Deported Mexican migrants: health status and access to care

OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico’s Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required.

Implementation of a dominance protocol for wireless medium access

Consider the problem of scheduling sporadic message transmission requests with deadlines. For wired channels, this has been achieved successfully using the CAN bus. For wireless channels, researchers have recently proposed a similar solution; a collision-free medium access control (MAC) protocol that implements static-priority scheduling. Unfortunately no implementation has been reported, yet. We implement and evaluate it to find that the implementation indeed is collision-free and prioritized. This allows us to develop schedulability analysis for the implementation. We measure the response times of messages in our implementation and find that our new response-time analysis indeed offers an upper bound on the response times. This enables a new class of wireless real-time systems with timeliness guarantees for sporadic messages and it opens-up a new research area: schedulability analysis for wireless networks.

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.

Direct search optimization application programming interface with remote access

Search Optimization methods are needed to solve optimization problems where the objective function and/or constraints functions might be non differentiable, non convex or might not be possible to determine its analytical expressions either due to its complexity or its cost (monetary, computational, time,...). Many optimization problems in engineering and other fields have these characteristics, because functions values can result from experimental or simulation processes, can be modelled by functions with complex expressions or by noise functions and it is impossible or very difficult to calculate their derivatives. Direct Search Optimization methods only use function values and do not need any derivatives or approximations of them. In this work we present a Java API that including several methods and algorithms, that do not use derivatives, to solve constrained and unconstrained optimization problems. Traditional API access, by installing it on the developer and/or user computer, and remote API access to it, using Web Services, are also presented. Remote access to the API has the advantage of always allow the access to the latest version of the API. For users that simply want to have a tool to solve Nonlinear Optimization Problems and do not want to integrate these methods in applications, also two applications were developed. One is a standalone Java application and the other a Web-based application, both using the developed API.

Socioeconomic inequalities in the access to and quality of health care services

OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

Access to continued-use medication among older adults, Brazil

OBJECTIVE To determine the prevalence and associated access factors for all continued-use prescription drugs and the ways in which they can be obtained.METHODS Data was obtained from the 2008 Household National Survey. The sample comprised 27,333 individuals above 60 years who reported that they used continued-use prescription drugs. A descriptive analysis and binary and multiple multinomial logistic regressions were performed.RESULTS 86.0% of the older adults had access to all the medication they needed, and among them, 50.7% purchased said medication. Those who obtained medication from the public health system were younger (60-64 years), did not have health insurance plans, and belonged to the lower income groups. It is remarkable that 14.0% of the subjects still had no access to any continued-use medication, and for those with more than four chronic diseases, this amount reached 22.0%. Those with a greater number of chronic diseases ran a higher risk of not having access to all the medication they needed.CONCLUSIONS There are some groups of older adults with an increased risk of not obtaining all the medication they need and of purchasing it. The results of this study are expected to contribute to guide programs and plans for access to medication in Brazil.

Lack of access and continuity of adult health care: a national population-based survey

OBJECTIVE To describe the lack of access and continuity of health care in adults.METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas.RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care.CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce.

A type system for access control in an object-oriented language

Trabalho apresentado no âmbito do Mestrado em Engenharia Informática, como requisito parcial para obtenção do grau de Mestre em Engenharia Informática

Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.

Difficulties in access and estimates of public beds in intensive care units in the state of Rio de Janeiro

ABSTRACT OBJECTIVE To estimate the required number of public beds for adults in intensive care units in the state of Rio de Janeiro to meet the existing demand and compare results with recommendations by the Brazilian Ministry of Health. METHODS The study uses a hybrid model combining time series and queuing theory to predict the demand and estimate the number of required beds. Four patient flow scenarios were considered according to bed requests, percentage of abandonments and average length of stay in intensive care unit beds. The results were plotted against Ministry of Health parameters. Data were obtained from the State Regulation Center from 2010 to 2011. RESULTS There were 33,101 medical requests for 268 regulated intensive care unit beds in Rio de Janeiro. With an average length of stay in regulated ICUs of 11.3 days, there would be a need for 595 active beds to ensure system stability and 628 beds to ensure a maximum waiting time of six hours. Deducting current abandonment rates due to clinical improvement (25.8%), these figures fall to 441 and 417. With an average length of stay of 6.5 days, the number of required beds would be 342 and 366, respectively; deducting abandonment rates, 254 and 275. The Brazilian Ministry of Health establishes a parameter of 118 to 353 beds. Although the number of regulated beds is within the recommended range, an increase in beds of 122.0% is required to guarantee system stability and of 134.0% for a maximum waiting time of six hours. CONCLUSIONS Adequate bed estimation must consider reasons for limited timely access and patient flow management in a scenario that associates prioritization of requests with the lowest average length of stay.

Extending access to remote labs from mobile devices in educational contexts

This paper describes how to extend the access to remote experiments from mobile devices, aiming to better engage digital native students who expect a more interactive and ubiquitous access mode. The extension is based on features of HTML5 and the jQuery Mobile framework, which allow accessing the experiments from different operating systems via the browser or native applications. As a result, users have a richer interaction mode with the experiments, which includes access from simple hand-held devices such as smartphones and PDAs. Extending the access to remote experiments, from simple devices, enables its use in other educational stages, such as high schools, where teachers struggle to engage students in STEM learning. By enabling students to use their everyday "technological companions", e.g. cellular phones, to access remote experiments, we seek to increase the educational value of this technology-enhanced learning resource.

The Farol Deposit (Depósito do Farol) – a Pleistocene beach deposit from Cape Mondego (Figueira da Foz, West Central Portugal)*

Among the Pleistocene and Holocene units recorded near the marine cliffs of Cape Mondego (Figueira da Foz, West Central Portugal) stands out the Farol Deposit (Depósito do Farol), at an altitude of ±95 m above present sea level. It is a marine terrace with three exposures of interstratified conglomerates and sands, overlapped by calclititic-fanglomerates. This sedimentary setting indicates that deposition took place in a seashore environment influenced by the proximity of a marine palaeocliff. The deposit has an interesting subfossil fauna with abraded and fragmented shells of Nucella lapillus (LINNÉ, 1758), Patella vulgata (LINNÉ, 1758) and Littorina littorea (LINNÉ, 1758), suggesting the existence of an environment with colder surface seawater, when compared with the present day Portuguese seashore. These specimens belonged to marine communities adapted to live in intertidal rocky platforms, which have been exposed to the cyclic action of waves and tidal flows, on the swash and surf zones. The Farol Deposit can be related to an Early/Middle Pleistocene “cold-water” episode, earlier to the Isotopic Stages 7 and 11. This episode occurred before the deposition of the units Quiaios Sands (Areias de Quiaios) and Cantanhede Sands (Areias de Cantanhede) (Sicilian?), but later than the Arazede Sands (Areias de Arazede) and Marinha das Ondas Sands (Areias de Marinha das Ondas) (Early Pleistocene).

Topics regarding access to european information institutions: European Union so close and yet so far

From the 1990s, the Parliament, the Council and the European Commission adopted a new approach to disclosure of their working papers. Legal instruments to regulate and allow a fairly broad access to internal working documents of these institutions were created. European institutions also exploited the potential of Information and Communication Technologies, developing new instruments to register the documents produced and make them accessible to the public. The commitment to transparency sought to shows a more credible European government, and reduces the democratic deficit. However, the data analysis regarding access to EU institutions documents shows that general public is still far from direct contact with European bodies.

European institutions at your fingertips: EUROPA gateway tools for dissemination and access to information

This paper intends to present the legal background that support dissemination and access to documents from European institutions, namely the Parliament, the Council and the European Commission. Currently, this legal framework is accomplished with a set of Internet tools that are analyzed regarding official documents types and options searches available. Some statistical data on access to European information published in annual reports from the institutions are also evaluated. The relationship between shadow and light in transparency to access administrative documents and marketing issues of a political communication are underlined. Neo-institutional approach, reputational concept in public organizations and systemic perspective are used as theoretical background.