Longitudinal analysis of income-related health inequality

This paper considers the characterisation and measurement of income-related health inequality using longitudinal data. The paper elucidates the nature of the Jones and Lopez Nicholas (2004) index of “health-related income mobility” and explains the negative values of the index that have been reported in all the empirical applications to date. The paper further questions the value of their index to health policymakers and proposes an alternative index of “income-related health mobility” that measures whether the pattern of health changes is biased in favour of those with initially high or low incomes. We illustrate our work by investigating mobility in the General Health Questionnaire measure of psychological well-being over the first nine waves of the British Household Panel Survey from 1991 to 1999.

Longitudinal analysis of income-related health inequality: welfare foundations and alternative measures

This paper elaborates the approach to the longitudinal analysis of income-related health inequalities first proposed in Allanson, Gerdtham and Petrie (2010). In particular, the paper establishes the normative basis of their mobility indices by embedding their decomposition of the change in the health concentration index within a broader analysis of the change in “health achievement” or wellbeing. The paper further shows that their decomposition procedure can also be used to analyse the change in a range of other commonly-used incomerelated health inequality measures, including the generalised concentration index and the relative inequality index. We illustrate our work by extending their investigation of mobility in the General Health Questionnaire measure of psychological well-being over the first nine waves of the British Household Panel Survey from 1991 to 1999.

Accounting for the dead in the longitudinal analysis of income-related health inequalities

This paper develops an accounting framework to consider the effect of deaths on the longitudinal analysis of income-related health inequalities. Ignoring deaths or using inverse probability weights (IPWs) to re-weight the sample for mortality-related attrition can produce misleading results, since to do so would be to disregard the most extreme of all health outcomes. Incorporating deaths into the longitudinal analysis of income-related health inequalities provides a more complete picture in terms of the evaluation of health changes in respect to socioeconomic status. We illustrate our work by investigating health mobility in Quality Adjusted Life Years (QALYs) as measured by the SF6D from 1999 till 2004 using the British Household Panel Survey (BHPS). We show that for Scottish males explicitly accounting for the dead, rather than using IPWs to account for mortality-related attrition, changes the direction of the relationship between relative health changes and initial income position, while for other population groups it increases the strength of this relationship by up to 14 times. When deaths are explicitly incorporated into the analysis it is found that over this five year period for both Scotland and England & Wales the relative health changes were significantly regressive such that the poor experienced a larger share of the health losses relative to their initial share of health and a large amount of this was related to mortality.

How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study.

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning.

Politicians in the Media: Determinants of Legislators' Presence and Prominence in Swiss Newspapers

In times of increasing "mediatization" of politics, when voters and their elected representatives primarily communicate through the media, the question of who gets into the news and why becomes of the utmost importance. This article examines the determinants of Swiss legislators' presence and prominence in the print media by focusing on three competing approaches drawn from communication studies. The first approach regards the media as a "mirror" of political reality and argues that the media focus on the most active deputies in parliament. Second, news values theory predicts that "authoritative" politicians in leadership positions get the most media coverage. Third, theories of "news bias" hold that the media privilege legislators who are in line with their own editorial interests. Overall, the statistical analyses show an important leadership effect and provide strong support for the second explanation. While deputies in official functions get the most extensive news coverage, media access can also be won by parliamentary activity. The least support is shown for the news bias theory, although some newspapers try to localize parliamentary news coverage by focusing on deputies from their own media market.

Enhancing the vertical resolution of surface georadar data

There are far-reaching conceptual similarities between bi-static surface georadar and post-stack, "zero-offset" seismic reflection data, which is expressed in largely identical processing flows. One important difference is, however, that standard deconvolution algorithms routinely used to enhance the vertical resolution of seismic data are notoriously problematic or even detrimental to the overall signal quality when applied to surface georadar data. We have explored various options for alleviating this problem and have tested them on a geologically well-constrained surface georadar dataset. Standard stochastic and direct deterministic deconvolution approaches proved to be largely unsatisfactory. While least-squares-type deterministic deconvolution showed some promise, the inherent uncertainties involved in estimating the source wavelet introduced some artificial "ringiness". In contrast, we found spectral balancing approaches to be effective, practical and robust means for enhancing the vertical resolution of surface georadar data, particularly, but not exclusively, in the uppermost part of the georadar section, which is notoriously plagued by the interference of the direct air- and groundwaves. For the data considered in this study, it can be argued that band-limited spectral blueing may provide somewhat better results than standard band-limited spectral whitening, particularly in the uppermost part of the section affected by the interference of the air- and groundwaves. Interestingly, this finding is consistent with the fact that the amplitude spectrum resulting from least-squares-type deterministic deconvolution is characterized by a systematic enhancement of higher frequencies at the expense of lower frequencies and hence is blue rather than white. It is also consistent with increasing evidence that spectral "blueness" is a seemingly universal, albeit enigmatic, property of the distribution of reflection coefficients in the Earth. Our results therefore indicate that spectral balancing techniques in general and spectral blueing in particular represent simple, yet effective means of enhancing the vertical resolution of surface georadar data and, in many cases, could turn out to be a preferable alternative to standard deconvolution approaches.

Second-hand tobacco smoke in prison: tackling a public health matter through research.

OBJECTIVES: This action-research study conducted in a Swiss male post-trial detention centre (120 detainees and 120 staff) explored the attitudes of detainees and staff towards tobacco smoking. Tackling public health matters through research involving stakeholders in prisons implies benefits and risks that need exploration. STUDY DESIGN: The observational study involved multiple strands (quantitative and qualitative components, and air quality measurements). This article presents qualitative data on participants' attitudes and expectations about research in a prison setting. METHODS: Semi-structured interviews were used to explore the attitudes of detainees and staff towards smoking before and after a smoke-free regulation change in the prison in 2009. Specific coding and thematic content analysis for research were performed with the support of ATLAS.ti. RESULTS: In total, 77 interviews were conducted (38 before the regulation change and 39 after the regulation change) with 31 detainees (mean age 35 years, range 22-60 years) and 27 prison staff (mean age 46 years, range 29-65 years). Both detainees and staff expressed satisfaction regarding their involvement in the study, and wished to be informed about the results. They expected concrete changes in smoke-free regulation, and that the research would help to find ways to motivate detainees to quit smoking. CONCLUSION: Active involvement of stakeholders promotes public health. Interviewing detainees and prison staff as part of an action-research study aimed at tackling a public health matter is a way of raising awareness and facilitating change in prisons. Research needs to be conducted independently from the prison administrators in order to increase trust and to avoid misunderstandings.

Liver hyperplasia and paradoxical regulation of glycogen metabolism and glucose-sensitive gene expression in GLUT2-null hepatocytes. Further evidence for the existence of a membrane-based glucose release pathway.

We investigated the impact of GLUT2 gene inactivation on the regulation of hepatic glucose metabolism during the fed to fast transition. In control and GLUT2-null mice, fasting was accompanied by a approximately 10-fold increase in plasma glucagon to insulin ratio, a similar activation of liver glycogen phosphorylase and inhibition of glycogen synthase and the same elevation in phosphoenolpyruvate carboxykinase and glucose-6-phosphatase mRNAs. In GLUT2-null mice, mobilization of glycogen stores was, however, strongly impaired. This was correlated with glucose-6-phosphate (G6P) levels, which remained at the fed values, indicating an important allosteric stimulation of glycogen synthase by G6P. These G6P levels were also accompanied by a paradoxical elevation of the mRNAs for L-pyruvate kinase. Re-expression of GLUT2 in liver corrected the abnormal regulation of glycogen and L-pyruvate kinase gene expression. Interestingly, GLUT2-null livers were hyperplasic, as revealed by a 40% increase in liver mass and 30% increase in liver DNA content. Together, these data indicate that in the absence of GLUT2, the G6P levels cannot decrease during a fasting period. This may be due to neosynthesized glucose entering the cytosol, being unable to diffuse into the extracellular space, and being phosphorylated back to G6P. Because hepatic glucose production is nevertheless quantitatively normal, glucose produced in the endoplasmic reticulum may also be exported out of the cell through an alternative, membrane traffic-based pathway, as previously reported (Guillam, M.-T., Burcelin, R., and Thorens, B. (1998) Proc. Natl. Acad. Sci. U. S. A. 95, 12317-12321). Therefore, in fasting, GLUT2 is not required for quantitative normal glucose output but is necessary to equilibrate cytosolic glucose with the extracellular space. In the absence of this equilibration, the control of hepatic glucose metabolism by G6P is dominant over that by plasma hormone concentrations.

MEVA-Ambiental: MEtodologia per a la Valoració de l'Aprenentatge. Centrada en l'educació ambiental

Aquest projecte abasta el disseny i el desenvolupament d’un model prototípic de Metodologia per a la Valoració de l’Aprenentatge Ambiental, a la qual anomenem “MEVA-Ambiental”. Per a fer possible aquesta fita ens hem basat en fonaments ontològics i constructivistes per representar i analitzar el coneixement a fi de poder quantificar l’Increment de Coneixement (IC). Per nosaltres l’IC esdevé un indicador socio-educatiu que ens servirà per a determinar l’efectivitat dels tallers d’educació ambiental en percentatge. En procedir d’aquesta manera, les qualificacions resultats poden es poden prendre com punt de partida per a desenvolupar estudis en el temps i comprendre com “s’ancora” el nou coneixement a l’estructura cognitiva dels aprenents. Més enllà del plantejament teòric de mètode, també proveïm la solució tècnica que mostra com n’és de funcional i d’aplicable la part empírica metodològica. A aquesta solució que hem anomenat “MEVA-Tool”, és una eina virtual que automatitza la recollida i tractament de dades amb una estructura dinàmica basada en “qüestionaris web” que han d’emplenar els estudiants, una “base de dades” que acumula la informació i en permet un filtratge selectiu, i més “Llibre Excel” que en fa el tractament informatiu, la representació gràfica dels resultats, l’anàlisi i conclusions.

DCU per a la configurabilitat d'una estació de treball clínic

Gairebé un 50% dels metges de la sanitat catalana realitzen actualment les seves tasques assistencials en entorns SAP. Donada la naturalesa de la seva feina, és fàcil afirmar que les aplicacions que utilitzen habitualment haurien d'haver estat desenvolupades centrant l'atenció en l'usuari i el context en què aquest realitza la seva feina. Però degut a diversos motius organitzatius, això no ha estat així. Aquest projecte pretén demostrar el valor afegit que pot aportar el Disseny Centrat en l'Usuari en el desenvolupament d'aplicacions assistencials en l'àmbit SAP Sanitat. S'ha realitzat una investigació prèvia de les necessitats reals dels usuaris, un anàlisi del context d'ús i dels diferents perfils de usuari, s'ha desenvolupat un prototip amb la nova tecnologia que aporta SAP per al desenvolupament de interfícies tipus web integrades en el sistema (SAP Webdynpro for ABAP), i finalment s'ha realitzat la corresponent avaluació heurística i el test de usuaris. S'ha arribat principalment a tres conclusions: en primer lloc, ha sorprès la bona disposició dels usuaris metges per a participar en aquesta mena de projectes; en segon lloc, ha quedat demostrada la importància de l'anàlisi del context, així com la rellevància que el dissenyador estigui quan més a prop millor de l'usuari final; i finalment, cal destacar que la tecnologia emprada ha limitat qualitativament diverses opcions de disseny.

Competencias profesionales del ingeniero en informática

Este proyecto final de carrera pertenece al área de Competencias Profesionales y tiene como objetivo el análisis de experiencias de enseñanza-aprendizaje de la competencia de comunicación escrita en currículos TIC. El estudio se compone de tres partes: contextualización, investigación y reflexión. En la contextualización se define el concepto de competencia profesional y se clasifican las competencias genéricas o transversales en: competencias instrumentales, competencias interpersonales y competencias sistémicas. Por último, se indicarán las competencias genéricas para un Ingeniero en Informática, según el libro blanco para el título de grado de Ingeniería Informática. La investigación se ha llevado a cabo en los planes de estudio de Grado en Ingeniería Informática de 20 universidades españolas. En una primera parte se buscará qué universidades contemplan, en sus planes de estudio, competencias genéricas y realizaremos una clasificación. La segunda parte de investigación, se centrará en localizar la competencia de comunicación escrita y los objetivos de competencia de comunicación escrita. En la parte de la reflexión se identificarán las competencias genéricas explícitas e implícitas desarrolladas en el plan de estudios cursado en el itinerario formativo de la UOC. En esta parte también se analizará el modelo educativo de la UOC. El motivo de este proyecto de investigación es comprobar si los planes de estudio de Grado en Ingeniería Informática se han adaptado al EEES, en concreto, ver si las universidades seleccionadas tienen la intención de desarrollar la competencia comunicativa escrita. Esto nos permitirá analizar si un Graduado en Ingeniería Informática ha recibido una formación adecuada para conseguir dicha competencia.

Gestió de Centres en J2EE

Veurem el desenvolupament del projecte pas a pas, des de l¿estudi dels marcs de treballs més importants que es poden incorporar en projectes J2EE, passant per un anàlisi i disseny acurat, fins arribar a la implementació dels mòduls bàsics que inclouria el sistema de gestió dels centres intentant aprofitar totes les avantatges que ens ofereixen els marcs de treball més adients i tecnologies de darrera generació con AJAX per a fer un sistema flexible i robust capaç d¿assolir totes les necessitats de gestió de la informació dels centres. També veurem com apliquen diversos patrons en aquesta arquitectura client-servidor de tres capes aconseguint, entre altres aspectes, que cada component s¿assigni a una capa a un cert nivell d¿abstracció.

Implementació d'un esquema criptogràfic per a la gestió segura d'historials mèdics a través d'una xarxa de comunicacions

Aquest projecte es proposa dissenyar i implementar un sistema de gestió d'historials mèdics per a ser usat remotament a través d'una xarxa de comunicacions, amb un èmfasi principal enl'assoliment d'un nivell de seguretat considerat alt.

Anàlisi i disseny de una aplicació per la gestió de reserva d'un complexe d'apartaments

Aquest treball consisteix en l'anàlisi i disseny d'una aplicació per la gestió de reserves d'un complex de 39 apartaments, anomenat AIDA

Creació d'un magatzem de dades per a l'empresa "Sostre per a tothom"

Es presenta l'anàlisi, disseny, implementació i explotació d'un magatzem dedades per a l'anàlisi d'informació de gestió de l'empresa immobiliària "Sostreper a Tothom". Els elements d'anàlisi són els immobles i les vendes produïdesdes de gener de 2006 a gener de 2008 sent clau l'evolució del preus. La implementació es fa sobre SGBD Oracle 10gXE i Oracle Discoverer(Administrator i Desktop).