Multidimensional poverty indices and first order dominance techniques : an empirical comparison of different approaches

In this paper we contrast different perspectives to the measurement of multidimensional poverty. Using data from 38 Demographic and Health Surveys around the developing world, we have compared the performance of two broad approaches: multidimensional poverty indices and first order dominance techniques (FOD). Our empirical findings suggest that the FOD approach might be a reasonable cost-effective alternative to the United Nations Development Program (UNDP)'s flagship poverty indicator: the Multidimensional Poverty Index (MPI). To the extent that the FOD approach is able to uncover the socio-economic gradient that exists between countries, it can be proposed as a viable alternative to the MPI with the advantage of not having to rely on the somewhat arbitrary and normatively binding assumptions that underpin the construction of UNDP's index

First Order Dominance Techniques and Multidimensional Poverty Indices:An Empirical Comparison of Different Approaches

In this empirically driven paper we compare the performance of two techniques in the literature of poverty measurement with ordinal data: multidimensional poverty indices and first order dominance techniques (FOD). Combining multiple scenario simulated data with observed data from 48 Demographic and Health Surveys around the developing world, our empirical findings suggest that the FOD approach can be implemented as a useful robustness check for ordinal poverty indices like the multidimensional poverty index (MPI; the United Nations Development Program's flagship poverty indicator) to distinguish between those country comparisons that are sensitive to alternative specifications of basic measurement assumptions and those which are not. To the extent that the FOD approach is able to uncover the socio-economic gradient that exists between countries, it can be proposed as a viable complement to the MPI with the advantage of not having to rely on many of the normatively binding assumptions that underpin the construction of the index

P42 127. Impacto hospitalario de las complicac iones esternales

IntroducciónLas complicaciones esternales suponen una de las complicaciones más importantes dentro de la cirugía cardíaca, con necesidad, en ocasiones, de reintervenir al paciente con el aumento de estancia hospitalaria y gasto económico que ello supone. Hemos analizado el impacto hospitalario que provoca en nuestro servicio la aparición de dicha complicación.Material y métodosHemos recogido durante 2 años consecutivos (2007 y 2008) todos los pacientes intervenidos en nuestro centro (n = 1.001), cuyo acceso quirúrgico ha sido la esternotomía media. Se han contabilizado todas las complicaciones esternales, registrando la estancia media en unidad de cuidados intensivos (UCI), estancia media hospitalaria y mortalidad a los 30 días de cada paciente.Se han comparado estos datos con los datos recogidos en pacientes sin complicaciones esternales. Se ha estimado el impacto económico que se deriva del tratamiento de dichas complicaciones mediante.ResultadosLa tasa de complicaciones esternales ha sido de 3,8% (n=38), siendo necesaria la reintervención sólo en cinco pacientes (13%). La estancia media en planta ponderada de los 2 años analizados ha sido de 9,5 días/paciente frente a 29,85 días en los pacientes con complicaciones esternales. La estancia media en UCI ha sido de 5,22 días/paciente frente a 11,63 en los pacientes con complicaciones. La mortalidad global ha sido de 5,6 frente a 23,6% en los pacientes con complicaciones esternales. El gasto medio global por ingreso ha sido de 9.600 €/paciente, elevándose a 28.000 € en los pacientes con complicaciones esternales.ConclusionesLas complicaciones esternales aumentan la estancia media hospitalaria y en UCI, condicionando un aumento de la mortalidad y del gasto sanitario

Use of venous thromboprophylaxis and adherence to guideline recommendations : a cross-sectional study

Background: Consensus Conferences and Guidelines for deep vein thrombosis prophylaxis have been published, which recommend the use of prophylactic heparins in patients with risk of venous thromboembolism (VTE). The aim of this study was the assessment of the prophylaxis of VTE and the adherence to accepted guideline recommendations throughout the hospital. Methods: A cross-sectional study was carried out in a teaching hospital after guidelines were implemented. Patients' risk factors of deep vein thrombosis, risk categories of patients, and prophylaxis used in different wards were recorded. Appropriate adherence to the guidelines was analysed. Results: Of 397 patients, prophylaxis was used in 231 patients (58%), and low-molecular-weight heparins (LMWH) were used in 224 of them (97%). Patients with prophylaxis had a higher mean number of risk factors (SD) than those without prophylaxis [3.1 (1.4) vs 1.9 (1.4); p < 0.05)]. Prophylaxis was used in 72% and 90% of moderate and high-risk patients respectively. Appropriate adherence to all guideline recommendations was observed in 42% of patients. Adherence to guidelines was high as regards the use of prophylaxis according to patients' risk factors (78%) and the use of appropriate types of prophylaxis (99%), but was low regarding appropriate heparin dosage (47%) and preoperative dosage (37%). Appropriate prophylaxis use was higher in critical care and surgical wards than in medical wards. Conclusion: Prophylaxis of VTE is generally used in risk patients, but appropriate adherence to guidelines is less frequent and variable among different wards. Continuing medical education, discussion and dissemination of guidelines, and regular clinical audit are necessary to improve prophylaxis of VTE in clinical practice

Assessment of the impact of a clinical and health services research call in Catalonia

This article presents the ex-post assessment of a program of clinical and health services research and the evaluation of the social impact. The Catalan Agency for Health Information, Assessment, and Quality (CAHIAQ) promotes a biannual open, public, competitive extramural research call to conduct non-commercial clinical and health services research. Its aim is to address local needs of research (knowledge gaps) and to assess the implementation of innovation. Approximately 5.8 million Euros have been allocated to the call. To meet the Agency’s mission, a periodical ‘call for expressions of interest’ and topic prioritization is organized prior to the research call. The awarded projects are submitted to an ex-ante, ongoing, and ex-post assessment. Impact assessment of the research call on advancing knowledge and healthcare decision making is based on the Canadian Academy of Health Sciences framework (Panel on Return on Investment in Health Research, 2009). The methods used include bibliometric analysis, surveys to researchers and decision-makers, and a more in-depth case study of translation pathways. This includes a crossover of cases from 1996 to 2004. Some results are compared against other international health services research calls. The conclusion is that local agencies can significantly contribute to fill knowledge gaps in a specific context. Assessment of the complete research cycle provides opportunities for improving the entire research process (identification of knowledge needs, call for proposals, funding allocation, research completion, subsequent impact). Specifically, assessment of the different types of impact of research development on knowledge generation and decision making closes the evaluation cycle fulfilling the Agency's mission.Fil: Adam, Paula. Catalan Agency for Health Information; España. Epidemiologia y Salud Pública; EspañaFil: Solans Doménech, Maite. Catalan Agency for Health Information; España. Epidemiologia y Salud Pública; EspañaFil: Pons, Joan M. V.. Catalan Agency for Health Information; España. Epidemiologia y Salud Pública; España. Gobierno de Catalunya. Ministerio de Salud; EspañaFil: Aymerich, Marta. Gobierno de Catalunia. Ministerio de Salud; España. Universidad de Girona; EspañaFil: Berra, Silvina del Valle. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Guillamon, Imma. Catalan Agency for Health Information; España. Epidemiologia y Salud Pública; EspañaFil: Sánchez, Emilia. Universitat Ramon Llull; EspañaFil: Permanyer Miralda, Gaieta. Catalan Agency for Health Information; España. Epidemiologia y Salud Pública; España. Universidad Autonoma de Barcelona. Hospital Vall D; Españ

Aspectes ètics de la innovació clínica: la cirurgia com a exemple

Ètica; Innovació quirúrgica; TransparènciaÉtica; Innovación quirúrgica; TransparenciaEthics; Surgical innovation; TransparencyAquest document no pot ser de caràcter normatiu, més quan es tracta d’un terreny difícil de delimitar. El que es pretén es impulsar un debat entre totes les parts implicades en la innovació quirúrgica (intervencionisme en general), és a dir, entre pacients i associacions que els representen, professionals i societats científiques i institucions i finançadors de l’assistència i la recerca en ciències de la salut, per tal que el procés d’innovació clínica es pugui portar a terme en unes condicions més favorables al progrés i millora de la qualitat en l’atenció i en la seguretat dels pacients

MGEScan-non-LTR: computational identification and classification of autonomous non-LTR retrotransposons in eukaryotic genomes

Computational methods for genome-wide identification of mobile genetic elements (MGEs) have become increasingly necessary for both genome annotation and evolutionary studies. Non-long terminal repeat (non-LTR) retrotransposons are a class of MGEs that have been found in most eukaryotic genomes, sometimes in extremely high numbers. In this article, we present a computational tool, MGEScan-non-LTR, for the identification of non-LTR retrotransposons in genomic sequences, following a computational approach inspired by a generalized hidden Markov model (GHMM). Three different states represent two different protein domains and inter-domain linker regions encoded in the non-LTR retrotransposons, and their scores are evaluated by using profile hidden Markov models (for protein domains) and Gaussian Bayes classifiers (for linker regions), respectively. In order to classify the non-LTR retrotransposons into one of the 12 previously characterized clades using the same model, we defined separate states for different clades. MGEScan-non-LTR was tested on the genome sequences of four eukaryotic organisms, Drosophila melanogaster, Daphnia pulex, Ciona intestinalis and Strongylocentrotus purpuratus. For the D. melanogaster genome, MGEScan-non-LTR found all known ‘full-length’ elements and simultaneously classified them into the clades CR1, I, Jockey, LOA and R1. Notably, for the D. pulex genome, in which no non-LTR retrotransposon has been annotated, MGEScan-non-LTR found a significantly larger number of elements than did RepeatMasker, using the current version of the RepBase Update library. We also identified novel elements in the other two genomes, which have only been partially studied for non-LTR retrotransposons

Multi-Way Multi-Group Segregation and Diversity Indices

Background: How can we compute a segregation or diversity index from a three-way or multi-way contingency table, where each variable can take on an arbitrary finite number of values and where the index takes values between zero and one? Previous methods only exist for two-way contingency tables or dichotomous variables. A prototypical three-way case is the segregation index of a set of industries or departments given multiple explanatory variables of both sex and race. This can be further extended to other variables, such as disability, number of years of education, and former military service. Methodology/Principal Findings: We extend existing segregation indices based on Euclidean distance (square of coefficient of variation) and Boltzmann/Shannon/Theil index from two-way to multi-way contingency tables by including multiple summations. We provide several biological applications, such as indices for age polyethism and linkage disequilibrium. We also provide a new heuristic conceptualization of entropy-based indices. Higher order association measures are often independent of lower order ones, hence an overall segregation or diversity index should be the arithmetic mean of the normalized association measures at all orders. These methods are applicable when individuals selfidentify as multiple races or even multiple sexes and when individuals work part-time in multiple industries. Conclusions/Significance: The policy implications of this work are enormous, allowing people to rigorously test whethe

A human rights-consistent approach to multidimensional welfare measurement applied to sub-Saharan Africa

We discuss and compare the properties of the multidimensional poverty index and first-order dominance approach and apply both measures to 26 African countries using data near 2002 and 2012. Results across the two measures are broadly similar but not the same. For example, while the multidimensional poverty index suggests that all countries are advancing, FOD indicates that 14 countries experience broad-based progress, two countries show more moderate likelihoods of progress, and the remaining 10 countries neither improve nor deteriorate in terms of attainment of rights for the dimensions considered. We conclude that the multidimensional poverty index and first-order dominance approaches are useful complements that should be employed in tandem.PRIFPRI3; ISI; 5 Strengthening Institutions and Governance; G Cross-cutting gender themeEPT