Miradas colectivas de los departamentos del Huila y Tolima, municipios Neiva, Santa Maria y Armero Guayabal

Las problemáticas que pueden existir en una comunidad pueden ser tan amplias como diversas a la hora de verificar y hacer una observación investigativa de la misma, son los miembros de estas comunidades quienes dan a conocer sus necesidades y como pueden implicar de forma precisa la realización de posibles soluciones que conlleven a un bienestar psicosocial y a una mejor calidad de vida en determinado contexto. Como miembros activos y en constante cambios, se busca la solidaridad y pertenencia hacia las situaciones que se presenten y que puedan afectar o beneficiar a la comunidad, con miras objetivas orientados a restablecer soluciones acordes a los objetivos y metas trazadas que cooperen a la mejora de la convivencia. Las necesidades de los miembros varían según las costumbres, tradiciones y cultura que se tenga en dicha comunidad, no es una tarea fácil dar vía libre y poder ser contundente con las soluciones, pero el trabajo en equipo, será una de las opciones que incidan en el cumplimiento de los diferentes lineamientos propuestos en beneficio individual y colectivo de la comunidad.The problems that can exist in a community can be as wide as diverse when it comes to verifying and making an investigative observation of it, it is the members of these communities who make known their needs and how they can imply in a precise way the realization of Possible solutions that lead to a psychosocial well-being and a better quality of life in a given context. As active and constantly changing members, we seek solidarity and belonging to the situations that arise and that can affect or benefit the community, with objective aims aimed at restoring solutions according to the objectives and goals outlined that cooperate to improve The coexistence. The needs of the members vary according to the customs, traditions and culture that they have in that community, it is not an easy task to give way and be able to be forceful with the solutions, but the teamwork will be one of the options that affect The fulfillment of the different guidelines proposed for the individual and collective benefit of the communit

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology