Sindrome de burnout en el personal asistencial de un Centro de Salud de Ayacucho 2023

Objetivo: Determinar si existe síndrome de burnout en el personal asistencial de un centro de salud de Ayacucho 2023. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal. El muestreo fue no probabilístico por conveniencia y el tamaño de la muestra fue de 77 personales asistenciales: Médico cirujano, enfermero, obstetra, cirujano dentista, psicólogo, biólogo, trabajador social, químico farmacéutico, médico veterinario y técnico de enfermería mediante la aplicación del cuestionario MBI-HSS. Resultados: la prevalencia de SB es de 6,5% de personales asistenciales y el 32,5% tiene indicios a desarrollarlo. La prevalencia de SB en las diferentes profesiones sanitarias mostro que 28,6% de médicos presenta indicios de SB; 50% de licenciadas en enfermería presento indicios de SB; 5,3% de obstetras mostro SB y el 26,3% indicios de ello; 25% de cirujano dentista mostro SB y 25% indicios de ello; 33,3% de psicólogos mostro SB y el otro 33,3% indicios de ello; 42,9% de biólogos mostro indicios de SB; 13,3% de técnicos de enfermería mostro SB y el 26,7% restante indicios de ello. El nivel de síndrome de burnout en la dimensión de cansancio emocional es de 63,6% bajo, 20,8% medio y 15,6% alto. El nivel de síndrome de burnout en la dimensión de despersonalización es de 74% bajo, 11,7% medio y 14,3% alto. El nivel de síndrome de burnout en la dimensión de realización personal es de 26% bajo, 26% medio y 48,1% alto. Conclusión: Si existe síndrome de burnout en el personal asistencial de un centro de salud de Ayacucho 2023

Percepción del impacto del contrato de aprendizaje como estrategia de apoyo a procesos administrativos educativos

Through the case study methodology (qualitative and quantitative), the perception of 23 apprentices from the I-2022 cohort of the CTMAE was investigated under the figure of an apprenticeship contract supporting administrative processes of the Training Center (CF). The perception of the impact in most of the support activities carried out by the apprentices is high and correlated with: (a) constant learning, (b) the deepening of technical skills and (c) the strengthening of the exit profile of the Technologist in Administrative Management program. The opportune management of apprenticeship contracts with large companies to be subsequently transferred to the CFs allows the apprentices to continue with their qualification through the development of labor functions in the productive stage as well as being key players in the processes of continuous improvement within the CFs. A través de la metodología de estudio de caso (cualitativo y cuantitativo) se indagó la percepción de 23 aprendices de la cohorte I-2022 del CTMAE bajo la figura de contrato de aprendizaje apoyando procesos administrativos del Centro de Formación (CF). La percepción del impacto en la mayor parte de las actividades de apoyo realizadas por los aprendices es alta y correlacionable con: (a) el constante aprendizaje, (b) la profundización en las competencias técnicas y (c) el fortalecimiento del perfil de salida del programa Tecnólogo en Gestión Administrativa. La oportuna gestión de contratos de aprendizaje con grandes empresas para ulteriormente ser cedidos a los CF permite a los aprendices el proseguir con su cualificación a través del desarrollo de funciones laborales en etapa productiva, así como ser actores claves de los procesos de mejora continua al interior de los CF. &nbsp

Exploración del mercado de flores tropicales en el segmento de consumidor intermedio en ciudades seleccionadas de colombia

En el presente documento se explora el grado de acogida y aceptación del subsector de flores tropicales por parte de algunos mercados seleccionados a fin de encontrar segmentos que den viabilidad económica a una propuesta de producción de especies ornamentales de clima cálido. Metodológicamente, en la consulta de fuentes primarias, se utilizó la encuesta directa a floristas ubicados en las ciudades de Bogotá, Medellín y Bucaramanga; para las fuentes secundarias se revisaron bases de datos de exportaciones desde Colombia y documentación de productores reportados por la Secretaría de Agricultura de Antioquia

Agronomic, physiological and quality response of romaine and red oak-leaf lettuce to nitrogen input

Protecting the environment by improving the crop-system nitrogen (N) use efficiency (NUE) while maximising yield and quality is a primary challenge for modern agriculture, and understanding the processes that govern N fluxes in the plant-soil system is essential to improve NUE. An on-farm study was conducted over two fall-winter seasons to evaluate the NUE, agronomical and physiological response of romaine (var. longifolia, cv Manavert) and red oak-leaf (var. crispa, cv Aruba) lettuce (Lactuca sativa L.) to different N-rates (0, 60, 120, 180 kg ha–1 of N). Nitrogen rate influenced all tested parameters, including plant fresh and dry weight, N accumulation, leaf NO3– and dry matter content, NUE indices, N nutrition index (NNI), soil residual N and the estimated N losses at the end of the crop season. Fresh yield, dry weight and N-accumulation response to N rate were influenced by lettuce genotype. Manavert had higher N recovery, NUE, and lower leaf NO3– concentration than Aruba. Analysing the NNI overtime, 120 kg ha–1 of N assured an optimal N status in both Manavert and Aruba, while N deficiency and excess were observed at lower and higher N-rates, respectively. An empirical relationship was observed between NNI and leaf NO3– concentration, suggesting that leaf NO3– concentration may be used to predict NNI and thus the crop N status. The relationship between NNI and leaf NO3– concentration may be used to define optimal leaf NO3– concentration ranges for the rapid and site-specific assessment of the crop N status, and the dynamic adjustment of N-fertilisation, contributing to improve crop NUE, minimise N-losses, and optimise yield and quality of lettuce crops

Extracellular Administration of BCL2 Protein Reduces Apoptosis and Improves Survival in a Murine Model of Sepsis

Severe sepsis and septic shock are major causes of morbidity and mortality worldwide. In experimental sepsis there is prominent apoptosis of various cell types, and genetic manipulation of death and survival pathways has been shown to modulate organ injury and survival.We investigated the effect of extracellular administration of two anti-apoptotic members of the BCL2 (B-cell lymphoma 2) family of intracellular regulators of cell death in a murine model of sepsis induced by cecal ligation and puncture (CLP). We show that intraperitoneal injection of picomole range doses of recombinant human (rh) BCL2 or rhBCL2A1 protein markedly improved survival as assessed by surrogate markers of death. Treatment with rhBCL2 or rhBCL2A1 protein significantly reduced the number of apoptotic cells in the intestine and heart following CLP, and this was accompanied by increased expression of endogenous mouse BCL2 protein. Further, mice treated with rhBCL2A1 protein showed an increase in the total number of neutrophils in the peritoneum following CLP with reduced neutrophil apoptosis. Finally, although neither BCL2 nor BCL2A1 are a direct TLR2 ligand, TLR2-null mice were not protected by rhBCL2A1 protein, indicating that TLR2 signaling was required for the protective activity of extracellularly adminsitered BCL2A1 protein in vivo.Treatment with rhBCL2A1 or rhBCL2 protein protects mice from sepsis by reducing apoptosis in multiple target tissues, demonstrating an unexpected, potent activity of extracellularly administered BCL2 BH4-domain proteins

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

BACKGROUND: Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological trans ..

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9·3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (17·2 billion, 95% uncertainty interval [UI] 15·4–19·2 billion) and diarrhoeal diseases (2·39 billion, 2·30–2·50 billion). Eight causes of chronic disease and injury each affected more than 10% of the world's population in 2015: permanent caries, tension-type headache, iron-deficiency anaemia, age-related and other hearing loss, migraine, genital herpes, refraction and accommodation disorders, and ascariasis. The impairment that affected the greatest number of people in 2015 was anaemia, with 2·36 billion (2·35–2·37 billion) individuals affected. The second and third leading impairments by number of individuals affected were hearing loss and vision loss, respectively. Between 2005 and 2015, there was little change in the leading causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our analysis. For low SDI geographies, Group 1 causes typically accounted for 20–30% of total disability, largely attributable to nutritional deficiencies, malaria, neglected tropical diseases, HIV/AIDS, and tuberculosis. Lower back and neck pain was the leading global cause of disability in 2015 in most countries. The leading cause was sense organ disorders in 22 countries in Asia and Africa and one in central Latin America; diabetes in four countries in Oceania; HIV/AIDS in three southern sub-Saharan African countries; collective violence and legal intervention in two north African and Middle Eastern countries; iron-deficiency anaemia in Somalia and Venezuela; depression in Uganda; onchoceriasis in Liberia; and other neglected tropical diseases in the Democratic Republic of the Congo. Interpretation Ageing of the world's population is increasing the number of people living with sequelae of diseases and injuries. Shifts in the epidemiological profile driven by socioeconomic change also contribute to the continued increase in years lived with disability (YLDs) as well as the rate of increase in YLDs. Despite limitations imposed by gaps in data availability and the variable quality of the data available, the standardised and comprehensive approach of the GBD study provides opportunities to examine broad trends, compare those trends between countries or subnational geographies, benchmark against locations at similar stages of development, and gauge the strength or weakness of the estimates available. Funding Bill & Melinda Gates Foundation

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016