Determinantes sociales de la salud en Bogotá DC: el caso del acceso y calidad de los servicios 2003, 2007 y 2011

Bogotá D.C. es una ciudad de más de siete millones de habitantes en su mayoría de estrato medio, dividida políticamente por veinte localidades. Aquí se generan la mayoría de oportunidades de desarrollo y día a día llega la población fluctuante de otras ciudades de Colombia en busca de un mejor futuro. Las necesidades de la población en una metrópolis como ésta no se hacen esperar y la salud entendida, como un buen estado físico y mental, además de ser una necesidad humana primordial se ha convertido en uno de los temas más agobiantes para los ciudadanos y los creadores de políticas públicas en el Distrito Capital. Alcanzar un adecuado estado de salud no es solo cuestión de asegurar y dar cobertura de servicio, también se requiere que las diferentes políticas públicas que existen estén articuladas para llegar al deseado estado de salud. Estas políticas públicas son los mismos determinantes sociales de salud, por los cuales la Organización Mundial de la Salud (OMS) ha impartido la instrucción de incrementar esfuerzos con el fin de mejorar el estado de salud de la población mundial. En esta investigación se realiza un análisis del Índice de Condiciones de Vida, calculado por el DANE, en la Encuesta Calidad de Vida para Bogotá en 2003, 2007 y Encuesta Multipropósito 2011, estudiando el primer factor que hace parte de dicho índice, el Acceso y Calidad de los Servicios, el cual se compone por cuatro aspectos: i) Abastecimiento y calidad del agua, ii) Eliminación de excretas; iii) Recolección de basuras y iv) Combustible para cocinar. La revisión teórica que aborda a los determinantes sociales de la salud evidencia que estos cuatro componentes son fundamentales para garantizar el estado de salud de los bogotanos y hacen parte de los objetivos del milenio. Adicionalmente se realizan regresiones lineales para determinar el peso que ha tenido el factor acceso y calidad de los servicios, en el estado de salud de los bogotanos, definiendo el Índice de Condiciones de Vida como variable proxy al estado de salud, para cada uno de los años de estudio. Por último se presentan algunos datos de los resultados de las políticas públicas relacionadas con el acceso y calidad de los servicios de los gobiernos de la ciudad correspondientes a los años de estudio.

The Role of Kinaesthetic Motor Imagery in Promoting Activation of the Lumbrical Muscles in the Hemiparetic Hand: a Randomised Controlled Study

The objective of the investigation who gave as result this work was to investigate the effectiveness of kinaesthetic motor imagery in the activation of the hemiplegic hand muscles following stroke. The experiment consisted of two random groups. Movements were measured after treatment. The participants were ten patients with hemiplegic hands (men who mean age was 74.4 years; mean time since stroke 3.05 months). All patients received three sessions of physical treatment based on an identical treatment protocol. Five patients were randomly assigned to an experimental group practising kinaesthetic motor imagery of a grasp using the 'lumbrical action' (experimental group). The others five (control group) followed a relaxation script. All the patients were then asked to grasp an object using the 'lumbrical action'. The grasps were recorded using an optoelectronic motion capture system. The magnitude of the extension of the index finger and the correlation of the angular displacement of the proximal phalangeal joints and the metacarpophalangeal joints were calculated. The movement time for the whole grip was calculated. The experimental group demonstrated higher extension in the index finger (p = < 0.01) and they had a higher correlation coefficient (0.99) than the control group (0.77) for the displacement of the proximal interphalangeal joint and the metacarpophalangeal joints. The movement time for the experimental group was faster, although the difference was not significant.

Efectos de la ansiedad sobre el rendimiento motor : mecanismos cognitivos y fisiológicos.

Analizar qué efectos tiene la ansiedad sobre la ejecución de tareas motrices de baja y elevada complejidad cognitiva, y proponer una explicación de los posibles efectos negativos, deterioro del rendimiento, ocasionado por los niveles altos de ansiedad en la ejecución de tales tareas motrices. Experimento 1: muestra aleatoria de 40 sujetos, alumnos de primero, segundo y tercero de Psicología de la Universidad de la Laguna. Experimento 2: 40 sujetos de los que participaron en el experimento anterior: los 20 que obtuvieron mayor puntuación en los cuestionarios de ansiedad IDARE e IDASE y los 20 que obtuvieron menor puntuación en los mismos. Experimento 3: los 10 sujetos de más alta puntuación en los cuestionarios IDARE e IDASE y otros 10 de más baja puntuación. Experimento 1: para determinar la complejidad atencional de dos versiones de una tarea motrizmente fina y dos versiones de otra tarea motrizmente gruesa. Se realizó un doble diseño factorial de varianza de dos variables independientes intergrupo. Un diseño 2x2: tarea atencionalmente compleja (atencionalmente simple; con carga de memoria) sin carga de memoria, para la tarea motrizmente gruesa y otro idéntico para la tarea motrizmente fina. Variable dependiente: el rendimiento en la ejecución de la tarea. Experimento 2: para determinar los efectos de la ansiedad sobre el rendimiento. Se realizó un diseño factorial de varianza 2x2x3. Variables independientes: a. Tipo de información o instrucciones: evaluativa-no evaluativa. b. Rasgo de ansiedad: elevado-bajo. c. Ensayos de práctica, con medidas repetidas en este factor. Variable dependiente: medida del rendimiento en la tarea. Experimento 3: complementario del anterior, después que las tareas han sido relativamente aprendidas. El tipo de diseño fue el de bloques aleatorizados de dos grupos independientes con una variable independiente intergrupo: rasgo de ansiedad, alto-bajo; las variables dependientes fueron las mismas que en el experimento anterior. Dos máquinas de escribir, cronómetro, en la fase preexperimental se aplicó a los sujetos diversas escalas para seleccionar la muestra: IDARE, IDASE y la escala de deseabilidad social de Crwne y Marlowe, 1964, para la fase experimental, el mismo material que en el experimento anterior. Experimento 3: se empleó el mismo material que en el anterior. Experimento 1: se ha establecido la complejidad atencional de las distintas tareas motrices. Experimento 2: a)La ansiedad elevada perjudica el rendimiento en aquellas tareas donde el número de estímulos es elevado y que exigen toma de decisiones y selección entre varias respuestas alternativas. b/La ansiedad elevada daña el rendimiento en las tareas que requieren un control fino, graduación de la fuerza y firmeza en el pulso y beneficia a aquellas tareas en las que se requiere fuerza, rapidez y movimiento grueso. Experimento 3: a) No hay diferencias en el rendimiento entre los sujetos de rasgo de ansiedad elevado y bajo, cuando son sometidos a condiciones evaluativas. El efecto de la ansiedad desaparece cuando la tarea ha sido previamente practicada. b) La experiencia de éxito o fracaso previo tiene una importancia específica como componente de condiciones evaluativas.

Diferencias individuales y desarrollo de habilidades de liderazgo : el rol del locus de control

El presente proyecto se ha elaborado con la finalidad de encontrar la relación existente entre el liderazgo y el locus de control, por medio de una revisión documental que permita dar una visión más amplia de estos dos fenómenos. De acuerdo con investigaciones realizadas, existen características individuales que afectan el desarrollo de liderazgo, lo cual a su vez tiene un impacto sobre el comportamiento de los individuos dentro de una sociedad. Uno de estos factores es el locus de control, el cual sesta determinado por características del individuo, y por el ambiente en el cual se desenvuelven las personas. Existen diferentes evidencias que soportan ésta relación entre locus de control y liderazgo. En éste estudio documental se describirán estos hallazgos, identificando las características del individuo y del contexto que influyen sobre ellos. Asimismo se pondrá en contexto a través del trabajo las características principales de los líderes y como se presentan las interacciones entre los lideres y seguidores, teniendo en cuenta que no todas las veces los seguidores desarrollan este papel al seguir a su líder, sino que por otro lado y estos pueden tomar parte fundamental en la interacción, influyendo de manera directa sobre el líder. Se recuerda que a los lideres los hacen sus seguidores y que sin estos no podrían desarrollar el papel de líder.

El control de esfínteres : gran avance en la autonomía infantil.

Resumen basado en la publicación

Perfiles de desarrollo motor y deficiencia mental.

Identificar perfiles de desarrollo motor grueso en alumnos con deficiencia mental. Grupo de 97 alumnos de entre 6 y 16 años, matriculados en un centro concertado de Educación Especial de la Comunidad de Madrid. Se mide el desarrollo motor de los alumnos que componen la muestra, atendiendo a varios aspectos: agilidad, equilibrio, coordinación bilateral, fuerza, coordinación entre los miembros superiores, velocidad de respuesta, control viso-motor, velocidad en miembros superiores y lateralidad. Después, se realiza un análisis de Cluster sobre los datos obtenidos, que permite obtener cuatro grupos con perfiles de desarrollo motor distintos. Además, se observa la relación existente entre las funciones motrices y las funciones cognitivas para determinar las variables cognitivas que caracterizan a los perfiles obtenidos. Estas variables proporcionan la información necesaria para realizar adaptaciones curriculares en el área de Educación Física. Se utiliza el Test de Bruininks-Ozeretsky para medir la eficacia motriz. Además, se realizan varias pruebas psicológicas: Escala de Inteligencia de Wechsler para Niños, Escalas McCarthy de Aptitudes y Psicomotricidad para Niños, Test Guestáltico Viso-Motor de Bender, Test Illinois de Habilidades Psicolingüísticas,y Signos Neurológicos Menores. Se utiliza la metodología ex-post-facto o no experimental, que comprende análisis descriptivos y correlativos. Esta investigación proporciona orientaciones para la adaptación de métodos, programas, terapias y actividades encaminados a la mejora del desarrollo motor de los alumnos con deficiencias mentales.

Estudio del nivel de integración perceptivo-motor en el escolar de ciclo inicial : diseño y baremo de una batería de pruebas.

Estructurar un método de examen no tecnicantal, de fácil aplicación por los educadores, que permita obtener criterios de referencia cuantificados sobre el nivel de integración perceptivo-motor en la población infantil de Ciclo Inicial. Muestra aleatoria estratificada, compuesta por 100 niños/as, escolarizados en Ciclo Inicial, de centros educativos públicos y privados de las distintas zonas de Pamplona, durante el curso 83-84. I. Síntesis teórica de las aportaciones en el área de los trastornos psicomotores. II. Aplicación de una prueba de predominio lateral como variable, que afecta al nivel de integración perceptivo-motriz. III. Elaboración de una batería de doce ítems que permita medir diversos aspectos del desarrollo psicomotor. IV. Estudio individual de cada prueba explorada. V. Análisis estadístico global y por áreas de la batería a fin de elaborar un perfil psicomotor. I. Prueba de dominancia lateral: ojo, mano, pie. II. Prueba de persistencia motriz. III. Prueba de actividad coreiforme. IV. Prueba de marcha en tandem. V. Prueba de equilibrio sobre un pie. VI. Prueba de salto sobre un pie. VII. Prueba de canto, palma, puño. VIII. Prueba de círculos. IX. Prueba de diadococinesias. X. Pruebas de sincinesias: imitación contralateral e irradiación homolateral; irradiación axo-segmentaria; irradiación facio-segmentaria; irradiación intersegmentaria. XI. Prueba de estereognosias. XII. Prueba de somatognosia. XIII. Prueba de gnosias visuales. Todas ellas modificaciones y agrupamientos de las pruebas de Peters, Youners y Touwen. I. El tecnicanto construido considera sujeto a riesgo aquel que supere la puntuación 23, o aquellos que no superándola muestran notable dispersión entre los items. II. Las niñas superan a los niños en destreza manual, velocidad y control de movimientos delicados, control motor global y equilibrio. III. Los sujetos de mayor edad y curso superior presenta nivel perceptivomotor más desarrollado. IV. Las variables: nivel socio-económico-cultural, lateralidad, posición entre hermanos y tipo de centro no influyen significativamente en el desarrollo perceptivo-motor de los escolares de 6 a 8 años. I. La batería elaborada permite obtener un perfil psicomotor que indica si el sujeto presenta riesgo de tener problemas de aprendizaje o de conducta, y si necesita diagnóstico y tratamiento más específico. II. El tecnicanto elaborado permite explorar en un único examen los niveles de coordinación motriz e integración perceptiva, a diferencia de otros que olvidan aspectos gnósicos. III. Las niñas de segundo de EGB están en condiciones más favorables de enfrentarse a los aprendizajes escolares. IV. Teniendo en cuenta los resultados más deficientes en niños con lateralidad no definida o mal definida, deberán estudiarse en posteriores investigaciones con más detenimiento.

Cotxe de ràdio control basat en un Fórmula 1 a escala 1/5

L’objecte d’aquest projecte és dissenyar un Renault R26 de Fórmula 1 a escala 1/5 capaç de córrer i realitzar les accions pròpies d’un cotxe, de forma teledirigida. La carrosseria, el tipus de suspensions i xassís seran el més semblant possible al cotxe real i estarà propulsat amb un motor de combustió interna de 2 temps

Modelling, control and supervision for a class of hybrid systems

The aim of this thesis is to narrow the gap between two different control techniques: the continuous control and the discrete event control techniques DES. This gap can be reduced by the study of Hybrid systems, and by interpreting as Hybrid systems the majority of large-scale systems. In particular, when looking deeply into a process, it is often possible to identify interaction between discrete and continuous signals. Hybrid systems are systems that have both continuous, and discrete signals. Continuous signals are generally supposed continuous and differentiable in time, since discrete signals are neither continuous nor differentiable in time due to their abrupt changes in time. Continuous signals often represent the measure of natural physical magnitudes such as temperature, pressure etc. The discrete signals are normally artificial signals, operated by human artefacts as current, voltage, light etc. Typical processes modelled as Hybrid systems are production systems, chemical process, or continuos production when time and continuous measures interacts with the transport, and stock inventory system. Complex systems as manufacturing lines are hybrid in a global sense. They can be decomposed into several subsystems, and their links. Another motivation for the study of Hybrid systems is the tools developed by other research domains. These tools benefit from the use of temporal logic for the analysis of several properties of Hybrid systems model, and use it to design systems and controllers, which satisfies physical or imposed restrictions. This thesis is focused in particular types of systems with discrete and continuous signals in interaction. That can be modelled hard non-linealities, such as hysteresis, jumps in the state, limit cycles, etc. and their possible non-deterministic future behaviour expressed by an interpretable model description. The Hybrid systems treated in this work are systems with several discrete states, always less than thirty states (it can arrive to NP hard problem), and continuous dynamics evolving with expression: with Ki ¡ Rn constant vectors or matrices for X components vector. In several states the continuous evolution can be several of them Ki = 0. In this formulation, the mathematics can express Time invariant linear system. By the use of this expression for a local part, the combination of several local linear models is possible to represent non-linear systems. And with the interaction with discrete events of the system the model can compose non-linear Hybrid systems. Especially multistage processes with high continuous dynamics are well represented by the proposed methodology. Sate vectors with more than two components, as third order models or higher is well approximated by the proposed approximation. Flexible belt transmission, chemical reactions with initial start-up and mobile robots with important friction are several physical systems, which profits from the benefits of proposed methodology (accuracy). The motivation of this thesis is to obtain a solution that can control and drive the Hybrid systems from the origin or starting point to the goal. How to obtain this solution, and which is the best solution in terms of one cost function subject to the physical restrictions and control actions is analysed. Hybrid systems that have several possible states, different ways to drive the system to the goal and different continuous control signals are problems that motivate this research. The requirements of the system on which we work is: a model that can represent the behaviour of the non-linear systems, and that possibilities the prediction of possible future behaviour for the model, in order to apply an supervisor which decides the optimal and secure action to drive the system toward the goal. Specific problems can be determined by the use of this kind of hybrid models are: - The unity of order. - Control the system along a reachable path. - Control the system in a safe path. - Optimise the cost function. - Modularity of control The proposed model solves the specified problems in the switching models problem, the initial condition calculus and the unity of the order models. Continuous and discrete phenomena are represented in Linear hybrid models, defined with defined eighth-tuple parameters to model different types of hybrid phenomena. Applying a transformation over the state vector : for LTI system we obtain from a two-dimensional SS a single parameter, alpha, which still maintains the dynamical information. Combining this parameter with the system output, a complete description of the system is obtained in a form of a graph in polar representation. Using Tagaki-Sugeno type III is a fuzzy model which include linear time invariant LTI models for each local model, the fuzzyfication of different LTI local model gives as a result a non-linear time invariant model. In our case the output and the alpha measure govern the membership function. Hybrid systems control is a huge task, the processes need to be guided from the Starting point to the desired End point, passing a through of different specific states and points in the trajectory. The system can be structured in different levels of abstraction and the control in three layers for the Hybrid systems from planning the process to produce the actions, these are the planning, the process and control layer. In this case the algorithms will be applied to robotics ¡V a domain where improvements are well accepted ¡V it is expected to find a simple repetitive processes for which the extra effort in complexity can be compensated by some cost reductions. It may be also interesting to implement some control optimisation to processes such as fuel injection, DC-DC converters etc. In order to apply the RW theory of discrete event systems on a Hybrid system, we must abstract the continuous signals and to project the events generated for these signals, to obtain new sets of observable and controllable events. Ramadge & Wonham¡¦s theory along with the TCT software give a Controllable Sublanguage of the legal language generated for a Discrete Event System (DES). Continuous abstraction transforms predicates over continuous variables into controllable or uncontrollable events, and modifies the set of uncontrollable, controllable observable and unobservable events. Continuous signals produce into the system virtual events, when this crosses the bound limits. If this event is deterministic, they can be projected. It is necessary to determine the controllability of this event, in order to assign this to the corresponding set, , controllable, uncontrollable, observable and unobservable set of events. Find optimal trajectories in order to minimise some cost function is the goal of the modelling procedure. Mathematical model for the system allows the user to apply mathematical techniques over this expression. These possibilities are, to minimise a specific cost function, to obtain optimal controllers and to approximate a specific trajectory. The combination of the Dynamic Programming with Bellman Principle of optimality, give us the procedure to solve the minimum time trajectory for Hybrid systems. The problem is greater when there exists interaction between adjacent states. In Hybrid systems the problem is to determine the partial set points to be applied at the local models. Optimal controller can be implemented in each local model in order to assure the minimisation of the local costs. The solution of this problem needs to give us the trajectory to follow the system. Trajectory marked by a set of set points to force the system to passing over them. Several ways are possible to drive the system from the Starting point Xi to the End point Xf. Different ways are interesting in: dynamic sense, minimum states, approximation at set points, etc. These ways need to be safe and viable and RchW. And only one of them must to be applied, normally the best, which minimises the proposed cost function. A Reachable Way, this means the controllable way and safe, will be evaluated in order to obtain which one minimises the cost function. Contribution of this work is a complete framework to work with the majority Hybrid systems, the procedures to model, control and supervise are defined and explained and its use is demonstrated. Also explained is the procedure to model the systems to be analysed for automatic verification. Great improvements were obtained by using this methodology in comparison to using other piecewise linear approximations. It is demonstrated in particular cases this methodology can provide best approximation. The most important contribution of this work, is the Alpha approximation for non-linear systems with high dynamics While this kind of process is not typical, but in this case the Alpha approximation is the best linear approximation to use, and give a compact representation.

Neural systems in the visual control of steering

Visual control of locomotion is essential for most mammals and requires coordination between perceptual processes and action systems. Previous research on the neural systems engaged by self-motion has focused on heading perception, which is only one perceptual subcomponent. For effective steering, it is necessary to perceive an appropriate future path and then bring about the required change to heading. Using function magnetic resonance imaging in humans, we reveal a role for the parietal eye fields (PEFs) in directing spatially selective processes relating to future path information. A parietal area close to PEFs appears to be specialized for processing the future path information itself. Furthermore, a separate parietal area responds to visual position error signals, which occur when steering adjustments are imprecise. A network of three areas, the cerebellum, the supplementary eye fields, and dorsal premotor cortex, was found to be involved in generating appropriate motor responses for steering adjustments. This may reflect the demands of integrating visual inputs with the output response for the control device.

Determining feature relevance for the grouping of motor unit action potentials through generative topographic mapping

The study of motor unit action potential (MUAP) activity from electrornyographic signals is an important stage on neurological investigations that aim to understand the state of the neuromuscular system. In this context, the identification and clustering of MUAPs that exhibit common characteristics, and the assessment of which data features are most relevant for the definition of such cluster structure are central issues. In this paper, we propose the application of an unsupervised Feature Relevance Determination (FRD) method to the analysis of experimental MUAPs obtained from healthy human subjects. In contrast to approaches that require the knowledge of a priori information from the data, this FRD method is embedded on a constrained mixture model, known as Generative Topographic Mapping, which simultaneously performs clustering and visualization of MUAPs. The experimental results of the analysis of a data set consisting of MUAPs measured from the surface of the First Dorsal Interosseous, a hand muscle, indicate that the MUAP features corresponding to the hyperpolarization period in the physisiological process of generation of muscle fibre action potentials are consistently estimated as the most relevant and, therefore, as those that should be paid preferential attention for the interpretation of the MUAP groupings.

Architecture for neuronal cell control of a mobile robot

It is usually expected that the intelligent controlling mechanism of a robot is a computer system. Research is however now ongoing in which biological neural networks are being cultured and trained to act as the brain of an interactive real world robot - thereby either completely replacing or operating in a cooperative fashion with a computer system. Studying such neural systems can give a distinct insight into biological neural structures and therefore such research has immediate medical implications. In particular, the use of rodent primary dissociated cultured neuronal networks for the control of mobile `animals' (artificial animals, a contraction of animal and materials) is a novel approach to discovering the computational capabilities of networks of biological neurones. A dissociated culture of this nature requires appropriate embodiment in some form, to enable appropriate development in a controlled environment within which appropriate stimuli may be received via sensory data but ultimate influence over motor actions retained. The principal aims of the present research are to assess the computational and learning capacity of dissociated cultured neuronal networks with a view to advancing network level processing of artificial neural networks. This will be approached by the creation of an artificial hybrid system (animal) involving closed loop control of a mobile robot by a dissociated culture of rat neurons. This 'closed loop' interaction with the environment through both sensing and effecting will enable investigation of its learning capacity This paper details the components of the overall animat closed loop system and reports on the evaluation of the results from the experiments being carried out with regard to robot behaviour.

Impedance mismatch: some differences between the way humans and robots control interaction forces

In over forty years of research robots have made very little progress still largely confined to industrial manufacture and cute toys, yet in the same period computing has followed Moores Law where the capacity double roughly every two years. So why is there no Moores Law for robots? Two areas stand out as worthy of research to speedup progress. The first is to get a greater understanding of how human and animal brains control movement, the second to build a new generation of robots that have greater haptic sense, that is a better ability to adapt to the environment as it is encountered. A remarkable property of the cognitive-motor system in humans and animals is that it is slow. Recognising an object may take 250 mS, a reaction time of 150 mS is considered fast. Yet despite this slow system we are well designed to allow contact with the world in a variety of ways. We can anticipate an encounter, use the change of force as a means of communication and ignore sensory cues when they are not relevant. A better understanding of these process has allowed us to build haptic interfaces to mimic the interaction. Emerging from this understanding are new ways to control the contact between robots, the user and the environment. Rehabilitation robotics has all the elements in the subject to not only enable and change the lives of people with disabilities, but also to facilitate revolution change in classic robotics.

Generative topographic mapping applied to clustering and visualization of motor unit action potentials

The identification and visualization of clusters formed by motor unit action potentials (MUAPs) is an essential step in investigations seeking to explain the control of the neuromuscular system. This work introduces the generative topographic mapping (GTM), a novel machine learning tool, for clustering of MUAPs, and also it extends the GTM technique to provide a way of visualizing MUAPs. The performance of GTM was compared to that of three other clustering methods: the self-organizing map (SOM), a Gaussian mixture model (GMM), and the neural-gas network (NGN). The results, based on the study of experimental MUAPs, showed that the rate of success of both GTM and SOM outperformed that of GMM and NGN, and also that GTM may in practice be used as a principled alternative to the SOM in the study of MUAPs. A visualization tool, which we called GTM grid, was devised for visualization of MUAPs lying in a high-dimensional space. The visualization provided by the GTM grid was compared to that obtained from principal component analysis (PCA). (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Thought communication and control: a first step using radiotelegraphy

A signalling procedure is described involving a connection, via the Internet, between the nervous system of an able-bodied individual and a robotic prosthesis, and between the nervous systems of two able-bodied human subjects. Neural implant technology is used to directly interface each nervous system with a computer. Neural motor unit and sensory receptor recordings are processed real-time and used as the communication basis. This is seen as a first step towards thought communication, in which the neural implants would be positioned in the central nervous systems of two individuals.