Broughton E.I.,Bethesda University |
Broughton E.I.,International Health Associate |
Nunez O.,University of Managua |
Arana R.,University of Managua |
Oviedo A.,University of Managua
Frontiers in Public Health | Year: 2016
Objective: HIV in Nicaragua is concentrated among key populations (KPs) - men who have sex with men, female sex workers, and female transgender - in whom prevalence is 600-4,000 times higher than the general population. The United States Agency for International Development PrevenSida project is aimed at increasing healthy behavior among KPs and people with HIV and improving testing, counseling, and continuity of prevention and treatment by building capacity and improving performance of non-governmental organizations (NGOs) providing services to KPs. We evaluated the cost-effectiveness of PrevenSida's activities. Methods: This retrospective observational evaluation used individuals in KPs covered by NGOs receiving assistance from PrevenSida from 2012 to 2014. Cost-effectiveness analysis compared PrevenSida's intervention with business-as-usual. Model inputs were generated from epidemiological modeling and PrevenSida's records. Results: By 2014, 24 NGOs received grants and technical assistance from PrevenSida with 72,955 people in KPs served at $11.32/person ($9.39-$16.55/person, depending on region). The estimated incremental cost-effectiveness ratio was $50,700/HIV case averted or $2,600/Disability-adjusted Life Year (DALY) averted (95% CI: $1,000-$99,000 and $50-$5,100, respectively). Conclusion: PrevenSida distributed about $600,000 in grants and used $230,000 to support 24 NGOs in 2014. Cost-effectiveness from the program perspective compared to no program was slightly over half of GDP per capita per DALY averted, considered highly cost-effective by WHO criteria. Cost and efficiency varied by region, reflecting the number of people in KPs receiving services. Cost-sharing by NGOs improved cost-effectiveness from the program perspective and likely promotes sustainability. Focused interventions for KP service provision organizations can be acceptably efficient in this setting. © 2016 Broughton, Nunez, Arana and Oviedo.
Icabalzeta J.C.C.,University of Managua |
Fernandez G.E.D.,University of Managua |
Arias M.R.,University of Managua
GHTC 2016 - IEEE Global Humanitarian Technology Conference: Technology for the Benefit of Humanity, Conference Proceedings | Year: 2016
The aim of this work is to provide an evaluation guide for the Nicaraguan telecommunications regulator Instituto Nicaraguense de Telecomunicaciones y Correos TELCOR to assess the Non-Ionizing Radiation NIR levels emitted by FM Radio and Free-To-Air TV broadcasting systems installed in the municipality of El Crucero, an empoverished municipality where 44 FM Radio and TV Broadcasting operators simultaneously transmit nearby populated areas, using measurement equipment available in TELCOR's mobile monitoring units. These mobile units, each equipped with an ESMB Monitoring Receiver, Antenna ADD-190 and Software ArgusMon 4.3, were made available for this investigation, alongside the personnel of Dirección de Calidad y Monitoreo del Espectro Radioeléctrico (DCAMER-TELCOR) for NIR measurement campaigns performed in 11 selected points in El Crucero. The measurements results show that the exposition to these emissions does not exceed 1% of ICNIRP's general public exposure limits in 7 points, and 5% on the rest. © 2016 IEEE.
Santanach P.,University of Barcelona |
Ruano P.,University of Granada |
Ruano P.,Instituto Andaluz Of Ciencias Of La Tierra |
Ortuno M.,University of Barcelona |
And 2 more authors.
Bulletin of the Seismological Society of America | Year: 2016
In 1865–1866, a series of catastrophic earthquakes struck Managua, Nicaragua. We present new data supporting the view that these earthquakes were caused by the seismogenic Cofradía fault. The data were collected at three paleoseismological sites: La Vaquería (central-northern area), El Cocal (central area), and Piedra Menuda (located at an antithetic strand of the southern fault segment). Coseis-mic evidence includes liquefaction features, offset layers, and colluvial wedges dated using radiocarbon ages and pottery fragments, providing relative cultural ages. The minimum event displacement observed at the central site (1 m) and the total length of the mapped geomorphological trace (39 km) are consistent with a maximum expected magnitude around 7. A minimum slip rate between 1.1 and 1:4 mm=yr is obtained from the new data, reinforcing earlier estimates. In line with paleoseismic chronology and compared with a Bayesian OxCal model of the stratigraphic sequence, at least three seismic events have occurred since A.D. 300, the last one occurring after A.D. 790 and the twentieth century. Thus, the earthquakes of 1865–1866 that resulted in surface alterations in the Tipitapa River probably correspond to the last paleoseismic event on the Cofradía fault. This assumption yields a range between 1511 and 1245 yr for the best estimated maximum recurrence interval between the ultimate and penultimate event. © 2016, Seismological Society of America. All rights reserved.
PubMed | University of Managua and Johns Hopkins University
Type: | Journal: Frontiers in public health | Year: 2016
HIV in Nicaragua is concentrated among key populations (KPs) - men who have sex with men, female sex workers, and female transgender - in whom prevalence is 600-4,000 times higher than the general population. The United States Agency for International Development PrevenSida project is aimed at increasing healthy behavior among KPs and people with HIV and improving testing, counseling, and continuity of prevention and treatment by building capacity and improving performance of non-governmental organizations (NGOs) providing services to KPs. We evaluated the cost-effectiveness of PrevenSidas activities.This retrospective observational evaluation used individuals in KPs covered by NGOs receiving assistance from PrevenSida from 2012 to 2014. Cost-effectiveness analysis compared PrevenSidas intervention with business-as-usual. Model inputs were generated from epidemiological modeling and PrevenSidas records.By 2014, 24 NGOs received grants and technical assistance from PrevenSida with 72,955 people in KPs served at $11.32/person ($9.39-$16.55/person, depending on region). The estimated incremental cost-effectiveness ratio was $50,700/HIV case averted or $2,600/Disability-adjusted Life Year (DALY) averted (95% CI: $1,000-$99,000 and $50-$5,100, respectively).PrevenSida distributed about $600,000 in grants and used $230,000 to support 24 NGOs in 2014. Cost-effectiveness from the program perspective compared to no program was slightly over half of GDP per capita per DALY averted, considered highly cost-effective by WHO criteria. Cost and efficiency varied by region, reflecting the number of people in KPs receiving services. Cost-sharing by NGOs improved cost-effectiveness from the program perspective and likely promotes sustainability. Focused interventions for KP service provision organizations can be acceptably efficient in this setting.
Broughton E.I.,Bethesda University |
Gomez I.,University of Managua |
Sanchez N.,Hospital Bertha Calderon |
Vindell C.,Hospital Bertha Calderon
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2013
Objective. To examine the costs of implementing kangaroo mother care (KMC) in a referral hospital in Nicaragua, including training, implementation, and ongoing operating costs, and to estimate the economic impact on the Nicaraguan health system if KMC were implemented in other maternity hospitals in the country. Methods. After receiving clinical training in KMC, the implementation team trained their colleagues, wrote guidelines for clinicians and education material for parents, and ensured adherence to the new guidelines. The intervention began September 2010. The study compared data on infant weight, medication use, formula consumption, incubator use, and hospitalization for six months before and after implementation. Cost data were collected from accounting records of the implementers and health ministry formularies. Results. A total of 46 randomly selected infants before implementation were compared to 52 after implementation. Controlling for confounders, neonates after implementation had lower lengths of hospitalization by 4.64 days (p = 0.017) and 71% were exclusively breastfed (p < 0.001). The intervention cost US$ 23 113 but the money saved with shorter hospitalization, elimination of incubator use, and lower antibiotic and infant formula costs made up for this expense in 1-2 months. Extending KMC to 12 other facilities in Nicaragua is projected to save approximately US$ 166 000 (based on the referral hospital incubator use estimate) or US$ 233 000 after one year (based on the more conservative incubator use estimate). Conclusions. Treating premature and low-birth-weight infants in Nicaragua with KMC implemented as a quality improvement program saves money within a short period even without considering the beneficial health effects of KMC. Implementation in more facilities is strongly recommended.
Which agricultural choices to meet transformation challenges in africa debating small-scale versus large-scale [Quelles agricultures face aux défis des transitions africaines? Le small-scale versus large-scale en débat]
Losch B.,CIRAD - Agricultural Research for Development |
Freguin-Gresh S.,University of Managua
Cahiers Agricultures | Year: 2013
The recent food price crisis has been used by public and private investors to justify land grabbing in sub-Saharan Africa. At the same time, it has reopened the debate on agricultural development models and drawn attention to the differences between small-scale and largescale farming. After reviewing the public debate around these issues-one that has featured many sensationalist announcements about land grabbing, but very little concrete evidence about the scope and magnitude of thisphenomenon-thispaper offers newinsights into the debate about the advantages and disadvantages of different agricultural development models. Family farms are the dominant type of agriculture worldwide, and their diversity expresses a « continuum » of stages that reflects the shape of agrarian systems and markets. The resilience of family farms can be explained by their many advantageswhen compared to large-scale corporate farms, and agricultural history has shown their outstanding capacity for innovation, largely determined by economic and institutional conditions. In Africa, where most family farmers are poor, the lack of technical and financial assets, exacerbated by adverse environmental conditions, is the source of strong constraints that inhibit productivity growth in the small-scale farming sector. In such a context, large-scale corporate agriculture might appear to be an attractive alternative, but abandonment of family farms is not a feasible option. Continuing support of family farms, at least for the foreseeable future, is dictated by the structure of African economies, most of which are characterized by a lack of economic diversification and the considerable weight of agriculture in the labor force.
Avellan D.R.,University of Managua |
Avellan D.R.,National Autonomous University of Mexico |
Macias J.L.,National Autonomous University of Mexico |
Pardo N.,Massey University |
And 2 more authors.
Journal of Volcanology and Geothermal Research | Year: 2012
The Nejapa Volcanic Field (NVF) is located on the western outskirts of Managua, Nicaragua. It consists of at least 30 volcanic structures emplaced along the N-S Nejapa fault, which represents the western active edge of the Managua Graben. The study area covers the central and southern parts of the volcanic field. We document the basic geomorphology, stratigraphy, chemistry and evolution of 17 monogenetic volcanic structures: Ticomo (A, B, C, D and E); Altos de Ticomo; Nejapa; San Patricio; Nejapa-Norte; Motastepe; El Hormigón; La Embajada; Asososca; Satélite; Refinería; and Cuesta El Plomo (A and B). Stratigraphy aided by radiocarbon dating suggests that 23 eruptions have occurred in the area during the past ~. 34,000. years. Fifteen of these eruptions originated in the volcanic field between ~. 28,500 and 2,130. yr BP with recurrence intervals varying from 400 to 7,000. yr. Most of these eruptions were phreatomagmatic with minor strombolian and fissural lava flow events. A future eruption along the fault might be of a phreatomagmatic type posing a serious threat to the more than 500,000 inhabitants in western Managua. © 2011 Elsevier B.V.
Garache M.S.,University of Managua
Proceedings of the 2014 IEEE Central America and Panama Convention, CONCAPAN 2014 | Year: 2014
Multi-carrier High Speed Downlink Packet Access (HSDPA) technology, in Universal Mobile Telecommunications Service Cellular Networks (UMTS), allows efficient Radio Resource Management (RRM) of spreading codes, transmission power, and interference rise per carrier. However, poor radio network planning and configuration parameters can limit HSDPA system capacity, measured in terms of average user throughput. In this paper, we analyze the downlink throughput degradation problem that can occur as the traffic increases from low to moderate levels. A real network is studied and, in order to increase the capacity, we reduce the other-to-own-interference by optimizing antenna tilts and power optimization of physical channels. The results show that proper network planning significantly improves the average user throughput (up to 55% improvement) and contributes to the system RRM to exploit high spectral efficiency per carrier. © 2014 IEEE.
Santos-Cluters S.,University of Managua |
Villanueva-Ortiz J.,University of Managua |
Munguia-Mena M.,University of Managua
Proceedings of the 2014 IEEE Central America and Panama Convention, CONCAPAN 2014 | Year: 2014
In this paper, the method proposed in ¡Error No se encuentra el origen de la referencia. was extended by introducing two new features: Fm and Bm. These features use time scaling to take into account all the beat morphology and to compensate due to the differences in heart rates from patient to patient. The database consists of before and after angioplasty recordings as well as reference recordings. The assessment of the new features was carried out at two levels: intra-patient (by patient), and inter-patients (all patients). Moreover, the performances of the new features were compared to the feature proposed in ¡Error No se encuentra el origen de la referencia. The results at the intra-patient level showed that the accuracy of SVM classifier for Fm and Bm parameters, on average, increased by 4.2% and 4% respectively. At the inter-patients level the increase was 10% for Fm and 6% for Bm when before angioplasty and reference recordings were compared. In addition, statistical significance was obtained for first principal component analysis coefficient. © 2014 IEEE.
PubMed | University of Managua and Federal University of Pelotas
Type: Journal Article | Journal: Brazilian oral research | Year: 2016
The aim of this study was to assess the prevalence of black stains (BS) and factors associated with their occurrence and to investigate the association of BS with caries experience after adjusting for other risk indicators. A school-based, cross-sectional study using multistage sampling of children aged 10-12 years from 20 private and public schools in Pelotas/Southern Brazil was conducted (n = 706). Children were evaluated for BS and dental caries (DMFT/dmft index) and socioeconomic information was collected by questionnaire. Univariate and multivariate Poisson regressions were used to assess variables associated with the prevalence of BS and with caries experience. The prevalence of BS was 5.81%. The mean DMFT/dmft was 1.54 (1.91), with a maximum value of 10. Among the children with BS, mean dmft/DMFT was 1.22 (SD 1.68), with a maximum value of 6. After adjustments for demographics and socioeconomic variables, dental plaque and tooth brushing habits, prevalence of BS was associated with lower caries experience (RR 0.67; 95%CI 0.49-0.92). In conclusion, the presence of BS showed an association with lower dental caries experience in the evaluated population. Future studies should investigate the mechanisms behind this association.