Opportunities and constraints of peri-urban buffalo and dairy cattle systems in Faisalabad, Punjab, Pakistan

In the big cities of Pakistan, peri-urban dairy production plays an important role for household income generation and the supply of milk and meat to the urban population. On the other hand, milk production in general, and peri-urban dairy production in particular, faces numerous problems that have been well known for decades. Peri-urban dairy producers have been especially neglected by politicians as well as non-government-organizations (NGOs). Against this background, a study in Pakistan’s third largest city, Faisalabad (Punjab Province), was carried out with the aims of gathering basic information, determining major constraints and identifying options for improvements of the peri-urban milk production systems. For data collection, 145 peri-urban households (HH) engaged in dairy production were interviewed face to face using a structured and pretested questionnaire with an interpreter. For analyses, HH were classified into three wealth groups according to their own perception. Thus, 38 HH were poor, 95 HH well off and 12 HH rich (26.2%, 65.5% and 8.3%, respectively). The richer the respondents perceived their HH, the more frequently they were actually in possession of high value HH assets like phones, bank accounts, motorbikes, tractors and cars. Although there was no difference between the wealth groups with respect to the number of HH members (about 10, range: 1 to 23), the educational level of the HH heads differed significantly: on average, heads of poor HH had followed education for 3 years, compared to 6 years for well off HH and 8 years for rich HH. About 40% of the poor and well off HH also had off-farm incomes, while the percentage was much higher - two thirds (67%) - for the rich HH. The majority of the HH were landless (62%); the rest (55 HH) possessed agricultural land from 0.1 to 10.1 ha (average 2.8 ha), where they were growing green fodder: maize, sorghum and pearl millet in summer; berseem, sugar cane and wheat were grown in winter. Dairy animals accounted for about 60% of the herds; the number of dairy animals per HH ranged from 2 to 50 buffaloes (Nili-Ravi breed) and from 0 to 20 cows (mostly crossbred, also Sahiwal). About 37% (n=54) of the HH did not keep cattle. About three quarters of the dairy animals were lactating. The majority of the people taking care of the animals were family workers; 17.3% were hired labourers (exclusively male), employed by 11 rich and 32 well off HH; none of the poor HH employed workers, but the percentages were 33.7% for the well off and 91.7% for the rich HH. The total number of workers increased significantly with increasing wealth (poor: 2.0; well off:2.5; rich: 3.4). Overall, 69 female labourers were recorded, making up 16.8% of employed workers and one fourth of the HH’s own labourers. Apparently, their only duty was to clean the animals´ living areas; only one of them was also watering and showering the animals. Poor HH relied more on female workers than the other two groups: 27.1% of the workers of poor HH were women, but only 14.8% and 6.8% of the labour force of well off and rich HH were female. Two thirds (70%) of the HH sold milk to dhodis (middlemen) and one third (35%) to neighbours; three HH (2%) did doorstep delivery and one HH (1%) had its own shop. The 91 HH keeping both species usually sold mixed milk (97%). Clients for mixed and pure buffalo milk were dhodis (78%, respectively 59%) and neighbours (28%, respectively 47%). The highest milk prices per liter (Pakistani Rupees, 100 PKR @ 0.8 Euro) were paid by alternative clients (44 PKR; 4 HH), followed by neighbours (40 PKR, 50 HH); dhodis paid lower prices (36 PKR, 99 HH). Prices for pure buffalo and mixed milk did not differ significantly. However, HH obtaining the maximum price from the respective clients for the respective type of milk got between 20% (mixed milk, alternative clients) and 68% (mixed milk, dhodi) more than HH fetching the minimum price. Some HH (19%) reported 7% higher prices for the current summer than the preceding winter. Amount of milk sold and distance from the HH to the city center did not influence milk prices. Respondents usually named problems that directly affected their income and that were directly and constantly visible to them, such as high costs, little space and fodder shortages. Other constraints that are only influencing their income indirectly, e.g. the relatively low genetic potential of their animals due to neglected breeding as well as the short- and long-term health problems correlated with imbalanced feeding and insufficient health care, were rarely named. The same accounts for problems accompanying improper dung management (storage, disposal, burning instead of recycling) for the environment and human health. Most of the named problems are linked to each other and should be addressed within the context of the entire system. Therefore, further research should focus on systematic investigations and improvement options, taking a holistic and interdisciplinary approach instead of only working in single fields. Concerted efforts of dairy farmers, researchers, NGOs and political decision makers are necessary to create an economic, ecological and social framework that allows dairy production to serve the entire society. For this, different improvement options should be tested in terms of their impact on environment and income of the farmers, as well as feasibility and sustainability in the peri-urban zones of Faisalabad.

Keyword Join: Realizing Keyword Search in P2P-based Database Systems

In this paper, we present a P2P-based database sharing system that provides information sharing capabilities through keyword-based search techniques. Our system requires neither a global schema nor schema mappings between different databases, and our keyword-based search algorithms are robust in the presence of frequent changes in the content and membership of peers. To facilitate data integration, we introduce keyword join operator to combine partial answers containing different keywords into complete answers. We also present an efficient algorithm that optimize the keyword join operations for partial answer integration. Our experimental study on both real and synthetic datasets demonstrates the effectiveness of our algorithms, and the efficiency of the proposed query processing strategies.

Systems Design: Activity and Sequence modelling using Visual Paradigm

This lab follows the lectures 'System Design: http://www.edshare.soton.ac.uk/9653/ and http://www.edshare.soton.ac.uk/6280/ . Students use Visual Paradigm for UML to build Activity and Sequence models through project examples: Library, Plant Nursery and a Health Spa

Visión y análisis de las propuestas de reforma al Sistema General de Seguridad Social en Salud en Colombia, vigencia 2012-2013

Con la Constitución Política de 1991, se inicia una nueva estructura funcional en el país a partir de los preceptos consagrados en la carta magna como un estado social de derecho, situación que no fue ajena al sector salud en el cual se estableció la seguridad social como un servicio público basado en los principios fundamentales de universalidad, solidaridad y eficiencia, enunciados que fueron plasmados entre otros en la Ley 100 de 1993, la cual incorporó estos elementos que resultaban innovadores en el contexto. Hoy después de 18 años de promulgada la Ley, se ha generado un modelo estructural que ha permitido mejorar los resultados en esta área, que si bien posee falencias en algunos de sus componentes (Acceso, Flujo de Recursos, Salud Pública), las mismas pueden ser superadas, con una reforma estructural al sistema que elimine los intereses particulares de los diferentes actores al momento de su elaboración y promulgación. Uno de los avances significativos en la reforma al sistema es la promulgación de la salud como derecho fundamental, inherente al ser humano, otorgando el carácter de inalienable, imprescriptible y sagrado, dejando en segundo plano su condición prestacional establecida. El derecho a la salud tendrá como eje principal la salud pública armonizada con la promoción y prevención, diagnóstico y tratamiento integral de la enfermedad, las cuales deben ser articuladas con las políticas sociales, ambientales, culturales y económicas que permitan incidir en los determinantes sociales de la salud para mejorar la calidad de vida de la población. La reforma a la salud en el eje de la financiación como se encuentra propuesta, no generará cambios sustanciales toda vez que se avanza hacia un sistema en que el estado será el principal actor con las funciones afiliación, recaudo, pago, giro o transferencia de los recursos, responsable de la información. Sin embargo la administración del riesgo en salud seguirá delegada, función que es determinante para la administración de los recursos del sistema, en resumen se demuestra el interés del estado en retomar la gobernanza y su empoderamiento como administrador de lo público, sin que esto responda a las necesidades de cambio en el sistema de salud.

Teleconsultation in sexual and reproductive health for young adults through mobile devices: Experience in Colombia

Background: Sexual risk behaviors associated with poor information on sexuality have contributed to major public health problems in the area of sexual and reproductive health in teenagers and young adults in Colombia. Objective: To measure the perception of changes in sexual and reproductive risk behavior after the use of a teleconsultation service via mobile devices in a sample of young adults. Methods: A before and after observational study was designed, where a mobile application to inquire about sexual and reproductive health was developed. The perception of changes in sexual and reproductive health risk behaviors in a sample of young adults after the use of the application was measured using the validated survey “Family Health International (FHI) – Behavioral Surveillance Survey (BSS) – Survey for Adults between 15 to 40 Years”. Non-probabilistic convenience recruitment was undertaken through the study´s web page. Participants answered the survey online before and after the use of the mobile application for a six month period (intervention). For the inferential analysis, data was divided into three groups (dichotomous data, discrete quantitative data, and ordinal data), to compare the results of the questions between the first and the second survey. For all tests, a confidence interval of 95% was established. For dichotomous data, the Chi-squared test was used. For quantitative data, we used the Student’s t-test, and for ordinal data, the Mann-Whitney-Wilcoxon test. Results: A total of 257 subjects were registered in the study and met the selection criteria. The pre-intervention survey was answered by 232 subjects, and 127 completely answered the post-intervention survey, of which 54.3% did not use the application, leaving an effective population of 58 subjects for analysis. 53% (n=31) were female, and 47% (n=27) were male. The mean age was 21 years, ranging between 18 and 40 years. The differences between the answers on the first and the second survey were not statistically significant. The main risk behaviors identified in the population were homosexual relations, non-use of condoms, sexual relations with non-regular and commercial partners, the use of psychoactive substances, and ignorance about the symptoms of sexually transmitted diseases and HIV transmission. Conclusions: Although there were no differences between the pre- and post-intervention results, the study revealed different risk behaviors among the participating subjects. These findings highlight the importance of promoting educational strategies on this matter and the importance of providing patients with easily accessible tools with reliable health information.

Community Health Managers: A Pilot Pedagogic Experience in the University of Rosario

The “Grupo de Estudios en Sistemas Tradicionales de Salud” from the School of Medicine of Universidad del Rosario, in agreement with the “Instituto de Etnobiología”, has designed a training course for a new health agent (the community health manager) meant to consider in its curriculum the difficulties, deficiencies and successes of the Primary Health Care Program. In particular, we have attended OMS suggestions in terms of adequate training of local leaders who should look for self-responsibility and selfdetermination in health care coverage. This training proposal is meant to take into account diverse cultures and traditions in order to offer health care models able to consider cultural particularities, epidemiological profiles, and contextual possibilities, with an intercultural point of view. Hence, the training course’s objective is to offer working tools so that community leaders be able to value and promote traditional health knowledge and practices; seek for food security by means of recovery of traditional productive systems or adaptation of appropriate technologies; environment conservation; use of medicinal plants especially in self-care, and stimulation of community and institutional health promotion activities. Preliminary evaluation suggests that this new health agent will be able to set bridges between communities and health care offers available, always looking for healthy ways of life, culturally and environmentally friendly.

Monologue or Intercultural Dialogue Between Medical Systems? An Educational Challenge for Medical Sciences

Each medical cultural system constructs knowledge about health through specialization or interculturalism. The knowledge constructed through interculturalism has sought, mainly, to adapt the delivery of health care services to the users’ cultural referents. This emphasis has overlooked the opportunities embedded in the establishment of intercultural relationships between medical systems based on dialogue, especially in regard to the adjustment of the disciplinary boundaries of medical cultural systems that would allow the construction of new knowledge on health. This absence of dialogue has been determined by epistemological barriers inherent to every system as well as by social domination. This article presents some concepts related to cognition processes which encourage the reflection on the possibilities to overcome such barriers so that the health sciences may contribute to the effective implementation of the World Health Organization and the State’s recommendations on the matter.

Aproximación a la asociatividad y la estructuración de redes basadas en confianza en instituciones prestadoras de servicios de salud

En este documento se concentra en un análisis sobre la asociatividad y la conformación de redes empresariales en dos instituciones prestadoras de servicios de salud del municipio de Tenjo Cundinamarca. En la primera parte se desarrolla el estado de la asociatividad con un enfoque de red, se plantea los objetivos, la justificación y los alcances de la investigación. En el segunda parte se hace alusión al marco teórico, marco legal, sistema general de seguridad social en salud, y la importancia que tiene las asociaciones empresariales, cooperación, participación y la confianza en las instituciones de salud; haciendo mención sobre clusters, alianzas y ecosistemas empresariales. En la tercera parte se realizó el marco metodológico de la investigación, análisis de resultado de las entrevistas, se describen las organizaciones objeto de este estudio. En la cuarta parte se realizan la discusión de la investigación, y se presentan las conclusiones que los autores de este estudio han presentado sobre la confianza fortalecida y la obligación prolongada de las empresas en el tiempo. Finamente, esta investigación presenta un punto de partida para la conformación de modelos que integren varias empresas, que puedan mejorar la competitividad, en las instituciones prestadoras de servicios de salud, permitiendo el acercando de los procesos del área administrativa con el área asistencia, en procura de brindar un mejoramiento continuo en la atención de los pacientes y su grupo familiar.

La instrumentalización del derecho fundamental a la salud a través de la prestación del servicio público

La salud además de ser un derecho fundamental también es un servicio público, el cual debe brindarse adecuadamente en términos de oportunidad, cobertura y calidad. Al entender la salud como un derecho fundamental autónomo, significa, que requiere por parte del Estado la garantía de su goce efectivo para todos los habitantes del territorio nacional, el cual es susceptible de limitaciones, con sujeción a los principios de eficiencia, universalidad y solidaridad, dentro del marco de la dignidad humana. Por otro lado, el análisis de la salud como un servicio público puede abordarse desde la prestación del mismo por parte de los particulares, lo que significa analizar la figura de la descentralización por colaboración en un Estado Unitario, lo que implica: 1. La actuación de particulares en la prestación del servicio público, previa autorización legal 2. La implementación de sistemas de control, inspección y vigilancia, por parte del Estado sobre dicha prestación. 3. La expedición de instrumentos de regulación y reglamentación normativa que regulen la prestación del servicio público de salud. A través de la interpretación integradora podemos afirmar que la salud es un derecho de la persona que se materializa mediante la prestación de un servicio público de carácter obligatorio. Es decir, los servicios públicos se constituyen como instrumentos para garantizar el logro de la plena vigencia y eficacia de los derechos constitucionales y por ende de la realización de los fines del Estado Social de Derecho.

Desarrollo de un estado de la cuestión acerca de las interacciones entre el control de gestión y el aprendizaje organizacional.

Las organizaciones en la actualidad deben encontrar diferentes maneras de sobrevivir en un tiempo de rápida transformación. Uno de los mecanismos usados por las empresas para adaptarse a los cambios organizacionales son los sistemas de control de gestión, que a su vez permiten a las organizaciones hacer un seguimiento a sus procesos, para que la adaptabilidad sea efectiva. Otra variable importante para la adaptación es el aprendizaje organizacional siendo el proceso mediante el cual las organizaciones se adaptan a los cambios del entorno, tanto interno como externo de la compañía. Dado lo anterior, este proyecto se basa en la extracción de documentación soporte valido, que permita explorar las interacciones entre estos dos campos, los sistemas de control de gestión y el aprendizaje organizacional, además, analizar el impacto de estas interacciones en la perdurabilidad organizacional. ​

Evaluación de tecnologías sanitarias aplicada a la selección de un módulo de proteína para uso hospitalario

Introducción: La evaluación de tecnologías en salud aplicadas a la selección de un módulo de proteína para uso hospitalario, tiene como finalidad servir de apoyo en la elección de productos costo efectivos y seguros, con el fin de favorecer la toma de decisiones a los diferentes agentes que participan en la elección de alternativas terapéuticas, recomendadas en pacientes con necesidades elevadas de proteínas, como es el caso de la presente investigación. Objetivo: Aplicar un método matemático - multicriterio que permita evaluar los módulos de proteína disponibles en el mercado para la terapia nutricional institucional. Métodos: Se establecieron dos fases, una revisión de la literatura para establecer y priorizar los criterios de evaluación técnica de las diferentes ofertas de módulos de proteína, y dos se realizó una aplicación de un modelo matemático con el fin de considerar el modulo proteico para uso dentro de las instituciones hospitalarias, el cual consistió en la asignación de un valor a cada una de las variables mediante una escala diferencial semántica establecida, que permitieron calcular el peso porcentual de cada una de las variables, cuya sumatoria arrojo la calificación porcentual de cada alternativa. Resultados: Respecto a la búsqueda de criterios de evaluación técnica para las diferentes ofertas de módulos de proteína, en la literatura se identificaron las siguientes variables para evaluación, la naturaleza o equivalencia, condiciones de administración y uso, seguridad, y eficacia. La naturaleza se evaluó mediante la calificación del cómputo químico de aminoácidos corregido por digestibilidad proteica (PDCAAS) con un peso en la evaluación del 39.05%, en referencia a las condiciones de administración y uso se tuvo en cuenta factores incluidos en los sistemas de distribución por dosis unitaria con un peso del 27.61%, la eficacia fue definida por la tasa de eficiencia proteica (PER) la cual impacta el 19.53% de la calificación y finalmente, el criterio de seguridad con un 13.81% referente al empaque y etiquetado. Conclusiones: Al realizar la evaluación de cuatro alternativas de módulos de proteína, ofertadas por las diferentes casas farmacéuticas, la mayor puntuación correspondiente a las alternativas con una calificación superior al 90%, la obtuvieron dos alternativas de módulos de proteína para uso hospitalario, las cuales contienen proteínas del suero (“Whey”) y aminoácidos en combinaciones.

Small-area variation in health care affecting the choice of cesarean delivery: the case of a Colombian health insurer

In the midst of health care reform, Colombia has succeeded in increasing health insurance coverage and the quality of health care. In spite of this, efficiency continues to be a matter of concern, and small-area variations in health care are one of the plausible causes of such inefficiencies. In order to understand this issue, we use individual data of all births from a Contributory-Regimen insurer in Colombia. We perform two different specifications of a multilevel logistic regression model. Our results reveal that hospitals account for 20% of variation on the probability of performing cesarean sections. Geographic area only explains 1/3 of the variance attributable to the hospital. Furthermore, some variables from both demand and supply sides are found to be also relevant on the probability of undergoing cesarean sections. This paper contributes to previous research by using a hierarchical model and by defining hospitals as cluster. Moreover, we also include clinical and supply induced demand variables.

New delay-dependent stability criteria for uncertain neutral systems with mixed time-varying delays and nonlinear perturbations

The problem of stability analysis for a class of neutral systems with mixed time-varying neutral, discrete and distributed delays and nonlinear parameter perturbations is addressed. By introducing a novel Lyapunov-Krasovskii functional and combining the descriptor model transformation, the Leibniz-Newton formula, some free-weighting matrices, and a suitable change of variables, new sufficient conditions are established for the stability of the considered system, which are neutral-delay-dependent, discrete-delay-range dependent, and distributeddelay-dependent. The conditions are presented in terms of linear matrix inequalities (LMIs) and can be efficiently solved using convex programming techniques. Two numerical examples are given to illustrate the efficiency of the proposed method

A proposal for the diagnosis of uncertain dynamic systems based on interval models

The performance of a model-based diagnosis system could be affected by several uncertainty sources, such as,model errors,uncertainty in measurements, and disturbances. This uncertainty can be handled by mean of interval models.The aim of this thesis is to propose a methodology for fault detection, isolation and identification based on interval models. The methodology includes some algorithms to obtain in an automatic way the symbolic expression of the residual generators enhancing the structural isolability of the faults, in order to design the fault detection tests. These algorithms are based on the structural model of the system. The stages of fault detection, isolation, and identification are stated as constraint satisfaction problems in continuous domains and solved by means of interval based consistency techniques. The qualitative fault isolation is enhanced by a reasoning in which the signs of the symptoms are derived from analytical redundancy relations or bond graph models of the system. An initial and empirical analysis regarding the differences between interval-based and statistical-based techniques is presented in this thesis. The performance and efficiency of the contributions are illustrated through several application examples, covering different levels of complexity.

Computationally reliable approaches of contractive MPC for discrete-time systems

La tesis pretende explorar acercamientos computacionalmente confiables y eficientes de contractivo MPC para sistemas de tiempo discreto. Dos tipos de contractivo MPC han sido estudiados: MPC con coacción contractiva obligatoria y MPC con una secuencia contractiva de conjuntos controlables. Las técnicas basadas en optimización convexa y análisis de intervalos son aplicadas para tratar MPC contractivo lineal y no lineal, respectivamente. El análisis de intervalos clásicos es ampliado a zonotopes en la geometría para diseñar un conjunto invariante de control terminal para el modo dual de MPC. También es ampliado a intervalos modales para tener en cuenta la modalidad al calcula de conjuntos controlables robustos con una interpretación semántica clara. Los instrumentos de optimización convexa y análisis de intervalos han sido combinados para mejorar la eficacia de contractive MPC para varias clases de sistemas de tiempo discreto inciertos no lineales limitados. Finalmente, los dos tipos dirigidos de contractivo MPC han sido aplicados para controlar un Torneo de Fútbol de Copa Mundial de Micro Robot (MiroSot) y un Tanque-Reactor de Mezcla Continua (CSTR), respectivamente.