Infant mortality rates and pneumococcal vaccines: a time-series trend analysis in 194 countries, 1950–2020

Pneumonia due to Streptococcus pneumoniae (pneumococcus) is a major cause of mortality in infants (children under 1 year of age), and pneumococcal conjugate vaccines (PCVs), delivered during the first year of life, are available since the year 2000. Given those two premises, the conclusion follows logically that favourable impact reported for PCVs in preventing pneumococcal disease should be reflected in the infant mortality rates (IMRs) from all causes. Using publicly available datasets, country-level IMR estimates from UNICEF and PCV introduction status from WHO, country-specific time series analysed the temporal relationship between annual IMRs and the introduction of PCVs, providing a unique context into the long-term secular trends of IMRs in countries that included and countries that did not include PCVs in their national immunisation programmes. PCV status was available for 194 countries during the period 1950–2020: 150 (77.3%) of these countries achieved nationwide PCV coverage at some point after the year 2000, 13 (6.7%) achieved only partial or temporary PCV coverage, and 31 (15.9%) never introduced PCVs to their population. One hundred and thirty-nine (92.7%) of countries that reported a decreasing (negative) trend in IMR, also reported a strong correlation with decreasing maternal mortality rates (MMRs), suggesting an improvement in overall child/ mother healthcare. Conversely, all but one of the countries that never introduced PCVs in their national immunisation programme also reported a decreasing trend in IMR that strongly correlates with MMRs. IMRs have been decreasing for decades all over the world, but this latest decrease may not be related to PCVs

Infant mortality rates and pneumococcal vaccines: a time-series trend analysis in 194 countries, 1950–2020

Pneumonia due to Streptococcus pneumoniae (pneumococcus) is a major cause of mortality in infants (children under 1 year of age), and pneumococcal conjugate vaccines (PCVs), delivered during the first year of life, are available since the year 2000. Given those two premises, the conclusion follows logically that favourable impact reported for PCVs in preventing pneumococcal disease should be reflected in the infant mortality rates (IMRs) from all causes. Using publicly available datasets, country-level IMR estimates from UNICEF and PCV introduction status from WHO, country-specific time series analysed the temporal relationship between annual IMRs and the introduction of PCVs, providing a unique context into the long-term secular trends of IMRs in countries that included and countries that did not include PCVs in their national immunisation programmes. PCV status was available for 194 countries during the period 1950–2020: 150 (77.3%) of these countries achieved nationwide PCV coverage at some point after the year 2000, 13 (6.7%) achieved only partial or temporary PCV coverage, and 31 (15.9%) never introduced PCVs to their population. One hundred and thirty-nine (92.7%) of countries that reported a decreasing (negative) trend in IMR, also reported a strong correlation with decreasing maternal mortality rates (MMRs), suggesting an improvement in overall child/ mother healthcare. Conversely, all but one of the countries that never introduced PCVs in their national immunisation programme also reported a decreasing trend in IMR that strongly correlates with MMRs. IMRs have been decreasing for decades all over the world, but this latest decrease may not be related to PCVs

Herd immunity in older adults from a middle-income country: A time-series trend analysis of community-acquired pneumonia mortality 2003–2017

Background and Aims: Community-acquired pneumonia is responsible for substantial mortality, and pneumococcus is commonly accepted as a major cause of pneumonia, regardless of laboratory confirmation. Child immunization programs have reported success in decreasing pneumonia mortality: directly in young children and indirectly (herd immunity) in unvaccinated adult populations in some countries. We assess changes in mortality trends for all-cause pneumonia in older adults associated with the introduction of pneumococcal vaccination for children in Peru. Methods: This is a secondary analysis on administrative data collected periodically by the Peruvian Ministry of Health. An observational retrospective time series analysis was conducted using longitudinal population-based data from death certificates in Peru between 2003 and 2017. The time series includes 6 years before and 9 years after the introduction of the pneumococcal-conjugated vaccines in the national child immunization program in 2009. Monthly frequencies and annual rates for all-cause pneumonia deaths in children under 5 years of age and adults over 65 years of age are presented. Linear and quadratic trends are analyzed. Results: Deaths among older adults accounted for 75.6% of all-cause pneumonia mortality in Peru, with 94.4% of these reporting “pneumonia due to unspecified organism” as the underlying cause of death. Comparing pre- and post-child immunization program periods, annual average mortality rates from unspecified pneumonia decreased by 22.7% in young children but increased by 19.6% in older adults. A linear trend model supports this overall tendency, but a quadratic curve explains the data better. Conclusion: Pneumococcal-conjugated vaccines are developed using serotypes prevalent in selected countries from less common (invasive) pneumococcal disease and expected to prevent mortality worldwide from widespread (noninvasive) pneumonia. Our results do not support the presence of herd immunity from pneumococcal vaccination of children for community-acquired pneumonia in the increasingly ageing population of Peru. This should direct future research and could influence public health policy.Revisión por pare

Uric Acid and Chronic Kidney Disease: Still More to Do

Gout and hyperuricemia are present in 25% and 60% of patients with chronic kidney disease (CKD), respectively. Despite the common association, the role of uric acid in the progression of kidney disease and in metabolic complications remains contested. Some authorities argue that the treatment of asymptomatic hyperuricemia in CKD is not indicated, and some have even suggested hyperuricemia may be beneficial. Here, we review the various arguments both for and against treatment. The weight of the evidence suggests asymptomatic hyperuricemia is likely injurious, but it may primarily relate to subgroups, those who have systemic crystal deposits, those with frequent urinary crystalluria or kidney stones, and those with high intracellular uric acid levels. We recommend carefully designed clinical trials to test if lowering uric acid in hyperuricemic subjects with cardiometabolic complications is protective

Development and validation of a scale for streaming dependence (SDS) of online games in a Peruvian population

"Background: Addiction to online video game streaming has become one of the most appealing ways to occupy leisure time and is one of the most popular activities. The satisfaction it provides and the time invested in it are two of the main reasons why it is preferred. However, despite the clear benefits that this activity offers, in some cases, excessive use can lead to personal and/or family problems or abuse. Objective: The objective of the study was to develop and validate a scale to measure potential traits of dependence on online game streaming. The participants were 423 Peruvian adults aged between 18 and 47 years (M = 22.87, SD = 5.02). The Streaming Dependence Scale (SDS) was developed based on a literature review, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Results: The scale showed adequate internal consistency (α, CR, ω, and H > 80). Confirmatory analysis confirmed the one-dimensional structure (χ2 = 10.250, df = 5; p = 0.068; CFI = 0.98, TLI = 0.96, RMSEA = 0.06, SRMR = 0.05). Conclusion: The brief SDS is a valid and reliable measure that can be used as a useful tool to identify and evaluate streaming dependence.

Análisis económico y financiero y su incidencia en la toma de decisiones en la Empresa AVICESAT Cia.Ltda. ubicada en la parroquia Cotalo cantón Pelileo Periodo 2010- 2011

En la Provincia de Tungurahua se puede encontrar la mayor producción de huevos y venta de aves especialmente en la Parroquia Cotaló donde la producción es de aproximadamente 1.000.000,00 de huevos por día por lo que se considera a esta actividad de vital importancia por la inversión que realizan para esta actividad ,así como también por las fuentes de trabajo que genera en el sector y el país , AVICESAT una de las más grandes productoras de huevos la misma que brinda cobertura a clientes del sector y fuera de él, su trabajo se basa en el beneficio de la colectividad, satisfaciendo así sus necesidades esta manejada por sus propietario, formada por un capital social, intelectual y moral de todos quienes conforman esta compañía. Capítulo I está conformado por el planteamiento del problema, que se fundamenta en la contextualización macro, meso, micro, el análisis crítico que toma referencia las causas y efectos del problema a investigar, también se determina el objetivo general y objetivos específicos de la presente investigación, finalmente se detalla la justificación de la investigación en la cual consta el motivo del por qué se desarrolla el problema de investigación. Capitulo II es el extracto de toda la indagación; ya que se refiere a antecedentes investigativos, fundamentación filosófica, fundamentación legal la misma que se apoya en leyes, reglamentos y permisos para su correcto funcionamiento como empresa, además la conceptualización sobre los vocablos básicos empleados en la investigación, por ende se da a conocer la hipótesis que se quiere comprobar con sus respectivas variables. Capitulo III contiene la metodología empleada para el desarrollo de la investigación, especificando la modalidad básica de la misma, los tipos o niveles investigativos, métodos en donde se precisan la certeza del procesamiento de datos aquí se define la población, la muestra con la que se va a trabajar, también se presenta la operacionalización de las variables y se establece las técnicas e instrumentos que se utilizaron en la recolección de la información, procesamiento y análisis de la misma. Capitulo IV consta del trabajo de investigación que propone encontrar una solución al problema planteado y a sus diferentes objetivos, para de esta manera ayudar a solucionar las debilidades detectadas en la empresa AVICESAT CIA. LTDA., en la que se presenta los estados Financieros, Análisis e interpretación de los Estados financieros políticas para el diseño en la toma de decisiones, matriz FODA creada con fines de evaluación, desarrollo prácticos de indicadores Financieros los cuales permitirán obtener hallazgos suficientes y competentes, con sus correspondientes evidencias que aportarán a las Investigadoras para la elaboración del informe final. Las mismas que contendrán como recomendaciones la aplicación de indicadores propuestos y su interpretación. Con el propósito de tener una mejor comprensión del análisis financiero y su incidencia en la correcta toma de decisiones, se describe a continuación en forma resumida el contenido del proyecto de investigación.In province of Tungurahua it can be found the largest egg production and sale of birds specially in the Cotalo Parish where the production is approximately 1.000.000,00 of eggs per day so this activity is considered relevant due to the investment that it is done for this activity, as well as jobs that generate in the that place and country .AVICESAT one of the biggest producer of eggs that offers coverage to its clients of that place and outside of is as well. Its work is based on the community profit, be satisfying its need, it is managed by its owners, it is formed by a social, intellectual and moral capital of whom make this company. Chapter I is comprised by the approach to the problem which is based on the contextualization macro, meso, micro, the critical analysis that takes as reference the causes and effects of the research problem, it was also determined the general objective and specific objectives of this current research, finally it was detailed the justification of research in which has the reason why the research problem is developed. Chapter II is the abstract of all inquiry; since it refers to researchable background, philosophical foundation, legal foundation that laws support, regulations and permits for proper operation as a company besides the conceptualization of the basic words used in research, thus the hypothesis that will be verified is disclosed. Chapter III has the used methodology for the development of the research, by specifying the basic mode of it, the researchable types or levels, methods where the completeness of the data processing are required here it is defined the population, the sample with which it will work, it is also presented the operationalization of variables and it is established the techniques and instruments that were used in the collection, processing and analysis of information of it. Chapter IV consist in the research work that propose to find a solution to the posed problem and its different objectives, in this way to help solve the identified weaknesses in the enterprise AVICESAT CIA:LTDA., in which is presented the financial statements, analysis and interpretation of financial statements policies for the design in making decisions, SWOT matrix created for evaluation practical development of financial indicators which will allow obtaining enough findings and competent , whit its corresponding evidences that will contribute to the researchers for elaborating the final report. These evidences will have recommendation the application of proposed indicators and its interpretation. It is described bellow in summary form the content of the research project in order to have a better comprehension of the financial analysis and its impact on making correct decision

Sirba 1.0 information system for ballistic recognition based on the vulger calls found in scenes of crimes

  The bullet casings found at crime scenes, are key to start investigations to clarify the facts. A weapon fring a projectile, leaving a set of marks on the cartridges, many of them in his shorts. In this paper we present an algorithm based on a 2D image taken from a bullet casings shorts, use processing techniques and image analysis to obtain some of these characteristic marks left by the weapon, then, based on a database that records the bullet casings found previously in other crime scenes and the K-nn algorithm used to relate the bullet casings with previously registered weapons or with other cartridges found in other scenes. To determine the importance of each characteristic marks, we design a genetic algorithm to further defne the optimal number of neighbors. An experiment was conducted with 15 weapons fred 10 or 30 times each obtained promising results. Las vainillas encontradas en las escenas de crímenes, son pieza clave para iniciar las investigaciones que esclarecen los hechos. Un arma al disparar un proyectil, deja un conjunto de marcas impresas en las vainillas, muchas de ellas en su culote. En éste artículo se presenta un algoritmo que partiendo de una imagen 2D, tomada del culote de una vainilla, utiliza técnicas de procesamiento y análisis de imágenes para obtener algunas de dichas marcas características que deja el arma, luego, basado en una base de datos que registra las vainillas encontradas previamente en otras escenas de crímenes y el algoritmo K-nn permite relacionar la vainilla con armas previamente registradas o con otras vainillas encontradas en otras escenas. Para determinar la importancia de cada característica, se diseño un algoritmo genético que además defne el número de vecinos óptimo. Se realizó un experimento con 15 armas disparadas 10 o 30 veces cada una, obteniendo resultados promisorios.  &nbsp

Prácticas de autocuidado de COVID-19 en unidades médicas y centros hospitalarios

Aim: Propose and reinforce self-care practices to mitigate the contagion by COVID-19 in workers of medical units and hospital centers in Mexico. Reflection: The research published on the SARS-CoV-2 virus and the disease caused called COVID-19, have put into discussion the multiple health measures that must be taken in the different socio-occupational settings to combat this health problem at a global level. This reflection is exposed with the purpose of sharing some actions that can be considered are the most conducive to take into account in medical and hospital units; Since it has been observed, it is the most conducive environment to contract the disease derived from the high concentration of sick patients with the SARS-CoV-2 virus. That is why the information provided is intended to consider some criteria that have been overlooked or do not have the importance that we really believe they should have. Results: The research published on the SARS-CoV-2 virus and the disease caused called COVID-19, have put into discussion the multiple health measures that must be taken in the different socio-occupational settings to combat this health problem at a global level. This reflection is exposed with the purpose of sharing some actions that can be considered are the most conducive to take into account in medical and hospital units; Since it has been observed, it is the most conducive environment to contract the disease derived from the high concentration of sick patients with the SARS-CoV-2 virus. That is why the information provided is intended to consider some criteria that have been overlooked or do not have the importance that we really believe they should have. Conclusions: The importance of exchanging self-care practices that are implemented in the spaces assigned for the care of patients with COVID-19 would help in the creation of standardized clinical protocols, which specify the procedures that must be followed and what actions must be prohibited with strict adherence to these guidelines to guarantee the least possible number of infections.Objetivo: Proponer y reforzar las prácticas de autocuidado para mitigar el contagio por COVID-19 en trabajadores de unidades médicas y centros hospitalarios en México. Reflexión: Las investigaciones publicadas sobre el virus SARS-CoV-2 y la enfermedad causada llamada COVID-19, han puesto en discusión las múltiples medidas sanitarias que se deben tener en los diferentes ámbitos sociolaborales para combatir este problema de salud a nivel global. Se expone esta reflexión con el propósito de compartir algunas acciones que pueden considerarse son las más propicias a tomar en cuenta en las unidades médicas y hospitalarias; ya que se ha observado, es el ambiente más propicio para contraer la enfermedad derivado a la alta concentración de pacientes enfermos con el virus SARS-CoV-2. Es por ello que la información que se proporciona tiene la intención de considerar algunos criterios que se han dejado pasar por alto o no tienen la importancia que realmente consideramos deberían tener. Resultados: Se un aproximado de 60 publicaciones científicas por vía electrónica de diferentes fuentes que cumplieran con rigor metodológico, sobre el COVID-19 y su relación en áreas médicas y centros hospitalarios. Identificar las acciones que se han implementado, que después de presentar errores y aciertos en la atención del paciente. Se observó que el personal de salud además de preocuparse por la enfermedad del COVID-19 están presentando efectos negativos en su estado físico, emocional y social, destacando como principales causas el aumento de la atención de pacientes enfermos, las horas extraordinarias de trabajo, la falta de personal médico y el aumento de enfermos en este gremio, la tensión por evitar errores de intervención, el estigma social, entre otros. Conclusiones: La importancia de intercambiar las prácticas de autocuidado que se implementan en los espacios asignados para la atención de pacientes con COVID-19 ayudaría en la creación de protocolos clínicos estandarizados, en donde se precise los procedimientos que deben seguirse y que acciones deben prohibirse con estricto apego a dichos lineamientos para garantizar el menor número posible de contagios

Desarrollo e implementación de un sistema de información estratégico basado en la metodología del balanced scorecard y proceso de planificación estratégica de la fabrica de embutidos la española

El sistema computacional desarrollado se enfoca principalmente a proporcionar información de la situación actual de la compañía, y provee al ejecutivo un acceso fácil a la información interna y externa al negocio, con la capacidad de manejar la información que proviene de los sistemas transaccionales de la empresa y/o fuentes externas de información, permitiéndoles tomar decisiones adecuadas y oportunas. Este sistema esta basado primeramente en la Planificación Estratégica, que es una técnica de gestión que ayuda a definir un proyecto de futuro y a dirigir el negocio según los planes. El plan estratégico de la Fábrica de Embutidos “La Española”, es el plan maestro en el que los ejecutivos han recogido las decisiones estratégicas corporativas que se han adoptado respecto a lo que hará en los próximos 5 años, para lograr ser lo suficientemente competitivo y satisfacer los objetivos estratégicos marcados de acuerdo al crecimiento y rentabilidad. En el proceso de Planificación Estratégica, se ha implantado el Balanced Scorecard, que es una metodología que transforma y evalúa la estrategia del negocio en una serie coherente de indicadores que reflejan el cumplimiento de los objetivos diseñados usando medidas en cuatro categorías que son Financiera, Clientes, Procesos Internos, y Formación y Crecimiento. Este Balanced Scorecard, facilita la visualización – en función del tiempo – de las desviaciones entre resultados alcanzados y metas planificadas, también sigue la pista para buscar probables causas endógenas, exógenas o de diseño estratégico, y desde allí simular nuevas estrategias o formular y comparar acciones correctivas que harán viable el alcance de niveles satisfactorios de valor económico-financiero, y así obtener clientes satisfechos y fidelizados, excelencia en los procesos realizados, trabajadores formados y motivados, tecnología, organización y recursos

Transformando Territorio. El Aula como Escenario de Aprendizaje Contextualizado

The article emphasizes some ideas from the research on the strengthening of general labor competencies for the municipality of San Vicente of Caguán Caquetá, anchored to the experience of a significant experience focused on developing a didactic proposal in the implementation of teaching practices to promote meaningful learning and contextualized in multigrade classrooms. In this sense, the implemented methodology was oriented under a qualitative research approach in the classroom (on pedagogical practice) using participant observation as the main technique. The data analysis was structured from the qualitative narrative, in which conclusions were written as a result of the techniques used and later analyzed to obtain information relevant to the object of study. The results show the need to influence effectively in rural educational projects to enable the territorial vocation aimed at sustainable development. The various (socio-productive) learning scenarios that exist within the territory allow interaction with the areas of knowledge in a multigrade methodology that promotes the development of basic skills in a dual way: training for life and for the territory.El artículo enfatiza algunas ideas de la investigación fortalecimiento de competencias laborales generales para el municipio de San Vicente del Caguán Caquetá, anclado a la vivencia de una experiencia significativa centrada en desarrollar una propuesta didáctica en la implementación de prácticas de enseñanza para promover un aprendizaje significativo y contextualizado en aulas multigrado. En este sentido, la metodología implementada se orientó bajo un enfoque cualitativo de  investigación en el aula (sobre la practica pedagógica) utilizando como técnica principal  la observación participante. El análisis de datos, se estructuro desde el cualitativo narrativo, en el que se escribieron conclusiones producto de las técnicas empleadas y posteriormente se analizaron para obtener información pertinente al objeto de estudio. Los resultados evidencian la necesidad de incidir de manera efectiva en los proyectos educativos rurales para posibilitar la vocación territorial encaminada al desarrollo sostenible. Los diversos escenarios de aprendizaje (socio productivos) que hay dentro del territorio, permite la interacción con las áreas del saber en una metodología multigrado que fomenta el desarrollo de competencias básicas de manera dual: una formación para la vida y  para el territorio