Electronic Health Record in Bolivia and ICT: A Perspective for Latin America

The emergence of new technologies in society through its application to many areas and very diverse realities is a clear element in the time in which we live. The health sector has been unable to escape this reality and has been renovated many of its traditional structures with new options brought by the application of information technology and communication (ICT) in areas such as management and hospital administration. This paper focuses on analyzing from the point of view of medical diagnosis the importance of electronic medical records as a unifying element of the information essential for this type of diagnosis, and the use of artificial intelligence techniques in this field. To this end the current situation of electronic medical records is analyzed in a country like Bolivia exhaustively analyzing three of the most important health centers. Is used for this unstructured interview experts on the subject reflect the current status of electronic medical records from the point of view of protection of the right to privacy of individuals and will serve as a model for development, not only in Bolivia but also in other Latin American countries

Legal Issues Concerning P2P Exchange of Educational Materials and Their Impact on E-Learning Multi-Agent Systems

The last years have known an impressive change in the use of technologies for the sharing and dissemination of knowledge, thus affecting deeply all the traditional means used by education in all its shapes and levels. This transformation has not been fully understood by the society at large for its immense impacts and its short life. This paper describes in the question emerging from the clash of the rights to education in a wide sense and the rights derived from authorship and how that issue is affecting the design of e-learning multi-agent tools

Structural shape sensitivity analysis for nonlinear material models with strain softening

This paper describes some considerations around the analytical structural shape sensitivity analysis when the structural behaviour is computed using the finite element method with a nonlinear constitutive material model. Traditionally, the structural sensitivity analysis is computed using an incremental approach based on the incremental procedures for the solution of the structural equilibrium problem. In this work, a direct (nonincremental) formulation for computing these structural sensitivities, that is valid for some specific nonlinear material models, is proposed. The material models for which the presented approach is valid are characterized by the fact that the stresses at any timet can be expressed in terms of the strains at the timet and, in some cases, the strains at a specific past timet u (t u<t). This is the case of elasticity (linear as well as nonlinear), perfect plasticity and damage models. A special strategy is also proposed for material models with strain softening. For the cases where it is applicable, the sensitivity analysis proposed here allows us to compute the structural sensitivities around any structural equilibrium point after finishing the solution process and it is completely independent of the numerical scheme used to solve the structural equilibrium problem. This possibility is particularized for the case of a damage model considering a strain-softening behaviour. Finally, the quality and reliability of the proposed approach is assessed through its application to some exampl

The effects of non-adherence on health care utilisation:panel data evidence on uncontrolled diabetes

Despite size and relevance of non-adherence to health treatments, robust evidence on its effects on health care utilisation is very limited. We focus on non-adherence to diabetes treatments, a widespread problem, and employ longitudinal administrative data from Spain (2004-2010) to identify and quantify the effects of uncontrolled type 2 diabetes on health care utilisation. We use a biomarker (glycated haemoglobin, HbA1c) to detect the presence of uncontrolled diabetes and explore its effects on both primary and secondary health care. We estimate a range of panel count data models, including negative binomials with random effects, dynamic and hurdle specifications to account for unobserved heterogeneity, previous utilisation and selection. We find uncontrolled diabetes in around 30% of patients of both genders. Although women appear to systematically consume more health care compared to men, their consumption levels do not appear to be influenced by uncontrolled diabetes. Conversely, among men uncontrolled diabetes increases the average number of GP visits per year by around 4%, specialist visits by 4.4% and greatly extends hospital length of stay

Uncontrolled diabetes and healthcare utilisation: a bivariate Latent Markov model

Although uncontrolled diabetes (UD) or poor glycaemic control is a widespread condition with potentially life‐threatening consequences, there is sparse evidence of its effects on health care utilisation. We jointly model the propensities to consume health care and UD by employing an innovative bivariate latent Markov model that allows for dynamic unobserved heterogeneity, movements between latent states and the endogeneity of UD. We estimate the effects of UD on primary and secondary health care consumption using a panel dataset of rich administrative records from Spain and measure UD using a biomarker. We find that, conditional on time‐varying unobservables, UD does not have a statistically significant direct effect on health care use (...

Uncontrolled diabetes and health care utilisation: panel data evidence from Spain

Despite size and relevance of uncontrolled diabetes, robust evidence on its effects on health care utilisation is very limited, especially among European countries. We employed longitudinal administrative data from Spain (2004-2010) to explore the relationship between uncontrolled type 2 diabetes and health care utilisation. We used a biomarker (glycated haemoglobin, HbA1c) to detect the presence of uncontrolled diabetes and explore its effects on both primary and secondary health care. We estimated a range of panel count data models, including negative binomials with random effects, dynamic and hurdle specifications to account for unobserved heterogeneity, previous utilisation and selection. We found uncontrolled diabetes in between 27-30% of patients of both genders. Our estimates suggested that although women appeared to systematically consume more health care compared to men, their consumption levels did not seem to be influenced by uncontrolled diabetes. Conversely, among men uncontrolled diabetes increased the average number of GP visits per year by between 3-3.4%, specialist visits by 5.3-6.1%, depending on specifications, and also extended annual hospital length of stay by 15%. We also found some evidence of heterogeneity in utilisation based on the level of uncontrolled diabetes among male individuals. Overall, our results suggested the need for different diabetes management plans depending on gender and levels of glycaemic control

Uncontrolled diabetes and health care utilisation: a bivariate Latent Markov model approach [WP]

While uncontrolled diabetes (UD) or poor glycaemic control is a widespread condition with potentially life-threatening consequences, there is sparse evidence of its effects on health care utilisation. We model the propensities to consume health care and UD by employing an innovative bivariate Latent Markov model which allows for dynamic unobserved heterogeneity, movements between latent states and the endogeneity of UD. We estimate the effects of UD on primary and secondary Health care consumption using a panel dataset of rich administrative records from Spain and measure UD using a biomarker. We find that UD does not have a statistically significant effect on health care use. Furthermore, individuals appear to move across latent classes and increase their propensities to poor glycaemic control and health care use over time. Our results suggest that by ignoring time-varying unobserved heterogeneity and the endogeneity of UD, the effects of UD on health care utilisation might be overestimated and this could lead to biased findings. Our approach reveals heterogeneity in behaviour beyond standard groupings of frequent versus infreqüent users of health care services. We argue that this dynamic latent Markov approach could be used more widely to model the determinants of health care use

Light scattering from self-affine fractal silver surfaces with nanoscale cutoff: Far-field and near-field calculations

We study the light scattered from randomly rough, one-dimensional self-affine fractal silver surfaces with nanoscale lower cutoff, illuminated by s- or p-polarized Gaussian beams a few microns wide. By means of rigorous numerical calculations based on the Green theorem integral equation formulation, we obtain both the far- and near-field scattered intensities. The influence of diminishing the fractal lower scale cutoff (from below a hundred, down to a few nanometers) is analyzed in the case of both single realizations and ensemble average magnitudes. For s polarization, variations are small in the far field, being only significant in the higher spatial frequency components of evanescent character in the near field. In the case of p polarization, however, the nanoscale cutoff has remarkable effects stemming from the roughness-induced excitation of surface-plasmon polaritons. In the far field, the effect is noticed both in the speckle pattern variation and in the decrease of the total reflected energy upon ensemble averaging, due to increased absorption. In the near field, more efficient excitation of localized optical modes is achieved with smaller cutoff, which in turn leads to huge surface electric field enhancements.Comment: REVTeX 4, 10 page

Health information and lifestyle behaviours: the impact of a diabetes diagnosis

We estimate short- and long-term causal impacts of a type-2 diabetes mellitus (T2DM) diagnosis on lifestyle behaviours. We employ a fuzzy regression discontinuity design exploiting the exogenous cut-off value in the diagnosis of T2DM provided by a biomarker (glycated haemoglobin, HbA1c). We make use of unique administrative longitudinal data from Spain and focus on the impact of a diagnosis on clinically measured BMI, smoking and alcohol consumption. We find that, following a T2DM diagnosis, individuals appear to reduce their weight in the short-term. These effects are particularly large among obese individuals and those diagnosed with depression. Patients who are younger, still in the labour market and healthier also present increased short-term probabilities of quitting smoking. In addition, we provide evidence of statistically significant long-term impacts of a T2DM diagnosis on BMI up to three years from the diagnosis. Our results are consistent across parametric and non-parametric estimations with varying bandwidths

Análisis de motivos decorativos de tejidos y revestimientos cerámicos en el entorno de la visión artificial. Aplicación a la reconstrucción de motivos históricos y al diseño

El objetivo de esta tesis es la contribución a la creación, e implementación en herramientas informáticas, de una metodología aplicable para el análisis y edición de imágenes procedentes del campo de los diseños cerámicos y textiles, y por extensión, de todas aquellas imágenes que siguen un patrón repetitivo y que, por tanto, se ajustan a la Teoría de Grupos de Simetría. Para ello, se ha definido una metodología de análisis dividida en etapas, en la que se va aumentando gradualmente el nivel de la información manejada, desde los píxeles de la imagen inicial, pasando por los objetos (formas o unidades básicas perceptúales) y los motivos (agrupaciones de objetos realizadas con criterios perceptúales) hasta llegar a la estructura del patrón, es decir, las distintas transformaciones geométricas que relacionan los elementos (objetos y motivos) que lo forman. La información estructural obtenida es utilizada con fines diversos: la clasificación de las imágenes según el Grupo de Simetría del Plano del patrón, la reconstrucción de las imágenes aprovechando el conocimiento de qué partes están relacionadas por la estructura, y por último, la edición de patrones, tanto a nivel de formas y motivos, como de estructura, permitiendo realizar cambios estructurales con facilidad, con lo que se generan familias de patrones a partir de uno analizado. Las herramientas desarrolladas han sido probadas con un amplio conjunto de imágenes de patrones de procedencias muy diversas, destacando el estudio de los alicatados de la Alhambra de Granada y del Alcázar de Sevilla, así como de textiles y, ampliando los objetivos iniciales, a diversos elementos del entorno urbano.Albert Gil, FE. (2006). Análisis de motivos decorativos de tejidos y revestimientos cerámicos en el entorno de la visión artificial. Aplicación a la reconstrucción de motivos históricos y al diseño [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/1936Palanci