Evaluación de la conservación vial del pavimento de la av. Grau entre av. Chulucanas y av. Bellavista, Piura, utilizando el método PCI

El presente trabajo de investigación tuvo como objetivo determinar el estado de conservación del pavimento flexive de la Av. Grau entre la Av. Chulucanas y la Av. Bellavista de la ciudad de Piura. Para ello se calculó el Índice de Condición del Pavimento (PCI), cuyo procedimiento se encuentra descrito en el estándar ASTM D6433 – 18. Dicha metodología tiene una escala de calificación entre 0 y 100, donde el mínimo valor representa un pavimento fallado y el máximo un pavimento en buen estado. La inspección visual sobre el pavimento de la Av. Grau se realizó teniendo como base los 20 daños considerados por el método en su versión 2018, además del nivel de severidad y la proporción en la que se encuentra cada uno de ellos con respecto al área de su unidad. Con esta información y las curvas de valores deducibles que proporciona el estándar, se pudo determinar que el índice Condición del Pavimento en el tramo 01 es de 82 y para el tramo 02 fue de 72. En promedio se obtuvo un valor PCI de 77, que es indicativo de un pavimento en estado satisfactorio. Finalmente, con la ayuda de la información recogida en campo, se proponen algunas medidas correctivas para evitar que los deteriores sigan aumentando en su severidad y terminen afectando gravemente la condición del pavimento. Estas medidas van desde un sellado de grietas y cambio de parches, hasta realizar sobrecarpetas y reconstrucciones. Las opciones de reparación se basaron en las sugerencias que ofrece el manual del Ing. Luis Ricardo Vásquez Varela y teniendo en cuenta que resulte económicamente posible su ejecución.The purpose of this research work was to determine the state of preservation of the flexural pavement of Grau Avenue between Chulucanas Avenue and Bellavista Avenue in the city of Piura. For this purpose, the Pavement Condition Index (PCI) was calculated, whose procedure is described in the ASTM D6433 - 18 standard. This methodology has a rating scale between 0 and 100, where the minimum value represents a failed pavement and the maximum value represents a pavement in good condition. The visual inspection on the pavement of Grau Avenue was performed based on the 20 damages considered by the method in its 2018 version, in addition to the severity level and the proportion in which each of them is found with respect to the area of its unit. With this information and the deductible value curves provided by the standard, it was possible to determine that the Pavement Condition Index in section 01 is 82 and for section 02 it was 72. On average, a PCI value of 77 was obtained, which is indicative of a pavement in satisfactory condition. Finally, with the help of the information collected in the field, some corrective measures are proposed to prevent the deterioration from continuing to increase in severity and end up seriously affecting the condition of the pavement. These measures range from crack sealing and patch replacement to overlaying and reconstruction. The repair options were based on the suggestions offered in Luis Ricardo Vásquez Varela's manual and taking into account that it is economically feasible to carry them out.Tesi

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially