RESUMEN

BACKGROUND: Kawasaki disease is a systemic vasculitis that affects small and medium-sized vessels, primarily the coronary arteries. First-line treatment includes intravenous immunoglobulin (IVIG) and acetylsalicylic acid; however, 20% do not respond adequately despite treatment. We describe a case treated with etanercept after initial IVIG failure, showing a good response. CASE REPORT: A 5-year-old female was diagnosed with classic Kawasaki disease. Echocardiography and angiotomography revealed giant and fusiform aneurysms in the coronary arteries. A first dose of IVIG therapy was administered without improvement; after the second dose, the fever persisted, so etanercept was administered, and the fever subsided. There were no new lesions in medium-caliber vessels and the previously identified coronary lesions did not progress. CONCLUSIONS: The use of etanercept in Kawasaki disease has demonstrated a clinically favorable response. Controlled clinical trials of this drug are needed to establish it as a formal therapy in cases of initial IVIG failure.

INTRODUCCIÓN: La enfermedad de Kawasaki es una vasculitis sistémica que afecta los vasos de pequeño y mediano calibre con predominio de las arterias coronarias. El tratamiento de primera línea incluye inmunoglobulina intravenosa (IGIV) y ácido acetilsalicílico; a pesar del tratamiento, el 20% de los pacientes no responden adecuadamente. Se presenta un caso tratado con etanercept debido a la falla inicial a IGIV, con buena respuesta. CASO CLÍNICO: Se trata de una paciente de 5 años de edad, a quien se diagnosticó con enfermedad de Kawasaki clásica. En ecocardiografía y angiotomografía se evidenciaron aneurismas gigantes y fusiformes en las coronarias. Se administró una primera dosis con IGIV, sin mejoría; después de la segunda dosis, la paciente persistió con fiebre, por lo que se administró etanercept, tras lo cual esta cesó. No aparecieron nuevas lesiones en vasos de mediano calibre y las lesiones coronarias previas no progresaron. CONCLUSIONES: Con el uso de etanercept se presentó una respuesta favorable clínicamente en la enfermedad de Kawasaki. Se requieren ensayos clínicos controlados con este fármaco para establecerlo como terapia formal en los casos de falla inicial a IGIV.

Asunto(s)

RESUMEN

Abstract Background: Kawasaki disease is a systemic vasculitis that affects small and medium-sized vessels, primarily the coronary arteries. First-line treatment includes intravenous immunoglobulin (IVIG) and acetylsalicylic acid; however, 20% do not respond adequately despite treatment. We describe a case treated with etanercept after initial IVIG failure, showing a good response. Case report: A 5-year-old female was diagnosed with classic Kawasaki disease. Echocardiography and angiotomography revealed giant and fusiform aneurysms in the coronary arteries. A first dose of IVIG therapy was administered without improvement; after the second dose, the fever persisted, so etanercept was administered, and the fever subsided. There were no new lesions in medium-caliber vessels and the previously identified coronary lesions did not progress. Conclusions: The use of etanercept in Kawasaki disease has demonstrated a clinically favorable response. Controlled clinical trials of this drug are needed to establish it as a formal therapy in cases of initial IVIG failure.

Resumen Introducción: La enfermedad de Kawasaki es una vasculitis sistémica que afecta los vasos de pequeño y mediano calibre con predominio de las arterias coronarias. El tratamiento de primera línea incluye inmunoglobulina intravenosa (IGIV) y ácido acetilsalicílico; a pesar del tratamiento, el 20% de los pacientes no responden adecuadamente. Se presenta un caso tratado con etanercept debido a la falla inicial a IGIV, con buena respuesta. Caso clínico: Se trata de una paciente de 5 años de edad, a quien se diagnosticó con enfermedad de Kawasaki clásica. En ecocardiografía y angiotomografía se evidenciaron aneurismas gigantes y fusiformes en las coronarias. Se administró una primera dosis con IGIV, sin mejoría; después de la segunda dosis, la paciente persistió con fiebre, por lo que se administró etanercept, tras lo cual esta cesó. No aparecieron nuevas lesiones en vasos de mediano calibre y las lesiones coronarias previas no progresaron. Conclusiones: Con el uso de etanercept se presentó una respuesta favorable clínicamente en la enfermedad de Kawasaki. Se requieren ensayos clínicos controlados con este fármaco para establecerlo como terapia formal en los casos de falla inicial a IGIV.

RESUMEN

COVID-19 has changed educational opportunities for students around the world, and, in the process, affected their lifestyle, happiness, and engagement. The present research is part of a project from six universities in different countries across Latin America to examine the impact of COVID-19 on university students. Objectives: The purpose of this study was to assess and compare the impact of COVID-19 on lifestyle changes, orientations to happiness, and student engagement among a sample of college students in Mexico, El Salvador, Colombia, the Dominican Republic, Peru, and the US. Methods: Participants were 1764 students from the six previously identified countries. Data were collected using the Student Health Behavior Inventory, the Orientations to Happiness Scale, and the University Student Engagement Inventory. Results: Student respondents were mostly female, with a median age of 22. Most reported no changes in academic performance and statistically significant changes in some lifestyle behaviors such as nutrition and physical activity. Conclusions: The global pandemic led to behavioral changes among college students in Latin America, and it affected their orientations to happiness and engagement. Institutions of higher learning are called to create opportunities for their students to reintegrate into an in-person learning environment to facilitate positive lifestyle changes for their students.

El COVID-19 ha cambiado las oportunidades educativas para los estudiantes de todo el mundo y en el proceso afectó su estilo de vida, felicidad y compromiso. La presente investigación es parte de un proyecto de seis universidades en diferentes países de América Latina para determinar el impacto de COVID-19 en estudiantes universitarios. Objetivos: El propósito de este estudio fue evaluar y comparar el impacto del COVID-19 en los cambios de estilo de vida, las orientaciones hacia la felicidad y el compromiso de los estudiantes entre una muestra de estudiantes universitarios en México, El Salvador, Colombia, República Dominicana, Perú y Estados Unidos. Métodos: Los participantes fueron 1764 estudiantes de los seis países previamente identificados. Los datos se recolectaron utilizando el Inventario de Conducta de Salud del Estudiante, la Escala de Orientaciones a la Felicidad y el Inventario de Participación de los Estudiantes Universitarios. Resultados. Los estudiantes encuestados eran en su mayoría mujeres con una edad promedio de 22 años. La mayoría informó que no hubo cambios en el rendimiento académico y cambios estadísticamente significativos en algunos comportamientos de estilo de vida, como la nutrición y la actividad física. Conclusiones: La pandemia global provocó cambios de comportamiento entre los estudiantes universitarios de América Latina y afectó sus orientaciones hacia la felicidad y su compromiso. Las instituciones de educación superior están llamadas a crear oportunidades para que sus estudiantes se reintegren en un entorno de aprendizaje en persona para facilitar cambios positivos en el estilo de vida de sus estudiantes.

RESUMEN

Abstract Objective: The purpose of this cross-sectional study was to measure students' sleep disorders 12 months after the start of the COVID-19 pandemic. Materials and Methods: Data were collected from 693 students from three universities in El Salvador, Mexico, and the United States using the Student Health Behavior Inventory. Results: Sleep disorders were identified in the sample with those in the US reporting higher levels of sleep disorders and those in El Salvador reported the least. Differences were also observed by gender with females reporting more sleep disorders one year into the pandemic than males. Conclusions: The global pandemic related to COVID-19 has had a profound impact on the mental and physical wellbeing of students. Sudden changes in learning modalities, modifications to work schedules, and potential loss of loved ones have contributed to sleep disorders in this population group. Universities need to take steps to address the evolving needs of college students as they cope with this pandemic.

Resumen Objetivo: El propósito de este estudio transversal fue medir los trastornos de sueño de los estudiantes, 12 meses después del principio de la pandemia de COVID. Materiales y Métodos: Se recolectaron datos de 693 estudiantes de tres universidades en El Salvador, México y los Estados Unidos, utilizando el Inventario de Conducta de Salud del Estudiante. Resultados: Se identificaron síntomas de trastornos del sueño; los universitarios de EUA informaron niveles más altos de trastornos del sueño y los de El Salvador menos. También, se observaron diferencias por género, ya que las mujeres reportaron más trastornos del sueño un año después de la pandemia que los hombres. Conclusiones: La pandemia relacionada con COVID-19 ha tenido un profundo impacto en el bienestar mental y físico de los estudiantes. Los cambios repentinos en las modalidades de aprendizaje, las modificaciones en los horarios de trabajo y la posible pérdida de seres queridos han contribuido a los trastornos del sueño en este grupo poblacional. Las universidades deben tomar medidas para abordar las necesidades cambiantes de los estudiantes universitarios a raíz de la pandemia.

RESUMEN

Enhanced activity and overexpression of Pannexin 1 (Panx1) channels contribute to neuronal pathologies such as epilepsy and Alzheimer's disease (AD). The Panx1 channel ablation alters the hippocampus's glutamatergic neurotransmission, synaptic plasticity, and memory flexibility. Nevertheless, Panx1-knockout (Panx1-KO) mice still retain the ability to learn, suggesting that compensatory mechanisms stabilize their neuronal activity. Here, we show that the absence of Panx1 in the adult brain promotes a series of structural and functional modifications in the Panx1-KO hippocampal synapses, preserving spontaneous activity. Compared to the wild-type (WT) condition, the adult hippocampal neurons of Panx1-KO mice exhibit enhanced excitability, a more complex dendritic branching, enhanced spine maturation, and an increased proportion of multiple synaptic contacts. These modifications seem to rely on the actin-cytoskeleton dynamics as an increase in the actin polymerization and an imbalance between the Rac1 and the RhoA GTPase activities were observed in Panx1-KO brain tissues. Our findings highlight a novel interaction between Panx1 channels, actin, and Rho GTPases, which appear to be relevant for synapse stability.

Asunto(s)

RESUMEN

Abstract: Objective: To investigate factors associated with chronic malnutrition among children aged five and under in Peru. Materials and Methods: Secondary data analysis based on the Peruvian 2018 Demographic and Family Health Survey. Results: Child's age (PR = 1.01; 95% CI: 1.009 to 1.015) and living in a rural area (PR = 1.36; 95% CI: 1.21 to 1.54) were associated with a higher risk of chronic malnutrition in the sample. Educational level, wealth index, and not belonging to the publicly funded Comedor Popular nutrition program, were identified as protective factors to chronic malnutrition. Conclusion: Being under five and living in a rural area was associated with an increased risk of chronic malnutrition in children residing in Peru. A higher wealth index and mother's level of education decrease the chances of chronic malnutrition in children under five years of age.

Resumen: Objetivo: Determinar factores asociados a la desnutrición crónica infantil en niños peruanos menores de cinco años. Materiales y Métodos: Estudio de tipo retrospectivo, basado en un análisis de la base de los datos de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018. Resultados: Se encontró una prevalencia nacional de desnutrición crónica del 9,7% (n=2097) con diferencias según región geográfica de residencia. Se evidenció en el modelo ajustado que la edad del niño mayor de 25 meses (PRa=1,25; IC95%: 1,13 a 1,38, p<0,001) y vivir en zona rural (PR=1,36; IC95%: 1,21 a 1,54) con desnutrición crónica. El tener un mayor nivel de instrucción, un mayor índice de riqueza y no pertenecer al programa comedor popular estuvieron asociados como factores protectores para presentar desnutrición crónica. Conclusiones: La edad de los niños y residir en una zona rural se asocia a mayor riesgo de presentar desnutrición crónica en los niños menores de cinco años.

RESUMEN

Sr. Editor: La Organización Mundial de la Salud define la salud como "un estado de completo bienestar físico, mental y social, y no solamente la ausencia de afecciones o enfermedades". Esta definición, propuesta por primera vez en 1948, ha evolucionado y actualmente incluye más dominios que los citados originalmente por la OMS. De hecho, las definiciones contemporáneas de salud se centran en la capacidad de la persona para hacer frente a las demandas de la vida a través de un equilibrio entre la ausencia de enfermedad y deficiencia, y su capacidad para funcionar en su entorno social y físico. Independientemente de la definición empleada, la salud humana no existe en el vacío, ya que representa la totalidad de las realidades socioeconómicas de la persona.

Mr. Editor The World Health Organization defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". This definition, first proposed in 1948, has evolved and currently includes more domains than those originally cited by the WHO. In fact, contemporary definitions of health focus on the person's ability to deal with life's demands through a balance between the absence of disease and impairment, and their ability to function in their social and physical environments. Regardless of the definition employed, human health does not exist in a vacuum, as it represents the total socioeconomic realities of the person.

RESUMEN

ABSTRACT Objective: To determine the effectiveness of the roll-over test as a predictor of pre-eclampsia. Methodology: The studied population had a size of 272, with a sample of 262 pregnant women, between 28 and 32 weeks of gestational age, who obtained pre-natal care at the Guillermo Almenara Irigoyen National Hospital, between January and September of 2017. The ROC curve, and the sensitivity and specificity of the roll-over test to predict pre-eclampsia, were calculated. Results: The prevalence of the roll-over test in this study was 9%, with a 95% confidence interval (5.43 - 12.22). In this study, the ROC curve was determined (0.725 and 0.734, for the first and second measurements, respectively) and found to be statistically significant at the p <0.05 level. The sensitivity of the roll-over test for a cutoff point of 20 mmHg was 60%, and the specificity of 95% also had a PPV of 37% and a NPV of 98%. Differences between the first and second measurements suggest that the second measurement is more sensitive than the first one. Conclusions: The roll-over test is a simple, cost-effective test with potential application in initial evaluation of pre-eclampsia in pregnant women with a history of pre-eclampsia and/ or other risk factors.

RESUMEN Objetivo: determinar la efectividad de la prueba de presión supina como predictor de pre-eclampsia. Metodología: La población del estudio fue de 272 y la muestra consistió en 262 mujeres embarazadas entre 28 y 32 semanas de edad gestacional que obtuvieron atención prenatal en el Hospital Nacional Guillermo Almenara Irigoyen entre enero y septiembre de 2017. Se realizó la curva ROC y se calculó la sensibilidad y la especificidad de la prueba de vuelco para predecir la pre-eclampsia. Resultados: La prevalencia de la prueba de presión supina en este estudio fue del 9% con un intervalo de confianza del 95% (5,43 - 12,22). En este estudio, se determinó la curva ROC (0,725 y 0,734 para la primera y la segunda medición respectivamente) y se encontró que era estadísticamente significativa al nivel de p <0,05. La sensibilidad de la prueba de presión supina para un punto de corte de 20 mmHg fue del 60% y la especificidad del 95% también tuvo un VPP del 38% y un VPN del 98%. Las diferencias entre la primera y la segunda medición sugieren que la segunda medición es más sensible que la primera. Conclusiones: la prueba de presión supina es una prueba simple y rentable con una posible aplicación en la evaluación inicial de la pre-eclampsia en mujeres embarazadas con antecedentes o pre-eclampsia y / u otros factores de riesgo.

RESUMEN

Dentists are highly exposed and vulnerable during the coronavirus disease (COVID-19) pandemic, as physical proximity to patients is necessary for effective dental examination and treatment. The objective of this study was to describe the concerns, knowledge, and infection control practices of dentists in Mexico during the COVID-19 pandemic. In this cross-sectional study conducted from 22 May 2020 to 8 July 2020, an anonymous survey was distributed to dentists, which covered information regarding dentists' sociodemographic and professional characteristics, clinical practices during the pandemic, and perceptions regarding the application of infection prevention and control guidance for dental settings during the COVID-19 pandemic. Out of 703 respondents, 73.1% (n = 514) were women and 53.6% (n = 377) were dentists with 1-10 years of experience. Regarding the statements issued by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), the responses for 11 survey items had total agreement rates >90% (high frequency); seven and nine items had moderate and low frequency of total agreement, respectively. Most dentists in this study agreed with the WHO and CDC statements and were concerned regarding the possibility of infection, despite using the protective gear.

RESUMEN

OBJECTIVES: Undergraduate dentistry students in their final year often lack the knowledge and confidence required to prescribe oral health medications. Online courses could help to solve this problem through augmenting traditional teaching methods. This study assessed the effectiveness of a non-curricular, online, clinical case-based dental pharmacology course designed to improve medication management in senior dentistry students. MATERIALS AND METHODS: This study developed and implemented an online dental pharmacotherapy course for 287 dentistry students in Mexico. Pre- and post-course tests evaluated knowledge acquisition, and a 5-point Likert scale questionnaire was administered to 238 participants to evaluate the course's content and educational strategies. RESULTS: Mean knowledge scores significantly increased from pre- (5.5 ± 1.6) to post-test (9.1 ± 1.3, P < 0.001). Participants reported a high satisfaction level (70.2%) with the course content and materials, educational techniques, and instructors. CONCLUSION: These findings support the use of online, clinically based dental pharmacotherapy courses, in conjunction with traditional teaching methods, as a viable strategy for effectively educating dentistry students.

Asunto(s)

RESUMEN

Introduction: While different contraceptive attitudes have been reported among different ethnic groups in the US, little if any research has been conducted to understand the reproductive health needs and attitudes among Hmong young adults. To our knowledge, this is the first study to investigate the relationship among contraceptive perception of this community. Objective: The purpose of this research was to identify attitudes that influence Hmong college students' contraceptive practices. Methods: A campus-wide online survey was used as part of the data collection at a midsize institution in Central California. The questionnaire was a 32-items scale instrument called Contraceptive Attitude Scale (CAS), developed by Dr. Black. Results: Three hundred and forty-four students successfully completed the 32-items scale instrument CAS, which measured general contraceptive attitudes among Hmong young adults in rural California. The data reveals a high prevalence of unmarried (85%) Hmong college students reporting being sexually active (67%), with 62% having at least one sexual partner over the past 12 months; however, only 36% reported to use condom compared to 58% who did not use condoms during the last time of sexual intercourse. Conclusion: The findings indicated statistically significant differences between groups on the characteristics of sexual partners, contraceptive methods, marital status, birthplace, primary language spoken at home, years spent in college and years lived in the United States. The findings greatly contribute to the understanding of factors that influence contraceptive choices among the Hmong college population. More importantly, the information is crucial in designing programs to promote contraceptive knowledge and practices that are specific to the Hmong.

Introducción: Si bien se informaron diferencias en las actitudes anticonceptivas entre los diferentes grupos étnicos en los EE. UU., Se ha realizado poca o ninguna investigación para comprender las necesidades y actitudes de salud reproductiva entre los adultos jóvenes Hmong. Hasta donde sabemos, este es el primer estudio que investiga la relación entre la percepción anticonceptiva de esta comunidad. Objetivo: El propósito de esta investigación fue identificar actitudes que influyen en las prácticas anticonceptivas de los estudiantes universitarios de Hmong.Métodos: Se utilizó una encuesta en línea en todo el campus como parte de la recopilación de datos en una institución mediana en California Central. El cuestionario era un instrumento a escala de 32 ítems llamado Escala de Actitud Anticonceptiva (CAS), desarrollado por el Dra. Black. Resultados:Trescientos cuarenta y cuatro estudiantes completaron con éxito el instrumento CAS de escala de 32 ítems, que midió las actitudes anticonceptivas generales entre los adultos jóvenes Hmong en las zonas rurales de California. Los datos revelan una alta prevalencia de estudiantes universitarios Hmong solteros (85%) que informan ser sexualmente activos (67%), al menos una pareja sexual en los últimos 12 meses (62%); sin embargo, solo el 36% informó usar condón en comparación con el 58% que no usó condón durante la última vez que tuvo relaciones sexuales. Conclusión: Los resultados indicaron diferencias estadísticamente significativas entre los grupos en cuanto a las características de las parejas sexuales, los métodos anticonceptivos, el estado civil, el lugar de nacimiento, el idioma principal que se habla en el hogar, los años que pasaron en la universidad y los años que vivieron en los Estados Unidos. Los hallazgos contribuyen en gran medida a la comprensión de los factores que influyen en las elecciones de anticonceptivos entre la población universitaria de Hmong. Más importante aún, la información es crucial en el diseño de programas para promover el conocimiento y las prácticas anticonceptivas que son específicos del Hmong.

RESUMEN

Objetivo: Discutir el desarrollo y la implementación de una experiencia de aprendizaje de servicio diseñada para mejorar el estado de salud de las poblaciones vulnerables en un país de ingresos medios a través de la implementación de programas basados ​​en la ciencia diseñados para abordar las "Diez amenazas a la salud global" de la Organización Mundial de la Salud. "Métodos: describe el desarrollo pragmático de una experiencia de aprendizaje de servicio diseñada para proporcionar experiencias prácticas a los estudiantes de medicina y salud pública a medida que se convierten en profesionales en países de ingresos medios altos y bajos. Resultados: "Explorando los determinantes sociales globales de la salud en la República Dominicana", originalmente diseñado como una experiencia de observación de los determinantes sociales de la salud, se ha convertido en una experiencia de aprendizaje experimental diseñada para ayudar a los estudiantes en la aplicación de su conocimiento y experiencia en salud pública. Conclusión: Los profesionales de la salud pública, incluidos los que están en capacitación, tienen la responsabilidad de implementar acciones diseñadas para mejorar el estado de salud de las poblaciones de todo el mundo. Los programas de servicio de aprendizaje como "Explorando los determinantes sociales globales de la salud en la República Dominicana" brindan esas oportunidades prácticas.

Objective: To discuss the development and implementation of a service learning experience designed to improve the health status of vulnerable populations in a middle-income country through the implementation of science-based programs designed to address the World Health Organization's "Ten Threats to Global Health." Methods: Describes the pragmatic development of a service learning experience designed to provide hands-on experiences to public health and medical students as they develop into professionals in high-middle-and low-income countries. Results: "Exploring Global Social Determinants of Health in the Dominican Republic," originally designed as an observational experience of social determinants of health, has evolved into an experiential learning experience designed to assist students in the application of their public health knowledge and experience. Conclusion: Public health professionals, including those in training, have a responsibility to implement actions designed to improve the health status of populations around the world. Service learning programs such as "Exploring Global Social Determinants of Health in the Dominican Republic," provide those hands-on opportunities.

RESUMEN

ABSTRACT Objective: To determine the prognostic value of RDW in patients with hip fracture and its association with selected variables such as unfavorable functional grade, postoperative complications, comorbidities, previous fracture, age and sex. Method: A clinical trial with both retrospective and prospective components study was carried out among 99 patients hospitalized at the Hospital Central de la Fuerza Aérea del Perú [Central Hospital of the Peruvian Air Force], from January 2014 to July 2015, with a follow-up at 6 months for the evaluation of mortality and degree of dependence. RDW and association with related variables were investigated. Results: High RDW values (Q4 RDW> 14.1) were strongly associated with increased mortality (OR = 5.41 CI: 2.35-12.46 p = 0.000) and with an increased patient dependence grade (OR = 1.607 CI : 1.074-2.44 p = 0.040)., with respect to the other quartiles. A positive trend was observed with the highest RDW values and the antecedent of previous fracture showed a significant association with mortality at 6 months. Conclusion: RDW is a simple, easy and widely available parameter in the total red blood cell count. Our study shows that both the RDW and the antecedent of previous fracture are associated with an increased risk of mortality at 6 months after discharge, in addition RDW is associated with an increase in patient dependence after hip fracture.

RESUMEN Objetivo: Determinar el valor pronóstico de RDW en pacientes con fractura de cadera y su asociación con variables seleccionadas como grado funcional desfavorable, complicaciones postoperatorias, comorbilidades, fractura previa, edad y sexo. Método: Se realizó un ensayo clínico con un estudio de componentes prospectivo y retrospectivo realizado entre 99 pacientes hospitalizados en el Hospital Central de la Fuerza Aérea del Peru con un seguimiento a los 6 meses para la evaluación de la mortalidad y el grado de dependencia. RDW y asociación con variables relacionadas fueron investigados. Resultados: Los valores altos de RDW (Q4 RDW> 14.1) se asociaron fuertemente con una mayor mortalidad (OR = 5.41 IC: 2.35-12.46 p = 0.000) y con un mayor grado de dependencia del paciente (OR = 1.607 CI: 1.074-2.44 p = 0.040), con respecto a los otros cuartiles. Una tendencia positiva se observó con los valores más altos de RDW y el antecedente de fractura previa mostró Una asociación significativa con la mortalidad a los 6 meses. Conclusión: RDW es un parámetro simple, fácil y ampliamente disponible en el total de sangre roja recuento de células. Nuestro estudio muestra que tanto el RDW como el antecedente de fractura previa son asociado con un mayor riesgo de mortalidad a los 6 meses después del alta, además de RDW se asocia con un aumento en la dependencia del paciente después de una fractura de cadera.

RESUMEN

Objetivo: analisar a qualidade do sono dos profissionais da equipe de enfermagem do servico móvel de atendimento de urgência do Distrito Federal. Método: pesquisa transversal e quantitativa, realizada em outubro de 2018 junto a 66 profissionais de enfermagem por meio de um questionário sociodemográfico e ocupacional e do Índice de Qualidade do Sono de Pittsburg. Utilizou-se a estatistica descritiva para analisar os dados. Resultados: predominaram profissionais que trabalham 40 horas semanais (74,5%), há mais de 11 anos (74,5%), possuem outro vínculo empregatício (74,5%), atuam 12 horas diariamente (74,5%), não utilizam inibidores de sono ou medicações para dormir (74,5%). 56% apresentaram baixa qualidade de sono. Os fatores que mais contribuem para isso são: Sonolência Diurna, Distúrbios do Sono e Duração do Sono. Conclusão: os profissionais estão expostos a fatores laborais e demográficos que podem levar a baixa qualidade do sono, com impacto a segurança do paciente e a saúde do trabalhdor.

Objective: to assess the sleep quality in health team workers of the Mobile First-Aid Service from Federal District. Method: this is a crossectional and quantitative study conducted in october 2018 with 66 nursing professionals. We applied a sociodemographic and ocupational form and the Pittsburg Sleep Quality Index. The descpritive measures for data analysis. Results: most of nursing professionals work 40 hours a week (74,5%), for more than 11 years (74,5%), has an extra employment (74,5%), and work 12 hours daily (74,5%). They do not use sleep inhibitors or medication to sleep in (74,5%). 56% of the sample had poor sleep quality that is more affected for: Daily Sleepiness, Sleep Disturbances and Sleep Duration. Conclusion: nursing team members are exposed to demographic and occupational factors that decrease the sleep quality, with a negative impact on patient's safety and workers' health.

Asunto(s)

RESUMEN

Investigaram-se as atitudes e percepções de estudantes universitários com relação ao uso de métodos contraceptivos na República Dominicana, utilizando a Escala de Atitudes sobre Contraceptivos. Este é um estudo quantitativo descritivo desenhado para examinar atitudes relativas ao uso de contraceptivos e conhecer sua utilização entre estudantes universitários na República Dominicana. Os dados foram coletados usando a Escala de Atitudes sobre Contraceptivos entre estudantes universitários selecionados aleatoriamente em uma universidade de médio porte localizada na parte oriental da República Dominicana. As conclusões deste estudo sugerem diferenças entre os gêneros no que se refere à percepção da necessidade do uso de contraceptivos, às consequências do seu uso, ao seu encorajamento e a problemas com o uso. O número de anos na universidade (anos acadêmicos) também aparece associado a diferenças nos sentimentos e nas razões relacionadas ao uso de contraceptivos, e diferenças de idade estão associadas a questões como encorajamento ao uso entre pessoas amigas e preferências quanto ao tipo de contraceptivo. As conclusões sugerem a necessidade de se aprimorar as normas sociais e as percepções sobre contraceptivos a fim de aumentar o seu uso entre estudantes em idade universitária. A concentração do foco na educação sexual e no uso de contraceptivos entre universitários, recorrendo a educadores vistos pelos estudantes como seus pares, implantando medidas de reforço da autoestima dos estudantes e adotando intervenções específicas junto às mulheres são medidas que podem ajudar a melhorar a saúde geral de jovens adultos na República Dominicana

Asunto(s)

RESUMEN

O aumento nas taxas de diabetes no México levaram as autoridades mexiacanas a delcarem estado de emergência. Estima-se que in 2017 aproximadamente 13 milhôes ou 10% das pessoas no México tenham diabetes mellitus, sendo a diabetes tipo II a causa líder de morte e incapacidade associadas no referido país. Na verdade, se as taxas continuarem a aumentar dessa forma, um efeito adverso na redução da expetativa de vida do pais é esperado. O objetivo desse artigo é discutir a necessidade de expandir as politicas de saúde em relação à alimentação e consumo de calorias inúteis para combater a epidemia de diabetes no méxico, bem como discutir a importância do exercício, promocao de saúde e educação em saúde em relação a doencas não comunicáveis, detecção de diabetes and cobertura de serviços de saúde

Increasing rates of diabetes in Mexico have lead health authorities to declare a state of emergency. It is estimated that in 2017 some 13 million, or 10% of people in Mexico have diabetes mellitus, with Type 2 diabetes being the leading cause of death and disability combined in that country. In fact, if rates continue to increase unabated, it is expected to have an adverse impact on the life expectancy of the country. The aim of this paper is to discuss the necessity of expanding health care policy regarding nutrition and the consumption of empty calories to combat the diabetes epidemic in Mexico as well as discussing the importance of exercise, health promotion and health education regarding non-communicable diseases, diabetes detection, and health coverage.

Asunto(s)

RESUMEN

We present deterministic and stochastic programming models for the workover rig problem, one of the most challenging problems in the oil industry. In the deterministic approach, an integer linear programming model is used to determine the rig fleet size and schedule needed to service wells while maximizing oil production and minimizing rig usage cost. The stochastic approach is an extension of the deterministic method and relies on a two-stage stochastic programming model to define the optimal rig fleet size considering uncertainty in the intervention time. In this approach, different scenario-generation methods are compared. Several experiments were performed using instances based on real-world problems. The results suggest that the proposed methodology can be used to solve large instances and produces quality solutions in computationally reasonable times.

Asunto(s)