Socioeconomic disparities in childhood cancer survival in Switzerland.

In this study, we investigated whether childhood cancer survival in Switzerland is influenced by socioeconomic status (SES), and if disparities vary by type of cancer and definition of SES (parental education, living condition, area-based SES). Using Cox proportional hazards models, we analyzed 5-year cumulative mortality in all patients registered in the Swiss Childhood Cancer Registry diagnosed 1991-2006 below 16 years. Information on SES was extracted from the Swiss census by probabilistic record linkage. The study included 1602 children (33% with leukemia, 20% with lymphoma, 22% with central nervous system (CNS) tumors); with an overall 5-year survival of 77% (95%CI 75-79%). Higher SES, particularly parents' education, was associated with a lower 5-year cumulative mortality. Results varied by type of cancer with no association for leukemia and particularly strong effects for CNS tumor patients, where mortality hazard ratios for the different SES indicators, comparing the highest with the lowest group, ranged from 0.48 (95%CI: 0.28-0.81) to 0.71 (95%CI: 0.44-1.15). We conclude that even in Switzerland with a high quality health care system and mandatory health insurance, socioeconomic differences in childhood cancer survival persist. Factors causing these survival differences have to be further explored, to facilitate universal access to optimal treatment and finally eliminate social inequalities in childhood cancer survival. This article is protected by copyright. All rights reserved.

Developing Accessible Mobile Phone Applications: The Case of a Contact Manager and Real Time Text Applications

Mobile phones are becoming increasingly popular and are already the first access technology to information and communication. However, people with disabilities have to face a lot of barriers when using this kind of technology. This paper presents an Accessible Contact Manager and a Real Time Text application, designed to be used by all users with disabilities. Both applications are focused to improve accessibility of mobile phones.

Results of the Technical Validation of an Accessible Contact Manager for Mobile Devices

The apparition of new mobile phones operating systems often leads to a flood of mobile applications rushing into the market without taking into account needs of the most vulnerable users groups: the people with disabilities. The need of accessible applications for mobile is very important especially when it comes to access basic mobile functions such as making calls through a contact manager. This paper presents the technical validation process and results of an Accessible Contact Manager for mobile phones as a part of the evaluation of accessible applications for mobile phones for people with disabilities.

Using cloud technologies for engaging people with cultural heritage

Cultural heritage is an important asset of Europe which is largely underexplored. One of the main reasons is that the general public do not really incorporate cultural activities in their life style. Currently, curators and professionals in the heritage sector face the toughest challenges on how to attract, engage and retain visitors of heritage institutions (libraries, museums, archives and historical societies). TAG CLOUD FP7 European project seeks to overcome this situation and promote lifelong engagement with culture by personalising the visitors? cultural experiences through cloud technologies.

3D information visualisation: An historical perspective

The use of 3D visualisation of digital information is a recent phenomenon. It relies on users understanding 3D perspectival spaces. Questions about the universal access of such spaces has been debated since its inception in the European Renaissance. Perspective has since become a strong cultural influence in Western visual communication. Perspective imaging assists the process of experimenting by the sketching or modelling of ideas. In particular, the recent 3D modelling of an essentially non-dimensional Cyber-space raises questions of how we think about information in general. While alternate methods clearly exist they are rarely explored within the 3D paradigm (such as Chinese isometry). This paper seeks to generate further discussion on the historical background of perspective and its role in underpinning this emergent field. © 2005 IEEE.

Assessment of national health systems performance in the WHO African region

There is growing peer and donor pressure on African countries to utilize available resources more efficiently in a bid to support the ongoing efforts to expand coverage of health interventions with a view to achieving the health-related Millennium Development Goals. The purpose of this study was to estimate the technical and scale efficiency of national health systems in African continent. Methods The study applied the Data Envelopment Analysis approach to estimate the technical efficiency and scale efficiency among the 53 countries of the African Continent. Results Out of the 38 low-income African countries, 12 countries national health systems manifested a constant returns to scale technical efficiency (CRSTE) score of 100%; 15 countries had a VRSTE score of 100%; and 12 countries had a SE score of one. The average variable returns to scale technical efficiency (VRSTE) score was 95% and the mean scale efficiency (SE) score was 59%; meaning that while on average the degree of inefficiency was only 5%, the magnitude of scale inefficiency was 41%. Of the 15 middle-income countries, 5 countries, 9 countries and 5 countries had CRSTE, VRSTE and SE scores of 100%. Ten countries, six countries and 10 countries had CRSTE, VRSTE and SE scores of less than 100%; and thus, they were deemed inefficient. The average VRSTE (i.e. pure efficiency) score was 97.6%. The average SE score was 49.9%. Conclusion There are large unmet need for health and health-related services among countries of the African Continent. Thus, it would not be advisable for health policy-makers address NHS inefficiencies through reduction in excess human resources for health. Instead, it would be more prudent for them to leverage health promotion approaches and universal access prepaid (tax-based, insurance-based or mixtures) health financing systems to create demand for under utilised health services/interventions with a view to increasing ultimate health outputs to efficient target levels.

The Impact of the Internet in Six Latin American Countries

Access to the Internet has grown exponentially in Latin America over the past decade. The International Telecommunications Union (ITU) estimates that in 2009 there were 144.5 million Internet users in South America, 6.4 million in Central America, and 8.2 million in the Caribbean, or a total 159.2 million users in all of Latin America.1 At that time, ITU reported an estimated 31 million Internet users in Mexico, which would bring the overall number of users in Latin America to 190.2 million people. More recent estimates published by Internet World Stats place Internet access currently at an estimated 204.6 million out of a total population of 592.5 million in the region (this figure includes Mexico).2 According to those figures, 34.5 per cent of the Latin American population now enjoys Internet access. In recent years, universal access policies contributed to the vast increase in digital literacy and Internet use in Argentina, Brazil, Chile, Colombia, and Costa Rica. Whereas the latter was the first country in the region to adopt a policy of universal access, the most expansive and successful digital inclusion programs in the region have taken hold in Brazil and Chile. These two countries have allocated considerable resources to the promotion of digital literacy and Internet access among low income and poor populations; in both cases, civil society groups significantly assisted in the promotion of inclusion at the grassroots level. Digital literacy and Internet access have come to represent, particularly in the area of education, a welcome complementary resource for populations chronically underserved in nations with a long-standing record of inadequate public social services. Digital inclusion is vastly expanding throughout the region, thanks to stabilizing economies, increasingly affordable technology, and the rapid growth in the supply of cellular mobile telephony. A recent study by the global advertising agency Razorfish revealed significant shifts in the demographics of digital inclusion in the major economies of South America, where Web access is rapidly increasing amid the lower middle class and the working poor.3 Several researchers have suggested that Internet access will bring about greater civic participation and engagement, although skeptics remain unsure this could happen in Latin America. Yet, there have been some recent instances of political mobilization facilitated through the use of the Web and social media applications, starting in Chile when “smart mobs” nationwide demonstrated against former Chilean President Michelle Bachelet when she failed to enact education reforms in May 2006. The Internet has also been used by marginalized groups and by guerrillas groups to highlight their stories. In sum, Internet access in Latin is no longer a medium restricted to the elite. It is rather a public sphere upon which civil society has staked its claim. Some of the examples noted in this study point toward a developing trend whereby civil society, through online grassroots movements, is able to effectively pressure public officials, instill transparency and demand accountability in government. Access to the Internet has also made it possible for voices on the margins to participate in the conversation in a way that was never previously feasible. 1 International Telecommunications Union [ITU], “Information Technology Public & Report,” accessed May 15, 2011, http://www.itu.int/. 2 Internet World Stats, “Internet Usage Statistics for the Americas,” accessed March 24, 2011, http://www.internetworldstats.com/stats2.htm 3 J. Crump, “The finch and the fox,” London, UK (2010), http://www.slideshare.net/razorfishmarketing/the-finch-and-the-fox.

A multimodal and adaptive real-time human -computer interface for peoples with severe motor disability

This dissertation introduces the design of a multimodal, adaptive real-time assistive system as an alternate human computer interface that can be used by individuals with severe motor disabilities. The proposed design is based on the integration of a remote eye-gaze tracking system, voice recognition software, and a virtual keyboard. The methodology relies on a user profile that customizes eye gaze tracking using neural networks. The user profiling feature facilitates the notion of universal access to computing resources for a wide range of applications such as web browsing, email, word processing and editing. ^ The study is significant in terms of the integration of key algorithms to yield an adaptable and multimodal interface. The contributions of this dissertation stem from the following accomplishments: (a) establishment of the data transport mechanism between the eye-gaze system and the host computer yielding to a significantly low failure rate of 0.9%; (b) accurate translation of eye data into cursor movement through congregate steps which conclude with calibrated cursor coordinates using an improved conversion function; resulting in an average reduction of 70% of the disparity between the point of gaze and the actual position of the mouse cursor, compared with initial findings; (c) use of both a moving average and a trained neural network in order to minimize the jitter of the mouse cursor, which yield an average jittering reduction of 35%; (d) introduction of a new mathematical methodology to measure the degree of jittering of the mouse trajectory; (e) embedding an onscreen keyboard to facilitate text entry, and a graphical interface that is used to generate user profiles for system adaptability. ^ The adaptability nature of the interface is achieved through the establishment of user profiles, which may contain the jittering and voice characteristics of a particular user as well as a customized list of the most commonly used words ordered according to the user's preferences: in alphabetical or statistical order. This allows the system to successfully provide the capability of interacting with a computer. Every time any of the sub-system is retrained, the accuracy of the interface response improves even more. ^

Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Transição demográfica e a questão educacional: uma abordagem para o ensino médio do Rio Grande do Norte

Due to demographic transition process, the educational public sector politics formers encounter a highly specific demographic situation because, nowadays, despite the demographic transition, population is still growing because of the demographic inertia; however, due to steady decline in fertility, young population tends to decrease in next years. In this way, aiming to make high school widely accessible in the country, the issue of education quality is highlighted as well the importance of the physical structure of schools and their teaching equipments to confirm a favorable or not environment for developing educational processes. In this way, this work aims to relate the enrollment of students as school types with the demand of young people who will be able to attend high school on the Rio Grande do Norte state by the year of 2020, emphasizing teaching unities structural aspects, from a school profiling to the design of three prospective alternatives. So, from INEP's Scholar Census data and IBGE population's projections, this work is composed by four stages: i) literature review about research related subjects; ii) database design and build; iii) school profiling; and, iv) prospective alternatives creation. As results, three alternatives relate potential demand and enrollment using the built profiles and they are: i) “Alternative A” attends PEE's requirements related to demands but do not provide improvements in the school structural aspects; ii) “Alternative B” points into an increase of enrollment offering to the detriment of school's structural conditions which are offered to these students; iii) “Alternative C” propitiates a quantitative enrollment increasing combined with improvements on school's physical structure. These alternatives help to support decision making related to goals and realization of universal access with physical conditions which are necessary to a favorable environment to educational activity development.

DOCUMENT CONTROL OF NATIONAL MAPPING AND METRIC STUDIES CHARACTERIZING NATIONAL IDENTITY AND INDIVIDUAL. I STAGE

This is a project of the School of Library, Documentation and Information of the National University, is performed to support the initiative of UNESCO to build the Memory of the World (UNESCO, 1995) and to help provide universal access to documentation. To this end, the School of Library Science students has promoted the realization of final graduation work on documentary control of domestic production. This project has the following objectives:Objectives1. Conduct mapping national documentary through the identification, analysis, organization and access to documentary heritage of Costa Rica, to contribute to the Memory of the World.2. Perform bibliometric analysis of documentary records contained in the integrated databases.This project seeks to bring undergraduate students graduating from the school, in making final graduation work on document control. Students have the opportunity to make final graduation work on the documentary production of Costa Rica on a specific theme or on a country's geographical area.Desk audits aimed at identifying the document using access points and indicate its contents to allow recovery by the user.The result is the production of a new document, other than the original, a secondary document: the bibliography. The records in the database each control documentation completed work will be integrated into a single database to be placed on the website of EBDI, for consultation of researchers and interested users.

Índice de Materias

ACCESO A LA INFORMACION - VENTAJAS000046ACCESO UNIVERSAL DE PUBLICACIONES000023, 000054

Non-use of Formal Health Services in Malawi: Perceptions from Non-users

Background The study upon which this paper is based was undertaken to understand users’ and non-users’ perceptions concerning facilitators and barriers to equitable and universal access to health care in resource-poor countries such as Malawi. In this study, non-users of health services were defined as people who were not in need of health services or those who had stopped using them due to significant barriers. Methods A total of 80 interviews with non-users of health services were conducted in Rumphi, Ntchisi, Phalombe and Blantyre Districts of Malawi. Interviews focused on why informants were not using formal health services at the time of data collection. In order to identify non-users, snowballing was used health surveillance assistants, village headmen and community members also helped. One focus group discussion was also conducted with non-users of health services who were members of the Zion Church. Results Informants described themselves as non-users of health services due to several reasons: cost of health services; long distances to health facilities; poor attitude of health workers; belief in the effectiveness of traditional medicines; old age and their failure to walk. Others were non-users due to their disability; hence they could not walk over long distances or could not communicate effectively with health providers. Some of these non-users were complete non-users, namely members of the Zion Church and those who believed in traditional medicine, and they stated that nothing could be done to transform them into users of health services. Other non-users stated that they could become users if their challenges were addressed e.g. for those who were non-users of health services due to poor attitudes of health workers, they stated that if these health workers were transferred they would be able to access health services. Conclusions Public health education targeting both health workers and non-users, ensuring a functional outreach program and addressing other health system challenges such as shortage of drugs and human resources would assist in transforming non-users into users of health services.

Evocando o cachimbo de Magritte: das dotações, políticas de pessoal e discursos de acessibilidade

Uma análise que interliga a questão das dotações (da diferença com os rácios, dos métodos e dos fatores a ter em conta) com a gestão de recursos humanos (a necessidade de um plano estratégico de recursos humanos na saúde) e os discursos de acessibilidade e acesso universal a cuidados de enfermagem. Três prismas que convergem na necessidade de se prestar atenção e ter em conta, portanto a recentrar nas questões da equidade e da responsabilidade.

El efecto de la definición regulatoria de banda ancha sobre la difusión y la competencia del mercado de servicios de Internet fijo en Colombia

A partir de la dinámica evolutiva de la economía de las Tecnologías de la Información y las Comunicaciones y el establecimiento de estándares mínimos de velocidad en distintos contextos regulatorios a nivel mundial, en particular en Colombia, en el presente artículo se presentan diversas aproximaciones empíricas para evaluar los efectos reales que conlleva el establecimiento de definiciones de servicios de banda ancha en el mercado de Internet fijo. Con base en los datos disponibles para Colombia sobre los planes de servicios de Internet fijo ofrecidos durante el periodo 2006-2012, se estima para los segmentos residencial y corporativo el proceso de difusión logístico modificado y el modelo de interacción estratégica para identificar los impactos generados sobre la masificación del servicio a nivel municipal y sobre las decisiones estratégicas que adoptan los operadores, respectivamente. Respecto a los resultados, se encuentra, por una parte, que las dos medidas regulatorias establecidas en Colombia en 2008 y 2010 presentan efectos significativos y positivos sobre el desplazamiento y el crecimiento de los procesos de difusión a nivel municipal. Por otra parte, se observa sustituibilidad estratégica en las decisiones de oferta de velocidad de descarga por parte de los operadores corporativos mientras que, a partir del análisis de distanciamiento de la velocidad ofrecida respecto al estándar mínimo de banda ancha, se demuestra que los proveedores de servicios residenciales tienden a agrupar sus decisiones de velocidad alrededor de los niveles establecidos por regulación.