Spatially homogeneous solutions of the Vlasov-Nordstr\"om-Fokker-Planck system

The Vlasov-Nordstr\"{o}m-Fokker-Planck system describes the evolution of self-gravitating matter experiencing collisions with a fixed background of particles in the framework of a relativistic scalar theory of gravitation. We study the spatially-homogeneous system and prove global existence and uniqueness of solutions for the corresponding initial value problem in three momentum dimensions. Additionally, we study the long time asymptotic behavior of the system and prove that even in the absence of friction, solutions possess a non-trivial asymptotic profile. An exact formula for the long time limit of the particle density is derived in the ultra-relativistic case.Comment: 25 pages, 1 figure. Several changes from previous version. To appear in J. Diff. Eq

Relación entre las dimensiones del Síndrome de Burnout y la satisfacción laboral en obstetras de un hospital del cono norte de Lima

Objetivo: determinar si existe relación entre las dimensiones del Síndrome de Burnout y la Satisfacción laboral en obstetras del Hospital Carlos Lanfranco La Hoz, Puente Piedra - Lima, 2015. Materiales y métodos: La investigación fue cuantitativa, descriptiva, correlacional de corte transversal y la información se recolectó a través de dos instrumentos: el Inventario Burnout de Maslach (MBI) y la Encuesta de Satisfacción del Personal de Salud (MINSA). El estudio fue realizado con 50 obstetras. Los análisis datos fueron procesados en el programa SPSS versión 22, se utilizó la Prueba X² de Pearson para evaluar asociación entre dos variables y el coeficiente de correlación de Pearson (r). Resultados: Con respecto a las dimensiones del Síndrome de Burnout se encontró que el 70% (n=35) de los profesionales presentan un nivel bajo de agotamiento emocional, el 66% (n=33) presentó un nivel bajo de despersonalización y el 50% (n=25) un alto ni

VALIDEZ DE LOS MATERIALES DIDÁCTICOS EN EL DESARROLLO DE LAS PRÁCTICAS PREPROFESIONALES DE LOS ESTUDIANTES DEL X CICLO DE LA CARRERA PROFESIONAL DE EDUCACIÓN PRIMARIA DE LA UNHEVAL, 2015

Teniendo en cuenta que el Nuevo Enfoque Educativo, propone aprendizajes significativos los cuales partiendo de los conocimientos previos del estudiante, puedan lograr nuevos aprendizajes, útiles para la vida, que respondan a las expectativas del aprendiz y ligados con el contexto, viendo que se perpetúan en su práctica el uso de materiales didácticos considerados ya ancestrales, nos propusimos el siguiente objetivo: Determinar la validez de los materiales didácticos en el desarrollo de las prácticas pre profesionales de los estudiantes del X ciclo de la Carrera Profesional de Educación Primaria de la UNHEVAL, 2015 para ello, tratándose de una investigación de nivel aplicativo y de tipo experimental, utilizamos el método descriptivo correlacional para someter a los estudiantes del X Ciclo de la Carrera Profesional de Educación Primaria en número de 25 quienes fueron a la vez nuestra población y nuestra muestra, seleccionada de modo aleatorio a seleccionar y valorar los materiales mas usados en su práctica pre profesional, en el área de Matemática: el Äbaco y la Yupana y en el área de Comunicación, los Carteles Léxicos y Las Letras Móviles, aplicando un instrumento debidamente validado por expertos para evaluar dichos materiales, se utilizaron además las técnicas del fichaje y la entrevista nos respaldamos para ello en lo expresado por 1: Los materiales constituyen elementos concretos, físicos, que portan los mensajes educativos, a través de uno o más canales de comunicación, y se utilizan en distintos momentos o fases del proceso enseñanza- aprendizaje”, por tanto son ineludibles al momento de propiciar los aprendizajes. siendo los resultados los siguientes: más de un 50% de la muestra valoró a dichos materiales educativos como vigentes, lo cual nos lleva a rechazar la hipótesis nula (Ho) y aceptar la hipótesis de trabajo: Si los materiales didácticos son válidos entonces se desarrollaran óptimamente las prácticas pre profesionales de los estudiantes del X ciclo de la Carrera profesional de Educación Primaria de la UNHEVAL, 2015, con lo cual se prueba que dichos materiales a pesar de su antigüedad, siguen vigentes en cuanto su función motivacional y a su rol de auxiliares muy eficaces en el proceso de enseñanza aprendizaje

Factors associated to the access of prenatal care in the hospitals of Huaral and Chancay, Peru

Introducción. La atención prenatal aún no cubre al total de gestantes, situación que se repite en Latinoamérica y son pocos los estudios que evalúan las barreras que explican este fenómeno. El objetivo del presente estudio fue determinar los factores asociados al acceso de la atención prenatal en sus dimensiones de atención oportuna y cobertura. Métodos. Estudio de enfoque cuantitativo, observacional y analítico, realizado en 110 puérperas de los hospitales de Huaral y Chancay, Perú. Se evaluaron los factores (personales y sociodemográficos) asociados al acceso a la atención prenatal de acuerdo a su cobertura (mínimo 6 controles) y atención oportuna (primer control <14 semanas). Se realizó un análisis de regresión logística multivariada considerando un nivel de confianza del 95%. Resultados. Se halló que el olvido de las citas se muestra como un factor asociado a la cobertura inadecuada de la atención prenatal (p=0,048), mientras que la presencia de un seguro de salud, previo al control prenatal, se asoció a la atención prenatal oportuna (p=0,013). Conclusiones. La ausencia de olvido de las citas y la presencia de un seguro de salud previo al embarazo se asocian con el acceso a la atención prenatal.Introduction. Prenatal care still does not cover the total of pregnant women, a situation that is repeated in Latin America and the few that evaluate the barriers that explain this phenomenon. The objective of study was to determine the factors associated with the access of prenatal care in its opportunity and coverage dimensions. Methods. Study of quantitative, observational, analytical approach carried out in 110 schools of the Hospitals of Huaral and Chancay, Peru. The factors (personal and sociodemographic) associated with access to prenatal care were evaluated according to their coverage (minimum 6 controls) and timely care (first control <14 weeks). A multivariate logistic regression analysis was performed considering a confidence level of 95%. Results. It was found that forgetfulness of appointments is shown as a factor associated with inadequate coverage of antenatal care (p=0,048), while the presence of a safe state of prenatal care was associated with timely prenatal care (p=0,013). Conclusions. The absence of forgetfulness of appointments and the presence of a safe state of health during pregnancy is associated with access to prenatal care

Community-based therapy for multidrug-resistant tuberculosis in Lima, Peru.

BACKGROUND: Despite the prevalence of multidrug-resistant tuberculosis in nearly all low-income countries surveyed, effective therapy has been deemed too expensive and considered not to be feasible outside referral centers. We evaluated the results of community-based therapy for multidrug-resistant tuberculosis in a poor section of Lima, Peru. METHODS: We describe the first 75 patients to receive ambulatory treatment with individualized regimens for chronic multidrug-resistant tuberculosis in northern Lima. We conducted a retrospective review of the charts of all patients enrolled in the program between August 1, 1996, and February 1, 1999, and identified predictors of poor outcomes. RESULTS: The infecting strains of Mycobacterium tuberculosis were resistant to a median of six drugs. Among the 66 patients who completed four or more months of therapy, 83 percent (55) were probably cured at the completion of treatment. Five of these 66 patients (8 percent) died while receiving therapy. Only one patient continued to have positive cultures after six months of treatment. All patients in whom treatment failed or who died had extensive bilateral pulmonary disease. In a multiple Cox proportional-hazards regression model, the predictors of the time to treatment failure or death were a low hematocrit (hazard ratio, 4.09; 95 percent confidence interval, 1.35 to 12.36) and a low body-mass index (hazard ratio, 3.23; 95 percent confidence interval, 0.90 to 11.53). Inclusion of pyrazinamide and ethambutol in the regimen (when susceptibility was confirmed) was associated with a favorable outcome (hazard ratio for treatment failure or death, 0.30; 95 percent confidence interval, 0.11 to 0.83). CONCLUSIONS: Community-based outpatient treatment of multidrug-resistant tuberculosis can yield high cure rates even in resource-poor settings. Early initiation of appropriate therapy can preserve susceptibility to first-line drugs and improve treatment outcomes

Principales indicadores bibliométricos de la actividad científica peruana. 2012-2017

La actividad científica, como uno de los principales motores de desarrollo económico, implica la participación de diversos sectores e instituciones. Para ello, el Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC), como institución rectora del Sistema Nacional de Ciencia, Tecnología e Innovación Tecnológica (SINACYT), desarrolla diversas actividades orientadas no solo a generar las condiciones necesarias para el desarrollo de la investigación, sino también para su promoción, fomento y orientación. En este contexto, la elaboración de análisis sobre los resultados de investigación que se generan en el país es fundamental para la evaluación que hacen las diferentes instancias gubernamentales implicadas en el desarrollo de la política nacional de Ciencia, Tecnología e Innovación (CTeI) y en el planteamiento de estrategias que contribuyan a consolidar la actividad investigadora en el país.Por ello, el objetivo principal de este informe es caracterizar la investigación científica desarrollada en Perú, mediante la determinación del grado de visibilidad, colaboración, impacto, excelencia y liderazgo, que alcanzaron los investigadores peruanos, durante el sexenio de 2012-2017. Para lo cual, se usaron como fuente de datos bibliométricos Scopus de Elsevier y la metodología de SCImago Research Group.Peer reviewe

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

Long-term Follow-up for Multidrug-resistant Tuberculosis

Patients treated in Peru for multidrug-resistant tuberculosis (MDR-TB) were followed-up for a median of 67 months. Among 86 patients considered cured after completion of treatment, 97 % remain healthy; 1 patient relapsed. Employment increased from 34 % before treatment to 71%. We observed favorable long-term outcomes among MDR-TB patients. Increasing awareness of the rising global rates of multidrug-resistant tuberculosis (MDR-TB) has led to a concerted international effort to confront this disease, particularly in countries with a high incidence of TB (1–3). Nonetheless, despite cure rates&gt;80 % in some programs, MDR-TB patients tend to have chronic disease and require prolonged therapy. Little is known about the long-term follow-up of patients treated for MDR-TB, including rates of relapse and chronic disability among cured persons. Among patients treated for pansusceptible TB, chronic disability caused by pulmonary sequelae and malnutrition can be substantial (4). Given the prolonged nature of MDR-TB, one might expect higher rates of chronic disability among patients with drugresistant TB compared with those with pansusceptible TB. To explore these questions, we conducted long-term follow-up, defined as follow-up for a minimum of 4 years after treatment was initiated, of MDR-TB patients who received individualized therapy in Lima, Peru (1). The Study We performed a retrospective study among all patients who initiated individualized, community-based MDR-TB therapy from August 1, 1996, to March 1, 2000. The details of patient identification, enrollment, and treatment are described elsewhere (5). Patients were resistant to a median of 5 drugs (range 2–9). Regimens generally included at least 5 drugs to which the infecting isolate was susceptible, and treatment duration was 18–24 months. Routine follow-up after completion of MDR-TB therap