Suplementación estratégica para vacas lecheras de pequeños productores en la provincia de Ubaté

El consumo de materia seca es una de las principales variables que determinan la producción de bovinos de leche. En Colombia, el sistema de alimentación se desarrolla en condiciones de pastoreo con suplementación con alimento balanceado. En la provincia de Ubaté, la oferta ambiental limitada y el inadecuado manejo de la cuerda eléctrica (restringiendo la oferta y generando variaciones diarias de la misma), no permite que los pequeños productores de leche ofrezcan a sus animales la cantidad de alimento que deberían consumir. El presente estudio tiene tres objetivos: categorizar a estos pequeños productores de leche de la provincia, basados en el sistema de alimentación; realizar un balance nutricional en algunas de las fincas de pequeños y medianos productores de leche y demostrar que, bajo condiciones de restricción de oferta forrajera (siendo en promedio de 15 kg de MS/vaca/día), la mayor determinante de la producción de leche es el consumo de materia seca y no la calidad nutricional de los suplementos que se ofrezcan a los animales. Para la categorización de los pequeños productores, fue aplicada una encuesta a 341 ganaderos, conteniendo preguntas de las características del sistema de alimentación utilizado en su finca. Con las respuestas fue realizado un análisis de conglomerados (k – modas), el cual dio como resultado 3 tipologías de productores diferentes: Un primer grupo que no recurre a la suplementación y dos grupos que sí recurren a ella de manera diferencial, los primeros de manera arbitraria y los segundos de manera estratégica. Sin embargo, la productividad de cada uno de los conglomerados no se vio afectada por el sistema de alimentación. Otros aspectos, probablemente la oferta y el consumo de materia seca serían más importantes. Fue realizado un balance nutricional, a lo largo del tiempo (3 muestreos), de los animales de pequeños productores de leche, tomando como base 40 fincas representativas de la provincia, distribuidas en los 10 municipios que la componen (120 datos en total). Este balance nutricional dio como resultado un consumo de materia total (promedio) de 10 kg, de los cuales casi el 80% era proveniente de la pastura, siendo ésta la principal fuente de variación sobre el consumo total en cada una de las fincas. Ante esta restricción de flujo de nutrientes, la energía se presenta como el primer limitante en la producción de leche. Por el contrario, la proteína metabolizable, en la mayor parte de los muestreos, fue excedentaria. En cuanto a los minerales, el calcio resultó ser deficiente en la dieta de los animales (si no es tenida en cuenta la sal mineralizada dentro de la misma), el fósforo por el contrario es excedentario y no debería ser suplementado dentro de la sal. Adicionalmente, fue llevado a cabo un experimento que involucraba 12 animales distribuidos en 6 fincas de pequeños productores de la provincia de Ubaté (2 animales por finca), a los cuales se les ofrecieron, en un diseño de sobre-cambio, 3 suplementos que diferían en calidad en una misma cantidad diaria (4 kg/vaca/día) Suplemento 1 – baja concentración de almidón y alta concentración de azúcares, formulado con subproductos industriales Suplemento 2 – Alta concentración de almidón y baja concentración de azúcares, formulado con inclusión de granos y subproductos industriales Suplemento 3 – Alta concentración de almidón, baja concentración de azúcares e inclusión de aceite vegetal (aceite de palma). La producción de leche, la concentración de proteína, la producción de proteína diaria y la condición corporal, no fueron modificados por el tipo de suplemento utilizado. Sin embargo, la producción de leche corregida por energía, la concentración de grasa, de sólidos totales y la producción de grasa, fue mayor en el suplemento 3, siendo la inclusión de aceite de palma y el perfil de ácidos grasos que éste le confiere a la dieta, el factor diferencial para la obtención de estos resultados. Se concluye que el consumo de materia seca es uno de los principales factores que influencian la producción de leche de animales en pastoreo que se encuentran bajo condiciones de restricción de consumo y que la inclusión de aceites vegetales (aceite de palma), tiene la capacidad de incrementar la concentración de la grasa de la leche, sin embargo, esta tecnología tendría restricciones de uso por su costo.Abstract Dry matter intake in one of the main variables that determine the milk production of dairy cattle. In Colombia, the feeding system is developed under grazing conditions with supplementation of concentrates. In Ubate´s province, the limited environmental offer and the inadequate management of electric fence, does not allow small milk producers to offer their animals the amount of food they should consume. The present study has three objectives, categorize these small milk producers of the province, based on their feeding system; make a nutritional balance in some farms of small and medium milk producers and show that, under low intake conditions, the major determinant of milk production is the dry matter intake and not the nutritional quality of the supplements offered to the animals. For the categorization of small producers, a survey was applied to 341 farmers, who had questions about their feeding systems. With the answers, a cluster analysis (K-modes) was carried out, which resulted in three different types of producers. A first group that does not use supplementation and two groups that use it in a differential manner, the first ones in an arbitrarily way and the others use it strategically. However, the productivity of each cluster were not affected by its feeding system, other aspects, probably the dry matter intake would be more important. A nutritional balance was made (with the CNCPS v6.5 software), over the time (3 sampling periods) of the animals of small producers based on 40 representative famers of the province, distributed in the 10 municipalities that compose it (120 data in total). This nutritional balance resulted in a total dry matter intake (average) of approximately 10 kg, of which almost 80% was from pasture, being this, the main source of variation over the total dry matter intake in each one of the farms. This intake restriction of nutrient flow, leads the energy to be the limiting nutrient in milk production. On the contrary, the metabolizable protein, in most of the samples, was surplus. For minerals, calcium was found to be deficient in the diet of the animals (if mineral salt is no taken into account), phosphorus on the contrary is surplus and should not be supplemented in the mineral salt. To prove that milk production is directly related to the dry matter intake and no to the nutritional quality of the supplements offered, an experiment was carried out involving 12 animals distributed in 6 farms of smalls producers in the Ubate´s province (2 animals per farm). These animals (homogenous in age, production, breed and management conditions) were offered, in a crossover design, three supplements that differ in quality: Supplement 1 – low concentration of starch and high concentration of sugars, formulated with industrial by-products. Supplement 2 – high concentration of starch and low concentration of sugars, formulated including grains and industrial by-products Supplement 3 – high concentration of starch, low concentration of sugars and inclusion of vegetable oil (palm oil). These supplements were offer at the same amount per animal per day (4 kg). The results showed that milk production, body condition score, protein concentration and daily protein production, are not modified by the type of supplement used. However, energy corrected milk, fat concentration, total solids and production of fat was higher in supplement 3, being the fatty acid profile of the diet, the differential factor for obtaining these results. It is concluded that the dry matter intake is one of the main factor that influence the production of milk grazing animals that are under restriction conditions and that the inclusion of vegetable oils (palm oil), has the capacity to increase the concentration of milk fat, however, this technology would have restrictions of use because its cost.Maestrí

Análisis de la incidencia que tiene el Síndrome de Burnout y las condiciones de trabajo en los Formadores y Equipos Psicosociales del Centro de Orientación Juvenil Luis Amigó – COJLA

Analizar la relación de la incidencia que tiene el Síndrome de Burnout y las condiciones de trabajo en los Formadores y Equipos Psicosociales del Centro de Orientación Juvenil Luis Amigó.En la actualidad nuestra sociedad y las demás sociedades del mundo, han avanzado a la vanguardia de las necesidades de su población en los distintos ámbitos de la sociedad, como lo son el educativo, el económico, el social, el tecnológico y el laboral. Dentro del contexto laboral, las organizaciones también han evolucionado y en los últimos años han estado creando diferentes mecanismos que permitan minimizar los riesgos físicos, los riesgos de la salud mental y la búsqueda de una mejor calidad de vida de los trabajadores, es por esto que a través de la siguiente investigación, se analizó la relación de la incidencia que tiene el Síndrome de Burnout con las condiciones del trabajo en los formadores y equipos psicosociales del Centro de Orientación Juvenil Luis Amigó –COJLA, institución que cuenta con una alta experiencia y reconocimiento como una de las mejores instituciones en reeducación para menores en condición de vulnerabilidad. La muestra con la que se trabajó estuvo conformada por 32 trabajadores, subdividida en 16 Formadores y 16 Profesionales psicosociales (Trabajadores sociales y Psicólogos) del COJLA, a través de la observación y del desarrollo de los cuestionarios Calidad de Vida (WHOQOL-BREF) e Inventario de Burnout de Maslach- MBI, con la que se pretende evaluar una posible correlación entre los dos grupos de la muestra y la posible afectación que pueda estar generando las condiciones laborales de estos trabajadores. Los resultados arrojaron que tres profesionales padecen Síndrome de Burnout y trece profesionales presentan tendencia a padecerlo, es decir, que la mitad de estos profesionales que a diario trabajan con esta población, presenta una alta tendencia a sufrir importantes alteraciones en la salud mental y física, al estar expuestos a los diferentes síntomas de este síndrome Esto le permitirá al Centro de Orientación Juvenil Luis Amigó–COJLA crear estrategias que le permitan mitigar las afectaciones del Síndrome de Burnout, mejorar la calidad de vida y evitar afectaciones en la salud física y mental de todos los miembros que conforman la institución.Nowadays our society and all societies in the world, have advanced at the vanguard of their population needs in different society scopes, like education, economic, social, technological and working. In the working context, the organizations have been improving and in the latest years have been creating different mechanisms that minimizes the physical risks, mental health and are looking forward to improve the worker’s life quality , for that reason the following investigation has the analysis between the relation and incidence that Burnout Syndrome has with the work conditions for the trainers and psychosocial team on the Orientation Youth Center Luis Amigó .COJLA, this institution has experience and it is highly recognize like one of the best re education institutions for minors in vulnerable conditions. The sample chosen was conformed by 32 workers, divided on 16 trainers and 16 psychosocial professionals (social workers and psychologists) from COILA, through observation and developing questionnaires Life Quality (WHOQOL-BREF) and Burnout Inventory from Maslach -MBI, that has the purpose of evaluating the possible relation between the two sample teams and the possible affectation that can be producing on the labor conditions for this workers. Results shows that three professionals suffer Burnout Syndrome and thirteen present the trend to suffer it, that means half of this professionals that work daily with this population presents a high trend of suffering important mental health and physical alterations while been exposed to the different symptoms from this Syndrome. This investigation will allowed to the Orientation Youth Center Luis Amigó COJLA create strategies that can mitigate the Burnout Syndrome affectation, improve life quality and avoid physical and mental affectations in all the member from the institution

Association between emergency department length of stay and adverse perioperative outcomes in emergency surgery: A cohort study in two Colombian University hospitals

Background: In low- and middle-income countries emergency surgery represents a higher proportion of the total number of surgeries and is associated with greater morbidity/mortality. Study aims were to determine if emergency department length of stay (ED-LOS) was associated with adverse perioperative outcomes and if such association varied across patient's risk categories. Methods: A retrospective cohort study was conducted of adult patients who underwent orthopedic or abdominal emergency surgery at two Colombian University hospitals. The population comprised a mix of a representative sample of eligible cases, with unselected patients (2/3), enriched with a high-risk subset (1/3). ED-LOS was defined as the interval between emergency department arrival and surgery start time. Our primary outcome was an adverse perioperative outcome during hospitalization, which was a composite of in-hospital mortality or severe complications such as major cardiovascular adverse events, infection, renal failure and bleeding. Results: Among 1487 patients analyzed, there were 519 adverse perioperative outcomes including 150 deaths. In the unselected sample (n = 998) 17.9% of patients presented an adverse perioperative outcome with a mortality of 4.9%. The median ED-LOS was 24.6 (IQR 12.5-53.2) hours. ED-LOS was associated with age, comorbidities and known risk factors for 30-day mortality. Patients developing an adverse perioperative outcome started surgery 27.1 h later than their counterparts. Prolonged ED-LOS increased the risk of an adverse perioperative outcome in patients without risk factors (covariate-adjusted OR = 2.52), while having 1-2 or 3+ risk factors was negatively associated (OR = 0.87 and 0.72, respectively, p less than 0.001 for the interaction). Conclusion: Prolonged ED-LOS is associated with increased adverse perioperative outcome for patients without risk factors for mortality, but seems protective and medically justified for more complex cases. © 2019 The Author(s)

Enfermedades crónicas

Adherencia al tratamiento farmacológico y relación con el control metabólico en pacientes con DM2Aluminio en pacientes con terapia de reemplazo renal crónico con hemodiálisis en Bogotá, ColombiaAmputación de extremidades inferiores: ¿están aumentando las tasas?Consumo de edulcorantes artificiales en jóvenes universitariosCómo crecen niños normales de 2 años que son sobrepeso a los 7 añosDiagnóstico con enfoque territorial de salud cardiovascular en la Región MetropolitanaEfecto a corto plazo de una intervención con ejercicio físico, en niños con sobrepesoEfectos de la cirugía bariátrica en pacientes con síndrome metabólico e IMC < 35 KG/M2Encuesta mundial de tabaquismo en estudiantes de profesiones de saludEnfermedades crónicas no transmisibles: Consecuencias sociales-sanitarias de comunidades rurales en ChileEpidemiología de las muertes hospitalarias por patologías relacionadas a muerte encefálica, Chile 2003-2007Estado nutricional y conductas alimentarias en adolescentes de 4º medio de la Región de CoquimboEstudio de calidad de vida en una muestra del plan piloto para hepatitis CEvaluación del proceso asistencial y de resultados de salud del GES de diabetes mellitus 2Factores de riesgo cardiovascular en población universitaria de la Facsal, universidad de TarapacáImplicancias psicosociales en la génesis, evolución y tratamiento de pacientes con hipertensión arterial esencialInfarto agudo al miocardio (IAM): Realidad en el Hospital de Puerto Natales, 2009-2010Introducción de nuevas TIC y mejoría de la asistencia a un programa de saludNiños obesos atendidos en el Cesfam de Puerto Natales y su entorno familiarPerfil de la mortalidad por cáncer de cuello uterino en Río de JaneiroPerfil del paciente primo-consultante del Programa de Salud Cardiovascular, Consultorio Cordillera Andina, Los AndesPrevalencia de automedicación en mujeres beneficiarias del Hospital Comunitario de Til-TiPrevalencia de caries en población preescolar y su relación con malnutrición por excesoPrevalencia de retinopatía diabética en comunas dependientes del Servicio de Salud Metropolitano Occidente (SSMOC)Problemas de adherencia farmacológica antihipertensiva en población mapuche: Un estudio cualitativoRol biológico de los antioxidantes innatos en pacientes portadores de VIH/SidaSobrepeso en empleados de un restaurante de una universidad pública del estado de São Paul

A flagship for Austral temperate forest conservation: an action plan for Darwin's frogs brings key stakeholders together

Darwin’s frogs Rhinoderma darwinii and Rhinoderma rufum are the only known species of amphibians in which males brood their offspring in their vocal sacs. We propose these frogs as flagship species for the conservation of the Austral temperate forests of Chile and Argentina. This recommendation forms part of the vision of the Binational Conservation Strategy for Darwin’s Frogs, which was launched in 2018. The strategy is a conservation initiative led by the IUCN SSC Amphibian Specialist Group, which in 2017 convened 30 governmental, non-profit and private organizations from Chile, Argentina and elsewhere. Darwin’s frogs are iconic examples of the global amphibian conservation crisis: R. rufum is categorized as Critically Endangered (Possibly Extinct) on the IUCN Red List, and R. darwinii as Endangered. Here we articulate the conservation planning process that led to the development of the conservation strategy for these species and present its main findings and recommendations. Using an evidence-based approach, the Binational Conservation Strategy for Darwin’s Frogs contains a comprehensive status review of Rhinoderma spp., including critical threat analyses, and proposes 39 prioritized conservation actions. Its goal is that by 2028, key information gaps on Rhinoderma spp. will be filled, the main threats to these species will be reduced, and financial, legal and societal support will have been achieved. The strategy is a multi-disciplinary, transnational endeavour aimed at ensuring the long-term viability of these unique frogs and their particular habitat

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

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

Myxomycete assemblage turnover across a moisture and elevation gradient in Costa Rica

The formation of sporocarps in myxomycetes depends on environmental characteristics, among which, moisture and temperature seem to be relevant in tropical areas. Since temperature is linked to elevation, the effect of both of these variables can be studied along a natural moisture and elevation gradient. In the present study, myxomycete assemblages associated with three forest types representing a natural gradient of both climatic characteristics were studied during the same season in consecutive years. Species richess was higher in the driest studied locations and a clear separation among myxomycete assemblages across the gradient was documented. Such separation, however, highly likely implied the effect of sampling in different years. About 35% of the species were shared among forest types and 41% between sampling years. Using the ACOR scale, abundant and common myxomycetes were represented by species present in the three forest types, with clear changes in abundance across the gradient. However, occasional and rare myxomycete categories showed the loss of several species and the emergence of some others from the dry to the wet ecosystems, demonstrating a turnover of species across the different forest types within the gradient. These changes in species composition may be related to the El Niño Southern Oscillation events. Even though such turnover is a natural phenomenon based on species preferences for certain habitats, it is an important aspect to document, particularly in the less studied tropical regions of the world. In the small area studied herein, data showed that myxomycete dynamics are heavily influenced by the local microclimate. The increased speed and strength of ecological pressures on global biosystems represent a threat to microbial dynamics and perhaps myxomycetes can help offer some clues to understand such unbalances.Universidad de Costa Rica/[731-B5-062]/UCR/Costa RicaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ingeniería::Instituto Investigaciones en Ingeniería (INII

Eco-friendly convenience store for organic and healthy products "Qhali Store"

El objetivo de este trabajo de investigación es demostrar la viabilidad, rentabilidad y durabilidad del proyecto desarrollando una tienda de conveniencia eco amigable de productos orgánicos y saludables – QHALI STORE. Tienda que satisface la preocupación por el cuidado de la salud, bienestar y estilo de vida que viene en tendencia creciente en el país. Se presenta la oportunidad de atender esta necesidad, mediante la intermediación de productos orgánicos de alta calidad, y productos que cuentan con poco alcance o cobertura de mercado en la ciudad de Lima. Estos productos, aportan grandes beneficios al cuerpo humano y al medio ambiente. La investigación del presente estudio, empleo una metodología cualitativa y cuantitativa a través de encuestas, que concluye en una necesidad de mercado desatendida y con mucho potencial de crecimiento. Qhali emplea canales digitales como las redes sociales o páginas web para llegar y conectar con su público objetivo el cual inicialmente está conformado por un sector de la zona 7 de Lima Metropolitana donde se encuentra la mayor población de consumidores con un estilo de vida saludable. Para lograr captar mayores ingresos e incrementar las transacciones, se contará con 2 canales de venta, como son, visita en tienda física (tienda de conveniencia), compras web o compras a través de redes sociales, en donde destacara la participación del delivery. Para finalizar se realizó un estudio de factibilidad del proyecto en donde se demuestra su viabilidad en las áreas comerciales y financiera. Con una inversión de 106,175.00 soles, financiados con un 50% con aporte de los accionistas y un 50% financiado con un préstamo bancario con un plazo de 5 años, y una tasa de interés de 25%.The objective of this research work is to demonstrate the viability, profitability and durability of the project by developing an eco-friendly convenience store for organic and healthy products - QHALI STORE. Store that satisfies the concern for health care, well-being and lifestyle that is growing in the country. The opportunity to meet this market need is presented, through developing a retail store (convenience store) of high-quality organic products, and products that have little scope or market coverage in the city of Lima. These products provide great benefits to the human body and the environment. The research of the present study used a qualitative and quantitative methodology through surveys, which concludes in an unattended market need with great potential for growth. Qhali Store will use digital marketing channels such as social networks or web pages to reach and connect with its target audience, which is initially made up of a sector of Zone 7 of Metropolitan Lima where the largest population of consumers with a healthy lifestyle is found. In order to capture more income and increase transactions, there will be 2 sales channels, such as visits to a physical store (convenience store), web purchases or purchases through social networks, where the participation of delivery stands out. Finally, a feasibility study of the project was carried out, demonstrating its viability in the commercial and financial areas. With an investment of 106,175.00 soles, financed with 50% with a contribution from the shareholders and 50% financed with a bank loan with a term of 5 years, and an interest rate of 25%.Trabajo de investigació

Experience of the intensive care nurses professional improvement to face COVID 19. Cienfuegos, 2020

Background: continuity and contextual specificity of overcoming become essential after COVID 19 appearance. Updating knowledge and developing skills is the fundamental premise to encourage dedication and responsibility towards the patient in the nursing professional.Objective: to describe the development of intensive care nurses professional improvement to face COVID 19.Methods: descriptive study carried out at the Cienfuegos Medical Sciences University between March-May 2020, with 238 nursing graduates (intensive care graduates). Variables analyzed: characterization of the nurses, link with the graduation of the Intensive Care Diploma, description of the current diploma, students assessment on satisfaction with this improvement modality, as well as contribution to the excellent performance of the professionals.Results: The 78.1% of the trainees are between 41-60 years of age, the 87% with more than 16 years of experience. The diploma course lasted five school weeks, using alternatives such as the use of simulators for the exercise of practical activities. At the end, the 95% served in hospitals of suspected COVID 19 patients and isolation centers in the province and the 53% are on an internationalist mission in the Henry Reeve Team.Conclusions: the overcoming carried out allowed to improve skills, using simulators as a means of teaching so that the trainees could apply specific biosafety actions and care in comprehensive care for the patient with SARS / CoV 2 subjected to artificial mechanical ventilation.</p