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

Damage evaluation during installation of geosynthetics used in asphalt pavements

Geosynthetics are commonly used as anti-reflective cracking systems in asphalt pavements. The rehabilitation design methods use the characteristics of as-received geosynthetics as inputs. However, these materials undergo physical damage during their installation due to mechanical and thermal loads which currently are not taken into account in the design processes. These loads can produce a reduction in geosynthetic strength and therefore, it is necessary to know the secant modulus after installation in order to improve the pavement design incorporating these materials. The secant modulus of a material indicates its initial stiffness. This paper describes an experimental study of damage due to installation of five different geosynthetics using three different procedures: (i) mechanical damage induced in the laboratory considering the action of aggregates, (ii) in situ mechanical and thermal damage due to actual installation in a test section, and (iii) a new mechanical and thermal damage experimental test developed with the aim of reproducing the real installation conditions. The main results of the study indicate that the obtained secant modulus of the tested geosynthetics reduced after applying the three damage procedures, and the loss of properties differed depending on the type and constitutive material and on the applied damage procedure.This investigation was supported by the research Project ‘Rehabilitation of roads and highways (REHABCAR)’ file number IPT-370000–2010–029, led by DRAGADOS (ACS Group), in collaboration with GEOCISA and ASFALTOS AUGUSTA among others. The project has been funded by the Ministry of Economy and Competitiveness (MINECO) within the National Plan for Scientific Research, Development and Innovation 2008–2011 (INNPACTO 2010) and the European Union under ERDF Funds (European Regional Development Fund)

GraphCombEx: A Software Tool for Exploration of Combinatorial Optimisation Properties of Large Graphs

We present a prototype of a software tool for exploration of multiple combinatorial optimisation problems in large real-world and synthetic complex networks. Our tool, called GraphCombEx (an acronym of Graph Combinatorial Explorer), provides a unified framework for scalable computation and presentation of high-quality suboptimal solutions and bounds for a number of widely studied combinatorial optimisation problems. Efficient representation and applicability to large-scale graphs and complex networks are particularly considered in its design. The problems currently supported include maximum clique, graph colouring, maximum independent set, minimum vertex clique covering, minimum dominating set, as well as the longest simple cycle problem. Suboptimal solutions and intervals for optimal objective values are estimated using scalable heuristics. The tool is designed with extensibility in mind, with the view of further problems and both new fast and high-performance heuristics to be added in the future. GraphCombEx has already been successfully used as a support tool in a number of recent research studies using combinatorial optimisation to analyse complex networks, indicating its promise as a research software tool

Ministries of Health and the Stewardship of Health Evidence

This chapter describes how Ministries of Health have been mandated to act as stewards of populations’ health according to the World Health Organization. We argue that this mandate extends to them having (at least partial) responsibility for ensuring relevant evidence informs policy decisions. Yet this requires consideration of the evidence advisory systems serving Ministry needs, particularly whether or how such systems work to provide relevant information in a timely manner to key decision points in the policy process. Insights from our six cases are presented to illustrate the structural and practical differences which exist between evidence advisory systems and how, at certain times, key health decisions may in fact lie outside ministerial authority. These divergent experiences highlight a range of analytical challenges when considering the provision of evidence to inform health decisions from an institutional perspective

Potential migratory routes of Urania boisduvalii (Lepidoptera: Uraniidae) among host plant populations

This work is licensed under a Creative Commons Attribution 4.0 International License.Aim Migratory species depend on various habitats and resources along their migration routes. Characteristics such as dependence on distinct habitats and the presence of multiple threats along their migratory routes make these species vulnerable, and gaps in knowledge about their ecology and migration processes make them difficult to conserve. Urania boisduvalii is a diurnal moth endemic to Cuba that feeds on plants of Omphalea spp. during its larval phases. These plants produce secondary metabolites as a defence against the moth's larvae, which then are forced to migrate. Although some ecological aspects of Urania boisduvalii are known, its migration routes remain largely unknown. This research proposes potential migratory routes of Urania boisduvalii among populations of its host plant. Location Cuba. Methods We developed ecological niche models of the moth and its hosts based on environmental, anthropic, biotic and biogeographic factors to obtain potential distributional areas that include zones where positive interactions are found but exclude those where negative factors are present. These areas were overlapped to hypothesize potential breeding areas for the moths. Potential migratory corridors were proposed based on environmental connectivity. Results The moth and its hosts have broad potential distributions; however, limiting factors have substantially reduced these areas, especially for plants. The potential migratory routes of Urania boisduvalii are complex and mostly involve the western and eastern regions of Cuba. Most records outside potential breeding areas were close to these migratory corridors. Main conclusions We offer initial hypotheses of the migratory routes of U. boisduvalii, which may be useful to guiding monitoring projects that can provide more definitive views of the seasonal distribution of this species across the Cuban archipelago

Minería de datos y big data: aplicaciones en señales y textos

Esta línea de investigación se centra en el estudio y desarrollo de Sistemas Inteligentes para la resolución de problemas de Minería de Datos y Big Data utilizando técnicas de Aprendizaje Automático. Los sistemas desarrollados se aplican particularmente al procesamiento de señales y textos. Con respecto al procesamiento de Señales el énfasis está puesto en el análisis de videos con el objetivo de identificar acciones humanas que faciliten la interfaz hombre/máquina y en la detección de patrones de movimiento de los objetos presentes. En el área de la Minería de Datos se está trabajando, por un lado, en la generación de un modelo de fácil interpretación a partir de la extracción de reglas de clasificación que permita justificar la toma de decisiones y, por otro lado, en el desarrollo de nuevas estrategias para tratar grandes volúmenes de datos. Con respecto a Minería de Textos se han desarrollado métodos capaces de extraer las palabras clave de documentos independientemente del lenguaje. Además, se han desarrollando estrategias para resumir documentos a través de la extracción de párrafos.Eje: Bases de datos y Minería de datos.Red de Universidades con Carreras en Informátic

Prenatal ultrasound and postmortem histologic evaluation of tooth germs: an observational, transversal study

Introduction: Hypodontia is the most frequent developmental anomaly of the orofacial complex, and its detection in prenatal ultrasound may indicate the presence of congenital malformations, genetic syndromes and chromosomal abnormalities.To date, only a few studies have evaluated the histological relationship of human tooth germs identified by two-dimensional (2D) ultrasonography. In order to analyze whether two-dimensional ultrasonography of tooth germs may be successfully used for identifying genetic syndromes, prenatal ultrasound images of fetal tooth germs obtained from a Portuguese population sample were compared with histological images obtained from fetal autopsies.Methods: Observational, descriptive, transversal study. The study protocol followed the ethical principles outlined by the Helsinki Declaration and was approved by the Ethics Committee of the School of Dental Medicine, University of Porto (FMDUP, Porto, Portugal) and of the Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/EPE, Porto, Portugal) as well as by the CGC Genetics Embryofetal Pathology Laboratory. Eighty-five fetuses examined by prenatal ultrasound screening from May 2011 to August 2012 had an indication for autopsy following spontaneous fetal death or medical termination of pregnancy. Of the 85 fetuses, 37 (43.5%) were randomly selected for tooth germ evaluation by routine histopathological analysis. Fetuses who were up to 30 weeks of gestation, and whose histological pieces were not representative of all maxillary tooth germs was excluded. Twenty four fetus between the 13th and 30th weeks of gestation fulfilled the parameters to autopsy.Results: Twenty four fetuses were submitted to histological evaluation and were determined the exact number, morphology, and mineralization of their tooth germs. All tooth germs were identifiable with ultrasonography as early as the 13th week of gestation. Of the fetuses autopsied, 41.7% had hypodontia (29.1% maxillary hypodontia and 20.9% mandibular hypodontia).Conclusions: This results indicateinfo:eu-repo/semantics/publishedVersio

Aprendizaje automático profundo y visión por computadora: aplicaciones en el reconocimiento de lengua de señas e imágenes astronómicas

Esta línea de investigación se centra en el estudio y desarrollo de Sistemas Inteligentes para la resolución de problemas de reconocimiento de patrones en imágenes y video, utilizando técnicas de Aprendizaje Automático clásicas, junto con Redes Neuronales Convolucionales y Aprendizaje profundo. El trabajo presentado describe diferentes casos de aplicación en visión por computadora. Una de las líneas de investigación principales que se continúa desarrollando es el reconocimiento de lengua de señas. Este es un problema complejo y multidisciplinar, que presenta diversos subproblemas a resolver como el reconocimiento del intérprete, la segmentación de manos, la clasificación de diferentes configuraciones y de un gesto dinámico, entre otros. En esta área se está estudiando la forma de reconocer formas de mano de la Lengua de Señas con conjuntos de datos de tamaño reducido, dada la falta de datos de entrenamiento para este dominio. Además, se están comenzando a utilizar Redes Generativas Adversarias (GANs) para aumentar bases de datos de formas de mano, con el objetivo de complementar desde otro enfoque el entrenamiento de modelos para su clasificación. Por otro lado, se está estudiando la forma en que las redes neuronales codifican la invarianza a las transformaciones y otras propiedades transformacionales, con el objetivo de poder analizar y comparar estos modelos, y finalmente mejorarlos. De esta forma se espera poder mejorar los modelos de clasificación de objetos transformados, en particular, de formas de mano. Siguiendo con la línea de reconocimiento de patrones en imágenes, se está llevando a cabo una colaboración con investigadores de la Facultad de Astronomía y Geofísica de la UNLP para crear modelos de clasificación de imágenes de objetos celestes. Además, se está desarrollando un sistema para recuperar la información de placas espectrográficas astronómicas antiguas, con el objetivo de recuperar los espectrogramas que contienen. Por último, se está diseñando un prototipo para crear experiencias interactivas multimedia que incorpore técnicas de aprendizaje profundo tanto para la entrada de datos por parte de los usuarios, como para la generación de una salida en forma de imágenes, videos, sonido y texto.Eje: Agentes y Sistemas Inteligentes.Red de Universidades con Carreras en Informátic