A novel approach to glaucoma screening and education in Nepal

<p>Abstract</p> <p>Background</p> <p>Glaucoma is a major cause of blindness worldwide and an increasingly significant global health problem. Glaucoma prevention and management efforts have been challenging due to inherent difficulty in developing a simple and cost-effective screening plan, limited access to health care and educational resources, poverty, and inadequate knowledge of the disease, particularly in developing countries. Starting in 2004 the Tilganga Eye Centre in Kathmandu, Nepal has provided targeted glaucoma screening, treatment, and education through a combination of clinical outreach programs and educational activities for patients.</p> <p>Methods</p> <p>A simple, age-based glaucoma screening algorithm was incorporated into three one-day cataract screening clinics. Using this algorithm, patients who were newly diagnosed with glaucoma were referred to TEC, where medication and surgery were provided free of charge through private donor funding. In addition, we describe two ongoing educational programs for increasing glaucoma awareness: an annual Glaucoma Awareness Week (which includes free screening, treatment, and counseling), and a repeating lecture series which generates new counselors.</p> <p>Results</p> <p>From 2004 to 2007 screening at the annual Glaucoma Awareness Week resulted in the diagnosis of 120 individuals with glaucoma, or 7.6% of total registrants. Attendance increased annually with a trend toward an increasing number of returning patients but a decreasing percentage of newly diagnosed patients, though the absolute numbers have remained relatively stable (range 21 to 38). Data from the three one-day screening clinics in 2006 show that approximately 2 to 4% of patients 50 years of age or older per clinic were newly diagnosed with POAG.</p> <p>Conclusion</p> <p>This multi-faceted approach appears to successfully identify individuals with glaucoma and provide treatment to those who would otherwise not be able to afford it. While more data is needed to validate this model, specifically regarding the effectiveness of educational activities, long-term visual outcomes, and medication compliance, it may serve as a useful framework for other developing countries with similarly limited resources.</p

Solving Weighted Least Squares (WLS) problems on ARM-based architectures

TheWeighted Least Squares algorithm (WLS) is applied to numerous optimization problems, but requires the use of high computational resources, especially when complex arithmetic is involved. This work aims to accelerate the resolution of a WLS problem by reducing the computational cost (relaying on BLAS/LAPACK routines) and the computational precision from double to single. As a test case, we design an IIR filter for a Graphic Equalizer, where the numerical errors due to single precision are easily visualized. In addition, given the importance of low power architectures for this kind of implementations, we evaluate the performance, scalability, and energy efficiency of each method on two different processors implementing the ARMv7 architecture, widely used in current mobile devices with power constraints. Results show that the method that exhibits a high theoretical computational cost overcomes in efficiency other methods with lower theoretical cost in architectures of this type.This work started in spring 2016 when Jose A. Belloch was a visiting postdoctoral researcher at Budapest University of Technology and Economics thanks to the European Network COST Action IC1305 inside the program Short Term Scientific Mission with the following reference: COST-SPASM-ECOST-STSM-IC1305-020416-072431. Dr. Jose A. Belloch is supported by GVA contract APOSTD/2016/069. The researchers from Universitat Jaume I are supported by the CICYT projects TIN2014-53495-R of MINECO and FEDER. The authors from the Universitat Politecnica de Valencia are supported by MINECO Projects TEC2015-67387-C4-1-R, PROMETEOII/2014/003 and CAPAP-H5 network TIN2014-53522-REDT. The researcher from UCM is supported by the EU (FEDER) and the Spanish MINECO, under Grants TIN 2015-65277-R and TIN2012-32180. The work of Balazs Bank was supported by the UNKP-16-4-III New National Excellence Program of the Ministry of Human Capacities, Hungary.Belloch Rodríguez, JA.; Bank, B.; Igual Peña, FD.; Quintana Ortí, ES.; Vidal Maciá, AM. (2017). Solving Weighted Least Squares (WLS) problems on ARM-based architectures. Journal of Supercomputing. 73(1):530-542. https://doi.org/10.1007/s11227-016-1910-9S530542731Smith TM, van de Geijn RA, Smelyanskiy M, Hammond JR, Van Zee FG (2014) Anatomy of high-performance many-threaded matrix multiplication. In: 28th IEEE International Parallel and Distributed Processing Symposium (IPDPS 2014)Burrus CS (2012) Iterative reweighted least squares. OpenStax-CNC document, May 2012, module m45285. http://cnx.org/content/m45285/1.12 . Accessed 2 Nov 2016Khang SW (1972) Best $$L_p$$ L p approximation. Math Comput 26(118):505–508Jackson LB (2008) Frequency-domain Steiglitz-McBride method for least-squares filter design, ARMA modeling, and periodogram smoothing. IEEE Signal Process Lett 15:49–52Bank B (2012) Magnitude-priority filter design for audio applications. In: Proceedings of $$132^{{\rm nd}}$$ 132 nd AES Convention, Preprint No. 8591, Budapest, Hungary, May 2012Daubechies I, Devire R, Fornasier M, Gntrk CS (2010) Iteratively reweighted least squares minimization for sparse recovery. Comput Music J 23(2):52–69Rämö J, Välimäki V, Bank B (2014) High-precision parallel graphic equalizer. IEEE/ACM Trans Audio Speech Lange Proc 22(12):1894–1904Perez Gonzales E, Reiss J (2009) Automatic equalization of multi-channel audio using cross-adaptive methods. In: Proceedings of AES 127th Convention, New York, Oct. 2009Rämö J, Välimäki V (2013) Live sound equalization and attenuation with a headset. In: Proceedings of AES 51st International Conference, Helsinki, Finland, Aug. 2013Mäkivirta A, Antsalo P, Karjalainen M, Välimäki V (2003) Modal equalization of loudspeaker-room responses at low frequencies. J Audio Eng Soc 51(5):324–343Holters M, Zölzer U (2006) Graphic equalizer design using higher-order recursive filters. In: Proceedings of International Conference Digital Audio Effects, Montreal, QC, pp 37–40Tassart S (2013) Graphical equalization using interpolated filter banks. J Audio Eng Soc 61(5):263–279Chen Z, Geng GS, Yin FL, Hao J (2014) A pre-distortion based design method for digital audio graphic equalizer. Digital Signal Process 25:296–302Välimäki V, Reiss J (2016) All about audio equalization: solutions and frontiers. Appl Sci 6(5):129–145Belloch JA, Välimäki V (2016) Efficient target-response interpolation for a graphic equalizer. In: 2016 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP), March 2016, pp 564–568Belloch JA, Alventosa FJ, Alonso P, Quintana-Ortí ES, Vidal AM (2016) Accelerating multi-channel filtering of audio signal on arm processors. J Supercomput, pp 1–12. doi: 10.1007/s11227-016-1689-8Belloch JA, Gonzalez A, Igual FD, Mayo R, Quintana-Ortí ES (2015)Vectorization of binaural sound virtualization on the ARM cortex-A15 architecture. In: Proceedings of 23rd European Signal Processing Conference, (EUSIPCO), Nize, France, September 2015Mitra G, Johnston B, Rendell A, McCreath E, Zhou J (2013) Use of simd vector operations to accelerate application code performance on low-powered arm and intel platforms. In: IEEE 27th International Parallel and Distributed Processing Symposium Workshops PhD Forum (IPDPSW), May 2013, pp 1107–1116Tomov S, Dongarra J, Baboulin M (2008) Towards dense linear algebra for hybrid gpu accelerated manycore systems. LAPACK Working Note, Tech. Rep. 210, Oct. 2008. http://www.netlib.org/lapack/lawnspdf/lawn210.pdf . Accessed 2 Nov 2016Dongarra JJ, DuCroz J, Hammarling S, Hanson RJ (1985) A proposal for an extended set of fortran basic linear algebra subprograms. ACM Signum Newsletter, New York, pp 2–18Golub GH, Loan CFV (2013) Matrix Comput, 4th edn. The John Hopkins University Press, BaltimoreAlonso P, Badia RM, Labarta J, Barreda M, Dolz MF, Mayo R, Quintana-Ortí ES, Reyes R (2012) Tools for power-energy modelling and analysis of parallel scientific applications. In: 41st International Conference on Parallel Processing—ICPP, 2012, pp 420–42

Identification of Degraded Land in the Canary Islands; Tests and Reviews

Degraded Land is an area that either by natural causes (fires, floods, storms or volcanic eruptions) or more by direct or indirect causes of human action, has been altered or modified from its natural state. Restoration is an activity that initiates or accelerates the recovery of an ecosystem. It can be defined as the set of actions taken in order to reverse or reduce the damage caused in the territory. In the case of the Canary Islands there is a high possibility for the territory to suffer processes that degrade the environment, given that the islands are very fragile ecosystems. Added to this they are territories isolated from the continent, which complicates the process of restoring them. In this paper, the different types of common degraded areas in the Canary Islands are identified, as well as the proposed solutions for remediation, such as afforestation of agricultural land or landfill closure and restoration

Socioeconomic status, urbanicity and risk behaviors in Mexican youth: an analysis of three cross-sectional surveys

<p>Abstract</p> <p>Background</p> <p>The relationship between urbanicity and adolescent health is a critical issue for which little empirical evidence has been reported. Although an association has been suggested, a dichotomous rural versus urban comparison may not succeed in identifying differences between adolescent contexts. This study aims to assess the influence of locality size on risk behaviors in a national sample of young Mexicans living in low-income households, while considering the moderating effect of socioeconomic status (SES).</p> <p>Methods</p> <p>This is a secondary analysis of three national surveys of low-income households in Mexico in different settings: rural, semi-urban and urban areas. We analyzed risk behaviors in 15-21-year-olds and their potential relation to urbanicity. The risk behaviors explored were: tobacco and alcohol consumption, sexual initiation and condom use. The adolescents' localities of residence were classified according to the number of inhabitants in each locality. We used a logistical model to identify an association between locality size and risk behaviors, including an interaction term with SES.</p> <p>Results</p> <p>The final sample included 17,974 adolescents from 704 localities in Mexico. Locality size was associated with tobacco and alcohol consumption, showing a similar effect throughout all SES levels: the larger the size of the locality, the lower the risk of consuming tobacco or alcohol compared with rural settings. The effect of locality size on sexual behavior was more complex. The odds of adolescent condom use were higher in larger localities only among adolescents in the lowest SES levels. We found no statically significant association between locality size and sexual initiation.</p> <p>Conclusions</p> <p>The results suggest that in this sample of adolescents from low-income areas in Mexico, risk behaviors are related to locality size (number of inhabitants). Furthermore, for condom use, this relation is moderated by SES. Such heterogeneity suggests the need for more detailed analyses of both the effects of urbanicity on behavior, and the responses--which are also heterogeneous--required to address this situation.</p

Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal.

Background: Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth. Methods: A qualitative study comprising five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers. The qualitative findings in Nepal were compared and contrasted with the literature on practices and cultural beliefs related to the pregnancy and childbirth period across the globe and at different times in history. Results: The themes that emerged from the analysis included: (a) cord cutting & placenta rituals; (b) rest & seclusion; (c) purification, naming & weaning ceremonies and (d) nutrition and breastfeeding. Physiological changes in mother and baby may underpin the various beliefs, ritual and practices in the postnatal period. These practices often mean women do not access postnatal health services. Conclusions: The cultural practices, taboos and beliefs during pregnancy and around childbirth found in Nepal largely resonate with those reported across the globe. This paper stresses that local people’s beliefs and practices offer both opportunities and barriers to health service providers. Maternity care providers need to be aware of local values, beliefs and traditions to anticipate and meet the needs of women, gain their trust and work with them

Migrant and refugee populations: a public health and policy perspective on a continuing global crisis.

The 2015-2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day