Long-term effects of school quality on health and lifestyle: evidence from comprehensive schooling reforms in England

Members of the National Child Development Study cohort attended very different types of secondary schools, as their schooling lay within the transition period of the comprehensive education reform in England and Wales. This provides a natural setting to explore the impact of educational attainment and of school quality on health and health-related behavior later in life. We use a combination of matching methods and parametric regressions to deal with selection effects and to evaluate differences in adult health outcomes and health-related behavior for cohort members exposed to the old selective and to the new comprehensive educational systems

Quality of schooling and inequality of opportunity in health

This paper explores the role of quality of schooling as a source of inequality of opportunity in health. Substantiating earlier literature that links differences in education to health disparities, the paper uses variation in quality of schooling to test for inequality of opportunity in health. Analysis of the 1958 NCDS cohort exploits the variation in type and quality of schools generated by the comprehensive schooling reforms in England and Wales. The analysis provides evidence of a statistically significant and economically sizable association between some dimensions of quality of education and a range of health and health-related outcomes. For some outcomes the association persists, over and above the effects of measured ability, social development, academic qualifications and adult socioeconomic status and lifestyle

Livestock Identification and Traceability System – a case study mobile implementation based on a generic architecture for livestock management

In a constantly growing market, the ability to provide quick, reliable solutions is becoming more and more important. Companies want to spend less time build the base of the project and more time in what makes it unique, perfecting it to the client’s wishes. It is not surprising that a company ends up reusing the base of an old project and adapting it to new ones. As this goes on, it becomes clearer that a base project with a well-defined generic architecture would benefit the companies that do this. Based on previous applications developed by the company, a set of requirements were defined that would need to be included in the generic architecture, such as offline mode, communication with RFID devices, and synchronization. This thesis purposes a solution, based on the recommended guidelines, of how this can be achieved, the technologies it uses, and how they interact with each other to achieve a flexible, adaptable solution

Barefoot and Footloose Doctors: Optimal Resource Allocation in Developing Countries with Medical Migration

In light of the shortage of healthcare professionals, many developing countries operate a defacto two-tiered system of healthcare provision, in which Community Health Workers (CHWs) supplement service provision by fully qualified physicians. CHWs are relatively inexpensive to train but can treat only a limited range of medical conditions. This paper explicitly models a two-tiered structure of healthcare provision and characterizes the optimal allocation of resources between training doctors and CHWs, and implications for population health outcomes. We analyze how medical migration alters resource allocation and population health outcomes, shifting resources towards training CHWs. In the model, migration stimulates health care provision at the lower end of the illness severity spectrum, improving health outcomes for those patients; sufferers of relatively severe medical conditions who can only be treated by doctors are made worse off. It is further shown that donor countries must be reimbursed by more than the training cost of emigrating physicians in order to restore aggregate population health to the pre-migration level, assuming that there are increasing marginal costs in involved in replacing migrating physicians

Antimicrobial resistance in Streptococcus pneumoniae: mechanisms and current epidemiology

Infections caused by Streptococcus pneumoniae are a worrisome public health problem worldwide. Young children and elderly are the main age group affected and the highest burden of the disease are among developing countries. Pneumococcal infections cause 11% of the total of infant deaths, representing the leading cause of child death currently preventable by vaccination. Epidemiologic information about pneumococci in Brazil is somehow restrict, but available data reinforce the worrisome occurrence of pneumococcal diseases, which are commonly treated empirically. Limitations in the diagnostic methods, along with the severity of disease contribute to this behavior. Thus, surveillance studies are crucial to define the prevalence of resistant strains both globally or in a particular region, as these strains may compromise empirical therapeutical choices. However, although different clones of PNSP are internationally distributed, and considering diseases other than meningitis, the prevalence to penicillin is quite low, making this old, safe, and inexpensive drug an attractive first choice to treat pneumococcal infections. The widespread use of conjugate vaccines among children, influencing the circulation of resistant clones and the distribution of serotypes reinforces the need of surveillance studies to define prevalence of resistance.Infections caused by Streptococcus pneumoniae are a worrisome public health problem worldwide. Young children and the elderly are the main age groups affected and the highest burden of the disease is found in developing countries. Pneumococcal infections cause 11% of the total infant deaths, representing the leading cause of child death currently preventable by vaccination. Epidemiologic information about pneumococci in Brazil is somehow restricted, but available data reinforce the worrisome occurrence of pneumococcal diseases, which are commonly treated empirically. Limitations in the diagnostic methods, along with the severity of disease contribute to this behavior. Thus, surveillance studies are crucial to define the prevalence of resistant strains both globally and in a particular region, as these strains may compromise empirical therapeutic choices. However, although different clones of penicillin non-susceptible pneumococci are internationally distributed, and considering diseases other than meningitis, the prevalence of resistance to penicillin is quite low, making this old, safe, and inexpensive drug an attractive first choice to treat pneumococcal infections. The widespread use of conjugate vaccines among children, influencing the circulation of resistant clones and the distribution of serotypes reinforces the need of surveillance studies to define the prevalence of resistance

Azathioprine-induced interstitial nephritis in an anti-neutrophil cytoplasmic antibody (ANCA) myeloperoxidase (MPO) vasculitis patient

Azathioprine (AZA) is used in a wide array of autoimmune diseases, still corresponding to the mainstay maintenance therapy in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Although generally well-tolerated, several side effects are recognized. We report the case of a 50-year-old Caucasian man with kidney-limited ANCA myeloperoxidase (MPO) vasculitis who presented with general malaise, fever, worsening renal function, and elevated inflammatory markers 2 weeks after the initiation of therapy with oral AZA. Although a disease relapse was suspected, renal biopsy revealed an eosinophilic infiltrate, suggestive of acute interstitial nephritis. After suspension of AZA, a sustained improvement of renal function and normalization of inflammatory markers was observed. A diagnosis of allergic interstitial nephritis secondary to AZA was established, corresponding to the first biopsy-proven case described in an ANCA MPO vasculitis patient. Although rare, renal toxicity of AZA must be present in the clinician's mind, avoiding the straightforward assumption of disease relapse in the case of worsening renal function.info:eu-repo/semantics/publishedVersio

Ensaio Clínico Randomizado para o Tratamento do Helicobacter pylori em Doentes Portugueses Naive : É o Tratamento Sequencial Superior ao Tratamento Triplo na Prática Clínica?

Introduction: Helicobacter pylori eradication has become increasingly difficult as resistances to several antibiotics develop. We aimed to compare Helicobacter pylori eradication rates between triple therapy and sequential therapy in a naive Portuguese population. Material and Methods: Prospective randomized trial including consecutive patients referred for first-line Helicobacter pylori eradication treatment. Exclusion criteria: previous gastric surgery/neoplasia, pregnancy/lactancy, allergy to any of the drugs. The compared eradication regimens were triple therapy (pantoprazol, amoxicillin and clarithromycin 12/12 hours, 14 days) and sequential therapy (pantoprazol 12/12 hours for 10 days, amoxicillin 12/12 hours for days 1-5 and clarithromycin plus metronidazol 12/12 hours during days 6 -10). Eradication success was confirmed with urea breath test. Statistical analysis was performed with SPSS v21.0 and a p-value < 0.05 was considered statistically significant. Results: Included 60 patients, 39 (65%) female with mean age 52 years (SD +/- 14.3). Treatment groups were homogeneous for gender, age, indication for treatment and smoking status. No statistical differences were encountered between sequential and triple therapy eradication rates (86.2% vs 77.4%, p = 0.379), global eradication rate was 82%. Tobacco consumption was associated with a significantly lower eradication success (54.5 vs 87.8%, p = 0.022). Discussion: In this randomized controlled trial in a naive Portuguese population, we found a satisfactory global Helicobacter pylori eradication rate of 82%, with no statistical differences observed in the efficacy of the treatment between triple and sequential regimens. Conclusion: These results support the use of either therapy for the first-line eradication of Helicobacter pylori.info:eu-repo/semantics/publishedVersio

A aprendizagem de sistemas de duas equações a duas incógnitas no 8.º ano de escolaridade

Relatório de estágio de mestrado, Educação (Didática da Matemática), Universidade de Lisboa, Instituto de Educação, 2012O presente trabalho apresenta um relatório de uma unidade de ensino sobre a resolução de sistemas de equações que procura estudar a relação entre a abordagem utilizada na sala de aula e a aprendizagem realizada pelos alunos. Visa ainda perceber até que ponto a compreensão da noção de equação e as possíveis dificuldades na manipulação algébrica, nomeadamente na simplificação de expressões algébricas, condicionam a compreensão formal da noção de sistema de equações. A metodologia utilizada consistiu na lecionação dos sistemas de equações do 1.º grau a duas incógnitas a uma turma do 8.º ano de escolaridade utilizando uma estratégia de ensino-aprendizagem de cunho exploratório através da aplicação de um conjunto diversificado de tarefas e valorizando as discussões coletivas. A análise de dados deu especial atenção às produções escritas de todos os alunos da turma, bem como aos momentos de discussão. Além disso, foi recolhido material vídeo e áudio e documental que foi igualmente analisado e mobilizado para a construção deste relatório. Os resultados confirmam que a já prevista dificuldade na manipulação algébrica constitui um forte fator de insucesso de aprendizagem dos sistemas de equações. Contudo, essa dificuldade não pareceu afetar a compreensão da noção de sistemas de equações. Os alunos, para além de mostrarem compreender a necessidade de encontrarem um par ordenado para satisfazer a conjunção de duas equações, mostraram ainda compreender a interpretação gráfica de sistemas de equações, bem como a importância de aprender como criar sistemas de equações para resolver problemas. Algumas destas estratégias foram encontradas pelos alunos com o auxílio do Geogebra e permitem identificar um claro progresso na sua aprendizagem e uma fácil adaptação à utilização deste software. O papel das tecnologias na aprendizagem deverá mesmo ser objeto de estudo e desenvolvimento futuro.The present work presents a report of a teaching unit about the study of the solution of systems of equations that seeks to study the relationship between the approach used in the classroom and students’ learning. It also seeks to know how far the understanding of the notion of equation and the possible difficulties in algebraic manipulation, particularly in simplifying algebraic expressions, conditions the understanding of conceptual formal system of equations. The methodology used consisted in teaching systems of first degree equations with two unknowns to a class of grade 8 students using an exploratory teaching strategy using a diversity of tasks. Data analysis gave especial attention to the written productions of all students in the class as well as to collective discussions. In addition, video and audio records and other documental data was also analyzed and mobilized for the construction of this report. The results confirm that the already anticipated difficulty in algebraic manipulation is a strong factor of failure in learning systems of equations. However, this difficulty did not seem to affect the understanding of the notion of systems of equations. The students not only seem to understand the need of finding an ordered pair to solve two equations simultaneously, but also understood the graphic interpretation of systems of equations as well as the importance of learning how to create them to solve problems. Some of these strategies were established by the students with the support of Geogebra and allow the identification of a global progress in student learning and also an easy adaptation to the use of this software. The role of technology in learning process must be object of further studies

Heterogeneity in the Impact of Type of Schooling on Adult Health and Lifestyle

Using data from a major educational reform in England and Wales, we examine heterogeneity in the long-term impacts of the exposure to different secondary schooling systems, characterized by selective early-tracking system versus non-selective comprehensive schooling, on health outcomes and smoking. We adopt a local instrumental variables approach to estimate person-centered treatment (PeT) effects, thereby recovering the full distribution of individual-level causal effects. We find that the transition from a selective early-tracking system to a non-selective one produced, on a fraction of individuals, significantly increased depression and cigarette smoking. These effects were persistent over time. Cognitive abilities did not moderate the effects, but students with lower non-cognitive skills were most likely to be negatively affected by this exposure

Estimating the impact of trained midwives and upgraded health facilities on institutional delivery rates in Nigeria using a quasi-experimental study design

OBJECTIVES: Studies have shown that demand-side interventions, such as conditional cash transfers and vouchers, can increase the proportion of women giving birth in a health facility in low-income and middle-income countries, but there is limited evidence of the effectiveness of supply-side interventions. We evaluated the impact of the Subsidy Reinvestment and Empowerment Programme Maternal and Child Health Project (SURE-P MCH) on rates of institutional delivery and antenatal care. DESIGN, SETTING AND PARTICIPANTS: We used a differences-in-differences study design that compared changes in rates of institutional delivery and antenatal care in areas that had received additional support through the SURE-P MCH programme relative to areas that did not. Data on outcomes were obtained from the 2013 Nigerian Demographic and Health Survey. RESULTS: We found that the programme significantly increased the proportion of women giving birth in a health facility by approximately 7 percentage points (p=0.069) or approximately 10% relative to the baseline after 9 months of implementation. The programme, however, did not significantly increase the use of antenatal care. CONCLUSION: The findings of this study suggest there could be important improvements in institutional delivery rates through greater investment in supply-side interventions