Delays In Receiving Obstetric Care And Poor Maternal Outcomes: Results From A National Multicentre Cross-sectional Study.

The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.

Effect of removing user fees on attendance for curative and preventive primary health care services in rural South Africa

User fees are used to recover costs and discourage unnecessary attendance at primary care clinics in many developing countries. In South Africa, user fees for children aged under 6 yea rs and pregnant women were removed in 1994, and in 1997 all user fees at all primary health care clinics were abolished. The intention of these policy changes was to improve access to health services for previously disadvantaged communities. We investigated the impact of these changes on clinic attendance patterns in Hlabisa health district. Average quarterly new registrations and total attendances for preventive services (antenatal care, immunization, growth monitoring) and curative services (treatment of ailments) at a mobile primary health care unit were studied from 1992 to 1998. Regression analysis was undertaken to assess whether trends were statistically significant. There was a sustained increase in new registrations (P = 0.0001) and total attendances (P = 0.0001)for curative services, and a fall in new registrations (P = 0.01) and total attendances for immunization and growth monitoring (P = 0.0002) over the study period. The upturn in demand for curative services started at the time of the first policy change. The decreases in antenatal registrations (P = 0.07) and attendances (P = 0.09) were not statistically significant The number of new registrations for immunization and growth monitoring increased following the first policy change but declined thereafter. We found no evidence that the second policy change influenced underlying trends. The removal of user fees improved access to curative services but this may have happened at the expense of some preventive services. Governments should remain vigilant about the effects of new health policies in order to ensure that objectives are being met.

Pressure-Frequency Sensing Subxiphoid Access System for Use in Percutaneous Cardiac Electrophysiology: Prototype Design and Pilot Study Results

We have designed, built, and tested an early prototype of a novel subxiphoid access system intended to facilitate epicardial electrophysiology, but with possible applications elsewhere in the body. The present version of the system consists of a commercially available insertion needle, a miniature pressure sensor and interconnect tubing, read-out electronics to monitor the pressures measured during the access procedure, and a host computer with user-interface software. The nominal resolution of the system is <0.1 mmHg, and it has deviations from linearity of <1%. During a pilot series of human clinical studies with this system, as well as in an auxiliary study done with an independent method, we observed that the pericardial space contained pressure-frequency components related to both the heart rate and respiratory rate, while the thorax contained components related only to the respiratory rate, a previously unobserved finding that could facilitate access to the pericardial space. We present and discuss the design principles, details of construction, and performance characteristics of this system.

Attitudes to entry fees to National Parks: Results and policy implications from a Queensland case study

Examines visitor attitudes and whether visitors are willing to pay to enter Lamington National Park and under what circumstances they would do so. First a sample of visitors is asked a general (normative) question as to whether visitors should pay to visit Lamington National Park and in another question (positive) they are asked whether they would be more willing to pay if the money collected would be invested in the park to improve visitor facilities and for conservation work. The results show that visitors are more willing to accept the ‘user-pays’ principle if the money will be used for the benefit of the national park and its visitors. It was found that foreigners are more in support for a ‘user-pay’ fee than Australians, and among Australians, those visitors from Queensland are the least willing to accept the idea of a user-pay fee to enter the park. The results indicate that if visitors can be shown the benefits (both for visitors and for conservation) of charging an entry fee, then visitors are more likely to support such a concept than when they are unaware of the benefits of a user-fee. The study shows that on average foreigners are willing to pay more than Australians. Finally, the regression results identify significant factors influencing visitors’ attitudes and suggested amounts to visit the national park.

Precise Insertion of Orthodontic Miniscrews with a Stereolithographic Surgical Guide Based on Cone Beam Computed Tomography Data: A Pilot Study

Purpose: Orthodontic miniscrews are commonly used to achieve absolute anchorage during tooth movement. One of the most frequent complications is screw loss as a result of root contact. Increased precision during the process of miniscrew insertion would help prevent screw loss and potential root damage, improving treatment outcomes. Stereo lithographic surgical guides have been commonly used for prosthetic implants to increase the precision of insertion. The objective of this paper was to describe the use of a stereolithographic surgical guide suitable for one-component orthodontic miniscrews based on cone beam computed tomography (CBCT) data and to evaluate implant placement accuracy. Materials and Methods: Acrylic splints were adapted to the dental arches of four patients, and six radiopaque reference points were filled with gutta-percha. The patients were submitted to CBCT while they wore the occlusal splint. Another series of images was captured with the splint alone. After superimposition and segmentation, miniscrew insertion was simulated using planning software that allowed the user to check the implant position in all planes and in three dimensions. In a rapid-prototyping machine, a stereolithographic guide was fabricated with metallic sleeves located at the insertion points to allow for three-dimensional control of the pilot bur. The surgical guide was worn during surgery. After implant insertion, each patient was submitted to CBCT a second time to verify the implant position and the accuracy of the placement of the miniscrews. Results: The average differences between the planned and inserted positions for the ten miniscrews were 0.86 mm at the coronal end, 0.71 mm at the center, and 0.87 mm at the apical tip. The average angular discrepancy was 1.76 degrees. Conclusions: The use of stereolithographic surgical guides based on CBCT data allows for accurate orthodontic mini screw insertion without damaging neighboring anatomic structures. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:860-865

User's Views of an Outreaching Social Work Team in Hong Kong

This article reports the survey findings of a recent study on users’ views of the service provided by an outreaching social work team in Hong Kong. It attempts to explore how youth at risk can be jointly involved in evaluating the quality of the social service. Users appear to have favourable opinions towards the service received and would like to have greater involvement in programme planning, implementation and evaluation. Finally, recommendations on improving the understanding of the needs of users and encouraging greater user participation in future service delivery are suggested.

Web survey system to discover the actual role of experience in learning in higher education: a case study

March 19 - 22, 2006, São Paulo, BRAZIL World Congress on Computer Science, Engineering and Technology Education

A study on dynamic state information (DSI) around users for safe urban life

To select each node by devices and by contexts in urban computing, users have to put their plan information and their requests into a computing environment (ex. PDA, Smart Devices, Laptops, etc.) in advance and they will try to keep the optimized states between users and the computing environment. However, because of bad contexts, users may get the wrong decision, so, one of the users’ demands may be requesting the good server which has higher security. To take this issue, we define the structure of Dynamic State Information (DSI) which takes a process about security including the relevant factors in sending/receiving contexts, which select the best during user movement with server quality and security states from DSI. Finally, whenever some information changes, users and devices get the notices including security factors, then an automatic reaction can be possible; therefore all users can safely use all devices in urban computing.

Study on influence of the new CoDeSys V3.0 on the existing CoDeSys discipline of the Mind8 Engineering Center

CoDeSys "Controller Development Systems" is a development environment for programming in the area of automation controllers. It is an open source solution completely in line with the international industrial standard IEC 61131-3. All five programming languages for application programming as defined in IEC 61131-3 are available in the development environment. These features give professionals greater flexibility with regard to programming and allow control engineers have the ability to program for many different applications in the languages in which they feel most comfortable. Over 200 manufacturers of devices from different industrial sectors offer intelligent automation devices with a CoDeSys programming interface. In 2006, version 3 was released with new updates and tools. One of the great innovations of the new version of CoDeSys is object oriented programming. Object oriented programming (OOP) offers great advantages to the user for example when wanting to reuse existing parts of the application or when working on one application with several developers. For this reuse can be prepared a source code with several well known parts and this is automatically generated where necessary in a project, users can improve then the time/cost/quality management. Until now in version 2 it was necessary to have hardware interface called “Eni-Server” to have access to the generated XML code. Another of the novelties of the new version is a tool called Export PLCopenXML. This tool makes it possible to export the open XML code without the need of specific hardware. This type of code has own requisites to be able to comply with the standard described above. With XML code and with the knowledge how it works it is possible to do component-oriented development of machines with modular programming in an easy way. Eplan Engineering Center (EEC) is a software tool developed by Mind8 GmbH & Co. KG that allows configuring and generating automation projects. Therefore it uses modules of PLC code. The EEC already has a library to generate code for CoDeSys version 2. For version 3 and the constant innovation of drivers by manufacturers, it is necessary to implement a new library in this software. Therefore it is important to study the XML export to be then able to design any type of machine. The purpose of this master thesis is to study the new version of the CoDeSys XML taking into account all aspects and impact on the existing CoDeSys V2 models and libraries in the company Harro Höfliger Verpackungsmaschinen GmbH. For achieve this goal a small sample named “Traffic light” in CoDeSys version 2 will be done and then, using the tools of the new version it there will be a project with version 3 and also the EEC implementation for the automatically generated code.

A study on security grade assignment model for mobile users in urban computing

The relation between the information/knowledge expression and the physical expression can be involved as one of items for an ambient intelligent computing [2],[3]. Moreover, because there are so many contexts around user/spaces during a user movement, all appplcation which are using AmI for users are based on the relation between user devices and environments. In these situations, it is possible that the AmI may output the wrong result from unreliable contexts by attackers. Recently, establishing a server have been utilizes, so finding secure contexts and make contexts of higher security level for save communication have been given importance. Attackers try to put their devices on the expected path of all users in order to obtain users informationillegally or they may try to broadcast their SPAMS to users. This paper is an extensionof [11] which studies the Security Grade Assignment Model (SGAM) to set Cyber-Society Organization (CSO).

Transfering data from a server to an Android Mobile application: a case study

Nowadays, due to the incredible grow of the mobile devices market, when we want to implement a client-server applications we must consider mobile devices limitations. In this paper we discuss which can be the more reliable and fast way to exchange information between a server and an Android mobile application. This is an important issue because with a responsive application the user experience is more enjoyable. In this paper we present a study that test and evaluate two data transfer protocols, socket and HTTP, and three data serialization formats (XML, JSON and Protocol Buffers) using different environments and mobile devices to realize which is the most practical and fast to use.

The evolution of user mobility on the Eduroam network

The emergence of smartphones with Wireless LAN (WiFi) network interfaces brought new challenges to application developers. The expected increase of users connectivity will impact their expectations for example on the performance of background applications. Unfortunately, the number and breadth of the studies on the new patterns of user mobility and connectivity that result from the emergence of smartphones is still insufficient to support this claim. This paper contributes with preliminary results on a large scale study of the usage pattern of about 49000 devices and 31000 users who accessed at least one access point of the eduroam WiFi network on the campuses of the Lisbon Polytechnic Institute. Results confirm that the increasing number of smartphones resulted in significant changes to the pattern of use, with impact on the amount of traffic and users connection time.

Towards e-learning 2.0: case study of an e-learning environment

In these days the learning experience is no longer confined within the four walls of a classroom. Computers and primarily the internet have broadened this horizon by creating a way of delivering education that is known as e-learning. In the meantime, the internet, or more precisely, the Web is heading towards a new paradigm where the user is no longer just a consumer of information and becomes an active part in the communication. This two-way channel where the user takes the role of the producer of content triggered the appearance of new types of services such as Social Networks, Blogs and Wikis. To seize this second generation of communities and services, educational vendors are willing to develop e-learning systems focused on the new and emergent users needs. This paper describes the analysis and specification of an e-learning environment at our School (ESEIG) towards this new Web generation, called PEACE – Project for ESEIG Academic Environment. This new model relies on the integration of several services controlled by teachers and students such as social networks, repositories libraries, e-portfolios and e-conference sytems, intelligent tutors, recommendation systems, automatic evaluators, virtual classrooms and 3D avatars.

Participatory mapping in the design process of a spatial data infrastructure SDI: a case study in the Biosphere Reserve Rio Platano (Honduras)

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Dimensions of source credibility in the case of user-generated advertisements

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics