Diseño y confort térmico para el centro de educación básica regular cuna - jardin en la ciudad de Acora

En los últimos años, Perú se ha preocupado por la creación de una arquitectura respetuosa con el medio ambiente en respuesta al problema del cambio climático, lo que ha dado lugar al desarrollo de proyectos arquitectónicos que deben tener en cuenta los factores bioclimáticos. El título del proyecto de investigación “Diseño y confort térmico para el centro de educación básica regular cuna-jardín en la ciudad de Acora” responde a un problema puesto de manifiesto en la ciudad de Acora como consecuencia de una deficiencia en las infraestructuras de los centros educativos de tipo ciclo I. Ciclo II (Jardín) con ambientes deficientes, para el cual este proyecto de infraestructura; “Diseño y confort térmico para el centro de educación básica regular cuna-jardín en la ciudad de Acora”, es una institución del estado que tiene como función cuidar a niños (as) de 0 a 3 años (ciclo I) y niños (as) 3 a 5 años (ciclo II) buscando que el confort térmico sea una opción para la mejora de ambientes de la institución. En el proceso de diseño arquitectónico se toma como punto de inicio el medio ambiente, el clima y su entorno, proponiendo un método de acondicionamiento ambiental basado en el análisis de las condiciones climáticas, así como el uso de materiales apropiados, cumpliendo con las exigencias requeridas por ser confortable. A su vez con los principios básicos del pedagogo Friedrich Fröbel, se considera un análisis de las actividades que se realzaran dentro y fuera de este centro educativo básico en relación a las necesidades del niño. y las diferentes funciones que deben cumplir. Finalmente, el objetivo principal de la investigación es “Proponer el diseño y confort térmico que mejore el déficit en el centro de educación básica cuna-jardín en la Ciudad de Acora”

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

Bibliometric Study of Scientific Productivity on the Impacts on Mental Health in Times of Pandemic

Background and Objectives: The presence of the new SARS-CoV-2 virus is causing enormous threats to people’s health and lives, so quantifying the scientific productivity on mental health in times of pandemic is an urgent need, especially to expand the degree of knowledge on mental health problems in regions of low scientific productivity. The aim was to characterize the bibliometric indicators of scientific productivity on mental health during the pandemic in the PubMed Identifier database of the National Library of Medicine in the United States. Materials and Methods: A documentary study (bibliometric) of the scientific productivity on mental health in times of pandemic from January 2020 to June 2021 was carried out. The PubMed database was used to abstract the information from the original scientific articles. The data abstracted were: authors, year of publication, journal name, country, and language of publication. Results: We identified 47 original articles worldwide, which were published in 29 journals and in three languages (English, Spanish, and German). We observed three groups of countries that published on mental health topics. The first group comprised the largest number of publications, which were multicenter studies (six studies), followed by India (five studies), and Italy (four studies). A second group comprised Bangladesh, China, USA, and Spain, with 3 studies each; and a third group comprised 13 countries (Albania, Saudi Arabia, Argentina, Brazil, South Korea, Denmark, Ecuador, Egypt, Greece, Japan, Jordan, Kuwait, and New Zealand) with one study each. Conclusions: Bibliometric indicators of scientific productivity on mental health during the COVID-19 pandemic have ostensibly increased. We verified 47 studies in PubMed, which could serve to improve the understanding and management of COVID-19, as well as serve as a thought-provoking means for other countries and researchers to publish on the state of mental health during and post pandemic