Formative research contributions to the development of Risaralda

Es importante establecer y visibilizar a los estudiantes los beneficios relacionados con la formación en investigación, dentro de los cuales encontramos el fortalecimiento de las capacidades de liderazgo así como el compromiso activo y las experiencias en independencia y colaboración. Así mismo, la formación integral hacia una mayor apreciación del valor de la literatura disciplinaria, generando de esta manera habilidades de pensamiento crítico, indagación y análisis. Además, esto permite forjar la confianza en sí mismo para presentar las propias ideas a la comunidad, permitiendo al estudiante la preparación de futuras actividades académicas, incluidos estudios de posgrado. La investigación formativa tiene como propósito la difusión de la información existente y permitir que el estudiante la integre como conocimientos, considerándolo como un aprendizaje permanente y necesario. Uno de los principales problemas que debe enfrentar la investigación formativa es el número de docentes con las capacidades necesarias para generar en el estudiante capacidades investigativas, exigiendo al profesor universitario adoptar una actitud contraria al objeto de enseñanza, generando un carácter complejo y dinámico del conocimiento.CONTENTS RETOS DE LA INVESTIGACIÓN EN PREGRADO..................................................5 CHALLENGES OF UNDERGRADUATE RESEARCH.............................................9 German Oved Acevedo Osorio CHAPTER 1 HEALTH AND SPORTS SCIENCES FACTORS ASSOCIATED WITH EXACERBATIONS OR CRISIS EVENTS OF CHRONIC NON COMMUNICABLE DISEASES.........................13 Giovanni García Castro, Sandra Milena Bedoya Gaviria, Isabela Patiño Pulgarín y Valentina Valencia Flórez ORAL ANTICOAGULATION IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN A UNIVERSITY HOSPITAL IN COLOMBIA.....................................................................................................29 María Leonor Galindo Márquez, Adrian Giraldo Diaconeasa, Juan Darío Franco Ramírez y Eduardo Ramírez Vallejo PERFORMANCE IN INITIAL TRAUMAASSESSMENT OF EMERGENCY TEAMS FROM PREHOSPITAL CARE TEAMS..................43 Giovanni García Castro, Yamileth Estrada Berrio, Manuela Aguirre Torres e Isabella Díaz Leal ACADEMIC TRAINING AND WORKING CONDITIONS OF NURSING PROFESSIONALS IN PEREIRA - RISARALDA 2020.....................55 Miguel Ángel Gómez Puerta, Laura Isabel Orozco Santamaría, Alexandra Villa Patiño y Gladys Judith Basto Hernández EFFECTS OF DYNAMIC TAPE WITH ANTI-VALGUS APPLICATION ON VERTICAL JUMP PERFORMANCE IN PHYSICALLY ACTIVE WOMEN: A CASE STUDY ..........................................73 María Camila Arias Castro, Alejandro Gómez Rodas y Ángela María Cifuentes Ríos PROPOSAL OF CARE FOR DIAGNOSTIC PREVALENT NURSES IN AN EMERGENCY DEPARTMENT................................................................89 Tatiana Restrepo Pérez, Jessica Viviana Ríos Uribe, Anyi Daniela Lemos Córdoba, Anyi Katherine Mapura Benjumea and Mónica Margarita Barón Castro FACTORS AND CONCEPTS ASSOCIATED WITH THE INITIATION OF CIGARETTE CONSUMPTION IN UNIVERSITY STUDENTS OF PEREIRA, COLOMBIA ............................................................................... 113 Giovanni García Castro, Claudia Milena Bernal Parra, Natalia Cardona Arroyave, Brahiam Stiven Moreno Bustamante y Daniela Ospina Sierra CHAPTER 2 ECONOMIC, ADMINISTRATIVE AND ACCOUNTING SCIENCES TECHNICAL-FINANCIAL EVALUATION OF BEAN (PHASEOLUS VULGARIS) VARIETY CARGAMANTO IN THE VILLAGE OF THE MUNICIPALITY OF SIBUNDOY IN THE DEPARTMENT OF PUTUMAYO ................................................................................................ 131 Adriana María Cuervo Rubio, Alejandra Arango Baranza IMPLEMENTATION OF THE NIF IN MICRO-ENTERPRISES OF PEREIRA CITY ............................................................................................ 151 Laura Cortes Correa y Nataly Andrea Gutiérrez STRATEGIC FRAMEWORK FOR SUSTAINABLE PRODUCTION IN COLOMBIA................................................................................................... 163 Paulina Murillo Gómez, Manuela Ramírez Osorio, Laura Juliana Rodríguez Henao, Lindy Neth Perea Mosquera, Isabel Redondo Ramírez SUSTAINABLE INNOVATION IN MANUFACTURING INDUSTRY........... 179 Mariana Buitrago Zuleta, Laura Juliana Rodríguez Henao, Lindy Neth Perea Mosquera y Marlen Isabel Redondo Ramírez CHAPTER 3 ARTS, HUMANITIES AND SOCIAL SCIENCES PERSONAL AND FAMILY CHANGES OF UNDERGRADUATE PSYCHOLOGY STUDENTS. IS A PROGRAM IN PSYCHOLOGY A PATHWAY TO PERSONALAND FAMILY CHANGE?...................................197 Linda Michelle De La Torre Álvarez, Mireya Ospina Botero PREGNANT MOTHERS DEPRIVED OF LIBERTY IN COLOMBIA AND MEXICO. A LOOK FROM COMPARATIVE LAW .................................225 Mary Luz Vélez Cárdenas, Katherine Almanza Astrid Milena Calderón Cárdenas CHAPTER 4 NATURAL SCIENCES DIFFERENTIAL DIAGNOSIS AND TREATMENT OF CUTANEOUS LYMPHOMA VS MASTOCYTOMA IN A 9 YEARS OLD CANINE: CASE REPORT...................................................................................................241 Diana Patricia Diaz García, Stephany Loaiza Pulgarín, Rafael R. Santisteban Arenas y Juan C. Ramírez Ante CHAPTER 5 TECHNOLOGÍES AND ENGINEERING STUDY OF INVENTORY-ROUTING PROBLEM IRP.....................................257 Frank Alejandro Hincapié Londoño, Jhonatan Stiven García Guevara y Eliana Mirldey Toro Ocamp

Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies

Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding

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

© 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

© 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