Assessment of general bullying and bullying due to appearance of teeth in a sample of 11-16 year-old Peruvian schoolchildren.

Objective: To assess the incidence of general bullying and bullying due to the appearance of teeth in a sample of 11-16 year-old Peruvian schoolchildren. Materials and methods: Cross-sectional study with a sample of 218 students aged 11 to 16 years old (13.41±1.44), 109 males, and 153 from a public school. A survey on general bullying and the appearance of teeth was applied using a validated questionnaire. Results: The frequency of general bullying was 32.57%, and bullying due to dental appearance was 18.81%. General bullying (p=0.005) and dental appearance (p=0.024) were more frequent in the public school, but there were no statistically significant differences according to sex. The highest frequency of general bullying was related to name-calling, which accounted for 47.71%. Victimization by appearance of teeth in one or two occasions in the last two months accounted for 12.39%, according to participating subjects

Comparación de bullying general y por la apariencia de dientes entre una institución educativa publica y privada en escolares de 11 a 16 años de edad

El presente estudio tuvo como propósito comparar bullying general y por la apariencia de dientes entre una institución educativa pública y privada en escolares de 11 a 16 años de edad. Se diseñó un estudio prospectivo, transversal, comparativo y observacional; con una muestra conformada por 218 estudiantes de 11 a 16 años de edad (promedio: 13.41, DE: +/- 1.44), 109 mujeres y 109 varones, 153 fueron de una institución educativa pública y 65 de una institución educativa privada, a quienes se les encuestó para determinar el bullying general y por la apariencia de dientes empleando un cuestionario validado. Para comparar la frecuencia de bullying entre ambas instituciones educativas se empleó la prueba Z. Los resultados mostraron que el bullying general y por la apariencia de dientes fue más frecuente en la institución educativa pública que en la privada (p<0.05). Según sexo, no se encontraron diferencias estadísticamente significativas de bullying entre mujeres y hombres en la institución pública; en la institución privada, tanto el bullying general como por la apariencia de dientes fue más frecuente en hombres que en mujeres (p<0.05). Se concluye que el bullying general y por la apariencia de dientes fue más frecuente en la institución educativa pública que en la privada en escolares de 11 a 16 años de edad.The purpose of this study was to compare general bullying and teeth-appearance bullying between a public and private educational institution in between 11 to 16-year-old schoolchildren. A prospective, transversal, comparative and observational study was designed; with a sample of 218 students aged 11 to 16 years (average: 13.41, DE: +/- 1.44), 109 females and 109 males, 153 were from a public educational institution and 65 from a private educational institution. To determine general bullying and teeth-appearance bullying it was used a validated questionnaire. To compare the frequency of bullying between both educational institutions the Z test was used. The results showed that general bullying and teeth-appearance bullying were more frequent at the public educational institution than at the private school (p<0.05). According to sex, there were no statistically significant differences in bullying between women and men at the public institution; at the private institution, both general bullying and teeth-appearance bullying were more frequent in men than in women (p<0.05). It is concluded that general and by teeth-appearance bullying were more frequent in at public educational institution than at private school in 11 to 16 years-old students

Increasing Latino Participation in Cancer Research: Feasibility of the Promotora Model

The recruitment of ethnic minorities, particularly Latinos, into clinical trials and cancer research is a formidable challenge. However, Latinos generally do not reach their proportional representation in current clinical trials, with Latinos making up only 1-5% of clinical trial participants, and fewer than 3% of cancer clinical trial participants. To date, programs promoting clinical trial participation that are culturally and linguistically tailored to the Latino community are scarce. The promotora model has been successful in implementing cancer prevention and early detection program in Latino populations. However, the promotora model has never been evaluated as a recruitment method to increase Latino participation in therapeutic cancer clinical trials.This study seeks to examine the feasibility of implementing the promotora model as a recruitment method to increase Latino participation in clinical trials at a comprehensive cancer center, and to understand the facilitators and barriers to clinical trial participation. A sequential explanatory mixed-methods design combined quantitative and qualitative approaches to evaluate factors that would facilitate recruitment of Latinos into research using promotora model. Promotoras recruited Latino patients into 2 therapeutic cancer clinical trials. The number of participants who were approached and recruited to the studies was tracked. The qualitative component assessed the feasibility and acceptability of the promotora model via semi-structured key informant interviews (KII). KII were conducted with a total of 15 key informants across the 4 different groups: 1) patients who agreed to participate (n=4); 2) promotoras (n=3); 3) clinicians/principal investigators (n=3) and 4) study staff (n=5). Key informants were asked to discuss their experiences with the promotora recruitment method, evaluate the acceptability and feasibility, as well as barriers and facilitators of the implementation of these methods. This study has shown that the promotora model is a feasible and acceptable recruitment method, and revealed the model’s preliminary efficacy to increase Latino participation in therapeutic cancer clinical trials. Hence, this study can inform future efforts to increase Latino participation in clinical trials in a culturally responsive and effective manner. Taken together, this study, the recommended strategies, and plan for change have the potential to facilitate greater Latino participation in therapeutic cancer clinical trials.Doctor of Public Healt

Paradiplomacia en tiempos de desastre en el Caribe: Un análisis de las islas no-soberanas

In the Caribbean region multiple political configurations of non-sovereign territories coexist which link to the metropolises of France, the United States, the Netherlands, and the United Kingdom. In 2017, several of these territories were devastated by the Hurricanes María and Irma. These events put their relations with the metropolises to the test and showed that paradiplomacy has a fundamental role in responding to natural disasters. Using the critical incident method this research analyzes primary documents published months after the hurricanes to analyze the variations in the use of paradiplomacy. It shows that while the American territories did not use paradiplomatic networks, the British territories, such as the Virgin Islands, achieved greater international participation. This allowed them to secure funds and technical assistance from various regional and international organizations. These differences between paradiplomatic experiences require further theorizing, in which the impact of structures versus the agency of the leaders of each territory is analyzed as a possible explanation. This work then discovers the need for a historical-institutional analysis of the evolution of Caribbean paradiplomacy in particular and paradiplomacy in general.En el Caribe coexisten múltiples configuraciones políticas de territorios no-soberanos ligados a las metrópolis de Francia, Estados Unidos, Países Bajos y el Reino Unido. En el 2017, varios de estos territorios fueron devastados por los huracanes María e Irma. Estos eventos pusieron a prueba sus relaciones con las metrópolis y mostraron que la paradiplomacia tiene un rol fundamental en responder a desastres naturales. Mediante el empleo de la técnica del incidente crítico, esta investigación analiza documentos primarios publicados meses posteriores a los huracanes para analizar la variación en el empleo de la paradiplomacia. Muestra que mientras los territorios americanos no utilizaron redes paradiplomáticas, los territorios británicos, como las Islas Vírgenes, agenciaron una mayor participación internacional. Esto les permitióasegurar fondos y ayuda técnica de distintas organizaciones regionales e internacionales. Estas diferencias entre las experiencias paradiplomáticas, requieren una mayor teorización, en la cual se analice el impacto de las estructuras versus la agencia de los líderes de cada territorio como posible explicación. Este trabajo descubre entonces la necesidad de un análisis histórico-institucional de la evolución de la paradiplomacia caribeña y la paradiplomacia en general

A Long History of Wall Street Bailouts and How Puerto Rico Will Not Be Different

Even though in 2012, publications such as Morningstar were advising investors to “Watch Out for Puerto Rico,” and pundits were commenting about a very likely default, by 2013 and 2014, Wall Street was frenetically buying up Puerto Rican bonds. Wall Street incurred in a risky behavior that is comparable with what happened during the 1980s Latin America crisis, the 1997 Asian crisis, the 1998 Long-Term Capital Management (LTCM) crisis, and the 2008 mortgage subprime crisis. By giving a brief overview of a series of economic crises around the world caused by speculation and risky lending, this article shows that the case of Puerto Rico, a nonincorporated territory of the United States of America, mirrors the same patterns of financialization of the economy and risky lending. It suggests that Wall Street bought these speculative-level bonds since this type of behavior has always been compensated by a bailout either through the US Treasury or an International Financial Institution (IFI), thus posing a moral hazard problem. The main argument of this article is that Wall Street and other bondholders will try to get their risky loans paid by the Government of Puerto Rico by forcing austerity measures, and when this inevitably fails, they will turn to the Treasury of United States to recover their money. It concludes with the question on how long the Island will have to suffer through the wave of higher taxes and cuts on social services before Washington bails them out

Técnica Shadowing para enseñar comprensión oral a estudiantes de EFL de nivel A1

Shadowing is a listening technique that develops the bottom-up process (the understanding of the smallest units of the audio input such as individual sounds) of the listening skill by training the learners’ ears to recognize phonemes, words, and thus phrases. It is said this is a useful technique for the development of English as a Foreign Language (EFL) learners’ listening skills. Therefore, this study aims to analyze the effect of the shadowing technique on the listening skill of A1-level EFL learners from Luisa de Jesús Cordero High School. An explanatory sequential mixed method design will be carried out by using the listening part of the A2 Key for Schools from Cambridge Language Assessment exam and a close-ended survey to assess the impact of shadowing on the students’ listening performance and their perception of shadowing. For this purpose, experimental and control groups were carried out. The study outcomes provide information about how shadowing, as a technique to teach listening, has influenced English learners’ listening skill and their perspectives in an Ecuadorian high school setting.Shadowing es una técnica de escucha que desarrolla la comprensión de las unidades más pequeñas de significado de un audio, como los sonidos individuales (bottom-up skills) al entrenar el oído de los estudiantes para reconocer fonemas, palabras y, por lo tanto, frases. Se considera que esta técnica es útil para el desarrollo de las habilidades auditivas de los estudiantes de inglés como lengua extranjera. Por lo tanto, este estudio tiene como objetivo analizar el efecto de la técnica de shadowing en la habilidad auditiva de los estudiantes de inglés como lengua extranjera de nivel A1 de la Unidad Educativa Luisa de Jesús Cordero. Se llevará a cabo un diseño de método mixto secuencial explicativo utilizando la parte de comprensión auditiva del examen A2 Key for Schools de Cambridge Language Assessment, una encuesta y un grupo focal para evaluar el impacto de la técnica de shadowing en el rendimiento auditivo de los estudiantes y la percepción de este. Para ello, un grupo experimental y otro de control fueron llevados a cabo. Los resultados del estudio pretenden proporcionar información sobre cómo shadowing como una técnica para enseñar a escuchar ha influenciado en la competencia auditiva de los aprendices del idioma inglés, así como sus perspectivas en el contexto de un colegio ecuatoriano

The regulatory and Health Technology processes in Europe and drug market access. The case of cystic fibrosis

In order to reach the European market, a new drug needs to receive a positive evaluation regarding its quality, safety and efficacy by regulatory health authorities and also obtain a positive HTA appraisal regarding its cost-effectiveness by HTA bodies. Regulators and HTA bodies are collaborating in several projects at European level in order to harmonize the scientific requirements of both evaluations to the maximum extent possible. The comparison of the regulatory evaluation performed by EMA for Kalydeco and the HTA appraisals issued by several EU bodies exemplifies the dilemma between scientific evidence and local economic considerations and the difficulties in the achievement of harmonization and therefore equity in the access to drugs

La norma ISO 21001:2018 en el sistema de gestión de calidad de las instituciones educativas particulares

En Ecuador, la calidad es un componente agregador de valor en la educación, el mismo que se encuentra legalmente constituido en el corpus de la normativa educativa vigente; para ello, el estado ha promulgado un conjunto de políticas que orientan, instruyen y controlan el logro de las metas de calidad en los distintos servicios educativos. El objetivo del presente trabajo investigativo es identificar el alcance y los beneficios que aporta la norma ISO 21001:2018 en el Sistema de Gestión de Calidad de las instituciones educativas particulares en Ecuador. La ruta metodológica se diseña desde el plano cualitativo, no experimental, que se complementa con el análisis de las proposiciones de autores y documentos especializados reconocidos por la comunidad científica. En el orden teórico, este trabajo de investigación aporta significativamente puesto que constituye un referente para el desarrollo de otras investigaciones y como fuente de consulta para futuros trabajos académicos relacionados con la gestión de la calidad y la estandarización en los sistemas educativos. Los resultados muestran que el sistema educativo ecuatoriano cuenta con estándares específicos de gestión educativa, de desempeño profesional, de aprendizaje y de infraestructura, similares a los existentes dentro de la norma ISO 21001:2018. No obstante, desde el dinamismo de mejora continua estos estándares no están totalmente articulados como un sistema de gestión; dejando abierta la posibilidad de adoptar e implementar la norma técnica ISO 21001:2018 como el modelo de gestión de la calidad para las instituciones educativas de derecho privado

Profile of infective endocarditis in the Foscal complex between june 2013 to june 2017. Clinical, microbiological and echocardiographic features

Introducción: La endocarditis infecciosa es la infección de la superficie endocárdica del corazón donde puede comprometer el endocardio valvular, pueden afectar las cuerdas tendinosas, los músculos papilares o el endocardio mural. Se ha observado modificaciones en sus factores de riesgo, así como modificación en su curso clínico y desenlaces. Actualmente en Colombia hay disponibles estudios no recientes de esta entidad que no logran describir las principales características de estos pacientes y su comportamiento clínico. En Santander no existe ningún estudio epidemiológico hasta el momento. Diseño: Estudio descriptivo y analítico de tipo cohorte retrospectiva de datos secundarios anonimizados. Métodos: Se incluyeron pacientes mayores de edad de ambos sexos, con diagnóstico de endocarditis infecciosa probable o definitiva según los criterios diagnósticos establecidos por Duke. Resultados: Se realizó una revisión del registro de la base de datos de 108 pacientes. La edad promedio fue de 68 años. De la población en estudio 32 (29,6%) eran mujeres y 76 (70,3%) eran hombres. El factor de riesgo más frecuente en la población fue el uso de dispositivo intravascular. Los síntomas predominantes fueron la fiebre y los escalofríos. Los microorganismos más frecuentes fueron los cocos gram positivos de genero Staphylococcus spp (45%) y Streptococcus spp. (19,5%), en tercer lugar se encontró el Enterococcus faecalis (6,51%). Dentro de los hallazgos ecocardiográficos la válvula nativa y protésica más afectada fue la aortica (37,9%), seguida de la mitral (31,4%), en tercer lugar se encontró el compromiso simultaneo de 2 válvulas (aortica y mitral) (14,8%). La válvula tricúspide fue la menos afectada. Los pacientes que presentaban complicaciones la más frecuente fue la neumonía (12,97%) seguida del ACV isquémico (10.20%). Se demostró asociación con mayor riego de muerte intrahospitalaria con la edad mayor de 65 años, índice de Charlson mayor a 3 puntos, enfermedad renal crónica, trombocitopenia, presencia de complicaciones como neumonía o ACV. La infección por Streptococcus gallolitycus (S. Bovis), y el hallazgo de fiebre fueron factores protectores. Conclusiones: La endocarditis infecciosa es una enfermedad cambiante que amenaza la vida, actualmente su incidencia viene en ascenso. Este estudio nos aporta información valiosa en conocer la epidemiología local de esta enfermedad, además nos reflejan factores relacionados con el pronóstico de estos pacientes.LISTA DE TABLAS .................................................................................................. 5 LISTA DE FIGURAS ............................................................................................... 6 LISTA DE ANEXOS ................................................................................................ 7 RESUMEN .............................................................................................................. 8 1. INTRODUCCIÓN ............................................................................................ 10 2. PLANTEAMIENTO DEL PROBLEMA ............................................................. 12 3. JUSTIFICACIÓN ............................................................................................. 13 4. OBJETIVOS .................................................................................................... 14 4.1 Objetivo general .......................................................................................... 14 4.2 Objetivos específicos .................................................................................. 14 5. MARCO TEÓRICO ......................................................................................... 16 5.1 Definición: .................................................................................................... 16 5.2 Epidemiología mundial. ................................................................................ 16 5.2 Epidemiologia en Colombia ......................................................................... 17 5.4 Factores de riesgo ....................................................................................... 18 5.5 Fisiopatología: .............................................................................................. 19 5.6 Clasificación: ................................................................................................ 21 5.7 Microbiología ............................................................................................... 21 5.8 Manifestaciones clínicas .............................................................................. 22 5.9 Complicaciones de la endocarditis infecciosa: ............................................. 24 5.10 Hallazgos paraclínicos ............................................................................... 24 5.11 Imágenes diagnósticas ............................................................................. 25 5.12 Criterios diagnósticos ................................................................................. 27 5.13 Tratamiento ................................................................................................ 29 5.14 Pronóstico .................................................................................................. 31 6. METODOLOGÍA ............................................................................................. 32 6.1 Diseño: ......................................................................................................... 32 6.2 Tiempo de Estudio ....................................................................................... 32 6.3 Población Blanco o diana ............................................................................. 32 6.4 Selección de los pacientes ........................................................................... 32 6.5 Variables del estudio: ................................................................................... 32 6.6 Recolección de la Información: .................................................................... 33 6.7 Procesamiento y control de calidad de los datos: ........................................ 33 6.8 Análisis de datos .......................................................................................... 33 7. CONSIDERACIONES ÉTICAS ....................................................................... 35 8. RESULTADOS ............................................................................................... 36 8.1 Análisis univariado ...................................................................................... 36 8.2 Análisis bivariado ........................................................................................ 48 9. DISCUSIÓN .................................................................................................... 53 10. CONCLUSIONES .......................................................................................... 57 11. LIMITACIONES ............................................................................................. 58 12. BIBLIOGRAFÍA ............................................................................................... 68EspecializaciónIntroduction: Infective endocarditis is the infection of the endocardial surface of the heart where it can compromise the valvular endocardium, can affect the chordae tendineae, the papillary muscles or the mural endocardium. Changes have been observed in its risk factors, as well as changes in its clinical course and outcomes. Currently in Colombia there are non-recent studies of this entity that fail to describe the main characteristics of these patients and their clinical behavior. In Santander there is no epidemiological study to date. Design: A descriptive and analytical retrospective cohort study of anonymized secondary data. Methods: Elderly patients of both sexes were included, with a diagnosis of probable or definitive infective endocarditis according to the diagnostic criteria established by Duke. Results: A database registry review of 108 patients was performed. The average age was 68 years. Of the study population, 32 (29.6%) were women and 76 (70.3%) were men. The most frequent risk factor in the population was the use of an intravascular device. The predominant symptoms were fever and chills. The most frequent microorganisms were gram positive cocci of the genus Staphylococcus spp (45%) and Streptococcus spp. (19.5%), in third place was Enterococcus faecalis (6.51%). Among the echocardiographic findings, the native and prosthetic valve most affected was the aortic (37.9%), followed by the mitral (31.4%), in third place the simultaneous involvement of 2 valves (aortic and mitral) was found ( 14.8%). The tricuspid valve it was the least affected. The most frequent patients with complications were pneumonia (12.97%) followed by ischemic stroke (10.20%). An association with a higher risk of in-hospital death was demonstrated with age over 65 years, Charlson index greater than 3 points, chronic kidney disease, thrombocytopenia, and the presence of complications such as pneumonia or stroke. Infection by Streptococcus gallolitycus (S. Bovis), and the finding of fever were protective factors. Conclusions: Infective endocarditis is a life-threatening, changing disease, its incidence is currently on the rise. This study provides us with valuable information in knowing the local epidemiology of this disease, as well as factors related to the prognosis of these patients