An evaluation of Primary health care system in Kerala

The thesis entitled An Evaluation of Primary Health Care System in Kerala. The present study is intended to examine the working of primary health care system and its impact on the health status of people. The hypothesis tested in the thesis includes, a. The changes in the health profile require reallocation of resources of primary health care system, b. Rate of utilization depends on the quality of services provided by primary health centers, and c. There is a significant decline in the operational efficiency of the primary health care system. The major elements of primary health care stated in the report of AlmaAta International Conference on Primary Health Care (WHO, 1994)” is studied on the basis of the classification of the elements in to three: Preventive, Promotive, and Curative measures. Preventive measures include Maternal and Child Health Care including family Planning. Provision of water and sanitation is reviewed under promotive measures. Curative measures are studied using the disease profile of the study area. Collection of primary data was done through a sample survey, using pre-tested interview schedule of households of the study area. Multi stage random sampling design was used for selecting the sample. The design of the present study is both descriptive and analytical in nature. As far as the analytical tools are concerned, growth index, percentages, ratios, rates, time series analysis, analysis of variance, chi square test, Z test were used for analyzing the data. Present study revealed that no one in these areas was covered under any type of health insurance. Conclusion states that considering the present changes in the health profile, traditional pattern of resource allocation should be altered to meet the urgent health care needs of the people. Preventive and promotive measures like health education for giving awareness among people to change health habits, diet pattern, life style etc. are to be developed. Proper diagnosis and treatment of the disease at the beginning of the stage itself may help to cure majority of disease. For that, Public health policy must ensure the primary health care as enunciated at Alma- Ata international Conference. At the same time Public health is not to be treated as the sole responsibility of the government. Active community participation is an essential means to attain the goals.

Design And Development Of A Named Entity Based Question Answering System For Malayalam Language

This is a Named Entity Based Question Answering System for Malayalam Language. Although a vast amount of information is available today in digital form, no effective information access mechanism exists to provide humans with convenient information access. Information Retrieval and Question Answering systems are the two mechanisms available now for information access. Information systems typically return a long list of documents in response to a user’s query which are to be skimmed by the user to determine whether they contain an answer. But a Question Answering System allows the user to state his/her information need as a natural language question and receives most appropriate answer in a word or a sentence or a paragraph. This system is based on Named Entity Tagging and Question Classification. Document tagging extracts useful information from the documents which will be used in finding the answer to the question. Question Classification extracts useful information from the question to determine the type of the question and the way in which the question is to be answered. Various Machine Learning methods are used to tag the documents. Rule-Based Approach is used for Question Classification. Malayalam belongs to the Dravidian family of languages and is one of the four major languages of this family. It is one of the 22 Scheduled Languages of India with official language status in the state of Kerala. It is spoken by 40 million people. Malayalam is a morphologically rich agglutinative language and relatively of free word order. Also Malayalam has a productive morphology that allows the creation of complex words which are often highly ambiguous. Document tagging tools such as Parts-of-Speech Tagger, Phrase Chunker, Named Entity Tagger, and Compound Word Splitter are developed as a part of this research work. No such tools were available for Malayalam language. Finite State Transducer, High Order Conditional Random Field, Artificial Immunity System Principles, and Support Vector Machines are the techniques used for the design of these document preprocessing tools. This research work describes how the Named Entity is used to represent the documents. Single sentence questions are used to test the system. Overall Precision and Recall obtained are 88.5% and 85.9% respectively. This work can be extended in several directions. The coverage of non-factoid questions can be increased and also it can be extended to include open domain applications. Reference Resolution and Word Sense Disambiguation techniques are suggested as the future enhancements

Numerical Simulation of Two-Part Underwater Towing System

The motion instability is an important issue that occurs during the operation of towed underwater vehicles (TUV), which considerably affects the accuracy of high precision acoustic instrumentations housed inside the same. Out of the various parameters responsible for this, the disturbances from the tow-ship are the most significant one. The present study focus on the motion dynamics of an underwater towing system with ship induced disturbances as the input. The study focus on an innovative system called two-part towing. The methodology involves numerical modeling of the tow system, which consists of modeling of the tow-cables and vehicles formulation. Previous study in this direction used a segmental approach for the modeling of the cable. Even though, the model was successful in predicting the heave response of the tow-body, instabilities were observed in the numerical solution. The present study devises a simple approach called lumped mass spring model (LMSM) for the cable formulation. In this work, the traditional LMSM has been modified in two ways. First, by implementing advanced time integration procedures and secondly, use of a modified beam model which uses only translational degrees of freedoms for solving beam equation. A number of time integration procedures, such as Euler, Houbolt, Newmark and HHT-α were implemented in the traditional LMSM and the strength and weakness of each scheme were numerically estimated. In most of the previous studies, hydrodynamic forces acting on the tow-system such as drag and lift etc. are approximated as analytical expression of velocities. This approach restricts these models to use simple cylindrical shaped towed bodies and may not be applicable modern tow systems which are diversed in shape and complexity. Hence, this particular study, hydrodynamic parameters such as drag and lift of the tow-system are estimated using CFD techniques. To achieve this, a RANS based CFD code has been developed. Further, a new convection interpolation scheme for CFD simulation, called BNCUS, which is blend of cell based and node based formulation, was proposed in the study and numerically tested. To account for the fact that simulation takes considerable time in solving fluid dynamic equations, a dedicated parallel computing setup has been developed. Two types of computational parallelisms are explored in the current study, viz; the model for shared memory processors and distributed memory processors. In the present study, shared memory model was used for structural dynamic analysis of towing system, distributed memory one was devised in solving fluid dynamic equations.

An Encoded Infrared Sheet Of Light Navigational Beacon System For Precise Localization Of Indoor Mobile Robot Vehicles

A new localization approach to increase the navigational capabilities and object manipulation of autonomous mobile robots, based on an encoded infrared sheet of light beacon system, which provides position errors smaller than 0.02m is presented in this paper. To achieve this minimal position error, a resolution enhancement technique has been developed by utilising an inbuilt odometric/optical flow sensor information. This system respects strong low cost constraints by using an innovative assembly for the digitally encoded infrared transmitter. For better guidance of mobile robot vehicles, an online traffic signalling capability is also incorporated. Other added features are its less computational complexity and online localization capability all these without any estimation uncertainty. The constructional details, experimental results and computational methodologies of the system are also described

Developing a Child Friendly Text-to-Speech System

This paper discusses the implementation details of a child friendly, good quality, English text-to-speech (TTS) system that is phoneme-based, concatenative, easy to set up and use with little memory. Direct waveform concatenation and linear prediction coding (LPC) are used. Most existing TTS systems are unit-selection based, which use standard speech databases available in neutral adult voices.Here reduced memory is achieved by the concatenation of phonemes and by replacing phonetic wave files with their LPC coefficients. Linguistic analysis was used to reduce the algorithmic complexity instead of signal processing techniques. Sufficient degree of customization and generalization catering to the needs of the child user had been included through the provision for vocabulary and voice selection to suit the requisites of the child. Prosody had also been incorporated. This inexpensive TTS systemwas implemented inMATLAB, with the synthesis presented by means of a graphical user interface (GUI), thus making it child friendly. This can be used not only as an interesting language learning aid for the normal child but it also serves as a speech aid to the vocally disabled child. The quality of the synthesized speech was evaluated using the mean opinion score (MOS).

More than irrigation - The Balinese Subak system as a unique form of cooperative water resource management in Indonesia

For over 1,000 years, the Balinese have developed a unique system of democratic and sustainable water irrigation. It has shaped the cultural landscapes of Bali and enables local communities to manage the ecology of terraced rice fields at the scale of whole watersheds. The Subak system has made the Balinese the most productive rice growers in Indonesia and ensures a high level of food sovereignty for a dense population on the volcanic island. The Subak system provides a vibrant example of a diverse, ecologically sustainable, economically productive and democratic water management system that is also characterized by its nonreliance on fossil fuel derivatives or heavy machinery. In 2012, UNESCO has recognized five rice terraces and their water temples as World Heritage site and supports its conservation and protection. However, the fragile Subak system is threatened for its complexity and interconnectedness by new agricultural practices and increasing tourism on the island.

A system to evaluate the accuracy of a visual mosaicking methodology

When underwater vehicles navigate close to the ocean floor, computer vision techniques can be applied to obtain motion estimates. A complete system to create visual mosaics of the seabed is described in this paper. Unfortunately, the accuracy of the constructed mosaic is difficult to evaluate. The use of a laboratory setup to obtain an accurate error measurement is proposed. The system consists on a robot arm carrying a downward looking camera. A pattern formed by a white background and a matrix of black dots uniformly distributed along the surveyed scene is used to find the exact image registration parameters. When the robot executes a trajectory (simulating the motion of a submersible), an image sequence is acquired by the camera. The estimated motion computed from the encoders of the robot is refined by detecting, to subpixel accuracy, the black dots of the image sequence, and computing the 2D projective transform which relates two consecutive images. The pattern is then substituted by a poster of the sea floor and the trajectory is executed again, acquiring the image sequence used to test the accuracy of the mosaicking system

Behaviours implemented using a vision system based on coded light projection

In a search for new sensor systems and new methods for underwater vehicle positioning based on visual observation, this paper presents a computer vision system based on coded light projection. 3D information is taken from an underwater scene. This information is used to test obstacle avoidance behaviour. In addition, the main ideas for achieving stabilisation of the vehicle in front of an object are presented

Exámenes de laboratorio clínico en menores de cinco años atendidos en sala ERA (enfermedad respiratoria aguda) en una empresa social del estado de primer nivel de atención

Las Salas ERA (Enfermedad Respiratoria Aguda) son áreas definidas en las Unidades Primarias de Atención (UPAs), Centros de Atención Médica Inmediata (CAMIs) y de algunas instituciones de segundo nivel, para la atención de pacientes con ERA, que puedan ser manejados con esquemas terapéuticos básicos que en muchas oportunidades se ocupan las salas de observación de urgencias por casos que podrían manejarse en un nivel de complejidad más bajo, pero tampoco pueden ser manejados a nivel domiciliario. La enfermedad respiratoria aguda (ERA) es un conjunto de patologías que afectan el sistema respiratorio, siendo esta una causa muy frecuente de morbilidad y mortalidad en los niños y niñas menores de 5 años, en especial por infección respiratoria aguda (IRA). El pago de la atención integral en las salas ERA a los niños menores de cinco años (población vinculada) de edad corresponde al Fondo Financiero Distrital el cual ha establecido un paquete que incluye valoración médica, valoración con la terapeuta respiratoria, analgésicos, corticosteroides e inhaladores. En el momento en que el médico ordena un examen de laboratorio clínico como ayuda diagnóstica el Fondo Financiero Distrital deja de pagar el paquete completo de prestación de servicios en Salas ERA y paga los medicamentos y dispositivos médicos empleados en la atención de pacientes de manera individual, con esta segunda manera de pago tiene menos ganancias el hospital ya que este debe asumir los costos de la valoración por parte del médico y la terapeuta respiratoria. El objetivo de esta investigación es conocer la magnitud en la solicitud de exámenes de Laboratorio Clínico a los niños menores de cinco años que recibieron atención por parte de la Sala ERA de una Empresa Social del Estado de primer nivel de atención en la ciudad de Bogotá.

A beginner's guide to referencing books based on the Harvard system

An interactive tutorial on how to reference books correctly. It begins with an example, and interactively draws the student through the stages of accessing the relevant information through to how to include the final citation in the bibliography. It concludes with a ‘test your knowledge’ set of activities. When you view this object note that the panel on the left generated by the repository can be dragged sideways to view the learning object full screen.

16/6-idiotype expressing antibodies induce brain inflammation and cognitive impairment in mice: the mosaic of central nervous system involvement in lupus

Background: The 16/6-idiotype (16/6-Id) of the human anti-DNA antibody was found to induce experimental lupus in naive mice, manifested by production of autoantibodies, leukopenia and elevated inflammatory markers, as well as kidney and brain involvement. We assessed behavior and brain pathology of naive mice injected intracerebra-ventricularly (ICV) with the 16/6-Id antibody. Methods: C3H female mice were injected ICV to the right hemisphere with the human 16/6-Id antibody or commercial human IgG antibodies (control). The mice were tested for depression by the forced swimming test (FST), locomotor and explorative activity by the staircase test, and cognitive functions were examined by the novel object recognition and Y-maze tests. Brain slices were stained for inflammatory processes. Results: 16/6-Id injected mice were cognitively impaired as shown by significant differences in the preference for a new object in the novel object recognition test compared to controls (P = 0.012). Similarly, the preference for spatial novelty in the Y-maze test was significantly higher in the control group compared to the 16/6-Id-injected mice (42% vs. 9%, respectively, P = 0.065). Depression-like behavior and locomotor activity were not significantly different between the16/6-Id-injected and the control mice. Immunohistochemistry analysis revealed an increase in astrocytes and microglial activation in the hippocampus and amygdala, in the 16/6-Id injected group compared to the control. Conclusions: Passive transfer of 16/6-Id antibodies directly into mice brain resulted in cognitive impairments and histological evidence for brain inflammation. These findings shed additional light on the diverse mosaic pathophysiology of neuropsychiatric lupus.

Contribuyendo al reto de la sostenibilidad: el sistema producto- servicio en la industria de la moda rápida

El presente proyecto de grado se inscribe bajo el proyecto de Responsabilidad Social Empresarial de la línea de investigación de Realidad Empresarial de la Facultad de Administración de la Universidad del Rosario. El problema de investigación surge de dos problemas actuales, que convergen en la insostenibilidad a largo y mediano plazo de la manera en que se hacen la mayoría de los negocios hoy en día. El primer problema, es el de suficiencia, se evidencia desde el punto de vista del consumidor, el cual pareciera estar diseñado para comprar y acumular objetos y cosas que luego de un tiempo irán a parar a la basura. El segundo problema es el modelo de negocio que extrae recursos, los transforma, los comercializa de manera repetitiva y obliga al cliente a seguir comprando, olvidando que la mayoría de cosas que produce, terminan en el basurero. La deficiencia actual del consumismo insostenible y del diseño que no piensa en las generaciones futuras son dos caras de la misma moneda. Por eso es que se estudia el problema desde la perspectiva tanto del consumidor, como del productor. Las tendencias internacionales relacionadas con la sostenibilidad están llevando a los negocios por una nueva senda, la cual les dará ventajas competitivas a los adoptadores tempranos. A raíz de los problemas planteados y con el objetivo de encontrar la sostenibilidad empresarial, se estudia una posible solución para cada actor del problema. Por el lado del consumidor, se analiza la teoría que gira alrededor del consumo responsable y de cómo los consumidores tienen el poder de causar un efecto positivo con lo que mejor saben hacer: comprando (y eligiendo que comprar). Por el lado del productor se estudia un nuevo modelo de negocios llamado el sistema producto-servicio, el cual se enfoca a satisfacer necesidades de los clientes por medio de una combinación de prestación de servicios y facilitación de productos, en vez de la comercialización de estos. Es decir que en vez de vender cosas que los consumidores quieran acumular (problema de suficiencia), se les vende soluciones que satisfagan sus necesidades, reteniendo la compañía la propiedad sobre los productos que integran al servicio. Se estudia también de que maneras este modelo particular de sistemas producto-servicio puede ser recibido por los consumidores de hoy en día, tan acostumbrados al modelo actual. Se quiere explorar el sistema de productos y servicio como una alternativa empresarial perdurable que solucione los retos ambientales del siglo XXI. Para poder probar la viabilidad de este hipotético modelo que cambia los patrones de interacción de las empresas con los usuarios, se plantea una idea de negocio que integre productos y servicios para satisfacer las necesidades del cliente. Se escogió un área viii caracterizada por ser de las más consumistas y acumuladoras en cuanto al volumen de compras anual de los clientes: el negocio de la ropa. Y no solo cualquier tipo de ropa, sino el de la moda rápida, un modelo que obliga a los consumidores a comprar ropa con una frecuencia aún mayor. Se hizo esto con el objetivo de probar que el modelo propuesto puede funcionar inclusive bajo los supuestos más “consumistas” que existen hoy en día.

Validación diagnóstica del test neural 1 para el síndrome de túnel del carpo

El objetivo de este estudio fue realizar una prueba de validez diagnostica del test neural 1 para el diagnóstico del Síndrome de Túnel del Carpo (STC) utilizando como prueba de referencia o de oro el test de conducción nerviosa. En este estudio participaron 115 sujetos, 230 manos con sospecha clínica de STC quienes fueron evaluados con el test de conducción nerviosa y el test neural 1. Se encontró una sensibilidad del 93.0% (IC 95%:88,21-96,79) y una especificidad del 6,67% (IC 95%:0,0-33,59), razón de verosimilitud positiva fue de 1,00 y razón de verosimilitud negativa de 1,05. Valor predictivo positivo de 86,9% y un valor predictivo negativo de 12,5%. Se concluye que el test neural 1 es una prueba clínica de alta sensibilidad y baja especificidad de gran utilidad para el monitoreo e identificación del STC. Es un procedimiento para el diagnóstico clínico de bajo costo que puede incluirse en los exámenes de rutina de los trabajadores como complemento a las pruebas clínicas sugeridas por las Gatiso para dar mayor precisión a la identificación temprana del STC. Se sugiere combinarla con otros test de mayor especificidad para ser aplicada en trabajadores en condiciones de riesgo o que presenten síntomas en miembros superiores y realizar otros estudios en donde participen sujetos sin diagnóstico clínico del STC.

The effects of information and communication technologies on the banking sector and the payments system

This dissertation studies the effects of Information and Communication Technologies (ICT) on the banking sector and the payments system. It provides insight into how technology-induced changes occur, by exploring both the nature and scope of main technology innovations and evidencing their economic implications for banks and payment systems. Some parts in the dissertation are descriptive. They summarise the main technological developments in the field of finance and link them to economic policies. These parts are complemented with sections of the study that focus on assessing the extent of technology application to banking and payment activities. Finally, it includes also some work which borrows from the economic literature on banking. The need for an interdisciplinary approach arises from the complexity of the topic and the rapid path of change to which it is subject. The first chapter provides an overview of the influence of developments in ICT on the evolution of financial services and international capital flows. We include main indicators and discuss innovation in the financial sector, exchange rates and international capital flows. The chapter concludes with impact analysis and policy options regarding the international financial architecture, some monetary policy issues and the role of international institutions. The second chapter is a technology assessment study that focuses on the relationship between technology and money. The application of technology to payments systems is transforming the way we use money and, in some instances, is blurring the definition of what constitutes money. This chapter surveys the developments in electronic forms of payment and their relationship to the banking system. It also analyses the challenges posed by electronic money for regulators and policy makers, and in particular the opportunities created by two simultaneous processes: the Economic and Monetary Union and the increasing use of electronic payment instruments. The third chapter deals with the implications of developments in ICT on relationship banking. The financial intermediation literature explains relationship banking as a type of financial intermediation characterised by proprietary information and multiple interactions with customers. This form of banking is important for the financing of small and medium-sized enterprises. We discuss the effects of ICT on the banking sector as a whole and then apply these developments to the case of relationship banking. The fourth chapter is an empirical study of the effects of technology on the banking business, using a sample of data from the Spanish banking industry. The design of the study is based on some of the events described in the previous chapters, and also draws from the economic literature on banking. The study shows that developments in information management have differential effects on wholesale and retail banking activities. Finally, the last chapter is a technology assessment study on electronic payments systems in Spain and the European Union. It contains an analysis of existing payment systems and ongoing or planned initiatives in Spain. It forms part of a broader project comprising a series of country-specific analyses covering ten European countries. The main issues raised across the countries serve as the starting point to discuss implications of the development of electronic money for regulation and policies, and in particular, for monetary-policy making.

A dynamic knowledge-based decision support system to handle solids separation problems in activated sludge systems: development and validation

El sistema de fangs activats és el tractament biològic més àmpliament utilitzat arreu del món per la depuració d'aigües residuals. El seu funcionament depèn de la correcta operació tant del reactor biològic com del decantador secundari. Quan la fase de sedimentació no es realitza correctament, la biomassa no decantada s'escapa amb l'efluent causant un impacte sobre el medi receptor. Els problemes de separació de sòlids, són actualment una de les principals causes d'ineficiència en l'operació dels sistemes de fangs activats arreu del món. Inclouen: bulking filamentós, bulking viscós, escumes biològiques, creixement dispers, flòcul pin-point i desnitrificació incontrolada. L'origen dels problemes de separació generalment es troba en un desequilibri entre les principals comunitats de microorganismes implicades en la sedimentació de la biomassa: els bacteris formadors de flòcul i els bacteris filamentosos. Degut a aquest origen microbiològic, la seva identificació i control no és una tasca fàcil pels caps de planta. Els Sistemes de Suport a la Presa de Decisions basats en el coneixement (KBDSS) són un grup d'eines informàtiques caracteritzades per la seva capacitat de representar coneixement heurístic i tractar grans quantitats de dades. L'objectiu de la present tesi és el desenvolupament i validació d'un KBDSS específicament dissenyat per donar suport als caps de planta en el control dels problemes de separació de sòlids d'orígen microbiològic en els sistemes de fangs activats. Per aconseguir aquest objectiu principal, el KBDSS ha de presentar les següents característiques: (1) la implementació del sistema ha de ser viable i realista per garantir el seu correcte funcionament; (2) el raonament del sistema ha de ser dinàmic i evolutiu per adaptar-se a les necessitats del domini al qual es vol aplicar i (3) el raonament del sistema ha de ser intel·ligent. En primer lloc, a fi de garantir la viabilitat del sistema, s'ha realitzat un estudi a petita escala (Catalunya) que ha permès determinar tant les variables més utilitzades per a la diagnosi i monitorització dels problemes i els mètodes de control més viables, com la detecció de les principals limitacions que el sistema hauria de resoldre. Els resultats d'anteriors aplicacions han demostrat que la principal limitació en el desenvolupament de KBDSSs és l'estructura de la base de coneixement (KB), on es representa tot el coneixement adquirit sobre el domini, juntament amb els processos de raonament a seguir. En el nostre cas, tenint en compte la dinàmica del domini, aquestes limitacions es podrien veure incrementades si aquest disseny no fos òptim. En aquest sentit, s'ha proposat el Domino Model com a eina per dissenyar conceptualment el sistema. Finalment, segons el darrer objectiu referent al seguiment d'un raonament intel·ligent, l'ús d'un Sistema Expert (basat en coneixement expert) i l'ús d'un Sistema de Raonament Basat en Casos (basat en l'experiència) han estat integrats com els principals sistemes intel·ligents encarregats de dur a terme el raonament del KBDSS. Als capítols 5 i 6 respectivament, es presenten el desenvolupament del Sistema Expert dinàmic (ES) i del Sistema de Raonament Basat en Casos temporal, anomenat Sistema de Raonament Basat en Episodis (EBRS). A continuació, al capítol 7, es presenten detalls de la implementació del sistema global (KBDSS) en l'entorn G2. Seguidament, al capítol 8, es mostren els resultats obtinguts durant els 11 mesos de validació del sistema, on aspectes com la precisió, capacitat i utilitat del sistema han estat validats tant experimentalment (prèviament a la implementació) com a partir de la seva implementació real a l'EDAR de Girona. Finalment, al capítol 9 s'enumeren les principals conclusions derivades de la present tesi.