Asoparupa, una red social con un saber ancestral, que contribuye en la eliminación de la violencia obstétrica

A través del presente ensayo crítico se analiza el aporte que realiza la Red Social de una Organización Social Participativa (OSP) como la Asociación de Parteras Unidas del Pacífico, Asoparupa, asentada en el Distrito de Buenaventura, en la eliminación de la violencia obstétrica a través de su práctica y saberes ancestrales, este análisis y argumentación se construye mediante el trabajo de campo realizado con apoyo de los planteamientos de los autores trabajados en el Diplomado en Construcción de Redes Sociales de Comunicación. Se invita al lector a comprender la importancia de este conocimiento ancestral como aporte para la eliminación de la violencia obstétrica, el maltrato contra las mujeres en los servicios de salud, durante la atención en el parto, y la manera en como a través de una red social fortalecida se brinda mayor bienestar y calidad de vida a las comunidades.Through this critical essay, the contribution made by the Social Network of a Participatory Social Organization (OSP) such as the United Pacific Midwives Association, Asoparupa, based in the Buenaventura District, in the elimination of obstetric violence through From its ancestral practice and knowledge, this analysis and argumentation is built through field work carried out with the support of the proposals of the authors worked in the Diploma in Construction of Social Communication Networks. The reader is invited to understand the importance of this ancestral knowledge as a contribution to the elimination of obstetric violence, mistreatment against women in health services, during childbirth care, and the way in which through a network Strengthened social security provides greater well-being and quality of life to the communities

Análisis financiero y la rentabilidad en la empresa Inversiones y Representaciones Mafersa S.A.C.

Esta investigación tuvo como objetivo general, determinar la incidencia de la aplicación del análisis financiero sobre el nivel de rentabilidad de la empresa Inversiones y Representaciones Mafersa S.A.C, en donde se usó como metodología un enfoque cuantitativo, de tipo básica y diseño no experimental. Para lo cual, se consideró como población el personal de la empresa y la muestra el Gerente General de la compañía, las técnicas utilizadas fueron la encuesta y el análisis documental para la recolección de datos de los estados financieros de la empresa. Los resultados presentan que desconocen de la aplicación del análisis financiero y por ello no detectaron las desviaciones que tuvo en su rentabilidad del 2020 al 2021, las cuales fueron una disminución en el ratio de margen neto de 5.0% a 3.4%, el ROA de 2.4% a 1.7%, el ROE de 7.5% a 6.2% y el ratio de margen bruto de 14.6% a 6.8%. Por consiguiente, se concluye que la empresa Inversiones y Representaciones Mafersa S.A.C, debe establecer la aplicación de análisis financiero y capacitar a sus empleados, ya que se encontró desviaciones oportunas en su rentabilidad

Optical Coherence Tomography Artifacts in Optic Atrophy

Optical coherence tomography is a relative new imaging technique which becoming in a complementary tool in the study of the retinal and optic nerve diseases. Automated segmentation is requiered to automatically process the data and produces images of the retinal layers and optic nerve. However, some artifacts can cause error diagnosis as we observed in 3 patients with optic atrophy where the nerve fiber layer (RNFL) appears normal in temporal and nasal area

Disaggregation of Public Health Data by Race & Ethnicity: A Legal Handbook

This handbook addresses the role of law in collecting and disseminating public health data disaggregated by race and ethnicity for public health practitioners and attorneys across state, Tribal, and local governments. It is intended to assist practitioners and attorneys with framing and navigating the various legal and non-legal issues around disaggregated public health data. Data disaggregation is the breakdown and categorization of large sets of data by certain data elements, such as race and ethnicity

A multi-country analysis of COVID-19 hospitalizations by vaccination status

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. Methods: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section

Implementation of Recommendations on the Use of Corticosteroids in Severe COVID-19

Importance: Research diversity and representativeness are paramount in building trust, generating valid biomedical knowledge, and possibly in implementing clinical guidelines. Objectives: To compare variations over time and across World Health Organization (WHO) geographic regions of corticosteroid use for treatment of severe COVID-19; secondary objectives were to evaluate the association between the timing of publication of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial (June 2020) and the WHO guidelines for corticosteroids (September 2020) and the temporal trends observed in corticosteroid use by region and to describe the geographic distribution of the recruitment in clinical trials that informed the WHO recommendation. Design, setting, and participants: This prospective cohort study of 434 851 patients was conducted between January 31, 2020, and September 2, 2022, in 63 countries worldwide. The data were collected under the auspices of the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC)-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Analyses were restricted to patients hospitalized for severe COVID-19 (a subset of the ISARIC data set). Exposure: Corticosteroid use as reported to the ISARIC-WHO Clinical Characterisation Protocol for Severe Emerging Infections. Main outcomes and measures: Number and percentage of patients hospitalized with severe COVID-19 who received corticosteroids by time period and by WHO geographic region. Results: Among 434 851 patients with confirmed severe or critical COVID-19 for whom receipt of corticosteroids could be ascertained (median [IQR] age, 61.0 [48.0-74.0] years; 53.0% male), 174 307 (40.1%) received corticosteroids during the study period. Of the participants in clinical trials that informed the guideline, 91.6% were recruited from the United Kingdom. In all regions, corticosteroid use for severe COVID-19 increased, but this increase corresponded to the timing of the RECOVERY trial (time-interruption coefficient 1.0 [95% CI, 0.9-1.2]) and WHO guideline (time-interruption coefficient 1.9 [95% CI, 1.7-2.0]) publications only in Europe. At the end of the study period, corticosteroid use for treatment of severe COVID-19 was highest in the Americas (5421 of 6095 [88.9%]; 95% CI, 87.7-90.2) and lowest in Africa (31 588 of 185 191 [17.1%]; 95% CI, 16.8-17.3). Conclusions and relevance: The results of this cohort study showed that implementation of the guidelines for use of corticosteroids in the treatment of severe COVID-19 varied geographically. Uptake of corticosteroid treatment was lower in regions with limited clinical trial involvement. Improving research diversity and representativeness may facilitate timely knowledge uptake and guideline implementation

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes