26 research outputs found
Relación de la estrategia social media marketing y el posicionamiento del instituto médico Soy Diabético EIRL Piura – 2021
La investigación se desarrolló con la finalidad de brindar datos consistentes sobre
la relación del social media marketing y el posicionamiento de marca del instituto
médico especializado Soy Diabético. El objetivo de esta investigación fue
determinar la relación entre social media marketing y el posicionamiento del
Instituto Médico Soy Diabético EIRL Piura 2021. Asimismo, la metodología fue no
experimental, transversal con un enfoque cuantitativo y de nivel correlacional, en la
que se empleó la técnica de encuesta y como instrumento de recolección de datos
el cuestionario estructurado con escala de Likert, basado en las dimensiones de
social media marketing y posicionamiento de marca; la muestra fue de 248 usuarios
de la ciudad de Piura. Los resultados indicaron una correlación alta con un Rho
Spearman de 0,604, con lo que se concluyó que existe una relación significativa
buena positiva entre social media marketing y el posicionamiento del instituto
médico Soy Diabético Piura 2021
Efficacy of nutritional talks in the prevention of anemia in children (6 to 36 months of age) from a health center in Chiclayo, Peru
Introduction:ThereisahighprevalenceofanemiainPeruvianchildren.Objective:Toevaluatethe effectiveness of nutritional talks in the reduction and prevention of anemia in boys and girls from 6 to 36 months of age. Methods: Longitudinal analytical study of retrospective cohorts. The sample included 78 children attended at a primary health care center. The information was extracted from a database generated by the center. The hemoglobin (Hb) level was recorded close to the date of the intervention and in subsequent controls ≥1 month. Results: 41 children (52.6%) participated in the nutritional talk, not observing signicant differences with the group that did not participate. A higher frequency of anemia was observed in the group that did not participate in the nutritional talk (23%) compared to the group that did participate (0%), a signicant difference was evidenced in the time between Hb evaluations (p<0.001). and the indication of micronutrients (p<0.001) for both groups. Despite this, there was no signicant difference between the initial and nal Hb values. Conclusion: Children whose parents participated in nutritional talks had less anemia. This suggests that nutritional talks could help prevent anemia
Spatial and Temporal Characteristics of the 2009 A/H1N1 Influenza Pandemic in Peru
Background: Highly refined surveillance data on the 2009 A/H1N1 influenza pandemic are crucial to quantify the spatial and temporal characteristics of the pandemic. There is little information about the spatial-temporal dynamics of pandemic influenza in South America. Here we provide a quantitative description of the age-specific morbidity pandemic patterns across administrative areas of Peru.
Methods: We used daily cases of influenza-like-illness, tests for A/H1N1 influenza virus infections, and laboratory-confirmed A/H1N1 influenza cases reported to the epidemiological surveillance system of Peru’s Ministry of Health from May 1 to December 31, 2009. We analyzed the geographic spread of the pandemic waves and their association with the winter school vacation period, demographic factors, and absolute humidity. We also estimated the reproduction number and quantified the association between the winter school vacation period and the age distribution of cases.
Results: The national pandemic curve revealed a bimodal winter pandemic wave, with the first peak limited to school age children in the Lima metropolitan area, and the second peak more geographically widespread. The reproduction number was estimated at 1.6–2.2 for the Lima metropolitan area and 1.3–1.5 in the rest of Peru. We found a significant association between the timing of the school vacation period and changes in the age distribution of cases, while earlier pandemic onset was correlated with large population size. By contrast there was no association between pandemic dynamics and absolute humidity.
Conclusions: Our results indicate substantial spatial variation in pandemic patterns across Peru, with two pandemic waves of varying timing and impact by age and region. Moreover, the Peru data suggest a hierarchical transmission pattern of pandemic influenza A/H1N1 driven by large population centers. The higher reproduction number of the first pandemic wave could be explained by high contact rates among school-age children, the age group most affected during this early wave
Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations
Dengue virus (DENV) causes disease in millions of people annually and disproportionately affects those in the developing world. DENVs may be divided into four serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) and a geographical region may be affected by one or more DENV serotypes simultaneously. Infection with DENV may cause life-threatening disease such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), but more often causes less severe manifestations affecting a wide range of organs. Although many previous reports have explored the role of the different DENV serotypes in the development of severe manifestations, little attention has focused on the relative role of each DENV serotype in the development of cutaneous, respiratory, gastrointestinal, musculoskeletal, and neurological manifestations. We recruited a large group of participants from four countries in South America to compare the prevalence of more than 30 manifestations among the four different DENV serotypes. We found that certain DENV serotypes were often associated with a higher prevalence of a certain manifestation (e.g., DENV-3 and diarrhea) or manifestation group (e.g., DENV-4 and cutaneous manifestations)
Estudo dos mediadores inflamatórios e de coagulação na epidemia 2013 pelo DENV-4
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Previous issue date: 2014Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, BrasilA dengue se tornou a arbovirose mais difundida no mundo, atingindo mais de 100 países. O sorotipo DENV-4 foi reintroduzido no Brasil em 2010, se espalhou para as diferentes regiões brasileiras sendo responsável por uma das maiores epidemias de dengue relatadas no país em 2013. O objetivo deste estudo foi avaliar o perfil clínico-laboratorial, citocinas/quimiocinas inflamatórias e mediadores da coagulação em pacientes infectados pelo DENV durante esta epidemia. Para isto, foram avaliados 265 casos confirmados de dengue atendidos nos centros de saúde dos estados do RJ e MS no ano de 2013. Os pacientes foram classificados de acordo com a nova classificação da OMS, 2009 nos grupos: 158 (70,2%) dengue sem sinais de alarme (DSSA), 65 (28,9%) dengue com sinais de alarme (DCSA) e 2 (0,9%) dengue grave. Os sinais de alarme mais frequentes foram dor abdominal persistente (61,5%) e sangramento de mucosas (32,3%). O DENV-4 foi o sorotipo de maior incidência e 85,2% dos pacientes apresentaram infecção secundária. Pacientes DCSA/DG apresentaram baixa contagem de leucócitos totais, de plaquetas e altos níveis séricos de AST/TGO e ALT/TGP quando comparados aos pacientes DSSA e aqueles ODF (outras doenças febris). A quantificação dos mediadores inflamatórios por ensaios imunoenzimáticos indicou: (i) níveis aumentados de citocinas (TNF-\03B1, IL- 6 e IL-10) e quimiocinas (IL-8/CXCL8, IP-10/CXCL10 e MCP-1/CCL2) nos pacientes DSSA e DCSA/DG quando comparados com o grupo controle; (ii) níveis aumentados de IL-10 e IL-6 nos pacientes DCSA/DG enquanto que IL-8/CXCL8 foi maior nos pacientes DSSA
Em relação aos parâmetros de coagulação: (iii) Os pacientes DSSA e DCSA/DG apresentaram menores níveis do fator tecidual (TF) e maiores níveis do inibidor fisiológico da via do TF (TFPI) quando comparados com o grupo controle; (iv) Baixos níveis de fibrinogênio foram encontrados nos pacientes DCSA/DG e níveis elevados de trombomodulina foram encontrados nos pacientes entre 4-7 dias de doença. As análises de correlação demonstraram correlação inversa entre os níveis circulantes de IP-10/CXCL10 e IL-10 com a contagem de plaquetas e leucócitos totais e correlação positiva com níveis séricos de AST/TGO. Além disso, IL-10 foi associada diretamente com relação albumina/globulina. As análises de correlação demonstraram que os níveis de TF estavam diretamente correlacionados com os níveis do TFPI, que por sua vez foi associado inversamente com a contagem de plaquetas. Estes resultados sugerem mecanismos de regulação da cascata da coagulação durante a infecção pelo DENV. Apesar dos altos níveis circulantes de IL-10 encontrados nos pacientes DCSA/DG, a análise da curva sob a área ROC não encontrou bom valor preditivo na discriminação entre DSSA e DCSA/DG e, portanto a IL-10 não se mostrou adequada para o uso como um biomarcador nesta populaçãoDengue has become the most widespread arbovirus in the world, reaching more th
an
100 countries. The DENV
-
4 serotype was reintroduced in Brazil in 2010,
and
spread
to the different Brazilian regions being responsible for one of the largest epidemics of
dengue reported in the country in 2013
.
The objective of this study was to evaluat
e
the clinical and laboratory profile, and inflammatory cytokines
/chemokines
and
coagulation mediators in patients infected with DENV during this epidemic. For this,
were evaluated 265 confirmed cases of dengue attended at health centers in the
states of
R
J
and MS in the year 2013.
P
atients were classified according to the new
WHO classification, 2009 in groups: 158 (70.2%) de
ngue without warning signs
(DwoWS
), 65 (28.9%) dengu
e with warning signs (DwWS
) and 2 (0.9%) severe
dengue
(SD)
.
The most
frequent
w
a
rning signals were persistent abdominal pain
(61.5%) and mucosa
l
bleeding (32.3%). The DENV
-
4
was the most prevalent
serotype and 85,2%
of
dengue patients showed secondary infection
.
DwWS/SD
patients
showed low
er
white blood cell
and
platele
t
count
s
,
and h
igher AST
and ALT
serum levels compared to
DwoWS
and
other febrile illnesses
patients.
Quantification
of inflammatory mediators by immunoassays
indicated
: (i)
i
ncreased levels of
cytokines (
TNF
-
α
,
IL
-
6 and
IL
-
10
) and chemokines (
IL
-
8/CXCL8, IP
-
10/CXCL10 an
d
MCP
-
1/CCL2
)
in
DwoWS and DwWS patients
compared
with healthy
individuals
; (
ii)
increased levels of
IL
-
10 and IL
-
6
in
DwWS/SD
patients
while
IL
-
8/CXCL8
was
increased
in DSSA
patients;
In respect to
coagulation parameters:
(iii
) DwoWS
and
DwWS/SD
patients
showed
lower levels of sTF and higher of TFPI compared with
the control group; (
i
v) Low
er
levels of fibrinogen
were found
in
DwWS/SD
patients
and high
er
levels of thrombomodulin in patie
nts between 4
-
7 days of illness;
Correlation analysis
showed
an invers
e correlation between circulating levels of
IP
-
10/CXCL10
and IL
-
10 with the total amount of platelets and leukocytes and positive
correlat
ion
with
serum
levels of
AST
.
Furthermore,
IL
-
10
was
directly
a
ssociated with
albumin/
globulin ratio. Corre
lation anal
ysis showed that
TF levels
were directly
correlated with
TFPI
l
evels,
which in turn
was inversely related
with
platelets
counts
.
These results suggest mechanisms
involving
regulation of the coagulation cascade
during DENV infection. Despite high
er
circulat
ing levels of
IL
-
10 found in
DwWS/SD
patients, analysis of
the area under the
ROC
curve,
did not
showed
a good
predictive
value in discriminating
those who were likely to develop
DwWS/SD
and therefore IL
-
10 was not suitable for use as a biomarker in this p
opulation
Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus
The incidence of dengue in Latin America has increased dramatically during the last decade. Understanding the pathogenic mechanisms in dengue is crucial for the identification of biomarkers for the triage of patients. We aimed to characterize the profile of cytokines (IFN-γ, TNF-α, IL-1β, IL-6, IL-18 and IL-10), chemokines (CXCL8/IL-8, CCL2/MCP-1 and CXCL10/IP-10) and coagulation mediators (Fibrinogen, D-dimer, Tissue factor-TF, Tissue factor pathway inhibitor-TFPI and Thrombomodulin) during the dengue-4 epidemic in Brazil. Laboratory-confirmed dengue cases had higher levels of TNF-α (p < 0.001), IL-6 (p = 0.005), IL-10 (p < 0.001), IL-18 (p = 0.001), CXCL8/IL-8 (p < 0.001), CCL2/MCP-1 (p < 0.001), CXCL10/IP-10 (p = 0.001), fibrinogen (p = 0.037), D-dimer (p = 0.01) and TFPI (p = 0.042) and lower levels of TF (p = 0.042) compared to healthy controls. A principal component analysis (PCA) distinguished between two profiles of mediators of inflammation and coagulation: protective (TNF-α, IL-1β and CXCL8/IL-8) and pathological (IL-6, TF and TFPI). Lastly, multivariate logistic regression analysis identified high aspartate aminotransferase-to-platelet ratio index (APRI) as independent risk factors associated with severity (adjusted OR: 1.33; 95% CI 1.03–1.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681–0.869) and an optimal cutoff value was 1.4 (sensitivity: 76%; specificity: 79%), so it could be a useful marker for the triage of patients attending primary care centers
Adecuada aplicación de estrategias metodológicas en la comprensión lectora: plan de acción.
En la I.E N° 14071, luego de realizar el diagnóstico se detectaron diversos problemas, pero hemos priorizado el que está relacionado con la capacidad de comprensión lectora en los estudiantes, que en nuestra sociedad se tiene un bajo nivel. Esto sucede debido a que los docentes no desarrollan estrategias metodológicas que promuevan la comprensión de diversos textos que se les presenta y por lo consiguiente difícilmente se podrá lograr aprendizajes significativos en cualquier área. La alternativa de solución que planteamos al problema contribuye a que los docentes apliquen estrategias metodológicas apropiadas para lograr una mejor comprensión lectora en los niños y niñas del IV ciclo de educación primaria de la I.E. Se requiere hacer referencia a las dimensiones del liderazgo eficaz de Viviane Robinson, quien a través de una ardua investigación determinó cinco dimensiones que establecen un liderazgo con resultados en los estudiantes. El problema priorizado, está enmarcado en estas cinco dimensiones, poniendo mayor énfasis en la Dimensión: 4. Promoción y participación en aprendizaje y desarrollo docente, ya que "La calidad de los profesores tiene impacto directo en la oportunidades que tendrán los niños a futuro", enfatiza Viviane Robinson. Para estimular esta calidad se requiere un liderazgo que no sólo promueva, sino que participe directamente con los docentes en el desarrollo profesional formal e informal (educarchile, 2016). Al encontrarse en nuestro contexto educativo diversas dificultades en la comprensión lectora de los estudiantes es preocupación y atención por parte de los docentes para superar este problema aplicando en su práctica pedagógica estrategias metodológicas y lograr que los estudiantes sean competentes, reflexivos, críticos que sepan analizar cualquier tipo de texto. Como directivo es importante realizar el acompañamiento y monitoreo que permita mejorar la práctica pedagógica de los docentes sustentado en el Marco del Buen Desempeño Directivo y Docente método procedimiento realizado.Trabajo académic