Sociedades justas: Una nueva visión para la equidad en la salud en la Región de las Américas después de la COVID19

Objective. Determine patterns of tuberculosis (TB) incidence indicators and number of deaths from TB within the framework of target 3.3 of the Sustainable Development Goals (SDGs) and their correlation with social determinants. Methods. Ecological study methodology was used, in which the population is the unit of analysis. Social determinants were analyzed using a negative binomial regression model and strength of association. Results. In the Americas, there was an average annual reduction in the TB incidence rate of 0.3% from 2009 to 2018; however, from 2015 to 2018, the rate increased, from 27.6 to 28.8 per 100,000 population. With regard to social determinants, the groups of countries with the lowest human development index (HDI) and gross domestic product (GDP) have a higher incidence of TB. TB risk in the country with the lowest HDI is six times that of the country with the highest HDI. Conclusions. At the current rate of reduction in the incidence rate and number of deaths from TB, the Region of the Americas will not meet the targets in the SDGs and in the End TB Strategy. Rapid implementation and expansion of interventions for TB prevention and control are required to attain the targets. This involves, among other actions, reducing access barriers to diagnosis and treatment and strengthening initiatives to address social determinants

Life expectancy and mortality in 363 cities of Latin America

The significant challenges to equity in health in the Region of the Americas, as detailed in the report of the Pan American Health Organization Independent Commission on Equity and Health Inequalities in the Americas, gave original impetus to this Special Issue on Equity in Health by the Pan American Journal of Public Health. The report, Just Societies: Health Equity and Dignified Lives, analyzed a vast body of evidence that indicated the overwhelming inequalities in the Region that relate to three factors: structural drivers, conditions of daily life, and governance for health equity (taking action). Highlighting the continued realities of the interrelationship between social and health inequities in the Americas is by no means new. However, since early 2020 this interrelationship has been further exposed and exacerbated by the unprecedented COVID-19 pandemic, which is testing governments, communities, economies, and individuals in ways previously unimagined in their scope and intensity. The crisis is exposing underlying inequalities in health and the cost of inaction to address this long-standing social injustice, and the COVID-19 response is even reversing improvements in social and health indicators made in the last two decades

Self-assembled InAs quantum dots formed by molecular beam epitaxy at low temperature and postgrowth annealing

Self-assembled InAs quantum dots are grown at low temperature (LT) by molecular beam epitaxy (MBE) on GaAs substrates. The growth is in situ monitored by reflection high-energy electron diffraction, and ex situ evaluated by atomic force microscopy for the morphological properties, and by high-resolution x-ray diffraction for the structural properties. While two monolayers as-grown LT (250 degrees C) InAs layers exhibit shallow mounds due to the low adatom migration length at low temperature, well-developed InAs dots are formed after postgrowth annealing above 450 degrees C. The structural quality of the LT GaAs matrix grown on top and of the embedded InAs dot layer is improved when a 3 nm GaAs interlayer is deposited (at 480 degrees C) on the InAs dots and subsequently annealed at 580 degrees C before LT GaAs overgrowth. These high structural quality LT-grown InAs dots are considered for applications in high-speed optical modulators and switches operating at low power by combining the high optical nonlinearity of quantum dots with the ultrafast optical response provided by LT growth in MB

Cytokine Release in HR-HPV(+) Women without and with Cervical Dysplasia (CIN II and III) or Carcinoma, Compared with HR-HPV(−) Controls

Aims. We investigated the effect of HR-HPV infection on the capacity of the cytokine network in whole blood cultures during carcinogenesis of cervical carcinoma. Methods. Thirty-nine women with moderate dysplasia, severe dysplasia, cervical carcinoma, or without dysplasia formed the study group. The control group consisted of 10 HR-HPV-negative women without CIN. Whole blood cultures were stimulated with phytohemagglutinin (PHA) and concentrations of tumour necrosis factor α (TNFα), interferon γ (IFNγ), interleukin 2 (IL-2), interleukin 12 (IL-12), interleukin 4 (IL-4), and interleukin 10 (IL-10) were determined by ELISAs. Results. A significant increase in cytokine release was detected in HR-HPV-positive women without dysplasia. In women with cervical cancer, release of IFNγ and IL-12 was of the same magnitude as in HR-HPV-positive women without clinical manifestations. Most Th1-type/Th2-type ratios decreased form CIN II to CIN III, and increased from CIN III to invasive carcinoma. Conclusions. (1) Infection with HR-HPV without expression of cervical dysplasia induces activation of the cytokine network. (2) Increases in ratios of Th1-type to Th2-type cytokines at the stage of cervical carcinoma were found by comparison with stage CIN III. (3) Significant changes in the kinetics of cytokine release to a Th2-type immune response in blood of women with cervical dysplasia occurred progressively from CIN II to CIN III

Управление финансовой устойчивостью и рентабельностью предприятия

Целью статьи является изучение значения управления финансовой устойчивостью и рентабельностью предприятия в современных условиях хозяйствования

The relation between clinically diagnosed and parent-reported feeding difficulties in children with and without clefts

A cleft lip and/or palate (CL/P) is one of the most common craniofacial malformations, occurring worldwide in about one in 600-1000 newborn infants. CL/P is known to influence the feeding process negatively, causing feeding difficulties in 25-73% of all children with CL/P. Because there is a risk for serious complications in these children regarding feeding difficulties, there is often a need for intensive medical counseling and treatment. At this moment, adequate diagnosis and measurement remain a challenge and often lead to a delayed referral for professional help. Since parents play a big part in reporting feeding difficulties, it is important to help objectify parents' experiences, as well as the use of a frontline screening instrument for routine check-ups during medical appointments. The aim of this study is to investigate the relationship between parent perspective and standardized observation by medical professionals on feeding difficulties in 60 children with and without clefts at the age of 17 months. We focus on the information from parents and health professionals by comparing the Observation List Spoon Feeding and the Schedule for Oral Motor Assessment with the validated Dutch translation of the Montreal Children's Hospital Feeding Scale. Conclusion: There is a need for timely and adequate diagnosis and referral when it comes to feeding difficulties in children with CL/P. This study underscores the importance of combining both parental observations and measurements of oral motor skills by healthcare professionals to enable this. What is Known: • Early identification of feeding difficulties can prevent adversely affected growth and development. • Clefts increase the probability of feeding difficulties; however, the diagnostic trajectory is unclear. • The Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) are validated to measure oral motor skills. The Montreal Children's Hospital Feeding Scale Dutch version (MCH-FSD) has been validated for the parental perception of infant feeding difficulties. What is New: • Parents of children with CL/P experience relatively few feeding problems in their child on average. • Oral motor skills for spoon feeding are associated with oral motor skills for solid foods in children with CL/P. • The extent of the cleft is associated with experiencing more feeding difficulties in children with CL/P.</p