Remaining missed opportunities of child survival in Peru:Modelling mortality impact of universal and equitable coverage of proven interventions

Abstract Background Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. Methods We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban–rural residence. Results Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Conclusions Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030

Memory for Object Location in Augmented Reality: The Role of Gender and the Relationship Among Spatial and Anxiety Outcomes

The potential of augmented reality (AR) technology for the study of spatial memory and orientation is a new research field. AR defines systems that attempt to enhance the user's experience with the physical world. In our app, we enhance the sense of sight by adding interactive 3D elements to the real environment. Our app can be used in any real environment so that the experimental conditions during the tasks and the way in which an individual navigates are similar to those used in real life. With AR, the experimenter has a high level of control of the task and can store the participant's responses accurately. The classical factors that influence an individual's performance on virtual spatial tasks are gender and cognitive factors. The influence of emotional factors on spatial performance has been studied more recently. Since AR tasks for the study of spatial memory and spatial orientation are new developments, little is known about the factors that are related to performance on tasks of this type. In our study, we tested 46 young adults (26 women) in an AR object-location task that was performed in a building. The participants had to memorize the position of eight virtual objects while they were walking through the environment. We also assessed the participants' performance on an object-recall task, a map-pointing task, and a paper-and-pencil spatial orientation task. The self-reported importance of different spatial strategies for wayfinding and the levels of trait anxiety and wayfinding anxiety were also evaluated. Our findings indicate that men performed better on the spatial paper-and-pencil test and spent more time completing the learning phase of the AR task. The spatial memory for the location of the objects in AR and on the map correlated positively. Anxiety was related to individual differences in the self-reported use of a spatial orientation strategy, but the association among them was weak. Trait anxiety was positively related to the time employed by the participants during the learning phase of the AR task, whereas wayfinding anxiety correlated negatively with the preference for an orientation strategy. Our results highlight the importance of anxiety in spatial orientation

On The Low Frequency Quasi Periodic Oscillations of X-ray Sources

Based on the interpretation of the twin kilohertz Quasi Periodic Oscillations (kHz QPOs) of X-ray spectra of Low Mass X-Ray Binaries (LMXBs) to the Keplerian and the periastron precession frequencies at the magnetosphere-disk of X-ray neutron star (NS) respectively, we ascribe the low frequency Quasi Periodic Oscillations (LFQPO) and HBO (15-60 Hz QPO for Z sources or Atoll sources) to the periastron precession at some outer disk radius. The obtained conclusions include: all QPO frequencies increase with increasing the accretion rate. The obtained theoretical relations between HBO (LFQPO) frequency and the kHz QPO frequency are similar to the measured empirical formula. Further, the possible dynamical mechanism for QPO production is discussed.Comment: 6 pages, 2 figures, accepted by APSS, 200

Could people with stereo-deficiencies have a rich 3D experience using HMDs?

People with stereo-deficiencies usually have problems for the perception of depth using stereo devices. This paper presents a study that involves participants who did not have stereopsis and participants who had stereopsis. The two groups of participants were exposed to a maze navigation task in a 3D environment in two conditions, using a HMD and a large stereo screen. Fifty-nine adults participated in our study. From the results, there were no statistically significant differences for the performance on the task between the participants with stereopsis and those without stereopsis. We found statistically significant differences between the two conditions in favor of the HMD for the two groups of participants. The participants who did not have stereopsis and could not perceive 3D when looking at the Lang 1 Stereotest did have the illusion of depth perception using the HMD. The study suggests that for the people who did not have stereopsis, the head tracking largely influences the 3D experience

Missed opportunities in full immunization coverage:findings from low- and lower-middle-income countries

Background: An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions. Design: Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis) vaccine below 70% were selected. We defined full immunization coverage (FIC) as having received one dose of BCG (bacille Calmette-Guérin), one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC), skilled birth attendance (SBA), postnatal care for the mother (PNC), vitamin A supplementation (VitA) for the child, and sleeping under an insecticide-treated bed-net (ITN). Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions. Results: Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp) between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute difference: 16 pp. Conclusions: Our results show the need to develop and implement strategies to vaccinate all children who contact health services in order to receive other interventions

Patterns and determinants of antenatal care utilization:analysis of national survey data in seven countdown countries

Antenatal care (ANC) is critical for improving maternal and newborn health. WHO recommends that pregnant women complete at least four ANC visits. Countdown and other global monitoring efforts track the proportions of women who receive one or more visits by a skilled provider (ANC1+) and four or more visits by any provider (ANC4+). This study investigates patterns of drop–off in use between ANC1+ and ANC4+, and explores inequalities in women’s use of ANC services. It also identifies determinants of utilization and describes countries’ ANC–related policies, and programs