Propuesta de medidas preventivas para el control de la propagación de covid-19 en el centro poblado Palo Blanco - Pomahuaca, 2020

The purpose of this thesis was: to propose preventive measures to control the contagion and spread of COVID-19 in the Palo Blanco - Pomahuaca Town Center. The research methodology was of a descriptive propositional type, of non-experimental design; The one population and sample was 352 inhabitants of the Palo Blanco Population Center of the District of Pomahuaca. The survey was used as a technique, the instrument was the questionnaire that was validated by expert judgment; The results being: factors causing the contagion and spread of COVID-19, 47.16% growth and self-updating, 46.48% protection measures, 41.48% perception of reality, 38.97% integration; as strategies: epidemiological surveillance, diagnostic measures, hygiene measures, information measures, social isolation measures, rational use of resources, social integration, adequate distancing and personal protection measures, pharmacological measures and care indicators. It is concluded that the proposal on preventive measures to control the contagion and spread of COVID-19 requires an investment of S/. 6,477.00 soles for its implementation. Recommending, implement the proposal raised in the investigation, taking into consideration that it will allow to control the spread of COVID-19 in the Palo Blanco - Pomahuaca populated center.La presente tesis tuvo como finalidad: proponer medidas preventivas para el control de contagio y propagación de COVID-19 en el Centro Poblado Palo Blanco – Pomahuaca. La metodología de investigación fue de tipo descriptiva propositiva, de diseño no experimental; la población y muestra fue de 352 habitantes del Centro Poblado Palo Blanco del Distrito de Pomahuaca.   Se utilizó como técnica la encuesta, el instrumento fue el cuestionario que fue validado mediante juicio de expertos; siendo los resultados: factores causantes del contagio y propagación del COVID-19, 47,16% crecimiento y autoactualización, 46,48% medidas de protección, 41,48% percepción de la realidad, 38,97% integración; como estrategias: vigilancia epidemiológica, medidas diagnósticas, medidas de higiene, medidas de información, medidas de aislamiento social, uso racional de recursos, integración social, adecuadas medidas de distanciamiento y protección personal, medidas farmacológicas e indicadores de atención. Se concluye que la propuesta sobre medidas preventivas para el control de contagio y propagación de COVID-19 requiere de una inversión de S/. 6,477.00 soles para su implementación. Recomendando, implementar la propuesta planteada en la investigación, teniendo en consideración que esta permitirá controlar la propagación del COVID-19 en el centro poblado Palo Blanco – Pomahuaca

Nivel de colesterolemia con relación al sobrepeso en personas atendidas en el programa Adulto Mayor Centro Salud Morro Solar-Jaén

Rresearchpurpose was to determine the relationship between cholesterolemia level and overweight in older adults treated at Morro Solar health center, study type is cross-sectional descriptive, non-experimental design, the sample consisting of 200 people, obtaining as a result: there is a relationship (Chi square= 10.001, p-value= 0.040) of dependence between cholesterolemia level and overweight. The total number of people served, 22% are overweight while 6% are obese. Cholesterolemia level indicates that 19.5% have a suspicious level and 17.5% have a high level. According to sex, 56.5% female and 43.5% male. The age group with a percentage of 49% between 60 and 69 years of age. Of the male sex, 18.4% are overweight and 2.3% are obese, in the female sex 24.8% and 8.8% are overweight and obese respectively. Overweight and the relationship with high levels of cholesterolemia can lead to a series of complications and cardiovascular diseases, high blood pressure, diabetes, etc., and thus improve the quality of life of the elderly.La presente investigación tuvo como objetivo determinar la relación entre el nivel de colesterolemia y sobrepeso en personas adultas mayores atendidas en el centro de salud Morro Solar, el tipo de estudio es descriptivo correlacional transversal, diseño no experimental, la muestra constituida por 200 personas, obteniendo como resultado: Que existe relación (Chi cuadrado= 10.001, p-valor= 0.040) de dependencia entre el nivel de colesterolemia y el sobrepeso. Que del total de las personas atendidas el 22% tienen sobrepeso mientras que el 6% tienen obesidad. El nivel de colesterolemia indica que el 19.5% tiene un nivel alto sospechoso y el 17.5% nivel elevado. Según el sexo el 56.5% femenino y el 43.5% masculino. El grupo etario con porcentaje 49% entre 60 a 69 años de edad. Del Sexo masculino el 18.4% tienen sobrepeso y el 2.3% obesidad, en el sexo femenino el 24.8% y 8.8% tiene sobrepeso y obesidad respectivamente. El sobrepeso y la relación con los niveles altos de colesterolemia pueden traer consigo una serie de complicaciones y enfermedades cardiovasculares, hipertensión arterial, diabetes etc., y por ende desmejorar la calidad de vida de las personas adultas mayores

EDUCACIÓN AMBIENTAL Y SOCIEDAD. SABERES LOCALES PARA EL DESARROLLO Y LA SUSTENTABILIDAD

Este texto contribuye al análisis científico de varias áreas del conocimiento como la filosofía social, la patología, la educación para el cuidado del medio ambiente y la sustentabilidad que inciden en diversas unidades de aprendizaje de la Licenciatura en Educación para la Salud y de la Maestría en Sociología de la SaludLas comunidades indígenas de la sierra norte de Oaxaca México, habitan un territorio extenso de biodiversidad. Sin que sea una área protegida y sustentable, la propia naturaleza de la región ofrece a sus visitantes la riqueza de la vegetación caracterizada por sus especies endémicas que componen un paisaje de suma belleza

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Plan de Marketing como herramienta para la rentabilidad del Hotel Luna del Valle de Jaén

La presente investigación tiene como finalidad Proponer un Plan de Marketing que permita a la empresa mejorar su rentabilidad. El tipo de investigación es de enfoque mixto, de propósito aplicada, de alcance explicativa, con diseño no experimental - predictivo; y, con una población (N) y muestra (N) constituida por 15 trabajadores y 01 gerente. Se “emplearon técnicas e instrumentos como la encuesta, la entrevista y el análisis documental, los que fueron validados por juicio de expertos y sometidos” a la confiabilidad del instrumento aplicando el Alfa de Cronbach; donde se logró determinar como resultado que la empresa no está invirtiendo en marketing, generándole reducción en la rentabilidad, teniendo que aplicar las estrategias de participación en eventos corporativos y sociales, auspicios de eventos nacionales en internacionales, uso de la Tecnología que permita difundir la marca y servicio, aprovechamiento del turismo receptivo, y, adecuadas condiciones sanitarias para mejorar. Se concluye que las estrategias de marketing propuestas van a permitir mayores rendimientos económicos, por lo que se requiere una inversión de S/, 32 600 para implementar el plan. Recomendando, implementar la propuesta planteada en la investigación, teniendo en consideración que esta permitirá mejorar el ROI del Marketing actual de la empresa

Modelo de estrategias didácticas para mejorar la comprensión lectora en niños (as) de 05 años, de PRONOEI-Perú.

The objective of the research was to propose a model of "grandparents" didactic strategies, which improves the reading comprehension of 05-year-old children in PRONOEI. The methodology used was basic type, descriptive, proactive design. For the diagnosis, a validated questionnaire with KR-20&gt;0.7 was used. For the analysis and identification of models, the literature review on didactic strategies and reading comprehension was used, with search engines: Scielo, Dialnet, La reference, Redalyc, Latindex, academic google. The result was the model of didactic strategy with theoretical bases: Constructivism, meaningful, cognitive learning, approach by competencies and levels of reading comprehension, stories and legends originating in the community are used, community promoters apply commented, modeled and dramatized reading. , with cognitive, metacognitive and resource management strategies. Concluding that the didactic strategy model should be applied to improve reading comprehension at a literal, inferential and criterial level.El objetivo de la investigación fue proponer un modelo de estrategias didácticas “abuelitos”, que mejore la comprension lectora de niños de 05 años en PRONOEI. La metodogia empleada fue de tipo&nbsp; basico, diseño&nbsp; descriptivo, propositivo. Para&nbsp; el diagnóstico&nbsp; se utilizó&nbsp; un cuestionario validado&nbsp; con KR-20&gt;0,7.&nbsp; Para el análisis e identificación de modelos se utilizó la revisión de literatura sobre estrategias didácticas y comprensión lectora, con buscadores: Scielo, Dialnet, La referencia, Redalyc, Latindex, google académico. El resultado fue el modelo de estrategia didáctica con bases teóricas: Constructivismo, aprendizaje significativo, cognitivo, enfoque por competencias y niveles de compresión lectora, se utiliza los cuentos y leyendas originarios de la comunidad, las promotoras comunitarias aplican la lectura comentada, modelada y dramatizada, con estrategias cognitiva, metacognitiva y administración de recursos. Concluyendo que debe aplicarse el modelo de estrategia didáctica para mejorar comprensión lectora a nivel literal, inferencial y criterial.&nbsp; &nbsp

Effectiveness of a nationwide COVID-19 vaccination program in Mexico against symptomatic COVID-19, hospitalizations, and death: a retrospective analysis of national surveillance data

ABSTRACT: Objectives: Vaccination has been effective in ameliorating the impact of COVID-19. Here, we report vaccine effectiveness (VE) of the nationally available COVID-19 vaccines in Mexico. Methods: Retrospective analysis of a COVID-19 surveillance system to assess the VE of the BNT162b2, messenger RNA (mRNA)-12732, Gam-COVID-Vac, Ad5-nCoV, Ad26.COV2.S, ChAdOx1, and CoronaVac vaccines against SARS-CoV-2 infection, COVID-19 hospitalization, and death in Mexico. The VE was estimated using time-varying Cox proportional hazard models in vaccinated and unvaccinated adults, adjusted for age, sex, and comorbidities. VE was also estimated for adults with diabetes, aged ≥60 years, and comparing the predominance of SARS-CoV-2 variants B.1.1.519 and B.1.617.2. Results: We assessed 793,487 vaccinated and 4,792,338 unvaccinated adults between December 24, 2020 and September 27, 2021. The VE against SARS-CoV-2 infection was the highest for fully vaccinated individuals with mRNA-12732 (91.5%, 95% confidence interval [CI] 90.3-92.4) and Ad26.COV2.S (82.2%, 95% CI 81.4-82.9); for COVID-19 hospitalization, BNT162b2 (84.3%, 95% CI 83.6-84.9) and Gam-COVID-Vac (81.4% 95% CI 79.5-83.1), and for mortality, BNT162b2 (89.8%, 95% CI 89.2-90.2) and mRNA-12732 (93.5%, 95% CI 86.0-97.0). The VE decreased for all vaccines in adults aged ≥60 years, people with diabetes, and periods of Delta variant predominance. Conclusion: All the vaccines implemented in Mexico were effective against SARS-CoV-2 infection, COVID-19 hospitalization, and death. Mass vaccination with multiple vaccines is useful to maximize vaccination coverage

Efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate in ten countries in Europe and Latin America (HERALD): a randomised, observer-blinded, placebo-controlled, phase 2b/3 trial

Background: Additional safe and efficacious vaccines are needed to control the COVID-19 pandemic. We aimed to analyse the efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate. Methods: HERALD is a randomised, observer-blinded, placebo-controlled, phase 2b/3 clinical trial conducted in 47 centres in ten countries in Europe and Latin America. By use of an interactive web response system and stratification by country and age group (18–60 years and ≥61 years), adults with no history of virologically confirmed COVID-19 were randomly assigned (1:1) to receive intramuscularly either two 0·6 mL doses of CVnCoV containing 12 μg of mRNA or two 0·6 mL doses of 0·9% NaCl (placebo) on days 1 and 29. The primary efficacy endpoint was the occurrence of a first episode of virologically confirmed symptomatic COVID-19 of any severity and caused by any strain from 15 days after the second dose. For the primary endpoint, the trial was considered successful if the lower limit of the CI was greater than 30%. Key secondary endpoints were the occurrence of a first episode of virologically confirmed moderate-to-severe COVID-19, severe COVID-19, and COVID-19 of any severity by age group. Primary safety outcomes were solicited local and systemic adverse events within 7 days after each dose and unsolicited adverse events within 28 days after each dose in phase 2b participants, and serious adverse events and adverse events of special interest up to 1 year after the second dose in phase 2b and phase 3 participants. Here, we report data up to June 18, 2021. The study is registered at ClinicalTrials.gov, NCT04652102, and EudraCT, 2020–003998–22, and is ongoing. Findings: Between Dec 11, 2020, and April 12, 2021, 39 680 participants were enrolled and randomly assigned to receive either CVnCoV (n=19 846) or placebo (n=19 834), of whom 19 783 received at least one dose of CVnCoV and 19 746 received at least one dose of placebo. After a mean observation period of 48·2 days (SE 0·2), 83 cases of COVID-19 occurred in the CVnCoV group (n=12 851) in 1735·29 person-years and 145 cases occurred in the placebo group (n=12 211) in 1569·87 person-years, resulting in an overall vaccine efficacy against symptomatic COVID-19 of 48·2% (95·826% CI 31·0–61·4; p=0·016). Vaccine efficacy against moderate-to-severe COVID-19 was 70·7% (95% CI 42·5–86·1; CVnCoV 12 cases in 1735·29 person-years, placebo 37 cases in 1569·87 person-years). In participants aged 18–60 years, vaccine efficacy against symptomatic disease was 52·5% (95% CI 36·2–64·8; CVnCoV 71 cases in 1591·47 person-years, placebo, 136 cases in 1449·23 person-years). Too few cases occurred in participants aged 61 years or older (CVnCoV 12, placebo nine) to allow meaningful assessment of vaccine efficacy. Solicited adverse events, which were mostly systemic, were more common in CVnCoV recipients (1933 [96·5%] of 2003) than in placebo recipients (1344 [67·9%] of 1978), with 542 (27·1%) CVnCoV recipients and 61 (3·1%) placebo recipients reporting grade 3 solicited adverse events. The most frequently reported local reaction after any dose in the CVnCoV group was injection-site pain (1678 [83·6%] of 2007), with 22 grade 3 reactions, and the most frequently reported systematic reactions were fatigue (1603 [80·0%] of 2003) and headache (1541 [76·9%] of 2003). 82 (0·4%) of 19 783 CVnCoV recipients reported 100 serious adverse events and 66 (0·3%) of 19 746 placebo recipients reported 76 serious adverse events. Eight serious adverse events in five CVnCoV recipients and two serious adverse events in two placebo recipients were considered vaccination-related. None of the fatal serious adverse events reported (eight in the CVnCoV group and six in the placebo group) were considered to be related to study vaccination. Adverse events of special interest were reported for 38 (0·2%) participants in the CVnCoV group and 31 (0·2%) participants in the placebo group. These events were considered to be related to the trial vaccine for 14 (<0·1%) participants in the CVnCoV group and for five (<0·1%) participants in the placebo group. Interpretation: CVnCoV was efficacious in the prevention of COVID-19 of any severity and had an acceptable safety profile. Taking into account the changing environment, including the emergence of SARS-CoV-2 variants, and timelines for further development, the decision has been made to cease activities on the CVnCoV candidate and to focus efforts on the development of next-generation vaccine candidates. Funding: German Federal Ministry of Education and Research and CureVac