Obesity and Diabetes: Evaluating the Impact of Promotores as a Prevention and Intervention Strategy in the Latino Community

This paper aims to examine obesity and diabetes among the Latino population as a health problem. As the largest minority racial group in the U.S, Latino rates of obesity and diabetes are greatly higher than whites. The prevalence of obesity in Latinos is 45% compared to that of whites at 34.5% (CDC, 2015). The disproportionate rates at which Latinos are affected by obesity and diabetes have prompted numerous programs to combat this health problem. Promotores or Latino community health workers have been able to provide the important piece of culturally and linguistically appropriate education for the population. Evidence shows Promotores dramatically improve intervention outcomes. Evidence also points to the cost effectiveness of using community health workers for a program related to lifestyle modification for Latinos with type 2 diabetes. The program was cost effective, yielding results of lower AIC levels by generous amounts (Brown et al., 2012). As a result, conducting my fieldwork at an agency that uses Promotores was key in order to examine the positive impact Promotores have on the local Latino community. The program evaluation consisted of forty-two client satisfaction surveys as well as four in-depth interviews with Promotores. Overall the results were positive, many clients indicated a better understanding of services available in their community and many continue to use those services after a year or more of being part of the program. The in-depth interviews also illustrated some of the challenges that come with being a Promotor/a but also indicated an overall high job satisfaction rate. These results illustrated the positive impact Promotores have on the Latino population however, it is evident more research is needed in this area. Specifically, more research can influence policy changes that can then yield more funding in addressing the barriers Latinos face when it comes to healthcare in the U.S

Visual Analytics of Temporal Event Sequences

Temporal event sequence data (such as event logs) is collected in a wide variety of domains ranging from healthcare to cyber security, vehicle fault diagnosis, population living activities, and web clickstream records. Visual analytics aims to obtain a summary or overview of the data to allow knowledge discovery and support the improvement of the process being studied. Despite the great advances in visual analytics of event data, two main gaps were found in the literature. First, existing visualisations provide an overview of event sequences where its level-of-detail can be transformed by drilling down certain elements, but do not provide dynamic levels of detail simultaneously across sequences and longitudinally. Second, current overviews of event data focus on the visual encoding of sequential patterns but present limitations when representing temporal and multivariate attributes: the attributes are not encoded in the overview or if present, these are oversimplified (e.g. using average values). This thesis tackles both gaps by proposing a technique to build a multilevel and multivariate overview of temporal event sequences. The overview is multilevel as its level of granularity can be transformed across sequences (vertical level-of-detail) or longitudinally (horizontal level-of-detail), using hierarchical aggregation and a novel cluster data representation Align-Score-Simplify. By default, the overview shows an optimal number of sequence clusters obtained through the average silhouette width metric – then users are able to explore alternative optimal sequence clusterings. The vertical level-of-detail of the overview changes along with the number of clusters, whilst the horizontal level-of-detail refers to the level of summarisation applied to each cluster representation. The overview is multivariate as it allows to visualise event types in the overview using an EventBox, a novel visual encoding that aggregates temporal and multivariate attributes for a set of event occurrences of the same type. The overview allows the identification of trends and outliers involving multivariate attributes within and across clusters. The proposed technique has been implemented into a visualisation system called Sequence Cluster Explorer (Sequen-C) that allows detail-on-demand exploration through three coordinated views, and the inspection of data attributes at cluster, unique sequence, and individual sequence level. The technique is demonstrated through four case studies using three different types of real-world datasets in the healthcare domain: patient flow, hospital admissions and prescription history, and calls made to the emergency services. The case studies show how the technique can aid experts in exploring and defining a set of pathways that best summarise the dataset, while exploring data attributes for selected patterns. Moreover, Sequen-C was evaluated with 13 non-expert users. The results indicate that the system Sequen-C can allow novice users to quickly familiarise with the proposed visualisations and successfully obtain insights from the data according to the objective analytic tasks. Furthermore, the results of the System Usability Scale questionnaire indicate that Sequen-C has a good usability level

Prevalencia de citologías con lectura anormal en mujeres de 20 a 55 años de edad en la Unidad Comunitaria de Salud Familiar Básica Conacaste en el año 2019

El objetivo de este estudio consistió en Identificar la prevalencia de citologías con lectura anormal en mujeres de 20 a 55 años de edad en la Unidad Comunitaria de Salud Familiar Básica Conacaste en el año 2019, así como la asociación de factores epidemiológicos que contribuyen en la aparición de cáncer de cuello uterino

Manual para evaluar la aplicación de la Ley de protección al consumidor en las empresas dedicadas a la venta de electrodomésticos y muebles en el municipio de San Salvador.

En El Salvador como en cualquier otro país, existen proveedores de bienes y servicios para el consumo de una amplia gama de usuarios; por ello, la relación que éstos tengan entre sí, es muy importante, debido a que las personas cuando adquieren un producto buscan principalmente satisfacer una o varias necesidades de manera eficiente, mientras que las empresas necesitan tener muchos clientes, ya que son quienes generan la principal fuente de sus ingresos; por ésta razón se puede decir que uno depende del otro. En el país, la relación jurídica entre vendedores y consumidores, está regulada por la Ley de Protección al Consumidor; sin embargo, en la actualidad existe mucha inconformidad por abusos e irrespeto a los derechos de los compradores, lo que genera denuncias por: mala calidad, cobros injustos, publicidad engañosa, entre otras prácticas indebidas, que afectan la imagen corporativa o que van en detrimento de los clientes. La reputación de las entidades es de suma importancia, puesto que es la primera percepción que se tiene al momento de elegir el establecimiento donde se van realizar las compras, es responsabilidad de cada uno de los negocios, analizar, evaluar y tomar las medidas necesarias de control interno; para acatar las regulaciones a las que estén sujetos dependiendo de su naturaleza, es por ello que hoy en día las auditorías de cumplimiento juegan un papel transcendental, debido a que por medio de estos trabajos se puede emitir una conclusión, sobre los procedimientos que se están ejecutando, determinando si están en concordancia con lo establecido en la Ley. En atención a lo antes mencionado, nace la oportunidad para el auditor de ofrecer sus servicios para realizar evaluaciones sobre la aplicación de la Ley e incursionar en nuevas áreas como profesional y así obtener nuevas fuentes de ingresos. Uno de los principales problemas con los que se encuentra el auditor, es el poco conocimiento de la Ley o la falta de recursos técnicos y bibliográficos que sirvan de parámetro y que le permitan poder revisar los puntos claves que están regulados en la normativa, es por ello que surgió la necesidad del presente estudio, en el que se elaboró un manual para evaluar la aplicación de la Ley, que le servirá como guía al momento de realizar el encargo, considerando la etapa de planeación, ejecución y elaboración del informe. La investigación se desarrolló a través del método hipotético deductivo, describiendo las características del problema, se planteó la hipótesis y se tomaron como unidades de análisis a 29 auditores externos con la finalidad de poder sustentar una base real para la formulación de la propuesta; además, para determinar la necesidad que las empresas presentan de realizar evaluaciones a sus procedimientos por medio de auditorías de cumplimiento, se consideraron 32 jefes de sala de las empresas dedicadas a la venta de electrodomésticos y muebles en el municipio de San Salvador. A partir de los resultados obtenidos se pudo evidenciar que los auditores tienen un conocimiento no muy amplio sobre la Ley y poseen poca experiencia en la ejecución de este tipo de encargos

Plan de comunicación integrada de marketing para club deportivo FAS, en el municipio de Santa Ana, El Salvador

Las Comunicaciones Integradas de Marketing constituyen un área poco explorada en el ámbito deportivo salvadoreño, tiene como principal objetivo optimizar todos las áreas de la empresa, orientándose a transmitir al target un mensaje claro que permita crear relaciones sólidas no solo con el target poblacional sino con todos los stakeholders que involucran a la empresa u organización, como base para crear una marca fuerte y exitosa capaz de superar las limitantes y amenazas, optimizando no solo el área de Marketing sino todas las áreas que componen la organización, un completo Plan de Comunicaciones Integradas de Marketing se enfocan en unir todas las estrategias mercadológicas y comunicacionales en un solo esfuerzo articulado de forma estratégica

Diabetes Status is Associated With Plantar Soft Tissue Stiffness Measured Using Ultrasound Reverberant Shear Wave Elastography Approach

Introduction: The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. Method: 51 (M/F-21/30) participants with pre-diabetes onset (Fasting Blood Sugar Level-FBS>100 mg/dL), age>18 years, and no lower limb amputation were recruited after ethical approval was granted from Pontificia Universidad Catolica del Peru ethical review board. Ultrasound reverberant shear wave elastography was used to assess the soft tissue stiffness at the 1st MTH, 3rd MTH and the heel at both feet. Results: Spearman’s rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .05) higher shear wave speed in the plantar soft tissue with the following effect sizes (r) at the 1st MTH of the left foot at all tested frequencies: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. Conclusion: An association between fasting blood sugar level and the stiffness of the plantar soft tissue with higher values of shear wave speed in diabetes vs prediabetes group was observed. This indicated that the proposed approach can improve the assessment of the severity of diabetic foot complications with potential implications in patient stratification

Diabetes Status is Associated With Plantar Soft Tissue Stiffness Measured Using Ultrasound Reverberant Shear Wave Elastography Approach

Introduction: The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. Method: 51 (M/F-21/30) participants with pre-diabetes onset (Fasting Blood Sugar Level-FBS>100 mg/dL), age>18 years, and no lower limb amputation were recruited after ethical approval was granted from Pontificia Universidad Catolica del Peru ethical review board. Ultrasound reverberant shear wave elastography was used to assess the soft tissue stiffness at the 1st MTH, 3rd MTH and the heel at both feet. Results: Spearman’s rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .05) higher shear wave speed in the plantar soft tissue with the following effect sizes (r) at the 1st MTH of the left foot at all tested frequencies: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. Conclusion: An association between fasting blood sugar level and the stiffness of the plantar soft tissue with higher values of shear wave speed in diabetes vs prediabetes group was observed. This indicated that the proposed approach can improve the assessment of the severity of diabetic foot complications with potential implications in patient stratification

Integrated Carbon Budget Models for the Everglades Terrestrial-Coastal-Oceanic Gradient: Current Status and Needs for Inter-Site Comparisons

Recent studies suggest that coastal ecosystems can bury significantly more C than tropical forests, indicating that continued coastal development and exposure to sea level rise and storms will have global biogeochemical consequences. The Florida Coastal Everglades Long Term Ecological Research (FCE LTER) site provides an excellent subtropical system for examining carbon (C) balance because of its exposure to historical changes in freshwater distribution and sea level rise and its history of significant long-term carbon-cycling studies. FCE LTER scientists used net ecosystem C balance and net ecosystem exchange data to estimate C budgets for riverine mangrove, freshwater marsh, and seagrass meadows, providing insights into the magnitude of C accumulation and lateral aquatic C transport. Rates of net C production in the riverine mangrove forest exceeded those reported for many tropical systems, including terrestrial forests, but there are considerable uncertainties around those estimates due to the high potential for gain and loss of C through aquatic fluxes. C production was approximately balanced between gain and loss in Everglades marshes; however, the contribution of periphyton increases uncertainty in these estimates. Moreover, while the approaches used for these initial estimates were informative, a resolved approach for addressing areas of uncertainty is critically needed for coastal wetland ecosystems. Once resolved, these C balance estimates, in conjunction with an understanding of drivers and key ecosystem feedbacks, can inform cross-system studies of ecosystem response to long-term changes in climate, hydrologic management, and other land use along coastlines