El cultivo del plátano en los departamentos de Caldas, Quindío y Risaralda

El cultivo del plátano ha sido por muchos años una importante actividad económica y con frecuencia constituye buena parte de los ingresos de la mayoría de la población rural del viejo Caldas. Como complemento de la explotación cafetera, el plátano es huésped necesario en ella y en la zona del viejo Caldas. Su forma de cultivo no es inferior a los cultivos especializados de otras áreas económicas, tales como Urabá, Meta, Caquetá, Putumayo, etc.; su importancia como producto básico, tanto en la alimentación humana como animal, hacía necesaria una evaluación de su situación real dentro de nuestra economía, complementada por una monografía concisa que definiera las variedades cultivadas, los requerimientos edáficos y climatológicos, los tipos de plagas y enfermedades, la estructura de su mercado y las políticas gubernamentales y privadas requeridas para una explotación más racional.Los resultados de la investigación, producto del esfuerzo conjunto entre el Banco de la República y el Ministerio de Agricultura a través del Instituto Colombiano Agropecuario -ICA-, se ofrecen como un aporte valioso y oportuno en las circunstancias actuales, cuando existe gran interés gubernamental por llevar a cabo una verdadera política de transformación agraria a nivel nacional

Gestión de inventarios y desempeño laboral en el Minimarket J&S del distrito de Chancay, 2022

El propósito del estudio fue analizar la relación entre la gestión de inventarios y el desempeño laboral en el Minimarket J&S del Distrito de Chancay, 2022; la investigación fue de tipo descriptiva, nivel correlacional, con diseño no experimental de corte transversal. La población estuvo constituida por todo el personal que labora en la empresa, la muestra fueron los 18 trabajadores (1 administrador, 1 auxiliar de contabilidad, 1 almacenero, 1 auxiliar, 4 vendedores y 10 repartidores). Para la recolección de datos se empleó la encuesta como técnica y como instrumento el cuestionario para ambas variables; ambos instrumentos contaron con alta confiabilidad y validez por juicio de expertos. Los resultados estadísticos demostraron que los niveles de las variables de estudio y sus respectivas dimensiones , desde la percepción de los encuestados, es malo; así también se evidenció que existe relación positiva y moderada (r=0,504 y p=0.00) entre la gestión de inventarios y el desempeño laboral en el Minimarket J&S del Distrito de Chancay, 2022; así como también se halló que las dimensiones presentan correlaciones moderadas: entre la planeación de compras (r=0,710), las compras (r=0,761) y el control de mercaderías (r=0,504) con el desempeño laboral en el Minimarket J&S del Distrito de Chancay, 2022.Tesi

Hábitos de estudio y rendimiento académico en los estudiantes del primer año de la Escuela de Educación Superior Técnico Profesional PNP Puente Piedra – Lima

Es objetivo general fue determinar si existe relación de los hábitos de estudio con el rendimiento académico en estudiantes del primer año de la Escuela de Educación Superior Técnico Profesional PNP Puente Piedra. La investigación es de enfoque cuantitativo con diseño descriptivo correlacional. Se utilizó un diseño no experimental en la aplicación de un cuestionario estandarizado y confidencial en un solo y único momento a los sujetos de la muestra intencionada de las secciones ―9‖ y ―10‖ (77 UM) vía red social ya que los alumnos están en sus hogares recibiendo clases virtuales. Una vez obtenidos los resultados y se evidenció qué hábitos de estudios tuvo cada uno de ellos, se procedió a comparar estos resultados con sus notas de la asignatura de ―Control de multitudes‖ que constan en el registro del docente. Al respecto, el Alfa de Cronbach es de 0,610 lo cual permitió estimar que el instrumento de medida de 100 Items es confiable, Chi Cuadrado de Pearson: 50.380. La correlación de Spearman es de = 0,763 determinando una relación significativa entre las dos variables, concluyéndose que existe una correlación positiva fuerte entre los hábitos de estudio y el rendimiento académico en estudiantes de este centro de formación

Relationship between vegetation of the levee neo-ecosystems and environmental heterogeneity in the Lower Delta of the Paraná River, Argentina

The relationship between environmental heterogeneity and the vegetation of the levee neo-ecosystems in the Delta of the Paraná River was studied. These habitat types were considered plant communities of recent origin related to local productive activities. Vegetation coverage was evaluated in 97 plots of three different environmental units (A, B and C), using classification analysis, indirect and direct ordinations. The differential vegetation in different environmental units could be related to a greater fluvial influence of the Paraná River on unit A and a greater tidal influence of the de la Plata River on units B and C. The Lower Delta hydrological regimes only affect a few of edaphic variables particularly pH, organic matter percentage and clay content. To understand the spatial pattern of neo-ecosystems vegetation, it is also necessary to consider the invasion of alien species that has been taking place for over 50 years.Facultad de Ciencias Naturales y Muse

Guidelines for a model of teaching human rights in the UAEM, according to the new mexican legal system

El objetivo es proponer criterios desde el sistema jurídico mexicano en materia de educación en derechos humanos para la creación de lineamientos de un modelo de enseñanza de los Derechos Humanos en la Universidad Autónoma del Estado de México (UAEM). La enseñanza como parte de la educación en derechos humanos, se analiza en un marco teórico de sistemas sociales, abordando la comunicación entre el sistema jurídico y político mexicanos, desde la implementación del sistema internacional de derechos humanos en México. Resultados: la necesidad de incluir la transversalización de los derechos humanos en el plan de estudios de la licenciatura en derecho, y la reestructuración de la unidad de aprendizaje derechos humanos, cultura y democracia; así como la capacitación de docentes que permita una formación holística en los estudiantes de derecho

Early goal-directed therapy using a physiological holistic view: the ANDROMEDA-SHOCK—a randomized controlled trial

Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate‐targeted resuscitation is the gold‐standard under current guidelines, although it has several pitfalls including that non‐hypoxic sources of lactate might predominate in an unknown proportion of patients. Peripheral perfusion‐targeted resuscitation might provide a real‐time response to increases in ow that could lead to a more timely decision to stop resuscitation, thus avoiding uid overload and the risks of over‐resuscitation. This article reports the rationale, study design and analysis plan of the ANDROMEDA‐SHOCK Study. Methods: ANDROMEDA‐SHOCK is a randomized controlled trial which aims to determine if a peripheral perfusion‐ targeted resuscitation is associated with lower 28‐day mortality compared to a lactate‐targeted resuscitation in patients with septic shock with less than 4 h of diagnosis. Both groups will be treated with the same sequential approach during the 8‐hour study period pursuing normalization of capillary re ll time versus normalization or a decrease of more than 20% of lactate every 2 h. The common protocol starts with uid responsiveness assessment and uid loading in responders, followed by a vasopressor and an inodilator test if necessary. The primary outcome is 28‐day mortality, and the secondary outcomes are: free days of mechanical ventilation, renal replacement therapy and vasopressor support during the rst 28 days after randomization; multiple organ dysfunction during the rst 72 h after randomization; intensive care unit and hospital lengths of stay; and all‐cause mortality at 90‐day. A sample size of 422 patients was calculated to detect a 15% absolute reduction in mortality in the peripheral perfusion group with 90% power and two‐tailed type I error of 5%. All analysis will follow the intention‐to‐treat principle. Conclusions: If peripheral perfusion‐targeted resuscitation improves 28‐day mortality, this could lead to simpli ed algorithms, assessing almost in real‐time the reperfusion process, and pursuing more physiologically sound objec‐ tives. At the end, it might prevent the risk of over‐resuscitation and lead to a better utilization of intensive care unit resources

Factores de riesgo de complicaciones respiratorias postquirúrgicas

Introduction: postoperative respiratory complications increase morbidity and mortality, hospital stay and health care costs.Objectives: to identify the incidence and risk factors for post-surgical respiratory complications.Methods: an observational, anality, cross-sectional study was conducted in 1 650 patients at the “Celestino Hernández Robau” Hospital between January 2018 and December 2019. The variables sex, age, weight, height, body mass index, smoking, alcoholism, physical status classification, type of anesthesia, type of surgery according to elective or urgent, type of surgery according to surgical location and time, nasogastric tube, hemoglobin level, albuminemia and preoperative oxygen saturation were evaluated and post-surgical respiratory complications were determined.Results: 5.15% of the patients presented postoperative respiratory complications and the frecuence of these complications was 6.72%. Risk factors were identified as age equal to or older than 68 years, smoking, physical status classification III and IV, endotracheal general anesthesia, surgical time longer than three hours, urgent, upper abdominal and head and neck surgery, hemoglobin levels less than 10 g/L, albumin levels less than 34 g/L, use of nasogastric tube and preoperative oxygen saturation equal to or less than 92%. Sex, body mass index and alcoholism were not related to an increase in respiratory complications.Conclusions: the association of risk factors increased the number of patients with postoperative respiratory complications.Introducción: las complicaciones respiratorias postquirúrgicas aumentan la morbimortalidad, la estadía hospitalaria y los costes sanitarios.Objetivos: identificar la incidencia y los factores de riesgo para complicaciones respiratorias postquirúrgicas.Métodos: se realizó un estudio observacional, analitico y de corte transversal en 1 650 pacientes en el Hospital “Celestino Hernández Robau” entre enero de 2018 y diciembre de 2019. Se evaluaron las variables sexo, edad, peso, talla, índice de masa corporal, tabaquismo, alcoholismo, clasificación del estado físico, tipo de anestesia, tipo de cirugía según electiva o urgente, tipo de cirugía según la localización y el tiempo quirúrgico, sonda nasogástrica, nivel de hemoglobina, albuminemia y saturación de oxígeno preoperatoria y se determinaron las complicaciones respiratorias postquirúrgicas.Resultados: el 5,15% de los pacientes presentaron complicaciones respiratorias postquirúrgicas y la frecuencia de estas complicaciones fue de 6,72%. Se identificaron como factores de riesgo la edad igual o mayor de 68 años, el tabaquismo, la clasificación del estado físico III y IV, la anestesia general endotraqueal, el tiempo quirúrgico mayor de tres horas, la cirugía urgente, abdominal alta y de cabeza y cuello, los niveles de hemoglobina menores de 10 g/l, los niveles de albúmina menores de 34 g/l, el uso de sonda nasogástrica y la saturación de oxígeno preoperatoria igual o menor a 92%. El sexo, el índice de masa corporal y el alcoholismo no se relacionaron con un aumento de complicaciones respiratorias.Conclusiones: la asociación de factores de riesgo aumentó el número de pacientes con complicaciones respiratorias postquirúrgicas

Náuseas y vómitos postoperatorios en pacientes pediátricos sometidos a anestesia general para cirugía electiva

Introduction: Postoperative nausea and vomiting depend on a combination of several patient-dependent factors, surgical intervention and anesthesia.Objective: to know the incidence of postoperative nausea and vomiting in pediatric patients undergoing general anesthesia for elective surgery.Methods: an observational, descriptive, cross-sectional study was conducted at the Anesthesiology and Resuscitation Service of the "José Luis Miranda" Hospital between February 2016 and February 2018.The variables studied were age, sex, smoking, American Anesthesia Association classification, history of postoperative nausea and vomiting and motion sickness (or both), anesthetic agents used, type of surgical intervention according to diagnosis, hospital stay, and surgical site approach, surgical time and presence of postoperative nausea and vomiting in the first 24 hours.Results: the incidence of postoperative nausea and vomiting was 6.7%, with predominance in non-smokers, those with a history of postoperative nausea and vomiting and motion sickness (or both), in the strabismus operation, in the non-ambulatory surgical intervention, in patients with surgical times longer than 30 minutes and in those using halogenated agents.Conclusions: the incidence of postoperative nausea and vomiting was low, and the greater the number of risk factors, the more postoperative nausea and vomiting occurred.Introducción: las náuseas y los vómitos postoperatorios dependen de la combinación de varios factores dependientes del paciente, la intervención quirúrgica y la anestesia.Objetivo: conocer la incidencia de náuseas y vómitos postoperatorios en pacientes pediátricos sometidos a anestesia general para cirugía electiva.Métodos: se realizó un estudio observacional, descriptivo, de corte transversal en el Servicio de Anestesiología y Reanimación del Hospital “José Luis Miranda” entre febrero de 2016 y febrero de 2018. Se estudiaron las variables edad, sexo, tabaquismo, clasificación de la Asociación Americana de Anestesia, antecedentes de náuseas y vómitos postoperatorios y cinetosis (o ambas), agentes anestésicos utilizados, tipo de intervención quirúrgica según diagnóstico, estancia hospitalaria y abordaje del sitio quirúrgico, tiempo quirúrgico y presencia de náuseas y vómitos postoperatorios en las primeras 24 horas.Resultados: la incidencia de náuseas y vómitos postoperatorios fue de 6,7%, con predominio en los no fumadores, los que presentaban antecedentes de náuseas y vómitos postoperatorios y cinetosis (o ambos), en la operación de estrabismo, en la intervención quirúrgica no ambulatoria, en los pacientes con tiempos quirúrgicos mayores de 30 minutos y en los que se utilizaron agentes halogenados.Conclusiones: la incidencia de náuseas y vómitos postoperatorios fue baja y a mayor número de factores de riesgo hubo más náuseas y vómitos postoperatorios

The practice of intensive care in Latin America: a survey of academic intensivists

Intensive care medicine is a relatively young discipline that has rapidly grown into a full-fledged medical subspecialty. Intensivists are responsible for managing an ever-increasing number of patients with complex, life-threatening diseases. Several factors may influence their performance, including age, training, experience, workload, and socioeconomic context. The aim of this study was to examine individual- and work-related aspects of the Latin American intensivist workforce, mainly with academic appointments, which might influence the quality of care provided. In consequence, we conducted a cross-sectional study of intensivists at public and private academic and nonacademic Latin American intensive care units (ICUs) through a web-based electronic survey submitted by email. Questions about personal aspects, work-related topics, and general clinical workflow were incorporated. RESULTS: Our study comprised 735 survey respondents (53% return rate) with the following country-specific breakdown: Brazil (29%); Argentina (19%); Chile (17%); Uruguay (12%); Ecuador (9%); Mexico (7%); Colombia (5%); and Bolivia, Peru, Guatemala, and Paraguay combined (2%). Latin American intensivists were predominantly male (68%) young adults (median age, 40 [IQR, 35-48] years) with a median clinical ICU experience of 10 (IQR, 5-20) years. The median weekly workload was 60 (IQR, 47-70) h. ICU formal training was between 2 and 4 years. Only 63% of academic ICUs performed multidisciplinary rounds. Most intensivists (85%) reported adequate conditions to manage patients with septic shock in their units. Unsatisfactory conditions were attributed to insufficient technology (11%), laboratory support (5%), imaging resources (5%), and drug shortages (5%). Seventy percent of intensivists participated in research, and 54% read scientific studies regularly, whereas 32% read no more than one scientific study per month. Research grants and pharmaceutical sponsorship are unusual funding sources in Latin America. Although Latin American intensivists are mostly unsatisfied with their income (81%), only a minority (27%) considered changing to another specialty before retirement. CONCLUSIONS: Latin American intensivists constitute a predominantly young adult workforce, mostly formally trained, have a high workload, and most are interested in research. They are under important limitations owing to resource constraints and overt dissatisfaction. Latin America may be representative of other world areas with similar challenges for intensivists. Specific initiatives aimed at addressing these situations need to be devised to improve the quality of critical care delivery in Latin America

Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock The ANDROMEDA-SHOCK Randomized Clinical Trial

Importance Abnormal peripheral perfusion after septic shock resuscitation has been associated with organ dysfunction and mortality. The potential role of the clinical assessment of peripheral perfusion as a target during resuscitation in early septic shock has not been established. Objective To determine if a peripheral perfusion–targeted resuscitation during early septic shock in adults is more effective than a lactate level–targeted resuscitation for reducing mortality. Design, Setting, and Participants Multicenter, randomized trial conducted at 28 intensive care units in 5 countries. Four-hundred twenty-four patients with septic shock were included between March 2017 and March 2018. The last date of follow-up was June 12, 2018. Interventions Patients were randomized to a step-by-step resuscitation protocol aimed at either normalizing capillary refill time (n = 212) or normalizing or decreasing lactate levels at rates greater than 20% per 2 hours (n = 212), during an 8-hour intervention period. Main Outcomes and Measures The primary outcome was all-cause mortality at 28 days. Secondary outcomes were organ dysfunction at 72 hours after randomization, as assessed by Sequential Organ Failure Assessment (SOFA) score (range, 0 [best] to 24 [worst]); death within 90 days; mechanical ventilation–, renal replacement therapy–, and vasopressor-free days within 28 days; intensive care unit and hospital length of stay. Results Among 424 patients randomized (mean age, 63 years; 226 [53%] women), 416 (98%) completed the trial. By day 28, 74 patients (34.9%) in the peripheral perfusion group and 92 patients (43.4%) in the lactate group had died (hazard ratio, 0.75 [95% CI, 0.55 to 1.02]; P = .06; risk difference, −8.5% [95% CI, −18.2% to 1.2%]). Peripheral perfusion–targeted resuscitation was associated with less organ dysfunction at 72 hours (mean SOFA score, 5.6 [SD, 4.3] vs 6.6 [SD, 4.7]; mean difference, −1.00 [95% CI, −1.97 to −0.02]; P = .045). There were no significant differences in the other 6 secondary outcomes. No protocol-related serious adverse reactions were confirmed. Conclusions and Relevance Among patients with septic shock, a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not reduce all-cause 28-day mortality