Implementación de NT Nº 144/MINSA/2018 para mejorar el manejo de los residuos sólidos del Centro de Atención Primaria II Baños del Inca-Essalud 2022

En esta investigación tuvo como fin implementar la NT Nº 144/MINSA/2018 para mejorar el manejo de los residuos sólidos del Centro de Atención Baños del Inca, con un enfoque cuantitativo con alcance explicativo de diseño no experimental corte transversal en el cual se evaluó el manejo de residuos sólidos empleando indicadores de cumplimientos de la normativa utilizando la observación directa, fichas de verificación, consiguiendo resultados como el peso promedio de residuos biocontaminados de 3,34 Kg/día, se encontró incumplimientos de la normativa en aspectos administrativos y en las etapas. Posteriormente se diseña 04 acciones de mejora que incrementaron los indicadores de la siguiente manera, en la planificación de actividades administrativas de 18% a 72%, en documentos elaborados de 22% a 80% de cumplimiento, y en la etapa de segregación y almacenamiento primario de 33% a 66 % de actividades cumplidas, y de 42.8% de servicios que segregan correctamente a 71%. En la etapa de recolección y transporte interno de 50% a 75% de actividades cumplidas y en el almacenamiento final de 22% a 78% de actividades cumplidas. Por lo tanto, se concluye que la implementación de la NT Nº 144/MINSA/2018 si mejora el manejo de los residuos sólidos del centro además este proyecto es viable dando resultados positivos al análisis de costo-efectividad.In this research aimed to implement the NT No. 144/MINSA/2018 to improve the management of solid waste of the Baños del Inca Care Center, with a quantitative approach with explanatory scope of nonexperimental cross-sectional design in which solid waste management was evaluated using indicators of compliance with the regulations using direct observation, verification sheets, achieving results such as the average weight of biocontaminated waste of 3.34 kg/day, non-compliance with the regulations was found in administrative aspects and in the stages. Subsequently, 04 improvement actions were designed that increased the indicators as follows: in the planning of administrative activities from 18% to 72%, in documents prepared from 22% to 80% compliance, and in the stage of segregation and primary storage from 33% to 66% of activities complied with, and from 42.8% of services that segregate correctly to 71%. In the collection and internal transport stage, from 50% to 75% of activities were completed, and in final storage, from 22% to 78% of activities were completed. Therefore, it is concluded that the implementation of NT No. 144/MINSA/2018 does improve the management of solid waste from the center in addition this project is feasible giving positive results to the cost-effectiveness analysis

Linfoma não-Hodgkin primário do fígado em paciente com SIDA

Non-Hodgkin's lymphomas (NHL) are the second most frequent malignancies in AIDS patients. The majority of NHL associated with AIDS involves extranodal sites, especially the digestive tract and the central nervous system. Primary liver lymphoma (PLL) is an uncommon neoplasm among these patients. Ultrasonography and computed tomography scans may be helpful in the diagnosis of focal hepatic lymphoma. Image-guided fine-needle biopsy with histopathology of the liver lesions is the gold standard for the diagnosis of hepatic lymphoma. We report a case of PLL as the initial manifestation of AIDS in a patient without any previous infection by hepatitis C or B virus, presented as multiple and large hepatic masses.Os linfomas não-Hodgkin (LNH) são as segundas neoplasias mais freqüentes nos pacientes com síndrome da imunodeficiência adquirida (SIDA). A maioria dos LNH associados à AIDS envolvem locais extra-ganglionares, especialmente o trato digestivo e o sistema nervoso central. O linfoma não-Hodgkin primário do fígado (LPF) é uma neoplasia incomum nestes pacientes. A ultrassonografia (US) e a tomografia computadorizada (TC) podem ser úteis no diagnóstico de linfoma não-Hodgkin hepático apresentando-se como lesões multifocais. A biópsia com agulha fina guiada por imagens (US, TC) juntamente com a histopatologia das lesões do fígado constitui o padrão-ouro para o diagnóstico de linfoma hepático. Este trabalho relata um caso de LPF como manifestação inicial de AIDS em um paciente sem infecção prévia pelo vírus da hepatite C e B, que se apresentou como massas hepáticas múltiplas e de grandes dimensões

SIMULACIÓN MEDIANTE DINÁMICA DE SISTEMAS PARA EVALUACIÓN DE INVERSIONES EN TECNOLOGÍAS DE INFORMACIÓN (TI)

RESUMENLa innegable importancia de las tecnologías de información (TI) en las organizaciones no siempre se ve acompañada de una apropiada gestión, pues habitualmente los proyectos tecnológicos no son adecuadamente planeados y proyectados, en parte por la dificultad para establecer mediciones que orienten la aprobación de la inversión. El presente trabajo propone y desarrolla una herramienta para apoyar la toma de decisiones en la inversión en proyectos tecnológicos, teniendo en cuenta el impacto financiero y organizacional que esto podría generar. Dicha herramienta es un modelo de simulación que sirve como instrumento a ingenieros y administradores en el planteamiento y evaluación de alternativas en determinadas tecnologías. El desarrollo de los modelos permitió determinar diversos factores que cobran importancia en la gestión de proyectos tecnológicos y las simulaciones permitir entregar a los decisores algunas ayudas para visualizar la dinámica de las complejas interrelaciones de dichos factores, despejando en algún grado la incertidumbre de sus decisiones.PALABRAS CLAVE: Dinámica de sistemas, Tecnologías de Información (TI), Gestión de proyectos tecnológicos, Simulación. ABSTRACTThe undeniable importance of the information technology (IT) in the organizations it is not always accompanied by an appropriate administration, because habitually the technological projects are not appropriately planned and projected, partly for the difficulty measurements that guide the approval of the investment. The present work proposes and develops a tool to support the taking of decisions in the investment in technological projects, keeping in mind the financial and organizational impact that this could generate. This tool is a simulation model that helps as an instrument to engineers and administrators in the planning and evaluation of alternative in technologies projects. The development of the models allowed to determine diverse and important factors in the managing Information technology projects and the simulations allowed to give to the manager some aids to visualize the dynamics of the complex interrelations of these factors, clearing in some degree the uncertainty of their decisions.KEYWORDS: Dynamics systems, Information Technology (IT), Technological projects, Simulation

Placement work experience may mitigate lower achievement levels of Black and Asian vs. White students at university

Ethnic minority groups have been shown to obtain poorer final year degree outcomes than their majority group counterparts in countries including the US, the UK and The Netherlands. Obtaining a lower degree classification may limit future employment prospects of graduates as well as opportunities for higher level study. To further investigate this achievement gap, we analysed performance levels across three academic years of study of 3,051 Black, Asian and White students from a UK University. Analyses of covariance investigated effects of ethnicity and work placement experience (internships) on first, second and final year marks, whilst statistically controlling for a number of factors thought to influence achievement, including prior academic performance. Results demonstrated superior achievement of White students consistently across all years of study. Placement experience reduced, but did not eliminate, the size of the achievement gap exhibited by final year students. Sex, parental education and socioeconomic status had no significant main effects. Female students showed a more complex pattern of results than males, with Black females not showing the same final year uplift in marks as their Asian and White counterparts. Implications and possible explanations are discussed

Relação de percepção de risco e consumo de álcool por adolescentes

El propósito del estudio fue conocer la relación entre percepción de riesgo y el consumo de alcohol en adolescentes de preparatoria. El estudio fue descriptivo, correlacional. El muestreo fue probabilístico, estratificado por semestre con asignación proporcional al tamaño de cada estrato, con una muestra de 345 adolescentes. Se utilizó una Cédula de identificación, el Cuestionario de Percepción de Riesgo hacia el Consumo de Alcohol y el instrumento AUDIT. De acuerdo a los resultados, se identificó una relación negativa significativa entre el índice de percepción de riesgo con el índice de AUDIT (rs= -.418, p=.001). Se concluye que a mayor percepción de riesgo, menor será el consumo de alcohol por parte de los adolescentes.O propósito do estudo foi conhecer a relação entre percepção de risco e o consumo de álcool por adolescentes do ensino médio. O estudo foi descritivo, correlacional. A amostragem foi probabilística, estratificada por semestre com distribuição proporcional ao tamanho de cada estrato, com uma amostra de 345 adolescentes. Utilizou-se uma ficha de identificação, um questionário de percepção de risco sobre o consumo de álcool e o instrumento AUDIT. De acordo com os resultados, identificou-se uma relação negativa significativa entre o índice de percepção de risco e o índice AUDIT (rs= -.418, p=.001). Conclui-se que quanto maior for a percepção de risco, menor será o consumo de álcool por parte dos adolescentes.The aim of the study was to discover the relationship between risk perception and alcohol consumption in adolescents in high school. This was a descriptive, correlational study. The sample was probabilistic, stratified by semester with allocation proportional to the size of each stratum, in a sample of 345 adolescents. We used identity cards, the Alcohol Risk Perception Questionnaire and the AUDIT instrument. The results showed a significant negative relationship between the risk perception rate and the AUDIT (rs= -.418, p=.001). We can conclude that the higher the perceived risk, the lower the alcohol consumption among adolescents

New insights into HIV-1-primary skin disorders

Since the first reports of AIDS, skin involvement has become a burdensome stigma for seropositive patients and a challenging task for dermatologist and infectious disease specialists due to the severe and recalcitrant nature of the conditions. Dermatologic manifestations in AIDS patients act as markers of disease progression, a fact that enhances the importance of understanding their pathogenesis

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Five-year response to growth hormone in children with Noonan syndrome and growth hormone deficiency

BACKGROUND: Noonan syndrome (NS) is an autosomal dominant disorder characterized by specific features including short stature, distinctive facial dysmorphic features, congenital heart defects, hypertrophic cardiomyopathy, skeletal anomalies and webbing of the neck. Molecular screening has shown that the majority of individuals with NS have a mutation in the PTPN11 gene. Noonan syndrome children may show an impaired growth hormone (GH)/insulin-like growth factor axis. Moreover, recombinant human GH (rhGH) has been shown to improve growth rate in patients with NS, although data are still limited. METHODS: In the present study, we assessed growth response following GH therapy (0.25 mg/Kg/week) in 5 (2 M and 3 F) GH-deficient NS patients (NSGHD, mean age 8.5 years) and in 5 (2 M and 3 F) idiopathic GH deficient (IGHD, mean age 8.6 years) patients. We also evaluated the safety of rhGH therapy in NS patients with GHD. RESULTS: At the beginning of GH treatment, height and growth rate were statistically lower in NSGHD children than in IGHD ones. During the first three years of rhGH therapy, NSGHD patients showed a slight improvement in height (from −2.71 SDS to −2.44 SDS) and growth rate (from −2.42 SDS to −0.23 SDS), although the values were always significantly lower than in IGHD children. After five years of rhGH treatment, height gain was higher in IGHD children (mean 28.3 cm) than in NSGHD patients (mean 23.6 cm). During the first five years of rhGH therapy, regular cardiological and haematological check-ups were performed, leading to the conclusion that rhGH therapy was safe. CONCLUSIONS: In conclusion, pre-pubertal NS children with GHD slightly increased their height and growth rate during the first years of GH therapy, although the response to rhGH treatment was significantly lower than IGHD children. Furthermore, the therapy appeared to be safe since no severe adverse effects were reported, at least during the first five years. However, a close follow-up of these patients is mandatory, especially to monitor cardiac function