propose a strategic framework for the sustainability of the tangible cultural heritage of the Historic Center of Manizales based on its appropriation dynamics; understanding this as a cultural system in which actors, heritages and interrelationships between them converge and determine a territorial identity. Analyzing the different territorial political configurations, the cultural products and services, the challenges of sustainability of the assets of cultural interest, the different policies that allow or exclude the social appropriation of heritage, the phenomena of transmission and patrimonialization of practices and knowledge in order to have a contemporary understanding of this territory. The development of this study had four (4) moments from which the information was collected, (1) bibliographic review that allowed identifying the different conceptualizations around cultural systems, heritage and its appropriation dynamics, (2) construction of the socio-spatial network of the Historic Center of Manizales that allowed identifying the cultural system of this through the development of focus groups (3) development of interviews to actors of the public, private and civil society sector managing to identify the diversity of actors that develop actions within the system, as well as the challenges for the management of heritage. (4) construction of a strategic framework based on the territorial visions of the actors involved, seeking a holistic and integral vision of the complexities and opportunities currently presented by the tangible cultural heritage of the Historic Center of Manizales.Con este fondo de apoyo al desarrollo de proyectos de investigación de maestrías, se espera poder movilizar a los estudiantes de estudios superiores en diferentes campos del conocimiento y a las universidades de Manizales para que sus objetos de estudio se centren en retos de ciudad que puedan traducirse en soluciones y alternativas enmarcados en los objetivos de desarrollo sostenible y priorizados como sellos verdes.MaestríaMagíster en Gestión CulturalCiencias Sociales, Cultura Y Comunicación.Sede Manizale

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

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

Sustainability strategies for the tangible cultural heritage of the historic center of Manizales based on its dynamics of social appropriation.

fotografías, graficas, tablasLa presente investigación tiene como objetivo proponer un marco estratégico para la sostenibilidad del patrimonio cultural material del Centro Histórico de Manizales a partir de sus dinámicas de apropiación; comprendiendo este como un sistema cultural en el que convergen actores, patrimonios e interrelaciones entre estos que determinan una identidad territorial. Analizando las diferentes configuraciones políticas territoriales, los productos y servicios culturales, los desafíos de sostenibilidad de los bienes de interés cultural, las diferentes políticas que permiten o excluyen la apropiación social del patrimonio, los fenómenos de transmisión y de patrimonialización de prácticas y saberes para tener una comprensión contemporánea de dicho territorio que permita desarrollar un ejercicio de orden prospectivo y con un carácter participativo para la sostenibilidad del centro histórico desde su patrimonio cultural material y las comunidades que configuran el sistema cultural de este. El desarrollo de la presente tuvo cuatro (4) momentos a partir de los cuales se recopilo la información, (1) revisión bibliográfica que permitió identificar las diferentes conceptualizaciones alrededor de los sistemas culturales, el patrimonio y sus dinámicas de apropiación, (2) construcción de la red socio espacial del Centro Histórico de Manizales que permitió identificar el sistema cultural de este a través del desarrollo de grupos focales (3) desarrollo de entrevistas a actores de los sectores público, privado y sociedad civil logrando identificar la diversidad de actores que desarrollan acciones dentro del sistema, así como los retos para la gestión del patrimonio. (4) construcción de un marco estratégico a partir de las visiones territoriales de los actores involucrados buscando una mirada holística e integral frentes a las complejidades y oportunidades que presente actualmente el patrimonio cultural material del Centro Histórico de Manizales. (Texto tomado de la fuente)The objective of this research is to propose a strategic framework for the sustainability of the tangible cultural heritage of the Historic Center of Manizales based on its appropriation dynamics; understanding this as a cultural system in which actors, heritages and interrelationships between them converge and determine a territorial identity. Analyzing the different territorial political configurations, the cultural products and services, the challenges of sustainability of the assets of cultural interest, the different policies that allow or exclude the social appropriation of heritage, the phenomena of transmission and patrimonialization of practices and knowledge in order to have a contemporary understanding of this territory. The development of this study had four (4) moments from which the information was collected, (1) bibliographic review that allowed identifying the different conceptualizations around cultural systems, heritage and its appropriation dynamics, (2) construction of the socio-spatial network of the Historic Center of Manizales that allowed identifying the cultural system of this through the development of focus groups (3) development of interviews to actors of the public, private and civil society sector managing to identify the diversity of actors that develop actions within the system, as well as the challenges for the management of heritage. (4) construction of a strategic framework based on the territorial visions of the actors involved, seeking a holistic and integral vision of the complexities and opportunities currently presented by the tangible cultural heritage of the Historic Center of Manizales.Con este fondo de apoyo al desarrollo de proyectos de investigación de maestrías, se espera poder movilizar a los estudiantes de estudios superiores en diferentes campos del conocimiento y a las universidades de Manizales para que sus objetos de estudio se centren en retos de ciudad que puedan traducirse en soluciones y alternativas enmarcados en los objetivos de desarrollo sostenible y priorizados como sellos verdes.MaestríaMagíster en Gestión CulturalCiencias Sociales, Cultura Y Comunicación.Sede Manizale