Diálogo Regional de Política de América Latina y el Caribe: Retos y oportunidades en adaptación al cambio climático en materia de agua: Elementos para una agenda regional

El presente documento representa un esfuerzo coordinado entre varias instituciones y organizaciones de la región de América Latina y el Caribe por plasmar los resultados de una reflexión conjunta sobre el tema de la adaptación al cambio climático en la comunidad hídrica y en el marco de un Diálogo Regional de Política. El propósito principal de este Diálogo es el de dar a conocer una serie de mensajes claves y recomendaciones que permitan definir de manera informada las políticas públicas pertinentes y sus acciones correspondientes al cambio climático. Los resultados del Diálogo hasta el día de hoy se han plasmado en la presente versión del documento, que se presentará en el marco de los Diálogos por el Agua y el Cambio Climático, un evento asociado a la COP16 en Cancún, México.Cambio climático, Gestión de recursos hídricos, Administración pública y definición de políticas, cambio climático, COP-16, agua

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care