Análisis del manejo de residuos sólidos y orgánicos en la zona de restaurantes de fontibón con base en la legislación colombiana y la norma ISO 14001

El desarrollo de esta monografía tiene como objetivo principal, analizar y determinar los manejos de los residuos sólidos y orgánicos generados en la zona de restaurantes de Fontibón en Bogotá, Colombia, ubicados sobre la carrera 100, desde la calle 22i hasta la calle 23. Se realizará un análisis del manejo de residuos en esta zona de Fontibón, con la finalidad de identificar cuáles deben ser los manejos adecuados debido a que hoy en día vemos que en el sector de Fontibón que se producen volúmenes considerables de residuos sólidos y orgánicos, los cuales son una de las principales causas que contribuyen a la contaminación ambiental, se producen fuertes olores presentándose roedores, perros callejeros, gatos callejeros e insectos como cucarachas, moscas y zancudos poniendo en riesgo la salud de la comunidad. Se identificarán las prácticas adecuadas para el manejo de los residuos, basado en la legislación colombiana ley 09 de 1979 de protección del medio ambiente, ley 430 de 1998 el cual establece las disposiciones en las cuales se debe hacer la adecuada separación de los residuos, la ley 605 de 1996 en el cual se establece la reglamentación que aplica para la prestación del servicio público de aseo , y la norma ISO 14001 la cual direcciona a un adecuado balance entre el medio ambiente y la economía, con la finalidad de conseguir un equilibrio entre el medio ambiente, la sociedad y la economía. Para disminuir la contaminación se deben identificar los posibles causantes del mal manejo de los residuos sólidos y orgánicos, para esto se deben clasificar los residuos tanto solidos como orgánicos generados por los restaurantes, para así identificar la correcta manipulación y desecho de estos residuos, de tal forma que esté alienado con las normatividades vigentes.The main objective of this monograph is to analyze and determine the management of solid and organic waste generated in the area of Fontibón restaurants in Bogotá, Colombia, located on Carrera 100, from 22i street to 23rd street. An analysis of waste management will be carried out in this area of Fontibón, in order to identify what the appropriate management should be because today we see that in the Fontibón sector that considerable volumes of solid and organic waste are produced, the which are one of the main causes that contribute to environmental pollution, strong odors are produced by rodents, stray dogs, stray cats and insects such as cockroaches, flies and mosquitoes putting the health of the community at risk. Appropriate practices for waste management will be identified, based on Colombian legislation, Law 09 of 1979 on environmental protection, Law 430 of 1998 which establishes the provisions in which adequate separation of waste must be made, the Law 605 of 1996, which establishes the regulations that apply for the provision of the public toilet service, and ISO 14001 which directs an adequate balance between the environment and the economy, in order to achieve a balance between the environment, society and the economy. To reduce pollution, the possible causes of the mismanagement of solid and organic waste must be identified, for this, both solid and organic waste generated by restaurants must be classified, in order to identify the correct handling and disposal of these wastes, of such form that is alienated with current regulations

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London