Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.

Free Medical Information Doctor = Publisher

Today, doctors can be publishers – computer technology and the internet make it possible, and book projects are tempting in terms of money. A doctor who publishes his own textbooks can earn many times what he would be paid in royalties by a publishing house. More important than this, however, is the fact that a doctor who writes and publishes wants his texts to be read by as many colleagues, students and patients as possible. The best way to achieve this is through free parallel publication of these texts on the internet

Spatial modelling of biodiversity at the community level

1. Statistical modelling is often used to relate sparse biological survey data to remotely derived environmental predictors, thereby providing a basis for predictively mapping biodiversity across an entire region of interest. The most popular strategy for such modelling has been to model distributions of individual species one at a time. Spatial modelling of biodiversity at the community level may, however, confer significant benefits for applications involving very large numbers of species, particularly if many of these species are recorded infrequently. 2. Community-level modelling combines data from multiple species and produces information on spatial pattern in the distribution of biodiversity at a collective community level instead of, or in addition to, the level of individual species. Spatial outputs from community-level modelling include predictive mapping of community types (groups of locations with similar species composition), species groups (groups of species with similar distributions), axes or gradients of compositional variation, levels of compositional dissimilarity between pairs of locations, and various macro-ecological properties (e.g. species richness). 3. Three broad modelling strategies can be used to generate these outputs: (i) 'assemble first, predict later', in which biological survey data are first classified, ordinated or aggregated to produce community-level entities or attributes that are then modelled in relation to environmental predictors; (ii) 'predict first, assemble later', in which individual species are modelled one at a time as a function of environmental variables, to produce a stack of species distribution maps that is then subjected to classification, ordination or aggregation; and (iii) 'assemble and predict together', in which all species are modelled simultaneously, within a single integrated modelling process. These strategies each have particular strengths and weaknesses, depending on the intended purpose of modelling and the type, quality and quantity of data involved. 4. Synthesis and applications. The potential benefits of modelling large multispecies data sets using community-level, as opposed to species-level, approaches include faster processing, increased power to detect shared patterns of environmental response across rarely recorded species, and enhanced capacity to synthesize complex data into a form more readily interpretable by scientists and decision-makers. Community-level modelling therefore deserves to be considered more often, and more widely, as a potential alternative or supplement to modelling individual species.

The Signalling Channel of Central Bank Interventions: Modelling the Yen/US Dollar Exchange Rate

This paper presents a theoretical framework analysing the signalling channel of exchange rate interventions as an informational trigger. We develop an implicit target zone framework with learning in order to model the signalling channel. The theoretical premise of the model is that interventions convey signals that communicate information about the exchange rate objectives of central bank. The model is used to analyse the impact of Japanese FX interventions during the period 1999 -2011 on the yen/US dollar dynamics.

The Signalling Channel of Central Bank Interventions: Modelling the Yen/US Dollar Exchange Rate

This paper presents a theoretical framework analysing the signalling channel of exchange rate interventions as an informational trigger. We develop an implicit target zone framework with learning in order to model the signalling channel. The theoretical premise of the model is that interventions convey signals that communicate information about the exchange rate objectives of central bank. The model is used to analyse the impact of Japanese FX interventions during the period 1999 -2011 on the yen/US dollar dynamics.

Modelling the distribution of bats in relation to landscape structure in a temperate mountain environment

1. Landscape modification is often considered the principal cause of population decline in many bat species. Thus, schemes for bat conservation rely heavily on knowledge about species-landscape relationships. So far, however, few studies have quantified the possible influence of landscape structure on large-scale spatial patterns in bat communities. 2. This study presents quantitative models that use landscape structure to predict (i) spatial patterns in overall community composition and (ii) individual species' distributions through canonical correspondence analysis and generalized linear models, respectively. A geographical information system (GIS) was then used to draw up maps of (i) overall community patterns and (ii) distribution of potential species' habitats. These models relied on field data from the Swiss Jura mountains. 3. Fight descriptors of landscape structure accounted for 30% of the variation in bat community composition. For some species, more than 60% of the variance in distribution could be explained by landscape structure. Elevation, forest or woodland cover, lakes and suburbs, were the most frequent predictors. 4. This study shows that community composition in bats is related to landscape structure through species-specific relationships to resources. Due to their nocturnal activities and the difficulties of remote identification, a comprehensive bat census is rarely possible, and we suggest that predictive modelling of the type described here provides an indispensable conservation tool.

Les TIC a l'ensenyament de la modelització matemàtica en Ciències Econòmiques i en Ciències Experimentals

Aquest projecte proposa materials didàctics per a un nou plantejament de les assignatures de Matemàtiques dels primers cursos de Ciències Empresarials i d'Enginyeria Tècnica, més acord amb el procés de convergència europea, basat en la realització de projectes que anomenem “Tallers de Modelització Matemàtica” (TMM) en els quals: (1) Els alumnes parteixen de situacions i problemes reals per als quals han de construir per sí mateixos els models matemàtics més adients i, a partir de la manipulació adequada d’aquests models, poden obtenir la informació necessària per donar-los resposta. (2) El treball de construcció, experimentació i avaluació dels models es realitza amb el suport de la calculadora simbòlica Wiris i del full de càlcul Excel com a instruments “normalitzats” del treball matemàtic d’estudiants i professors. (3) S’adapten els programes de les assignatures de matemàtiques de primer curs per tal de poder-les associar a un petit nombre de Tallers que parteixen de situacions adaptades a cada titulació. L’assignatura de Matemàtiques per a les Ciències Empresarials s’articula entorn de dos tallers independents: “Matrius de transició” pel que fa a l’àlgebra lineal i “Previsió de vendes” per a la modelització funcional en una variable. L’assignatura de Matemàtiques per a l’Enginyeria s’articula entorn d’un únic taller, “Models de poblacions”, que abasta la majoria de continguts del curs: successions i models funcionals en una variable, àlgebra lineal i equacions diferencials. Un conjunt d’exercicis interactius basats en la calculadora simbòlica WIRIS (Wiris-player) serveix de suport per al treball tècnic imprescindible per al desenvolupament de les dues assignatures. L’experimentació d’aquests tallers durant 2 cursos consecutius (2006/07 i 2007/08) en dues universitats catalanes (URL i UAB) ha posat en evidència tant els innegables avantatges del nou dispositiu docent per a l’aprenentatge dels estudiants, així com les restriccions institucionals que actualment dificulten la seva gestió i difusió.

Information systems for water resources management improvement in developing countries

Water resources management, as also water service provision projects in developing countries have difficulties to take adequate decisions due to scarce reliable information, and a lack of proper information managing. Some appropriate tools need to be developed in order to improve decision making to improve water management and access of the poorest, through the design of Decision Support Systems (DSS). On the one side, a DSS for developing co-operation projects on water access improvement has been developed. Such a tool has specific context constrains (structure of the system, software requirements) and needs (Logical Framework Approach monitoring, organizational-learning, accountability and evaluation) that shall be considered for its design. Key aspects for its successful implementation have appeared to be a participatory design of the system and support of the managerial positions at the inception phase. A case study in Tanzania was conducted, together with the Spanish NGO ONGAWA – Ingeniería para el Desarrollo. On the other side, DSS are required also to improve decision making on water management resources in order to achieve a sustainable development that not only improves the living conditions of the population in developing countries, but that also does not hinder opportunities of the poorest on those context. A DSS made to fulfil these requirements shall be using information from water resources modelling, as also on the environment and the social context. Through the research, a case study has been conducted in the Central Rift Valley of Ethiopia, an endhorreic basin 160 km south of Addis Ababa. There, water has been modelled using ArcSWAT, a physically based model which can assess the impact of land management practices on large complex watersheds with varying soils, land use and management conditions over long periods of time. Moreover, governance on water and environment as also the socioeconomic context have been studied.

Sound Texture Modelling

In the PhD thesis “Sound Texture Modeling” we deal with statistical modelling or textural sounds like water, wind, rain, etc. For synthesis and classification. Our initial model is based on a wavelet tree signal decomposition and the modeling of the resulting sequence by means of a parametric probabilistic model, that can be situated within the family of models trainable via expectation maximization (hidden Markov tree model ). Our model is able to capture key characteristics of the source textures (water, rain, fire, applause, crowd chatter ), and faithfully reproduces some of the sound classes. In terms of a more general taxonomy of natural events proposed by Graver, we worked on models for natural event classification and segmentation. While the event labels comprise physical interactions between materials that do not have textural propierties in their enterity, those segmentation models can help in identifying textural portions of an audio recording useful for analysis and resynthesis. Following our work on concatenative synthesis of musical instruments, we have developed a pattern-based synthesis system, that allows to sonically explore a database of units by means of their representation in a perceptual feature space. Concatenative syntyhesis with “molecules” built from sparse atomic representations also allows capture low-level correlations in perceptual audio features, while facilitating the manipulation of textural sounds based on their physical and perceptual properties. We have approached the problem of sound texture modelling for synthesis from different directions, namely a low-level signal-theoretic point of view through a wavelet transform, and a more high-level point of view driven by perceptual audio features in the concatenative synthesis setting. The developed framework provides unified approach to the high-quality resynthesis of natural texture sounds. Our research is embedded within the Metaverse 1 European project (2008-2011), where our models are contributting as low level building blocks within a semi-automated soundscape generation system.

Building Evidence for Dementia Prevention

As was the case in 2010 when the National Institutes of Health issued a consensus statement on the prevention of Alzheimer’s and other dementias, there remains a lack of firm evidence for dementia prevention. Because of the difficulties in studying this phenomenon, no modifiable risk factors for dementia have been definitively established, and no pharmaceutical or nutritional supplements been proven to prevent Alzheimer’s disease or cognitive decline. However, longitudinal observational studies have identified several factors associated with dementia. A recent review article summarizes the current epidemiological evidence about Alzheimer’s and other dementias, and presents three ongoing large scale randomized control trials (RCTs) that focus on preventing dementia. The review argues that there is substantial evidence for many factors that, in combination, might reduce the risk of, or delay the onset of, dementia. Although no specific cure for dementia exists, and no specific pathway between risk factor and disease onset has been identified, several cardiovascular, stress, toxicity, and psychosocial variables have been repeatedly associated with dementia. Protective factors, such as high education, physical exercise, and not smoking cigarettes, have been identified as well. Intervention studies that account for these multiple factors may well identify strategies for preventing or delaying dementia. However, the protective effects and risk factors suggested by observational data have yet to be assessed in RCT research. The role of such factors in reducing or increasing the risk for dementia needs to be more specifically defined. Three ongoing RCT studies in Europe show promise in this area, as they target multiple risk and protective factors by promoting healthy lifestyle changes and medical treatment of vascular diseases. These are: FINGER, a Finnish trial involving 1,200 older adults at risk for dementia. This intervention features nutritional guidance, physical activity, cognitive and social engagement, and medical management of risk factors. Participants were involved in previous, intensive observational studies of vascular health and health behavior, so FINGER will provide a level of relevant information about its research subjects that is normally impossible for clinical RCTs to attain;MAPT, a multicenter study of 1,680 frail older adults in France. This study will compare the efficacy of omega-3 dietary supplementation with a multidomain training intervention that involves physical and cognitive training. The study will include follow-up assessments after five years;PreDIVA, a Dutch study of 3,534 community dwelling participants between 70 and 78 years old, recruited from primary care clinics. This study will compare standard medical care with a multicomponent vascular health intervention. The study will last for six years and measure both dementia and disability outcomes. These studies are an important step in dementia research, using earlier observational studies as the basis for rigorously assessed interventions. Although a cure for dementia has not been identified, this new research may identify preventive strategies against dementia. �� Source: Mangialasche F, Kivipelto M, et al. (2012). Dementia prevention: current epidemiological evidence and future perspective. Alzheimer’s Research and Therapy 4:6.

Debris flow hazard modelling on medium scale: Valtellina di Tirano, Italy

Debris flow hazard modelling at medium (regional) scale has been subject of various studies in recent years. In this study, hazard zonation was carried out, incorporating information about debris flow initiation probability (spatial and temporal), and the delimitation of the potential runout areas. Debris flow hazard zonation was carried out in the area of the Consortium of Mountain Municipalities of Valtellina di Tirano (Central Alps, Italy). The complexity of the phenomenon, the scale of the study, the variability of local conditioning factors, and the lacking data limited the use of process-based models for the runout zone delimitation. Firstly, a map of hazard initiation probabilities was prepared for the study area, based on the available susceptibility zoning information, and the analysis of two sets of aerial photographs for the temporal probability estimation. Afterwards, the hazard initiation map was used as one of the inputs for an empirical GIS-based model (Flow-R), developed at the University of Lausanne (Switzerland). An estimation of the debris flow magnitude was neglected as the main aim of the analysis was to prepare a debris flow hazard map at medium scale. A digital elevation model, with a 10 m resolution, was used together with landuse, geology and debris flow hazard initiation maps as inputs of the Flow-R model to restrict potential areas within each hazard initiation probability class to locations where debris flows are most likely to initiate. Afterwards, runout areas were calculated using multiple flow direction and energy based algorithms. Maximum probable runout zones were calibrated using documented past events and aerial photographs. Finally, two debris flow hazard maps were prepared. The first simply delimits five hazard zones, while the second incorporates the information about debris flow spreading direction probabilities, showing areas more likely to be affected by future debris flows. Limitations of the modelling arise mainly from the models applied and analysis scale, which are neglecting local controlling factors of debris flow hazard. The presented approach of debris flow hazard analysis, associating automatic detection of the source areas and a simple assessment of the debris flow spreading, provided results for consequent hazard and risk studies. However, for the validation and transferability of the parameters and results to other study areas, more testing is needed.

NanoImpactNet - building a multi-stakeholder dialogue on the health and environmental impact of nanomaterials

NanoImpactNet (NIN) is a multidisciplinary European Commission funded network on the environmental, health and safety (EHS) impact of nanomaterials. The 24 founding scientific institutes are leading European research groups active in the fields of nanosafety, nanorisk assessment and nanotoxicology. This 4-year project is the new focal point for information exchange within the research community. Contact with other stakeholders is vital and their needs are being surveyed. NIN is communicating with 100s of stakeholders: businesses; internet platforms; industry associations; regulators; policy makers; national ministries; international agencies; standard-setting bodies and NGOs concerned by labour rights, EHS or animal welfare. To improve this communication, internet research, a questionnaire distributed via partners and targeted phone calls were used to identify stakeholders' interests and needs. Knowledge gaps and the necessity for further data mentioned by representatives of all stakeholder groups in the targeted phone calls concerned: • the potential toxic and safety hazards of nanomaterials throughout their lifecycles; • the fate and persistence of nanoparticles in humans, animals and the environment; • the associated risks of nanoparticle exposure; • greater participation in: the preparation of nomenclature, standards, methodologies, protocols and benchmarks; • the development of best practice guidelines; • voluntary schemes on responsibility; • databases of materials, research topics and themes, but also of expertise. These findings suggested that stakeholders and NIN researchers share very similar knowledge needs, and that open communication and free movement of knowledge will benefit both researchers and industry. Subsequently a workshop was organised by NIN focused on building a sustainable multi-stakeholder dialogue. Specific questions were asked to different stakeholder groups to encourage discussions and open communication. 1. What information do stakeholders need from researchers and why? The discussions about this question confirmed the needs identified in the targeted phone calls. 2. How to communicate information? While it was agreed that reporting should be enhanced, commercial confidentiality and economic competition were identified as major obstacles. It was recognised that expertise was needed in the areas of commercial law and economics for a wellinformed treatment of this communication issue. 3. Can engineered nanomaterials be used safely? The idea that nanomaterials are probably safe because some of them have been produced 'for a long time', was questioned, since many materials in common use have been proved to be unsafe. The question of safety is also about whether the public has confidence. New legislation like REACH could help with this issue. Hazards do not materialise if exposure can be avoided or at least significantly reduced. Thus, there is a need for information on what can be regarded as acceptable levels of exposure. Finally, it was noted that there is no such thing as a perfectly safe material but only boundaries. At this moment we do not know where these boundaries lie. The matter of labelling of products containing nanomaterials was raised, as in the public mind safety and labelling are connected. This may need to be addressed since the issue of nanomaterials in food, drink and food packaging may be the first safety issue to attract public and media attention, and this may have an impact on 'nanotechnology as a whole. 4. Do we need more or other regulation? Any decision making process should accommodate the changing level of uncertainty. To address the uncertainties, adaptations of frameworks such as REACH may be indicated for nanomaterials. Regulation is often needed even if voluntary measures are welcome because it mitigates the effects of competition between industries. Data cannot be collected on voluntary bases for example. NIN will continue with an active stakeholder dialogue to further build on interdisciplinary relationships towards a healthy future with nanotechnology.

Effective exposure to solar UV in building workers: influence of local and individual factors.

Excessive exposure to solar UV light is the main cause of skin cancers in humans. UV exposure depends on environmental as well as individual factors related to activity. Although outdoor occupational activities contribute significantly to the individual dose received, data on effective exposure are scarce and limited to a few occupations. A study was undertaken in order to assess effective short-term exposure among building workers and characterize the influence of individual and local factors on exposure. The effective exposure of construction workers in a mountainous area in the southern part of Switzerland was investigated through short-term dosimetry (97 dosimeters). Three altitudes, of about 500, 1500 and 2500 m were considered. Individual measurements over 20 working periods were performed using Spore film dosimeters on five body locations. The postural activity of workers was concomitantly recorded and static UV measurements were also performed. Effective exposure among building workers was high and exceeded occupational recommendations, for all individuals for at least one body location. The mean daily UV dose in plain was 11.9 SED (0.0-31.3 SED), in middle mountain 21.4 SED (6.6-46.8 SED) and in high mountain 28.6 SED (0.0-91.1 SED). Measured doses between workers and anatomical locations exhibited a high variability, stressing the role of local exposure conditions and individual factors. Short-term effective exposure ranged between 0 and 200% of ambient irradiation, indicating the occurrence of intense, subacute exposures. A predictive irradiation model was developed to investigate the role of individual factors. Posture and orientation were found to account for at least 38% of the total variance of relative individual exposure, and were also found to account more than altitude on the total variance of effective daily exposures. Targeted sensitization actions through professional information channels and specific prevention messages are recommended. Altitude outdoor workers should also benefit from preventive medical examination.

Modelling and Prospects for Audience Measurement of Outdoor Advertising using GPS Devices

The paper describes how to integrate audience measurement and site visibility as the main research approaches in outdoor advertising research in a single concept. Details are portrayed on how GPS is used on a large scale in Switzerland for mobility analysis and audience measurement. Furthermore, the development of a software solution is introduced that allows the integration of all mobility data and poster location information. Finally a model and its results is presented for the calculation of coverage of individual poster campaigns and for the calculation of the number of contacts generated by each billboard.