Health system stewardship and evidence informed health policy

This Working Paper reviews the recent international debates on the role of the state in health system governance, and uses those discussions to establish the legitimate role of the state in ensuring the appropriate use of evidence for health policy making. Specifically it examines the concept of stewardship which has emerged within recent global health governance debates, applying this concept to the stewardship of evidence. The stewardship function of national ministries of health was originally introduced by the World Health Organization in the 2000 World Health Report, but has been subsequently debated by authors who have associated the concept with a range of government and service provision functions. This paper develops a clearer and more nuanced understanding of the concept of stewardship to differentiate it from the related, yet distinct, concept of governance. We argue that the unique, and therefore conceptually useful, aspect stewardship lies in the way it allocates a single ultimate responsibility for the health of the population. The WHO has further established that it is national ministries of health, specifically, which possess the legitimacy to assume the functions as stewards of population health. The stewardship concept has been established with a range of functional characteristics, including the appropriate use of information to guide health planning and decision making. Taken together, these elements have direct implications for conceptualising how to ensure appropriate use of evidence in health policy. Ministries of health, as population health stewards, tasked with appropriate information use, possess a responsibility to ensure health system decisions are appropriately informed by evidence. In order to do this, they must establish institutional structures and procedures that function to synthesise, disseminate and apply health information and research evidence for use in policy making

Tensile and hydraulic properties of geosynthetics after mechanical damage and abrasion laboratory tests

Installation damage of geosynthetics occurs during their handling, positioning on the ground and the placing and compacting of fill material. Abrasion is a common damage mechanism where there is cyclic relative motion (friction) between a geosynthetic and contact soil. This paper presents the laboratory test results of mechanical damage and abrasion performed on six geosynthetics. The in isolation and combined effects on mechanical, hydraulic and physical properties of the geosynthetics were assessed. Results show that the effects of induced mechanical and abrasion damage essentially depend on the geosynthetic structure. For the most affected materials, strength losses after abrasion (in isolation and combined with mechanical damage) are higher than after the induced mechanical damage. Therefore, for most geosynthetics studied, abrasion is the conditioning mechanism which most affects their tensile strength. An increase of the characteristic opening size of the geosynthetics was observed, while their permittivity did not increase. This may be caused by differences in the test set-ups

Eccentric, concentric and isometric strength in trained and untrained older adults

The process of aging includes changes in muscle and connective tissue architecture and function, increased stiffness, loss of strength and functionality. Nonetheless, older adults are able to maintain eccentric (ECC) strength levels in a greater proportion, when compared to maintaining isometric (ISO) strength and concentric (CON) strength. The purpose of this study was to compare CON, ECC and ISO leg extension torque between trained (T) and untrained (U) older adults. Twenty older adults (60 years and older) who had no knee pathologies were recruited. A Biodex dynamometer was used to measure leg extensor torque for ISO, CON and ECC, in T and U subjects. Torque values relative to body weight (relative torques) were determined for each subject and compared between groups. The ratio of ECC: ISO was calculated and compared across groups. The T group were significantly stronger for ISO (p = 0.009). No significant differences were found for CON (p = 0.088) and ECC (p = 0.220). In addition, the U group registered a significantly higher ratio of ECC: ISO (p = 0.029), when compared to the T group. The findings in this study demonstrate older adults are able to maintain ECC, regardless of training status

Desarrollo de plataforma IoT para control y monitoreo de salones de clase y laboratorios de innovación

T3-2019Las redes de sensores inalámbricas han sido introducidas diariamente a nuestra sociedad y el concepto de Internet de las cosas (IoT) tiene una presencia cada vez mayor. Tras adaptar un esquema de control y comunicación similar al utilizado en las ciudades inteligentes a las instalaciones de un campus se obtiene un sistema donde la información proveniente de diferentes sensores y señales son combinadas con el propósito de ofrecer nuevos servicios a la comunidad académica tales como el control de iluminación y monitoreo de temperatura, iluminación y ocupación de salones de clase y laboratorios de innovación, así como el potencial de asegurar la administración energética, entre otros beneficios que darán soporte a la comunidad en general. El proyecto que se presenta tiene como finalidad el planteamiento de una arquitectura IoT que permite reducir el impacto ambiental producto del consumo energético en aulas y laboratorios que no se encuentren en uso por estudiantes o personal de la institución en el Centro de Excelencia Innovación y Diseño (CEID) de CETYS Universidad Campus Mexicali, para lo cual se evaluaron las distintas alternativas de tecnologías web, dispositivos de comunicación y de procesamiento de imágenes, así como algoritmos de clasificación mediante redes neuronales, teniendo como resultado la implementación efectiva en laboratorios y salones de clase de la arquitectura propuesta reduciendo en un 23.78% el gasto energético relacionado a la utilización de luminarias.Maestrí

Approaching rank aggregation problems by using evolution strategies: The case of the optimal bucket order problem

The optimal bucket order problem consists in obtaining a complete consensus ranking (ties are allowed) from a matrix of preferences (possibly obtained from a database of rankings). In this paper, we tackle this problem by using evolution strategies. We designed specific mutation operators which are able to modify the inner structure of the buckets, which introduces more diversity into the search process. We also study different initialization methods and strategies for the generation of the population of descendants. The proposed evolution strategies are tested using a benchmark of 52 databases and compared with the current state-of-the-art algorithm LIA. We carry out a standard machine learning statistical analysis procedure to identify a subset of outstanding configurations of the proposed evolution strategies. The study shows that the best evolution strategy improves upon the accuracy obtained by the standard greedy method (BPA) by 35%, and that of LIA by 12.5%

From coconut to cassava: the coconut lethal yellowing phytoplasma is worsening the threat to food security in C\uf4te d\u2019Ivoire

Background. Cassava (Manihot esculenta Crantz) is a major staple food in the developing countries whose total world production reached approximately 278 million metric tonnes in 2017. C\uf4te d'Ivoire produces around three million tonnes of cassava every year and reached 4.54 metric tonnes in 2017. It is typically consumed as 'attiek\ue9', which is currently exported on regional and international markets. Cassava crop is now threaten by the C\uf4te d'Ivoire lethal yellowing disease (CILY) first reported and associated with a phytoplasma in Grand-Lahou in 2013. CILY destroyed over 400 ha of coconut groves in smallholder coconut farms where women farmers started planting cassava as an alternative food and cash crop in coconut lands devastated by the disease. Methods. Symptoms of leaf mosaic, curling and yellowing were observed in cassava orchards intwo coconut-growing villages located in the south coastal littoral of Grand-Lahou. Leaf samples were collected from symptom-bearing and symptomless cassava plants and subjected to total DNA extraction. PCR with phytoplasma universal 16S rRNA primers, and group-specific primers for subgroup 16SrXXII-B, \u2018Candidatus Phytoplasma palmicola\u2019-related strains; and with specific primers for African/Eastern cassava mosaic viruses (ACMV, EACMV). Amplicons were purified, cloned and sequenced. Sequences were compared to those of reference in NCBI (https://www.ncbi.nlm.nih.gov) and used for phylogeny analysis of phytoplasma and virus strains, respectively. Results. Phytoplasma DNA was amplified from six out of 12 symptom-bearing samples, five of which co-amplified virus DNA. Phytoplasma sequences showed 99% identity to those of 16SrXXII-B phytoplasmas as confirmed through phylogeny analysis. One cassava plant was co-infected with ACMV, closely related to the Angola strain, while the other four showed co-infection with both the ACMV (Angola) and an EACMV strain from Madagascar. All cassava varieties were phytoplasma-begomovirus co-infected, except the Yac\ue9 variety. Conclusions. Cassava plants in Grand-Lahou orchards were found infected by CILY phytoplasma (group 16SrXXII-B) and ACMV/EACMV virus strains. Results indicate that cassava may be an alternative host for the CILY phytoplasma, which may play a role spreading and worsening CILY epidemic. Prompt actions are required while waiting for a suitable resistant coconut cultivar. Short-term solutions may include replanting cassava yards with newly developed cassava varieties that enhance plant resilience against the coconut phytoplasma and ACMV/EACMV viruses to help supporting food production and improve livelihoods of smallholder coconut farmers in Grand-Lahou