Factores asociados a la reducción de la hemoglobina en puérperas atendidas en el Instituto Nacional Materno Perinatal – 2012

Objective. To analyze the factors that are associated with reduced hemoglobin levels in postpartum women treated at the National Maternal and Perinatal Institute during 2012. Materials and methods. Case-control study where 274 patients divided in 137 postpartum women with hemoglobin difference 1.3 g / di (cases) and 137 with a difference of hemoglobin <1.3 g / di (controls). Descriptive and inferential statistics, measures of central tendency and dispersion for quantitative variables, frequency distribution for qualitative variables for statistical inferences applied Chi-square, OR 95% CI and binary logistic regression for multivariate analysis was applied.Objetivo. Analizar los factores que se asocian a la reducción de los niveles de hemoglobina en puérperas atendidas en el Instituto Nacional Materno Perinatal durante el año 2012. Materiales y Métodos. Estudio de casos y controles donde se asignó a 274 pacientes puérperas divididas en 137 con diferencia de hemoglobina M ,3 g/dl (casos) y 137 con diferencia de hemoglobina <1,3 g/dl (controles). Se aplicó estadísticas descriptivas e inferenciales, medidas de tendencia central y de dispersión en las variables cuantitativas, distribución de frecuencias para las variables cualitativas, para las inferencias estadísticas se aplicó Chi cuadrado, OR IC al 95% y regresión logística binaria para el análisis multivariado

Maternal-perinatal complications associated with adolescent pregnancy: A case-control study

Objetivo: Evaluar las complicaciones maternas perinatales asociadas al embarazo adolescente en un hospital peruano, 2018. Métodos: Estudio analítico de casos y controles donde participaron 160 puérperas, considerándose como caso a quien presente al menos una complicación perinatal. Se realizó una revisión de la historia clínica, considerándose solo los registros diagnósticos generados en la institución, asimismo,  toda persona que presente entre 10 a 19 años fue categorizada como adolescente. Se contó con la aprobación del comité de ética institucional. La asociación fue determinada mediante la prueba Chi cuadrado de Pearson y Regresión Logística, los riesgos fueron evaluados mediante Odds Ratio crudo y ajustado y su respectivo Intervalo de confianza al 95%. Resultados: Entre las adolescentes, gran parte se encuentra en su adolescencia tardía (90.54%), es soltera (74.32%) y ama de casa (93.24%). Las complicaciones maternas con mayor presencia en el grupo de gestantes adolescentes fueron la infección del tracto urinario (ORa:2.46 p=0.072) y la distocia funicular (ORa:3.21; p=0.017); asimismo, la complicación perinatal más recurrente en adolescentes fue el sufrimiento fetal agudo (ORa:2.11; p=0.091). Conclusiones: El embarazo adolescente se presenta como un factor de riesgo para la presencia de infección del tracto urinario, distocia funicular y sufrimiento fetal agudo.Objective: To evaluate the perinatal maternal complications associated with adolescent pregnancy in a Peruvian hospital, 2018. Methods: Analytical study of cases and controls where 160 puerperal women participated, considering as a case those who present at least one perinatal complication. A review of the medical history was performed, considering only the diagnostic records generated in the institution, likewise, every person who is between 10 and 19 years old was categorized as a teenager. It was approved by the institutional ethics committee. The association was determined by Pearson's Chi-square test and Logistic Regression, the risks were evaluated using crude and adjusted Odds Ratio and their respective 95% Confidence Interval. Results: Among adolescents, a large part is in its late adolescence (90.54%), is single (74.32%) and a housewife (93.24%). The maternal complications with greater presence in the group of teenage pregnant women were urinary tract infection (ORa:2.46 p=0.072) and funicular dystocia (ORa:3.21; p=0.017); also, the most recurrent perinatal complication in adolescents was acute fetal distress (ORa: 2.11; p=0.091). Conclusions: Teen pregnancy is presented as a risk factor for the presence of urinary tract infection, funicular dystocia and acute fetal distress

Costo de servicio y su relación con los estados financieros de la empresa Estudio Omega, Los Olivos 2021

El presente estudio titulado "Costo de servicio y su relación con los estados financieros de la empresa Estudio Omega, Los Olivos 2021", tiene como objetivo principal, analizar como la variable independiente incide en la variable dependiente en la empresa Estudio Omega, en el distrito de Los Olivos, año 2021. El tipo de investigación es básica, su diseño es no experimental. La población está conformada por 50 trabajadores de la empresa Estudio Omega. La muestra no se calculó ya que está constituida por todas las unidades de la población, no existiendo técnica de muestreo. La técnica manejada fue la encuesta y el instrumento el cuestionario, eficaz y debidamente aprobado por juicio de expertos, el proceso de información que se ejecutó es mediante el programa SPSS V.28; se usó el coeficiente de correlación de Rho Spearman, donde el nivel de significancia es p= 0.001 es menor que 0.05, con un nivel de confiabilidad del 76.50%, demostrando que existe correlación positiva considerable entre las dos variables. En conclusión, el costo de servicio tiene relación con los estados financieros de la Empresa Estudio Omega, Los Olivos 2021

Anemia during pregnancy in Peru: Prevalence, geographical distribution and associated factors

Objetivo: Determinar la prevalencia, distribución geográfica y factores asociados a la anemia durante el embarazo en el Perú. Material y métodos: Análisis de la Encuesta Demográfica y de Salud Familiar del 2018, donde participaron 19 777 mujeres entre 15 a 49 años que hayan presentado un embarazo previo. El análisis se realizó considerando el muestreo complejo de la encuesta. Las proporciones fueron ponderadas y los factores se analizaron mediante un modelo generalizado de Poisson crudo y ajustado, considerando como asociación al p<0,05. Resultados: La prevalencia de anemia fue del 23,85%, de los cuales el 11,49% no recibió tratamiento. Los factores sociodemográficos que predisponían la presencia de anemia fueron el vivir en la capital (p<0,001; RP:1,37) y tener grado de instrucción secundaria (p=0,038; RP:1,05), mientras que el tener mayor cantidad de años (p=0,004; RP:0,99) y el ser “Rico” (p=0,008; RP:0,82) y “Muy rico” (p<0,001; RP:0,68) fueron factores protectores. Las prevalencias de anemia fueron mayores en los establecimientos del MINSA (25,02%) mientras que en EsSalud hubo mayor ausencia de tratamiento (14,57%) Conclusiones: La prevalencia de anemia es relativamente mayor respecto a los países latinoamericanos, con una considerable proporción que no recibe tratamiento. El vivir en la capital, nivel educativo y atenderse en establecimientos del MINSA fueron características donde se presentó mayor prevalencia de anemia, mientras que este fue menor al tener mayor índice de riqueza, una mayor edad y atenderse en establecimientos privados.Objective: To determine the prevalence, geographic distribution and factors associated with anemia during pregnancy in Peru. Material and methods: Analysis of the Demographic and Family Health Survey of 2018, where 19 777 women between 15 and 49 years who had a previous pregnancy participated. The analysis was performed considering the complex sampling of the survey. The proportions were weighted, and the factors were analysed using a generalized and adjusted Poisson model, considering p<0,05 as an association. Results: The prevalence of anemia was 23,85%, of which 11,49% received no treatment. The sociodemographic factors that predisposed the presence of anemia were living in the capital (p<0,001; RP: 1,37) and having secondary education (p=0,038; RP: 1,05), while having more of years (p=0,004; RP: 0,99) and being “rich” (p=0,008; RP: 0,82) and “very rich” (p<0,001; RP: 0,68) were protective factors. The prevalence of anemia was higher in MINSA establishments (25,02%) while in EsSalud there was a greater absence of treatment (14,57%). Conclusions: The prevalence of anemia is relatively higher compared to Latin American countries, with a considerable proportion that does not receive treatment. Living in the capital, educational level and attending MINSA establishments were characteristics where there was a higher prevalence of anemia, while this was lower because it had a higher index of wealth, an older age and attending private establishments

Violencia física durante el embarazo en el Perú: Proporción, distribución geográfica y factores asociados, 2016-2018

Background: Physical violence during pregnancy is a poorly evaluated sensitive public health problem that, additionally, is related to various perinatal complications. The objective is to estimate the proportion, geographic distribution and sociodemographic factors associated with physical violence during pregnancy between 2016 and 2018. Material and methods: Secondary baseline analysis of the Demographic and Family Health Survey (ENDES), which included respondents who answered whether or not they had experienced physical violence during pregnancy in the last 12 months. Results: The proportion of physical violence was 9,9% [95%CI:9,6-10,4%] during 2016, 9,2% [95%CI:8,8-9,6%] during 2017 and 8,6% [95%CI:8,3-8,9%] during 2018, The regions with the highest proportion were Puno, Arequipa, and Apurímac during the 3 years. Among the associated factors, the residue in rural areas (PR:0,49; p=0,011) and be “very rich” (PR:0,63; p=0,029) was protective; while they were at risk of not presenting studies (PR:1,87; p=0,014), the cohabiting marital status (PR:1,51; p=0,001), separated (PR:3,56; p<0,001), showing an age between 40 a 49 years (PR:1,79; p=0,012) and that partner drinks alcohol (RP:1,61; p<0,001). Conclusions: The proportion of violence in Peru has been decreasing in recent years, presenting higher indicators in the south of the country. The factors that predispose this phenomenon are the wealth index, educational level, marital status, and the age of the pregnant woman.Introducción: La violencia física durante el embarazo es una problemática de salud pública sensible poco evaluada que, adicionalmente, se relaciona con diversas complicaciones perinatales. El objetivo es estimar la proporción, distribución geográfica y factores sociodemográficos asociados a la violencia física durante el embarazo entre el 2016 y 2018. Material y métodos: Análisis de base secundaria de la Encuesta Demográfica y de Salud Familiar (ENDES), donde se incluyeron a quienes respondieron si presentaron o no violencia física durante el embarazo en los último 12 meses. Resultados: La proporción de violencia física fue de 9,9% [IC95%:9,6-10,4%] durante el 2016, 9,2% [IC95%:8,8-9,6%] durante el 2017 y 8,6% [IC95%:8,3-8,9%] durante el 2018. Las regiones con mayor proporción fueron Puno, Apurímac y Cusco durante los 3 años. Entre los factores asociados, fueron protectores el residir en área rural (RP:0,49; p=0,011) y ser “muy rico” (RP:0,63; p=0,029); mientras que fueron de riesgo el no presentar estudios (RP:1,87; p=0,014), el estado civil conviviente (RP:1,51; p=0,001), separada (RP:3,56; p<0,001), mostrar una edad entre 40 a 49 años (RP:1,79; p=0,012) y que pareja consuma alcohol (RP:1,61; p<0,001). Conclusiones: La proporción de violencia en el Perú se ha ido reduciendo en los últimos años, presentando mayores indicadores en el sur del país. Los factores que predisponen este fenómeno son el índice de riqueza, grado de instrucción, estado civil y la edad de la gestante

Ecosystem services of tropical dry forests : insights from longterm ecological and social research on the Pacific coast of Mexico

In the search for an integrated understanding of the relationships among productive activities, human well-being, and ecosystem functioning, we evaluated the services delivered by a tropical dry forest (TDF) ecosystem in the Chamela Region, on the Pacific Coast of Mexico. We synthesized information gathered for the past two decades as part of a long-term ecosystem research study and included social data collected in the past four years using the Millennium Ecosystem Assessment (MA) conceptual framework as a guide. Here we identify the four nested spatial scales at which information has been obtained and emphasize one of them through a basin conceptual model. We then articulate the biophysical and socio-economic constraints and drivers determining the delivery of ecosystem services in the Region. We describe the nine most important services, the stakeholders who benefit from those services, and their degree of awareness of such services. We characterize spatial and temporal patterns of the services&rsquo; delivery as well as trade-offs among services and stakeholders. Finally, we contrast three alternative future scenarios on the delivery of ecosystem services and human well-being. Biophysical and socioeconomic features of the study site strongly influence human&minus;ecosystem interactions, the ecosystem services delivered, the possible future trajectories of the ecosystem, and the effect on human well-being. We discuss future research approaches that will set the basis for an integrated understanding of human&minus;ecosystem interactions and for constructing sustainable management strategies for the TDF.<br /

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI