Healthcare Service Utilization and Life Satisfaction in South Africa

South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall life satisfaction. Therefore, the objectives of this study were to investigate: (i) rural/urban disparities and sociodemographic predictors of utilization of public healthcare services in South Africa; and (ii) socioeconomic and demographic predictors of life satisfaction among residents of Gauteng province, South Africa. Retrospective cross-sectional studies were conducted using data from the 2019 South African General Household Survey and 2017-2018 Gauteng Quality-of-Life Survey. Descriptive analyses were performed to assess: (a) characteristics of households using public and private healthcare services, and (b) disparities in healthcare utilization and life satisfaction. Weighted multinomial logistic and partial proportional odds models were used to investigate predictors of public healthcare use and life satisfaction, respectively. Three-quarters of the households reported using public healthcare services and nearly one-fifth reported a chronic condition among members. Predictors of public healthcare utilization were lower age of household head, lower educational attainment of household head, larger household size, rural residence, and at least one chronic condition among household members. Similarly, predictors of higher reported life satisfaction were older age, greater educational attainment, smaller household size, living with spouse, good/excellent health, and satisfaction with public health services. Additionally, respondents from suburban and rural municipalities tended to have greater odds of higher life satisfaction than those from urban Johannesburg. The identified disparities and predictors highlight the critical roles of poverty, education, rural residence, and healthcare accessibility in public healthcare use and life satisfaction. The findings suggest that targeted public healthcare accessibility initiatives may improve both healthcare utilization and overall life satisfaction. Retrospective cross-sectional studies were conducted using data from the 2019 South African General Household Survey and 2017-2018 Gauteng Quality-of-Life Survey. Descriptive analyses were performed to assess: (a) characteristics of households using public and private healthcare services, and (b) disparities in healthcare utilization and life satisfaction. Weighted multinomial logistic and partial proportional odds models were used to investigate predictors of public healthcare use and life satisfaction, respectively. Three-quarters of the households reported using public healthcare services and nearly one-fifth reported a chronic condition among members. Predictors of public healthcare utilization were lower age of household head, lower educational attainment of household head, larger household size, rural residence, and at least one chronic condition among household members. Similarly, predictors of higher reported life satisfaction were older age, greater educational attainment, smaller household size, living with spouse, good/excellent health, and satisfaction with public health services. Additionally, respondents from suburban and rural municipalities tended to have greater odds of higher life satisfaction than those from Johannesburg. The identified disparities and predictors highlight the critical roles of poverty, education, rural residence, and healthcare accessibility in public healthcare use and life satisfaction. The findings suggest that targeted public healthcare accessibility initiatives may improve both healthcare utilization and overall life satisfaction

The Stieltjes--Fekete problem and degenerate orthogonal polynomials

A famous result of Stieltjes relates the zeroes of the classical orthogonal polynomials with the configurations of points on the line that minimize a suitable energy. The energy has logarithmic interactions and an external field whose exponential is related to the weight of the classical orthogonal polynomials. The optimal configuration satisfies an algebraic set of equations: we call this set of algebraic equations the Stieltjes--Fekete problem or equivalently the Stieltjes--Bethe equations. In this work we consider the Stieltjes-Fekete problem when the derivative of the external field is an arbitrary rational complex function. We show that its solutions are in one-to-one correspondence with the zeroes of certain non-hermitean orthogonal polynomials that satisfy an excess of orthogonality conditions and are thus termed "degenerate". This generalizes the original result of Stieltjes.Comment: 21 pages. V2: 24 pages; improved historical overview and added references. 5 figures. Slight generalization of the proof. V3: 26 pages; expanded scope of proof and added significant example. V4: 30 pages. Added details on primality assumption and other improvement

Factores asociados a la diabetes mellitus tipo 2 en pacientes adultos que se atienden en un centro de salud nivel I-3

Objetivo: Identificar los factores de riesgo asociados a la diabetes mellitus tipo 2 en adultos atendidos en el Centro de Salud Nueve de Abril de Tarapoto, San Martín, durante el periodo de octubre a noviembre de 2023. Métodos: Se realizó un estudio observacional-analítico de casos y controles poblacional que abarcó a la totalidad de pacientes adultos del centro de salud. Los criterios de inclusión establecieron casos (pacientes mayores de 18 años con diagnóstico médico de diabetes mellitus tipo 2) y controles (pacientes mayores de 18 años sin diagnóstico de diabetes tipo 2). La muestra fue censal para casos (43 pacientes) y el doble para controles (86 pacientes). Las entrevistas personales, con autorización ética, se llevaron a cabo mediante una hoja de recolección de datos. Resultados: Se evidenciaron diferencias significativas entre los grupos de casos y controles. Los pacientes con diabetes tipo 2 presentaban una edad media significativamente mayor y una proporción más alta de individuos casados. Además, mostraban un índice de masa corporal (IMC) más elevado, con una prevalencia mayor de obesidad. Los antecedentes familiares de diabetes tipo 2 eran más frecuentes en los casos. También se observó una mayor prevalencia de fumadores actuales en el grupo de pacientes con diabetes. Conclusiones: Los resultados indican que la edad, el estado civil, el IMC, la obesidad y los antecedentes familiares de diabetes tipo 2 están asociados de manera significativa con la presencia de diabetes mellitus tipo 2 en esta población. Estos hallazgos subrayan la importancia de abordar estos factores de riesgo en la prevención y el manejo de la enfermedad

Marin County Youth Focus Group Project: Youth Perception Regarding Access and Barriers to Equitable Education and Careers

This collaborative project between the Workforce Investment Board of Marin and Dominican University of California emerged through the DUC Service-Learning Director’s involvement in a subcommittee of the Workforce Investment Board of Marin. The subcommittee’s mission is to identify needs of jobseekers, employers, and the future workforce. Youth voice and perception are vital to understanding how to create, maintain, and evolve towards greater sustainability and a thriving workforce with equitable opportunities for everyone. We purposely targeted youth of diverse ethnicities who participate in county and non-profit programs aimed, in a variety of ways, at their empowerment. The purpose of the youth focus groups was to acquire qualitative data based on youth perceptions regarding their educational experience, the opportunities available to them in higher education, and their knowledge of what services are currently available to them in Marin County to support their educational success. This project received funding through a grant from the DUC Provost’s Office and the project proposal, RBPHS Application #5069, was submitted to and approved by the Dominican University Institutional Review Board for the Protection of Human Subjects. Funding allowed us to offer hospitality to focus groups, $10 gift certificates to participants, and to hire the Research and Evaluation Team from Youth Leadership Institute to train our team in focus group methodology–– including question formulation, group facilitation techniques, and documenting, organizing, and analyzing data. The investigators came from outside the field of K-12 education and the findings are based directly on the youth responses and our observations during the groups. Report contents are divided into sections that attempt to make clear how findings were derived and what they might mean for better understanding the educational challenges and needs of youth in Marin County and the ways in which existing programs might come together and new initiatives may be implemented in response. Sections for this report occur in the following manner: An overview summarizes key findings and conclusions in an effort to highlight next steps for addressing educational success for Marin County youth based on the perceptions of participants. Data collection procedures are presented to make clear how information was gathered to assess youth perceptions, which includes the questions posed to them by facilitators to do so. Procedures for analyzing data are presented to explain derivation of findings. Focus group participants are described to understand the sample of youth responses subjected to analyses and how findings might be generalized to other populations. Findings are presented and interpreted to make clear youth perceptions as reported by participants about a variety of topics related to educational equity in their community. Conclusions are drawn from a summary of findings that provide the framework for discussion in the overview. Appendices: Data tables: Appendix A, Profile for Youth Participants; Appendix B, Analyzed Response Breakdown by group for Questions 3,4,5, Appendi

Nivel de estrés y desempeño laboral del personal de enfermería del área Covid del Hospital Regional Nuevo Chimbote, 2022

La presente investigación tuvo como objetivo, determinar la relación del nivel estrés y desempeño laboral del personal de enfermería del área Covid del Hospital Regional Nuevo Chimbote, 2022, el estudio fue de enfoque cuantitativo, tipo aplicada, de diseño no experimental y de corte transversal, la población estuvo constituida por 40 enfermeros del área Covid del Hospital Regional Eleazar Guzmán Barrón, se utilizó como técnica la encuesta y como instrumento los cuestionarios de Maslach para medir el nivel de estrés y de Quispe para el desempeño laboral; se utilizara una estadística descriptiva y se analizaran mediante el programa SPSS 25. Y luego de observar los resultados donde se apreció que el nivel de estrés del personal de enfermería del área Covid del Hospital Regional Nuevo Chimbote, 2022 en el 65% de las enfermeras tiene un nivel regular y el 35% alto; el nivel de desempeño del personal de enfermería del área Covid del Hospital Regional Nuevo Chimbote, 2022, en el 77.5% de las enfermeras tiene un nivel de desempeño regular y el 22.5% alto y e concluye finalmente que existe una correlación positiva, moderada y altamente significativa para r = 0.614 así como un p-valor 0.000 inferior al 1%

Uso de la estrategia de promoción de contenido en las redes sociales, Facebook e Instagram y su relación con la captación de nuevos seguidores de la Empresa Dimensiona, Trujillo año 2021

El presente trabajo de investigación titulado “USO DE LA ESTRATEGIA DE PROMOCIÓN DE CONTENIDO EN LAS REDES SOCIALES, FACEBOOK E INSTAGRAM Y SU RELACIÓN EN LA CAPTACIÓN DE NUEVOS SEGUIDORES DE LA EMPRESA DIMENSIONA, TRUJILLO AÑO 2021” se llevó acabo con el objetivo de determinar la relación que tiene el uso de la estrategia de promoción de contenido con la captación de nuevos seguidores de los clientes de la empresa Dimensiona. La investigación es de tipo correlacional, ya que el propósito de la investigación es examinar la relación entre dos variables. En ese sentido, “la investigación proporciona indicios de la relación que podría existir entre dos o más cosas, o de qué tan bien uno o más datos podrían predecir un resultado específico” (Hernández, Fernández, 2016). Para recolectar la información se aplicará dos encuestas de tipo Likert una medirá el Nivel de Captación de nuevos seguidores y Nivel de Estrategia de promoción de contenido, el cual da un total de 23 preguntas. Así mismo la población son todos los seguidores de la empresa Grupo Dimensiona SAC de la ciudad de Trujillo, en el año 2021, el cual es 2707 seguidores y la muestra está formado por un subconjunto de seguidores de la empresa Grupo Dimensiona SAC de la ciudad de Trujillo, en el año 2021. Para la selección de la muestra se consideró el Muestreo Aleatorio Simple, con un tamaño de muestra de 337 personas. Para la constatación de hipótesis se aplicó la prueba T de student y T de student coeficiente de spearman a un nivel de significancia del 5% , precisión de error del 5%, nivel de confianza de 95% y un spearman 1.968, el cual se acepta que existe relación significativa entre el Nivel de Estrategia de promoción de contenido en las redes sociales y el Nivel de Captación de nuevos seguidores de la empresa Grupo Dimensiona SAC de la ciudad de Trujillo, en el año 2021. Los seguidores de la empresa Grupo Dimensiona SAC de la ciudad de Trujillo, en el año 2021 según Nivel de Captación de nuevos seguidores, el 78.34% su nivel es Alta. Los seguidores consideran muy importante el cambio de contenido y publicaciones en la página de Dimensiona desde hace 6 meses, teniendo como resultado el 51.34% precisa que es muy importante y el 33.73% precisa que es importante.The present research work entitled "THE USE OF THE CONTENT PROMOTION STRATEGY IN SOCIAL NETWORKS, FACEBOOK AND INSTAGRAM AND ITS RELATIONSHIP WITH THE RECRUITMENT OF NEW FOLLOWERS OF THE COMPANY GRUPO DIMENSIONA SAC, OF THE CITY OF TRUJILLO, IN THE YEAR 2021" was carried out with the objective of determining the relationship that the use of the content promotion strategy has with the recruitment of new followers of the clients of the company Dimensiona. The research is correlational, since the purpose of the research is to examine the relationship between two variables. In that sense, "the research provides indications of the relationship that could exist between two or more things, or how well one or more data could predict a specific result" (Hernández, Fernández, 2016). To collect the information, two Likert-type surveys will be applied, one will measure the level of attraction of new followers and the level of content promotion strategy, which gives a total of 23 questions, and the population is all the followers of the company Grupo Dimensiona SAC in the city of Trujillo, in the year 2021, which is 2707 followers, and the sample is formed by a subset of followers of the company Grupo Dimensiona SAC in the city of Trujillo, in the year 2021. For the selection of the sample, the Simple Random Sampling was considered, with a sample size of 337 people. For the construction of hypotheses, the Student's t-test and spearman's coefficient t-test were applied at a significance level of 5%, error precision of 5%, confidence level of 95% and a spearman 1.968 which accepts that there is a significant relationship between the level of content promotion strategy in social networks and the level of attraction of new followers of the company Grupo Dimensiona SAC in the city of Trujillo, in the year 2021. The followers of the company Grupo Dimensiona SAC in the city of Trujillo, in the year 2021 according to the Level of Attraction of new followers, 78.34% of its level is High. Followers consider very important the change of content and publications on Dimensiona's web page since 6 months ago, with 51.34% stating that it is very important and 33.73% stating that it is important

Factores de éxito para la penetración de empresas peruanas y mexicanas al mercado de EE.UU. en el segmento de salsas picantes

El mercado de salsas picantes ha mostrado un gran crecimiento a nivel global en los últimos seis años. Se estima que para el año 2025 alcance un valor de 5,900 millones de dólares, con un CAGR del 5%. En el mundo, Norteamérica cuenta con los principales consumidores y las compañías más importantes de salsas picantes, en Estados Unidos y México. Este último país ha crecido en sus exportaciones con un CAGR del 8% entre los años 2015 y 2020. Sus salsas son las más conocidas internacionalmente y es el principal proveedor de Estados Unidos, el mayor mercado destino de salsas picantes en el mundo. Perú, por su parte, cuenta con un gran catálogo de ajíes, más de 300, pero sus salsas envasadas no son tan conocidas como las mencionadas anteriormente. Dentro de su portafolio, se destacan las de ají amarillo, panca y rocoto. También han aumentado sus exportaciones mundiales durante este periodo, con casi 6 millones de dólares exportados en el 2019 y un CAGR del 5%. Sin embargo, los productores locales cuentan con problemas para posicionarse internacionalmente, como el abastecimiento local de ajíes y la estandarización de cultivos, junto a la pobre infraestructura logística y portuaria. En base al estudio de casos de éxito, se detectó que los factores más importantes para el ingreso de empresas pequeñas peruanas a Estados Unidos son proporcionar maquilas, las alianzas con distribuidores y un enfoque en los mercados de nostalgia, con énfasis en la población peruana migrante. Por otro lado, el mejor posicionamiento de México se debe a su proximidad, además de que cuenta con más migrantes, tuvo un mayor tiempo para establecer sus salsas con un marketing de imagen y gastronomía, y el sabor de sus chiles es más atractivo para el consumidor estadounidense general por su nivel de picante.The hot sauce market has shown great global growth in the last six years. It is estimated that by 2025 it will reach a value of almost USD 6 billion, with a CAGR of 5%. Around the world, North America has the most consumers and the most important hot sauce companies, located in the United States and Mexico. The latter has increased its exports with a CAGR of 8% between the years 2015 and 2020. Their hot sauces are the best known internationally and it is the main supplier to the United States, the largest destination market for hot sauces in the world. On the other hand, Peru has a large catalog of chili peppers, more than 300, but its sauces are not as well known as the ones mentioned above. Within its portfolio, those made from yellow pepper, panca and rocoto stand out. They have also increased their world exports during this period, with almost 6 million dollars exported in 2019 and a CAGR of 5%. However, local manufacturers have shown some problems to position themselves internationally, such as the local supply of chili peppers and the standardization of crops, along with the poor port and logistic infrastructure. Based on the study of success cases, it was identified that the most important factors for the entry of small Peruvian companies to the United States are the alliances with dealers, providing the services of contract manufacturers, and a focus on nostalgic markets, with an emphasis on the Peruvian immigrant population. Conversely, the better positioning of Mexico is due to its proximity to the United States; in addition to having more immigrants there, a longer time to establish their sauces with marketing and gastronomy, and the fact that their chilies are more attractive to the American consumer because of their spiciness

Decentralizing Cell-Free RNA Sensing With the Use of Low-Cost Cell Extracts.

Cell-free gene expression systems have emerged as a promising platform for field-deployed biosensing and diagnostics. When combined with programmable toehold switch-based RNA sensors, these systems can be used to detect arbitrary RNAs and freeze-dried for room temperature transport to the point-of-need. These sensors, however, have been mainly implemented using reconstituted PURE cell-free protein expression systems that are difficult to source in the Global South due to their high commercial cost and cold-chain shipping requirements. Based on preliminary demonstrations of toehold sensors working on lysates, we describe the fast prototyping of RNA toehold switch-based sensors that can be produced locally and reduce the cost of sensors by two orders of magnitude. We demonstrate that these in-house cell lysates provide sensor performance comparable to commercial PURE cell-free systems. We further optimize these lysates with a CRISPRi strategy to enhance the stability of linear DNAs by knocking-down genes responsible for linear DNA degradation. This enables the direct use of PCR products for fast screening of new designs. As a proof-of-concept, we develop novel toehold sensors for the plant pathogen Potato Virus Y (PVY), which dramatically reduces the yield of this important staple crop. The local implementation of low-cost cell-free toehold sensors could enable biosensing capacity at the regional level and lead to more decentralized models for global surveillance of infectious disease

Multidisciplinary approach detects speciation within the kissing bug Panstrongylus rufotuberculatus populations (Hemiptera, Heteroptera, Reduviidae)

BACKGROUND Panstrongylus rufotuberculatus (Hemiptera-Reduviidae) is a triatomine species with a wide geographic distribution and a broad phenotypic variability. In some countries, this species is found infesting and colonising domiciliary ecotopes representing an epidemiological risk factor as a vector of Trypanosoma cruzi, etiological agent of Chagas disease. In spite of this, little is known about P. rufotuberculatus genetic diversity. METHODS Cytogenetic studies and DNA sequence analyses of one nuclear (ITS-2) and two mitochondrial DNA sequences (cyt b and coI) were carried out in P. rufotuberculatus individuals collected in Bolivia, Colombia, Ecuador and Mexico. Moreover, a geometric morphometrics study was applied to Bolivian, Colombian, Ecuadorian and French Guiana samples. OBJECTIVES To explore the genetic and phenetic diversity of P. rufotuberculatus from different countries, combining chromosomal studies, DNA sequence analyses and geometric morphometric comparisons. FINDINGS We found two chromosomal groups differentiated by the number of X chromosomes and the chromosomal position of the ribosomal DNA clusters. In concordance, two main morphometric profiles were detected, clearly separating the Bolivian sample from the other ones. Phylogenetic DNA analyses showed that both chromosomal groups were closely related to each other and clearly separated from the remaining Panstrongylus species. High nucleotide divergence of cyt b and coI fragments were observed among P. rufotuberculatus samples from Bolivia, Colombia, Ecuador and Mexico (Kimura 2-parameter distances higher than 9%). MAIN CONCLUSIONS Chromosomal and molecular analyses supported that the two chromosomal groups could represent different closely related species. We propose that Bolivian individuals constitute a new Panstrongylus species, being necessary a detailed morphological study for its formal description. The clear morphometric discrimination based on the wing venation pattern suggests such morphological description might be conclusive.MEC-DICYT: II/FVF/2019/054CSIC: No. 16

Proceso del cuidado aplicado en adulto mayor con hipertensión arterial

Objetivo: Brindar intervenciones de enfermería que ayuden a mejorar la ansiedad y modificar los pensamientos y emociones negativas. Caso clínico: Proceso de cuidado enfermero aplicado durante 3 días a adulto mayor de iniciales A. M. B. de 73 años, de sexo femenino, con antecedentes de 2 años post COVID. Hace 7 días ingresó por emergencia a la clínica Robles, dónde se le diagnosticó embolia cerebral por arritmia cardíaca. Presenta irritabilidad, preocupación, tristeza, frustración, inquietud, ojos ojerosos, desesperación, voz temblorosa, temperatura de 36 °C, FC: 110 lpm, PA: 140/110 mmHg, FR: 26 xm, pupilas irritadas, abdomen normal y confusión para hablar. Método: El método de estudio fue de caso único y de enfoque cualitativo, cuyo caso clínico se realizó en domicilio del paciente en el mes de abril, utilizando el marco teórico de valoración de Marjory Gordon y taxonomía NANDA-NOC-NIC. Resultados: La evolución de la paciente fue favorable, con los ejercicios, terapias y apoyo emocional que se le brindó en domicilio. Conclusiones: En el primer diagnóstico enfermero, disminución de la tolerancia a la actividad, su puntuación de cambio fue +3. En el segundo diagnóstico, ansiedad, su puntuación de cambio fue +3. En el tercer diagnóstico enfermero, deterioro de la movilidad física, su puntuación de cambio fue +2. En el cuarto diagnóstico enfermero, insomnio, su puntuación de cambio fue +3. En el quinto diagnóstico enfermero, aflicción crónica, su puntuación de cambio fue +3 y en el sexto diagnóstico enfermero, riesgo de deterioro de la función cardiovascular, su puntuación de cambio fue +3