Child Health Care in Ireland

The Irish health care system is based on a complex and costly mix of private, statutory, and voluntary provisions. The majority of health care expenditure comes from the state, with a significant proportion of acute hospital care funded from private insurance, but there are relatively high out-of-pocket costs for most service users. There is free access to acute hospital care, but not for primary care, for all children. About 40% of the population have free access to primary care. Universal preventive public health services, including vaccination and immunization, newborn blood spot screening, and universal neonatal hearing screening are free. Major health challenges include poverty, obesity, drug and alcohol use, and mental health. The health care system has been dominated for the last 5 years by the impact of the current recession, which has led to very sharp cuts in health care expenditure. It is unclear if the necessary substantial reform of the system will happen. Government policy calls for a move toward a patient-centered, primary care-led system, but without very substantial transfers of resources and investment in Information and Communication Technology, this is unlikely to occur. The paper has been published as part of an overall report of Child Health in Europe: Diversity of Child Health Care in Europe: A Study of the European Paediatric Association/Union of National European Paediatric Societies and Associations http://www.jpeds.com/issue/S0022-3476(16)X0010-8 . (J Pediatr 2016;177S:S87-106).  

Activité physique et récompense : impact de la leptine et de la signalisation STAT3 dans les neurones dopaminergiques

La course d’endurance active le système de récompense (SR) et est reliée aux comportements de recherche alimentaire. L’influence de la leptine sur l’activité physique (AP) volontaire est bien documentée d’un point de vue physiologique, mais très peu en termes d’impact hédonique. La leptine inhibe l’effet récompensant lié à la consommation de nourriture et joue un rôle semblable pour d’autres types de stimuli. La leptine s’arrime à la forme longue du récepteur à la leptine (Leprb) situé sur les neurones à dopamine (DA) et GABA de l’aire tegmentale ventrale (ATV) dans le mésencéphale. Signal transducer and Activator of Transcription 3 (STAT3) est un facteur de transcription important de la cascade de signalisation de la leptine. La phosphorylation de STAT3 n’est détectée que dans une parcelle des neurones DA positifs pour le Leprb, conférant aux neurones DA STAT3-spécifiques des caractéristiques uniques. Nous avons généré un modèle murin invalidé pour STAT3 sélectivement dans les neurones DA (STAT3DAT-KO). La première expérience consistait à évaluer les paramètres métaboliques de base de notre modèle en utilisant les chambres métaboliques Comprehensive Lab Animal Monitoring System (CLAMS), incluant l’activité ambulatoire, le ratio d’échanges respiratoires (RER) et la production de chaleur. Les STAT3DAT-KO sont hyperactives, démontré par une activité locomotrice augmentée, mais aucune variation entre les deux groupes n’est observée pour le RER et la production de chaleur, en plus d’un gain de poids identique. Une stratégie de récupération ciblant la réinsertion de STAT3 dans les neurones DA du système mésolimbique normalise l’AP anciennement plus élevée des STAT3DAT-KO à celle des contrôles, suivant l’accès libre à une roue d’exercice (RE) pour une durée de 4 semaines, suivant l’accès libre à une roue d’exercice (RE) pour une durée de 4 semaines. L’injection d’un psychostimulant (agoniste du récepteur DA de type 1 (D1R), le Chloro-APB-Hydrobromide (SKF 82958)) reflète une fonction dopaminergique réduite chez les STAT3DAT-KO. Un test de recherche compulsive de nourriture révèle une suppression de la prise alimentaire chez les deux groupes expérimentaux. Nous démontrons pour la première fois que la motivation alliée à la course d’endurance, indépendamment de la régulation de la prise alimentaire par la leptine, est dépendant d’une signalisation leptine-STAT3 amoindrie dans les neurones DA du système mésolimbique, révélant STAT3 comme élément clé dans la régulation du tonus dopaminergique et des propriétés récompensantes de l’AP.

LA MAPOTECA VIRTUAL: UN EJEMPLO DE COLABORACIÓN BAJO UNA PLATAFORMA DE SOFTWARE LIBRE

La Mapoteca Virtual es un sitio web construido sobre la plataforma Joomla, auspiciado por la Escuela de Ciencias Geográfica de la Universidad Nacional, en colaboración con UNA VIRTUAL.Este sitio pretende apoyar la labor docente al permitirle cargar y difundir cartografía digital para los estudiantes, y a los investigadores les facilita la localización de cartografía en línea, necesaria para la realización de sus trabajos en diferentes áreas del conocimiento. Adicionalmente, es un espacio para presentar documentos actuales en relación a la práctica de la cartografía y ciencias conexas, a la vez que fomenta la colaboración y el acceso libre a cartografía digital.Palabras clave: Cartografía, Joomla, Mapas digitales, Herramientas didácticas en líneaAbstractThe Virtual Map Library, www.mapoteca.geo.una.ac.cr, is a website constructed on the Joomla platform and supported by the School of Geographic Sciences at National University, Costa Rica, in collaboration with UNAVIRTUAL. The site intends to support the work of education by allowing the teacher to load and disseminate digital cartography for the students and helping geographic investigators locate cartography needed to accomplish their works in different areas of knowledge.In addition, Mapoteca offers a space to present current  documents relating to the practice of cartography and related sciences that at the same time promotes the contribution and free access to digital cartography.Key Words: Cartography, Mapoteca Virtual, Virtual Map Library, Joomla, digital maps, online teaching tools, School of Geographic Sciences, National University, Costa Rica.

El derecho fundamental de acceso a la información pública

Tanto en Italia como en España las personas han reivindicado que el ordenamiento jurídico reconozca un verdadero derecho de todos a acceder a la información pública de manera libre. En parte, esto ha sido así por la desafección de los ciudadanos con el sistema político que los ha llevado a reivindicar un rol más preponderante en los procesos de toma de decisiones públicas y a exigir una mayor eficiencia en la lucha contra la corrupción en el sector público. Con el libre acceso a la información pública se favorecen ambas cosas, ya que la información que posee el sector público resulta valiosísima para que los ciudadanos puedan enjuiciar de manera crítica «cómo se toman las decisiones que les afectan, cómo se manejan los fondos públicos o bajo qué criterios actúan nuestras instituciones» -apartado I del preámbulo de la LTAIBG-. Tradicionalmente, el derecho a acceder a los documentos públicos ha sido una cuestión vinculada al procedimiento administrativo y su ejercicio quedaba circunscrito a ser parte en el procedimiento. Este derecho ha sido el modelo seguido para la creación del derecho de acceso a la información público, aunque nace desvinculado del procedimiento administrativo en la medida en que tiene un fundamento democrático del que carece el derecho de acceso en el procedimiento administrativo. En esta tesis doctoral estudiamos las normas que han hecho posible que en Italia y España se cree este nuevo derecho político en el siglo XXI y su fundamento democrático. Concretamente, en Italia han sido el Decreto Legislativo 33/2013 y el Decreto Legislativo 97/2016 y en España la LTAIBG, las normas que han configurado este nuevo derecho.

Collision-free prioritized medium access in the presence of hidden nodes without relying on out-of-band signaling

Consider the problem of sharing a wireless channel between a set of computer nodes. Hidden nodes exist and there is no base station. Each computer node hosts a set of sporadic message streams where a message stream releases messages with real-time deadlines. We propose a collision-free wireless medium access control (MAC) protocol which implements staticpriority scheduling. The MAC protocol allows multiple masters and is fully distributed. It neither relies on synchronized clocks nor out-of-band signaling; it is an adaptation to a wireless channel of the dominance protocol used in the CAN bus. But unlike that protocol, our protocol does not require a node having the ability to receive an incoming bit from the channel while transmitting to the channel. Our protocol has the key feature of not only being prioritized and collision-free but also dealing successfully with hidden nodes. This key feature enables schedulability analysis of sporadic message streams in multihop networks.

Collision-free prioritized medium access control in wireless networks with hidden nodes

We propose a collision-free medium access control (MAC) protocol, which implements static-priority scheduling and works in the presence of hidden nodes. The MAC protocol allows multiple masters and is fully distributed; it is an adaptation to a wireless channel of the dominance protocol used in the CAN bus. But unlike that protocol, our protocol does not require a node having the ability to sense the channel while transmitting to the channel. Our protocol is collision-free even in the presence of hidden nodes and it achieves this without synchronized clocks or out-of-band busy tones. In addition, the protocol is designed to ensure that many non-interfering nodes can transmit in parallel and it functions for both broadcast and unicast transmissions.

April 2003: Collection Provides Free Public Access to Government Documents

http://digitalcommons.winthrop.edu/dacusfocus/1022/thumbnail.jpg

Differences in access and patient outcomes across antiretroviral treatment clinics in the Free State province: a prospective cohort study

Objective. To assess differences in access to antiretroviral treatment (ART) and patient outcomes across public sector treatment facilities in the Free State province, South Africa. Design. Prospective cohort study with retrospective database linkage. We analysed data on patients enrolled in the treatment programme across 36 facilities between May 2004 and December 2007, and assessed percentage initiating ART and percentage dead at 1 year after enrolment. Multivariable logistic regression was used to estimate associations of facility-level and patient-level characteristics with both mortality and treatment status. Results. Of 44 866 patients enrolled, 15 219 initiated treatment within 1 year; 8 778 died within 1 year, 7 286 before accessing ART. Outcomes at 1 year varied greatly across facilities and more variability was explained by facility-level factors than by patient-level factors. The odds of starting treatment within 1 year improved over calendar time. Patients enrolled in facilities with treatment initiation available on site had higher odds of starting treatment and lower odds of death at 1 year compared with those enrolled in facilities that did not offer treatment initiation. Patients were less likely to start treatment if they were male, severely immunosuppressed (CD4 count ≤50 cells/μl), or underweight (<50 kg). Men were also more likely to die in the first year after enrolment. Conclusions. Although increasing numbers of patients started ART between 2004 and 2007, many patients died before accessing ART. Patient outcomes could be improved by decentralisation of treatment services, fast-tracking the most immunodeficient patients and improving access, especially for men.

Evaluation of the impact of access to free influenza vaccine on immunization rates for children with cystic fibrosis

Children with cystic fibrosis are at increased risk of seasonal influenza associated complications, which makes them a judicious target of interventions designed to increase influenza vaccination rates. The Baylor College of Medicine/Texas Children's Hospital Pediatric Cystic Fibrosis (BCM/TCH CF) Care Center implemented an enhanced multi-component initiative designed to increase influenza vaccination rates in its patient population during the 2011-2012 influenza season. We evaluated the impact of specific components of this intervention on vaccination rates among the clinic's patient population via a historical medical chart review and examined the relationship between vaccination status and the number of pulmonary exacerbations requiring hospital admission during the influenza season. The multi-component intervention was comprised of providing influenza free of charge in the CF Care Center, reminders via phone call and letters, and drive through influenza vaccine clinics on nights and weekends. The intervention to increase influenza vaccination rates led to overall improved vaccination rates among the patients at the BCM/TCH CF Care Center, increasing from 90% adherence observed during the 2010-2011 season to 94% adherence during the 2011-2012 season. The availability of free influenza vaccine in the CF Care Center, combined with reminders about being vaccinated early in the season proved to be the most effective practices for improving the vaccination rate in the CF Care Center.^

La consécration du critère de l’« accès au marché » au sein de la libre circulation des marchandises: mythe ou réalité? = Consecration of the criterion of "market access" in the free movement of goods: myth or reality? Research Papers in Law, 04/2011

No abstract.

Access to the environment : a series of reference documents on the design and development of site facilities to make them barrier free to the physically handicapped and disabled /

Prepared under contract (H-2002-R) with the Office of Policy Development and Research, Dept. of Housing and Urban Development, and Architectural and Transportation Barriers Compliance Board.

DIY Archives: Enhancing Access to Collections via Free, Open-Source Platforms

Presentation from the MARAC conference in Boston, MA on March 18-21, 2015. S. 24 - DIY Archives: Enhancing Access to Collections via Free, Open-Source Platforms

The early sperm gets the good egg: mating order effects in free spawners

Mating order can have important consequences for the fertilization success of males whose ejaculates compete to fertilize a clutch of eggs. Despite an excellent body of literature on mating-order effects in many animals, they have rarely been considered in marine free-spawning invertebrates, where both sexes release gametes into the water column. In this study, we show that in such organisms, mating order can have profound repercussions for male reproductive success. Using in vitro fertilization for two species of sea urchin we found that the 'fertilization history' of a clutch of eggs strongly influenced the size distribution of unfertilized eggs, and consequently the likelihood that they will be fertilized. Males that had first access to a batch of eggs enjoyed elevated fertilization success because they had privileged access to the largest and therefore most readily fertilizable eggs within a clutch. By contrast, when a male's sperm were exposed to a batch of unfertilized eggs left over from a previous mating event, fertilization rates were reduced, owing to smaller eggs remaining in egg clutches previously exposed to sperm. Because of this size-dependent fertilization, the fertilization history of eggs also strongly influenced the size distribution of offspring, with first-spawning males producing larger, and therefore fitter, offspring. These findings suggest that when there is variation in egg size, mating order will influence not only the quantity but also the quality of offspring sired by competing males.

Efficient implementation of a dominance protocol for wireless medium access

Mestrado em Engenharia Electrotécnica e de Computadores

WiDom: a dominance protocol for wireless medium access

In this paper, we address the problem of sharing a wireless channel among a set of sporadic message streams where a message stream issues transmission requests with real-time deadlines. We propose a collision-free wireless medium access control (MAC) protocol which implements static-priority scheduling, supports a large number of priority levels and is fully distributed. It is an adaptation to a wireless channel of the dominance protocol used in the CAN bus. But, unlike that protocol, our protocol does not require a node having the ability to receive an incoming bit from the channel while transmitting to the channel. The evaluation of the protocol with real embedded computing platforms is presented to show that the proposed protocol is in fact collision-free and prioritized. We measure the response times of our implementation and show that the response-time analysis developed for the protocol offers an upper bound on the response times.