Effect of Training Healthcare Providers in Helping Babies Breathe Program on Neonatal Mortality Rates.

Background: Training in the Helping Babies Breathe (HBB) Program has been associated with a reduction in early neonatal mortality rate (ENMR), the neonatal mortality rate (NMR), and fresh stillbirth rate (FSBR) in low- and middle-income countries (LMICs). This program was implemented in five different healthcare facilities in the Oliver Reginald Tambo (ORT) District, South Africa from September 2015 to December 2020. Objective: To determine and compare the FSBR, ENMR, and NMR between 2015 before initiation of the program (baseline) and subsequent years up to 2020 following the implementation of facility-based training of HBB in five hospitals in ORT District. Methods: Records of perinatal statistics from January 2015 to December 2020 were reviewed to calculate FSBR, ENMR, and NMR. Data were collected from the five healthcare facilities which included two district hospitals (Hospital A&B), two regional hospitals (Hospital C&D), and one tertiary hospital (Hospital E). Comparisons were made between pre- (2015) and post- (2016-2020) HBB implementation periods. Differences in changes over time were also assessed using linear regression analysis. Results: There were 19,275 births in 2015, increasing to 22,192 in 2020 with the majority (55.3%) of births occurring in regional hospitals. There were significant reductions in ENMR (OR-0.78, 95% CI 0.70-0.87) and NMR (OR-0.81, 95% CI 0.73-0.90), but not in FSBR, in the five hospitals combined when comparing the two time periods. Significant reduction was also noted in trends over time in ENMR (r 2 = 0.45, p = 0.001) and NMR (r 2 = 0.23, p = 0.026), but not in FSBR (r 2 = 0.0, p = 0.984) with all hospitals combined. In looking at individual hospitals, Hospital A (r 2 = 0.61, p < 0.001) and Hospital E (r 2 = 0.19, p = 0.048) showed a significant reduction in ENMR over time, but there were no significant changes in all mortality rates for Hospitals B, C, and D, and for the district or regional hospitals combined. Conclusion: There was an overall reduction of 22% and 19% in ENMR and NMR, respectively, from pre- to post-HBB implementation periods, although there were variations from year to year over the 5-year period and, across hospitals. These differences suggest that there were other factors that affected the perinatal/neonatal outcomes in the hospital sites in addition to the implementation of training in HBB.

Couples talk about breastfeeding: Interviews with parents about decision-making, challenges, and the role of fathers and professional support.

Despite health benefits, sustained breastfeeding rates remain low in the United States, and the role of partners in breastfeeding is not well understood. Using a grounded theory approach, the current qualitative study explored how couples communicate regarding breastfeeding decisions and challenges. Mother-father dyads (n = 16) completed individual semi-structured interviews 1 year after the birth of their first child. Following iterative qualitative analysis, three phases of breastfeeding communication emerged: Should we try this? ( Mother's opinion counts) How do we make this work? (adjusting and problem-solving) and How do we settle into a routine? (gaining confidence, resolving issues) Findings underscore the complexity of defining the partner role in breastfeeding.

Manualised Cognitive Behaviour Therapy for Anorexia Nervosa: Use of Treatment Modules in the ANTOP Study.

Standardised treatment manuals facilitate therapy planning and enhance comparability for research purposes. Within the Anorexia Nervosa Treatment of Out Patients (ANTOP) study, the largest multisite outpatient intervention trial in anorexia nervosa (AN) to date, manualised enhanced cognitive-behavioural therapy (CBT-E) was offered as one treatment modality. The manual consisted of 9 modules, of which Motivation, Nutrition, Formulation and Relapse Prevention were compulsory. Homework worksheets were provided, to ensure the transfer of therapeutic improvements to daily life. This study investigated the use of modules and worksheets in order to explore practice styles of trained therapists in the treatment of AN. This secondary analysis was based on log-sheets (n = 2604) CBT-E therapists completed after each session. Frequencies of modules and worksheets used across all sessions were calculated. Relationships, such as that between use of module and duration of illness, were examined. The most commonly used module was Motivation. In patients with longer illness duration, the module Self Esteem seemed to be particularly important. The worksheet Scales, balancing the pros and cons of AN, was prioritised by therapists. The results underline the importance of motivational work in the treatment of AN, including validating the ambivalence experienced by most AN patients. With increasing duration of illness, resource-oriented elements, such as self esteem stabilisation, should be of focus.

Swiss ethnoveterinary knowledge on medicinal plants - a within-country comparison of Italian speaking regions with north-western German speaking regions.

BACKGROUND: Ethnoveterinary knowledge in Europe may play an important role as a basis for sustainable treatment options for livestock. Aims of our study were (a) to compare the ethnoveterinary practices of two culturally and sociodemographically different regions of Switzerland, (b) to compare results with earlier ethnoveterinary studies conducted in Switzerland and in adjacent Italian regions and, (c) to evaluate possible reasons for regional differences in European ethnoveterinary medicine. METHODS: 25 interviews were conducted in 2014 in all Italian speaking regions (ItR) of Switzerland, and 31 interviews were held in five north-western German speaking Cantons (GeC). Semi-structured questionnaires were used to collect detailed information regarding plant species, mode of preparation, dosage, route of administration, category of use, origin of knowledge, frequency of use, and satisfaction with outcomes of the treatments. RESULTS: A total of 162 homemade remedies in ItR and 219 in GeC were reported, out of which 125 and 145, respectively, were reported to contain only one plant species (homemade single species herbal remedy report, HSHR). 44 ItR and 43 GeC plant species were reported to treat livestock, of which only a half were used in both regions. For each HSHR, we classified the treatment intention of all use reports (UR), leading to a total of 205 and 219 UR in ItR and GeC respectively. While cattle were the most often treated livestock species in both study regions, in ItR 40% of UR were administered to small ruminants. Main indications in both regions were gastrointestinal diseases and skin afflictions, but in ItR a high number of URs were reported as antiparasitics. URs were mainly handed down from the past generation, but in GeC the source of knowledge for 20% of URs were from courses. Regarding the used plant species, ItR showed a higher concordance with Swiss than Italian studies, but with some differences to all regions. A total of 22 (14 ItR; 8 GeC) plant species in this study have not been reported before in ethnoveterinary studies of Swiss and Italian alpine regions. CONCLUSIONS: ItR and GeC, show differences and similarities with respect to their own ethnoveterinary practices and earlier Swiss and Italian ethnoveterinary studies. Linguistic, geographical, as well as social and farm-structural conditions influence the regional ethnoveterinary knowledge. However, political borders seem to be more important than language or geographical barriers.

The role of the atrial electromechanical delay in predicting atrial fibrillation in beta-thalassemia major patients.

BACKGROUND: Paroxysmal atrial tachyarrhythmias frequently occur in beta-thalassemia major (ß-TM) patients. The aim of the current study was to evaluate the atrial electromechanical delay (AEMD) in a large ß-TM population with normal cardiac function and its relationship to atrial fibrillation (AF) onset. METHODS: Eighty ß-TM patients (44 men, 36 women), with a mean age of 36.2 ± 11.1 years, and 80 healthy subjects used as controls, matched for age and gender, were studied for the occurrence of AF during a 5-year follow-up, through 30-day external loop recorder (ELR) monitoring performed every 6 months. Intra-AEMD and inter-AEMD of both atria were measured through tissue Doppler echocardiography. P-wave dispersion (PD) was carefully measured using 12-lead electrocardiogram (ECG). RESULTS: Compared to the healthy control group, the ß-TM patients showed a statistically significant increase in inter-AEMD, intra-left AEMD, maximum P-wave duration, and PD. Dividing the ß-TM group into two subgroups (patients with or without AF), the inter-AEMD, intra-left AEMD, maximum P-wave duration, and PD were significantly higher in the subgroup with AF compared to the subgroup without AF. There were significant good correlations of intra-left AEMD and inter-AEMD with PD. A cut-off value of 40.1 ms for intra-left AEMD had a sensitivity of 76.2% and a specificity of 97.5% in identifying ß-TM patients with AF risk. A cut-off value of 44.8 ms for inter-AEMD had a sensitivity of 81.2% and a specificity of 98.7% in identifying this category of patients. CONCLUSIONS: Our results showed that the echocardiographic atrial electromechanical delay indices (intra-left and inter-AEMD) and the PD were significantly increased in ß-TM subjects with normal cardiac function. PD and AEMD represent non-invasive, inexpensive, useful, and simple parameters to assess the AF risk in ß-TM patients.

Atrial Fibrillation and Beta Thalassemia Major: The Predictive Role of the 12-lead Electrocardiogram Analysis.

BACKGROUND: Paroxysmal atrial tachyarrhythmias frequently occur in beta-thalassemia major (ß-TM) patients.The aim of our study was to investigate the role of maximum P-wave duration (P max) and dispersion (PD), calculated trough a new manually performed measurement with the use of computer software from all 12-ECG-leads,as predictors of atrial-fibrillation (AF) in ß-TM patients with conserved systolic or diastolic cardiac function during a twelve-months follow-up. MATERIALS AND METHODS: 50 ß-TM-patients (age38.4±10.1; 38M) and 50-healthy subjects used as controls, matched for age and gender, were studied for the occurrence of atrial arrhythmias during a 1-year follow-up, through ECG-Holter-monitoring performed every three months. The ß-TM-patients were divided into two groups according to number and complexity of premature-supraventricular-complexes at the Holter-Monitoring (Group1: <30/h and no repetitive forms, n:35; Group2: >30/h or couplets, or run of supraventricular tachycardia and AF, n:15). RESULTS: Compared to the healthy control-group, ß-TM patients presented increased P-max (107.5± 21.2 vs 92.1±11ms, P=0.03) and PD-values (41.2±13 vs 25.1±5 ms,P=0.03). In the ß-TM population, the Group2 showed a statistically significant increase in PD (42.8±8.6 vs 33.2±6.5ms, P<0.001) and P-max (118.1±8.7 vs 103.1±7.5ms, P<0.001) compared to the Group1. Seven ß-TM patients who showed paroxysmal AF during this study had significantly increased P-max and PD than the other patients of the Group2. Moreover, P-max (OR:2.01; CI:1.12-3.59; P=0.01) and PD (OR=2.06;CI:1.17-3.64;P=0.01) demonstrated a statistically significant association with the occurrence of paroxysmal AF,P min was not associated with AF-risk (OR=0.99; CI:0.25-3.40; P=0.9) in ß-TM-patients. A cut-off value of 111ms for P-max had a sensitivity of 80% and a specificity of 87%, a cut-off value of 35.5ms for PD had a sensitivity of 90% and a specificity of 85% in identifying ß-TM patients at risk for AF. CONCLUSION: Our results indicate that P-max and PD are useful electrocardiographic markers for identifying the ß-TM-high-risk patients for AF onset, even when the cardiac function is conserved.

Treatment of organic livestock with medicinal plants: a systematic review of European ethnoveterinary research.

BACKGROUND: The EC Regulation for Organic Farming states that organic livestock should be treated preferably with phytotherapeutic products. In spite of the high importance of organic livestock in Europe, primarily ruminants, today almost no phytotherapeutic product is registered for livestock. Also, information regarding veterinary phytotherapy is rare. The aim of this paper is to find approaches to cope with health problems of organic ruminants in Europe on the basis of findings from the European ethnoveterinary medicine (EuEVM). METHODS: A systematic review of ethno-biomedicinal papers was conducted with the aid of the Scopus database, and 75 papers, from European countries were analyzed regarding ethnoveterinary information. RESULTS: A total of 590 plant species referring to 102 different plant families are reported to be used for animal treatment, with Asteraceae, Fabaceae and Lamiaceae being the most important families. The traditional use of some plant species (e.g. mallow, chamomile, wormwood) corresponds with findings from recent scientific literature. The large number of less studied plant species, such as white lupin as an antiparasitic herb, and Helleborus spp. as potential immunostimulatory agent, opens an interesting field for future research. CONCLUSIONS: In general, EuEVM provides interesting treatment approaches for gastrointestinal and dermatological disorders as well as parasitosis. Findings regarding disorders of female genital or respiratory tract are less consistent. Nevertheless, EuEVM offers a solid basis for stimulating research in veterinary phytotherapy in Europe with a perspective to solve animal health problems in organic or even nonorganic ruminant production.

Síndrome de Down versus alteração de linguagem: interação comunicativa entre pais e filhos / Down syndrome versus language disorder: communicative interaction between parents and children

É preciso interagir com outros seres humanos como meio de sobrevivência, proteção e estimulação, sendo que a comunicação nasce desta necessidade. A comunicação pode ser realizada por meio de códigos linguísticos e não-linguísticos e envolvem, no mínimo, duas pessoas (interlocutores), que trocam entre si uma mensagem qualquer. O objetivo do presente estudo foi investigar a interação de mães de crianças com síndrome de Down e seus filhos e mães de crianças com alteração de linguagem e seus filhos. Foram participantes da pesquisa cinco díades de crianças com síndrome de Down e suas mães e cinco díades de crianças com atraso de linguagem e suas mães. Foram gravadas três sessões de interação espontânea de mãe e criança em ambiente domiciliar. Os resultados mostraram que mães de crianças com atraso de linguagem apresentaram comportamentos mais adequados na interação com seus filhos, tais como equilíbrio da atividade dialógica durante a interação, estrutura gramatical e complexidade do discurso adequado, mais paciência com a criança e adequada entonação da fala. Por outro lado, mães de crianças com síndrome de Down demonstraram mais interesse durante a interação comunicativa.

Interacting with other human beings is necessary for survival, protection and stimulation - and communication emerges out of necessity. Communication can be accomplished through linguistic and non-linguistic codes involving, at least, two people, classified as interlocutors, who exchange messages between each other. The aim of this study was to investigate interaction between mothers with Down syndrome children and their children and mothers with children with language disorders and their children. Five dyads of Down syndrome children and their mothers, and five dyads of children with language disorders and their mothers participated in the study. Three sessions of spontaneous interaction between mother and child were recorded at home. The results showed that the behaviors of mothers of children with language disorders were more appropriate when interacting with their children. They showed greater balance of dialogic activity during interaction, better grammatical structure and greater complexity of proper speech, more patience with the child and proper speech intonation. For their part, the mothers of children with Down syndrome showed greater interest during communicative interaction.

Early electrocardiographic evaluation of atrial fibrillation risk in beta-thalassemia major patients.

Although previous studies have documented a variety of electrocardiogram abnormalities in beta-thalassemia major (ß-TM), little is known about P-wave dispersion (PD), an independent risk factor for development of atrial fibrillation. The aim of our study was to evaluate PD in ß-TM patients with conserved systolic and diastolic functions. The study involved 40 ß-TM patients (age 37.5 ± 10.2; 33 M) and 40 healthy subjects used as controls, matched for age and gender. PD was carefully measured using a 12-lead electrocardiogram. Cardiac iron levels were measured by cardiac magnetic resonance T2 star (CMR T2*) imaging. Comparing to the healthy control group, ß-TM group presented increased values of the PD (40.1 ± 12.9 vs. 24 ± 7 ms; P < 0.004) and decreased CMR T2* imaging (29 ± 15 vs. 55 ± 13 ms; P = 0.03). We found a significant correlation between PD and CMR T2* values. Our study showed a significant increase of PD in ß-TM patients with conserved systolic and diastolic cardiac functions. Our results indicate that PD is correlated to myocardial iron deposit, as assessed by CMR T2* imaging.

Dispersion of repolarization and beta-thalassemia major: the prognostic role of QT and JT dispersion for identifying the high-risk patients for sudden death.

BACKGROUND: Patients with beta-thalassemia major (ß-TM) are at increased risk for sudden cardiac death (SCD). Heterogeneity of ventricular repolarization is considered to provide an electrophysiological substrate for malignant arrhythmias. QT dispersion (QTc-D) and JT dispersion (JTc-D) are electrocardiographic parameters indicative of heterogeneity of ventricular repolarization. The aim of our study was to evaluate the heterogeneity of ventricular repolarization in patients with beta-thalassemia and to test the hypothesis that an abnormal QTc and JTc dispersion may predict SCD in this population. MATERIALS AND METHODS: The study involved 51 patients with ß-TM (age 33.9±8.4; 33M) and 51 healthy subjects used as controls, matched for age, gender, and body mass index (BMI). Among the ß-TM group, 14 patients with ß-TM (age 27±6.64; 11M) died from SCD during follow-up. For each patient, QTD and JTD intervals were calculated. RESULTS: Compared to the healthy control group, ß-TM group presented increased values of the QTc-D (65.36±33.95 vs. 37, 62±17.65; P<0.003) and JTc-D (74.64±33.27 vs. 40.32±12.45; P<0.001). In the ß-TM sudden death group, QTc-D and JTc-D were significantly greater than in survived ß-TM group (92.70±44.24 vs. 56.14±23.80, P=0.0001; 101.54±47.93 vs. 64.47±17.90, P=0.0001). A cutoff value of 70ms for QTc-D had a sensitivity and specificity of 77% in identifying patients at risk for SCD. A cutoff value of 100ms for JTc-D had a sensitivity of 65% and a specificity of 94% in identifying this category of patients. CONCLUSION: ß-TM is associated with significant changes in heterogeneity of ventricular repolarization. QTc and JTc dispersion are useful markers of risk of SCD in patients with ß-TM.

Molecular determinants of ammonia and urea conductance in plant aquaporin homologs.

Aquaporins and/or aquaglyceroporins regulate the permeability of plant membranes to water and small, uncharged molecules. Using molecular simulations with a plant plasma membrane aquaporin tetramer, the residues in the channel constriction region were identified as the crucial determinants of ammonia and urea conductance. The impact of these residues was experimentally verified using AtPIP2;1 pore mutants. Several, but not all, mutants with a NIP-like selectivity filter promoted yeast growth on urea or ammonia as sole sources of nitrogen. TIP-like mutants conducted urea but not NH(3), and a residue without direct contact to the pore lumen was critical for conduction in the mutants.

Regulation of NH4+ transport by essential cross talk between AMT monomers through the carboxyl tails.

Ammonium transport across plant plasma membranes is facilitated by AMT/Rh-type ammonium transporters (AMTs), which also have homologs in most organisms. In the roots of the plant Arabidopsis (Arabidopsis thaliana), AMTs have been identified that function directly in the high-affinity NH4+ acquisition from soil. Here, we show that AtAMT1;2 has a distinct role, as it is located in the plasma membrane of the root endodermis. AtAMT1;2 functions as a comparatively low-affinity NH4+ transporter. Mutations at the highly conserved carboxyl terminus (C terminus) of AMTs, including one that mimics phosphorylation at a putative phosphorylation site, impair NH4+ transport activity. Coexpressing these mutants along with wild-type AtAMT1;2 substantially reduced the activity of the wild-type transporter. A molecular model of AtAMT1;2 provides a plausible explanation for the dominant inhibition, as the C terminus of one monomer directly contacts the neighboring subunit. It is suggested that part of the cytoplasmic C terminus of a single monomer can gate the AMT trimer. This regulatory mechanism for rapid and efficient inactivation of NH4+ transporters may apply to several AMT members to prevent excess influx of cytotoxic ammonium.

Different transport mechanisms in plant and human AMT/Rh-type ammonium transporters.

The conserved family of AMT/Rh proteins facilitates ammonium transport across animal, plant, and microbial membranes. A bacterial homologue, AmtB, forms a channel-like structure and appears to function as an NH3 gas channel. To evaluate the function of eukaryotic homologues, the human RhCG glycoprotein and the tomato plant ammonium transporter LeAMT1;2 were expressed and compared in Xenopus oocytes and yeast. RhCG mediated the electroneutral transport of methylammonium (MeA), which saturated with Km = 3.8 mM at pHo 7.5. Uptake was strongly favored by increasing the pHo and was inhibited by ammonium. Ammonium induced rapid cytosolic alkalinization in RhCG-expressing oocytes. Additionally, RhCG expression was associated with an alkali-cation conductance, which was not significantly permeable to NH4+ and was apparently uncoupled from the ammonium transport. In contrast, expression of the homologous LeAMT1;2 induced pHo-independent MeA+ uptake and specific NH4+ and MeA+ currents that were distinct from endogenous currents. The different mechanisms of transport, including the RhCG-associated alkali-cation conductance, were verified by heterologous expression in appropriate yeast strains. Thus, homologous AMT/Rh-type proteins function in a distinct manner; while LeAMT1;2 carries specifically NH4+, or cotransports NH3/H+, RhCG mediates electroneutral NH3 transport.

Ammonium ion transport by the AMT/Rh homologue LeAMT1;1.

AMT (ammonium transporter)/Rh (Rhesus) ammonium transporters/channels are identified in all domains of life and fulfil contrasting functions related either to ammonium acquisition or excretion. Based on functional and crystallographic high-resolution structural data, it was recently proposed that the bacterial AmtB (ammonium transporter B) is a gas channel for NH3 [Khademi, O'Connell, III, Remis, Robles-Colmenares, Miercke and Stroud (2004) Science 305, 1587-1594; Zheng, Kostrewa, Berneche, Winkler and Li (2004) Proc. Natl. Acad. Sci. U.S.A. 101, 17090-17095]. Key residues, proposed to be crucial for NH3 conduction, and the hydrophobic, but obstructed, pore were conserved in a homology model of LeAMT1;1 from tomato. Transport by LeAMT1;1 was affected by mutations of residues that were predicted to constitute the aromatic recruitment site for NH4+ at the external pore entrance. Despite the structural similarities, LeAMT1;1 was shown to transport only the ion; each transported 14C-methylammonium molecule carried a single positive elementary charge. Similarly, NH4+ (or H+/NH3) was transported, but NH3 conduction was excluded. It is concluded that related proteins and a similar molecular architecture can apparently support contrasting transport mechanisms.

Preclinical changes in the mechanical properties of abdominal aorta in obese children.

Obesity in childhood has been associated with the development of early cardiovascular abnormalities. The aim of the present study was to investigate whether preclinical functional changes are detectable in the abdominal aorta of obese children. One hundred consecutively seen obese children and 50 healthy controls were studied. The groups were matched in terms of age and gender. The pulsatile wall-motion of the abdominal aorta was determined using a B-mode ultrasound technique. The following mechanical property parameters were measured or computed: lumen diastolic and systolic diameters, relative aortic strain, elastic modulus, and stiffness. Compared to controls, obese children had higher blood pressure values and higher concentrations of total cholesterol, triglycerides, insulin, and C-reactive protein. Homeostasis model assessment (HOMA) score, a parameter of insulin resistance, was significantly higher in obese children than in controls (3.2 +/- 1.9 v 1.4 +/- 0.5, P <.001). Aortic mechanical parameters were significantly different in obese children as compared to controls: stiffness was higher (3.00 +/- 1.45 v 2.22 +/- 0.87, P <.001) as was elastic modulus (0.38 +/- 0.18 v 0.24 +/- 0.10 N/m(2), P <.001). Obese girls with insulin resistance (ie, in the highest tertile of HOMA, >3.7) had increased aortic stiffness (3.79 +/- 2.25) compared to obese girls in the lowest tertiles of HOMA (2.67 +/- 1.09, P =.045), even after adjustment for traditional cardiovascular risk factors (P =.031). The present findings suggest that preclinical changes in the aortic elastic properties are detectable in obese children. Insulin resistance seems to play an important role in the increased rigidity of the aortic wall in obese girls.

Utilizaçäo de bactérias e fungos como indicadores na avaliaçäo de fatores fisiográficos que interferem nos processos de auto-depuraçäo de um córrego sub-tropical / Utilization of bacteria and fungi as indicators in the evaluation of physiographyc factors that interfere in the self-depuration process in a subtropical stream

O estudo de autodepuraçäo de um córrego sub-tropical, córrego do Agriäo, afluente do Rio Jacaré-Pepira, S. P., que recebe afluentes de resíduos domésticos e pecuários foi efetuado utilizando-se indicadores biológicos: coliformes totais (CT) e fecais (CF), estreptococos fecais (EF), fungos aquáticos e geofungos. O período de estudo abrangeu duas estiagens e um período de chuvas. Foi observada a influência das condiçöes fisiográficas na auto-depuraçäo do curso d'água. A relaçäo CF/EF possibilitou a caracterizaçäo da origem dos despejos e constatou-se que o número de leveduras, (U.F.C./ml), foi bom indicador de poluiçäo de origem fecal, o que näo ocorreu com bolores aquáticos e terrestres

Programa de atencion en un Centro periferico de la ciudad de Resistencia

Del analisis de situacion de la Provincia y de un area programatica de un Centro de Salud de Resistencia, se propone un programa de atencion con los elementos con que se cuenta en este momento para reducir niveles de desnutricion, mejorar controles de menores de una año y de embarazadas adolescentes, buena cobertura de vacunas e incentivar la participacion comunitaria , todo a travez de la APS

Guardia externa del Hospital Pediatrico "Dr. Avelino L. Castelan": analisis y propuestas

Diagnostico de situacion del Hospital Pediatrico Castelan de Resistencia, particularmente de la guardia externa y propuesta de reestructuracion de la misma

Programa de atencion en un Centro periferico de la ciudad de Resistencia

Del analisis de situacion de la Provincia y de un area programatica de un Centro de Salud de Resistencia, se propone un programa de atencion con los elementos con que se cuenta en este momento para reducir niveles de desnutricion, mejorar controles de menores de una año y de embarazadas adolescentes, buena cobertura de vacunas e incentivar la participacion comunitaria , todo a travez de la APS

Guardia externa del Hospital Pediatrico "Dr. Avelino L. Castelan": analisis y propuestas

Diagnostico de situacion del Hospital Pediatrico Castelan de Resistencia, particularmente de la guardia externa y propuesta de reestructuracion de la misma