INTERVENCIÓN DE ENFERMERÍA Y SU INFLUENCIA EN LA PREVENCIÓN DEL EMBARAZO NO DESEADO EN LA ADOLESCENCIA

El embarazo no deseado en la adolescencia se concibe ya que los jóvenes inician su vida sexual de manera inapropiada y sin responsabilidad, dejándose llevar por la experimentación del deseo, Objetivo general: determinar las intervenciones de enfermería y su influencia como prevención para reducir el índice del embarazo no deseado en la adolescencia. El método seleccionado es el deductivo, inductivo e histórico lógico aplicando un enfoque mixto cuali-cuantitativo, siendo una investigación de tipo descriptiva, aplicada, de campo y transversal. Los resultados indican que el personal de enfermería no está cumpliendo con el rol de promoción de salud ya que el 62% de los adolescentes manifiesta que no reciben charlas de educación sexual y el 71% ya ha iniciado su vida sexual. La conclusión  nos permitió aceptar la hipótesis donde el alto índice de embarazos no deseados en la adolescencia está relacionado con las deficientes intervenciones de enfermería. Palabras claves: embarazo no deseado, adolescencia, prevención, intervenciones, enfermería

EL TRABAJO COLABORATIVO COMO ESTRATEGIA DIDÁCTICA PARA EL DESARROLLO DEL PENSAMIENTO CRÍTICO

El presente artículo se enfoca en el análisis del trabajo colaborativo como estrategia didáctica para el desarrollo del pensamiento crítico en estudiantes de sexto semestre de la carrera de enfermería de la Universidad técnica de Babahoyo. Este estudio se enmarca dentro de una investigación mixta, por cuanto permite cualificar y cuantificar la información recolectada a través de encuestas y entrevistas. La muestra de estudio fue de 43 estudiantes. Los resultados obtenidos de este estudio apuntaron a describir la forma como el trabajo colaborativo en tanto estrategia didáctica favorece el desarrollo del pensamiento crítico en los estudiantes dejan en claro que el trabajo colaborativo se consolida cada vez más como una estrategia didáctica válida y pertinente en la enseñanza/aprendizaje. &nbsp

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Afro-reparaciones: memorias de la esclavitud y justicia reparativa para negros, afrocolombianos y raizales

En Colombia, los negros, afrocolombianos y raizales son sujetos de reparaciones no solo dentro del debate de la Ley de Justicia y Paz, debido a la embestida paramilitar y guerrillera en sus territorios colectivos, sino también porque la trata negra transatlántica, la que enmarcó la llegada masiva de esclavos a la Nueva Granada colonial, se ha considerado un crimen de lesa humanidad. La Conferencia de Durban (Sudáfrica, 2001) hizo sujetos de reparación a todos los integrantes de la diáspora africana en el mundo. Este doble entronque enciende y complejiza el debate sobre justicia reparativa en el país. La presente obra recoge ensayos de varios especialistas sobre el tema. Todos ellos buscan dar respuesta, desde diferentes perspectivas, a las siguientes preguntas: ¿Es posible la reconstrucción de una nación como la colombiana, que estableció un novedoso pacto de convivencia ética y política mediante la asunción constitucional de su carácter pluriétnico y multicultural? y, ¿Es posible alcanzar este loable ideal sin actos estatales de reparación de las múltiples injusticias heredadas del pasado, de los traumas sociales que se ocasionaron, que se expresan en las adversas condiciones de vida que llevan ciertos grupos poblacionales?. / Contenido. Preliminares; Capítulo 1 - Color, inferioridad y esclavización: La invención de la diferencia en los discursos de la colonialidad temprana; Capítulo 2 - Ciudadanía, racialización y memoria del cautiverio en la historia de Brasil; Capítulo 3 - Sin justicia étnico-racial no hay paz: Las afro-reparaciones en perspectiva histórico-mundial; Capítulo 4 - Afroecuatorianos: reparaciones y acciones afirmativas; Capítulo 5 - Reparaciones contemporáneas: De la memoria de la esclavitud al cuestionamiento de la exclusión social y el racismo; Capítulo 6 - Reparaciones para negros, afrocolombianos y raizales como rescatados de la Trata Negrera Trasatlántica y desterrados de la guerra en Colombia; Capítulo 7 - El Dorado Negro, o el verdadero peso del oro neogranadino en la colonia; Capítulo 8 - San Andrés Isla, memorias de la colombianización y reparaciones; Capítulo 9 - Mirar hacia adentro para reparar las memorias en Providencia y Santa Catalina; Capítulo 10 - Afrouresanos: la historia de un Palenque, el devenir de un pueblo; Capítulo 11 - Memorias palenqueras de la libertad; Capítulo 12 - Los afronortecaucanos: de la autonomía a la miseria ¿Un caso de doble reparación?; Capítulo 13 - Afro-reparaciones en tierras de comunidades negras: Vuelta de Candelilla, Tumaco; Capítulo 14 - Desde adentro: Una aproximación al tema de Verdad, Justicia y Repación a partir de la víctimas afrocolombianas; Capítulo 15 - Bojayá: Entre el miedo y los medios; Capítulo 16 - Conocimientos ancestrales amenazados y destierro prorrogado: La encrucijada de los afrocolombianos; Capítulo 17- Subvirtiendo la autoridad de lo sentencioso: "Cantadoras que se alaban de poetas"; Capítulo 18 - Los rostros de la memoria afrodescendiente: fiestas, bailes y fandangos; Capítulo 19 - Un rastro del África Central en el Pacífico Colombiano: tallas sagradas entre los indígenas de Chocó y su legado africano; Capítulo 20 - El cementerio africano en Nueva York: enseñanzas de un ejercicio de reconciliación; Capítulo 21 - La educación y el patrimonio cultural, nodos de los procesos de reparación de las comunidades adrocolombianas; Capítulo 22 - Andinocentrismo, salvajismo y afro-reparaciones; Capítulo 23 - La población afrodescendiente y su referencia como sujeto de ley en el desarrollo normativo de Colombia: punto de partida para definir niveles de reconocimiento y reparación, Capítulo 24 - "Aquí ellos también son iguales": una aproximación al racismo en el ámbito escolar; Capítulo 25 - Políticas étnicas afrocolombianas en educación superior: Dinámicas identitarias en la Universidad de Antioquia; Capítulo 26 - Las desigualdades raciales en Colombia: Un análisis sociodemográfico de condiciones de vida, pobreza e ingresos para la ciudad de Cali y el departamento del Valle del Cauca; Capítulo 27 - Memoria y reparación: ¿Y de ser mujeres negras qué?; Capítulo 28 - La encrucijada de los rescatados: entre la memoria doliente y el olvido; Capítulo 29 - Comunidad de la Boquilla: lo patrimonial local en el escenario global; Capítulo 30 - La justicia afrocolombiana se construye en el reconocimiento de la diversidad; Anexo 01 - Índice temático; Anexo 02 - Notas biográficas de autoras y autores; Anexo 03 - Presentación Grupo de Estudios Afrocolombianos GE

Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study

Published by Elsevier Ltd.Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally. Methods: In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death. Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01-1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10-1·30]; p<0·0001), and population mobility (1·03 per 1% increase in number of visits to grocery and pharmacy stores [1·02-1·05]; p<0·0001 and 1·02 per 1% increase in number of visits to workplaces [1·00-1·03]; p=0·032) were independently associated with higher odds of mortality. Number of hospital beds (0·94 per 1-unit increase per 1000 people [0·88-1·00]; p=0·046), human development index (0·65 per 0·1-unit increase [0·44-0·96]; p=0·032), government response stringency (0·83 per 10-unit increase in containment index [0·74-0·93]; p=0·0018), as well as follow-up time (0·78 per month [0·69-0·88]; p<0·0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1·2% [0·1-9·5]; p=0·14). Interpretation: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.MAG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K01 AR070585 and K24 AR074534 [JY]). KDW is supported by the Department of Veterans Affairs and the Rheumatology Research Foundation Scientist Development award. JAS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, and P30 AR072577), the Rheumatology Research Foundation (K Supplement Award and R Bridge Award), the Brigham Research Institute, and the R. Bruce and Joan M. Mickey Research Scholar Fund. NJP is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32-AR-007258). AD-G is supported by grants from the Centers for Disease Control and Prevention and the Rheumatology Research Foundation. RH was supported by the Justus-Liebig University Giessen Clinician Scientist Program in Biomedical Research to work on this registry. JY is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155).info:eu-repo/semantics/publishedVersio

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

International audienceSignificance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population