Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru.

OBJECTIVES: Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. METHODS: The study was implemented from September 2009-November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. RESULTS: Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the "two for one strategy", offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. CONCLUSIONS: Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV testing

Estudio de prefactibilidad para la producción y comercialización de una línea de néctares para el adulto mayor

En los últimos años, el mercado de jugos y néctares ha presentado una tendencia creciente, llegando a 980 millones de soles al cierre del 2016 y proyectándose a 1,121 millones de soles para el 2021. Experimenta un fuerte dinamismo favorable por factores económicos, culturales y sociales; sin embargo, la tendencia principal dentro de la categoría es el cambio hacia opciones más saludables; ya que, los consumidores eligen cada vez más jugos y néctares en vez de bebidas de zumo. Sumado a esto, se ha podido identificar mediante fuentes primarias que a medida que el ser humano envejece, el sistema inmunológico se ralentiza ante respuestas, aumentando el riesgo de adquirir enfermedades. Esto ocasiona que, en muchos casos, los adultos mayores se vuelvan dependientes de medicamentos, los cuales pueden provocar efectos secundarios y deteriorar la calidad de vida. Es por esa razón que, surge la idea de transformar esta necesidad en una oportunidad de ofrecerle al adulto mayor una alternativa de complemento alimenticio, que cubra sus necesidades y, con sus valores nutricionales, les permita llevar una mejor calidad de vida. La presente tesis consiste en la realización de un estudio de pre factibilidad de una línea de néctares nutricionales llamada “Salú”, dirigida para las personas de 40 años a más. Estos néctares están hechos a base de fruta y plantas medicinales como valor agregado; ya que, se ha identificado que las plantas medicinales resultan rentables cuando son procesadas y transformadas por sus propiedades beneficiosas para la salud. Las plantas medicinales elegidas son: la uña de gato, planta de la selva peruana con hallazgos por el Acta Médica Peruana en el 2006 de propiedades antioxidantes que estimulan el sistema inmunológico; y la maca, planta proveniente de Junín que presenta un alto contenido de aminoácidos, vitaminas, minerales y fibras, y que actualmente es muy estudiada por ser un estimulante de energía natural que otorga equilibrio hormonal, mejora la función cognitiva y es un proveedor de resistencia en el deporte. Para dicha investigación, se realizaron distintos estudios tales como el análisis estratégico, el estudio de mercado, el estudio técnico, el estudio legal, el organizacional y finalmente, el económico financiero, los cuales permitieron evaluar la viabilidad del proyecto. En conclusión, la presente tesis demuestra que el proyecto es viable económica y financieramente; ya que, se obtuvo un VANE de S/. 395,443.53 y un TIR de 53.5%, el cual fue mayor al costo de oportunidad con el que se evaluó el proyecto.Tesi

Evaluation of Women's Empowerment in a Community-Based Human Papillomavirus Self-Sampling Social Entrepreneurship Program (Hope Project) in Peru : A Mixed-Method Study

Funding Information: This work was supported by the University of Washington: School of Nursing, the United States Agency for International Development (USAID-DIV 7200AA19FA00001), Duke Universities Bass Connections project titled Analysis of Bringing Elements of Referral Services to Community Care, and GMaP Region 5 program of the Fred Hutch/University of Washington Cancer Consortium 3P30CA015704-46S5. Publisher Copyright: Copyright © 2022 Shin, Garcia, Dotson, Valderrama, Chiappe, Ramanujam, Krieger, Ásbjörnsdóttir, Barnabas, Iribarren and Gimbel.Introduction: Understanding community women's relational and financial empowerment in social entrepreneurship could be the key to scaling up community-based human papillomavirus (HPV) self-sampling programs in low- and middle-income countries. The Hope Project, social entrepreneurship in Peru, trains women (Hope Ladies) to promote HPV self-sampling among other women in their communities. This study aims to evaluate the Hope Ladies' relational and financial empowerment after participating in the program. Materials and Methods: We evaluated the Hope Ladies' experiences of empowerment in social entrepreneurship using a parallel convergent mixed methods design. The Hope Ladies participated in semi-structured in-depth interviews (n = 20) and an eight-questions five-point Likert scale survey that evaluated their relational (n = 19)/financial (n = 17) empowerment. The interview and the survey questions were developed using three empowerment frameworks: Kabeer's conceptual framework, International Center for Research on Women's economic empowerment indicators, and the Relational Leadership Theory. Deductive content analysis was used to evaluate the interviews with pre-determined codes and categories of empowerment. Descriptive statistics were used to analyze the survey results. Qualitative and quantitative data were integrated through a cross-case comparison of emergent themes and corresponding survey responses during the results interpretation. Results: All Hope Ladies reported experiencing increased empowerment in social entrepreneurship. Interviews: The women reported challenges and improvement in three categories of empowerment: (1) resources (balancing between household and Hope Lady roles, recognition from the community as a resource, camaraderie with other Hope Ladies); (2) agency (increased knowledge about reproductive health, improved confidence to express themselves, and ability to speak out against male-dominant culture); and (3) achievement (increased economic assets, improved ability to make financial decisions, and widened social network and capital, and technology skills development). Survey: All (100%) agreed/totally agreed an increase in social contacts, increased unaccompanied visits to a healthcare provider (86%), improved confidence in discussing reproductive topics (100%), improved ability to make household decisions about money (57% pre-intervention vs. 92% post-intervention). Conclusions: The Hope Ladies reported improved relational and financial empowerment through participating in community-based social entrepreneurship. Future studies are needed to elucidate the relationship between empowerment and worker retention/performance to inform the scale-up of HPV self-sampling social entrepreneurship programs.Peer reviewe

Doctorado en educación: temas y conceptos

1 documento en PDF de 11 páginas.Los escritos reunidos aquí presentan varios rasgos comunes, que les dan derecho a formar parte de la primera publicación del Doctorado en Educación. El primero de ellos, el rigor documental y argumentativo. Sus autores muestran un sólido manejo de los temas que enfrental, se percibe su reflexión y apropiación crítica, lo que les permite exponerlos de forma sistemática y profunda, desde una perspectiva propia, a veces retadora y siempre propositiva. Otro rasgo es la apertura, en el sentido de que los autores no pretenden dar la última palabra, sino aportar al campo del saber educativo; abrir nuevas puertas a la investigación, al diálogo y a la reflexión académica. También salta a la vista la trans- e interdisciplinariedad de los contenidos, sino en los modos y perspectivas desde donde abordan sus objetos de estudio. El último rasgo que quiero destacar es la actualidad de los asuntos tratados, actualidad que proviene de la relevancia de los temas, de su íntima relación con elementos esenciales de la educación: su finalidad, sus agentes, sus instituciones y sus procesos, lo cual explica su permanencia en la investigación educativa.Presentación, Ciro Hernando Parra Moreno La formación doctoral en Colombia, Marina Camargo Abello Naturaleza de las instituciones educativas, Rafael Alvira Domínguez Finalidad de la Universidad: reflexión necesaria, Javier Bermúdez Aponte La Universidad, escuela al servicio de la verdad, Luz Yolanda Sandoval Estupiñán, Alfredo Rodríguez Sedano La vida y el reto contemporáneo de educar para la paz, María Elvira Martínez A. Teorías sociales contemporáneas en educación, Marta Ardila Debates en torno a la educación familiar desde una perspectiva pedagógica, Aurora Bernal Martínez de Soria, Sandra Patricia Varela Londoño Alfabetización y construcción de subjetividad, Rosa Julia Guzmán Rodríguez Educomunicación en entornos digitales: mirada desde la comunicación no verbal, Andrés Chiappe, Hugo Rozo, Eduardo Menjivar, María Alejandra Corchuelo, Maite Alarcón Retos para la formación del tutor en modalidad virtual, Cristina Hennig Manzuoli Juego serio: modelo teórico para su diseño y producción, Oscar Boude Figueredo, Edgar Andrés Sosa"Presentación, Ciro Hernando Parra Moreno La formación doctoral en Colombia, Marina Camargo Abello Naturaleza de las instituciones educativas, Rafael Alvira Domínguez Finalidad de la Universidad: reflexión necesaria, Javier Bermúdez Aponte La Universidad, escuela al servicio de la verdad, Luz Yolanda Sandoval Estupiñán, Alfredo Rodríguez Sedano La vida y el reto contemporáneo de educar para la paz, María Elvira Martínez A. Teorías sociales contemporáneas en educación, Marta Ardila Debates en torno a la educación familiar desde una perspectiva pedagógica, Aurora Bernal Martínez de Soria, Sandra Patricia Varela Londoño Alfabetización y construcción de subjetividad, Rosa Julia Guzmán Rodríguez Educomunicación en entornos digitales: mirada desde la comunicación no verbal, Andrés Chiappe, Hugo Rozo, Eduardo Menjivar, María Alejandra Corchuelo, Maite Alarcón Retos para la formación del tutor en modalidad virtual, Cristina Hennig Manzuoli Juego serio: modelo teórico para su diseño y producción, Oscar Boude Figueredo, Edgar Andrés Sosa

Aporte al lineamiento de los nuevos alumnos de la maestría en gestión estratégica de RRHH de UPC

En un mercado que crece y se desarrolla a pasos agigantados y donde las barreras geográficas se han ido eliminado, el cambio continuo se vuelve el factor crítico para la permanencia exitosa de las organizaciones en el tiempo

Prevalence of bacterial vaginosis and associated factors in twenty Peruvian cities

Objetives. To determine the prevalence of bacterial vaginosis (BV) and associated factors among 18–29-year-old women in 20 Peruvian cities using PREVEN project data. Materials and Methods. In this cross-sectional study, BV was defined using previously provided vaginal discharge samples on slides, which were Gram stained and observed under a microscope to determine the Nugent scores. A BV diagnosis was applied to samples with scores of 7–10. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated using generalized linear models. Results. A total of 6,322 women participated in the epidemiological survey and provided vaginal swabs. The prevalence of BV was 23.7% (95% CI: 22.6–24.7) and was associated with a greater number of sexual partners in the last 12 months (PR: 1.22, 95% CI: 1.03–1.44, p=0.020 for two partners; PR: 1.46, 95% CI: 1.23–1.74, p0.001 for three or more partners), not using a condom during last intercourse (PR: 1.16, 95% CI: 1.01–1.34, p=0.034), being a sierra resident (PR: 1.18, 95% CI: 1.05–1.31, p=0.004), and having abnormal vaginal discharge or a bad smell (PR: 1.20, 95% CI: 1.09–1.33, p0.001). Conclusions. The high prevalence of BV highlights the need to strengthen health services aimed at the detection and treatment of this condition

Hybrid Plasmonic-Photonic Nanostructures: Gold Nanocrescents Over Opals

The interaction of localized surface plasmon resonances (LSPRs) with the photonic modes in an opal photonic crystal is reported. Gold nanocrescents are evaporated at glancing angles over both microsphere monolayers and artifi cial opals. Microsphere monolayers allow the three localised plasmonic resonances observed in the nanocrescent optical spectra to be identifi ed. By changing the microsphere diameter, the opal photonic stop band and a selected plasmonic resonance can be spectrally overlapped causing a dramatic change of the properties of both excitations. The creation of new modes is observed, whose spectral position and dispersion properties are a combination of those localised in nanoparticle plasmons and in the photonic crystal

Neurocognitive functioning in first-episode Bipolar Disorder: Relationship with functional status

Background The aim of this study was to assess if an association between neurocognitive deficits and psychosocial functioning exists in first-episode BD patients. Methods Twenty-five euthymic first-episode BD patients and thirty-seven healthy controls were recruited. History of suicide attempts, psychiatric comorbidities, pharmacological exposure, and previous depressive episodes were investigated. Performances on neurocognitive domains (verbal memory, attention, processing speed, and executive functions) as well as a measure of psychosocial functioning were used as outcomes. Results First-episode BD patients showed medium-to-large size deficits on measures of attention, processing speed, and executive functions. A significant association between verbal memory and psychosocial functioning at the moment of BD diagnosis was detected (beta coefficient −3.9, IC 95% −6.7 to −1.2, p < 0.01). Conclusions A relationship between cognitive performance at the moment of BD diagnosis and psychosocial functioning was detected. Possible therapeutic implications of this finding are discussed.Fil: Szmulewicz, Alejandro G.. Universidad Favaloro; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Valerio, Marina Paula. Gobierno de la Ciudad de Buenos Aires. Hospital de Emergencias Psiquiáicas "Torcuato de Alvear"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lomastro, Julieta. Gobierno de la Ciudad de Buenos Aires. Hospital de Emergencias Psiquiáicas "Torcuato de Alvear"; ArgentinaFil: Smith, José M.. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; ArgentinaFil: Chiappe, Virginia. Gobierno de la Ciudad de Buenos Aires. Hospital de Emergencias Psiquiáicas "Torcuato de Alvear"; ArgentinaFil: Martino, Diego Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencias Cognitivas y Traslacional; ArgentinaFil: Igoa, Ana. Gobierno de la Ciudad de Buenos Aires. Hospital de Emergencias Psiquiáicas "Torcuato de Alvear"; Argentina. Universidad Favaloro; Argentin

HTLV-1 and -2 Infections among 10 Indigenous Groups in the Peruvian Amazon

Infections with HTLV-1 and -2 were detected in 12 (1.9%) and 6 (0.9%) indigenous individuals living in 27 Amazonian villages in Peru. All infections occurred in Shipibo-Konibo people. HTLV was more common among participants living in villages distant from larger port cities and women with non-monogamous sexual partners

Reproductive tract infections in rural women from the highlands, jungle, and coastal regions of Peru.

OBJECTIVE: To define the prevalences and manifestations of reproductive tract infections (RTIs) in rural Peruvian women. METHODS: During 1997-98, we visited 18 rural districts in coastal, highlands, and jungle regions of Peru. We administered standardized questionnaires and pelvic examinations to members of women's community-based organizations; and collected vaginal fluid for pH, amine odour, Gram stain, microscopy, and culture for Trichomonas vaginalis; cervical specimens for Chlamydia trachomatis, Neisseria gonorrhoeae; human papilloma virus (HPV) by polymerase chain reaction (PCR) assays, and blood for syphilis serology. FINDINGS: The 754 participants averaged 36.9 years of age and 1.7 sex partners ever; 77% reported symptoms indicative of RTIs; 51% and 26% reported their symptoms spontaneously or only with specific questioning, respectively. Symptoms reported spontaneously included abnormal vaginal discharge (29.3% and 22.9%, respectively). One or more RTIs, found in 70.4% of participants, included bacterial vaginosis (43.7%), trichomoniasis (16.5%), vulvovaginal candidiasis (4.5%), chlamydial infection (6.8%), gonorrhoea (1.2%), syphilis seropositivity (1.7%), cervical HPV infection (4.9%), and genital warts or ulcers (2.8%). Of 715 adequate Pap smears, 7 revealed cancer, 4 high-grade squamous intra-epithelial lesions (SIL) and 15 low-grade SIL. Clinical algorithms had very low sensitivity and predictive values for cervical infection, but over half the women with symptoms of malodorous vaginal discharge, signs of abnormal vaginal discharge, or both, had bacterial vaginosis or trichomoniasis. CONCLUSION: Overall, 77% of women had symptoms indicative of RTIs, and 70% had objective evidence of one or more RTIs. Women with selected symptoms and signs of vaginal infection could benefit from standard metronidazole therapy