Impacto de la pizarra luminosa en estudiantes de contaduría pública de estadística inferencial y fundamentos de matemáticas.

Diagnosticar el uso de la pizarra luminosa en cursos cuantitativos.El uso de recursos que inviten al estudiante a estar más comprometido con su proceso educativo puede incrementar su desempeño. El objetivo del estudio es encontrar el nivel de apreciación percibido en el uso de la pizarra luminosa en dos cursos cuantitativos y establecer las diferencias entre el sexo y la situación laboral de los estudiantes participantes. Se utilizó como instrumento una encuesta que diligenciaron los 97 participantes. Se encontró que el 82% de los estudiantes preferían los videos elaborados por el mismo profesor que orientaba la asignatura, el 82% prefirió verle la cara al profesor mientras escribe en el tablero. En las 3 dimensiones, comprensión, compromiso y satisfacción, se obtuvo 97%, 94% y 95% respectivamente en la categoría “Totalmente de acuerdo”. La apreciación total en relación con el sexo no presentó diferencias significativas, al igual que con la situación laboral

El borde urbano como territorio complejo: reflexiones para su ocupación

288 p.El borde urbano, como territorio complejo, es un espacio de reflexión multidisciplinar, multiescalar y multiactoral, que ofrece una discusión en torno a los asentamientos humanos sobre las periferias y, a la vez, se constituye en un espacio de actuación para el mejoramiento de la calidad de vida de los habitantes. La primera parte de este libro presenta distintas reflexiones desde la complejidad sobre el concepto de borde como espacio geográfico y nos lleva a considerar el desarrollo sustentable como “deber ser” para alcanzar el equilibrio, entendiendo la capacidad de carga como atributo para el desarrollo y la compacidad urbana como parte de la estrategia eficiente para la construcción social del hábitat de borde. La visión multidisciplinar entiende al sujeto y su comunidad como autores de su territorio y desde la dimensión social fundamenta el principio de empoderamiento para el trabajo participativo y la acción de investigación. Se destaca en la segunda parte una serie de estrategias que resultan de la construcción de indicadores e instrumentos capaces de ocupar el territorio de manera sustentable, que concluye con un marco de ejemplos realizados por los autores en territorios de borde y que, como impacto, reconstruyen la habitabilidad desde intervenciones simples y que se convierten en escenarios que resuelven la complejidad de los territorios de borde bajo realidades tangibles.The urban border, as a complex territory, is a multidisciplinary, multiscale reflection space that involves several participants and offers a discussion around human settlements on the peripheries and, at the same time, constitutes an action space for the improvement of the quality of life of the inhabitants. The first part of this book presents different reflections from the complexity of the concept of boundary as a geographical space and leads us to consider sustainable development as an “ought to be” to reach the right balance, understanding the carrying capacity as an attribute for development and urban compactness as part of the efficient strategy for the social construction of the border habitat. The multidisciplinary vision conceives the subject and their community as authors of their territory and from the social dimension it bases the principle of empowerment for participatory work and research action. The second part highlights a series of strategies that result from the construction of indicators and instruments capable of occupying the territory in a sustainable manner and concludes with a framework of examples carried out by the authors in border territories that, as an impact, reconstruct habitability from simple interventions, becoming scenarios which solve the complexity of border territories under tangible realitiesCAPÍTULO 1 Concepto de borde, límite y frontera desde el espacio geográfico .31 Introducción....32 El territorio: lo social, lo geográfico y lo económico....34 El borde urbano, el límite y la frontera: espacios de interacción sociocultural... 36 Las cualidades del borde, el límite y la frontera vistas desde el paisaje y el territorio... 46 Conclusiones... 52 Referencias. 54 CAPÍTULO 2 El desarrollo sustentable como “deber ser” de la intervención en el borde urbano .. 57 Introducción.. 58 El enfoque latinoamericano del desarrollo sostenible orientado a la intervención en el borde urbano.......... 59 Dimensión territorial, urbana, espacial y económica del desarrollo sustentable. 64 Referentes de evaluación de la sustentabilidad… 67 Conclusiones 83 Referencias... 84 CAPÍTULO 3 Capacidad de carga, concepto para la equidad de un escenario sostenible..... 87 Introducción…88 Aproximación inicial al concepto de capacidad de carga. ... 89 Definiendo la capacidad de carga... 92 Dimensiones del desarrollo sustentable con enfoques a la capacidad de carga...98 La capacidad de carga y la economía azul como dinámicas complementarias para definir indicadores conceptuales de análisis y desarrollo para el borde urbano... 101 La capacidad de carga en los procesos del diseño sustentable...106 La permacultura y la huella ecológica, indicadores para el desarrollo sustentable…106 Conclusiones... 113 Referencias...114 CAPÍTULO 4 Compacidad urbana en el contexto de borde urbano...117 Introducción..... 118 Modelos de ciudad…119 Compacidad urbana... 125 La compacidad en el borde urbano...130 Evaluación de la compacidad en el borde urbano… 133 Conclusiones... 137 Referencias....138 CAPÍTULO 5 Estrategias metodológicas para el fortalecimiento de la dimensión social en la perspectiva de desarrollo sustentable en zonas periurbanas....... 141 Introducción..... 142 Una aproximación a la definición de borde urbano desde la perspectiva social... 143 Estrategias metodológicas para la evaluación y el fortalecimiento de la dimensión social en zonas periurbanas... 146 Propuesta de trabajo con comunidades de zonas periurbanas... 158 Conclusiones... 169 Referencias...... 171 CAPÍTULO 6 Perspectiva multidimensional del desarrollo sustentable para el borde urbano...175 Introducción...176 Referentes para la construcción de un modelo integral de desarrollo sustentable en la consolidación del borde urbano....177 Propuesta de principios, propósitos y criterios de desarrollo sustentable para la consolidación del borde urbano...183 Conclusiones: Relaciones entre territorio y sociedad para la sustentabilidad del borde urbano... 196 Referencias...198 CAPÍTULO 7 Indicadores de compacidad urbana. Instrumento para el borde urbano. 201 Introducción..... 202 Revisión documental de indicadores...203 Indicadores de compacidad...209 Factores.......... 213 Indicadores...... 215 Definición de indicadores.... 222 Conclusiones... 224 Referencias.....225 CAPÍTULO 8 Indicadores aplicados a la capacidad de carga. Instrumento para equilibrar el desarrollo del borde urbano.... 227 Introducción..... 228 Definición teórica de los indicadores para la construcción de la capacidad de carga. 229 Indicadores de capacidad de carga para los bordes urbanos.... 230 Factores para determinar la capacidad de carga y la economía azul para los bordes urbanos... 231 Indicadores de capacidad de carga para los bordes urbanos... 234 Análisis de indicadores articulados con factores de capacidad de carga... 242 Cuadros de síntesis de indicadores y definiciones para el borde urbano.. 246 Referencias...... 253 CAPÍTULO 9 Experiencias y aproximaciones de diseño centrado en la persona con implicaciones territoriales a pequeña escala... 255 Introducción...256 Estado actual de la academia y su responsabilidad en la construcción de la ciudad.. 258 Metodologías participativas, iniciativas público-privadas e institucionales...... 261 Conclusiones... 281 Referencias...... 282 Conclusiones... 283 Glosario... 2861a ed

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

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

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

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

Genetic diversification of Panstrongylus geniculatus (Reduviidae: Triatominae) in northern South America

"Triatomines are the vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Although Triatoma and Rhodnius are the most-studied vector genera, other triatomines, such as Panstrongylus, also transmit T. cruzi, creating new epidemiological scenarios. Panstrongylus has at least 13 reported species but there is limited information about its intraspecific genetic variation and patterns of diversification. Here, we begin to fill this gap by studying populations of P. geniculatus from Colombia and Venezuela and including other epidemiologically important species from the region. We examined the pattern of diversification of P. geniculatus in Colombia using mitochondrial and nuclear ribosomal data. Genetic diversity and differentiation were calculated within and among populations of P. geniculatus. Moreover, we constructed maximum likelihood and Bayesian inference phylogenies and haplotype networks using P. geniculatus and other species from the genus (P. megistus, P. lignarius, P. lutzi, P. tupynambai, P. chinai, P. rufotuberculatus and P. howardi). Using a coalescence framework, we also dated the P. geniculatus lineages. The total evidence tree showed that P. geniculatus is a monophyletic species, with four clades that are concordant with its geographic distribution and are partly explained by the Andes orogeny. However, other factors, including anthropogenic and eco-epidemiological effects must be investigated to explain the existence of recent geographic P. geniculatus lineages. The epidemiological dynamics in structured vector populations, such as those found here, warrant further investigation. Extending our knowledge of P. geniculatus is necessary for the accurate development of effective strategies for the control of Chagas disease vectors. © 2019 Caicedo-Garzón et al.