Progress and Challenges of Implementing Decentralized HIV Testing For Prevention of Mother-to-Child Transmission of HIV - Myanmar.

BackgroundMyanmar has adopted point-of-care (POC) HIV testing for its prevention of mother-to-child transmission of HIV program, and was initiated in 84 townships in 2013. This study assessed the progress of HIV testing uptake from 2012, one year prior to POC testing, to 2015, and the challenges faced by service providers during the rapid rollout of this testing strategy.MethodsThis serial cross-sectional study included 23 townships randomly selected from the 84 townships. An open-question survey was used to collect information on the challenges faced by service providers. A random effects logistic model was used for assessing the progress of HIV testing uptake among urban and rural health center groups.ResultsHIV testing uptake for antenatal care (ANC) attendees increased from 60% to 90% for rural and from 70% to 90% for urban attendees. The proportion of ANC attendees who were tested at their first visit increased from 70% to 80% for rural and from 70% to 90% for urban attendees. In addition, the proportion receiving same-day test results increased from less than 10% to 90% for both groups. Major challenges faced during the initial rollout included low health awareness among pregnant women, fear of stigma and discrimination, long travel times and costs, and increased workloads of providers in rural settings.Conclusions and global health implicationsThe program should consider recruiting local volunteers to help reduce the workloads of service providers. Professional education based on need and continued mentoring and quality control schemes for HIV testing need to be in place. This decentralized strategy would be applicable to other resource-limited countries

A web-based information system for a regional public mental healthcare service network in Brazil

Acknowledgements We would like to thank all the participating representatives of public mental health services for their invaluable contribution to this system development and implementation and the XIII Regional Health Department of Sao Paulo state for their support. Funding: This study was funded by the ‘Conselho Nacional de Desenvolvimento Científico e Tecnológico’ (CNPq) and ‘Coordenação de Aperfeiçoamento de Pessoal de Nível Superior’ (CAPES)—Science Without Borders Programme.Peer reviewedPublisher PD

Plug-and-Play Fault Detection and control-reconfiguration for a class of nonlinear large-scale constrained systems

This paper deals with a novel Plug-and-Play (PnP) architecture for the control and monitoring of Large-Scale Systems (LSSs). The proposed approach integrates a distributed Model Predictive Control (MPC) strategy with a distributed Fault Detection (FD) architecture and methodology in a PnP framework. The basic concept is to use the FD scheme as an autonomous decision support system: once a fault is detected, the faulty subsystem can be unplugged to avoid the propagation of the fault in the interconnected LSS. Analogously, once the issue has been solved, the disconnected subsystem can be re-plugged-in. PnP design of local controllers and detectors allow these operations to be performed safely, i.e. without spoiling stability and constraint satisfaction for the whole LSS. The PnP distributed MPC is derived for a class of nonlinear LSSs and an integrated PnP distributed FD architecture is proposed. Simulation results in two paradigmatic examples show the effectiveness and the potential of the general methodology

Describing the effect of cultura hispanoamericana course on the Licenciatura en Bilingüismo con Énfasis en Inglés students in terms of interculturality and professional development

Progresivamente, la interculturalidad ha tomado un papel protagónico en la educación bilingüe ya que se ha reconocido que en este tipo procesos, el desarrollo lingüístico va acompañado de una dimensión intercultural. Sin embargo, en la práctica, se ha encontrado cómo varios docentes de lengua no incluyen aspectos culturales en sus clases o, en caso de hacerlo, los incorporan desde una perspectiva superficial y congratulatoria que imposibilita la comprensión crítica de una cultura. Además, una vez se abordan los contenidos culturales, estos tienden a centrarse en la segunda cultura, dejando de lado la oportunidad de los estudiantes de explorar y comprender su cultura profunda, perpetuando así realidades y estructuras injustas del contexto. Esta investigación describe los procesos pedagógicos e interculturales de un contexto educativo caracterizado por su énfasis en la cultura nativa desde una perspectiva descentralizada y profunda. Este estudio, enmarcado en un paradigma descriptivo-cualitativo, se realizó en el curso de una Licenciatura en Bilingüismo con Énfasis en Inglés. Los datos fueron recopilados de observaciones en el aula, cuestionarios al principio y al final del proceso pedagógico y entrevistas semiestructuradas, todo lo cual se analizó utilizando un enfoque de análisis de contenido

Can local institutions reduce poverty? Rural decentralization in Burkina Faso

The authors present evidence that in Burkina Faso, certain high-performing local institutions contribute to equitable economic development. They link reduced levels of poverty, and inequality to a high degree of internal village organization. The structure of these high-performing local organizations means they can exist in a number of African countries, because they depend more on internal participation, rather than on nay one country's cultural assets. The authors find that: 1) Service-asset management groups (SAMs) - one of three local institutions identified in the study - have helped to significantly reduce inequality in participating households. SAMs are a fusion of long-standing development committees, and indigenous management councils that collectively manage community assets, such as water. SAMs have combined the productivity goals of growth, with the values of equity, and solidarity. 2) Current development approaches use growth as an initiator, assuming that surpluses will be used to benefit the poor. SAMs, and other local institutions in Burkina Faso, start with equity, and solidarity, and aim for a result of growth, and development. 3) Internal participation is essential for SAMs to function. Only locally anchored participation can power the realignments, and institutional revisions needed to scale up development action. SAMs, and other local institutions have launched their communities on equitable growth paths, and are reducing poverty with little, or no outside assistance, despite severe resource constraints. Their impact could be enormous if external development resources augmented their potential. World Bank programs, and policy interventions could build on local strength, and make their activities more sustainable by mapping local institutions to guide new initiatives in pro-poor investment, and using that mapping to formalize, and increase internal local participation - expanding nationwide by using a network of local institutions. SAMs, and other local institutions, could be the vehicle for ensuring transparency, and accountability. Working with the results of local activities, national policies could favor the development of indigenously based, but externally oriented local economies.Decentralization,Regional Rural Development,Public Health Promotion,Enterprise Development&Reform,Economic Theory&Research,Regional Rural Development,Health Economics&Finance,Poverty Assessment,Governance Indicators,National Governance

FAST : a fault detection and identification software tool

The aim of this work is to improve the reliability and safety of complex critical control systems by contributing to the systematic application of fault diagnosis. In order to ease the utilization of fault detection and isolation (FDI) tools in the industry, a systematic approach is required to allow the process engineers to analyze a system from this perspective. In this way, it should be possible to analyze this system to find if it provides the required fault diagnosis and redundancy according to the process criticality. In addition, it should be possible to evaluate what-if scenarios by slightly modifying the process (f.i. adding sensors or changing their placement) and evaluating the impact in terms of the fault diagnosis and redundancy possibilities. Hence, this work proposes an approach to analyze a process from the FDI perspective and for this purpose provides the tool FAST which covers from the analysis and design phase until the final FDI supervisor implementation in a real process. To synthesize the process information, a very simple format has been defined based on XML. This format provides the needed information to systematically perform the Structural Analysis of that process. Any process can be analyzed, the only restriction is that the models of the process components need to be available in the FAST tool. The processes are described in FAST in terms of process variables, components and relations and the tool performs the structural analysis of the process obtaining: (i) the structural matrix, (ii) the perfect matching, (iii) the analytical redundancy relations (if any) and (iv) the fault signature matrix. To aid in the analysis process, FAST can operate stand alone in simulation mode allowing the process engineer to evaluate the faults, its detectability and implement changes in the process components and topology to improve the diagnosis and redundancy capabilities. On the other hand, FAST can operate on-line connected to the process plant through an OPC interface. The OPC interface enables the possibility to connect to almost any process which features a SCADA system for supervisory control. When running in on-line mode, the process is monitored by a software agent known as the Supervisor Agent. FAST has also the capability of implementing distributed FDI using its multi-agent architecture. The tool is able to partition complex industrial processes into subsystems, identify which process variables need to be shared by each subsystem and instantiate a Supervision Agent for each of the partitioned subsystems. The Supervision Agents once instantiated will start diagnosing their local components and handle the requests to provide the variable values which FAST has identified as shared with other agents to support the distributed FDI process.Per tal de facilitar la utilització d'eines per la detecció i identificació de fallades (FDI) en la indústria, es requereix un enfocament sistemàtic per permetre als enginyers de processos analitzar un sistema des d'aquesta perspectiva. D'aquesta forma, hauria de ser possible analitzar aquest sistema per determinar si proporciona el diagnosi de fallades i la redundància d'acord amb la seva criticitat. A més, hauria de ser possible avaluar escenaris de casos modificant lleugerament el procés (per exemple afegint sensors o canviant la seva localització) i avaluant l'impacte en quant a les possibilitats de diagnosi de fallades i redundància. Per tant, aquest projecte proposa un enfocament per analitzar un procés des de la perspectiva FDI i per tal d'implementar-ho proporciona l'eina FAST la qual cobreix des de la fase d'anàlisi i disseny fins a la implementació final d'un supervisor FDI en un procés real. Per sintetitzar la informació del procés s'ha definit un format simple basat en XML. Aquest format proporciona la informació necessària per realitzar de forma sistemàtica l'Anàlisi Estructural del procés. Qualsevol procés pot ser analitzat, només hi ha la restricció de que els models dels components han d'estar disponibles en l'eina FAST. Els processos es descriuen en termes de variables de procés, components i relacions i l'eina realitza l'anàlisi estructural obtenint: (i) la matriu estructural, (ii) el Perfect Matching, (iii) les relacions de redundància analítica, si n'hi ha, i (iv) la matriu signatura de fallades. Per ajudar durant el procés d'anàlisi, FAST pot operar aïlladament en mode de simulació permetent a l'enginyer de procés avaluar fallades, la seva detectabilitat i implementar canvis en els components del procés i la topologia per tal de millorar les capacitats de diagnosi i redundància. Per altra banda, FAST pot operar en línia connectat al procés de la planta per mitjà d'una interfície OPC. La interfície OPC permet la possibilitat de connectar gairebé a qualsevol procés que inclogui un sistema SCADA per la seva supervisió. Quan funciona en mode en línia, el procés està monitoritzat per un agent software anomenat l'Agent Supervisor. Addicionalment, FAST té la capacitat d'implementar FDI de forma distribuïda utilitzant la seva arquitectura multi-agent. L'eina permet dividir sistemes industrials complexes en subsistemes, identificar quines variables de procés han de ser compartides per cada subsistema i generar una instància d'Agent Supervisor per cadascun dels subsistemes identificats. Els Agents Supervisor un cop activats, començaran diagnosticant els components locals i despatxant les peticions de valors per les variables que FAST ha identificat com compartides amb altres agents, per tal d'implementar el procés FDI de forma distribuïda.Postprint (published version

The Economics of Labor Market Intermediation: An Analytic Framework

Labor Market Intermediaries (LMIs) are entities or institutions that interpose themselves between workers and firms to facilitate, inform, or regulate how workers are matched to firms, how work is accomplished, and how conflicts are resolved. This paper offers a conceptual foundation for analyzing the economic role played by these understudied institutions, and to develop a qualitative and, in some cases, quantitative sense of their significance to market operation and welfare. Though heterogeneous, I argue that LMIs share a common function, which is to redress – and in some cases exploit – a set of endemic departures of labor market operation from the efficient neoclassical benchmark. At a rudimentary level, LMIs such as online job boards reduce search frictions by aggregating and reselling disparate information at a cost below which workers and firms could obtain themselves. Beyond passively supplying information, a set of LMIs forcibly redress adverse selection problems in labor markets by compelling workers and firms to reveal normally hidden credentials, such as criminal background, academic standing, or financial integrity. At their most forceful, LMIs such as labor unions and centralized job matching clearinghouses resolve coordination and collective action failures in markets by tightly controlling – even monopolizing – the process by which workers and firms meet, match and negotiate. A unifying observation of the analytic framework is that participation in the activities of a given LMI are typically voluntary for one side of the market and compulsory for the other; workers cannot, for example, elect to suppress their criminal records and firms cannot opt out of collective bargaining. I argue that the nature of participation in an LMI’s activities – voluntary or compulsory, and for which parties – is dictated by the market imperfection that it addresses and thus tells us much about its economic function.intermediation, unions, job search, internet, temporary-help, adverse selection, collective action