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Chronic obstructive pulmonary disease (COPD) is widely underdiagnosed in Colombia, especially in rural departments with limited access to spirometry. We conducted a department-level ecological study using aggregated administrative data from 2020-2023 to generate diagnosis-based COPD prevalence estimates that explicitly account for regional disparities in diagnostic capacity and socioeconomic conditions. We assembled department-year data from the Individual Registry of Health Services Delivery, national mortality statistics, and the National Quality of Life Survey. A Bayesian generalized additive model with a Gamma family and log link was fitted to a Composite Bias-Correction Multiplier that captured under-ascertainment as a function of spirometry utilization, COPD lethality, outpatient contact rates, multidimensional poverty, household fuel type, and age structure. Posterior estimates of this multiplier were applied to diagnosis-based COPD prevalence in adults aged ≥40 years to obtain detection-adjusted departmental and national estimates. Model performance was summarized using the Bayesian R (proportion of variability in the multiplier explained by the covariates) and the leave-one-out information criterion (LOOIC) as a measure of expected predictive fit. The model estimated a population-weighted national COPD prevalence of 2.22% (95% credible interval [CrI], 2.21-2.23). Detection-adjusted departmental prevalence ranged from 0.81% in Vichada to 3.50% in Caldas, whereas diagnosis-based prevalence ranged from 0.27% to 2.22%. Spirometry utilization correlated strongly with diagnosis-based prevalence (r = 0.85, p < 0.001), and departments with higher COPD lethality and greater multidimensional poverty required larger adjustment multipliers. The model explained most of the variability in the Composite Bias-Correction Multiplier (Bayesian R = 0.99) and showed good expected predictive performance (LOOIC = -461.1). COPD prevalence in Colombia shows marked regional heterogeneity driven by demographic risk and uneven diagnostic capacity. Detection-adjusted estimates indicate that the highest burden lies in Andean departments such as Caldas, Boyacá, and Risaralda, while remote Amazon and Orinoco territories experience substantial underdiagnosis. These findings support targeted expansion of spirometry and chronic respiratory care in underserved regions and illustrate how accounting for detection bias can improve chronic disease surveillance in low- and middle-income settings.

Healthcare-associated adverse events represent a heavy burden of symptoms for pediatric oncology patients. Their description allows knowing the safety and quality of the care processes in countries with limited resources. This study aimed to describe the incidence, types, severity, and preventability of adverse events occurring in pediatric patients with acute lymphoblastic leukemia during the induction phase in a tertiary care pediatric hospital in Mexico. This study analyzed a cohort based on medical records of between 2015 and 2017. Initially, information on patients and adverse events was collected; subsequently, two pediatric oncologist reviewers independently classified adverse events, severity and preventability. Agreement between reviewers was evaluated. Adverse events incidence rates were estimated by type, severity, and preventability. One-hundred and eighty-one pediatric patients pediatric patients with acute lymphoblastic leukemia were studied. An overall adverse events rate of 51.8 per 1000 patient-days was estimated, involving 81.2% of patients during induction. Most adverse events were severe or higher (52.6%). Infectious processes were the most common severe or higher adverse event (30.5%). The presence of adverse events caused 80.2% of hospital readmissions. Of the adverse events, 10.5% were considered preventable and 53.6% could be ameliorable in severity. Improving the safety and quality of the care processes of children with acute lymphoblastic leukemia is possible, and this should contribute to the mitigation and prevention of adverse events associated morbidity and mortality during the remission induction phase.

Background Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis , and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila ; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae , Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae , or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population.

The increase in urbanization and the volume of construction has accelerated. This situation requires systematizing the use of limited resources, especially in island territories. The construction sector contributes to the depletion of these resources and has a significant impact on society, which is why it is necessary to change its strategy and decision-making. Corporate Social Responsibility (CSR) may be the strategy to develop a socio-environmentally responsible production model that replaces the traditional one. A socially responsible construction company optimizes use construction materials, gives value to waste generated, minimizes the impact that buildings have on the environment, makes responsible use of energy and water, uses innovations to improve the process and adequately manages its human resources. The aim of this work is to analyse the socially responsible behaviour of companies in the construction sector in a limited and fragmented territory as is the province of Santa Cruz de Tenerife and to compare the importance that companies give to their actions, using for the first time 99 indicators grouped into three factors: environmental, social and economic, thus also highlighting the contribution of CSR to sustainability. The companies surveyed indicate whether they have implemented or plan to implement them in the future. The results indicate that aspects related to environmental sensitivity and social contribution contribute most to the implementation of a CSR strategy, while economic aspects have a negative influence. In the case of companies planning to implement a CSR strategy in the future, the social contribution aspect is the most influential.

During the coronavirus disease 2019 (COVID-19) pandemic, pediatric inpatients frequently received at least one antibiotic, and several antimicrobial stewardship programs (ASPs) strategies were disrupted. In Mexico, no published data are available on antibacterial consumption in children. The aim of this study was to evaluate antibacterial consumption levels and trends before, during, and after the COVID-19 pandemic in a tertiary care pediatric hospital in Mexico, and to forecast future antibacterial consumption. This was a secondary analysis based on time series data of monthly antibacterial consumption from January 2016 to June 2024 in a tertiary care pediatric hospital. Antibacterial consumption was retrospectively measured for the pre-pandemic, pandemic, and post-pandemic periods. Consumption was expressed as days of therapy (DOT) per 1000 patient-days (pd). The mean antibacterial consumption at the Hospital Infantil de México Federico Gómez (HIMFG) from 2016 to 2024 was 789.3 (95% CI, 756.1-822.5) DOT/1000 pd. In the medical pediatric intensive care unit (M-PICU) and surgical pediatric intensive care unit (S-PICU), mean consumption was 1305.3 DOT/1000 pd (95% CI: 1119.1-1491.6) and 1634.5 DOT/1000 pd (95% CI: 1444.2-1824.9), respectively. Before the pandemic, the hospital-wide mean consumption was 848.8 DOT/1000 pd (95% CI: 811.3-886.2); during the pandemic, it was 709.6 DOT/1000 pd (95% CI: 650.3-769.0); and after the pandemic, 799.2 DOT/1000 pd (95% CI: 698.1-900.3). Overall, consumption rates oscillated around the mean, and no patterns were observed. The COVID-19 pandemic did not affect trends of antibacterial consumption across the hospital or in the pediatric intensive care unit. Although the prior authorization component of the ASP maintained antibacterial consumption around the mean, the implementation of additional ASP strategies -such as education and persuasive interventions- alongside current restrictive measures may help further optimize antibacterial consumption in pediatric units.

This research was made in the faculty of Social Communication and Journalism of a Colombian private university, renowned for its high-quality standards, with the goal to identify the actual characteristics of its organizational culture and its relationship in favor of innovation. This study was made with a mixed approach and involved compiled information gathered by using two instruments: the Inventory of Organizational Culture in Education Institutions (ICOE), designed by Marcone and Martin in Psycothema, 15(2), 292–299 (2003), and the TB Test, designed by Bridges in The character of organizations: Using personality type in organization development. Davies-Black Publishers (2000), as well as semi-structured interviews done to professors and administrative staff. The gathered information was compared with both theoretical models of cultural analysis built for superior education organizations and representative researchers in the area of organizational culture for innovation, a field of study broad and consolidated nowadays but one that is not usually geared toward understanding and explaining the relationship between organizational culture and innovation in high education organizations. Our findings let us make a characterization of the organizational culture of the faculty and identify its cultural strengths and weaknesses regarding adopting and favoring innovation. Also, this empirical research adds up to an effort to make studies regarding organizational culture for innovation specifically geared toward high-education organizations.

Drug-drug interactions (DDIs) detected in a patient may not be clinically apparent (potential DDIs), and when they occur, they produce adverse drug reactions (ADRs), toxicity or loss of treatment efficacy. In pediatrics, there are only few publications assessing potential DDIs and their risk factors. There are no studies in children admitted to emergency departments (ED). The present study estimates the prevalence and describes the characteristics of potential DDIs in patients admitted to an ED from a tertiary care hospital in Mexico; in addition, potential DDI-associated risk factors are investigated. A secondary analysis of data from 915 patients admitted to the ED of the Hospital Infantil de México \"Federico Gómez\" was conducted. The Medscape Drug Interaction Checker software was used to identify potential DDIs. The results are expressed as number of cases (%), means (95% CI) and medians (25-75th percentiles). Count data regressions for number of total and severity-stratified potential DDIs were performed adjusting for patient characteristics, number of administered drugs, days of stay, presence of ADRs and diagnoses. The prevalence of potential DDIs was 61%, with a median of 4 (2-8). A proportion of 0.2% of potential DDIs was \"Contraindicated\", 7.5% were classified as \"Serious\", 62.8% as \"Significant\" and 29.5% as \"Minor\". Female gender, age, days of stay, number of administered drugs and diagnoses of Neoplasms (C00-D48), Congenital malformations (Q00-Q99), Diseases of the Blood, Blood-forming Organs and Immunity (D50-D89) and Diseases of the nervous system (G00-G99) were significantly associated with potential DDIs. The prevalence of potential DDIs in the ED is high, and strategies should therefore be established to monitor patients' safety during their stay, in addition to conducting investigations to estimate the real harm potential DDIs inflict on patients.

In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children. To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico. A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package. Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs. ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.

Background In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients. Methods Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan. Results When making decisions regarding end-of-life care, professionals consider: 1. Patient’s clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional skills and expertise: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent ambiguity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not ask patients directly for their preferences. Fear of confrontation with family members and lawsuits leads healthcare workers to carry out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in the absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians have access to opioid medications, barriers to their application are largely in delivery by the health system, the requirement of trained personnel for intravenous administration and ambulatory and home care plans which in Colombia are rare. Conclusions To improve end-of-life decision making, Colombian healthcare workers and patients need to openly discuss wishes, needs and care options and prepare caregivers. Promotion of palliative care education and development of palliative care centres and home care plans is necessary to facilitate access to end-of-life care. Patients and caregivers’ perspectives are needed to complement physicians’ perceptions and practices.