Factores sociodemográficos, cuidado de enfermería y satisfacción de los pacientes post-operados del Servicio de Cirugía del Hospital Regional Virgen de Fátima de la provincia de Chachapoyas, Perú, 2015

El objetivo de la presente investigación fue determinar los factores sociodemográficos, cuidado de enfermería y satisfacción de los pacientes post-operados del Servicio de Cirugía del Hospital Regional Virgen de Fátima de la provincia de Chachapoyas, Perú, 2015. El método de investigación aplicado fue cuantitativo, de tipo descriptivo correlacional; el diseño empleado fue no experimental y de corte trasversal; aplicado a una población de 150 pacientes ingresados en el Servicio de Operaciones. Los resultados indican que los pacientes muestran niveles de atención buena a excelente que reciben del personal del Servicio Quirúrgico, pero el 24% recibe un nivel de atención regular; del mismo modo, el 94%. Un 76.7% se siente satisfecho con la atención de sus necesidades nutricionales, fisiológicas; asimismo, el 74% muestra satisfacción con la atención en el cuidado de eliminación. Por otro lado, el 66% muestra altos niveles de satisfacción con la atención a las necesidades fisiológicas de descanso, comodidad y prevención del dolor. En conclusión, el cuidado de enfermería en el departamento de Cirugía del Servicio post operatorio se relaciona con la satisfacción que sienten los pacientes de manera significativa (p = .000 y un coeficiente indirecto casi media -0,42). Dicho de otro modo, los pacientes post operados manifiestan sentir positivamente el cuidado de las enfermeras, aunque su satisfacción no es completa en el Servicio de Cirugía del hospital.LIMAUnidad de Posgrado de Ciencias de la SaludGestión de los sistemas y servicios hospitalario

Proceso de atención de enfermería a gestante 26 semanas con insuficiencia respiratoria aguda tipo I por SARS COV2, amenaza de parto pretérmino del Servicio de Emergencia de un hospital de Lima, 2020

La actual pandemia del SARS-CoV-2 ha ocasionado un desafío en la atención de pacientes en especial gestantes en el área de urgencias. En dicho contexto, se hace imprescindible aplicar el método científico para el análisis de los procesos de atención en enfermería, el que se constituye en un elemento fundamental articular los cuidados profesionales en la práctica diaria. El objetivo es aplicar el proceso de atención de enfermería en sus cinco etapas a una gestante de 26 semanas con diagnóstico médico de IRA tipo 1 por SARS COV2, con amenaza de parto pretérmino. La metodología que se aplicó inicia con la valoración basada en los 11 patrones funcionales de Marjory Gordon; con lo cual después de un análisis crítico de identificaron 9 diagnósticos de enfermería de la taxonomía NANDA y priorizándose: Deterioro del intercambio gaseoso, dolor agudo y riesgo de alteración de la díada materno/fetal. Se plantea un plan de cuidados basados en la taxonomía NOC y se ejecutaron las actividades elegidas de la taxonomía NIC. Se evaluó y se obtuvo como resultado una puntuación de cambio + 1+2, +2. Se concluyó que acorde a los diagnósticos identificados en la gestante se gestionó el proceso de atención de enfermería en sus cinco etapas, aspecto que favoreció brindar un cuidado de calidad a la gestante con COVID-19.LIMAEscuela de PosgradoAtención en Enfermerí

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

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M&gt;70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0&lt;e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM