7 research outputs found

    Nuevos datos sobre la distribución de mamíferos (Mammalia) en las dunas de Erg Chebbi (Marruecos)

    Get PDF
    The progressive increase of adventure tourism in the area around the dunes of Erg Chebbi has threatened, for almost two decades, the conservation of the only dune complex (Erg) of Morocco. In order to assess some of the effects of this activity on the local mammal communities, an intensive sampling was carried out between March and April 2018, based on 5 different detection methods. The main objective was to evaluate the presence and current distribution of the mammal species cited in the area since 1900. Of the 16 species historically cited, 9 have been detected in the present work, which represents 56.2%. The total absence of data on 5 of the potentially most abundant species such as Gerbillus amoenus (de Winton, 1902), Gerbillus gerbillus Olivier, 1801, Gerbillus tarabuli (Thomas, 1902), Pachyuromis duprasi Lataste, 1880 and Psammomys obesus Cretzschmar, 1828 is remarkable. Some data point to the drastic reduction of water resources experienced in recent years, as one of the causes of the apparent reduction of their populations. At the same time, other species with lower water requirement , such as Meriones libycus Lichtentstein, 1823 or Jaculus jaculus Linnaeus, 1758, have an apparent good state of conservation. The presence of Poecilictis libyca Hemprich & Ehrenberg, 1833 is confirmed after 32 years without being cited.El progresivo aumento del turismo de aventura en el entorno de las dunas de Erg Chebbi, amenaza, desde hace casi dos décadas, la conservación del único complejo dunar (Erg) de todo Marruecos. Con el propósito de valorar algunos de los efectos de esta actividad sobre la comunidad de mamíferos locales, entre marzo y abril de 2018 se llevó a cabo un muestreo intensivo utilizando 5 métodos de detección distintos. El objeto principal era evaluar la presencia y distribución actual de las especies de mamíferos presentes, teniendo como referencia las citadas en la zona desde 1900 (Aulagnier et al., 2017). De las 16 especies históricamente citadas, 9 han sido detectadas en el presente trabajo, lo que representa un 56.2%. Resulta de interés la ausencia total de datos sobre 5 de las especies potencialmente más abundantes como son: Gerbillus amoenus (de Winton, 1902), Gerbillus gerbillus Olivier, 1801, Gerbillus tarabuli (Thomas, 1902), Pachyuromis duprasi Lataste, 1880 y Psammomys obesus Cretzschmar, 1828. Algunos datos apuntan a la drástica reducción de los recursos hídricos experimentada en los últimos años, como una de las causas de la aparente reducción de sus poblaciones. Al mismo tiempo, otras especies de requerimiento hídricos menores, tales como: Meriones libycus Lichtenstein, 1823 o Jaculus jaculus Linnaeus, 1758, presentan un aparente buen estado de conservación. Se confirma la presencia de Poecilictis libyca Hemprich & Ehrenberg, 1833, tras 32 años de ausencia de datos

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

    Get PDF
    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

    Get PDF
    Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

    Biodiversidad 2015. Reporte de Estado y Tendencias de la Biodiversidad Continental de Colombia

    No full text
    El propósito de este documento es fortalecer la capacidad de agentes públicos y privados para la aplicación de la PNGIBSE, que constituye en sí misma una apuesta de interfaz entre ciencia, política y sociedad en la perspectiva de construir sostenibilidad en el desarrollo. Además de ello, representa un insumo para el seguimiento a los compromisos del país frente a convenios e iniciativas internacionales (CDB, IPBES, OCDE), así como un mecanismo pedagógico para generar interés, conciencia y apropiación de las diferentes dimensiones de la biodiversidad del país. En esta oportunidad, el reporte avanza en el desarrollo de nuevas infografías vinculadas con diferentes fuentes de información que garantizan la calidad de los datos con los que se propone y representa el estado de la biodiversidad y de su gestión en Colombia. Incluye como novedad la presentación de material en portal web dedicado (reporte.humboldt.org.co), de manera que todas las personas puedan apropiarse e interactuar con el contenido de manera más efectiva. La perspectiva es construir un modelo en tiempo real del trabajo que se desarrolla en el país para conocer, proteger, utilizar o restaurar su biodiversidad y servicios ecosistémicos, promoviendo la apropiación de todos los ciudadanos e instituciones en la tarea. Biodiversidad 2015, es evidente, aún no está en capacidad de dar cuenta de todos los procesos de gestión de biodiversidad que se dan en Colombia, liderados por múltiples actores y a todas las escalas. Paulatinamente esperamos poder abrir el espacio para incrementar la visibilidad de todas y cada una de las iniciativas que se adelanten, a sabiendas de que la posibilidad de encontrar nuevas respuestas y mejores prácticas no depende del Instituto ni de ninguna instancia en particular, sino de la capacidad colectiva de aprendizaje. Así, esperamos que este nuevo paso en la construcción de un producto colaborativo sea del interés de todos y nos permita avanzar en esa dirección. reporte.humboldt.org.coBogotá, D. C

    Biodiversidad 2015. Estado y tendencias de la biodiversidad continental de Colombia

    No full text
    El propósito de este documento es fortalecer la capacidad de agentes públicos y privados para la aplicación de la PNGIBSE, que constituye en sí misma una apuesta de interfaz entre ciencia, política y sociedad en la perspectiva de construir sostenibilidad en el desarrollo. Además de ello, representa un insumo para el seguimiento a los compromisos del país frente a convenios e iniciativas internacionales (CDB, IPBES, OCDE), así como un mecanismo pedagógico para generar interés, conciencia y apropiación de las diferentes dimensiones de la biodiversidad del país.Bogotá, D. C., ColombiaInstituto de Investigación de Recursos Biológicos Alexander von Humboldtreporte.humboldt.org.coreporte.humboldt.org.co/biodiversidad/en

    Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

    No full text
    © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

    No full text
    © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
    corecore