Estructura genética espacial en paisajes fragmentados : un estudio en poblaciones de curupay (Leguminosae: Anadenanthera colubrina var. cebil)

Tesis presentada para optar al Grado de Doctora en Ciencias NaturalesFil: Gonçalves, Alejandra Lorena. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo; Argentin

Global change and plankton ecology in Atlantic South America

In aquatic ecosystems, global change encompasses human-induced variations in the upper layer of the water column, where most of carbon fixation takes place. These changes include increments of exposure to solar UV radiation, mean temperature of surface seawater, ocean acidification and nutrient concentrations. These factors are well known to affect plankton ecosystems, although not all organisms are equally affected. In addition, many times these factors interact and the final results are not always additive or synergistic as expected. Finally, indirect effects (e.g., through trophic interactions) are often more pronounced than direct ones (e.g., survival or growth), which tend in some cases to mask overall and long-term expected ecological shifts in plankton communities.We review the main contributions in this field from the Atlantic coast of South America and discuss in a final section what have we learned and what is still unknown as global changes seems to be here to stay.Fil: Barbieri, Elena Susana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Centro para el Estudio de Sistemas Marinos; ArgentinaFil: Marcoval, Maria Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Hernández Moresino, Rodrigo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Centro para el Estudio de Sistemas Marinos; ArgentinaFil: Spinelli, Mariela Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Biodiversidad y Biología Experimental y Aplicada. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Biodiversidad y Biología Experimental y Aplicada; ArgentinaFil: Gonçalves, Rodrigo Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Centro para el Estudio de Sistemas Marinos; Argentin

Formación de recursos humanos

Análisis de evaluación desempeño como gestión RR.HH. y proceso organizacional, Ministerio de Catamarca, 2008-2009 Análisis de situación de salud, experiencia de formación para la gerencia en salud Educación recibida por un grupo de mujeres histerectomizadas: realidad y sugerencias Equipo de salud de la familia y construcción de vínculo: Percepciones de estudiantes de enfermería Formando formadores en salud pública: Análisis de las competencias aprendidas en la Región Metropolitana Perfil sociodemográfico y patologías de la población atendida por internos de medicina durante internado rura

Formación de recursos humanos

Análisis de evaluación desempeño como gestión RR.HH. y proceso organizacional, Ministerio de Catamarca, 2008-2009 Análisis de situación de salud, experiencia de formación para la gerencia en salud Educación recibida por un grupo de mujeres histerectomizadas: realidad y sugerencias Equipo de salud de la familia y construcción de vínculo: Percepciones de estudiantes de enfermería Formando formadores en salud pública: Análisis de las competencias aprendidas en la Región Metropolitana Perfil sociodemográfico y patologías de la población atendida por internos de medicina durante internado rura

First large-scale study reveals important losses of managed honey bee and stingless bee colonies in Latin America

International audienceOver the last quarter century, increasing honey bee colony losses motivated standardized large-scale surveys of managed honey bees ( Apis mellifera ), particularly in Europe and the United States. Here we present the first large-scale standardized survey of colony losses of managed honey bees and stingless bees across Latin America. Overall, 1736 beekeepers and 165 meliponiculturists participated in the 2-year survey (2016–2017 and 2017–2018). On average, 30.4% of honey bee colonies and 39.6% of stingless bee colonies were lost per year across the region. Summer losses were higher than winter losses in stingless bees (30.9% and 22.2%, respectively) but not in honey bees (18.8% and 20.6%, respectively). Colony loss increased with operation size during the summer in both honey bees and stingless bees and decreased with operation size during the winter in stingless bees. Furthermore, losses differed significantly between countries and across years for both beekeepers and meliponiculturists. Overall, winter losses of honey bee colonies in Latin America (20.6%) position this region between Europe (12.5%) and the United States (40.4%). These results highlight the magnitude of bee colony losses occurring in the region and suggest difficulties in maintaining overall colony health and economic survival for beekeepers and meliponiculturists

Métodos y mediciones

Actitud y conducta hacia la salud oral en estudiantes de la comuna de AraucoAnálisis de instrumentos de registro odontológicos en la red de APS de la Región MetropolitanaAnálisis de la eficiencia relativa del Hospital de Cabildo mediante la aplicación del análisis de fronteraAnálisis de letalidad intrahospitalaria y acumulada a 30 días de eventos IAM, 2003-2007Análisis del programa de cáncer cervicouterino en Chile con metodología de marco lógicoAños de vida perdidos por muerte prematura: efecto de diferentes criterios de corrección de subregistrosCalidad global de la alimentación de mujeres asistidas por el sistema de salud público chilenoCarga de mortalidad para el estado de Río de Janeiro, BrasilCausas de extracciones permanentes en adultos atendidos en la Posta Central, ChileComparación del consumo de drogas en escolares hombres utilizando metodología de pares y cuestionario autoregistradoCuidado hospitalario de pacientes con accidente cerebrovascular isquémico atendidos bajo régimen GESDescripción de dimensiones del constructo de calidad de vida en niños de 2-5 añosDistribución de benzodiacepinas en establecimientos del SNSS, período 2006-2008Evaluación de calidad, implementación del control odontológico del niño sano en CAP'S, Región del MauleEvaluación de la satisfacción del usuario interno de la Unidad de Cuidados Básicos del Hospital MetropolitanoEvaluación del protocolo de referencia de cefalea tensional y migraña en consultorio Llay-LlayEvaluación económica del Programa de Fluoración del Agua en ChileFactores de riesgo de enfermedad hipertensiva del embarazo en la UCI del H.G EcatepecImpacto de reforma sanitaria en autorizaciones sanitarias y de desempeño en instalaciones de radiodiagnóstico dentalInstitucionalidad de la investigación en salud pública en ChileLetalidad intrahospitalaria y a 30 días de los eventos de accidente cerebrovascular isquémico en ChileLimitaciones y desafíos de la investigación en salud pública en ChileMejora de agudeza visual y utilización cirugía de segundo ojo en pacientes con cataratas GESMortalidad infantil en la Región Metropolitana II del Estado de Río de Janeiro, 1981-2008Mortalidad por cáncer de tiroides en Chile en el período 1985-2007Mortalidad por tumores cerebrales en población infantil y adolescente, ciudad Río de Janeiro, 1980-2007Mortalidad por tumores del sistema nervioso central en adultos, Río de Janeiro, 1980 a 2007Prevalencia de anemia ferropriva en una muestra representativa de beneficiarios del PNACPrevalencia de caries y fluorosis previo a la fluoruración del agua potable en TemucoPrevalencia de traumatismos dentoalveolares en niños del Hospital Dr. Sótero del Río, enero-junio 2010Propuesta de un indicador de la calidad para los centros de salud familiarSalud pública y la emergencia del dispositivo clínico en la modernidad nacionalSatisfacción de funcionalidad familiar en adolescentes entre 12 y 18 años consumidores de drogasValidación cualitativa del cuestionario ASAQ para la determinación de la conducta sedentaria en escolare

Métodos y mediciones

Actitud y conducta hacia la salud oral en estudiantes de la comuna de AraucoAnálisis de instrumentos de registro odontológicos en la red de APS de la Región MetropolitanaAnálisis de la eficiencia relativa del Hospital de Cabildo mediante la aplicación del análisis de fronteraAnálisis de letalidad intrahospitalaria y acumulada a 30 días de eventos IAM, 2003-2007Análisis del programa de cáncer cervicouterino en Chile con metodología de marco lógicoAños de vida perdidos por muerte prematura: efecto de diferentes criterios de corrección de subregistrosCalidad global de la alimentación de mujeres asistidas por el sistema de salud público chilenoCarga de mortalidad para el estado de Río de Janeiro, BrasilCausas de extracciones permanentes en adultos atendidos en la Posta Central, ChileComparación del consumo de drogas en escolares hombres utilizando metodología de pares y cuestionario autoregistradoCuidado hospitalario de pacientes con accidente cerebrovascular isquémico atendidos bajo régimen GESDescripción de dimensiones del constructo de calidad de vida en niños de 2-5 añosDistribución de benzodiacepinas en establecimientos del SNSS, período 2006-2008Evaluación de calidad, implementación del control odontológico del niño sano en CAP'S, Región del MauleEvaluación de la satisfacción del usuario interno de la Unidad de Cuidados Básicos del Hospital MetropolitanoEvaluación del protocolo de referencia de cefalea tensional y migraña en consultorio Llay-LlayEvaluación económica del Programa de Fluoración del Agua en ChileFactores de riesgo de enfermedad hipertensiva del embarazo en la UCI del H.G EcatepecImpacto de reforma sanitaria en autorizaciones sanitarias y de desempeño en instalaciones de radiodiagnóstico dentalInstitucionalidad de la investigación en salud pública en ChileLetalidad intrahospitalaria y a 30 días de los eventos de accidente cerebrovascular isquémico en ChileLimitaciones y desafíos de la investigación en salud pública en ChileMejora de agudeza visual y utilización cirugía de segundo ojo en pacientes con cataratas GESMortalidad infantil en la Región Metropolitana II del Estado de Río de Janeiro, 1981-2008Mortalidad por cáncer de tiroides en Chile en el período 1985-2007Mortalidad por tumores cerebrales en población infantil y adolescente, ciudad Río de Janeiro, 1980-2007Mortalidad por tumores del sistema nervioso central en adultos, Río de Janeiro, 1980 a 2007Prevalencia de anemia ferropriva en una muestra representativa de beneficiarios del PNACPrevalencia de caries y fluorosis previo a la fluoruración del agua potable en TemucoPrevalencia de traumatismos dentoalveolares en niños del Hospital Dr. Sótero del Río, enero-junio 2010Propuesta de un indicador de la calidad para los centros de salud familiarSalud pública y la emergencia del dispositivo clínico en la modernidad nacionalSatisfacción de funcionalidad familiar en adolescentes entre 12 y 18 años consumidores de drogasValidación cualitativa del cuestionario ASAQ para la determinación de la conducta sedentaria en escolare

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

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