Planeamiento estratégico de la región Apurímac

El Perú ha venido registrando índices de crecimiento económico en los últimos años, y es indudable que las principales protagonistas de dicho crecimiento han sido las regiones del país. Estas son gestionadas por un Gobierno Regional, cuya responsabilidad es trabajar de forma sostenida y consistente en el desarrollo económico, lo que permite mejorar el bienestar general de la población. El presente trabajo es un planeamiento estratégico para la región Apurímac, la cual cuenta con una gran oportunidad de desarrollo sostenido a través del tiempo, debido a que se encuentra en una excelente ubicación geográfica con tierras ricas en minerales, grandes atractivos turísticos, extensión de suelo para el agro, buen clima y una amplia biodiversidad. Destaca su actividad exportadora no tradicional, a través de la quinua. El capital humano es fundamental para lograr la competitividad de la región, y por ello consideramos que la educación es el pilar principal que se debe desarrollar dentro de la presente gestión y las venideras. A su vez, la salud de los pobladores constituye un factor clave para el desarrollo de las actividades a realizar que garanticen el crecimiento económico de Apurímac. Para la presente investigación se utilizó el modelo de planeamiento estratégico desarrollado por el profesor Fernando D’Alessio Ipinza. En esa línea se enmarca el Plan Estratégico de la Región Apurímac proyectado al 2027 y se desarrollan las estrategias que se deben tener en consideración para posicionar a Apurímac como una de las cinco principales regiones del país, centrándose siempre en el bienestar general de la poblaciónFirst of all, Perú has been registering economic growth rates throughout recent years. The main protagonists of this standing growth are the different regions of the country. These are managed by a Regional Government whose responsibility is to work in a sustained and consistent manner in economic development, allowing to improve the general welfare of the population. This strategic planning for Apurimac, a region that has a great opportunity for sustained development in long term. This is due to it is located in an excellent geographical area that has a land rich in minerals, great tourist attractions, extension of land for agriculture, good climate and great biodiversity. Highlighting thier non-traditional export activity, through quinoa. Human capital becomes essential to achieve the competitiveness of this region. Reason why, we consider education as main pillar for developed within the present and future management. At the same time, the health of the inhabitants is a key factor for the development of the activities to be carried out that guarantee the economic growth of the present region. Furthermore, for the present study, the Strategic Planning model developed by Professor Fernando D'Alessio Ipinza was used. Through which, the strategies to be taken into consideration to position this region among the five main ones of the country are included in the Strategic Plan of the Apurímac region projected in 2027. All of this, focusing on the general welfare of the populationTesi

Older people facing COVID-19: demographic trends and policy actions

El impacto de la pandemia de COVID-19 en la población de los países de América Latina (AL) depende en gran medida de las acciones de política pública (en general) y de salud (en particular) que los gobiernos hayan adoptado para frenar su avance y efectos. Especial atención merecen las personas mayores como grupo demográfico de más vulnerabilidad frente a esta enfermedad infecciosa. Así, este trabajo tiene dos objetivos: primero, examinar la tendencia de COVID-19 a partir de los casos confirmados y la mortalidad por esa causa entre personas adultas mayores de una selección de países de AL (Argentina, Brasil, Chile, Colombia, Ecuador, México y Uruguay) junto con España; para luego destacar las acciones y políticas dirigidas a la atención de la población mayor en cada país durante la primera ola de la pandemia.The impact of the COVID-19 pandemic on the population of the countries of Latin America (LA) depends, to a large extent, on the public policies, and particularly on the health actions, that governments have adopted to confront the social and health crisis the pandemic has brought. Older people deserve special attention as one of the most vulnerable demographic groups to this infectious disease. The objec-tives of this work are: firstly, to examine the COVID-19 trend from confirmed cases and mortality due to this cause among older persons from a group of LA countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico and Uruguay) and Spain. Secondly, to explore actions and policies put in place in these countries to support older persons in particular, during the first wave of the pandemic.publishedVersionFil: Acosta, Laura Débora. Universidad Nacional de Córdoba. Facultad de Ciencias Sociales; Argentina.Fil: Acosta, Laura Débora. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina.Fil: Cardona Arango, Doris. Universidad Ces.; Colombia.Fil: Costa, José Vilton. Universidade Federal do Rio Grande do Norte; Brasil.Fil: Delgado, Alicia. Pontificia Universidad Católica del Ecuador; Ecuador.Fil: Freire, Flávio Henrique M. de A. Universidade Federal do Rio Grande do Norte; Brasil.Fil: Garay Villegas, Sagrario. Universidad Autónoma de Nuevo León; México.Fil: Gómez León, Madelin. Universitat Oberta de Catalunya; España.Fil: Paredes Della Croce, Mariana. Universidad de la República; Uruguay.Fil: Peláez, Enrique. Universidad Nacional de Córdoba. Facultad de Ciencias Sociales; Argentina.Fil: Peláez, Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudio sobre Cultura y Sociedad; Argentina.Fil: Peláez, Enrique. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Peláez, Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones de la Facultad de Psicología; Argentina.Fil: Rodríguez Rodríguez, Vicente. Consejo Superior de Investigaciones Científicas; España.Fil: Rojo Pérez, Fermina. Consejo Superior de Investigaciones Científicas; España.Fil: Silva Ramírez, Rafael. University of Montreal; Canadá

Forest Restoration in a Fog Oasis: Evidence Indicates Need for Cultural Awareness in Constructing the Reference

Background: In the Peruvian Coastal Desert, an archipelago of fog oases, locally called lomas, are centers of biodiversity and of past human activity. Fog interception by a tree canopy, dominated by the legume tree tara (Caesalpinia spinosa), enables the occurrence in the Atiquipa lomas (southern Peru) of an environmental island with a diverse flora and high productivity. Although this forest provides essential services to the local population, it has suffered 90% anthropogenic reduction in area. Restoration efforts are now getting under way, including discussion as to the most appropriate reference ecosystem to use. Methodology/Principal Findings: Genetic diversity of tara was studied in the Atiquipa population and over a wide geographical and ecological range. Neither exclusive plastid haplotypes to loma formations nor clear geographical structuring of the genetic diversity was found. Photosynthetic performance and growth of seedlings naturally recruited in remnant patches of loma forest were compared with those of seedlings recruited or planted in the adjacent deforested area. Despite the greater water and nitrogen availability under tree canopy, growth of forest seedlings did not differ from that of those recruited into the deforested area, and was lower than that of planted seedlings. Tara seedlings exhibited tight stomatal control of photosynthesis, and a structural photoprotection by leaflet closure. These drought-avoiding mechanisms did not optimize seedling performance under the conditions produced by forest interception of fog moisture. Conclusions/Significance: Both weak geographic partitioning of genetic variation and lack of physiological specialization of seedlings to the forest water regime strongly suggest that tara was introduced to lomas by humans. Therefore, the most diverse fragment of lomas is the result of landscape management and resource use by pre-Columbian cultures. We argue that an appropriate reference ecosystem for ecological restoration of lomas should include sustainable agroforestry practices that emulate the outcomes of ancient uses

Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis

[EN]This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). Methods Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

Línea de investigación en Helicobacter pylori para la formación de recurso humano en ciencia, tecnología e innovación en el programa de microbiología

Este libro nace de la unión de un maestro altamente calificado y alumnos dedicados con unas creatividades activas y dispuestas a trabajar por resolver los problemas que trae una bacteria a la humanidad. Las investigaciones aquí consignadas son producto de los trabajos de grado de los estudiantes del programa de Microbiología, quienes además fueron miembros del semillero de investigación, MICROORGANISMOS DE IMPORTANCIA EN SALUD HUMANA Y ANIMAL “OBVIO-MICROBIO”. Apoyados y dirigidos por la doctora Adalucy Alvarez-Aldana, quien gracias a su amplio conocimiento en el microorganismo supo sembrar curiosidad sobre el mismo durante las sesiones del semillero, incentivando a muchos de sus alumnos a dedicar su trabajo de grado a resolver alguna pregunta que les surgiera en torno a este microorganismo. Aunque diferentes son las investigaciones, todas fueron trazadas con un fin común, entregarle a la humanidad un poco más de conocimiento sobre Helicobacter pylori, por esto la unión de estas investigaciones en una sola consigna, son importantes para entender más sobre todo lo que rodea esta bacteria y pretenden resolver muchos misterios que aún aquejan la epidemiología detrás de la misma. Estos trabajos son fruto de muchos esfuerzos, materiales y académicos, de personas grandiosas, de la unión de universidades, doctores y docentes de diferentes disciplinas, razón que demuestra una vez más que la unión hace la fuerza, porque solo llegarás más rápido, pero en compañía llegarás más lejos. Además, contamos con la fortuna de tener un capitulo invitado, cuyo tema no es sobre Helicobacter pylori, pero si un sobre un tópico de gran interes en la actualidad como es la resistencia bacteriana. Capitulo titulado: “Caracterización epidemiológica y microbiológica de las bacteriemias y su perfil de resistencia durante el periodo junio 2011 a junio 2015”

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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat