Los Programas de Desarrollo con Enfoque Territorial pueden transformar la ruralidad y fortalecer la paz en Colombia

El proceso de los PDET permitirá que los conflictos sociales sean gestionados a través de la deliberación democrática y del respeto por la diferencia, ayudando a construir una nueva institucionalidad amplia y capaz con un profundo potencial transformador, escribe Mariana Escobar Arango (Agencia para la Renovación del Territorio)

Territorially Focused Development Plans can transform the countryside and strengthen peace in Colombia

The PDET process will allow social conflicts to be addressed through democratic discussion and respect for differences, thus helping to create a broad and effective institutional framework with significant potential for transformation, writes Mariana Escobar Arango (Territorial Renewal Agency, Colombia)

Microbicidal effect of solar radiation (SODIS) combined with Artemisia annua

RESUMEN: En este estudio se evaluó el método SODIS y SODIS combinado con Artemisia annua como una alternativa para la desinfección del agua en comunidades sin acceso a agua segura. Se determinó la eficiencia del método en la remoción de Escherichia coli, Bacillus subtilis, Enterococcus faecalis y Salmonella typhimurium usando botellas tipo PET con agua destilada estéril y una concentración inicial de 1x106 UFC/ml de cada microorganismo. Para la combinación SODIS-A. annua se adicionó a las botellas una infusión de A. annua al 10% (v/v); las botellas fueron expuestas al sol durante mínimo 6 horas y se determinaron las variables temperatura del agua, radiación solar y turbidez. Se encontró que el tratamiento SODIS fue más eficiente en la remoción de los cuatro microorganismos que el tratamiento SODIS + A. annua. Las remociones más altas se encontraron a partir de las cuatro horas de exposición para las especies bacterianas en estado vegetativo.ABSTARCT: This study evaluates the SODIS and SODIS method combined with Artemisia annua (SODIS+A. annua) as an alternative for water disinfection in communities without access to potable water. The efficiency of the method in removing E. coli, B. subtilis, E. faecalis and S. typhimurium was determined using PET bottles with sterile distilled water and an initial concentration of 1x106 UFC/ml of each microorganism. For SODIS+A. annua a 10% (v/v) infusion of A. annua was added; the bottles were exposed to sunlight for at least 6 hours and three variables (water temperature, solar radiation and turbidity) were measured. It was found that SODIS treatment was more efficient in the removal of the four microorganisms than SODIS + A. annua. The removals were higher after four hours of exposure to the bacterial species in their vegetative state

I Congreso - Convergencias y divergencias. Hacia educaciones y desarrollo otros.

La presente colección, en su primera publicación, recoge la experiencia del I Congreso Internacional de Educación para el Desarrollo en Perspectiva Latinoamericana- EpDl “Convergencias y divergencias. Hacia educaciones y desarrollos otros.” organizado por el Centro de Educación para el Desarrollo-CED de UNIMINUTO, específicamente en relación con las ponencias, libros e iniciativas fotográficas presentadas en las seis líneas temáticas de este evento académico, a saber: (a) experiencias y prácticas pedagógicas; (b) acciones colectivas, movimientos y redes sociales; (c) perspectivas críticas al desarrollo; (d) producción de conocimiento; (e) diferencias, identidades y ciudadanía; (f) cuerpos, emociones y espiritualidades; a partir de éstas propuestas y en el marco de estas líneas, se reflexionó sobre las dinámicas y problemáticas derivadas del desarrollo hegemónico, así como sobre la posibilidad de diálogo entre saberes y conocimientos construidos de forma contextualizada, que permitan agenciar apuestas y proyectos alternativos disidentes en la búsqueda de “desarrollos y educaciones otras” desde América Latina

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P<0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P<0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally

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