Interdisciplinariedad e Intersectorialidad para la producción social del hábitat. Diseño participativo de un Asentamiento en Resistencia, Chaco.

El trabajo presenta una experiencia de práctica profesional interdisciplinaria, iniciada a partir de la firma de acuerdos de cooperación entre la Facultad de Arquitectura y Urbanismo de la Universidad Nacional del Nordeste (FAU-UNNE), la Facultad de Derecho, Ciencias Sociales y Políticas y el Instituto Superior de Servicio Social Remedios de Escalada de San Martín (ISSS). La propuesta de intervención surge a partir de la solicitud de un dirigente barrial del Centro de Promoción y Participación Comunitaria (CPyPC) del Asentamiento Soberanía, ubicado en la zona sur de la ciudad de Resistencia, capital de la Provincia del Chaco, a la cátedra Gestión y Desarrollo de la Vivienda Popular (GDVP) de la FAU, para la realización del reloteo[1] del asentamiento mencionado. La metodología participativa utilizada se implementa a través de talleres con el objetivo de: consolidar las relaciones vecinales, compartiendo y trabajando con los habitantes la problemática de la configuración espacial espontánea del barrio y los inconvenientes que eso conlleva para su inserción en la ciudad, logrando los consensos necesarios para el diseño del reloteo del sector. La coordinación de la intervención presenta carácter intersectorial, debido a la necesaria articulación por un lado, con el sector gubernamental, representado en el Instituto Provincial de Desarrollo Urbano y Vivienda (IPDUV), que implementa en nuestra provincia el Programa de Mejoramiento Barrial (PROMEBA) y, por otro, con el CPyPC y las 91 familias que integran el asentamiento. La experiencia tiene incidencia directa sobre tres aspectos: el acceso a la propiedad de la tierra, al posibilitar la regulación definitiva de cada lote; el acceso en carácter de beneficiarios al PROMEBA, al cumplimentar con las condiciones mínimas que exige el municipio para incorporarlo al catastro; y el fortalecimiento de la organización comunitaria del asentamiento. La vinculación con la producción social del hábitat en un contexto de extrema necesidad y conflictos sociales, atravesado por la práctica del trabajo interdisciplinario y por los procesos administrativos de los Organismos Públicos, implica la constante revisión de estrategias, que orienten procesos sociales superadores de los intereses particulares. [1] En Colombia, se denomina reloteo a la autorización para dividir, redistribuir o modificar el loteo de uno o más predios previamente urbanizados, para un mayor aprovechamiento, de conformidad con las normas que para el efecto establezcan el Plan de Ordenamiento Territorial y los instrumentos que lo desarrollen y complementen. En nuestro caso, es utilizado con una definición similar, pero para intervenir en predios con distintos grados de urbanización, debido a la ausencia de planificación de la ciudad por parte de las autoridades (Ministerio de Ambiente, Vivienda y Desarrollo Territorial, Decreto nº 564 de 2006, Licencias Urbanísticas)

02. La Vivienda como parte de un proceso social. La experiencia del Nordeste argentino.

Conferència de Bela Pelli, arquitecta per la Universitat Nacional del Nordeste (UNNE, Argentina), per al Máster Laboratorio de la Vivienda, 8ena edició, presentada per Zaida Muxí, Directora del Màster

Appropriate shocks and mortality in patients with versus without diabetes with prophylactic implantable cardioverter defibrillators

OBJECTIVE: Diabetes increases the risk of all-cause mortality and sudden cardiac death (SCD). The exact mechanisms leading to sudden death in diabetes are not well known. We compared the incidence of appropriate shocks and mortality in patients with versus without diabetes with a prophylactic implantable cardioverter defibrillator (ICD) included in the retrospective EU-CERT-ICD registry. RESEARCH DESIGN AND METHODS AND RESULTS: A total of 3,535 patients from 12 European EU-CERT-ICD centers with a mean age of 63.7 ± 11.2 years (82% males) at the time of ICD implantation were included in the analysis. A total of 995 patients (28%) had a history of diabetes. All patients had an ICD implanted for primary SCD prevention. End points were appropriate shock and all-cause mortality. Mean follow-up time was 3.2 ± 2.3 years. Diabetes was associated with a lower risk of appropriate shocks (adjusted hazard ratio [HR] 0.77 [95% CI 0.62-0.96], P = 0.02). However, patients with diabetes had significantly higher mortality (adjusted HR 1.30 [95% CI 1.11-1.53], P = 0.001). CONCLUSIONS: All-cause mortality is higher in patients with diabetes than in patients without diabetes with primary prophylactic ICDs. Subsequently, patients with diabetes have a lower incidence of appropriate ICD shocks, indicating that the excess mortality might not be caused primarily by ventricular tachyarrhythmias. These findings suggest a limitation of the potential of prophylactic ICD therapy to improve survival in patients with diabetes with impaired left ventricular function

Appropriate shocks and mortality in patients with versus without diabetes with prophylactic implantable cardioverter defibrillators

Abstract Objective: Diabetes increases the risk of all-cause mortality and sudden cardiac death (SCD). The exact mechanisms leading to sudden death in diabetes are not well known. We compared the incidence of appropriate shocks and mortality in patients with versus without diabetes with a prophylactic implantable cardioverter defibrillator (ICD) included in the retrospective EU-CERT-ICD registry. Research design and methods and results: A total of 3,535 patients from 12 European EU-CERT-ICD centers with a mean age of 63.7 ± 11.2 years (82% males) at the time of ICD implantation were included in the analysis. A total of 995 patients (28%) had a history of diabetes. All patients had an ICD implanted for primary SCD prevention. End points were appropriate shock and all-cause mortality. Mean follow-up time was 3.2 ± 2.3 years. Diabetes was associated with a lower risk of appropriate shocks (adjusted hazard ratio [HR] 0.77 [95% CI 0.62–0.96], P = 0.02). However, patients with diabetes had significantly higher mortality (adjusted HR 1.30 [95% CI 1.11–1.53], P = 0.001). Conclusions: All-cause mortality is higher in patients with diabetes than in patients without diabetes with primary prophylactic ICDs. Subsequently, patients with diabetes have a lower incidence of appropriate ICD shocks, indicating that the excess mortality might not be caused primarily by ventricular tachyarrhythmias. These findings suggest a limitation of the potential of prophylactic ICD therapy to improve survival in patients with diabetes with impaired left ventricular function

Rationale and design of the EU-CERT-ICD prospective study: comparative effectiveness of prophylactic ICD implantation

AIMS: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) aims to assess its current clinical value. METHODS AND RESULTS: The EU-CERT-ICD is a prospective investigator-initiated non-randomized, controlled, multicentre observational cohort study performed in 44 centres across 15 European Union countries. We will recruit 2250 patients with ischaemic or dilated cardiomyopathy and a guideline indication for primary prophylactic ICD implantation. This sample will include 1500 patients at their first ICD implantation and 750 patients who did not receive a primary prevention ICD despite having an indication for it (non-randomized control group). The primary endpoint is all-cause mortality; the co-primary endpoint in ICD patients is time to first appropriate shock. Secondary endpoints include sudden cardiac death, first inappropriate shock, any ICD shock, arrhythmogenic syncope, revision procedures, quality of life, and cost-effectiveness. At baseline (and prior to ICD implantation if applicable), all patients undergo 12-lead electrocardiogram (ECG) and Holter ECG analysis using multiple advanced methods for risk stratification as well as detailed documentation of clinical characteristics and laboratory values. Genetic biobanking is also organized. As of August 2018, baseline data of 2265 patients are complete. All subjects will be followed for up to 4.5 years. CONCLUSIONS: The EU-CERT-ICD study will provide a necessary update about clinical effectiveness of primary prophylactic ICD implantation. This study also aims for improved risk stratification and patient selection using clinical and ECG risk markers.peerReviewe

Rationale and design of the EU‐CERT‐ICD prospective study:comparative effectiveness of prophylactic ICD implantation

Abstract Aims: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU‐CERT‐ICD) aims to assess its current clinical value. Methods and results: The EU‐CERT‐ICD is a prospective investigator‐initiated non‐randomized, controlled, multicentre observational cohort study performed in 44 centres across 15 European Union countries. We will recruit 2250 patients with ischaemic or dilated cardiomyopathy and a guideline indication for primary prophylactic ICD implantation. This sample will include 1500 patients at their first ICD implantation and 750 patients who did not receive a primary prevention ICD despite having an indication for it (non‐randomized control group). The primary endpoint is all‐cause mortality; the co‐primary endpoint in ICD patients is time to first appropriate shock. Secondary endpoints include sudden cardiac death, first inappropriate shock, any ICD shock, arrhythmogenic syncope, revision procedures, quality of life, and cost‐effectiveness. At baseline (and prior to ICD implantation if applicable), all patients undergo 12‐lead electrocardiogram (ECG) and Holter ECG analysis using multiple advanced methods for risk stratification as well as detailed documentation of clinical characteristics and laboratory values. Genetic biobanking is also organized. As of August 2018, baseline data of 2265 patients are complete. All subjects will be followed for up to 4.5 years. Conclusions: The EU‐CERT‐ICD study will provide a necessary update about clinical effectiveness of primary prophylactic ICD implantation. This study also aims for improved risk stratification and patient selection using clinical and ECG risk markers