Centralized injustices: understanding energy resilience in times of disruption in low-income settlements in Peru

What happens once people have electricity has received far less analytical and policy attention than the provision of the infrastructure itself. For low-income settlements that have gained a connection to the grid, energy access challenges can still prevail, keeping many inhabitants in energy poverty. This paper analyses energy practices in three low-income neighbourhoods in Lima, Peru, with particular attention to inhabitants’ responses in the face of the COVID-19 pandemic. In doing so, it seeks to draw lessons for energy policy and planning to enhance energy resilience in the transition towards more just and sustainable futures. Building on energy resilience scholarship and drawing links with justice debates, this paper discusses three community coping strategies: (1) fuel stacking; (2) collective practices and the shared economy; and (3) material and spatial changes. It analyses how these strategies relate to dominant policy directions, as well as their implications for energy resilience and justice more broadly

Sistema de gestión de venta y control de inventario

El propósito de este proyecto consiste en el desarrollo y accionamiento de un moderno sistema de información para una PYME, el cual facilitara la gestión de las ventas, de igual forma ayudara a realizar una mejor gestión sobre los recursos de la empresa. Según el alcance de la solución de este proyecto se realizó una cantidad específica de procesos, es por eso que el método que se empleó para el desarrollo y diseño del sistema, fue la metodología RUP. Como consecuencia, se logró llevar a cabo un sistema informático el cual realiza los procesos de manera automática, asimismo generar y mostrar información para poder elaborar de mejor forma las estrategias a utilizar por parte de la organización. La investigación permite concluir con el monitoreo continuo del cronograma del proyecto. Además, la solución automatizada brinda acceso a la información y realizar los procesos de una manera más efectiva y dinámica, lo cual permite tomar decisiones de manera segura y rápida, elevando la calidad de nuestros productos y servicios. Por último, se concluyeron con éxito todas las etapas de desarrollo del software.The purpose of this project is the development and operation of a modern information system for an SME, which will facilitate the management of sales, in the same way will help to make a better management of the company's resources. Depending on the scope of the solution of this project, a specific number of processes were carried out, which is why the method used for the development and design of the system was the RUP methodology. As a result, it was possible to carry out a computer system which performs the processes automatically, also to generate and display information in order to better develop the strategies to be used by the organization. The investigation allows concluding with the continuous monitoring of the project schedule. In addition, the automated solution provides access to information and perform processes in a more effective and dynamic way, which allows decisions to be made safely and quickly, raising the quality of our products and services. Finally, all stages of software development were successfully completed

Evaluación de indicadores de bienestar animal de bovinos en un rastro Tipo Inspección Federal

The slaughter process is the last stage of management and represents a point at which the welfare of the cattle is compromised. The objective of this study was to evaluate the animal welfare indicators of cattle in a Federal Inspection Type slaughterhouse. The slaughter process of 1,167 animals [740 males (63.8 %) and 420 females (36.2 %)] was observed in a Federal Inspection Type slaughter plant in northwestern Mexico. Management and behavioral variables, as well as indicators of return to sensitivity were recorded, and the bruises observed on the carcasses were characterized. 10 % of the cattle received electric shocks with prods, while 24.2 % were beaten by operators. Arching of the spine was observed (44.5 %), 62.2 % of the animals exhibited sensitivity during exsanguination. The prevalence of bruising was 88.8 %. Females had 1.62 % higher risk of bruising than males and the presence of large horns increased the risk of bruising by 1.46 %. The characteristics of the bruises observed were bright red (93.8 %), mottled (71.5 %), small (82.9 %), and grade 1 (95.7 %). The area most affected by bruises was the dorsal-lumbar area, with 58.3 %. It was concluded that the animals included in this study were exposed to conditions conducive to stress, including the use of the electric prod by the operators, undesirable behaviors of cattle during herding, ineffective stunning, and the presence of bruises on the carcasses.El proceso de sacrificio es la última etapa de manejo y representa un punto en el que se compromete el bienestar de los bovinos. El objetivo del presente trabajo fue evaluar los indicadores de bienestar animal de bovinos en un rastro Tipo Inspección Federal. Se observó el proceso de sacrificio de 1,167 animales [740 machos (63.8 %) y 420 hembras (36.2 %)] en una planta de sacrificio Tipo Inspección Federal en el noroeste de México. Se registraron variables de manejo y comportamiento, así como indicadores de retorno a la sensibilidad y se caracterizaron los hematomas observados en las canales. El 10 % del ganado recibió descargas eléctricas con picanas, el 24.3 % fue golpeado por los operarios. Se observó arqueamiento de la columna vertebral (44.5 %), el 62.2 % de los animales mostró sensibilidad durante el sangrado. La prevalencia de hematomas fue del 88.8 %. Las hembras tuvieron 1.62 mayor riesgo de sufrir hematomas que los machos y la presencia de cuernos grandes incrementó el riesgo de presentar hematomas 1.46. Las características de los hematomas observados fueron rojo brillante (93.8 %), moteado (71.5 %), pequeño (82.9 %) y grado 1 (95.7 %). La zona más afectada por hematomas fue la dorso-lumbar con un 58.3 %. Se concluyó que los animales incluidos en el presente estudio estuvieron expuestos a condiciones que propician el estrés, entre estos, el uso de la picana eléctrica por los operarios, las conductas indeseables de los bovinos durante el arreo, el aturdimiento ineficaz y la presencia de hematomas en las canales

Efectos de la resiliencia y la espiritualidad en la calidad de vida y salud emocional de la juventud durante la pandemia del Covid-19 en el Norte de México

The effects of the Covid-19 pandemic on humans are a cause for concern worldwide. Young people were crucial during the pandemic process and the effects on their lives were seen in their quality of life and emotional health. We seek to know if resilience and spirituality were key to overcoming the conditions and results of Covid-19. The study population was university students aged 18 to 25 years, a population of 33,999 university students were taken with a sample of 372 and a confidence level of 95% and 5% error. The data were obtained using a measurement instrument that integrates eight factors with 80 items, which were identified as daily life during the pandemic; quality of life; resilience; spirituality; DASS health. The validation of the instrument gave a Cronbach's alpha of 0.87. The results reveal the levels of affectation in the quality of life and emotional health of young university students, where resilience in adapting to change was key to facing the conditions experienced during the pandemic. It is concluded that young people in contingency conditions find changes that allow them to generate alternatives to face problems of all kinds.Las afectaciones de la pandemia del Covid-19 en los seres humanos son un motivo de preocupación a nivel mundial. Los jóvenes fueron clave durante el proceso de la pandemia y los efectos en su vida se vieron en la calidad de vida y la salud emocional. Se busca conocer si la resiliencia y la espiritualidad fueron claves para superar las condiciones y resultantes del Covid-19. La población de estudio fueron los jóvenes universitarios de 18 a 25 años, se tomó una población de 33,999 estudiantes universitarios con una muestra de 372 y el nivel de confianza del 95% y 5% error. Los datos se obtuvieron utilizando un instrumento de medición que integran ocho factores con 80 ítems, de los cuales se identificaron como: cotidianidad durante la pandemia; calidad de vida; resiliencia; espiritualidad; salud DASS. La validación del instrumento dio un alfa de Cronbach del 0.87. Los resultados revelan los niveles de afectaciones en la calidad de vida y la salud emocional de los jóvenes universitarios, en donde, la resiliencia en la adaptación al cambio fueron claves para afrontar las condiciones que se vivieron durante la pandemia. Se concluye que los jóvenes en las condiciones de contingencia encuentran cambios que les permite generar alternativas para afrontar problemas de todo tipo

Staging Parkinson's Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life.

Introduction: In a degenerative disorder such as Parkinson's disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr's motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient's quality of life (QoL) with regard to a defined clinical stage. Materials and methods: Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0-20; B: NMSS = 21-40; C: NMSS = 41-70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale. Results: A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (p < 0.0001). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (p < 0.005; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; p < 0.0001). Conclusion: The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the HΨ Patients with a lower H&Y stage may be more affected if they have a greater NMS burden

Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

COPPADIS Study Group.[Background and objective] The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD).[Patients and Methods] PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%.[Results] In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2.[Conclusions] In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.Fundación Curemos el Parkinson (www.curemoselparkinson.org).Peer reviewe

Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson’s Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up

COPPADIS Study Group.[Background and Objective] Non-motor symptoms (NMS) progress in different ways between Parkinson’s disease (PD) patients. The aim of the present study was to (1) analyze the change in global NMS burden in a PD cohort after a 2-year follow-up, (2) to compare the changes with a control group, and (3) to identify predictors of global NMS burden progression in the PD group.[Material and Methods] PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017, were followed-up with after 2 years. The Non-Motor Symptoms Scale (NMSS) was administered at baseline (V0) and at 24 months ± 1 month (V2). Linear regression models were used for determining predictive factors of global NMS burden progression (NMSS total score change from V0 to V2 as dependent variable).[Results] After the 2-year follow-up, the mean NMS burden (NMSS total score) significantly increased in PD patients by 18.8% (from 45.08 ± 37.62 to 53.55 ± 42.28; p < 0.0001; N = 501; 60.2% males, mean age 62.59 ± 8.91) compared to no change observed in controls (from 14.74 ± 18.72 to 14.65 ± 21.82; p = 0.428; N = 122; 49.5% males, mean age 60.99 ± 8.32) (p < 0.0001). NMSS total score at baseline (β = −0.52), change from V0 to V2 in PDSS (Parkinson’s Disease Sleep Scale) (β = −0.34), and change from V0 to V2 in NPI (Neuropsychiatric Inventory) (β = 0.25) provided the highest contributions to the model (adjusted R-squared 0.41; Durbin-Watson test = 1.865).[Conclusions] Global NMS burden demonstrates short-term progression in PD patients but not in controls and identifies worsening sleep problems and neuropsychiatric symptoms as significant independent predictors of this NMS progression.This research was funded by Fundación Española de Ayuda a la Investigación en Parkinson y otras Enfermedades Neuro-degenerativas (Curemos el Parkinson; www.curemoselparkinson.org).Peer reviewe

Staging Parkinson’s Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life

COPPADIS Study Group.[Introduction] In a degenerative disorder such as Parkinson’s disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr’s motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient’s quality of life (QoL) with regard to a defined clinical stage.[Materials and Methods] Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0–20; B: NMSS = 21–40; C: NMSS = 41–70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale.[Results] A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; ).[Conclusion] The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden.Peer reviewe

Predictors of clinically significant quality of life impairment in Parkinson’s disease

COPPADIS Study Group.Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R 2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.Mir P. has received honoraria from AbbVie, Abbott, Allergan, Bial, Merz, UCB and Zambon and have received grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575] co-founded by ISCIII (Subdirección General de Evaluación y Fomento de la Investigación) and by Fondo Europeo de Desarrollo Regional (FEDER), the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0437-2012, PI-0471-2013], the Sociedad Andaluza de Neurología, the Jacques and Gloria Gossweiler Foundation, the Fundación Alicia Koplowitz, the Fundación Mutua Madrileña.Peer reviewe

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed