Factores asociados a que usuarias de un hospital público, no soliciten los resultados de citologia cervical

El cáncer de cuello uterino y su mortalidad en Colombia ha permanecido constantes pese a los esfuerzos institucionales, distritales y nacionales que han buscado fortalecer los programas de prevención; sin embargo las estrategias actuales hacen énfasis en la toma de citología y no en la solicitud oportuna del resultado y el tratamiento de la usuaria en caso de anormalidad. METODOLOGIA: Se realizó un estudio en dos fases, un análisis descriptivo se analizaron 12875 y una segunda que involucro 257 pacientes en un análisis de casos y controles de una muestra aleatoria. RESULTADOS: Se utiliza para análisis bivariado la prueba de Chi cuadrado y regresión logística que muestran diferencias significativas en los siguientes variables: la explicación sobre la importancia del examen (p= 0.0060), importancia de la solicitud de resultado (p= 0.003), explicación sobre cuando reclamarlo (p=0.030), distancia entre residencia y centro de salud (p=0.065) DISCUSIÓN: En nuestro estudio se identificó que los factores como el acceso de la paciente al centro de salud, el tiempo del cual dispone para solicitar el resultado, si el dinero con el que cuenta la paciente para desplazarse al hospital, si es la primera vez que se realiza la citología, si le explicaron la importancia de reclamar el resultado y en que lapso de tiempo debía hacerlo, la información que tiene acerca de la importancia de realizarse la citología contribuyen en el hecho de que una paciente de esta población de un hospital público reclame o no su resultado de su citología

Back from beyond the bid-ask spread: perspectives on liquidity

Research into the topic of liquidity has greatly benefited from the availability of data. Although bid-ask spreads were inaccessible to researchers, Roll (1984) provided a conceptual model that estimated the effective bid-ask prices from regular time series data, recorded on a daily or longer interval. Later data availability improved and researchers were able to address questions regarding the factors that influenced the spreads and the relationship between spreads and risk, return and liquidity. More recently transaction data have been used to measure the effective spread and researchers have been able to refine the concepts of liquidity to include the impact of transactions on price movements (Clayton and McKinnon, 2000) on a trade-by-trade analysis. This paper aims to use techniques that combine elements from all three approaches and, by studying US data over a relatively long time period, to throw light on earlier research as well as to reveal the changes in liquidity over the period controlling for extraneous factors such as market, age and size of REIT. It also reveals some comparable results for the UK market over the same period.

Back from beyond bid-ask spread: estimating liquidity in international markets

Research on the topic of liquidity has greatly benefited from the improved availability of data. Researchers have addressed questions regarding the factors that influence bid-ask spreads and the relationship between spreads and risk, return and liquidity. Intra-day data have been used to measure the effective spread and researchers have been able to refine the concepts of liquidity to include the price impact of transactions on a trade-by-trade analysis. The growth in the creation of tax-transparent securities has greatly enhanced the visibility of securitized real estate, and has naturally led to the question of whether the increased visibility of real estate has caused market liquidity to change. Although the growth in the public market for securitized real estate has occurred in international markets, it has not been accompanied by universal publication of transaction data. Therefore this paper develops an aggregate daily data-based test for liquidity and applies the test to US data in order to check for consistency with the results of prior intra-day analysis. If the two approaches produce similar results, we can apply the same technique to markets in which less detailed data are available and offer conclusions on the liquidity of a wider set of markets.

Evaluation of the LBJ Hospital Ask Your Nurse Advice Line

This retrospective, case-control study investigated the effectiveness of the Houston, Texas Ask Your Nurse Advice Line (AYN) in diverting callers with non-emergent medical conditions away from the emergency department (ED). After asking callers a series of questions, AYN nurses evaluate the medical condition and make recommendations for appropriate care, e.g., home care, see a clinic physician, or visit the ED. To evaluate the AYN, the rate of caller ED visits before accessing the AYN for the first time was compared to the caller ED visit rate afterwards. The pre-post rate change was compared to that of a control group of similar caller age, race, gender, and insurance status drawn from a Harris County Hospital District HCHD database. ^ The treatment group (AYN caller) had a 66% reduction in ED visits after the first AYN call compared to an 18% drop in ED visits among control group subjects during the same time period. Study results were presented to HCHD staff on August 30th, 2007 and recommendations were made for future studies that would provide a basis for policy development. ^

A Transdiagnostic Social Skills Intervention; Using a Structured Story to Teach Children How to Ask a Friend to Play

An (independent samples comparison) controlled study was conducted to assess the efficacy of a novel approach to social skills training for children in a local socialization group at Knippenberg, Patterson & Associates (KPA). The treatment condition involved the combination of a Structured Story (i.e., novel bibliotherapy technique for children with social skills deficits), and a behavioral rehearsal (or role-play) segment, where the children practiced the target social skill featured in the Structure Story. The control group did not receive the Structured Story nor the behavioral rehearsal. Children in both groups engaged in ten-minutes of free play that was videorecorded for later observation and scoring by the principal investigator. Two target behaviors were assessed; asking a friend to play, and duration of joint play between two or more peers. The results did not show significant differences for either target variable between the group that received the novel intervention and the control group. Limitations of the current study and implications for further research are discussed.

What You Get Out of Memory Depends on the Question You Ask

Following study, participants received 2 tests. The 1st was a recognition test; the 2nd was designed to tap recollection. The objective was to examine performance on Test I conditional on Test 2 performance. In Experiment 1, contrary to process dissociation assumptions, exclusion errors better predicted subsequent recollection than did inclusion errors. In Experiments 2 and 3, with alternate questions posed on Test 2, words having high estimates of recollection with one question had high estimates of familiarity with the other question. Results supported the following: (a) the 2-test procedure has considerable potential for elucidating the relationship between recollection and familiarity; (b) there is substantial evidence for dependency between such processes when estimates are obtained using the process dissociation and remember-know procedures; and (c) order of information access appears to depend on the question posed to the memory system.

Belief in dealing with depression alone: Results from community surveys of adolescents and adults

Background: Community surveys have found that some people believe that it is better to deal with depression alone rather than seek help. However, there has been little research into the characteristics of this group. Methods: Data were drawn from three Australian surveys: (1) a national survey of 1001 adults aged 18+ years; (2) a school survey of 552 students aged 14-16 years from two regions; (3) a survey of 577 young people aged 12-17 years from the Melbourne region. In all three surveys, participants who believed it would be helpful to deal with depression alone were contrasted with those who believed it would be harmful in terms of sociodemographic characteristics, recognition of depression in a vignette, contact with people who experienced depression, beliefs about treatments, beliefs about using substances, beliefs about long-term outcomes, and beliefs about causes. Results: In both adolescents and adults, belief in dealing with depression alone was associated with male gender, less favourable views about mental health professionals, more favourable views about using substances to deal with depression, and a more positive expectation about the outcome if treatment is not sought. Adolescents believing in dealing with depression alone had more favourable views about some potential helpers, such as church workers and pharmacists. In adults, but not adolescents, there was an association with the belief that depression is caused by personal weakness. Limitations: The surveys did not directly ask about reasons for believing that dealing with depression alone would be helpful and did not assess actual help-seeking. Conclusions: Factors encouraging dealing with depression alone are a belief that it is a self-limiting disorder, that substances are an effective way to deal with it and, in adults, that depression is due to personal weakness. Consistent with previous research, males are an important target group for encouraging seeking help to deal with depression. (c) 2006 Elsevier B.V. All rights reserved.

42.6Gb/s RZ-ASK transmission over 2500km using quasi-lossless transmission spans

Here, for the first time, we experimentally demonstrate optical data transmission through such quasi-lossless fibre spans, which provide an entirely different nonlinear propagation regime to conventionally EDFA/Raman amplified systems. We demonstrate 42.6 Gb/s transmission over 2500 km of SMF-28 with an 82 km span length, and investigate the optimisation of the system in terms of launch power and nonlinear tolerance. Our results show the first ever data transmission experiment using an ultra-long Raman laser to provide quasi-lossless conditions in the transmission fibre. For a span length of 82 km we have shown 2500 km transmission over SMF-28 fibre at 42.6 Gb/s. Our quasi-lossless configuration had 6 dB lower optimum power and improved nonlinear tolerance compared with a conventional EDFA only system.

The microstructure of the foreign exchange market:the determinants of bid-ask spreads in the foreign exchange market

The purpose of this thesis is to shed more light in the FX market microstructure by examining the determinants of bid-ask spread for three currencies pairs, the US dollar/Japanese yen, the British pound/US dollar and the Euro/US dollar in different time zones. I examine the commonality in liquidity with the elaboration of FX market microstructure variables in financial centres across the world (New York, London, Tokyo) based on the quotes of three exchange rate currency pairs over a ten-year period. I use GARCH (1,1) specifications, ICSS algorithm, and vector autoregression analysis to examine the effect of trading activity, exchange rate volatility and inventory holding costs on both quoted and relative spreads. ICSS algorithm results show that intraday spread series are much less volatile compared to the intraday exchange rate series as the number of change points obtained from ICSS algorithm is considerably lower. GARCH (1,1) estimation results of daily and intraday bid-ask spreads, show that the explanatory variables work better when I use higher frequency data (intraday results) however, their explanatory power is significantly lower compared to the results based on the daily sample. This suggests that although daily spreads and intraday spreads have some common determinants there are other factors that determine the behaviour of spreads at high frequencies. VAR results show that there are some differences in the behaviour of the variables at high frequencies compared to the results from the daily sample. A shock in the number of quote revisions has more effect on the spread when short term trading intervals are considered (intra-day) compared to its own shocks. When longer trading intervals are considered (daily) then the shocks in the spread have more effect on the future spread. In other words, trading activity is more informative about the future spread when intra-day trading is considered while past spread is more informative about the future spread when daily trading is considered

Performance comparison of 40 Gb/s ULH transmissions using CSRZ-ASK or CSRZ-DPSK modulation formats on UltraWave (TM) fiber

In this work we present extensive comparisons between numerical modelling and experimental measurements of the transmission performance of either CSRZ-ASK or CSRZ-DPSK modulation formats for 40-Gb/s WDM ULH systems on UltraWave (TM) fiber spans with all-Raman amplification. We numerically optimised the amplification and the signal format parameters for both CSRZ-DPSK and CSRZ-ASK formats. Numerical and experimental results show that, in a properly optimized transmission link, the DPSK format permits to double the transmission distance ( for a given BER level) with respect to the ASK format, while keeping a substantial OSNR margin ( on ASK modulation) after the propagation in the fiber line. Our comparison between numerical and experimental results permits to identify what is the most suitable BER estimator in assessing the transmission performance when using the DPSK format. (c) 2007 Optical Society of America.

42.6Gb/s RZ-ASK transmission over 2500km using quasi-lossless transmission spans

Here, for the first time, we experimentally demonstrate optical data transmission through such quasi-lossless fibre spans, which provide an entirely different nonlinear propagation regime to conventionally EDFA/Raman amplified systems. We demonstrate 42.6 Gb/s transmission over 2500 km of SMF-28 with an 82 km span length, and investigate the optimisation of the system in terms of launch power and nonlinear tolerance. Our results show the first ever data transmission experiment using an ultra-long Raman laser to provide quasi-lossless conditions in the transmission fibre. For a span length of 82 km we have shown 2500 km transmission over SMF-28 fibre at 42.6 Gb/s. Our quasi-lossless configuration had 6 dB lower optimum power and improved nonlinear tolerance compared with a conventional EDFA only system.

Performance comparison of 40 Gb/s ULH transmissions using CSRZ-ASK or CSRZ-DPSK modulation formats on Ultra Wave™ fiber

In this work we present extensive comparisons between numerical modelling and experimental measurements of the transmission performance of either CSRZ-ASK or CSRZ-DPSK modulation formats for 40-Gb/s WDM ULH systems on UltraWave™ fiber spans with all-Raman amplification. We numerically optimised the amplification and the signal format parameters for both CSRZ-DPSK and CSRZ-ASK formats. Numerical and experimental results show that, in a properly optimized transmission link, the DPSK format permits to double the transmission distance (for a given BER level) with respect to the ASK format, while keeping a substantial OSNR margin (on ASK modulation) after the propagation in the fiber line. Our comparison between numerical and experimental results permits to identify what is the most suitable BER estimator in assessing the transmission performance when using the DPSK format. © 2007 Optical Society of America.

How do Firms ask for Consumers’ Data Permission? The Value of Companies Data Practices.

On May 25, 2018, the EU introduced the General Data Protection Regulation (GDPR) that offers EU citizens a shelter for their personal information by requesting companies to explain how people’s information is used clearly. To comply with the new law, European and non-European companies interacting with EU citizens undertook a massive data re-permission-request campaign. However, if on the one side the EU Regulator was particularly specific in defining the conditions to get customers’ data access, on the other side, it did not specify how the communication between firms and consumers should be designed. This has left firms free to develop their re-permission emails as they liked, plausibly coupling the informative nature of these privacy-related communications with other persuasive techniques to maximize data disclosure. Consequently, we took advantage of this colossal wave of simultaneous requests to provide insights into two issues. Firstly, we investigate how companies across industries and countries chose to frame their requests. Secondly, we investigate which are the factors that influenced the selection of alternative re-permission formats. In order to achieve these goals, we examine the content of a sample of 1506 re-permission emails sent by 1396 firms worldwide, and we identify the dominant “themes” characterizing these emails. We then relate these themes to both the expected benefits firms may derive from data usage and the possible risks they may experience from not being completely compliant to the spirit of the law. Our results show that: (1) most firms enriched their re-permission messages with persuasive arguments aiming at increasing consumers’ likelihood of relinquishing their data; (2) the use of persuasion is the outcome of a difficult tradeoff between costs and benefits; (3) most companies acted in their self-interest and “gamed the system”. Our results have important implications for policymakers, managers, and customers of the online sector.

The Burden Of Eclampsia: Results From A Multicenter Study On Surveillance Of Severe Maternal Morbidity In Brazil.

Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss). Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010. 426 cases of eclampsia were identified and classified according to the outcomes: SMO and non-SMO. We classified facilities as coming from low- and high-income regions and calculated the WHO's obstetric health indicators. SPSS and Stata softwares were used to calculate the prevalence ratios (PR) and respective 95% confidence interval (CI) to assess maternal characteristics, clinical and obstetrical history, and access to health services as predictors for SMO, subsequently correlating them with the corresponding perinatal outcomes, also applying multiple regression analysis (adjusted for cluster effect). Prevalence of and mortality indexes for eclampsia in higher and lower income regions were 0.2%/0.8% and 8.1%/22%, respectively. Difficulties in access to health care showed that ICU admission (adjPR 3.61; 95% CI 1.77-7.35) and inadequate monitoring (adjPR 2.31; 95% CI 1.48-3.59) were associated with SMO. Morbidity and mortality associated with eclampsia were high in Brazil, especially in lower income regions. Promoting quality maternal health care and improving the availability of obstetric emergency care are essential actions to relieve the burden of eclampsia.

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.