Factores asociados a la presencia de bullying en estudiantes de educación secundaria de un colegio estatal en el distrito el Porvenir, Perú

Objetivo: Identificar los factores asociados a la presencia de bullying en estudiantes de educación secundaria de un colegio estatal en el distrito El Porvenir, Perú. Material y métodos: Estudio con diseño observacional, descriptivo de corte transversal; se llevó a cabo mediante una encuesta auto aplicable. La población estuvo compuesta por 1,069 estudiantes del 1° al 5° año de secundaria. La muestra fue probabilística, del tipo estratificado, diseñada para ser representativa y dar estimaciones confiables sobre el problema. Incluyó a 318 estudiantes entre hombre y mujeres matriculados durante el año 2013. El instrumento utilizado fue el cuestionario diseñado y validado por el Equipo Técnico de la Comisión Nacional para el Desarrollo y Vida sin Drogas (DEVIDA), en base a un instrumento estandarizado, propuesto por el Sistema de Datos Uniformes sobre Consumo de Drogas de la Comisión Interamericana para el Control del Abuso de Drogas (SIDUC/CICAD). En una primera etapa se realizó un análisis bivariado mediante una prueba de independencia entre variables (Prueba Chi Cuadrado de independencia), con un nivel de significancia de 0,05. Resultados: El 47% de los estudiantes había experimentado situaciones de bullying durante el último año; 42% fue víctima esporádica (bullying leve a moderado) y 5% fue víctima persistente de un hostigamiento (severo a intenso). Los factores de riesgo relevantes (p˂0,05), para las víctimas fueron el sexo (varones; 61,3%) y el año de estudios (tercer año; 61,4%). Entre los tipos frecuentes de bullying predominan, la agresión verbal (52%), la psicológica (38%) y la física (31%). Conclusiones: El estudio revela que los factores de riesgo para la presencia de bullying, en el colegio, se relacionan con el sexo y el año de estudios; aunque existen otros factores habituales para ser víctimas de bullying como, el entorno comunitario, el núcleo familiar, tener alguna discapacidad, identificarse con algún grupo cultural; aunque no se asocian significativamente con su presencia

Factors associated with the presence of bullying in secondary school students of a state school in the district of El Porvenir, Peru

Objetivo: Identificar los factores asociados a la presencia de bullying en estudiantes de educación secundaria de un colegio estatal en el distrito El Porvenir, Perú. Material y métodos: Estudio con diseño observacional, descriptivo de corte transversal; se llevó a cabo mediante una encuesta auto aplicable. La población estuvo compuesta por 1,069 estudiantes del 1° al 5° año de secundaria. La muestra fue probabilística, del tipo estratificado, diseñada para ser representativa y dar estimaciones confiables sobre el problema. Incluyó a 318 estudiantes entre hombre y mujeres matriculados durante el año 2013. El instrumento utilizado fue el cuestionario diseñado y validado por el Equipo Técnico de la Comisión Nacional para el Desarrollo y Vida sin Drogas (DEVIDA), en base a un instrumento estandarizado, propuesto por el Sistema de Datos Uniformes sobre Consumo de Drogas de la Comisión Interamericana para el Control del Abuso de Drogas (SIDUC/CICAD). En una primera etapa se realizó un análisis bivariado mediante una prueba de independencia entre variables (Prueba Chi Cuadrado de independencia), con un nivel de significancia de 0,05. Resultados: El 47% de los estudiantes había experimentado situaciones de bullying durante el último año; 42% fue víctima esporádica (bullying leve a moderado) y 5% fue víctima persistente de un hostigamiento (severo a intenso). Los factores de riesgo relevantes (p˂0,05), para las víctimas fueron el sexo (varones; 61,3%) y el año de estudios (tercer año; 61,4%). Entre los tipos frecuentes de bullying predominan, la agresión verbal (52%), la psicológica (38%) y la física (31%). Conclusiones: El estudio revela que los factores de riesgo para la presencia de bullying, en el colegio, se relacionan con el sexo y el año de estudios; aunque existen otros factores habituales para ser víctimas de bullying como, el entorno comunitario, el núcleo familiar, tener alguna discapacidad, identificarse con algún grupo cultural; aunque no se asocian significativamente con su presencia.Objectives: Identify the factors associated with the presence of bullying in secondary school students of a state  school in the district of El Porvenir, Peru. Material  and  methods: This  descriptive, cross-sectional study with an observational  design  was carried out using a self-applicable  survey.  The  population  was composed of 1,069 students from the 1st to the 5th year of secondary school. The sample was probabilistic and  stratified, designed to be  representative and give reliable estimates about the problem and included 318 male and female students enrolled during 2013. The instrument used was the questionnaire developed and validated by the Technical Team of the National Commission for Development and Life without Drugs – DEVIDA, based on a standardizeddevice proposed by SIDUC/CICAD. In the first stage, a bivariate analysis was performed using a test of independence between variables (Chi-square test of independence), with a level of significance of 0,05. Results: 47% of the students had experienced bullying situations during the last year. 42% were sporadic victims (mild to moderate bullying), and 5% were persistent victims of harassment (severe to intense). The relevant risk factors (p˂0,05) for the victims were sex (males, 61,3%) and the year of studies (third year, 61,4%). The most frequent types of bullying are verbal aggression (52%), psychological aggression (38%) and physical aggression (31%). Conclusion: The study reveals that the risk factors for the presence  of  bullying  in  school  are related tosex and the year of studies, although there are other usual factors to be victims of bullying, such as the community environment, the family nucleus, having a disability, identifying with a cultural group; they are not significantly associated with their presenc

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Oscilaciones de Potencia, Tensión y Corriente en Unidades de Generación Distribuida: Power, Voltage and Current Oscillations in Distributed Generation Units

En las plantas de generación distribuidas accionadas por motores reciprocantes es necesario conocer las fluctuaciones de tensión, corriente y potencia para evaluar la calidad de la energía que entregan estos grupos electrógenos y como criterio de diagnóstico técnico. Las causas de estas fluctuaciones son diversas. La fundamental se debe a la presencia de oscilaciones forzadas producidas por el momento irregular de los motores primarios. Otras razones se encuentran en las excentricidades constructivas, el desbalance de corriente, los armónicos espaciales y de tiempo, la variación de la configuración del sistema, etc. En este trabajo fueron evaluadas satisfactoriamente las oscilaciones de una máquina conectada a la red mediante la instalación de un analizador de redes de 32 cortes por ciclo a la salida del generador de una de estas unidades. Se expone como caso de estudio las oscilaciones observadas en un generador de 425 kVA480 V accionado por un motor Diesel de seis cilindros y cuatro tiempos en la Provincia de Cienfuegos, Cuba.In distributed and standby power plants driven by reciprocating motors, is important to know the voltage, current and power oscillation as a delivery power quality and diagnostic criteria. There are several oscillation causes. The fundamental is due to the irregular torque of primary motors. Other causes are due to constructive eccentricities, current unbalance, time and spatial harmonics, changes in systems configuration, etc. In this paper the fundamental oscillations of a grid connected machine were evaluated with a power analyzer installed in one generating power plant. As a case there are shown the observed oscillations in 425 kVA generator driven by a four times, six cylinders Diesel motor in Cienfuegos Province of Cuba

Experiencia en la cirugía del bocio tóxico

Introducción: se hace recuento del hipertiroidismo y sus dos causas principales donde prima la enfermedad de Graves Basedow. Se mencionan su diagnóstico y tratamiento. Objetivo: determinar el comportamiento de la cirugía en el bocio tóxico en un grupo de trabajo del servicio de cirugía del Hospital Universitario "Amalia Simoni" de Camagüey. Métodos: se realizó un estudio retrospectivo transversal sobre bocio tóxico en 12 años con una muestra conformada por 57 pacientes operados en un grupo de trabajo. Se tuvieron en cuenta, aspectos clínicos, de diagnóstico y terapéuticos. Resultados: predominó el sexo femenino en un rango de edades de 21 a 40 años, así como la positividad de los complementarios realizados. Se expuso la preparación preoperatoria más utilizada, la técnica quirúrgica realizada y las complicaciones en el orden del 29,81 %. Conclusiones: la mayoría fueron mujeres, con edad media de 35 años, se subutilizaron algunos medios diagnósticos, la preparación preoperatoria más usada fue propiltiuracilo, propanolol y lugol. El proceder más realizado fue la tiroidectomía subtotal y las complicaciones no fueron ni elevadas ni graves

Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach During 3 Years in 6 Hospitals in 3 Mexican Cities

To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene (HH) approach in Mexico, and analyze predictors of poor HH compliance. From June 2002 to April 2006, we conducted a prospective, observational, before-and-after study in 8 intensive care units (ICUs) from 6 hospitals in 3 cities of Mexico. The approach included administrative support, availability of supplies, education and training, reminders in the workplace, process surveillance, and performance feedback. A total of 13,201 observations for HH opportunities were done in each ICU, during randomly selected 30-minute periods. Overall, HH compliance increased from 45% to 79% (95% confidence interval [CI], 69.1-86.5; P = 0.01). Univariate and multivariate analyses showed that several variables were significantly associated with poor HH compliance: males versus females (61% versus 66%; 95% CI, 0.91-0.96; P = 0.0001), physicians versus nurses (62% versus 67%; 95% CI, 0.91-0.97; P = 0.0001), and adult versus neonatal ICUs (67% versus 54%; 95% CI, 0.79-0.84; P = 0.0001), among others. Hand hygiene programs should focus on variables found to be predictors of poor HH compliance

Textos entre textos : las conexiones textuales en la formación del lector

Resumen basado en el de la publicaciónSe incluyen varios trabajos en los que se recogen y analizan los elementos intertextuales presentes en textos literarios dirigidos a la formación como lectores de alumnos de Educación Secundaria. Los ejemplos explican el complejo y entrelazado de conexiones, discursivas y culturales, incluyendo las distintas facetas intertextuales como los álbumes infantiles, la metaficción, la lectura visual, propuestas sobre el mito, los tópicos o la clave interdisciplinar. Se acompaña con propuestas y sugerencias de aplicación para el aula y las actividades para que el lector en formación amplíe sus experiencias de lectura y desarrolle su intertexto lector.CataluñaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach over 13 Years in 51 Cities of 19 Limited-Resource Countries from Latin America, Asia, the Middle East, and Europe

OBJECTIVE. To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multidimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance. DESIGN. An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period. SETTING. Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey. PARTICIPANTS. Healthcare workers at 99 ICU members of the INICC. METHODS. A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods. RESULTS. A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P < .001), physicians versus nurses (62% vs 72%; P < .001), and adult versus neonatal ICUs (67% vs 81%; P < .001), among others. CONCLUSIONS. Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented. Infect Control Hosp Epidemiol 2013;34(4):415-42

Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries

DESIGN. A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. SETTING. Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PATIENTS. PICU inpatients. METHODS. We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. RESULTS. During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UCdays in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. CONCLUSIONS. Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries. Infect Control Hosp Epidemiol 2012;33(7):696-70