La mujer peruana: evolución y perspectivas para su desarrollo futuro (1990-2020) región de Huancavelica

La presente investigación es un estudio cualitativo descriptivo que explora la situación de la mujer de la región Huancavelica en los últimos 20 años, así como las expectativas y obstáculos que presentan para los próximos diez años. Las mujeres que han participado en la investigación son mayores de 18 años, de diversa situación laboral y nivel educativo. El estudio se realizó a través de la estrategia cualitativa de casos múltiples bajo un diseño holístico, de manera que se pudo explorar aspectos complejos y personales. Se investigó siguiendo la lógica de réplica. La muestra de 30 mujeres fue construida utilizando la técnica de bola de nieve y máxima variación considerando aspectos como edad, estado civil, nivel educativo, actividad laboral y actividad económica. Con el análisis obtenido, se encontró que la población femenina de la región Huancavelica en cuanto a demografía, educación y salud reproductiva muestra avances de desarrollo; sin embargo, sigue existiendo una brecha importante para el desarrollo de los otros indicadores (e. g., la participación política de la mujer en la región). Respecto a las expectativas de desarrollo de las mujeres de la región, se focalizan en la mejora del desarrollo educativo, mejora en la atención de salud y mejora en su remuneración. A pesar de los trabajos realizados por diferentes organizaciones, en su mayoría no gubernamentales, para mejorar las condiciones de la mujer, sobre todo en relación con la violencia familiar, aún existen muchas diferencias asociadas al género. Los obstáculos de desarrollo encontrados principalmente fueron dos: no se encuentran conformes con la educación recibida y presentan diversas dificultades para el desarrollo laboral y económico. Se observa una falta de políticas claras hacia el desarrollo femenino por parte de los gobiernos locales y nacionales.This research is a descriptive qualitative study explores the status of women Huancavelica region in the last 20 years as well as the expectations and obstacles presented for the next ten years. Women who participated in the research are over 18 years of diverse employment status and educational level. The study was conducted through qualitative multiple case strategy under a holistic design, so you could explore complex personal issues. Was investigated following the logic of replication, the sample was 30 women. With the analysis obtained, it was found that the female population of the Huancavelica region in terms of demographics, education, reproductive health and development shows progress, but there remains a significant gap in the development of the other indicators (e. g., participation women's policy in the region). With regard to the expected development of women in the region are focused on: improvement of educational development, improved health care, and improved remuneration. Despite the work of various organizations, mostly NGOs, to improve the conditions of women, especially as far as violence is concerned, there are still many gender-related differences. Development obstacles were mainly found are not satisfied with the education received and present various obstacles to employment and economic development. There is a lack of clear policies towards female development by local and national governments.Tesi

Aportaciones a los estudios económico-administrativos. Reflexiones teóricas y evidencias empíricas

La economía y la administración están inmersas en el universo de las ciencias sociales, áreas del conocimiento que comprenden dominios diferentes, pero también convergen y se intersectan en un objeto de estudio: las organizacienones y sus agregados (industrias o sectores). Desde una perspectiva social, los estudios económico-administrativos informan sobre cómo hacer eficientes a las organizaciones y competitivos a los sectores con la finalidad de impactar positivamente en la justicia social (por ejemplo: mediante productos de mejor calidad a mejores precios). El auge de este tipo de estudios está extendido a fenómenos clave en el mundo de hoy, tales como: la ventaja competitiva, la innovación, la administración de la cadena de suministros y la administración verde, entre otros.El objetivo de este libro es difundir las aportaciones hechas a los estudios económico-administrativos, ya sea como reflexiones teóricas o a modo de evidencia empírica, pues la conjunción de varias ciencias ayuda a comprender fenómenos complejos mejor que una disciplina en forma aislada. Más que la homogeneidad de teorías o hegemonía de unas sobre otras, la investigación interdisciplinaria construye un acercamiento a la diversidad de puntos de vista: se buscan factores, métodos o lenguajes comunes alrededor de un objeto de estudio (Fernández, 2009; Martínez, 1997), llegándose a conformar una comunidad científica con antecedentes disciplinarios diferentes, pero con cierta unidad, relaciones y acciones recíprocas (Kuhn, 1995). Así, en este texto el objeto de estudio es el funcionamiento e interacción de las organizaciones, como integrantes de los sectores económicos, en los mercados locales y globales. La comunidad científica está conformada por investigadores y egresados del Doctorado en Ciencias Económico-Administrativas, el cual nace en 2006 en la Universidad Autónoma del Estado de México, a cargo de la Dependencia de Educación Superior (DES) Económico-Administrativa

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Altres ajuts: Departament de Salut. Generalitat de Catalunya ("Pla estratègic de recerca i innovació en salut (PERIS) 2019-2021"); Ministerio de Asuntos Económicos y Transformación Digital; Red Española de Investigación en Patología Infecciosa (REIPI).Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000patientdays. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000patientdays and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate:0.20episodes/1,000patientdays). Patients' median age was 64.1years; 36.6% (3,403/9,290) were female. In total, 73.7% (n=6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n=5,822) were related to central venous catheter (CVC), 24.1% (n=2,236) to peripheral venous catheters (PVC) and 13.3% (n=1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR:0.94;95%CI:0.93-0.96), especially in the ICU (IRR:0.88;95%CI:0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR:0.88;95%CI:0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC:1.08;95%CI:1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards

Análise comparativa das abordagens cirúrgicas no tratamento de cardiopatias

Em análise a evolução histórica e as inovações na cirurgia cardíaca, este estudo objetiva analisar comparativamente as abordagens cirúrgicas no tratamento de cardiopatias, destacando a transição das técnicas tradicionais de cirurgia aberta para métodos minimamente invasivos como a videolaparoscopia e a cirurgia robótica. Para tanto, procede-se à uma revisão narrativa da literatura, explorando uma gama extensiva de estudos e relatos científicos que ilustram os avanços tecnológicos e seus impactos nos resultados clínicos. Desse modo, observa-se que as técnicas minimamente invasivas oferecem benefícios substanciais, como redução no tempo de recuperação, diminuição do trauma cirúrgico, e menores taxas de complicações e mortalidade perioperatória em comparação com a cirurgia aberta. Estes resultados permitem concluir que a cirurgia minimamente invasiva representa um avanço significativo na prática cardiológica, proporcionando procedimentos mais seguros e eficazes, com menor impacto para os pacientes e melhores prognósticos a longo prazo. Para futuras pesquisas, sugere-se o aprofundamento na análise dos resultados a longo prazo e na integração de novas tecnologias, como inteligência artificial e realidade aumentada, para otimizar ainda mais as práticas cirúrgicas e expandir as possibilidades de tratamento das cardiopatias

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Exploring new physics frontiers through numerical relativity

The demand to obtain answers to highly complex problems within strong-field gravity has been met with significant progress in the numerical solution of Einstein's equations - along with some spectacular results - in various setups. We review techniques for solving Einstein's equations in generic spacetimes, focusing on fully nonlinear evolutions but also on how to benchmark those results with perturbative approaches. The results address problems in high-energy physics, holography, mathematical physics, fundamental physics, astrophysics and cosmology

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks