Estudio de caso sobre la implementación de la política de gestión de riesgo de desastres en una municipalidad, Lambayeque 2023

La presente investigación tuvo como objetivo conocer cómo se implementa la Política Nacional de la Gestión del Riesgo de Desastres de una Municipalidad de Lambayeque. El estudio fue de enfoque cualitativo, método inductivo y de tipo básico, el diseño de investigación usado fue el estudio de caso intrínseco. La Municipalidad Distrital de Íllimo fue el organismo estudiado para conocer la implementación de la Política; siendo la técnica aplicada la entrevista cuya cantidad se calculó aplicando una muestra no probabilística de tipo intencional, conteniendo 16 preguntas que fueron aplicadas a 20 trabajadores que conforman el Grupo de Trabajo para la Gestión del Riesgo de Desastres. Como resultado, cinco coeficientes de co-ocurrencia presentaron valores de 0.73, 0.72, 0.60, 0.43 y 0.34; y responden a 10 códigos asociados en 5 pares y que resultaron con los coeficientes de co-ocurrencia más altos, estos están dentro de las subcategorías de Comprensión del Riesgo de Desastres, Gobernanza de la Gestión del Riesgo, Gestión municipal del Riesgo de Desastres en la, Respuesta ante las emergencias y Recuperación de las emergencias. Esta investigación concluye que, el objetivo general planteado se cumplió; dado que los códigos que presentaron coeficiente de co-ocurrencia confirman lo establecido en cinco de seis categorías

Improving the Health of African Americans in the USA: An Overdue Opportunity for Social Justice

Using a modified social ecological model, we conducted a review of the literature and nationwide statistics on African American health. We discuss the main social determinants of health and main health disparities, risk factors, the leading causes of morbidity and mortality, and access to health services for blacks in the USA. The mechanisms through which social determinants, including racism, exert their deleterious effects on black health are discussed at the macro and individual levels. Incarceration and mental health care issues are highlighted as priorities to be addressed. African Americans remain the least healthy ethnic group in the USA, a somber legacy of years of racial and social injustice and a formidable challenge to equitable health care for all. Systemic causes of suboptimal black health require equally systemic solutions; positive trends in black health indicators seem to be driven by social development programs, economic investment in education, participation of African Americans in policy, and decision-making and expansion of access to health care

Hispanic Health in the USA: A Scoping Review of the Literature

Hispanics are the largest minority group in the USA. They contribute to the economy, cultural diversity, and health of the nation. Assessing their health status and health needs is key to inform health policy formulation and program implementation. To this end, we conducted a scoping review of the literature and national statistics on Hispanic health in the USA using a modified social-ecological framework that includes social determinants of health, health disparities, risk factors, and health services, as they shape the leading causes of morbidity and mortality. These social, environmental, and biological forces have modified the epidemiologic profile of Hispanics in the USA, with cancer being the leading cause of mortality, followed by cardiovascular diseases and unintentional injuries. Implementation of the Affordable Care Act has resulted in improved access to health services for Hispanics, but challenges remain due to limited cultural sensitivity, health literacy, and a shortage of Hispanic health care providers. Acculturation barriers and underinsured or uninsured status remain as major obstacles to health care access. Advantageous health outcomes from the “Hispanic Mortality Paradox” and the “Latina Birth Outcomes Paradox” persist, but health gains may be offset in the future by increasing rates of obesity and diabetes. Recommendations focus on the adoption of the Health in All Policies framework, expanding access to health care, developing cultural sensitivity in the health care workforce, and generating and disseminating research findings on Hispanic health

El significado psicológico de ciudadano , PRI y FOX

El objetivo de la presente investigación fue conocer el significado psicológico de "ciudadano" entre universitarios. Se trabajó con una muestra de 60 sujetos, distribuidos equitativamente por sexo. Las aplicaciones fueron grupales, utilizando la técnica de las redes semánticas naturales (Figueroa, González y Solís, 1981; Valdez, 1998). Los resultados obtenidos permiten observar de manera general que la tendencia de los grupos, al definir al ciudadano, fue con base en muchos elementos que giran en torno de él, pero que no necesariamente hablan de sus derechos y obligaciones. Por tanto, lo encontrado difiere de las propuestas idealistas de algunos autores, como el pensar que el ciudadano vive en sociedad buscando ayudarse los unos a los otros, lo cual, al parecer, sigue siendo una utopía

¿Somos un Estado igualitario? Reflexión en torno a la desigualdad de condiciones en materia de garantías sociales y prestacionales de los ministros de culto

analisis de las condiciones laborales y de segruridad social de los ministros de culto, frente a los beneficios de un trabajador colombiano

Use of zinc phosphate cement as a luting agent for Denzir™ copings: an in vitro study

BACKGROUND: The clinical success rate with zinc phosphate cemented Procera crowns is high. The objective with this study was to determine whether CADCAM processed and zinc phosphate cemented Denzir copings would perform as well as zinc phosphate cemented Procera copings when tested in vitro in tension. METHODS: Twelve Procera copings and twenty-four Denzir copings were made. After the copings had been made, twelve of the Denzir copings were sandblasted on their internal surfaces. All copings were then cemented with zinc phosphate cement to carbon steel dies and transferred to water or artificial saliva. Two weeks after cementation, half of the samples were tested. The remaining samples were tested after one year in the storage medium. All tests were done in tension and evaluated with an ANOVA. RESULTS: Sandblasted and un-sandblasted Denzir copings performed as well as Procera copings. Storage in water or artificial saliva up to one year did not decrease the force needed to dislodge any of the coping groups. Three copings fractured during testing and one coping developed a crack during testing. The three complete fractures occurred in Procera copings, while the partly cracked coping was a Denzir coping. CONCLUSION: No significant differences existed between the different material groups, and the retentive force increased rather than decreased with time. Fewer fractures occurred in Denzir copings, explained by the higher fracture toughness of the Denzir material. Based on good clinical results with zinc phosphate cemented Procera crowns, we foresee that zinc phosphate cement luted Denzir copings are likely to perform well clinically

Predicting sepsis severity at first clinical presentation:The role of endotypes and mechanistic signatures

BACKGROUND: Inter-individual variability during sepsis limits appropriate triage of patients. Identifying, at first clinical presentation, gene expression signatures that predict subsequent severity will allow clinicians to identify the most at-risk groups of patients and enable appropriate antibiotic use. METHODS: Blood RNA-Seq and clinical data were collected from 348 patients in four emergency rooms (ER) and one intensive-care-unit (ICU), and 44 healthy controls. Gene expression profiles were analyzed using machine learning and data mining to identify clinically relevant gene signatures reflecting disease severity, organ dysfunction, mortality, and specific endotypes/mechanisms. FINDINGS: Gene expression signatures were obtained that predicted severity/organ dysfunction and mortality in both ER and ICU patients with accuracy/AUC of 77–80%. Network analysis revealed these signatures formed a coherent biological program, with specific but overlapping mechanisms/pathways. Given the heterogeneity of sepsis, we asked if patients could be assorted into discrete groups with distinct mechanisms (endotypes) and varying severity. Patients with early sepsis could be stratified into five distinct and novel mechanistic endotypes, named Neutrophilic-Suppressive/NPS, Inflammatory/INF, Innate-Host-Defense/IHD, Interferon/IFN, and Adaptive/ADA, each based on ∼200 unique gene expression differences, and distinct pathways/mechanisms (e.g., IL6/STAT3 in NPS). Endotypes had varying overall severity with two severe (NPS/INF) and one relatively benign (ADA) groupings, consistent with reanalysis of previous endotype studies. A 40 gene-classification tool (accuracy=96%) and several gene-pairs (accuracy=89–97%) accurately predicted endotype status in both ER and ICU validation cohorts. INTERPRETATION: The severity and endotype signatures indicate that distinct immune signatures precede the onset of severe sepsis and lethality, providing a method to triage early sepsis patients

Cancer outcomes among Parkinson's disease patients with leucine rich repeat kinase 2 mutations, idiopathic Parkinson's disease patients, and nonaffected controls

BACKGROUND: Increased cancer risk has been reported in Parkinson's disease (PD) patients carrying the leucine rich repeat kinase 2 (LRRK2) G2019S mutation (LRRK2-PD) in comparison with idiopathic PD (IPD). It is unclear whether the elevated risk would be maintained when compared with unaffected controls. METHODS: Cancer outcomes were compared among 257 LRRK2-PD patients, 712 IPD patients, and 218 controls recruited from 7 LRRK2 consortium centers using mixed-effects logistic regression. Data were then pooled with a previous study to examine cancer risk between 401 LRRK2-PD and 1946 IPD patients. RESULTS: Although cancer prevalence was similar among LRRK2-PD patients (32.3%), IPD patients (27.5%), and controls (27.5%; P = 0.33), LRRK2-PD had increased risks of leukemia (odds ratio [OR] = 4.55; 95% confidence interval [CI], 1.46-10.61) and skin cancer (OR = 1.61; 95% CI, 1.09-2.37). In the pooled analysis, LRRK2-PD patients had also elevated risks of leukemia (OR = 9.84; 95% CI, 2.15-44.94) and colon cancer (OR = 2.34; 95% CI, 1.15-4.74) when compared with IPD patients. CONCLUSIONS: The increased risks of leukemia as well as skin and colon cancers among LRRK2-PD patients suggest that LRRK2 mutations heighten risks of certain cancers. © 2019 International Parkinson and Movement Disorder Society

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements