14 research outputs found

    Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

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    Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations

    Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

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    Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations

    Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

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    Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

    Amazonia Camtrap: a data set of mammal, bird, and reptile species recorded with camera traps in the Amazon forest.

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    Abstract : The Amazon forest has the highest biodiversity on Earth. However, information on Amazonian vertebrate diversity is still deficient and scatteredacross the published, peer-reviewed, and gray literature and in unpublishedraw data. Camera traps are an effective non-invasive method of surveying vertebrates, applicable to different scales of time and space. In this study, we organized and standardized camera trap records from different Amazonregions to compile the most extensive data set of inventories of mammal,bird, and reptile species ever assembled for the area. The complete data setcomprises 154,123 records of 317 species (185 birds, 119 mammals, and13 reptiles) gathered from surveys from the Amazonian portion of eightcountries (Brazil, Bolivia, Colombia, Ecuador, French Guiana, Peru,Suriname, and Venezuela). The most frequently recorded species per taxawere: mammals:Cuniculus paca (11,907 records); birds: Pauxi tuberosa (3713 records); and reptiles:Tupinambis teguixin(716 records). The infor-mation detailed in this data paper opens up opportunities for new ecological studies at different spatial and temporal scales, allowing for a moreaccurate evaluation of the effects of habitat loss, fragmentation, climatechange, and other human-mediated defaunation processes in one of themost important and threatened tropical environments in the world. The data set is not copyright restricted; please cite this data paper when usingits data in publications and we also request that researchers and educator sinform us of how they are using these data

    Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016.

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    BACKGROUND: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. METHODS: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita

    Alluvial debris fan of El Palón: coseismic evidence of vulnerability high level at the Chama river´s basin, Mérida state-Venezuela.

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    SUMARIO / SUMMARY 1.- Editorial Los encuentros de geógrafos de América Latina. Meetings of the Latin American geographers. Trinca Fighera, Delfina 2.- Artículos / Papers Diagnóstico agrosocioeconómico de las fincas cafetaleras de la microcuenca del río Monaicito, estado Trujillo-Venezuela. Agrosocioeconomic diagnostic of the coffee farms in the Monaicito River's microbasin, Trujillo State-Venezuela. Becerra, Ligia; Arellano G., Rosalva y Pineda, Neida Análisis morfométrico de la microcuenca de la quebrada Curucutí, estado Vargas - Venezuela. Morphometric analysis of the Curucutí creek catchment, Vargas state - Venezuela. Méndez, Williams y Marcucci, Ettore Ciudad y estructura espacial. Evolución morfológica de las ciudades del estado Mérida-Venezuela. City and spatial structure. Morphologic tridimensional development of Merida´s cities, Venezuela. Rangel Mora, Maritza Abanico El Palón: evidencia cosísmica del alto grado de vulnerabilidad de la cuenca del río Chama, estado Mérida-Venezuela. Alluvial debris fan of El Palón: coseismic evidence of vulnerability high level at the Chama river´s basin, Mérida state-Venezuela. Ayala O., Rubén I. La estereo-ortofoto digital en la elaboración de mapas temáticos. The digital stereo-orthophoto in the elaboration of thematic maps. Jauregui, Manuel; Jáuregui O., Luis M.; Chacón, Leira M. y Vílchez, José 4.- Notas y Documentos / Notes and Documents Paisaje natural, paisaje humanizado o simplemente paisaje. Natural landscape, cultural landscape or simply landscape. Trinca Fighera, Delfina Turismo, biodiversidad y academia ¿una opción para la extensión universitaria? El caso de la Universidad de Los Andes, Mérida-Venezuela. Tourism, biodiversity and academy an option for university extension? The case of the University of Los Andes, Venezuela. Guillén Calderón, Irma Teresa y Boada Jiménez, Ceres Isabel 4.- Bibliografía Crítica / Books Review López, Jesús; Giordani, Jorge y Castellano, Hercilio: Vigencia y perspectivas de la planificación en Venezuela. López, Jesús; Giordani, Jorge y Castellano, Hercilio: Validity and perspectives of planning in Venezuela. Reseñado por: Portillo, [email protected] analíticosemestra

    Información Investigador: Ayala Omaña, Rubén Ignacio

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    Resumen Curricular Ingeniero Geólogo, egresado de la ULA con tres años de experiencia en la Industria Petrolera. Aplicación de conocimientos de Ingeniería geológica y habilidades de computación para la delineación, desarrollo y descripción de yacimientos. Aplicando adicionalmente conocimientos de estratigrafía y sedimentología en la identificación de los mejores reservorios de areniscas y la reconstrucción de su historia sedimentaria. Identificación de trampas estratigráficas y estructurales. Monitoreo Operacional de Perforación de Pozos. Profesor Universitario con dos años y cuatro meses de experiencia en el área de Geomorfología y Riesgos en la Escuela de Geografía de la Facultad de Ciencias Forestales de la Universidad de Los Andes. Mérida, Estado Mérida.UniversitarioGeomorfología y Riesgos. Geología.Marzo de 2007Ingeniero Geólogo+58 274 2401607;+58 274 2402102Facultad de Ciencias Forestales y [email protected]

    Susceptibility zoning to occurrence of mass movements. Micro basins Agua Blanca and La Laja. Venezuelan Andes

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    Se aplicó una metodología bajo un enfoque heurístico basado en la combinación de factores, para zonificar áreas susceptibles a la ocurrencia de movimientos de masa en las microcuencas Agua Blanca y La Laja del estado Táchira, que actualmente presentan periódicas manifestaciones de procesos geomorfológicos que se traducen en la ocurrencia de procesos gravitacionales, que causan el deterioro de la mayor parte de las infraestructuras. Los resultados permitieron conocer cuáles son los sitios más inestables y propensos a que ocurra este tipo de procesos, con el beneficio de consolidar información relevante para prever y planificar los correctivos que mitiguen los dañ[email protected]@ula.ve, [email protected]@hotmail.comsemestralA methodology under a heuristic approach, based on combination of factors, for zoning susceptible areas to occurrence of mass movement was applied in the micro-basins Agua Blanca and La Laja in Táchira State. These micro-basins are currently having manifestations of morphological processes that result in the occurrence of mass movements that have caused damage to most of infrastructures. The results allows us to know which are the most unstable and susceptible places to the occurrence of this type of process, with the benefit of consolidating relevant information to anticipate and plan corrections to mitigate damages

    A multiwavelength analysis of a collection of short-duration GRBs observed between 2012 and 2015

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    We investigate the prompt emission and the afterglow properties of short-duration gamma-ray burst (sGRB) 130603B and another eight sGRB events during 2012-2015, observed by several multiwavelength facilities including the Gran Canarias Telescope 10.4 m telescope. Prompt emission high energy data of the events were obtained by INTEGRAL-SPI-ACS, Swift-BAT, and Fermi-GBM satellites. The prompt emission data by INTEGRAL in the energy range of 0.1-10 MeV for sGRB 130603B, sGRB 140606A, sGRB 140930B, sGRB 141212A, and sGRB 151228A do not show any signature of the extended emission or precursor activity and their spectral and temporal properties are similar to those seen in case of other short bursts. For sGRB 130603B, our new afterglow photometric data constrain the pre-jet-break temporal decay due to denser temporal coverage. For sGRB 130603B, the afterglow light curve, containing both our new and previously published photometric data is broadly consistent with the ISM afterglow model. Modeling of the host galaxies of sGRB 130603B and sGRB 141212A using the LePHARE software supports a scenario in which the environment of the burst is undergoing moderate star formation activity. From the inclusion of our late-time data for eight other sGRBs we are able to: place tight constraints on the non-detection of the afterglow, host galaxy, or any underlying 'kilonova' emission. Our late-time afterglow observations of the sGRB 170817A/GW170817 are also discussed and compared with the sub-set of sGRBs.© 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical SocietyAJCT acknowledges support from the Junta de Andalucia (Project P07-TIC-03094) and support from the Spanish Ministry Projects AYA2012-39727-C03-01 and 201571718R. This work has been supported by the Spanish Science Ministry 'Centro de Excelencia SeveroOchoa' Program under grant SEV-2017-0709. FEDER funds are acknowledged. E.S. acknowledges assistance from the Scientific and Technological Research Council of Turkey (TUBITAK) through project 112T224. We thank TUBITAK for a partial support in using T100 telescope with project number 10CT100-95. A.S.P acknowledges partial support grants RFBR 17-02-01388, 17-51-44018, and 1752-80139. E.D.M., A.A.V., and P.Yu.M. are grateful to RSCF grant 18-12-00522 for support. B.-B.Z. acknowledges support from National Thousand Young Talents program of China and National Key Research and Development Program of China (2018YFA0404204). R.Ya.I. is grateful for partial support by the grant RUSTAVELI/FR/379/6-300/14. R.S.R. acknowledges support from ASI (Italian Space Agency) through the Contract No. 2015-046R.0 and from European Union Horizon 2020 Programme under the AHEAD project (grant agreement No. 654215). SJ acknowledges the support of the Korea Basic Science Research Program through NRF-2015R1D1A4A01020961.Peer Reviewe
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