WorldWideScience

Sample records for system petis evidence

  1. Transfer function analysis of positron-emitting tracer imaging system (PETIS) data

    International Nuclear Information System (INIS)

    Keutgen, N.; Matsuhashi, S.; Mizuniwa, C.; Ito, T.; Fujimura, T.; Ishioka, N.S.; Watanabe, S.; Sekine, T.; Uchida, H.; Hashimoto, S.

    2002-01-01

    Quantitative analysis of the two-dimensional image data obtained with the positron-emitting tracer imaging system (PETIS) for plant physiology has been carried out using a transfer function analysis method. While a cut leaf base of Chinese chive (Allium tuberosum Rottler) or a cut stem of soybean (Glycine max L.) was immersed in an aqueous solution containing the [ 18 F] F - ion or [ 13 N]NO 3 - ion, tracer images of the leaf of Chinese chive and the trifoliate of soybean were recorded with PETIS. From the time sequence of images, the tracer transfer function was estimated from which the speed of tracer transport and the fraction moved between specified image positions were deduced

  2. Real-time monitoring and analysis of nutrient transportation in a living plant using a positron emitting tracer imaging system (PETIS)

    International Nuclear Information System (INIS)

    Matsuhashi, Shinpei

    2005-01-01

    We visualized the uptake and transportation of nutrition in a living plant using positron-emitting tracers and mathematical analysis of the data. We have been developing a positron-imaging technique to visualize the uptake and transportation of nutrients in a plant by a positron-emitting tracer-imaging system (PETIS) using positron-emitting nuclide-labeled compounds. The PETIS data is analyzed mathematically to understand the physiological meaning of the physical parameters. In this study, the results on the uptake and transportation of nutrients, which were obtained with the use of a positron-imaging method, are introduced. (author)

  3. Vanadium uptake and an effect of vanadium treatment on 18F-labeled water movement in a cowpea plant by positron emitting tracer imaging system (PETIS)

    International Nuclear Information System (INIS)

    Furukawa, J.; Yokota, H.; Tanoi, K.; Ueoka, S.; Nakanishi, T.M.; Uchida, H.; Tsuji, A.

    2001-01-01

    Real time vanadate (V 5+ ) uptake imaging in a cowpea plant by positron emitting tracer imaging system (PETIS) is presented. Vanadium-48 was produced by bombarding a Sc foil target with 50 MeV α-particles at Takasaki Ion Accelerators for Advanced Radiation application (TIARA) AVF cyclotron. Then 48 V was added to the culture solution to investigate the V distribution in a cowpea plant. The real time uptake of the 48 V was monitored by PETIS. Distribution of 48 V in a whole plant was measured after 3, 6 and 20 hours of V treatment by Bio-imaging Analyzer System (BAS). After the 20 hour treatment, vanadate was detected at the up-ground part of the plant. To know the effect of V uptake on plant activity, 18 F-labeled water uptake was analyzed by PETIS. When a cowpea plant was treated with V for 20 hours before 18 F-labeled water uptake experiment, the total amount of 18 F-labeled water absorption ws drastically decreased. Results suggest the inhibition of water uptake was mainly caused by the vanadate already moved to the up-ground part of the plant. (author)

  4. Light activates H{sub 2.}{sup 15}0 flow in rice: Detailed monitoring using a positron-emitting tracer imaging system (PETIS)

    Energy Technology Data Exchange (ETDEWEB)

    Kiyomiya, S.; Nakanishi, H.; Mori, S. [The Univ. of Tokyo, Dept. of Applied Biological Chemistry, Tokyo (Japan); Uchida, H.; Nishiyama, S.; Tsukada, H.; Tsuji, A. [Central Res. Lab. Hamamatsu Photonics KK, Shizuoka (Japan); Ishioka, N.S.; Watanabe, S.; Osa, A.; Mizuniwa, C.; Ito, T.; Matsuhashi, S.; Hashimoto, S.; Sekine, T. [Japan Atomic Energy Res. Inst., Takasaki Radation Chemistry Res. Establishment, Gunma (Japan)

    2001-07-01

    Water (H{sub 2}{sup 15}O) translocation from the roots to the top of rice plants (Oryza saliva L. cv. Nipponbare) was visualized over time by a positron-emitting tracer imaging system (PETIS). H{sub 2}{sup 15}O flow was activated 8 min after plants were exposed to bright light (1500 {mu}mol m{sup -2} s{sup -1}). When the light was subsequently removed, the flow gradually slowed and completely stopped after 12 min. In plants exposed to low light (500 {mu}mol m{sup -2} s{sup -1}), H{sub 2}{sup 15}O flow was activated more slowly, and a higher translocation rate of H{sub 2}{sup 15}O was observed in the same low light at the end of the next dark period. NaCl (80 mM) and methylmercury (1 mM) directly suppressed absorption of H{sub 2}{sup 15}O by the roots, while methionine sulfoximine (1 mM), abscisic acid (10 {mu}M) and carbonyl cyanide m-chlorophenylhydrazone (10 mM) were transported to the leaves and enhanced stomatal closure, reducing H{sub 2}{sup 15}O translocation. (au)

  5. Circadian rhythm in ''1''5O-labeled water uptake manner of a soybean plant by PETIS (Positron Emitting Tracer Imaging System)

    International Nuclear Information System (INIS)

    Nakanishi, Tomoko M.; Yokota, Harumi; Tanoi, Keitaro; Furukawa, Jun; Ikeue, Natsuko; Ookuni, Yoko; Uchida, Hiroshi; Tsuji, Atsunori

    2001-01-01

    We present a circadian rhythm of water uptake manner in a soybean plant through realtime imaging of water, labeled with 15 O. Nitrogen gas was irradiated with deuterons accelerated by a cyclotron at Hamamatsu Photonics Co. to produce 15 O-labeled water. Then the 15 O-labeled water was supplied to a soybean plant from the root and the realtime water uptake amount was measured for 20 min by Positron Emitting Tracer Imaging System (PETIS). All the targeting positions for the measurements were stems, two points at an internode between root and the first leaves, between the first leaves and the first trifoliates and between the first trifoliates and the second trifoliates. The water uptake amount was gradually increased and showed its maximum at around 13:00, especially at the basal part of the stem. Then the water uptake activity was gradually decreased until 17:00. The water amount taken up by a plant at 13:00 was about 40% higher than that at 17:00. (author)

  6. Circadian rhythm in ''1''5O-labeled water uptake manner of a soybean plant by PETIS (Positron Emitting Tracer Imaging System)

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Tomoko M.; Yokota, Harumi; Tanoi, Keitaro; Furukawa, Jun; Ikeue, Natsuko; Ookuni, Yoko [Tokyo Univ. (Japan). Graduate School of Agricultural and Life Sciences; Uchida, Hiroshi; Tsuji, Atsunori

    2001-05-01

    We present a circadian rhythm of water uptake manner in a soybean plant through realtime imaging of water, labeled with {sup 15}O. Nitrogen gas was irradiated with deuterons accelerated by a cyclotron at Hamamatsu Photonics Co. to produce {sup 15}O-labeled water. Then the {sup 15}O-labeled water was supplied to a soybean plant from the root and the realtime water uptake amount was measured for 20 min by Positron Emitting Tracer Imaging System (PETIS). All the targeting positions for the measurements were stems, two points at an internode between root and the first leaves, between the first leaves and the first trifoliates and between the first trifoliates and the second trifoliates. The water uptake amount was gradually increased and showed its maximum at around 13:00, especially at the basal part of the stem. Then the water uptake activity was gradually decreased until 17:00. The water amount taken up by a plant at 13:00 was about 40% higher than that at 17:00. (author)

  7. A feasibility study of PETiPIX: an ultra high resolution small animal PET scanner

    Science.gov (United States)

    Li, K.; Safavi-Naeini, M.; Franklin, D. R.; Petasecca, M.; Guatelli, S.; Rosenfeld, A. B.; Hutton, B. F.; Lerch, M. L. F.

    2013-12-01

    PETiPIX is an ultra high spatial resolution positron emission tomography (PET) scanner designed for imaging mice brains. Four Timepix pixellated silicon detector modules are placed in an edge-on configuration to form a scanner with a field of view (FoV) 15 mm in diameter. Each detector module consists of 256 × 256 pixels with dimensions of 55 × 55 × 300 μm3. Monte Carlo simulations using GEANT4 Application for Tomographic Emission (GATE) were performed to evaluate the feasibility of the PETiPIX design, including estimation of system sensitivity, angular dependence, spatial resolution (point source, hot and cold phantom studies) and evaluation of potential detector shield designs. Initial experimental work also established that scattered photons and recoil electrons could be detected using a single edge-on Timepix detector with a positron source. Simulation results estimate a spatial resolution of 0.26 mm full width at half maximum (FWHM) at the centre of FoV and 0.29 mm FWHM overall spatial resolution with sensitivity of 0.01%, and indicate that a 1.5 mm thick tungsten shield parallel to the detectors will absorb the majority of non-coplanar annihilation photons, significantly reducing the rates of randoms. Results from the simulated phantom studies demonstrate that PETiPIX is a promising design for studies demanding high resolution images of mice brains.

  8. PETIs as High-Temperature Resin-Transfer-Molding Materials

    Science.gov (United States)

    Connell, John N.; Smith, Joseph G., Jr.; Hergenrother, Paul M.

    2005-01-01

    Compositions of, and processes for fabricating, high-temperature composite materials from phenylethynyl-terminated imide (PETI) oligomers by resin-transfer molding (RTM) and resin infusion have been developed. Composites having a combination of excellent mechanical properties and long-term high-temperature stability have been readily fabricated. These materials are particularly useful for the fabrication of high-temperature structures for jet-engine components, structural components on highspeed aircraft, spacecraft, and missiles. Phenylethynyl-terminated amide acid oligomers that are precursors of PETI oligomers are easily made through the reaction of a mixture of aromatic diamines with aromatic dianhydrides at high stoichiometric offsets and 4-phenylethynylphthalic anhydride (PEPA) as an end-capper in a polar solvent such as N-methylpyrrolidinone (NMP). These oligomers are subsequently cyclodehydrated -- for example, by heating the solution in the presence of toluene to remove the water by azeotropic distillation to form low-molecular-weight imide oligomers. More precisely, what is obtained is a mixture of PETI oligomeric species, spanning a range of molecular weights, that exhibits a stable melt viscosity of less than approximately 60 poise (and generally less than 10 poise) at a temperature below 300 deg C. After curing of the oligomers at a temperature of 371 deg C, the resulting polymer can have a glass-transition temperature (Tg) as high as 375 C, the exact value depending on the compositions.

  9. PETI-298 Prepared by Microwave Synthesis: Neat Resin and Composite Properties

    Science.gov (United States)

    Smith, Joseph G.; Connell, John W.; Li, Chao-Jun; Wu, Wei; Criss, Jim M., Jr.

    2004-01-01

    PETI-298 is a high temperature/high performance matrix resin that is processable into composites by resin transfer molding (RTM), resin infusion and vacuum assisted RTM techniques. It is typically synthesized in a polar aprotic solvent from the reaction of an aromatic anhydride and a combination of diamines and endcapped with phenylethynylphthalic anhydride. Microwave synthesis of PETI-298 was investigated as a means to eliminate solvent and decrease reaction time. The monomers were manually mixed and placed in a microwave oven for various times to determine optimum reaction conditions. The synthetic process was subsequently scaled-up to 330g. Three batches were synthesized and combined to give 1 kg of material that was characterized for thermal and rheological properties and compared to PETI-298 prepared by the classic solution based synthetic method. The microwave synthesized PETI-298 was subsequently used to fabricate flat laminates on T650 carbon fabric by RTM. The composite panels were analyzed and mechanical properties determined and compared with those fabricated from PETI-298 prepared by the classic solution method. The microwave synthesis process and characterization of neat resin and carbon fiber reinforced composites fabricated by RTM will be presented. KEY WORDS: Resin Transfer Molding, High Temperature Polymers, Phenylethynyl Terminated Imides, Microwave Synthesis

  10. High Temperature Transfer Molding Resins: Preliminary Composite Properties of PETI-375

    Science.gov (United States)

    Connell, J. W.; Smith, J. G., Jr.; Hergenrother, P. M.; Criss, J. M., Jr.

    2004-01-01

    As part of an ongoing effort to develop materials for resin transfer molding (RTM) of high performance/high temperature composites, a new phenylethynyl containing imide designated as PETI-375 has been under evaluation. PETI-375 was prepared using 2,3,3 ,4 - biphenyltetracarboxylic dianhydride (a-BPDA), 1,3-bis(4-aminophenoxy)benzene and 2,2 - bis(trifluoromethyl)benzidine and endcapped with 4-phenylethynylphthalic anhydride. This material exhibited a stable melt viscosity of 0.1-0.4 Pa sec at 280 C. High quality, void-free laminates were fabricated by high temperature RTM using unsized T-650 carbon fabric and evaluated. After curing for 1 hour at 371 C, the laminates exhibited a glass transition temperature of approx. 375 C by thermomechanical analysis. The laminates were essentially void and microcrack free as evidenced by optical microscopic examination. The chemistry, physical, and composite properties of PETI-375 will be discussed.

  11. What is Happening in the Petišovci Fields? An Edited Conversation with an Activist of the Initiative “Stop the Fracking in Slovenia”

    Directory of Open Access Journals (Sweden)

    Danijela Tamše

    2015-12-01

    Full Text Available The article is an edited conversation with an activist of an initiative “Stop the fracking in Slovenia”. In order to start the process of fracking for natural gas extraction in the Prekmurje region, companies still have to obtain some environmental permits from the government environmental agency, which seems to have taken the companies’ side. The initiative is struggling to stop this. The conversation was focused on the developments in the Petišovci fields, formal procedures connected to obtaining permits, and the companies involved. The article also contains the explanation of what fracking is.

  12. Evidence accumulation in the magnitude system.

    Directory of Open Access Journals (Sweden)

    Anna Lambrechts

    Full Text Available Perceptual interferences in the estimation of quantities (time, space and numbers have been interpreted as evidence for a common magnitude system. However, if duration estimation has appears sensitive to spatial and numerical interferences, space and number estimation tend to be resilient to temporal manipulations. These observations question the relative contribution of each quantity in the elaboration of a representation in a common mental metric. Here, we elaborated a task in which perceptual evidence accumulated over time for all tested quantities (space, time and number in order to match the natural requirement for building a duration percept. For this, we used a bisection task. Experimental trials consisted of dynamic dots of different sizes appearing progressively on the screen. Participants were asked to judge the duration, the cumulative surface or the number of dots in the display while the two non-target dimensions varied independently. In a prospective experiment, participants were informed before the trial which dimension was the target; in a retrospective experiment, participants had to attend to all dimensions and were informed only after a given trial which dimension was the target. Surprisingly, we found that duration was resilient to spatial and numerical interferences whereas space and number estimation were affected by time. Specifically, and counter-intuitively, results revealed that longer durations lead to smaller number and space estimates whether participants knew before (prospectively or after (retrospectively a given trial which quantity they had to estimate. Altogether, our results support a magnitude system in which perceptual evidence for time, space and numbers integrate following Bayesian cue-combination rules.

  13. 33 CFR 157.148 - COW system: Evidence for inspections.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false COW system: Evidence for... CARRYING OIL IN BULK Crude Oil Washing (COW) System on Tank Vessels Inspections § 157.148 COW system... inspector evidence that the COW system has been installed in accordance with the plans accepted under § 157...

  14. PERBAIKAN KUALITAS PETIS KEPALA UDANG WINDU (Penaeus monodon DENGAN PENAMBAHAN TEPUNG ARANG KAYU GALAM (Melaleuca cajuputi powell, SEKAM PADI (Oryza sativa L DAN TEMPURUNG KELAPA (Cocos nucifera

    Directory of Open Access Journals (Sweden)

    Juhana Suhanda

    2016-06-01

    Full Text Available Penelitian ini dilaksanakan dengan waktu selama 4 bulan yaitu meliputi  pelaksanaan penelitian, analisis data, penyusunan laporan. Penelitian ini bertujuan untuk membuat petis sari kepala udang Windu yang berkualitas dengan penambahan tepung arang kayu galam, sekam padi, dan tempurung kelapa. Sedangkan kegunaannya adalah untuk menghasilkan petis sari kepala udang Windu yang dapat diterima dan disukai oleh konsumen. Penelitian ini menggunakan metode eksperimental dan dilakukan berdasarkan pola Rancangan Acak Lengkap (RAL dengan empat perlakuan yaitu A (tanpa penambahan tepung arang, perlakuan B (penambahan tepung arang kayu Galam 0,05%, perlakuan C (penambahan tepung arang sekam padi 0,05% dan perlakuan D (penambahan tepung arang tempurung kelapa 0,05%. Masing-masing perlakuan dilakukan 3 kali ulangan. Parameter yang diuji meliputi Uji Kadar Protein, Uji Kadar Air, Uji Kadar Abu, Uji Organoleptik yaitu rasa, warna, aroma dan tekstur. Penerimaan atau penolakan terhadap hipotesis didasarkan pada hasil Uji F (Analisis Sidik Ragam Dari hasil pengujian dan analisis keempat perlakuan tersebut untuk uji kadar protein yang tertinggi adalah perlakuan D (26,60%, uji kadar air terendah adalah pada perlakuan D (19,28% dan uji kadar abu terendah adalah perlakuan A (7,77%, tetapi antar perlakuan pada kadar abu tidak berbeda nyata sehingga dapat diartikan kadar abu pada tiap perlakuan tidak berbeda (tidak signifikan, sedangkan uji organoleptik untuk rasa, warna, aroma dan tekstur yang tertinggi adalah perlakuan D yaitu rasa (6,89, warna (7,31, aroma (6,48 dan tekstur (6,635. This research was conducted with time for 4 months which include the conduct of research, data analysis, report preparation. This study aims to make a paste shrimp head juice Windu quality with the addition of flour Galam wood charcoal, rice husk and coconut shell. While its use is to produce a paste shrimp head juice Windu acceptable and preferred by consumers. This study used an

  15. Perbaikan Tanah Dasar Menggunakan Pre-Fabricated Vertical Drain Dengan Variasi Kedalaman Dan Perkuatan Lereng Dengan Turap Studi Kasus : Lapangan Penumpukan Peti Kemas, Pelabuhan Trisakti, Banjarmasin, Kalimantan Selatan

    Directory of Open Access Journals (Sweden)

    Dofran Winner

    2017-03-01

    Full Text Available Metode perbaikan tanah dasar menggunakan preloading yang dikombinasikan dengan Pre-fabricated Vertical Drain (PVD dipilih untuk proyek pengembangan lapangan penumpukan peti kemas di Pelabuhan Trisakti, Banjarmasin, Kalimantan Selatan. Selama masa preloading, ternyata kelongsoran selebar 37 meter terjadi di area penumpukan. Diketahui bahwa kelongsoran terjadi saat preloading setinggi 4,0 meter. Agar lapangan penumpukan dapat beroperasi kembali, diperlukan perencanaan untuk perkuatan lereng dan untuk menghilangkan pemampatan tanah dasar di area lapangan penumpukan. Perbaikan tanah dasar menggunakan preloading yang dikombinasikan dengan Pre-fabricated Vertical Drain (PVD digunakan untuk Zona 3, 4, dan 5, dan perkuatan lereng dengan turap digunakan untuk Zona-1 dan Zona-2 yang merupakan bagian lereng dari lapangan penumpukan. Direncanakan PVD dipasang pada kedalaman yang berbeda: 1/3H, 2/3H, dan H (H adalah ketebalan lapisan tanah lunak untuk melihat kondisi yang menghasilkan biaya paling murah. Dari hasil perencanaan yang dilakukan, diketahui bahwa turap yang digunakan adalah Corrugated Concrete sheet pile type W-600 A1000. Turap dipasang sedalam 18 meter di Zona-1 dan sedalam 22 meter di Zona-2; selain itu, angker dipasang pada turap untuk meningkatkan kekakuan turap. Hasil perencanaan juga menunjukkan bahwa biaya yang paling ekonomis adalah PVD dipasang sampai 2/3H di Zona-3, dan tanpa PVD di Zona-4 dan Zona-5. Total biaya konstruksi adalah sebesar Rp 843.106.053,00 untuk Zona-1 dan Zona-2; Rp 9.446.530.597,00 untuk Zona-3; Rp 1.869.613.200,00 untuk Zona 4; dan Rp 3.577.392.000,00 untuk Zona 5.

  16. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  17. Evidence for Quantisation in Planetary Ring Systems

    OpenAIRE

    WAYTE, RICHARD

    2017-01-01

    Absolute radial positions of the main features in Saturn's ring system have been calculated by adapting the quantum theory of atomic spectra. Fine rings superimposed upon broad rings are found to be covered by a harmonic series of the form N α A(r)1/2, where N and A are integers. Fourier analysis of the ring system shows that the spectral amplitude fits a response profile which is characteristic of a resonant system. Rings of Jupiter, Uranus and Neptune also obey the same rules. Involvement o...

  18. Motivational systems or motivational states : Behavioural and physiological evidence

    NARCIS (Netherlands)

    Koolhaas, J.M.; de Boer, S.F.; Bohus, B.G J

    This paper will critically discuss the available behavioural and neurobiological evidence for the existence of motivational systems and motivational states on the basis of our studies on aggressive behaviour in male rats and mice. Three types of evidence will be discussed. First, some behavioural

  19. Corruption in the health care system: the circumstantial evidence.

    Science.gov (United States)

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

  20. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  1. ADDIS: A decision support system for evidence-based medicine

    NARCIS (Netherlands)

    G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)

    2013-01-01

    textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

  2. Characterization of Evidence for Human System Risk Assessment

    Science.gov (United States)

    Steinberg, S. L.; Van Baalen, M.; Rossi, M.; Riccio, G.; Romero, E.; Francisco, D.

    2016-01-01

    Understanding the kinds of evidence available and using the best evidence to answer a question is critical to evidenced-based decision-making, and it requires synthesis of evidence from a variety of sources. Categorization of human system risks in spaceflight, in particular, focuses on how well the integration and interpretation of all available evidence informs the risk statement that describes the relationship between spaceflight hazards and an outcome of interest. A mature understanding and categorization of these risks requires: 1) sufficient characterization of risk, 2) sufficient knowledge to determine an acceptable level of risk (i.e., a standard), 3) development of mitigations to meet the acceptable level of risk, and 4) identification of factors affecting generalizability of the evidence to different design reference missions. In the medical research community, evidence is often ranked by increasing confidence in findings gleaned from observational and experimental research (e.g., "levels of evidence"). However, an approach based solely on aspects of experimental design is problematic in assessing human system risks for spaceflight. For spaceflight, the unique challenges and opportunities include: (1) The independent variables in most evidence are the hazards of spaceflight, such as space radiation or low gravity, which cannot be entirely duplicated in terrestrial (Earth-based) analogs, (2) Evidence is drawn from multiple sources including medical and mission operations, Lifetime Surveillance of Astronaut Health (LSAH), spaceflight research (LSDA), and relevant environmental & terrestrial databases, (3) Risk metrics based primarily on LSAH data are typically derived from available prevalence or incidence data, which may limit rigorous interpretation, (4) The timeframe for obtaining adequate spaceflight sample size (n) is very long, given the small population, (5) Randomized controlled trials are unattainable in spaceflight, (6) Collection of personal and

  3. Changing tides: increasing evidence to embrace a patient classification system.

    Science.gov (United States)

    Malloch, Kathy

    2012-01-01

    The effective use of a patient classification system (PCS) in a way that provides value to all health care organizations has yet to be realized given the challenging developmental pathway of these systems. As the science and technology of workforce management emerges along with evidence to support the relationships between nurse work and patient care needs, it is no longer appropriate to rely on systems that provide aggregated and minimal data to address the need for safer patient care and retention of nurses. Specificity about patient care needs in a valid and reliable PCS is essential on our pathway to improved resource utilization, improved decision making, integration of nurse cognitive and knowledge work, and management of variances from planned resource use. Advancements with technology, the ability to create and monitor equitable nurse-patient assignments, conceptual clarity, evidence, regulatory requirements, and professional role development point to a new receptiveness for PCSs.

  4. Responses of rice to salinity and exogenous glycinebetaine by using positron emitting tracer imaging system

    International Nuclear Information System (INIS)

    Le Xuan Tham; Vo Huy Dang; Noriko, S.

    2002-01-01

    Effect of salinity stress (NaCl) and glycinebetaine on typical non-halophyte plants - rice (Oryza sativa L.) was examined for the growth, net photosynthesis and transpiration functions of seedlings. Using 22 Na, the inhibition of net uptake and translocation of sodium of seedlings stressed at 0.15% NaCl in solution and previously treated with exogenous glycinebetaine was observed by positron-emitting tracer imaging system, namely PETIS for diagnosis of early responses of plants to salt stress. Effects of exogenous glycinebetaine on rice plants stressed with salinity via osmotic protection and particularly stabilization of membrane permeability to inhibit Na uptake and translocation were discussed in connection with promising potentials of PETIS for researches on plants. (Author)

  5. Informed Systems: Enabling Collaborative Evidence Based Organizational Learning

    Directory of Open Access Journals (Sweden)

    Mary M. Somerville

    2015-12-01

    Full Text Available Objective – In response to unrelenting disruptions in academic publishing and higher education ecosystems, the Informed Systems approach supports evidence based professional activities to make decisions and take actions. This conceptual paper presents two core models, Informed Systems Leadership Model and Collaborative Evidence-Based Information Process Model, whereby co-workers learn to make informed decisions by identifying the decisions to be made and the information required for those decisions. This is accomplished through collaborative design and iterative evaluation of workplace systems, relationships, and practices. Over time, increasingly effective and efficient structures and processes for using information to learn further organizational renewal and advance nimble responsiveness amidst dynamically changing circumstances. Methods – The integrated Informed Systems approach to fostering persistent workplace inquiry has its genesis in three theories that together activate and enable robust information usage and organizational learning. The information- and learning-intensive theories of Peter Checkland in England, which advance systems design, stimulate participants’ appreciation during the design process of the potential for using information to learn. Within a co-designed environment, intentional social practices continue workplace learning, described by Christine Bruce in Australia as informed learning enacted through information experiences. In addition, in Japan, Ikujiro Nonaka’s theories foster information exchange processes and knowledge creation activities within and across organizational units. In combination, these theories promote the kind of learning made possible through evolving and transferable capacity to use information to learn through design and usage of collaborative communication systems with associated professional practices. Informed Systems therein draws from three antecedent theories to create an original

  6. Granular biodurable nanomaterials: No convincing evidence for systemic toxicity.

    Science.gov (United States)

    Moreno-Horn, Marcus; Gebel, Thomas

    2014-11-01

    Nanomaterials are usually defined by primary particle diameters ranging from 1 to 100 nm. The scope of this review is an evaluation of experimental animal studies dealing with the systemic levels and putative systemic effects induced by nanoparticles which can be characterized as being granular biodurable particles without known specific toxicity (GBP). Relevant examples of such materials comprise nanosized titanium dioxide (TiO2) and carbon black. The question was raised whether GBP nanomaterials systemically accumulate and may possess a relevant systemic toxicity. With few exceptions, the 56 publications reviewed were not performed using established standard protocols, for example, OECD guidelines but used non-standard study designs. The studies including kinetic investigations indicated that GBP nanomaterials were absorbed and systemically distributed to rather low portions only. There was no valid indication that GPB nanomaterials possess novel toxicological hazard properties. In addition, no convincing evidence for a relevant specific systemic toxicity of GBP nanomaterials could be identified. The minority of the papers reviewed (15/56) investigated both nanosized and microsized GBP materials in parallel. A relevant different translocation of GBP nanomaterials in contrast to GBP micromaterials was not observed in these studies. There was no evidence that GPB nanomaterials possess toxicological properties other than their micromaterial counterparts.

  7. Irrational reactions to negative outcomes: evidence for two conceptual systems.

    Science.gov (United States)

    Epstein, S; Lipson, A; Holstein, C; Huh, E

    1992-02-01

    According to cognitive-experiential self-theory (CEST), individuals have 2 systems for processing information, a rational system and an experiential system. Research conducted under norm theory (NT) has provided impressive evidence of an if only (IO) effect associated with postoutcome processing of aversive events that are highly consistent with formulations in CEST. Two studies involving vignettes adapted from NT were conducted that tested 4 hypotheses and corollaries derived from CEST. It was demonstrated, in support of hypotheses, that the IO effect can be obtained with ratings of one's own and of a protagonist's specific behaviors, as well as with ratings of a protagonist's diffuse emotions (the usual procedure); that a rational orientation decreases the IO effect; that increasing the intensity of outcomes increases it; and that priming the experiential system reduces people's ability to subsequently think rationally. The theoretical and research implications of these findings are discussed.

  8. Complex systems dynamics in aging: new evidence, continuing questions.

    Science.gov (United States)

    Cohen, Alan A

    2016-02-01

    There have long been suggestions that aging is tightly linked to the complex dynamics of the physiological systems that maintain homeostasis, and in particular to dysregulation of regulatory networks of molecules. This review synthesizes recent work that is starting to provide evidence for the importance of such complex systems dynamics in aging. There is now clear evidence that physiological dysregulation--the gradual breakdown in the capacity of complex regulatory networks to maintain homeostasis--is an emergent property of these regulatory networks, and that it plays an important role in aging. It can be measured simply using small numbers of biomarkers. Additionally, there are indications of the importance during aging of emergent physiological processes, functional processes that cannot be easily understood through clear metabolic pathways, but can nonetheless be precisely quantified and studied. The overall role of such complex systems dynamics in aging remains an important open question, and to understand it future studies will need to distinguish and integrate related aspects of aging research, including multi-factorial theories of aging, systems biology, bioinformatics, network approaches, robustness, and loss of complexity.

  9. Evidence for a common mucosal immune system in the pig.

    Science.gov (United States)

    Wilson, Heather L; Obradovic, Milan R

    2015-07-01

    The majority of lymphocytes activated at mucosal sites receive instructions to home back to the local mucosa, but a portion also seed distal mucosa sites. By seeding distal sites with antigen-specific effector or memory lymphocytes, the foundation is laid for the animal's mucosal immune system to respond with a secondary response should to this antigen be encountered at this site in the future. The common mucosal immune system has been studied quite extensively in rodent models but less so in large animal models such as the pig. Reasons for this paucity of reported induction of the common mucosal immune system in this species may be that distal mucosal sites were examined but no induction was observed and therefore it was not reported. However, we suspect that the majority of investigators simply did not sample distal mucosal sites and therefore there is little evidence of immune response induction in the literature. It is our hope that more pig immunologists and infectious disease experts who perform mucosal immunizations or inoculations on pigs will sample distal mucosal sites and report their findings, whether results are positive or negative. In this review, we highlight papers that show that immunization/inoculation using one route triggers mucosal immune system induction locally, systemically, and within at least one distal mucosal site. Only by understanding whether immunizations at one site triggers immunity throughout the common mucosal immune system can we rationally develop vaccines for the pig, and through these works we can gather evidence about the mucosal immune system that may be extrapolated to other livestock species or humans. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Evidence for consciousness-related anomalies in random physical systems

    Science.gov (United States)

    Radin, Dean I.; Nelson, Roger D.

    1989-12-01

    Speculations about the role of consciousness in physical systems are frequently observed in the literature concerned with the interpretation of quantum mechanics. While only three experimental investigations can be found on this topic in physics journals, more than 800 relevant experiments have been reported in the literature of parapsychology. A well-defined body of empirical evidence from this domain was reviewed using meta-analytic techniques to assess methodological quality and overall effect size. Results showed effects conforming to chance expectation in control conditions and unequivocal non-chance effects in experimental conditions. This quantitative literature review agrees with the findings of two earlier reviews, suggesting the existence of some form of consciousness-related anomaly in random physical systems.

  11. Combination of evidence in recommendation systems characterized by distance functions

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, L. M. (Luis Mateus)

    2002-01-01

    Recommendation systems for different Document Networks (DN) such as the World Wide Web (WWW), Digitnl Libarries, or Scientific Databases, often make use of distance functions extracted from relationships among documents and between documents and semantic tags. For instance, documents In the WWW are related via a hyperlink network, while documents in bibliographic databases are related by citation and collaboration networks.Furthermore, documents can be related to semantic tags such as keywords used to describe their content, The distance functions computed from these relations establish associative networks among items of the DN, and allow recommendation systems to identify relevant associations for iudividoal users. The process of recommendation can be improved by integrating associative data from different sources. Thus we are presented with a problem of combining evidence (about assochaons between items) from different sonrces characterized by distance functions. In this paper we summarize our work on (1) inferring associations from semi-metric distance functions and (2) combining evidence from different (distance) associative DN.

  12. The global stock of research evidence relevant to health systems policymaking

    OpenAIRE

    Wilson, Michael G; Moat, Kaelan A; Lavis, John N

    2013-01-01

    Background: Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. Methods: We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs fo...

  13. Academic Advising Systems: A Systematic Literature Review of Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Omiros Iatrellis

    2017-12-01

    Full Text Available This paper aims to provide the reader with a comprehensive background for understanding current knowledge on Academic Advising Systems (AAS and its impact on learning. It constitutes an overview of empirical evidence behind key objectives of the potential adoption of AAS in generic educational strategic planning. The researchers examined the literature on experimental case studies conducted in the domain during the past ten years (2008–2017. Search terms identified 98 mature pieces of research work, but inclusion criteria limited the key studies to 43. The authors analyzed the research questions, methodology, and findings of these published papers and categorized them accordingly. The results have highlighted three distinct major directions of the AAS empirical research. This paper discusses the emerged added value of AAS research and highlights the significance of further implications. Finally, the authors set their thoughts on possible uncharted key questions to investigate both from pedagogical and technical considerations.

  14. Participatory health system priority setting: Evidence from a budget experiment.

    Science.gov (United States)

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

    2015-12-01

    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Evidence for systems-level molecular mechanisms of tumorigenesis

    Directory of Open Access Journals (Sweden)

    Capellá Gabriel

    2007-06-01

    Full Text Available Abstract Background Cancer arises from the consecutive acquisition of genetic alterations. Increasing evidence suggests that as a consequence of these alterations, molecular interactions are reprogrammed in the context of highly connected and regulated cellular networks. Coordinated reprogramming would allow the cell to acquire the capabilities for malignant growth. Results Here, we determine the coordinated function of cancer gene products (i.e., proteins encoded by differentially expressed genes in tumors relative to healthy tissue counterparts, hereafter referred to as "CGPs" defined as their topological properties and organization in the interactome network. We show that CGPs are central to information exchange and propagation and that they are specifically organized to promote tumorigenesis. Centrality is identified by both local (degree and global (betweenness and closeness measures, and systematically appears in down-regulated CGPs. Up-regulated CGPs do not consistently exhibit centrality, but both types of cancer products determine the overall integrity of the network structure. In addition to centrality, down-regulated CGPs show topological association that correlates with common biological processes and pathways involved in tumorigenesis. Conclusion Given the current limited coverage of the human interactome, this study proposes that tumorigenesis takes place in a specific and organized way at the molecular systems-level and suggests a model that comprises the precise down-regulation of groups of topologically-associated proteins involved in particular functions, orchestrated with the up-regulation of specific proteins.

  16. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  17. Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

    Science.gov (United States)

    Wright, Stewart W; Trott, Alexander; Lindsell, Christopher J; Smith, Carol; Gibler, W Brian

    2008-01-01

    The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of reducing errors in emergency systems. The specialty of emergency medicine is well positioned to develop a complete system of innovative quality improvement, incorporating best practice guidelines with performance measures and practitioner feedback mechanisms to reduce errors and therefore improve quality of care. This article reviews the construction, ongoing development, and initial impact of such a system at a large, urban, university teaching hospital and at 2 affiliated community hospitals. The Committee for Procedural Quality and Evidence-Based Practice was formed within the Department of Emergency Medicine to establish evidence-based guidelines for nursing and provider care. The committee measures the effect of such guidelines, along with other quality measures, through pre- and postguideline patient care medical record audits. These measures are fed back to the providers in a provider-specific, peer-matched "scorecard." The Committee for Procedural Quality and Evidence-Based Practice affects practice and performance within our department. Multiple physician and nursing guidelines have been developed and put into use. Using asthma as an example, time to first nebulizer treatment and time to disposition from the emergency department decreased. Initial therapeutic agent changed and documentation improved. A comprehensive, guideline-driven, evidence-based approach to clinical practice is feasible within the structure of a department of emergency medicine. High-level departmental support with dedicated personnel is necessary for the success of such a system. Internet site development (available at http://www.CPQE.com) for product storage has proven valuable. Patient care has been improved in several ways; however, consistent and

  18. Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

    2014-07-01

    While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating

  19. [A health system's neoliberal reform: evidence from the Mexican case].

    Science.gov (United States)

    López-Arellano, Oliva; Jarillo-Soto, Edgar C

    2017-07-27

    This study addressed the shaping of Mexico's health system in recent years, with an analysis of the social determination conditioning the system's current formulation, the consequences for the population's living and working conditions, and the technical and legal reform measures that shaped the system's transformation. The article then analyzes the survival of social security institutions and the introduction of an individual insurance model and its current implications and consequences. From the perspective of the right to health, the article compares the measures, resources, and interventions in both health care models and highlights the relevance of the social security system for Popular Insurance. The article concludes that the measures implemented to reform the Mexican health system have failed to achieve the intended results; on the contrary, they have led to a reduction in interventions, rising costs, and a decrease in the installed capacity and professional personnel for the system's operation, thus falling far short of solving the problem, rather aggravating the inequities without solving the system's structural contradictions. Health systems face new challenges, inevitably requiring that the analyses be situated in a broader framework rather than merely focusing on the functional, administrative, and financial operation of the systems in the respective countries.

  20. Direct evidence for T violation in the neutral kaon system

    CERN Document Server

    Adler, R; Angelopoulos, Angelos; Aspostolakis, A; Aslanides, Elie; Backenstoss, Gerhard; Bee, C P; Behnke, O; Benelli, A; Bertin, V; Blanc, F; Bloch, P; Bula, C; Carlson, P J; Carroll, M; Carvalho, J; Cawley, E; Charalambous, S; Chardalas, M; Chardin, G; Chertok, M B; Cody, A; Danielsson, M; Dedoussis, S; Dejardin, M; Derré, J; Duclos, J; Ealet, A; Eckart, B; Eleftheriadis, C; Evangelou, I; Faravel, L; Fassnacht, P; Faure, J L; Felder, C; Ferreira-Marques, R; Fetscher, W; Fidecaro, Maria; Filipcic, A; Francis, D; Fry, J; Gabathuler, Erwin; Gamet, R; Garreta, D; Gerber, H J; Go, A; Guyot, C; Haselden, A; Hayman, P J; Henry-Coüannier, F; Hollander, R W; Hubert, E; Jon-And, K; Kettle, P R; Kochowski, Claude; Kokkas, P; Kreuger, R; Le Gac, R; Leimgruber, F; Liolios, A; Machado, E; Mandic, I; Manthos, N; Marel, Gérard; Mikuz, M; Miller, J; Montanet, François; Nakada, Tatsuya; Onofre, A; Pagels, B; Papadopoulos, I M; Pavlopoulos, P; Pinto da Cunha, J; Policarpo, Armando; Polivka, G; Rickenbach, R; Roberts, B L; Rozaki, E; Ruf, T; Sakelliou, L; Sanders, P; Santoni, C; Sarigiannis, K; Schäfer, M; Schaller, L A; Schopper, A; Schune, P; Soares, A; Tauscher, Ludwig; Thibault, C; Touchard, F; Touramanis, C; Triantis, F A; Van Beveren, E; van Eijk, C W E; Varner, G S; Vlachos, S; Weber, P; Wigger, O; Wolter, M; Yéche, C; Zavrtanik, D; Zimmerman, D

    1995-01-01

    We present the first direct observation of T violation in the neutral kaon system, showing a positive signal with a significance of more than two standard deviations. The result does not rely on the validity of the CPT theorem.

  1. Direct evidence for T violation in the neutral kaon system

    International Nuclear Information System (INIS)

    Dejardin, M.; Angelopoulos, A.; Apostolakis, A.; Aslanides, E.; Bertin, V.; Behnke, O.; Benelli, A.

    1995-01-01

    The first direct observation of T violation in the neutral kaon system, is presented showing a positive signal with a significance of more than two standard deviations. The results does not rely on the validity of the CPT theorem. (author)

  2. Systems Thinking Evidence from Colleges of Business and Their Universities

    Science.gov (United States)

    Seiler, John H.; Kowalsky, Michelle

    2011-01-01

    This study investigated instances of the term "systems thinking" among the websites of the Top 25 business schools as ranked by "U. S. News and World Report" in 2010. Since a greater number of instances of the term and its variants in a university's web documents may indicate an increased interest of the institution in the…

  3. Evidence of microbial rhodopsins in Antarctic Dry Valley edaphic systems.

    Science.gov (United States)

    Guerrero, Leandro D; Vikram, Surendra; Makhalanyane, Thulani P; Cowan, Don A

    2017-09-01

    Microorganisms able to synthesize rhodopsins have the capacity to translocate ions through their membranes, using solar energy to generate a proton motive force. Rhodopsins are the most abundant phototrophic proteins in oceanic surface waters and are key constituents in marine bacterial ecology. However, it remains unclear how rhodopsins are used in most microorganisms. Despite their abundance in marine and fresh-water systems, the presence of functional rhodopsin systems in edaphic habitats has never been reported. Here, we show the presence of several new putative H + , Na + and Cl + pumping rhodopsins identified by metagenomic analysis of Antarctic desert hypolithic communities. Reconstruction of two Proteobacteria genomes harboring xanthorhodopsin-like proteins and one Bacteroidetes genome with a Na-pumping-like rhodopsin indicated that these bacteria were aerobic heterotrophs possessing the apparent capacity for the functional expression of rhodopsins. The existence of these protein systems in hypolithic bacteria expands the known role of rhodopsins to include terrestrial environments and suggests a possible predominant function as heterotrophic energy supply proteins, a feasible microbial adaptation to the harsh conditions prevalent in Antarctic edaphic systems. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  4. Social capital and systems of care: some contrasting evidence ...

    African Journals Online (AJOL)

    No abstract available for this article... Keywords: social capital, systems. Research Review Supplement 16 (2004: 1-15). AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

  5. Using Evidence to Strengthen Health Systems in Africa and the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The project is timely for Lebanon, a country that is working to strengthen its primary health care system to respond to current priorities such as the emerging crisis of Syrian refugees. Timely access to information The project will strengthen institutional and individual abilities to conduct and use systematic and rapid reviews to ...

  6. The Doubting System 1: Evidence for automatic substitution sensitivity.

    Science.gov (United States)

    Johnson, Eric D; Tubau, Elisabet; De Neys, Wim

    2016-02-01

    A long prevailing view of human reasoning suggests severe limits on our ability to adhere to simple logical or mathematical prescriptions. A key position assumes these failures arise from insufficient monitoring of rapidly produced intuitions. These faulty intuitions are thought to arise from a proposed substitution process, by which reasoners unknowingly interpret more difficult questions as easier ones. Recent work, however, suggests that reasoners are not blind to this substitution process, but in fact detect that their erroneous responses are not warranted. Using the popular bat-and-ball problem, we investigated whether this substitution sensitivity arises out of an automatic System 1 process or whether it depends on the operation of an executive resource demanding System 2 process. Results showed that accuracy on the bat-and-ball problem clearly declined under cognitive load. However, both reduced response confidence and increased response latencies indicated that biased reasoners remained sensitive to their faulty responses under load. Results suggest that a crucial substitution monitoring process is not only successfully engaged, but that it automatically operates as an autonomous System 1 process. By signaling its doubt along with a biased intuition, it appears System 1 is "smarter" than traditionally assumed.

  7. Health Information Systems From evidence to action | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    28 mars 2013 ... In equitable health systems, health resources match what people need, with ... Countries may lack the technology and expertise to process and share ... La transformation de la santé des mères et des enfants à l'échelle ...

  8. Multiple Systems of Spatial Memory: Evidence from Described Scenes

    Science.gov (United States)

    Avraamides, Marios N.; Kelly, Jonathan W.

    2010-01-01

    Recent models in spatial cognition posit that distinct memory systems are responsible for maintaining transient and enduring spatial relations. The authors used perspective-taking performance to assess the presence of these enduring and transient spatial memories for locations encoded through verbal descriptions. Across 3 experiments, spatial…

  9. Business Processes Modeling Recommender Systems: User Expectations and Empirical Evidence

    Directory of Open Access Journals (Sweden)

    Michael Fellmann

    2018-04-01

    Full Text Available Recommender systems are in widespread use in many areas, especially electronic commerce solutions. In this contribution, we apply recommender functionalities to business process modeling and investigate their potential for supporting process modeling. To do so, we have implemented two prototypes, demonstrated them at a major fair and collected user feedback. After analysis of the feedback, we have confronted the findings with the results of the experiment. Our results indicate that fairgoers expect increased modeling speed as the key advantage and completeness of models as the most unlikely advantage. This stands in contrast to an initial experiment revealing that modelers, in fact, increase the completeness of their models when adequate knowledge is presented while time consumption is not necessarily reduced. We explain possible causes of this mismatch and finally hypothesize on two “sweet spots” of process modeling recommender systems.

  10. A system for rating the stability and strength of medical evidence

    Directory of Open Access Journals (Sweden)

    Reston James T

    2006-10-01

    Full Text Available Abstract Background Methods for describing one's confidence in the available evidence are useful for end-users of evidence reviews. Analysts inevitably make judgments about the quality, quantity consistency, robustness, and magnitude of effects observed in the studies identified. The subjectivity of these judgments in several areas underscores the need for transparency in judgments. Discussion This paper introduces a new system for rating medical evidence. The system requires explicit judgments and provides explicit rules for balancing these judgments. Unlike other systems for rating the strength of evidence, our system draws a distinction between two types of conclusions: quantitative and qualitative. A quantitative conclusion addresses the question, "How well does it work?", whereas a qualitative conclusion addresses the question, "Does it work?" In our system, quantitative conclusions are tied to stability ratings, and qualitative conclusions are tied to strength ratings. Our system emphasizes extensive a priori criteria for judgments to reduce the potential for bias. Further, the system makes explicit the impact of heterogeneity testing, meta-analysis, and sensitivity analyses on evidence ratings. This article provides details of our system, including graphical depictions of how the numerous judgments that an analyst makes can be combined. We also describe two worked examples of how the system can be applied to both interventional and diagnostic technologies. Summary Although explicit judgments and formal combination rules are two important steps on the path to a comprehensive system for rating medical evidence, many additional steps must also be taken. Foremost among these are the distinction between quantitative and qualitative conclusions, an extensive set of a priori criteria for making judgments, and the direct impact of analytic results on evidence ratings. These attributes form the basis for a logically consistent system that can

  11. The number processing and calculation system: evidence from cognitive neuropsychology.

    Science.gov (United States)

    Salguero-Alcañiz, M P; Alameda-Bailén, J R

    2015-04-01

    Cognitive neuropsychology focuses on the concepts of dissociation and double dissociation. The performance of number processing and calculation tasks by patients with acquired brain injury can be used to characterise the way in which the healthy cognitive system manipulates number symbols and quantities. The objective of this study is to determine the components of the numerical processing and calculation system. Participants consisted of 6 patients with acquired brain injuries in different cerebral localisations. We used Batería de evaluación del procesamiento numérico y el cálculo, a battery assessing number processing and calculation. Data was analysed using the difference in proportions test. Quantitative numerical knowledge is independent from number transcoding, qualitative numerical knowledge, and calculation. Recodification is independent from qualitative numerical knowledge and calculation. Quantitative numerical knowledge and calculation are also independent functions. The number processing and calculation system comprises at least 4 components that operate independently: quantitative numerical knowledge, number transcoding, qualitative numerical knowledge, and calculation. Therefore, each one may be damaged selectively without affecting the functioning of another. According to the main models of number processing and calculation, each component has different characteristics and cerebral localisations. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  12. [GRADE system: classification of quality of evidence and strength of recommendation].

    Science.gov (United States)

    Aguayo-Albasini, José Luis; Flores-Pastor, Benito; Soria-Aledo, Víctor

    2014-02-01

    The acquisition and classification of scientific evidence, and subsequent formulation of recommendations constitute the basis for the development of clinical practice guidelines. There are several systems for the classification of evidence and strength of recommendations; the most commonly used nowadays is the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The GRADE system initially classifies the evidence into high or low, coming from experimental or observational studies; subsequently and following a series of considerations, the evidence is classified into high, moderate, low or very low. The strength of recommendations is based not only on the quality of the evidence, but also on a series of factors such as the risk/benefit balance, values and preferences of the patients and professionals, and the use of resources or costs. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  13. Hydrothermal systems on Mars: an assessment of present evidence

    Science.gov (United States)

    Farmer, J. D.

    1996-01-01

    Hydrothermal processes have been suggested to explain a number of observations for Mars, including D/H ratios of water extracted from Martian meteorites, as a means for removing CO2 from the Martian atmosphere and sequestering it in the crust as carbonates, and as a possible origin for iron oxide-rich spectral units on the floors of some rifted basins (chasmata). There are numerous examples of Martian channels formed by discharges of subsurface water near potential magmatic heat sources, and hydrothermal processes have also been proposed as a mechanism for aquifer recharge needed to sustain long term erosion of sapping channels. The following geological settings have been identified as targets for ancient hydrothermal systems on Mars: channels located along the margins of impact crater melt sheets and on the slopes of ancient volcanoes; chaotic and fretted terranes where shallow subsurface heat sources are thought to have interacted with ground ice; and the floors of calderas and rifted basins (e.g. chasmata). On Earth, such geological environments are often a locus for hydrothermal mineralization. But we presently lack the mineralogical information needed for a definitive evaluation of hypotheses. A preferred tool for identifying minerals by remote sensing methods on Earth is high spatial resolution, hyperspectral, near-infrared spectroscopy, a technique that has been extensively developed by mineral explorationists. Future efforts to explore Mars for ancient hydrothermal systems would benefit from the application of methods developed by the mining industry to look for similar deposits on Earth. But Earth-based exploration models must be adapted to account for the large differences in the climatic and geological history of Mars. For example, it is likely that the early surface environment of Mars was cool, perhaps consistently below freezing, with the shallow portions of hydrothermal systems being dominated by magma-cryosphere interactions. Given the smaller

  14. The impacts of football point systems on the competitive balance: evidence from some European footbal leagues

    OpenAIRE

    HALICIOGLU, Ferda

    2006-01-01

    Introduction. – 1. Outcome of uncertainty and competitive balance in professional team sports. – 2. Measurement of competitive balance in professional team sports. – 3. Football point systems and competitive balance: empirical evidence . – 4. Some concluding remarks.

  15. The impact of football point systems on the competitive balance: evidence from some european football leagues

    OpenAIRE

    Ferda Halicioglu

    2006-01-01

    Introduction - 1 Outcome of uncertainty and competitive balance in professional team sports - 2 Measurement of competitive balance in professional team sports - 3 Football point systems and competitive balance: empirical evidence - 4. Concluding remarks

  16. Mirror neuron system and observational learning: behavioral and neurophysiological evidence.

    Science.gov (United States)

    Lago-Rodriguez, Angel; Lopez-Alonso, Virginia; Fernández-del-Olmo, Miguel

    2013-07-01

    Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Cost of Tuberculosis Treatment: Evidence from Iran's Health System.

    Science.gov (United States)

    Bay, Vahid; Tabarsi, Payam; Rezapour, Aziz; Marzban, Sima; Zarei, Ehsan

    2017-10-01

    This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran. In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district's health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider's perspective using an activity-based costing (ABC) method. The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%). Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.

  18. Health Professionals' Use of Online Information Retrieval Systems and Online Evidence.

    Science.gov (United States)

    Lialiou, Paschalina; Pavlopoulou, Ioanna; Mantas, John

    2016-01-01

    Across-sectional survey was designed to determine health professionals' awareness and usage of online evidence retrieval systems in clinical practice. A questionnaire was used to measure professionals' behavior and utilization of online evidences, as well as, reasons and barriers on information retrieval. 439 nurses and physicians from public and private hospitals in Greece formulate the study's sample. The two most common reasons that individuals are using online information systems were for writing scientific manuscripts or filling a knowledge gap. A positive correlation was found between participants with postgraduate studies and information system usage. The majority of them (90,6%) believe that online information systems improves patient care and 67,6% of them had their own experiences on this. More support is needed to nurses and physicians in order to use the online evidence and as a result to improve the provided care and practices.

  19. What is the Role of Legal Systems in Financial Intermediation? Theory and Evidence

    NARCIS (Netherlands)

    Bottazzi, L.; Da Rin, M.; Hellmann, T.

    2008-01-01

    We develop a theory and empirical test of how the legal system affects the relationship between venture capitalists and entrepreneurs. The theory uses a double moral hazard framework to show how optimal contracts and investor actions depend on the quality of the legal system. The empirical evidence

  20. The Dominance Behavioral System and Psychopathology: Evidence from Self-Report, Observational, and Biological Studies

    Science.gov (United States)

    Johnson, Sheri L.; Leedom, Liane J.; Muhtadie, Luma

    2012-01-01

    The dominance behavioral system (DBS) can be conceptualized as a biologically based system that guides dominance motivation, dominant and subordinate behavior, and responsivity to perceptions of power and subordination. A growing body of research suggests that problems with the DBS are evident across a broad range of psychopathologies. We begin by…

  1. Lessons Learned from A System-Wide Evidence-Based Practice Program Implementation

    Science.gov (United States)

    2017-04-25

    incorporating scientific evidence, clinical expertise and the patient’s values and preferences to provide quality healthcare . Despite growing...MEMORANDUM FOR ST DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS ATTN: LT COL JACQUELINE KILLIAN...FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 14 FEB 2017 1. Your paper, entitled Lesson Learned From A System-Wide Evidence- Based

  2. Scientific evidence-based effects of hydrotherapy on various systems of the body.

    Science.gov (United States)

    Mooventhan, A; Nivethitha, L

    2014-05-01

    The use of water for various treatments (hydrotherapy) is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack of studies/reviews in reporting the evidence-based effects of hydrotherapy on various systems. We performed PubMed and PubMed central search to review relevant articles in English literature based on "effects of hydrotherapy/balneotherapy" on various systems of the body. Based on the available literature this review suggests that the hydrotherapy has a scientific evidence-based effect on various systems of the body.

  3. Measuring the Impact of Online Evidence Retrieval Systems using Critical Incidents & Journey Mapping.

    Science.gov (United States)

    Westbrook, Johanna I; Coiera, Enrico W; Braithwaite, Jeffrey

    2005-01-01

    Online evidence retrieval systems are one potential tool in supporting evidence-based practice. We have undertaken a program of research to investigate how hospital-based clinicians (doctors, nurses and allied health professionals) use these systems, factors influencing use and their impact on decision-making and health care delivery. A central component of this work has been the development and testing of a broad range of evaluation techniques. This paper provides an overview of the results obtained from three stages of this evaluation and details the results derived from the final stage which sought to test two methods for assessing the integration of an online evidence system and its impact on decision making and patient care. The critical incident and journey mapping techniques were applied. Semi-structured interviews were conducted with 29 clinicians who were experienced users of the online evidence system. Clinicians were asked to described recent instances in which the information obtained using the online evidence system was especially helpful with their work. A grounded approach to data analysis was taken producing three categories of impact. The journey mapping technique was adapted as a method to describe and quantify clinicians' integration of CIAP into their practice and the impact of this on patient care. The analogy of a journey is used to capture the many stages in this integration process, from introduction to the system to full integration into everyday clinical practice with measurable outcomes. Transcribed interview accounts of system use were mapped against the journey stages and scored. Clinicians generated 85 critical incidents and one quarter of these provided specific examples of system use leading to improvements in patient care. The journey mapping technique proved to be a useful method for providing a quantification of the ways and extent to which clincians had integrated system use into practice, and insights into how information

  4. Development and implementation of the Ontario Stroke System: the use of evidence

    Directory of Open Access Journals (Sweden)

    Jill I. Cameron

    2007-08-01

    Full Text Available Introduction The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. Research Objective To identify the role evidence played in the development and implementation of the Ontario Stroke System. Methods This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery. Results Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1 informing system development; 2 mobilizing governmental support; 3 getting the system up and running; and 4 integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1 human capacity and 2 mechanisms to share evidence. Conclusion This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.

  5. CDS, UX, and System Redesign - Promising Techniques and Tools to Bridge the Evidence Gap.

    Science.gov (United States)

    McGinn, Thomas

    2015-01-01

    In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the "evidence gap." We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge. All of the articles in this issue explore, in some fashion, CDS systems and how we can best bring providers and their work environment to the evidence. We are at the very early stages of the science of usability. Much more research and funding is needed in this area if we hope to improve the dissemination and implementation of evidence in practice. While the featured examples, techniques, and tools in the special issue are a promising start to improving usability and CDS, many of the papers highlight current gaps in knowledge and a great need for generalizable approaches. The great promise is for "learning" approaches to generate new evidence and to integrate this evidence in reliable, patient-centered ways at scale using new technology. Closing the evidence gap is a real possibility, but only if the community works together to innovate and invest in research on the best ways to disseminate, communicate, and implement evidence in practice.

  6. A Regional PD Strategy for EPR Systems: Evidence-Based IT Development

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2006-01-01

    One of the five regions in Denmark has initiated a remark-able and alternative strategy for the development of Elec-tronic Patient Record (EPR) systems. This strategy is driven by Participatory Design (PD) experiments and based on evidence of positive effects on the clinical practice when using EPR...... systems. We present this PD strategy and our related research on evidence-based IT development. We report from a newly completed PD experiment with EPR in the region conducted through a close collaboration compris-ing a neurological stroke unit, the region’s EPR unit, the vendor, as well as the authors....

  7. How Does Procedural Fairness Affect Performance Evaluation System Satisfaction? (Evidence from a UK Police Force

    Directory of Open Access Journals (Sweden)

    Sholihin Mahfud

    2013-12-01

    Full Text Available This paper investigates whether, and if so, how procedural fairness affects performance evaluation system satisfaction in a UK Police Force. Employing a survey method with samples of detective inspectors and detective chief inspectors with significant managerial responsibilities in a UK Police Force, this study finds that procedural fairness affects performance evaluation system satisfaction. Further analysis reveals that the effect of procedural fairness on performance evaluation system satisfaction is mediated by trust. This study provides empirical evidence on how procedural fairness affects performance evaluation system satisfaction. The results of this study may benefit the designer of performance evaluation systems in police organizations.

  8. Enhancing requirements engineering for patient registry software systems with evidence-based components.

    Science.gov (United States)

    Lindoerfer, Doris; Mansmann, Ulrich

    2017-07-01

    Patient registries are instrumental for medical research. Often their structures are complex and their implementations use composite software systems to meet the wide spectrum of challenges. Commercial and open-source systems are available for registry implementation, but many research groups develop their own systems. Methodological approaches in the selection of software as well as the construction of proprietary systems are needed. We propose an evidence-based checklist, summarizing essential items for patient registry software systems (CIPROS), to accelerate the requirements engineering process. Requirements engineering activities for software systems follow traditional software requirements elicitation methods, general software requirements specification (SRS) templates, and standards. We performed a multistep procedure to develop a specific evidence-based CIPROS checklist: (1) A systematic literature review to build a comprehensive collection of technical concepts, (2) a qualitative content analysis to define a catalogue of relevant criteria, and (3) a checklist to construct a minimal appraisal standard. CIPROS is based on 64 publications and covers twelve sections with a total of 72 items. CIPROS also defines software requirements. Comparing CIPROS with traditional software requirements elicitation methods, SRS templates and standards show a broad consensus but differences in issues regarding registry-specific aspects. Using an evidence-based approach to requirements engineering for registry software adds aspects to the traditional methods and accelerates the software engineering process for registry software. The method we used to construct CIPROS serves as a potential template for creating evidence-based checklists in other fields. The CIPROS list supports developers in assessing requirements for existing systems and formulating requirements for their own systems, while strengthening the reporting of patient registry software system descriptions. It may be

  9. PENERAPAN ACTIVITY BASED COSTING SYSTEM DALAM PERHITUNGAN PROFITABILITAS PRODUK PADA UD. NIAGA BAKTI

    Directory of Open Access Journals (Sweden)

    Fena Ulfa Aulia

    2015-06-01

    Full Text Available The Charge imposition of factory overhead based on traditional systems often cause distorted costs. One of efforts to overcome these distortions fees is with charging the costs  factory overhead  by the activity based costing. The use of activity based costing can also help companies that produce many products  in determining the level of profitability. Profitability indicates whether an enterprise has good prospects in the future for the company's survival. This research is a quantitative descriptive research conducted at UD NIAGA BAKTI engaged in the processing of tuna fish PETIS in Pamekasan located in the village of Konang, Subdistrict of Galis, Regency of Pamekasan. The type of data  used in this research is quantitative data obtained by direct observation and Interview. This techniques of research analysis calculates and compares the products profitability of PETIS by using traditional cost systems and costing system based activity. The results of this research indicates that there are differences in the principal cost of production and profitability UD NIAGA BAKTI by using activity based costing compared  Traditional Cost Systems.

  10. A categorization of water system breakdowns: Evidence from Liberia, Nigeria, Tanzania, and Uganda.

    Science.gov (United States)

    Klug, Tori; Cronk, Ryan; Shields, Katherine F; Bartram, Jamie

    2018-04-01

    In rural sub-Saharan Africa, one in three handpumps are non-functional at any time. While there is some evidence describing factors associated with non-functional water systems, there is little evidence describing the categories of water system breakdowns that commonly occur. Insufficient water availability from broken down systems can force people to use unimproved water sources, which undermines the health benefits of an improved water source. We categorized common water system breakdowns using quantitative and qualitative monitoring data from Liberia, Nigeria, Tanzania, and Uganda (each N>3600 water systems) and examined how breakdown category varies by water system type and management characteristics. Specific broken parts were mentioned more frequently than all other reasons for breakdown; hardware parts frequently found at fault for breakdown were aprons (Liberia), pipes (Tanzania and Uganda), taps/spouts (Tanzania and Uganda), and lift mechanisms (Nigeria). Statistically significant differences in breakdown category were identified based on system type, age, management type, and fee collection type. Categorization can help to identify common reasons for water system breakdown. The analysis of these data can be used to develop improved monitoring instruments to inform actors of different breakdown types and provide reasons for system non-functionality. Improved monitoring instruments would enable actors to target appropriate resources to address specific breakdowns likely to arise based on system type and management characteristics in order to inform improved implementation of and post-construction support for water systems in sub-Saharan Africa. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. The validation of forensic DNA extraction systems to utilize soil contaminated biological evidence.

    Science.gov (United States)

    Kasu, Mohaimin; Shires, Karen

    2015-07-01

    The production of full DNA profiles from biological evidence found in soil has a high failure rate due largely to the inhibitory substance humic acid (HA). Abundant in various natural soils, HA co-extracts with DNA during extraction and inhibits DNA profiling by binding to the molecular components of the genotyping assay. To successfully utilize traces of soil contaminated evidence, such as that found at many murder and rape crime scenes in South Africa, a reliable HA removal extraction system would often be selected based on previous validation studies. However, for many standard forensic DNA extraction systems, peer-reviewed publications detailing the efficacy on soil evidence is either lacking or is incomplete. Consequently, these sample types are often not collected or fail to yield suitable DNA material due to the use of unsuitable methodology. The aim of this study was to validate the common forensic DNA collection and extraction systems used in South Africa, namely DNA IQ, FTA elute and Nucleosave for processing blood and saliva contaminated with HA. A forensic appropriate volume of biological evidence was spiked with HA (0, 0.5, 1.5 and 2.5 mg/ml) and processed through each extraction protocol for the evaluation of HA removal using QPCR and STR-genotyping. The DNA IQ magnetic bead system effectively removed HA from highly contaminated blood and saliva, and generated consistently acceptable STR profiles from both artificially spiked samples and crude soil samples. This system is highly recommended for use on soil-contaminated evidence over the cellulose card-based systems currently being preferentially used for DNA sample collection. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Initial steps towards an evidence-based classification system for golfers with a physical impairment

    NARCIS (Netherlands)

    Stoter, Inge K.; Hettinga, Florentina J.; Altmann, Viola; Eisma, Wim; Arendzen, Hans; Bennett, Tony; van der Woude, Lucas H.; Dekker, Rienk

    2017-01-01

    Purpose: The present narrative review aims to make a first step towards an evidence-based classification system in handigolf following the International Paralympic Committee (IPC). It intends to create a conceptual framework of classification for handigolf and an agenda for future research. Method:

  13. On-farm impact of the System of Rice Intensification (SRI): Evidence and knowledge gaps

    NARCIS (Netherlands)

    Berkhout, E.D.; Glover, D.B.A.; Kuyvenhoven, A.

    2015-01-01

    The System of Rice Intensification (SRI) is being promoted worldwide, but relatively little is yet known about its impacts at farm level. This article reviews available evidence on the impact of SRI practices in terms of yield and productivity. Adoption of SRI practices necessarily changes the mix

  14. Bank Systemic Risk-Taking and Loan Pricing : Evidence from Syndicated Loans

    NARCIS (Netherlands)

    Gong, D.

    2014-01-01

    In this paper we document evidence of systemic risk taking from syndicated loan pricing. Using U.S. syndicated loan data, we find that the borrower's idiosyncratic risk is positively priced whereas systematic risk is negatively related to loan spreads, controlling for firm, loan and bank specific

  15. Forensic Evidence Identification and Modeling for Attacks against a Simulated Online Business Information System

    Directory of Open Access Journals (Sweden)

    Manghui Tu

    2012-12-01

    Full Text Available Forensic readiness can support future forensics investigation or auditing on external/internal attacks, internal sabotage and espionage, and business frauds. To establish forensics readiness, it is essential for an organization to identify what evidences are relevant and where they can be found, to determine whether they are logged in a forensic sound way and whether all the needed evidences are available to reconstruct the events successfully.  Our goal of this research is to ensure evidence availability. First, both external and internal attacks are molded as augmented attack trees/graphs based on the system vulnerabilities. Second, modeled attacks are conducted against a honeynet simulating an online business information system, and each honeypot's hard drive is forensic sound imaged for each individual attack. Third, an evidence tree/graph will be built after forensics examination on the disk images for each attack. The evidence trees/graphs are expected to be used for automatic crime scene reconstruction and automatic attack/fraud detection in the future.

  16. Topics on vitamin D in systemic lupus erythematosus: analysis of evidence and critical literature review.

    Science.gov (United States)

    Marinho, António; Taveira, Mariana; Vasconcelos, Carlos

    2017-04-01

    Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multiorgan inflammation, linked to the loss of immune tolerance to self-antigens and the production of a diversity of autoantibodies. The phenotype and progression of SLE have been linked to a combination of environmental, genetic, and hormonal factors. One such environmental factor is vitamin D, a vital hormone with well-established effects on mineral metabolism, skeletal health, and effects on cardiovascular system. The purpose of this article is to make the analysis of evidence and literature review of the pleomorphic effects of Vitamin D in SLE. The article is structured in topics of interest based in the authors' opinion and summarizes the evidence of studies and trials of vitamin D in SLE.

  17. Effects of System Characteristics on Adopting Web-Based Advanced Traveller Information System: Evidence from Taiwan

    Directory of Open Access Journals (Sweden)

    Ting-Wei Lin

    2014-02-01

    Full Text Available This study proposes a behavioural intention model that integrates information quality, response time, and system accessibility into the original technology acceptance model (TAM to investigate whether system characteristics affect the adoption of Web-based advanced traveller information systems (ATIS. This study empirically tests the proposed model using data collected from an online survey of Web-based advanced traveller information system users. Con­firmatory factor analysis (CFA was performed to examine the reliability and validity of the measurement model, and structural equation modelling (SEM was used to evaluate the structural model. The results indicate that three system characteristics had indirect effects on the intention to use through perceived usefulness, perceived ease of use, and attitude toward using. Information quality was the most im­portant system characteristic factor, followed by response time and system accessibility. This study presents implica­tions for practitioners and researchers, and suggests direc­tions for future research.

  18. Interpersonal motor resonance in autism spectrum disorder: evidence against a global "mirror system" deficit.

    Science.gov (United States)

    Enticott, Peter G; Kennedy, Hayley A; Rinehart, Nicole J; Bradshaw, John L; Tonge, Bruce J; Daskalakis, Zafiris J; Fitzgerald, Paul B

    2013-01-01

    The mirror neuron hypothesis of autism is highly controversial, in part because there are conflicting reports as to whether putative indices of mirror system activity are actually deficient in autism spectrum disorder (ASD). Recent evidence suggests that a typical putative mirror system response may be seen in people with an ASD when there is a degree of social relevance to the visual stimuli used to elicit that response. Individuals with ASD (n = 32) and matched neurotypical controls (n = 32) completed a transcranial magnetic stimulation (TMS) experiment in which the left primary motor cortex (M1) was stimulated during the observation of static hands, individual (i.e., one person) hand actions, and interactive (i.e., two person) hand actions. Motor-evoked potentials (MEP) were recorded from the contralateral first dorsal interosseous, and used to generate an index of interpersonal motor resonance (IMR; a putative measure of mirror system activity) during action observation. There was no difference between ASD and NT groups in the level of IMR during the observation of these actions. These findings provide evidence against a global mirror system deficit in ASD, and this evidence appears to extend beyond stimuli that have social relevance. Attentional and visual processing influences may be important for understanding the apparent role of IMR in the pathophysiology of ASD.

  19. Socio-contextual Determinants of Research Evidence Use in Public-Youth Systems of Care.

    Science.gov (United States)

    Garcia, Antonio R; Kim, Minseop; Palinkas, Lawrence A; Snowden, Lonnie; Landsverk, John

    2016-07-01

    Recent efforts have been devoted to understanding the conditions by which research evidence use (REU) is facilitated from the perspective of system leaders in the context of implementing evidence-based child mental health interventions. However, we have limited understanding of the extent to which outer contextual factors influence REU. Outer contextual factors for 37 counties in California were gathered from public records in 2008; and child welfare, juvenile justice, and mental health system leaders' perceptions of their REU were measured via a web-based survey from 2010 to 2012. Results showed that leaders with higher educational attainment and in counties with lower expenditures on inpatient mental health services were significantly associated with higher REU. Positive relationships between gathering research evidence and racial minority concentration and poverty at the county level were also detected. Results underscore the need to identify the organizational and socio-political factors by which mental health services and resources meet client demands that influence REU, and to recruit and retain providers with a graduate degree to negotiate work demands and interpret research evidence.

  20. Insight and Evidence Motivating the Simplification of Dual-Analysis Hybrid Systems into Single-Analysis Hybrid Systems

    Science.gov (United States)

    Todling, Ricardo; Diniz, F. L. R.; Takacs, L. L.; Suarez, M. J.

    2018-01-01

    Many hybrid data assimilation systems currently used for NWP employ some form of dual-analysis system approach. Typically a hybrid variational analysis is responsible for creating initial conditions for high-resolution forecasts, and an ensemble analysis system is responsible for creating sample perturbations used to form the flow-dependent part of the background error covariance required in the hybrid analysis component. In many of these, the two analysis components employ different methodologies, e.g., variational and ensemble Kalman filter. In such cases, it is not uncommon to have observations treated rather differently between the two analyses components; recentering of the ensemble analysis around the hybrid analysis is used to compensated for such differences. Furthermore, in many cases, the hybrid variational high-resolution system implements some type of four-dimensional approach, whereas the underlying ensemble system relies on a three-dimensional approach, which again introduces discrepancies in the overall system. Connected to these is the expectation that one can reliably estimate observation impact on forecasts issued from hybrid analyses by using an ensemble approach based on the underlying ensemble strategy of dual-analysis systems. Just the realization that the ensemble analysis makes substantially different use of observations as compared to their hybrid counterpart should serve as enough evidence of the implausibility of such expectation. This presentation assembles numerous anecdotal evidence to illustrate the fact that hybrid dual-analysis systems must, at the very minimum, strive for consistent use of the observations in both analysis sub-components. Simpler than that, this work suggests that hybrid systems can reliably be constructed without the need to employ a dual-analysis approach. In practice, the idea of relying on a single analysis system is appealing from a cost-maintenance perspective. More generally, single-analysis systems avoid

  1. Reflections from the Jury Box: Improving Evidence Based Practice through a Comparison with Our Legal System

    Directory of Open Access Journals (Sweden)

    Valerie Coppenrath

    2017-08-01

    Full Text Available Background: An experience serving jury duty prompted reflection on the parallels between evidenced based medicine and our legal system. Findings: The steps of the legal system can be tied to each step of the practice of evidenced based medicine. Implications: Patients should be included in evidence based decisions. Pharmacists can act as resources for other providers practicing evidenced based medicine. Educators can use this analogy to teach evidence based medicine. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Commentary

  2. Non-Traditional Systemic Treatments for Diabetic Retinopathy: An
Evidence-Based Review

    Science.gov (United States)

    Simó, Rafael; Ballarini, Stefania; Cunha-Vaz, José; Ji, Linong; Haller, Hermann; Zimmet, Paul; Wong, Tien Y.

    2015-01-01

    The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing the appearance and progression of DR or in reversing DR; some with limited success while others appear promising. This up-to-date critical review of non-traditional systemic treatments for DR is based on the published evidence in MEDLINE spanning 1980-December 2014. It discusses a number of therapeutic options, paying particular attention to the mechanisms of action and the clinical evidence for the use of renin-angiotensin system blockade, fenofibrate and calcium dobesilate monohydrate in DR. PMID:25989912

  3. Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps.

    Science.gov (United States)

    Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B; Seguin, Rebecca A

    A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers' markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits.

  4. Brain MRI screening showing evidences of early central nervous system involvement in patients with systemic sclerosis.

    Science.gov (United States)

    Mohammed, Reem Hamdy A; Sabry, Yousriah Y; Nasef, Amr A

    2011-05-01

    Systemic sclerosis is a multisystem autoimmune collagen disease where structural and functional abnormalities of small blood vessels prevail. Transient ischemic attacks, ischemic stroke, and hemorrhage have been reported as primary consequence of vascular central nervous system affection in systemic sclerosis. Magnetic resonance imaging is considered to be the most sensitive diagnostic technique for detecting symptomatic and asymptomatic lesions in the brain in cases of multifocal diseases. The objective of this study is to detect subclinical as well as clinically manifest cerebral vasculopathy in patients with systemic sclerosis using magnetic resonance imaging. As much as 30 female patients with systemic sclerosis aged 27-61 years old, with disease duration of 1-9 years and with no history of other systemic disease or cerebrovascular accidents, were enrolled. Age-matched female control group of 30 clinically normal subjects, underwent brain magnetic resonance examination. Central nervous system (CNS) involvement in the form of white matter hyperintense foci of variable sizes were found in significantly abundant forms in systemic sclerosis patients on magnetic resonance evaluation than in age-related control group, signifying a form of CNS vasculopathy. Such foci showed significant correlation to clinical features of organic CNS lesion including headaches, fainting attacks and organic depression as well as to the severity of peripheral vascular disease with insignificant correlation with disease duration. In conclusion, subclinical as well as clinically manifest CNS ischemic vasculopathy is not uncommon in systemic sclerosis patients and magnetic resonance imaging is considered a sensitive noninvasive screening tool for early detection of CNS involvement in patients with systemic sclerosis.

  5. What is the role of health systems in responding to domestic violence? An evidence review.

    Science.gov (United States)

    Spangaro, Jo

    2017-12-01

    Objective The aim of the present study was to review and analyse academic literature and program evaluations to identify promising evidence for health system responses to domestic violence in Australia and internationally. Methods English-language literature published between January 2005 and March 2016 was retrieved from search results using the terms 'domestic violence' or 'intimate partner violence' in different combinations with other relevant terms, resulting in 1671 documents, of which 59 were systematic reviews. Electronic databases (Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psycinfo, Social work Abstracts, Informit, Violence and Abuse Abstracts, Family Studies Abstracts, Cochrane Library of Systematic Reviews and EMBASE) were searched and narrative analysis undertaken. Results This review details the evidence base for the following interventions by health services responding to domestic violence: first-line responses, routine screening, risk assessment and safety planning, counselling with women, mother-child interventions, responses to perpetrators, child protection notifications, training and system-level responses. Conclusions There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence. What is known about the topic? Domestic violence is a significant problem globally with enormous human, social and economic costs. Although women who have experienced abuse make extensive use of healthcare services, health services have lagged behind the policing, criminal justice and other human service domains in responding to domestic violence. What does this paper add? The present comprehensive review identifies best-practice health system responses to domestic violence. What are the implications for practitioners? Health systems can play a key role in identifying and responding to domestic violence for women who often do not access other services

  6. Diabetes mellitus disease management in a safety net hospital system: translating evidence into practice.

    Science.gov (United States)

    Butler, Michael K; Kaiser, Michael; Johnson, Jolene; Besse, Jay; Horswell, Ronald

    2010-12-01

    The Louisiana State University Health Care Services Division system assessed the effectiveness of implementing a multisite disease management program targeting diabetes mellitus in an indigent patient population. A population-based disease management program centered on evidence-based clinical care guidelines was applied from the system level. Specific clinic modifications and models were used, as well as ancillary services such as medication assistance and equipment subsidies. Marked improvement in process goals led to improved clinical outcomes. From 2001 to 2008, the percentage of patients with a hemoglobin A1c management programs can be successfully implemented and achieve statistically significant results.

  7. Violation of the fluctuation-dissipation theorem in glassy systems: basic notions and the numerical evidence

    International Nuclear Information System (INIS)

    Crisanti, A; Ritort, F

    2003-01-01

    This review reports on the research done during past years on violations of the fluctuation-dissipation theorem (FDT) in glassy systems. It is focused on the existence of a quasi-fluctuation-dissipation theorem (QFDT) in glassy systems and the current supporting knowledge gained from numerical simulation studies. It covers a broad range of non-stationary aging and stationary driven systems such as structural glasses, spin glasses, coarsening systems, ferromagnetic models at criticality, trap models, models with entropy barriers, kinetically constrained models, sheared systems and granular media. The review is divided into four main parts: (1) an introductory section explaining basic notions related to the existence of the FDT in equilibrium and its possible extension to the glassy regime (QFDT), (2) a description of the basic analytical tools and results derived in the framework of some exactly solvable models, (3) a detailed report of the current evidence in favour of the QFDT and (4) a brief digression on the experimental evidence in its favour. This review is intended for inexpert readers who want to learn about the basic notions and concepts related to the existence of the QFDT as well as for the more expert readers who may be interested in more specific results. (topical review)

  8. Systemic hypertension and the right-sided cardiovascular system: a review of the available evidence.

    Science.gov (United States)

    Pedrinelli, Roberto; Dell'Omo, Giulia; Talini, Enrica; Canale, Maria Laura; Di Bello, Vitantonio

    2009-02-01

    Abnormal vasoconstriction of the lesser circulation characterizes a subset of patients with essential hypertension, a possible effect of mechanisms, such as enhanced sympathetic tone, increased delivery of blood-borne vasoconstrictor substances or abnormal local release of vasoactive factors, acting on both sides of the circulation or to backward transmission of increased pressure due to stiffer left ventricles with more advanced diastolic dysfunction. Elevated systemic pressure also associates with thickening of the right ventricle, a central element of the low-pressure system. Right ventricular remodelling develops in parallel with a similar process occurring at the left side, likely as a result of ventricular interdependence under the influence of trophic factors targeting both ventricles, though other mechanisms, including increased pulmonary afterload, may also be operative. By and large independent of the extent of structural remodelling of both ventricles, systemic hypertension also conditions an impaired filling rate of the right ventricle that accompanies a similar phenomenon at the left side. Thus, quite in contrast with the common and simplistic assumption of a separate behaviour of the two ventricles, the right-sided cardiovascular system is not immune to the effect of systemic hypertension, a concept whose clinical and pathophysiological implications require further studies.

  9. Sustainability Strategy and Management Control Systems in Family Firms. Evidence from a Case Study

    Directory of Open Access Journals (Sweden)

    Fabio Caputo

    2017-06-01

    Full Text Available The aim of this paper is to investigate how the integration of new forms of sustainable control systems (SCSs and traditional management control systems (MCSs, and the use of these control systems affect the integration of sustainability within organizational strategy. A qualitative case study based on a longitudinal investigation of an Italian family firm operating in an environment-sensitive context, the intermodal transport industry, has been used to trace the company’s pathway to sustainability integration based on the Gond et al. framework. The paper enriches the Gond et al. conceptualization providing evidence of the external and internal factors relevant in affecting the organization’s pathway towards sustainability integration. To the best of the authors’ knowledge, the present study is the first analysis that investigates the integration of sustainability into organizational strategy in the context of family firms, from the point of view of performance management systems (PMSs.

  10. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

    Science.gov (United States)

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2014-11-29

    There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

  11. Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice

    Science.gov (United States)

    2012-01-01

    Background No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. Methods The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Results The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. Conclusions It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems. PMID:23171394

  12. Complementary roles of systems representing sensory evidence and systems detecting task difficulty during perceptual decision making

    Directory of Open Access Journals (Sweden)

    Douglas A Ruff

    2010-11-01

    Full Text Available Perceptual decision making is a multi-stage process where incoming sensory information is used to select one option from several alternatives. Researchers typically have adopted one of two conceptual frameworks to define the criteria for determining whether a brain region is involved in decision computations. One framework, building on single unite recordings in monkeys, posits that activity in a region involved in decision making reflects the accumulation of evidence toward a decision threshold, thus showing the lowest level of BOLD signal during the hardest decisions. The other framework instead posits that activity in a decision-making region reflects the difficulty of a decision, thus showing the highest level of BOLD signal during the hardest decisions. We had subjects perform a face detection task on degraded face images while we simultaneously recorded BOLD activity. We searched for brain regions where changes in BOLD activity during this task supported either of these frameworks by calculating the correlation of BOLD activity with reaction time - a measure of task difficulty. We found that the right supplementary eye field, right frontal eye field and right inferior frontal gyrus had increased activity relative to baseline that positively correlated with reaction time, while the left superior frontal sulcus and left middle temporal gyrus had decreased activity relative to baseline that negatively correlated with reaction time. We propose that a simple mechanism that scales a region’s activity based on task demands can explain our results.

  13. Evidence for a role of corticopetal, noradrenergic systems in the development of executive function.

    Science.gov (United States)

    Mokler, David J; Miller, Christine E; McGaughy, Jill A

    2017-09-01

    Adolescence is a period during which many aspects of executive function are maturing. Much of the literature has focused on discrepancies between sub-cortical and cortical development that is hypothesized to lead to over-processing of reinforcement related stimuli unchecked by fully matured response inhibition. Specifically, maturation of sub-cortical dopaminergic systems that terminate in the nucleus accumbens has been suggested to occur prior to the full maturation of corticopetal dopaminergic systems. However, converging evidence supports the hypothesis that many aspects of cognitive control are critically linked to cortical noradrenergic systems, that the effectiveness of drugs used to treat disorders of executive function, e.g. ADHD, may result primarily from increases in cortical norepinephrine (NE) and that cortical noradrenergic systems mature across adolescence. However, little attention has been given to the development of this system during adolescence or to its influence in executive function. In the present paper, we discuss the developmental trajectory of the noradrenergic system of the forebrain, highlight the interactions between noradrenergic and dopaminergic systems, and highlight the contribution of the immature corticopetal noradrenergic systems in the ontogeny of several aspects of executive function. Finally we compare data from adolescent rats to those gathered after selective depletion of NE in sub-regions of the prefrontal cortex with an emphasis on the similarities in performance of NE lesioned rats and adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. An examination of cross-cultural systems implementing evidence-based assessment and intervention approaches

    Directory of Open Access Journals (Sweden)

    Murray Laura K

    2006-01-01

    Full Text Available Implementation of evidence-based assessment and intervention approaches for youth with behavioral and/or emotional problems is rising to recognition worldwide. Feasibility research is critical to examine what characteristics of systems allow for success or barriers to the implementation of evidence-based practices into real-world settings, especially when working cross-culturally. This paper briefly reviews the experience of 4 international sites to understand how the overall structure and specific site variables directed the implementation of the World Health Organization and the World Psychiatry Association project. Discussion includes a thematic summary of the successes and challenges experienced by the sites, and future directions of feasibility studies.

  15. Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

    Science.gov (United States)

    Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

    2014-01-01

    In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

  16. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

    Science.gov (United States)

    Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

    2016-03-17

    There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity

  17. The Governance of Fair Trade System: Evidence from Small Honey Producers in Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Luciana Marques Vieira

    2009-10-01

    Full Text Available This paper discusses Fair Trade [FT] certification as a way to include small producers in global value chains, and identifies the main barriers for small honey producers from RS to meet these criteria. A new trading system such as FT has been providing access for food products coming from small farmers from developing countries. The method of this study integrates global value chain analysis and the methodology proposed by Paul (2005 to analyse FT as development projects. This study is three-fold: first to characterise the FT system; then to present the role of governance by third party certifiers such as FLO-CERT and finally to provide empirical evidence of the main difficulties that small producers have to comply with FT, such as export and organisation capacity. Our findings show that large retailers recently became big players in the FT system. The certification costs are high but can provide market access though there is a risk of overspecialisation.

  18. Experimental and theoretical evidence for fluctuation driven activations in an excitable chemical system

    Science.gov (United States)

    Hastings, Harold; Sobel, Sabrina; Field, Richard; Minchenberg, Scott; Spinelli, Nicole; Zauderer, Keith

    2011-03-01

    An excitable medium is a system in which small perturbations die out, but sufficiently large perturbations generate large ``excitations.'' Biological examples include neurons and the heart; the latter supports waves of excitation normally generated by the sinus node, but occasionally generated by other mechanisms. The ferroin-catalyzed Belousov-Zhabotinsky reaction is the prototype chemical excitable medium. We present experimental and theoretical evidence for that random fluctuations can generate excitations in the Belousov-Zhabothinsky reaction. Although the heart is significantly different, there are some scaling analogies. This material is based upon work supported by the Department of Energy under Award Number DE-FG02-08ER64623.

  19. Meteoritic Evidence for Injection of Trans-Neptunian Objects into the Inner Solar System

    Science.gov (United States)

    Zolensky, M.; Johnson, J.; Ziegler, K.; Chan, Q.; Kebukawa, Y.; Bottke, W.; Fries, M.; Martinez, J.; Le, L.

    2018-01-01

    There is excellent evidence that a dynamical instability in the early solar system led to gravitational interactions between the giant planets and trans-Neptunian planetesimals. Giant planetary migration triggered by the instability dispersed a disk of primordial trans-Neptunian object (TNOs) and created a number of small body reservoirs (e.g. the Kuiper Belt, scattered disk, irregular satellites, and the Jupiter/Neptune Trojan populations). It also injected numerous bodies into the main asteroid belt, where modeling shows they can successfully reproduce the observed P and D-type asteroid populations.

  20. 76 FR 27355 - Law Enforcement Vehicular Digital Multimedia Evidence Recording System Selection and Application...

    Science.gov (United States)

    2011-05-11

    ...In an effort to obtain comments from interested parties, the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice (NIJ) will make available, to the general public, the ``Law Enforcement Vehicular Digital Multimedia Evidence Recording System Selection and Application Guide.'' The opportunity to provide comments on these documents is open to industry technical representatives, law enforcement agencies and organizations, research, development and scientific communities, and all other stakeholders and interested parties. Those individuals wishing to obtain and provide comments on the draft documents under consideration are directed to the following Web site: http:// www.justnet.org.

  1. 75 FR 78269 - Vehicular Digital Multimedia Evidence Recording System (VDMERS) Standard for Law Enforcement

    Science.gov (United States)

    2010-12-15

    ...In an effort to obtain comments from interested parties, the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice (NIJ) will make available to the general public the draft ``Vehicular Digital Multimedia Evidence Recording System Standard for Law Enforcement.'' The opportunity to provide comments on this voluntary standard is open to industry technical representatives, law enforcement agencies and organizations, research, development and scientific communities, and all other stakeholders and interested parties. Those individuals wishing to obtain and provide comments on the draft standard under consideration are directed to the following Web site: http://www.justnet.org.

  2. Routine systemic antibiotic prophylaxis for burn injuries in developing countries: A best evidence topic (BET)

    Science.gov (United States)

    Stewart, Barclay T; Gyedu, Adam; Agbenorku, Pius; Amankwa, Richcane; Kushner, Adam L; Gibran, Nicole

    2015-01-01

    Background Burns are common in low- and middle-income countries (LMICs) and complicated by unhygienic conditions, malnutrition, use of high-risk homemade dressings and delayed presentation. Resultantly, use of routine systemic antibiotic prophylaxis (SAP) to prevent wound infection is common practice despite this intervention being abandoned in high-income countries due to increased antimicrobial resistance and non-bacterial suprainfection, Methods A best evidence topic (BET) was constructed using a structured protocol. The question addressed was: In LMICs, does routine use of SAP reduce burn wound infection, morbidity or mortality? Results From 704 retrieved records, 48 reports met criteria to be examined. Of those, 3 studies represented the best available evidence. Together, two randomized clinical trials (RCTs) and a retrospective cohort study reported no difference in the proportion of wound infection, any infection or length of hospital stay between SAP groups and controls. One RCT described a greater proportion of wounds infected with P. aeruginosa among SAP arms compared to controls. The studies had few participants and significant methodological weaknesses. Conclusion On the basis of limited, currently available evidence, the use of SAP cannot be recommended for patients in LMICs that present soon after burn injury. PMID:26260622

  3. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Hinkley Point 'C' power station public inquiry: proof of evidence on system considerations

    International Nuclear Information System (INIS)

    Eunson, E.M.

    1988-09-01

    A public inquiry has been set up to examine the planning application made by the Central Electricity Generating Board (CEGB) for the construction of a 1200 MW Pressurized Water Reactor power station at Hinkley Point (Hinkley Point ''C'') in the United Kingdom. This evidence to the Inquiry describes the CEGB system and the concepts of economy, security and quality of supply which underlie it. Attention is drawn to the present geographical imbalance between generation and demand on the CEGB system which leads to high power transfers at times of peak demand and for long periods at off-peak times. When there is a need to install new generating plant in the mid-1990s, system benefits can be achieved by siting plant in the South rather than in the North. The system benefits which would arise from the siting of a new PWR nuclear power station at Hinkley Point ''C'' rather than elsewhere are identified. The system benefits of other PWR sites and non-fossil options, such as a further link with France, interconnection with Iceland and the Severn Tidal Barrage, are reviewed. System benefits in terms of security and economics would accrue from locating a PWR station at Hinkley Point without the need for new transmission lines. (author)

  5. Sleep System Sensitization: Evidence for Changing Roles of Etiological Factors in Insomnia

    Science.gov (United States)

    Kalmbach, David A.; Pillai, Vivek; Arnedt, J. Todd; Anderson, Jason R.; Drake, Christopher L.

    2016-01-01

    Objectives To test for sensitization of the sleep system in response to insomnia development and major life stress. In addition, to evaluate the impact on depression and anxiety associated with sleep system sensitization. Methods A longitudinal study with three annual assessments. The community-based sample included 262 adults with no history of insomnia or depression who developed insomnia 1 year after baseline (67.6% female; 44.0±13.4y). Measures included the Ford Insomnia Response to Stress Test to assess sleep reactivity, Quick Inventory of Depressive Symptomatology, and Beck Anxiety Inventory. Insomnia classification was based on DSM-IV criteria. Sleep system sensitization was operationally defined as significant increases in sleep reactivity. Results Sensitization of the sleep system was observed from baseline to insomnia onset at 1-y follow-up among insomniacs with low premorbid vulnerability (pinsomnia remission (pinsomnia onset. The impact of sensitization on depression was stable at 2-y follow-up (p=.01). Conclusions Evidence supports sensitization of the sleep system as consequence of insomnia development and major life stress among individuals with low premorbid sleep reactivity. Sleep system sensitization may serve as a mechanism by which insomnia is perpetuated. Harmful effects of the sensitization process may increase risk for insomnia-related depression and anxiety. PMID:27448474

  6. Sleep system sensitization: evidence for changing roles of etiological factors in insomnia.

    Science.gov (United States)

    Kalmbach, David A; Pillai, Vivek; Arnedt, J Todd; Anderson, Jason R; Drake, Christopher L

    2016-05-01

    To test for sensitization of the sleep system in response to insomnia development and major life stress. In addition, to evaluate the impact on depression and anxiety associated with sleep system sensitization. A longitudinal study with three annual assessments. The community-based sample included 262 adults with no history of insomnia or depression who developed insomnia one year after baseline (67.6% female; 44.0 ± 13.4 yr). Measures included the Ford Insomnia Response to Stress Test to assess sleep reactivity, Quick Inventory of Depressive Symptomatology, and Beck Anxiety Inventory. Insomnia classification was based on DSM-IV criteria. Sleep system sensitization was operationally defined as significant increases in sleep reactivity. Sensitization of the sleep system was observed from baseline to insomnia onset at 1-yr follow-up among insomniacs with low premorbid vulnerability (p insomnia remission (p insomnia onset. The impact of sensitization on depression was stable at 2-yr follow-up (p = 0.01). Evidence supports sensitization of the sleep system as a consequence of insomnia development and major life stress among individuals with low premorbid sleep reactivity. Sleep system sensitization may serve as a mechanism by which insomnia is perpetuated. Harmful effects of the sensitization process may increase risk for insomnia-related depression and anxiety. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Evidence-based cross validation for acoustic power transmission for a novel treatment system.

    Science.gov (United States)

    Mihcin, Senay; Strehlow, Jan; Demedts, Daniel; Schwenke, Michael; Levy, Yoav; Melzer, Andreas

    2017-06-01

    The novel Trans-Fusimo Treatment System (TTS) is designed to control Magnetic Resonance guided Focused Ultrasound (MRgFUS) therapy to ablate liver tumours under respiratory motion. It is crucial to deliver the acoustic power within tolerance limits for effective liver tumour treatment via MRgFUS. Before application in a clinical setting, evidence of reproducibility and reliability is a must for safe practice. The TTS software delivers the acoustic power via ExAblate-2100 Conformal Bone System (CBS) transducer. A built-in quality assurance application was developed to measure the force values, using a novel protocol to measure the efficiency for the electrical power values of 100 and 150W for 6s of sonication. This procedure was repeated 30 times by two independent users against the clinically approved ExAblate-2100 CBS for cross-validation. Both systems proved to deliver the power within the accepted efficiency levels (70-90%). Two sample t-tests were used to assess the differences in force values between the ExAblate-2100 CBS and the TTS (p > 0.05). Bland-Altman plots were used to demonstrate the limits of agreement between the two systems falling within the 10% limits of agreement. Two sample t-tests indicated that TTS does not have user dependency (p > 0.05). The TTS software proved to deliver the acoustic power without exceeding the safety levels. Results provide evidence as a part of ISO13485 regulations for CE marking purposes. The developed methodology could be utilised as a part of quality assurance system in clinical settings; when the TTS is used in clinical practice.

  8. Attachment, self-esteem, worldviews, and terror management: evidence for a tripartite security system.

    Science.gov (United States)

    Hart, Joshua; Shaver, Phillip R; Goldenberg, Jamie L

    2005-06-01

    On the basis of prior work integrating attachment theory and terror management theory, the authors propose a model of a tripartite security system consisting of dynamically interrelated attachment, self-esteem, and worldview processes. Four studies are presented that, combined with existing evidence, support the prediction derived from the model that threats to one component of the security system result in compensatory defensive activation of other components. Further, the authors predicted and found that individual differences in attachment style moderate the defenses. In Studies 1 and 2, attachment threats motivated worldview defense among anxiously attached participants and motivated self-enhancement (especially among avoidant participants), effects similar to those caused by mortality salience. In Studies 3 and 4, a worldview threat and a self-esteem threat caused attachment-related proximity seeking among fearful participants and avoidance of proximity among dismissing participants. The authors' model provides an overarching framework within which to study attachment, self-esteem, and worldviews.

  9. Recognition and management of idiopathic systemic capillary leak syndrome: an evidence-based review.

    Science.gov (United States)

    Baloch, Noor Ul-Ain; Bikak, Marvi; Rehman, Abdul; Rahman, Omar

    2018-05-01

    Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.

  10. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.

    Science.gov (United States)

    Jeffcoat, Marjorie K; Jeffcoat, Robert L; Gladowski, Patricia A; Bramson, James B; Blum, Jerome J

    2014-08-01

    Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions. To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates. Statistically significant reductions in both outcomes (ppregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts. These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. UCLA, British astronomers discover wake of planet around nearby star. Strong evidence for solar system like ours

    CERN Multimedia

    2002-01-01

    "An international team of astronomers reports the first strong evidence for the existence of massive planets on wide orbits - like those of Saturn, Uranus and Neptune - around many stars. The new research provides some of the strongest evidence so far that solar systems similar to our own, or even larger, are likely to exist: (1 page).

  12. Cosmochemical evidence for astrophysical processes during the formation of our solar system.

    Science.gov (United States)

    MacPherson, Glenn J; Boss, Alan

    2011-11-29

    Through the laboratory study of ancient solar system materials such as meteorites and comet dust, we can recognize evidence for the same star-formation processes in our own solar system as those that we can observe now through telescopes in nearby star-forming regions. High temperature grains formed in the innermost region of the solar system ended up much farther out in the solar system, not only the asteroid belt but even in the comet accretion region, suggesting a huge and efficient process of mass transport. Bi-polar outflows, turbulent diffusion, and marginal gravitational instability are the likely mechanisms for this transport. The presence of short-lived radionuclides in the early solar system, especially (60)Fe, (26)Al, and (41)Ca, requires a nearby supernova shortly before our solar system was formed, suggesting that the Sun was formed in a massive star-forming region similar to Orion or Carina. Solar system formation may have been "triggered" by ionizing radiation originating from massive O and B stars at the center of an expanding HII bubble, one of which may have later provided the supernova source for the short-lived radionuclides. Alternatively, a supernova shock wave may have simultaneously triggered the collapse and injected the short-lived radionuclides. Because the Sun formed in a region where many other stars were forming more or less contemporaneously, the bi-polar outflows from all such stars enriched the local region in interstellar silicate and oxide dust. This may explain several observed anomalies in the meteorite record: a near absence of detectable (no extreme isotopic properties) presolar silicate grains and a dichotomy in the isotope record between (26)Al and nucleosynthetic (nonradiogenic) anomalies.

  13. Multimodal neuroimaging evidence linking memory and attention systems during visual search cued by context.

    Science.gov (United States)

    Kasper, Ryan W; Grafton, Scott T; Eckstein, Miguel P; Giesbrecht, Barry

    2015-03-01

    Visual search can be facilitated by the learning of spatial configurations that predict the location of a target among distractors. Neuropsychological and functional magnetic resonance imaging (fMRI) evidence implicates the medial temporal lobe (MTL) memory system in this contextual cueing effect, and electroencephalography (EEG) studies have identified the involvement of visual cortical regions related to attention. This work investigated two questions: (1) how memory and attention systems are related in contextual cueing; and (2) how these systems are involved in both short- and long-term contextual learning. In one session, EEG and fMRI data were acquired simultaneously in a contextual cueing task. In a second session conducted 1 week later, EEG data were recorded in isolation. The fMRI results revealed MTL contextual modulations that were correlated with short- and long-term behavioral context enhancements and attention-related effects measured with EEG. An fMRI-seeded EEG source analysis revealed that the MTL contributed the most variance to the variability in the attention enhancements measured with EEG. These results support the notion that memory and attention systems interact to facilitate search when spatial context is implicitly learned. © 2015 New York Academy of Sciences.

  14. Molecular evidence for ongoing complementarity and horizontal gene transfer in endosymbiotic systems of mealybugs

    Directory of Open Access Journals (Sweden)

    Sergio eLópez-Madrigal

    2014-08-01

    Full Text Available Intracellular bacterial supply of essential amino acids is common among sap-feeding insects, thus complementing the scarcity of nitrogenous compounds in plant phloem. This is also the role of the two mealybug endosymbiotic systems whose genomes have been sequenced. In the nested endosymbiotic system from Planococcus citri (Pseudococcinae, Candidatus Tremblaya princeps and Candidatus Moranella endobia cooperate to synthesize essential amino acids, while in Phenacoccus avenae (Phenacoccinae this function is performed by its single endosymbiont Candidatus Tremblaya phenacola. However, little is known regarding the evolution of essential amino acid supplementation strategies in other mealybug systems. To address this knowledge gap, we screened for the presence of six selected loci involved in essential amino acid biosynthesis in five additional mealybug species. We found evidence of ongoing complementarity among endosymbionts from insects of subfamily Pseudococcinae, as well as horizontal gene transfer affecting endosymbionts from insects of family Phenacoccinae, providing a more comprehensive picture of the evolutionary history of these endosymbiotic systems. Additionally, we report two diagnostic motifs to help identify invasive mealybug species.

  15. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa.

    Science.gov (United States)

    Byass, Peter; de Savigny, Don; Lopez, Alan D

    2014-01-01

    Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  16. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2014-05-01

    Full Text Available Background: Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. Proposals: We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. Conclusion: African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  17. Feature engineering and a proposed decision-support system for systematic reviewers of medical evidence.

    Directory of Open Access Journals (Sweden)

    Tanja Bekhuis

    Full Text Available Evidence-based medicine depends on the timely synthesis of research findings. An important source of synthesized evidence resides in systematic reviews. However, a bottleneck in review production involves dual screening of citations with titles and abstracts to find eligible studies. For this research, we tested the effect of various kinds of textual information (features on performance of a machine learning classifier. Based on our findings, we propose an automated system to reduce screeing burden, as well as offer quality assurance.We built a database of citations from 5 systematic reviews that varied with respect to domain, topic, and sponsor. Consensus judgments regarding eligibility were inferred from published reports. We extracted 5 feature sets from citations: alphabetic, alphanumeric(+, indexing, features mapped to concepts in systematic reviews, and topic models. To simulate a two-person team, we divided the data into random halves. We optimized the parameters of a Bayesian classifier, then trained and tested models on alternate data halves. Overall, we conducted 50 independent tests.All tests of summary performance (mean F3 surpassed the corresponding baseline, P<0.0001. The ranks for mean F3, precision, and classification error were statistically different across feature sets averaged over reviews; P-values for Friedman's test were .045, .002, and .002, respectively. Differences in ranks for mean recall were not statistically significant. Alphanumeric(+ features were associated with best performance; mean reduction in screening burden for this feature type ranged from 88% to 98% for the second pass through citations and from 38% to 48% overall.A computer-assisted, decision support system based on our methods could substantially reduce the burden of screening citations for systematic review teams and solo reviewers. Additionally, such a system could deliver quality assurance both by confirming concordant decisions and by naming

  18. Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care

    OpenAIRE

    Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

    2016-01-01

    Background Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy ? systems consultation ?intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy ? translation of a clinical practice guideline into a checklist-based im...

  19. Assessment and improvement of the Italian healthcare system: first evidence from a pilot national performance evaluation system.

    Science.gov (United States)

    Nuti, Sabina; Seghieri, Chiara; Vainieri, Milena; Zett, Silvia

    2012-01-01

    The Italian National Health System (NHS), established in 1978, follows a model similar to the Beveridge model developed by the British NHS (Beveridge 1942; Musgrove 2000). Like the British NHS, healthcare coverage for the Italian population is provided and financed by the government through taxes. Universal coverage provides uniform healthcare access to citizens and is the characteristic usually considered the added value of a welfare system financed by tax revenues. Nonetheless, in Italy the strong policy of decentralization, which has been taking place since the early 1990s, has gradually shifted powers from the state to the 21 Italian regions. Consequently, the state now retains limited supervisory control and continues to have overall responsibility for the NHS in order to ensure uniform and essential levels of health services across the country. In this context, it has become essential, both for the ministry and for regions, to adopt a common performance evaluation system (PES). This article reports the definition, implementation, and first evidences of a pilot PES at a national level. It shows how this PES can be viewed as a strategic tool supporting the Ministry of Health (MoH) in ensuring uniform levels of care for the population and assisting regional managers to evaluate performance in benchmarking. Finally, lessons for other health systems, based on the Italian experience, are provided.

  20. Mirror neuron system involvement in empathy: a critical look at the evidence.

    Science.gov (United States)

    Baird, Amee D; Scheffer, Ingrid E; Wilson, Sarah J

    2011-01-01

    It has been proposed that the human mirror neuron system (MNS) plays an integral role in mediating empathy. In this review, we critically examine evidence from three bodies of research that have been cited as supporting this notion: (1) behavioral studies that have examined the relationship between imitation and empathy, (2) findings from functional neuroimaging studies that report a positive correlation between MNS activation and self-report on an empathy questionnaire, and (3) observations of impaired imitation and empathy in autism spectrum disorders (ASD). In addition, we briefly review lesion studies of the neural correlates of imitation and empathy. Current evidence suggests that the MNS is broadly involved in empathy, but at this stage there has been limited consideration of its various forms, including motor, emotional, and cognitive empathy. There are also various forms of imitation, encompassing emotional and non-emotional, automatic, and voluntary actions. We propose that the relationship between imitation and empathy may vary depending on the specific type of each of these abilities. Furthermore, these abilities may be mediated by partially distinct neural networks, which involve the MNS to a variable degree.

  1. Firm Size, a Self-Organized Critical Phenomenon: Evidence from the Dynamical Systems Theory

    Science.gov (United States)

    Chandra, Akhilesh

    This research draws upon a recent innovation in the dynamical systems literature called the theory of self -organized criticality (SOC) (Bak, Tang, and Wiesenfeld 1988) to develop a computational model of a firm's size by relating its internal and the external sub-systems. As a holistic paradigm, the theory of SOC implies that a firm as a composite system of many degrees of freedom naturally evolves to a critical state in which a minor event starts a chain reaction that can affect either a part or the system as a whole. Thus, the global features of a firm cannot be understood by analyzing its individual parts separately. The causal framework builds upon a constant capital resource to support a volume of production at the existing level of efficiency. The critical size is defined as the production level at which the average product of a firm's factors of production attains its maximum value. The non -linearity is inferred by a change in the nature of relations at the border of criticality, between size and the two performance variables, viz., the operating efficiency and the financial efficiency. The effect of breaching the critical size is examined on the stock price reactions. Consistent with the theory of SOC, it is hypothesized that the temporal response of a firm breaching the level of critical size should behave as a flicker noise (1/f) process. The flicker noise is characterized by correlations extended over a wide range of time scales, indicating some sort of cooperative effect among a firm's degrees of freedom. It is further hypothesized that a firm's size evolves to a spatial structure with scale-invariant, self-similar (fractal) properties. The system is said to be self-organized inasmuch as it naturally evolves to the state of criticality without any detailed specifications of the initial conditions. In this respect, the critical state is an attractor of the firm's dynamics. Another set of hypotheses examines the relations between the size and the

  2. Evidence of tensor correlations in the nuclear many-body system using a modern NN potential

    International Nuclear Information System (INIS)

    Fiase, J.O.; Nkoma, J.S.; Sharmaand, L.K.; Hosaka, A.

    2003-01-01

    In this paper we show evidence of the importance of tensor correlations in the nuclear many-body system by calculating the effective two-body nuclear matrix elements in the frame work of the Lowest-Order Constrained Variational (LOCV) technique with two-body correlation functions using the Reid93 potential. We have achieved this by switching on and off the strength of the tensor correlations, α k . We have found that in order to obtain reasonable agreement with earlier calculations based on the G-matrix theory, we must turn on the strength of the tensor correlations especially in the triplet even (TE) and tensor even (TNE) channels to take the value of approximately, 0.05. As an application, we have estimated the value of the Landau - Migdal parameter, g' NN which we found to be g' NN = 0.65. This compares favorably with the G-matrix calculated value of g' NN = 0.54. (author)

  3. Evidence for two numerical systems that are similar in humans and guppies.

    Directory of Open Access Journals (Sweden)

    Christian Agrillo

    Full Text Available BACKGROUND: Humans and non-human animals share an approximate non-verbal system for representing and comparing numerosities that has no upper limit and for which accuracy is dependent on the numerical ratio. Current evidence indicates that the mechanism for keeping track of individual objects can also be used for numerical purposes; if so, its accuracy will be independent of numerical ratio, but its capacity is limited to the number of items that can be tracked, about four. There is, however, growing controversy as to whether two separate number systems are present in other vertebrate species. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we compared the ability of undergraduate students and guppies to discriminate the same numerical ratios, both within and beyond the small number range. In both students and fish the performance was ratio-independent for the numbers 1-4, while it steadily increased with numerical distance when larger numbers were presented. CONCLUSIONS/SIGNIFICANCE: Our results suggest that two distinct systems underlie quantity discrimination in both humans and fish, implying that the building blocks of uniquely human mathematical abilities may be evolutionarily ancient, dating back to before the divergence of bony fish and tetrapod lineages.

  4. The Dominance Behavioral System and Psychopathology: Evidence from Self-Report, Observational, and Biological Studies

    Science.gov (United States)

    Johnson, Sheri L.; Leedom, Liane J.; Muhtadie, Luma

    2012-01-01

    The dominance behavioral system (DBS) can be conceptualized as a biologically-based system which guides dominance motivation, dominant and subordinate behavior, and responsivity to perceptions of power and subordination. A growing body of research suggests that problems with the DBS are evident across a broad range of psychopathologies. We begin by describing psychological, social, and biological correlates of the dominance behavioral system (DBS). Extensive research suggests that externalizing disorders, mania-proneness, and narcissistic traits are related to heightened dominance motivation and behaviors. Mania and narcissistic traits also appear related to inflated self-perceptions of power. Anxiety and depression are related to subordination and submissiveness, as well as a desire to avoid subordination. Models of the DBS have received support from research with humans and animals; from self-report, observational, and biological methods; and using naturalistic and experimental paradigms. Limitations of available research include the relative lack of longitudinal studies using multiple measures of the DBS and the absence of relevant studies using diagnosed samples to study narcissistic personality disorder and bipolar disorder. We provide suggestions for future research on the DBS and psychopathology, including investigations of whether the DBS can be used to differentiate specific disorder outcomes; the need for more sophisticated biological research; and the value of longitudinal dynamical research. Implications of using the DBS as a tool in clinical assessment and treatment are discussed. PMID:22506751

  5. A MACROPRUDENTIAL SUPERVISION MODEL. EMPIRICAL EVIDENCE FROM THE CENTRAL AND EASTERN EUROPEAN BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Trenca Ioan

    2013-07-01

    Full Text Available One of the positive effects of the financial crises is the increasing concern of the supervisors regarding the financial system’s stability. There is a need to strengthen the links between different financial components of the financial system and the macroeconomic environment. Banking systems that have an adequate capitalization and liquidity level may face easier economic and financial shocks. The purpose of this empirical study is to identify the main determinants of the banking system’s stability and soundness in the Central and Eastern Europe countries. We asses the impact of different macroeconomic variables on the quality of capital and liquidity conditions and examine the behaviour of these financial stability indicators, by analyzing a sample of 10 banking systems during 2000-2011. The availability of banking capital signals the banking system’s resiliency to shocks. Capital adequacy ratio is the main indicator used to assess the banking fragility. One of the causes of the 2008-2009 financial crisis was the lack of liquidity in the banking system which led to the collapse of several banking institutions and macroeconomic imbalances. Given the importance of liquidity for the banking system, we propose several models in order to determine the macroeconomic variables that have a significant influence on the liquid reserves to total assets ratio. We found evidence that GDP growth, inflation, domestic credit to private sector, as well as the money and quasi money aggregate indicator have significant impact on the banking stability. The empirical regression confirms the high level of interdependence of the real sector with the financial-banking sector. Also, they prove the necessity for an effective macro prudential supervision at country level which enables the supervisory authorities to have an adequate control over the macro prudential indicators and to take appropriate decisions at the right time.

  6. Heavy Metal Exposure and Metabolic Syndrome: Evidence from Human and Model System Studies.

    Science.gov (United States)

    Planchart, Antonio; Green, Adrian; Hoyo, Cathrine; Mattingly, Carolyn J

    2018-03-01

    Metabolic syndrome (MS) describes the co-occurrence of conditions that increase one's risk for heart disease and other disorders such as diabetes and stroke. The worldwide increase in the prevalence of MS cannot be fully explained by lifestyle factors such as sedentary behavior and caloric intake alone. Environmental exposures, such as heavy metals, have been implicated, but results are conflicting and possible mechanisms remain unclear. To assess recent progress in determining a possible role between heavy metal exposure and MS, we reviewed epidemiological and model system data for cadmium (Cd), lead (Pb), and mercury (Hg) from the last decade. Data from 36 epidemiological studies involving 17 unique countries/regions and 13 studies leveraging model systems are included in this review. Epidemiological and model system studies support a possible association between heavy metal exposure and MS or comorbid conditions; however, results remain conflicting. Epidemiological studies were predominantly cross-sectional and collectively, they highlight a global interest in this question and reveal evidence of differential susceptibility by sex and age to heavy metal exposures. In vivo studies in rats and mice and in vitro cell-based assays provide insights into potential mechanisms of action relevant to MS including altered regulation of lipid and glucose homeostasis, adipogenesis, and oxidative stress. Heavy metal exposure may contribute to MS or comorbid conditions; however, available data are conflicting. Causal inference remains challenging as epidemiological data are largely cross-sectional; and variation in study design, including samples used for heavy metal measurements, age of subjects at which MS outcomes are measured; the scope and treatment of confounding factors; and the population demographics vary widely. Prospective studies, standardization or increased consistency across study designs and reporting, and consideration of molecular mechanisms informed by model

  7. Pathways towards chronic care-focused healthcare systems: evidence from Spain.

    Science.gov (United States)

    García-Goñi, Manuel; Hernández-Quevedo, Cristina; Nuño-Solinís, Roberto; Paolucci, Francesco

    2012-12-01

    Increasing healthcare expenditure is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation that include ageing, medical innovation, and changes in the burden of disease, such as the growing prevalence of chronic diseases. Most healthcare systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and therefore they are not suitably or efficiently organized to respond to the changing needs and preferences of users. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in several different countries showing their advantages but also the difficulties associated with their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies focused on testing the feasibility of moving towards chronic care models. In particular, we discuss a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based healthcare systems and apply it to the current Spanish National Health System (NHS). We find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts. We outline the policies that are being implemented and the pathway that the Spanish NHS is taking to address the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy being followed by the Spanish NHS will significantly transform its current healthcare delivery model in the next few years. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Picture Exchange Communication System (PECS) or Sign Language: An Evidence-Based Decision-Making Example

    Science.gov (United States)

    Spencer, Trina D.; Petersen, Douglas B.; Gillam, Sandra L.

    2008-01-01

    Evidence-based practice (EBP) refers to clinical decisions as a result of the careful integration of research evidence and student needs. Legal mandates such as No Child Left Behind require teachers to employ evidence-based practices in their classrooms, yet teachers receive little guidance regarding how to determine which practices are…

  9. Assessing risk factors in the organic control system: evidence from inspection data in Italy.

    Science.gov (United States)

    Zanoli, Raffaele; Gambelli, Danilo; Solfanelli, Francesco

    2014-12-01

    Certification is an essential feature in organic farming, and it is based on inspections to verify compliance with respect to European Council Regulation-EC Reg. No 834/2007. A risk-based approach to noncompliance that alerts the control bodies to activate planning inspections would contribute to a more efficient and cost-effective certification system. An analysis of factors that can affect the probability of noncompliance in organic farming has thus been developed. This article examines the application of zero-inflated count data models to farm-level panel data from inspection results and sanctions obtained from the Ethical and Environmental Certification Institute, one of the main control bodies in Italy. We tested many a priori hypotheses related to the risk of noncompliance. We find evidence of an important role for past noncompliant behavior in predicting future noncompliance, while farm size and the occurrence of livestock also have roles in an increased probability of noncompliance. We conclude the article proposing that an efficient risk-based inspection system should be designed, weighting up the known probability of occurrence of a given noncompliance according to the severity of its impact. © 2014 Society for Risk Analysis.

  10. Medicine Based Evidence for Individualized Decision Making: Case Study of Systemic Lupus Erythematosus.

    Science.gov (United States)

    Wivel, Ashley E; Lapane, Kate; Kleoudis, Christi; Singer, Burton H; Horwitz, Ralph I

    2017-11-01

    To guide management decisions for an index patient, evidence is required from comparisons between approximate matches to the profile of the index case, where some matches contain responses to treatment and others act as controls. We describe a method for constructing clinically relevant histories/profiles using data collected but unreported from 2 recent phase 3 randomized controlled trials assessing belimumab in subjects with clinically active and serologically positive systemic lupus erythematosus. Outcome was the Systemic lupus erythematosus Responder Index (SRI) measured at 52 weeks. Among 1175 subjects, we constructed an algorithm utilizing 11 trajectory variables including 4 biological, 2 clinical, and 5 social/behavioral. Across all biological and social/behavioral variables, the proportion of responders based on the SRI whose value indicated clinical worsening or no improvement ranged from 27.5% to 42.3%. Kappa values suggested poor agreement, indicating that each biological and patient-reported outcome provides different information than gleaned from the SRI. The richly detailed patient profiles needed to guide decision-making in clinical practice are sharply at odds with the limited information utilized in conventional randomized controlled trial analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Theory and evidence of economies of scale in the development of waste management systems

    International Nuclear Information System (INIS)

    Chang, Shoou-Yuh; Rivera, A.L.

    1989-01-01

    Waste is a cost of doing business. This cost can be considered in terms of the potential adverse health and environmental impacts, or the waste management costs associated with avoiding, minimizing, and controlling those impacts. There is an anticipated increase in the cost of waste management as a result of the increasing requirements for regulatory compliance. To meet the total waste management capacity needs of the organization and the compliance requirements, low-level radioactive, hazardous, and mixed waste management will need demonstrated technologies strategically managed as a technology portfolio. The role of the decision maker is to select the optimum mix of technologies and facilities to provide the waste management capacity needed for the next twenty years. The waste management system resulting from this mix includes multiple small-scale fixed facilities, large-scale centralized facilities, and waste management subcontracts. This study was conducted to examine the theory and evidence of economies of scale in the development of waste management systems as as exploratory research on the economic considerations in the process of technology selection and implementation. 25 refs., 24 figs., 11 tabs

  12. Spatializing Emotion: No Evidence for a Domain-General Magnitude System.

    Science.gov (United States)

    Pitt, Benjamin; Casasanto, Daniel

    2017-11-22

    People implicitly associate different emotions with different locations in left-right space. Which aspects of emotion do they spatialize, and why? Across many studies people spatialize emotional valence, mapping positive emotions onto their dominant side of space and negative emotions onto their non-dominant side, consistent with theories of metaphorical mental representation. Yet other results suggest a conflicting mapping of emotional intensity (a.k.a., emotional magnitude), according to which people associate more intense emotions with the right and less intense emotions with the left - regardless of their valence; this pattern has been interpreted as support for a domain-general system for representing magnitudes. To resolve the apparent contradiction between these mappings, we first tested whether people implicitly map either valence or intensity onto left-right space, depending on which dimension of emotion they attend to (Experiments 1a, b). When asked to judge emotional valence, participants showed the predicted valence mapping. However, when asked to judge emotional intensity, participants showed no systematic intensity mapping. We then tested an alternative explanation of findings previously interpreted as evidence for an intensity mapping (Experiments 2a, b). These results suggest that previous findings may reflect a left-right mapping of spatial magnitude (i.e., the size of a salient feature of the stimuli) rather than emotion. People implicitly spatialize emotional valence, but, at present, there is no clear evidence for an implicit lateral mapping of emotional intensity. These findings support metaphor theory and challenge the proposal that mental magnitudes are represented by a domain-general metric that extends to the domain of emotion. Copyright © 2017 Cognitive Science Society, Inc.

  13. Clinical team functioning and IT innovation: a study of the diffusion of a point-of-care online evidence system.

    Science.gov (United States)

    Gosling, A Sophie; Westbrook, Johanna I; Braithwaite, Jeffrey

    2003-01-01

    To investigate the association between clinical team functioning and diffusion (awareness, use, and impact) of a 24-hour online evidence retrieval system. To examine the relationships between clinical team characteristics and the adoption of the online evidence system. 18 clinical teams, consisting of 180 clinicians from three Australian hospitals, were identified and studied. Teams were categorized as small ( 15). Clinical team functioning was assessed using the Team Climate Inventory (TCI). Awareness, use, and impact of an online evidence retrieval system were measured using a self-administered questionnaire. The relationships between TCI scores and awareness, use, and impact were examined using t-tests and one-way ANOVAs. Chi square analyses were used to examine differences between small and large teams. RESULTS were interpreted within a diffusion of innovations framework. Clinical team functioning was not related to awareness or use of the online evidence retrieval system. However, clinical team functioning was significantly associated with the impact of online evidence in terms of reported experience of improved patient care following system use. Clinicians in small teams ( 15) teams. Team functioning had the greatest impact on the fourth stage of innovation diffusion, the effective use of online evidence for clinical care. This supports Rogers' diffusion of innovation theory, to the effect that different types of communication about an innovation are important at different stages in the diffusion process. Members of small teams were more aware of the system than members of large teams. Team functioning is amenable to improvement through interventions. The findings suggest that the role of team climate in the diffusion of information systems is a promising area for future research.

  14. Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

    Science.gov (United States)

    Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

    2017-05-01

    Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub

  15. Road traffic related mortality in Vietnam: Evidence for policy from a national sample mortality surveillance system

    Directory of Open Access Journals (Sweden)

    Ngo Anh D

    2012-07-01

    Full Text Available Abstract Background Road traffic injuries (RTIs are among the leading causes of mortality in Vietnam. However, mortality data collection systems in Vietnam in general and for RTIs in particular, remain inconsistent and incomplete. Underlying distributions of external causes and body injuries are not available from routine data collection systems or from studies till date. This paper presents characteristics, user type pattern, seasonal distribution, and causes of 1,061 deaths attributable to road crashes ascertained from a national sample mortality surveillance system in Vietnam over a two-year period (2008 and 2009. Methods A sample mortality surveillance system was designed for Vietnam, comprising 192 communes in 16 provinces, accounting for approximately 3% of the Vietnamese population. Deaths were identified from commune level data sources, and followed up by verbal autopsy (VA based ascertainment of cause of death. Age-standardised mortality rates from RTIs were computed. VA questionnaires were analysed in depth to derive descriptive characteristics of RTI deaths in the sample. Results The age-standardized mortality rates from RTIs were 33.5 and 8.5 per 100,000 for males and females respectively. Majority of deaths were males (79%. Seventy three percent of all deaths were aged from 15 to 49 years and 58% were motorcycle users. As high as 80% of deaths occurred on the day of injury, 42% occurred prior to arrival at hospital, and a further 29% occurred on-site. Direct causes of death were identified for 446 deaths (42% with head injuries being the most common cause attributable to road traffic injuries overall (79% and to motorcycle crashes in particular (78%. Conclusion The VA method can provide a useful data source to analyse RTI mortality. The observed considerable mortality from head injuries among motorcycle users highlights the need to evaluate current practice and effectiveness of motorcycle helmet use in Vietnam. The high number of

  16. Evaluation of the Performance of Routine Information System Management (PRISM framework: evidence from Uganda

    Directory of Open Access Journals (Sweden)

    Aqil Anwer

    2010-07-01

    Full Text Available Abstract Background Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS. In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a to assess the reliability and validity of the PRISM instruments and b to assess the validity of the PRISM conceptual framework. Methods Facility- and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework. Results Cronbach's alpha analysis suggests high reliability (0.7 or greater for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance

  17. Use of evidence-based assessments for childhood anxiety disorders within a regional medical system.

    Science.gov (United States)

    Sattler, Adam F; Ale, Chelsea M; Nguyen, Kristin; Gregg, Melissa S; Geske, Jennifer R; Whiteside, Stephen P H

    2016-11-01

    Anxiety disorders represent a common and serious threat to mental health in children and adolescents. To effectively treat anxiety in children, clinicians must conduct accurate assessment of patients' symptoms. However, despite the importance of assessment in the treatment of childhood anxiety disorders, the literature lacks a thorough analysis of the practices used by clinicians' when evaluating such disorders in community settings. Thus, the current study examines the quality of assessment for childhood anxiety disorders in a large regional health system. The results suggest that clinicians often provide non-specific diagnoses, infrequently document symptoms according to diagnostic criteria, and rarely administer rating scales and structured diagnostic interviews. Relatedly, diagnostic agreement across practice settings was low. Finally, the quality of assessment differed according to the setting in which the assessment was conducted and the complexity of the patient's symptomatology. These results highlight the need to develop and disseminate clinically feasible evidence-based assessment practices that can be implemented within resource-constrained service settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Decentralization of health care systems and health outcomes: Evidence from a natural experiment.

    Science.gov (United States)

    Jiménez-Rubio, Dolores; García-Gómez, Pilar

    2017-09-01

    While many countries worldwide are shifting responsibilities for their health systems to local levels of government, there is to date insufficient evidence about the potential impact of these policy reforms. We estimate the impact of decentralization of the health services on infant and neonatal mortality using a natural experiment: the devolution of health care decision making powers to Spanish regions. The devolution was implemented gradually and asymmetrically over a twenty-year period (1981-2002). The order in which the regions were decentralized was driven by political factors and hence can be considered exogenous to health outcomes. In addition, we exploit the dynamic effect of decentralization of health services and allow for heterogeneous effects by the two main types of decentralization implemented across regions: full decentralization (political and fiscal powers) versus political decentralization only. Our difference in differences results based on a panel dataset for the 50 Spanish provinces over the period 1980 to 2010 show that the lasting benefit of decentralization accrues only to regions which enjoy almost full fiscal and political powers and which are also among the richest regions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. EVIDENCE FOR AN ACCRETION ORIGIN FOR THE OUTER HALO GLOBULAR CLUSTER SYSTEM OF M31

    International Nuclear Information System (INIS)

    Mackey, A. D.; Huxor, A. P.; Ferguson, A. M. N.; Irwin, M. J.; Chapman, S. C.; Tanvir, N. R.; McConnachie, A. W.; Ibata, R. A.; Lewis, G. F.

    2010-01-01

    We use a sample of newly discovered globular clusters from the Pan-Andromeda Archaeological Survey (PAndAS) in combination with previously cataloged objects to map the spatial distribution of globular clusters in the M31 halo. At projected radii beyond ∼30 kpc, where large coherent stellar streams are readily distinguished in the field, there is a striking correlation between these features and the positions of the globular clusters. Adopting a simple Monte Carlo approach, we test the significance of this association by computing the probability that it could be due to the chance alignment of globular clusters smoothly distributed in the M31 halo. We find that the likelihood of this possibility is low, below 1%, and conclude that the observed spatial coincidence between globular clusters and multiple tidal debris streams in the outer halo of M31 reflects a genuine physical association. Our results imply that the majority of the remote globular cluster system of M31 has been assembled as a consequence of the accretion of cluster-bearing satellite galaxies. This constitutes the most direct evidence to date that the outer halo globular cluster populations in some galaxies are largely accreted.

  20. Use of Electronic Nicotine Delivery Systems Among Adolescents: Status of the Evidence and Public Health Recommendations.

    Science.gov (United States)

    Kamat, Aarti D; Van Dyke, Alison L

    2017-02-01

    Although the prevalence of tobacco smoking has been declining in recent years, the use of electronic nicotine delivery systems (ENDS) such as of electronic cigarettes, vaporizers, and hookahs has been steadily rising, especially among adolescents. ENDS are not only advertised to children, but their sale via the Internet has made them easily accessible to youth. In general, children perceive ENDS as safe, or at least safer than smoking traditional combustible tobacco products; however, exposure to nicotine may have deleterious effects on the developing brain. Concern also persists that ENDS may be a "starter" drug that may lead to further tobacco, drug, and/or alcohol use. In contrast to this precautionary stance that is associated with calls for legislative oversight of ENDS marketing and sales, harm reductionists claim that the risks posed by ENDS are minor in comparison with those of combustible tobacco products and that ENDS may be used as a means of nicotine replacement for smoking cessation, despite no concrete evidence to support this assertion. Many medical and health-related organizations have produced position statements concerning ENDS use, including among adolescents. This article summarizes the advantages and disadvantages of using ENDS espoused in these position statements, especially as they relate to use among adolescents. [Pediatr Ann. 2017;46(2):e69-e77.]. Copyright 2017, SLACK Incorporated.

  1. Evidence Report: Risk of Acute and Late Central Nervous System Effects from Radiation Exposure

    Science.gov (United States)

    Nelson, Gregory A.; Simonsen, Lisa; Huff, Janice L.

    2016-01-01

    Possible acute and late risks to the central nervous system (CNS) from galactic cosmic rays (GCR) and solar particle events (SPE) are concerns for human exploration of space. Acute CNS risks may include: altered cognitive function, reduced motor function, and behavioral changes, all of which may affect performance and human health. Late CNS risks may include neurological disorders such as Alzheimer's disease (AD), dementia and premature aging. Although detrimental CNS changes are observed in humans treated with high-dose radiation (e.g., gamma rays and 9 protons) for cancer and are supported by experimental evidence showing neurocognitive and behavioral effects in animal models, the significance of these results on the morbidity to astronauts has not been elucidated. There is a lack of human epidemiology data on which to base CNS risk estimates; therefore, risk projection based on scaling to human data, as done for cancer risk, is not possible for CNS risks. Research specific to the spaceflight environment using animal and cell models must be compiled to quantify the magnitude of CNS changes in order to estimate this risk and to establish validity of the current permissible exposure limits (PELs). In addition, the impact of radiation exposure in combination with individual sensitivity or other space flight factors, as well as assessment of the need for biological/pharmaceutical countermeasures, will be considered after further definition of CNS risk occurs.

  2. Preliminary evidence for a role of the adrenergic nervous system in generalized anxiety disorder.

    Science.gov (United States)

    Zhang, Xiaobin; Norton, Joanna; Carrière, Isabelle; Ritchie, Karen; Chaudieu, Isabelle; Ryan, Joanne; Ancelin, Marie-Laure

    2017-02-15

    Generalized anxiety disorder (GAD) is a common chronic condition that is understudied compared to other psychiatric disorders. An altered adrenergic function has been reported in GAD, however direct evidence for genetic susceptibility is missing. This study evaluated the associations of gene variants in adrenergic receptors (ADRs) with GAD, with the involvement of stressful events. Data were obtained from 844 French community-dwelling elderly aged 65 or over. Anxiety disorders were assessed using the Mini-International Neuropsychiatry Interview, according to DSM-IV criteria. Eight single-nucleotide polymorphisms (SNPs) involved with adrenergic function were genotyped; adrenergic receptors alpha(1A) (ADRA1A), alpha(2A) (ADRA2A), and beta2 (ADRB2) and transcription factor TCF7L2. Questionnaires evaluated recent stressful life events as well as early environment during childhood and adolescence. Using multivariate logistic regression analyses four SNPs were significantly associated with GAD. A 4-fold modified risk was found with ADRA1A rs17426222 and rs573514, and ADRB2 rs1042713 which remained significant after Bonferroni correction. Certain variants may moderate the effect of adverse life events on the risk of GAD. Replication in larger samples is needed due to the small case number. This is the first study showing that ADR variants are susceptibility factors for GAD, further highlighting the critical role of the adrenergic nervous system in this disorder.

  3. Polarimetric Evidence of the First White Dwarf Pulsar: The Binary System AR Scorpii

    Directory of Open Access Journals (Sweden)

    David A.H. Buckley

    2018-01-01

    Full Text Available The binary star AR Scorpii was recently discovered to exhibit high amplitude coherent variability across the electromagnetic spectrum (ultraviolet to radio at two closely spaced ∼2 min periods, attributed to the spin period of a white dwarf and the beat period. There is strong evidence (low X-ray luminosity, lack of flickering and absense of broad emission lines that AR Sco is a detached non-accreting system whose luminosity is dominated by the spin-down power of a white dwarf, due to magnetohydrodynamical (MHD interactions with its M5 companion. Optical polarimetry has revealed highly pulsed linear polarization on the same periods, reaching a maximum of 40%, consistent with a pulsar-like dipole, with the Stokes Q and U variations reminiscent of the Crab pulsar. These observations, coupled with the spectral energy distribution (SED which is dominated by non-thermal emission, characteristic of synchrotron emission, support the notion that a strongly magnetic (∼200 MG white dwarf is behaving like a pulsar, whose magnetic field interacts with the secondary star’s photosphere and magnetosphere. Radio synchrotron emission is produced from the pumping action of the white dwarf’s magnetic field on coronal loops from the M-star companion, while emission at high frequencies (UV/optical/X-ray comes from the particle wind, driven by large electric potential, again reminiscent of processes seen in neutron star pulsars.

  4. Human resource information systems in health care: a systematic evidence review.

    Science.gov (United States)

    Tursunbayeva, Aizhan; Bunduchi, Raluca; Franco, Massimo; Pagliari, Claudia

    2017-05-01

    This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies. There were no restrictions on language or publication year. Two reviewers screened publications, extracted data, and coded findings according to the innovation stages covered in the studies. The Critical Appraisal Skills Program checklist was adopted to assess study quality. The process of study selection was charted using a Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram. Of the 6824 publications identified by the search strategy, 68, covering 42 studies, were included for final analysis. Research on HRIS in health was interdisciplinary, often atheoretical, conducted primarily in the hospital sector of high-income economies, and largely focused uncritically on use and realized benefits. While studies of HRIS in health exist, the overall lack of evaluative research raises unanswered questions about their capacity to improve quality and efficiency and enable learning health systems, as well as how sociotechnical complexity influences implementation and effectiveness. We offer this analysis to decision makers and managers considering or currently implementing an HRIS, and make recommendations for further research. International Prospective Register of Systematic Reviews (PROSPERO): CRD42015023581. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023581#.VYu1BPl

  5. Credit Risk Determinants in the Vulnerable Economies of Europe: Evidence from the Spanish Banking System

    Directory of Open Access Journals (Sweden)

    Gila-Gourgoura, E.

    2017-03-01

    Full Text Available Purpose: The purpose of this paper is to investigate the determinants of non-performing loans in the Spanish banking system over the period 1997Q4–2015Q3. This timeframe includes not only the booming period for the Spanish economy but also an extended post-crises interval which is missing from other studies for Spain. Design/methodology/approach: Using quarterly data from the Central Bank of Spain and from the European Central Bank, the paper employs the ARDL approach to cointegration to identify the existence of a long or short-run relationship between NPLs and a set of macroeconomic, bank-related and country-specific indicators. Findings: Findings from the ARDL model indicate that macroeconomic, bank-specific variables and interest rates are important determinants of non-performing loans in the Spanish banking system. Specifically, the real GDP, the Spanish long-term government bond yield, the return on equity, the total credit granted by the Spanish banks and their capital to assets ratio, explain credit risk in Spain both in the short and the long run. Research limitations/implications: Data on the bank-specific variables are for the whole banking industry, and not for individual banks. If such data were available, a comparison of the credit risk determinants between small/ big banks, private/public or domestic/foreign could be possibly made. Originality/value: These findings provide useful evidence to bank managers and policymakers in dealing with loans' defaults in Spain and in undertaking crucial reforms to stabilize the economy.

  6. Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards

    Directory of Open Access Journals (Sweden)

    Valkenhoef Gert

    2012-09-01

    Full Text Available Abstract Background Decisions concerning drug safety and efficacy are generally based on pivotal evidence provided by clinical trials. Unfortunately, finding the relevant clinical trials is difficult and their results are only available in text-based reports. Systematic reviews aim to provide a comprehensive overview of the evidence in a specific area, but may not provide the data required for decision making. Methods We review and analyze the existing information systems and standards for aggregate level clinical trials information from the perspective of systematic review and evidence-based decision making. Results The technology currently used has major shortcomings, which cause deficiencies in the transfer, traceability and availability of clinical trials information. Specifically, data available to decision makers is insufficiently structured, and consequently the decisions cannot be properly traced back to the underlying evidence. Regulatory submission, trial publication, trial registration, and systematic review produce unstructured datasets that are insufficient for supporting evidence-based decision making. Conclusions The current situation is a hindrance to policy decision makers as it prevents fully transparent decision making and the development of more advanced decision support systems. Addressing the identified deficiencies would enable more efficient, informed, and transparent evidence-based medical decision making.

  7. Do you do Damon®? What is the current evidence base underlying the philosophy of this appliance system?

    Science.gov (United States)

    Wright, Natasha; Modarai, Faranak; Cobourne, Martyn T; Dibiase, Andrew T

    2011-09-01

    Self-ligating bracket systems are increasing in popularity amongst orthodontists. This reflects their high quality engineering, improved reliability and relative ease of use. However, it might also be related to claims of superior function made by the manufacturers of these appliances. In particular, the Damon(®) appliance system claims to offer significant advantages to both orthodontist and patient over conventional-ligation and other forms of self-ligated appliances. We have reviewed current literature relating to use of the Damon(®) appliance system. There is some evidence to suggest this appliance may lead to reductions in chairside time for the orthodontist, particularly those experienced with this system, in comparison to conventional-ligation. However, evidence that pain experience is reduced for the patient when using Damon(®) brackets is not conclusive. In the presence of identical archwire sequences, there is no evidence that Damon(®) brackets can align teeth faster or in a qualitatively differently manner, when compared with conventional-ligation. There is no high quality evidence that treatment with the Damon(®) appliance takes place more rapidly or leads to a superior occlusal or aesthetic result. Indeed, the best available evidence would suggest there is no difference in treatment outcome or time, at least in extraction cases. There is no evidence that treatment with the Damon(®) appliance is more stable. Claims relating to improved clinical performance of the Damon(®) appliance system are currently being made to orthodontists and patients that are not substantiated in the scientific literature.

  8. Computational and empirical simulations of selective memory impairments: Converging evidence for a single-system account of memory dissociations.

    Science.gov (United States)

    Curtis, Evan T; Jamieson, Randall K

    2018-04-01

    Current theory has divided memory into multiple systems, resulting in a fractionated account of human behaviour. By an alternative perspective, memory is a single system. However, debate over the details of different single-system theories has overshadowed the converging agreement among them, slowing the reunification of memory. Evidence in favour of dividing memory often takes the form of dissociations observed in amnesia, where amnesic patients are impaired on some memory tasks but not others. The dissociations are taken as evidence for separate explicit and implicit memory systems. We argue against this perspective. We simulate two key dissociations between classification and recognition in a computational model of memory, A Theory of Nonanalytic Association. We assume that amnesia reflects a quantitative difference in the quality of encoding. We also present empirical evidence that replicates the dissociations in healthy participants, simulating amnesic behaviour by reducing study time. In both analyses, we successfully reproduce the dissociations. We integrate our computational and empirical successes with the success of alternative models and manipulations and argue that our demonstrations, taken in concert with similar demonstrations with similar models, provide converging evidence for a more general set of single-system analyses that support the conclusion that a wide variety of memory phenomena can be explained by a unified and coherent set of principles.

  9. Floristic indicators of tropical landuse systems: Evidence from mining areas in Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Sehinde Akinbiola

    2016-07-01

    Full Text Available Most forests in the tropics have not only been reduced in size but have also experienced forest degradation. The delicate balance of the components of the forest ecosystem has been altered largely by the landuse systems which have resulted in the disappearance of some species and the introduction of new ones. In order to understand the influence of human disturbance caused by artisanal mining on plant biodiversity and the physical environment, this study assessed changes in vegetation characteristics using plant functional groups, such as invasive, pioneer and understory species. The study was conducted at two sites in two Southwestern states of Nigeria, Itagunmodi in Atakumosa West Local Government Area of Osun State and Olode in Oluyole Local Government Area of Oyo State. Complete enumerations of woody, non-woody and herbaceous plant species were carried out in 20 m by 20 m plots selected using stratified random sampling as representative of landuse classes: freshly mined (6 months and a control plot (secondary forest. The results showed that the control plot in Itagunmodi had undergone degradation as indicated by the presence of Alchornea laxiflora, Geophilia obvallata, Musa sapientum,Elaeis guineensis and Keetia hispida. However, if left undisturbed, it has the potential of regeneration back to its original state because of its woody tree species composition and lianas (Triclisia gilletii. In addition the forest soils in the mines had been exposed to direct insolation for a long period, and the soil structure and texture have been affected, consequently altering the viability of the seed bank. Poaceae and Papilionoideae were the most common in the freshly mined plots while invasive species were the most common in abandoned mined plots. In conclusion, the floristic composition in the mining sites has been altered and there was no clear evidence that regrowth would bring restoration of the lost ecosystem services.

  10. Multi-Sensor Building Fire Alarm System with Information Fusion Technology Based on D-S Evidence Theory

    Directory of Open Access Journals (Sweden)

    Qian Ding

    2014-10-01

    Full Text Available Multi-sensor and information fusion technology based on Dempster-Shafer evidence theory is applied in the system of a building fire alarm to realize early detecting and alarming. By using a multi-sensor to monitor the parameters of the fire process, such as light, smoke, temperature, gas and moisture, the range of fire monitoring in space and time is expanded compared with a single-sensor system. Then, the D-S evidence theory is applied to fuse the information from the multi-sensor with the specific fire model, and the fire alarm is more accurate and timely. The proposed method can avoid the failure of the monitoring data effectively, deal with the conflicting evidence from the multi-sensor robustly and improve the reliability of fire warning significantly.

  11. Striatal response to reward anticipation: evidence for a systems-level intermediate phenotype for schizophrenia.

    Science.gov (United States)

    Grimm, Oliver; Heinz, Andreas; Walter, Henrik; Kirsch, Peter; Erk, Susanne; Haddad, Leila; Plichta, Michael M; Romanczuk-Seiferth, Nina; Pöhland, Lydia; Mohnke, Sebastian; Mühleisen, Thomas W; Mattheisen, Manuel; Witt, Stephanie H; Schäfer, Axel; Cichon, Sven; Nöthen, Markus; Rietschel, Marcella; Tost, Heike; Meyer-Lindenberg, Andreas

    2014-05-01

    the NRG1 genotype (higher striatal responses in controls with the protective rs10503929 C allele; familywise error-corrected P reward anticipation in a directionality and localization consistent with prior patient findings. This provides evidence for a functional neural system mechanism related to familial risk. The phenotype can be assessed reliably, is independent of alterations in striatal structure, and is influenced by a schizophrenia candidate gene variant in NRG1. These data encourage us to further investigate the genetic and molecular contributions to this phenotype.

  12. Seismic Evidence for Conjugate Slip and Block Rotation Within the San Andreas Fault System, Southern California

    Science.gov (United States)

    Nicholson, Craig; Seeber, Leonardo; Williams, Patrick; Sykes, Lynn R.

    1986-08-01

    The pattern of seismicity in southern California indicates that much of the activity is presently occurring on secondary structures, several of which are oriented nearly orthogonal to the strikes of the major through-going faults. Slip along these secondary transverse features is predominantly left-lateral and is consistent with the reactivation of conjugate faults by the current regional stress field. Near the intersection of the San Jacinto and San Andreas faults, however, these active left-lateral faults appear to define a set of small crustal blocks, which in conjunction with both normal and reverse faulting earthquakes, suggests contemporary clockwise rotation as a result of regional right-lateral shear. Other left-lateral faults representing additional rotating block systems are identified in adjacent areas from geologic and seismologic data. Many of these structures predate the modern San Andreas system and may control the pattern of strain accumulation in southern California. Geodetic and paleomagnetic evidence confirm that block rotation by strike-slip faulting is nearly ubiquitous, particularly in areas where shear is distributed, and that it accommodates both short-term elastic and long-term nonelastic strain. A rotating block model accounts for a number of structural styles characteristic of strike-slip deformation in California, including: variable slip rates and alternating transtensional and transpressional features observed along strike of major wrench faults; domains of evenly-spaced antithetic faults that terminate against major fault boundaries; continued development of bends in faults with large lateral displacements; anomalous focal mechanisms; and differential uplift in areas otherwise expected to experience extension and subsidence. Since block rotation requires a detachment surface at depth to permit rotational movement, low-angle structures like detachments, of either local or regional extent, may be involved in the contemporary strike

  13. Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence.

    Science.gov (United States)

    Javadi, D; Feldhaus, I; Mancuso, A; Ghaffar, A

    2017-01-01

    This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

  14. Evidence-based Metrics Toolkit for Measuring Safety and Efficiency in Human-Automation Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — APRIL 2016 NOTE: Principal Investigator moved to Rice University in mid-2015. Project continues at Rice with the same title (Evidence-based Metrics Toolkit for...

  15. What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

    2013-08-06

    Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

  16. Apology in the criminal justice setting: evidence for including apology as an additional component in the legal system.

    Science.gov (United States)

    Petrucci, Carrie J

    2002-01-01

    The criminal justice system has reached unprecedented scope in the United States, with over 6.4 million people under some type of supervision. Remedies that have the potential to reduce this number are continually being sought. This article analyzes an innovative strategy currently being reconsidered in criminal justice: the apology. Despite a legal system that only sporadically acknowledges it, evidence for the use of apology is supported by social science research, current criminal justice theories, case law, and empirical studies. Social psychological, sociological and socio-legal studies pinpoint the elements and function of apology, what makes apologies effective, and concerns about apology if it were implemented in the criminal justice system. Theoretical evidence is examined (including restorative justice, therapeutic jurisprudence, crime, shame, and reintegration) to explore the process of apology in the criminal justice context. Attribution theory and social conduct theory are used to explain the apology process specifically for victims and offenders. A brief examination of case law reveals that though apology has no formal place in criminal law, it has surfaced recently under the federal sentencing guidelines. Finally, empirical evidence in criminal justice settings reveals that offenders want to apologize and victims desire an apology. Moreover, by directly addressing the harmful act, apology may be the link to reduced recidivism for offenders, as well as empowerment for victims. This evidence combined suggests that apology is worthy of further study as a potentially valuable addition to the criminal justice process. Copyright 2002 John Wiley & Sons, Ltd.

  17. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2006-11-18

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  18. [Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2007-01-01

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

  19. Exploring the dynamics of food-related policymaking processes and evidence use in Fiji using systems thinking.

    Science.gov (United States)

    Waqa, Gade; Moodie, Marj; Snowdon, Wendy; Latu, Catherine; Coriakula, Jeremaia; Allender, Steven; Bell, Colin

    2017-08-29

    Obesity and non-communicable diseases are significant public health issues globally and particularly in the Pacific. Poor diet is a major contributor to this issue and policy change is a powerful lever to improve food security and diet quality. This study aims to apply systems thinking to identify the causes and consequences of poor evidence use in food-related policymaking in selected government ministries in Fiji and to illicit strategies to strengthen the use of evidence in policymaking. The Ministry of Health and Medical Services and the Ministry of Agriculture in Fiji were invited through their respective Permanent Secretaries to participate in the study. Three 180-minute group model building (GMB) workshops were conducted separately in each ministry over three consecutive days with selected policymakers who were instrumental in developing food-related policies designed to prevent non-communicable diseases. The GMB workshops mapped the process of food-related policymaking and the contribution of scientific and local evidence to the process, and identified actions to enhance the use of evidence in policymaking. An average of 10 policymakers participated from each ministry. The causal loop diagrams produced by each ministry illustrated the causes and consequences of insufficient evidence use in developing food policies or precursors of the specific actions. These included (1) consultation, (2) engagement with stakeholders, (3) access and use of evidence, and (4) delays in policy processes. Participants agreed to potential leverage points on the themes above, addressing pertinent policymaker challenges in precursor control, including political influence, understanding of trade policies, competing government priorities and level of awareness on the problem. Specific actions for strengthening evidence use included training in policy development and research skills, and strengthening of coordination between ministries. The GMB workshops improved participants

  20. Bridging evidence, policy, and practice to strengthen health systems for improved maternal and newborn health in Pakistan.

    Science.gov (United States)

    Hirose, Atsumi; Hall, Sarah; Memon, Zahid; Hussein, Julia

    2015-11-25

    Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. Advocacy and research groups (i.e. those who would like to see research evidence used by policymakers) may use different approaches and tools to stimulate the diffusion of research findings. The use of mass- and social media, communication with study participants, and the involvement of stakeholders at the early stages of research development are examples of the approaches that can be employed to stimulate diffusion of evidence and increase evidence uptake. The Research and Advocacy Fund (RAF) for Maternal and Newborn Health (MNH) worked within the health system context in Pakistan with the aim of espousing the principles of evidence, advocacy, and dissemination to improve MNH outcomes. The articles included in this special issue are outputs of RAF and highlight where RAF's approaches contributed to MNH policy reforms. The papers discuss critical health system issues facing Pakistan, including service delivery components, demand creation, equitable access, transportation interventions for improved referrals, availability of medicines and equipment, and health workforce needs. In addition to these tangible elements, the health system 'software', i.e. the power and the political and social contexts, is also represented in the collection. These articles highlight three considerations for the future: the growing

  1. Fuzzy Decision-Making Fuser (FDMF for Integrating Human-Machine Autonomous (HMA Systems with Adaptive Evidence Sources

    Directory of Open Access Journals (Sweden)

    Yu-Ting Liu

    2017-06-01

    Full Text Available A brain-computer interface (BCI creates a direct communication pathway between the human brain and an external device or system. In contrast to patient-oriented BCIs, which are intended to restore inoperative or malfunctioning aspects of the nervous system, a growing number of BCI studies focus on designing auxiliary systems that are intended for everyday use. The goal of building these BCIs is to provide capabilities that augment existing intact physical and mental capabilities. However, a key challenge to BCI research is human variability; factors such as fatigue, inattention, and stress vary both across different individuals and for the same individual over time. If these issues are addressed, autonomous systems may provide additional benefits that enhance system performance and prevent problems introduced by individual human variability. This study proposes a human-machine autonomous (HMA system that simultaneously aggregates human and machine knowledge to recognize targets in a rapid serial visual presentation (RSVP task. The HMA focuses on integrating an RSVP BCI with computer vision techniques in an image-labeling domain. A fuzzy decision-making fuser (FDMF is then applied in the HMA system to provide a natural adaptive framework for evidence-based inference by incorporating an integrated summary of the available evidence (i.e., human and machine decisions and associated uncertainty. Consequently, the HMA system dynamically aggregates decisions involving uncertainties from both human and autonomous agents. The collaborative decisions made by an HMA system can achieve and maintain superior performance more efficiently than either the human or autonomous agents can achieve independently. The experimental results shown in this study suggest that the proposed HMA system with the FDMF can effectively fuse decisions from human brain activities and the computer vision techniques to improve overall performance on the RSVP recognition task. This

  2. Fuzzy Decision-Making Fuser (FDMF) for Integrating Human-Machine Autonomous (HMA) Systems with Adaptive Evidence Sources.

    Science.gov (United States)

    Liu, Yu-Ting; Pal, Nikhil R; Marathe, Amar R; Wang, Yu-Kai; Lin, Chin-Teng

    2017-01-01

    A brain-computer interface (BCI) creates a direct communication pathway between the human brain and an external device or system. In contrast to patient-oriented BCIs, which are intended to restore inoperative or malfunctioning aspects of the nervous system, a growing number of BCI studies focus on designing auxiliary systems that are intended for everyday use. The goal of building these BCIs is to provide capabilities that augment existing intact physical and mental capabilities. However, a key challenge to BCI research is human variability; factors such as fatigue, inattention, and stress vary both across different individuals and for the same individual over time. If these issues are addressed, autonomous systems may provide additional benefits that enhance system performance and prevent problems introduced by individual human variability. This study proposes a human-machine autonomous (HMA) system that simultaneously aggregates human and machine knowledge to recognize targets in a rapid serial visual presentation (RSVP) task. The HMA focuses on integrating an RSVP BCI with computer vision techniques in an image-labeling domain. A fuzzy decision-making fuser (FDMF) is then applied in the HMA system to provide a natural adaptive framework for evidence-based inference by incorporating an integrated summary of the available evidence (i.e., human and machine decisions) and associated uncertainty. Consequently, the HMA system dynamically aggregates decisions involving uncertainties from both human and autonomous agents. The collaborative decisions made by an HMA system can achieve and maintain superior performance more efficiently than either the human or autonomous agents can achieve independently. The experimental results shown in this study suggest that the proposed HMA system with the FDMF can effectively fuse decisions from human brain activities and the computer vision techniques to improve overall performance on the RSVP recognition task. This conclusion

  3. Evidence that deletion at FCGR3B is a risk factor for systemic sclerosis

    NARCIS (Netherlands)

    McKinney, C.; Broen, J.C.A.; Vonk, M.C.; Beretta, L.; Hesselstrand, R.; Hunzelmann, N.; Riemekasten, G.; Scorza, R.; Simeon, C.P.; Fonollosa, V.; Carreira, P.E.; Ortego-Centeno, N.; Gonzalez-Gay, M.A.; Airo, P.; Coenen, M.J.; Martin, J.; Radstake, T.R.D.J.; Merriman, T.R.

    2012-01-01

    There is increasing evidence that gene copy number (CN) variation influences clinical phenotype. The low-affinity Fc receptor 3B (FCGR3B) located in the FCGR gene cluster is a CN polymorphic gene involved in the recruitment of polymorphonuclear neutrophils to sites of inflammation and their

  4. Interactions between hare and brent goose in a salt marsh system : evidence for food competition?

    NARCIS (Netherlands)

    van der Wal, R; Kunst, P; Drent, R

    1998-01-01

    In this study we accumulate evidence that brown hare competes with brent goose for food resources in a temperate salt marsh. We show that both species overlap in habitat use and share food plants. The two herbivores mainly used the common habitat at different times of the day, with hares active in

  5. Physical, psychological, sexual, and systemic abuse of children with disabilities in East Africa: Mapping the evidence.

    Science.gov (United States)

    Winters, Niall; Langer, Laurenz; Geniets, Anne

    2017-01-01

    Children with disabilities (CWDs) are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don't know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE) were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of children with

  6. Physical, psychological, sexual, and systemic abuse of children with disabilities in East Africa: Mapping the evidence.

    Directory of Open Access Journals (Sweden)

    Niall Winters

    Full Text Available Children with disabilities (CWDs are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don't know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of

  7. A Novel Evaluation Model for Hybrid Power System Based on Vague Set and Dempster-Shafer Evidence Theory

    Directory of Open Access Journals (Sweden)

    Dongxiao Niu

    2012-01-01

    Full Text Available Because clean energy and traditional energy have different advantages and disadvantages, it is of great significance to evaluate comprehensive benefits for hybrid power systems. Based on thorough analysis of important characters on hybrid power systems, an index system including security, economic benefit, environmental benefit, and social benefit is established in this paper. Due to advantages of processing abundant uncertain and fuzzy information, vague set is used to determine the decision matrix. Convert vague decision matrix to real one by vague combination ruleand determine uncertain degrees of different indexes by grey incidence analysis, then the mass functions of different comment set in different indexes are obtained. Information can be fused in accordance with Dempster-Shafer (D-S combination rule and the evaluation result is got by vague set and D-S evidence theory. A simulation of hybrid power system including thermal power, wind power, and photovoltaic power in China is provided to demonstrate the effectiveness and potential of the proposed design scheme. It can be clearly seen that the uncertainties in decision making can be dramatically decreased compared with existing methods in the literature. The actual implementation results illustrate that the proposed index system and evaluation model based on vague set and D-S evidence theory are effective and practical to evaluate comprehensive benefit of hybrid power system.

  8. Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective

    OpenAIRE

    Beidas, Rinad S.; Kendall, Philip C.

    2010-01-01

    Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowled...

  9. Organic foods in Danish municipal school food systems – a multistakeholder analysis of available evidence on constraints and perspectives

    OpenAIRE

    Mikkelsen, Bent Egberg; Olsen, Tenna Doktor

    2009-01-01

    Previous studies have shown that organic supply and healthy eating initiatives in school food services share common features. Both types involves changes in supply, the collaboration of a number of different stakeholders and both include a physical food part as well as a non physical symbolic aspect. Studies have shown that introducing organic food in public food systems seems to affect the nutritional profile of the food service and anecdotal evidence suggest that organic supply forces food ...

  10. The Political Economy of Financial Systems: Evidence from Suffrage Reforms in the Last Two Centuries

    OpenAIRE

    Degryse, Hans; Lambert, Thomas; Schwienbacher, Armin

    2013-01-01

    Abstract: Initially, voting rights were limited to wealthy elites providing political support for stock markets. The franchise expansion induces the median voter to provide political support for banking development as this new electorate has lower financial holdings and benefits less from the uncertainty and financial returns from stock markets. Our panel data evidence covering 1830-1999 shows that tighter restrictions on the voting franchise induce a greater stock market development, whereas...

  11. Chitosan solutions as injectable systems for dermal filler applications: Rheological characterization and biological evidence.

    Science.gov (United States)

    Halimi, C; Montembault, A; Guerry, A; Delair, T; Viguier, E; Fulchiron, R; David, L

    2015-01-01

    A new generation of dermal filler for wrinkle filler based on chitosan was compared to current hyaluronic acid-based dermal fillers by using a new rheological performance criterion based on viscosity during injection related to Newtonian viscosity. In addition an in vivo evaluation was performed for preclinical evidence of chitosan use as dermal filler. In this way, biocompatibility and dermis reconstruction was evaluated on a pig model.

  12. Regulation of Aeroallergen Immunity by the Innate Immune System: Laboratory Evidence for a New Paradigm

    OpenAIRE

    Horner, Anthony A.

    2009-01-01

    Over the last decade, it has become increasingly clear that innate responses to microbes are mediated largely by toll-like receptors (TLRs), which recognize a diverse family of molecules produced by viruses, bacteria and fungi. This article will present evidence that TLRs also play a dominant role in innate responses to non-infectious immunostimulatory materials present in house dust extracts (HDEs) and the living environments they represent. However, our investigations challenge the commonly...

  13. Systemic Risk-Taking at Banks: Evidence from the Pricing of Syndicated Loans

    NARCIS (Netherlands)

    D. Gong (Di); W.B. Wagner (Wolf)

    2016-01-01

    textabstractPublic guarantees extended during systemic crises can affect the relative pricing of risks in the financial system. Studying the market for syndicated loans, we find that banks require lower compensation for aggregate risk than for idiosyncratic risk, consistent with systemic risk-taking

  14. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

    Science.gov (United States)

    Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

    2009-04-01

    Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

  15. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

    Science.gov (United States)

    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  16. Structural Disadvantage: Evidence of Gender Disparities in the Norwegian Pension System

    Directory of Open Access Journals (Sweden)

    Erika K. Palmer

    2017-02-01

    Full Text Available Norway is a world leader in gender equality according to sustainable development performance indicators. This study goes beyond these indicators to investigate systemic economic disadvantages for women, focusing specifically on the Norwegian pension system. System dynamics modeling is used to understand how gender disparity is built into social systems. A significant contributor to the gender inequality in pensions is the difference in lifetime working hours due to childbearing/rearing. There are childcare policies in place to equalize lifetime working hours between the genders; however, these policies require women to conform to the pension system structure and outsource their childcare. The system dynamics modeling illustrates how social investment strategy requires women to conform to a masculine pension system if they want equivalent financial security when they reach retirement.

  17. The influence of system quality characteristics on health care providers’ performance: Empirical evidence from Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd Idzwan Mohd Salleh

    2016-11-01

    Full Text Available Summary: Background: The Ministry of Health Malaysia initiated the total hospital information system (THIS as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Methods: Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Results and conclusions: Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider’s performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers’ performance was expected when the system usage fits with patients’ needs that eventually increased their productivity. Keywords: Electronic health records system, System quality characteristics, Care providers’ performance, Evaluation, Partial least squares-structural equation modeling

  18. INSTABILITY IN THE CEE BANKING SYSTEM. EVIDENCE FROM THE RECENT FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Renata Karkowska

    2013-12-01

    Full Text Available Sparked by the recent great recession and the role of financial markets, considerable interest exists among researchers within both the academic and public community in measuring and modeling systemic risk. This article introduces a new framework for measuring systemic risk by using a risk-adjusted balance sheet approach. In this regard, the analysis of 21 largest commercial banks operating in 7 countries from Central and Eastern Europe, shows potential risk which could threaten all the financial system. The paper concludes new directions for measuring systemic risk by using Merton model. It shows how risk management tools can be applied in new ways to measure and analyze systemic risk in European banking system.

  19. Competition, liquidity and stability: international evidence at the bank and systemic levels

    OpenAIRE

    Nguyen, Thi Ngoc My

    2017-01-01

    This thesis investigates the impact of market power on bank liquidity; the association between competition and systemic liquidity; and whether the associations between liquidity and stability at both bank- and systemic- levels are affected by competition. The first research question is explored in the context of 101 countries over 1996-2013 while the second and the third, which require listed banks, use a smaller sample of 32 nations during 2001-2013. The Panel Least Squares and the system Ge...

  20. Scientific evidence-based effects of hydrotherapy on various systems of the body

    OpenAIRE

    A Mooventhan; L Nivethitha

    2014-01-01

    The use of water for various treatments (hydrotherapy) is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack...

  1. Information-Theoretic Evidence for Predictive Coding in the Face-Processing System.

    Science.gov (United States)

    Brodski-Guerniero, Alla; Paasch, Georg-Friedrich; Wollstadt, Patricia; Özdemir, Ipek; Lizier, Joseph T; Wibral, Michael

    2017-08-23

    Predictive coding suggests that the brain infers the causes of its sensations by combining sensory evidence with internal predictions based on available prior knowledge. However, the neurophysiological correlates of (pre)activated prior knowledge serving these predictions are still unknown. Based on the idea that such preactivated prior knowledge must be maintained until needed, we measured the amount of maintained information in neural signals via the active information storage (AIS) measure. AIS was calculated on whole-brain beamformer-reconstructed source time courses from MEG recordings of 52 human subjects during the baseline of a Mooney face/house detection task. Preactivation of prior knowledge for faces showed as α-band-related and β-band-related AIS increases in content-specific areas; these AIS increases were behaviorally relevant in the brain's fusiform face area. Further, AIS allowed decoding of the cued category on a trial-by-trial basis. Our results support accounts indicating that activated prior knowledge and the corresponding predictions are signaled in low-frequency activity (information our eyes/retina and other sensory organs receive from the outside world, but strongly depends also on information already present in our brains, such as prior knowledge about specific situations or objects. A currently popular theory in neuroscience, predictive coding theory, suggests that this prior knowledge is used by the brain to form internal predictions about upcoming sensory information. However, neurophysiological evidence for this hypothesis is rare, mostly because this kind of evidence requires strong a priori assumptions about the specific predictions the brain makes and the brain areas involved. Using a novel, assumption-free approach, we find that face-related prior knowledge and the derived predictions are represented in low-frequency brain activity. Copyright © 2017 the authors 0270-6474/17/378273-11$15.00/0.

  2. The Galileo System of Measurement: Preliminary Evidence for Precision, Stability, and Equivalance to Traditional Measures

    Science.gov (United States)

    Gillham, James; Woelfel, Joseph

    1977-01-01

    Describes the Galileo system of measurement operations including reliability and validity data. Illustrations of some of the relations between Galileo measures and traditional procedures are provided. (MH)

  3. Evidence for a role of KISS-1/GPR54 system in decreased ...

    African Journals Online (AJOL)

    Short fasting has been shown to suppress luteinizing hormone (LH) secretion in ewes, however, the molecular mechanism underlying this phenomenon is not clear. Based on recent discovery of the crucial role of KiSS-1/GPR54 system in the central control of the GnRH axis, we hypothesized that KiSS-1/GPR54 system was ...

  4. Profitability of Western European banking systems: panel evidence on structural and cyclical determinants

    OpenAIRE

    Beckmann, Rainer

    2007-01-01

    This paper analyses structural and cyclical determinants of banking profitability in 16 Western European countries. We find that financial structure matters, particularly through the beneficial effect of the capital market orientation in the respective national financial system. Furthermore, higher diversification regarding banks' income sources shows a positive effect. The industry concentration of national banking systems, though, does not significantly affect aggregate profitability. Busin...

  5. Assessing the competitive conditions in the Italian banking system: some empirical evidence

    Directory of Open Access Journals (Sweden)

    P. COCCORESE

    1998-06-01

    Full Text Available The European banking industry is currently facing the effects arising from the increasing integration of national financial markets. In adapting to this new scenario, the Italian banking system has undergone a considerable transformation. The degree of competition in the Italian banking system is evaluated using a sample of banks during the period 1988-96.

  6. Assessing E-Learning System in Higher Education Institutes: Evidence from Structural Equation Modelling

    Science.gov (United States)

    Ali, Muhammad; Raza, Syed Ali; Qazi, Wasim; Puah, Chin-Hong

    2018-01-01

    Purpose: This study aims to examine university students' acceptance of e-learning systems in Pakistan. A Web-based learning system is a new form of utilizing technological features. Although, developed countries have initiated and established the concept for e-learning, developing countries require empirical support to implement e-learning.…

  7. Laparoscopic surgery for benign and malign diseases of the digestive system: indications, limitations, and evidence.

    Science.gov (United States)

    Küper, Markus Alexander; Eisner, Friederike; Königsrainer, Alfred; Glatzle, Jörg

    2014-05-07

    The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient's condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today's indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

  8. Regulation of aeroallergen immunity by the innate immune system: laboratory evidence for a new paradigm.

    Science.gov (United States)

    Horner, Anthony A

    2010-01-01

    Over the last decade, it has become increasingly clear that innate responses to microbes are mediated largely by toll-like receptors (TLRs), which recognize a diverse family of molecules produced by viruses, bacteria and fungi. This article will present evidence that TLRs also play a dominant role in innate responses to non-infectious immunostimulatory materials present in house dust extracts (HDEs) and the living environments they represent. However, our investigations challenge the commonly held view that microbial products in ambient air protect against the allergic march by promoting protective Th1 biased responses to inspired aeroallergens. Instead, all HDEs studied to date have preferentially promoted the development of Th2 biased airway hypersensitivities when used as adjuvants for intranasal (i.n.) vaccination. In contrast, daily low dose i.n. HDE delivery was found to promote the development of aeroallergen tolerance. This article will review these experimental findings as evidence to propose a new paradigm by which airborne TLR ligands and other stimulants of innate immunity may influence aeroallergen specific immunity and the genesis of allergic respiratory diseases.

  9. Early accretion of water and volatile elements to the inner Solar System: evidence from angrites.

    Science.gov (United States)

    Sarafian, Adam R; Hauri, Erik H; McCubbin, Francis M; Lapen, Thomas J; Berger, Eve L; Nielsen, Sune G; Marschall, Horst R; Gaetani, Glenn A; Righter, Kevin; Sarafian, Emily

    2017-05-28

    Inner Solar System bodies are depleted in volatile elements relative to chondrite meteorites, yet the source(s) and mechanism(s) of volatile-element depletion and/or enrichment are poorly constrained. The timing, mechanisms and quantities of volatile elements present in the early inner Solar System have vast implications for diverse processes, from planetary differentiation to the emergence of life. We report major, trace and volatile-element contents of a glass bead derived from the D'Orbigny angrite, the hydrogen isotopic composition of this glass bead and that of coexisting olivine and silicophosphates, and the 207 Pb- 206 Pb age of the silicophosphates, 4568 ± 20 Ma. We use volatile saturation models to demonstrate that the angrite parent body must have been a major body in the early inner Solar System. We further show via mixing calculations that all inner Solar System bodies accreted volatile elements with carbonaceous chondrite H and N isotope signatures extremely early in Solar System history. Only a small portion (if any) of comets and gaseous nebular H species contributed to the volatile content of the inner Solar System bodies.This article is part of the themed issue 'The origin, history and role of water in the evolution of the inner Solar System'. © 2017 The Author(s).

  10. Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles.

    Science.gov (United States)

    McLean, Sionnadh Mairi; Booth, Andrew; Gee, Melanie; Salway, Sarah; Cobb, Mark; Bhanbhro, Sadiq; Nancarrow, Susan A

    2016-01-01

    Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. "Reminder plus", which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service

  11. The Daily Liquidity Effect in a Floor System – Empirical Evidence from the Norwegian

    OpenAIRE

    Syrstad, Olav

    2013-01-01

    This paper analyses the liquidity effect in Norway by examining the relationship between a range of liquidity variables and five different measures of the short-term interbank premium. The models are estimated on data from January 2007 and up to the end of September 2011, a period in which Norges Bank implemented its liquidity policy within a so-called floor system, and prior to the new liquidity system introduced on 3 October 2011. In a floor system the key policy rate is equal to banks’ dep...

  12. The Daily Liquidity Effect in a Floor System – Empirical Evidence from the Norwegian Market

    OpenAIRE

    Syrstad, Olav

    2012-01-01

    This paper analyses the liquidity effect in Norway by examining the relationship between a range of liquidity variables and five different measures of the short-term interbank premium. The models are estimated on data from January 2007 and up to the end of September 2011, a period in which Norges Bank implemented its liquidity policy within a so-called floor system, and prior to the new liquidity system introduced on 3 October 2011. In a floor system the key policy rate is equal to banks' dep...

  13. Insulator–metal transition in a conservative system: An evidence for ...

    Indian Academy of Sciences (India)

    substrate, suggest that the mobility coalescence is responsible for the aging in island metal films. ... esting transition observed in a conservative system – after the stoppage of ... Oxidation of islands model and mobility coalescence model.

  14. A Case for Tamper-Resistant and Tamper-Evident Computer Systems

    National Research Council Canada - National Science Library

    Solihin, Yan

    2007-01-01

    .... These attacks attempt to snoop or modify data transfer between various chips in a computer system such as between the processor and memory, and between processors in a multiprocessor interconnect network...

  15. Collaborating to embrace evidence-informed management practices within Canada's health system.

    Science.gov (United States)

    Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

    2007-01-01

    In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

  16. Inductive reasoning and implicit memory: evidence from intact and impaired memory systems.

    Science.gov (United States)

    Girelli, Luisa; Semenza, Carlo; Delazer, Margarete

    2004-01-01

    In this study, we modified a classic problem solving task, number series completion, in order to explore the contribution of implicit memory to inductive reasoning. Participants were required to complete number series sharing the same underlying algorithm (e.g., +2), differing in both constituent elements (e.g., 2468 versus 57911) and correct answers (e.g., 10 versus 13). In Experiment 1, reliable priming effects emerged, whether primes and targets were separated by four or ten fillers. Experiment 2 provided direct evidence that the observed facilitation arises at central stages of problem solving, namely the identification of the algorithm and its subsequent extrapolation. The observation of analogous priming effects in a severely amnesic patient strongly supports the hypothesis that the facilitation in number series completion was largely determined by implicit memory processes. These findings demonstrate that the influence of implicit processes extends to higher level cognitive domain such as induction reasoning.

  17. Management Control Systems and Strategy: A Resource based Perspective. Evidence from Greece

    OpenAIRE

    Nikolaos Theriou; Dimitrios Maditinos; Georgios N. Theriou

    2017-01-01

    Purpose: The purpose of this paper is to empirically examine from the resource-based perspective, the relationship between the use of management control systems (MCS) and organisational capabilities in the Greek context. Design/Methodology/Approach: The study follows Henri's (2006) methodology and explores the relationships between the diagnostic and interactive uses of performance measurement systems (PMS) and the five capabilities (e.g. market orientation, organisational learning, entrep...

  18. Motivators, Barriers and Concerns in Adoption of Electronic Filing System: Survey Evidence from Malaysian Professional Accountants

    OpenAIRE

    Ming-Ling Lai; Kwai-Fatt Choong

    2010-01-01

    Problem statement: Worldwide, electronic filing (e-filing) system and its' adoption has attracted much attention, however, scholarly study on accounting professionals' acceptance of e-filing system is scant. Approach: This study aimed (i) to examine factors that motivated professional accountants to use e-filing (ii) to solicit their usage experience and (iii) to assess the barriers to adoption and other compliance considerations. The questionnaire survey was administered on 700 professionals...

  19. [Endocrine disruptors : Evidence from epidemiological studies necessitates a critical review of model systems].

    Science.gov (United States)

    Hoffmann, M; Gebauer, S; Nüchter, M; Baber, R; Ried, J; von Bergen, M; Kiess, W

    2017-06-01

    Endocrine disruptive chemicals (EDCs) cause adverse health effects through interaction with endocrine systems. They are classified by chemical structure, effects on specific endocrine systems, bioaccumulation, persistence in the environment, or clinically observable effects. For research of the complex mechanisms of action in the human body, only in vitro model systems have so far been available, that have insufficient high-throughput capacity, which makes risk evaluation more difficult. In addition, in industrial nations, living people are often exposed to mixtures of substances, with various effects. The clinical importance of epigenetic changes caused by the action of EDCs during vulnerable phases of development is currently unclear. Epidemiological studies are criticized because reproducibility is not always guaranteed. Nevertheless, they remain the method of choice for the development and analysis of suitable model systems. Positive associations, in spite of sometimes conflicting results, are key in the selection of factors that can then be analysed in model systems in an unbiased way. This article depicts the mainly positive epidemiological findings for EDC-caused effects in the fields of growth and metabolism, neurocognitive development and sexual development and reproduction. As a result, there is a need for closer linkage between epidemiological studies and mechanistic research into model systems, especially focusing on the interaction of different EDCs and the consequences of prenatal and early life exposure.

  20. Dual Systems for Spatial Updating in Immediate and Retrieved Environments: Evidence from Bias Analysis.

    Science.gov (United States)

    Liu, Chuanjun; Xiao, Chengli

    2018-01-01

    The spatial updating and memory systems are employed during updating in both the immediate and retrieved environments. However, these dual systems seem to work differently, as the difference of pointing latency and absolute error between the two systems vary across environments. To verify this issue, the present study employed the bias analysis of signed errors based on the hypothesis that the transformed representation will bias toward the original one. Participants learned a spatial layout and then either stayed in the learning location or were transferred to a neighboring room directly or after being disoriented. After that, they performed spatial judgments from perspectives aligned with the learning direction, aligned with the direction they faced during the test, or a novel direction misaligned with the two above-mentioned directions. The patterns of signed error bias were consistent across environments. Responses for memory aligned perspectives were unbiased, whereas responses for sensorimotor aligned perspectives were biased away from the memory aligned perspective, and responses for misaligned perspectives were biased toward sensorimotor aligned perspectives. These findings indicate that the spatial updating system is consistently independent of the spatial memory system regardless of the environments, but the updating system becomes less accessible as the environment changes from immediate to a retrieved one.

  1. Dual Systems for Spatial Updating in Immediate and Retrieved Environments: Evidence from Bias Analysis

    Directory of Open Access Journals (Sweden)

    Chuanjun Liu

    2018-02-01

    Full Text Available The spatial updating and memory systems are employed during updating in both the immediate and retrieved environments. However, these dual systems seem to work differently, as the difference of pointing latency and absolute error between the two systems vary across environments. To verify this issue, the present study employed the bias analysis of signed errors based on the hypothesis that the transformed representation will bias toward the original one. Participants learned a spatial layout and then either stayed in the learning location or were transferred to a neighboring room directly or after being disoriented. After that, they performed spatial judgments from perspectives aligned with the learning direction, aligned with the direction they faced during the test, or a novel direction misaligned with the two above-mentioned directions. The patterns of signed error bias were consistent across environments. Responses for memory aligned perspectives were unbiased, whereas responses for sensorimotor aligned perspectives were biased away from the memory aligned perspective, and responses for misaligned perspectives were biased toward sensorimotor aligned perspectives. These findings indicate that the spatial updating system is consistently independent of the spatial memory system regardless of the environments, but the updating system becomes less accessible as the environment changes from immediate to a retrieved one.

  2. What is the existing evidence supporting the efficacy of compression bandage systems containing both elastic and inelastic components (mixed-component systems)? A systematic review.

    Science.gov (United States)

    Welsh, Lynn

    2017-05-01

    To analyse current evidence on the efficacy of bandage systems containing both elastic and inelastic components (mixed-component systems). International consensus on the efficacy of types of compression systems is difficult to achieve; however, mixed-component systems are being promoted as combining the best properties of both elastic and inelastic bandage systems and increasingly being used to treat venous leg ulcers in practice. A systematic literature review. Search terms such as venous leg ulcer, varicose ulcer, leg ulcer, compression, bandage, elastic, inelastic, short stretch, healing rate, interface pressure, mixed component, two-layer, four-layer and multi-layer were used in database and hand searches in several combinations. Limits were set for years 2005-March 2015 and English-language publications. A total of 475 studies were identified at initial search, and following elimination from abstract and title, this was reduced to 7. A further study was identified on Google Scholar, bringing the final number of studies fitting inclusion criteria to 8. The following subgroups relating to outcomes of efficacy were identified: ulcer healing, maintenance of interface pressure, slippage, ease of application and patient quality of life. Mixed-component systems were found to have comparable ulcer healing rates to alternative compression systems and be easy to apply; have similar abilities to maintain pressure as four-layer bandages and better abilities than short-stretch bandages; have less slippage than alternative systems; and to be significantly associated with several favourable quality of life outcomes. Clinician skill in bandage application was an uncontrolled variable in all eight papers included in the review, which may limit reliability of findings. This review synthesises existing evidence on the efficacy of mixed-component systems and encourages clinicians to regard them as an effective alternative to purely elastic or inelastic compression systems

  3. Evidence of a tectonic transient within the Idrija fault system in Western Slovenia

    Science.gov (United States)

    Vičič, Blaž; Costa, Giovanni; Aoudia, Abdelkrim

    2017-04-01

    Western Slovenia and North-eastern Italy are areas of medium rate seismicity with rare historic earthquakes of higher magnitudes. From mainly reverse component faulting in north-western part of the region where 1976 Friuli earthquakes took place, tectonic regime changes to mostly strike-slip faulting in the Dinaric region, continuing towards southeast. In the northern part of the Idrija fault system, which represent the broader Dinaric strike-slip system there were two strong earthquakes in the recent times - Mw=5.6 1998 and Mw=5.2 2004 earthquakes. Further to the south, along the Idrija fault system, Idrija fault is the causative fault of 1511 Mw=6.8 earthquake. The southeastern most part of the Idrija fault system produced a Mw=5.2 earthquake in 1926 and few historic Mw>4 earthquakes. Since 2004 Mw=5.2 earthquake, no stronger earthquakes were recorded in the region covered by dense seismic network. Seismicity is mostly concentrated in Friuli region and north-western part of Idrija fault system - mostly on the Ravne fault which is the causative fault for the 1998 and 2004 earthquakes. In the central part of the fault system no strong or moderate earthquakes were recorded, except of an earthquake along the Idrija fault in 2014 of magnitude 3.4. Low magnitude background seismicity is burst like with no apparent temporal or spatial distribution. Seismicity of the southern part of Idrija fault system is again a bit higher than in the central part of the fault system with earthquakes up to Mw=4.4 that happened in 2014. In this study, detailed analysis of the seismicity is performed with manual relocation of the seismicity in the period between 2006 and 2016. With manual inspection of the waveform data, slight temporal clustering of seismicity is observed. We use a template algorithm method to increase the detection rate of the seismicity. Templates of seismicity in the north-western and south-eastern part of Idrija fault system are created. The continuous waveform data

  4. The Multiple-Demand System in the Novelty of Musical Improvisation: Evidence from an MRI Study on Composers.

    Science.gov (United States)

    Lu, Jing; Yang, Hua; He, Hui; Jeon, Seun; Hou, Changyue; Evans, Alan C; Yao, Dezhong

    2017-01-01

    The multiple-demand (MD) system has proven to be associated with creating structured mental programs in comprehensive behaviors, but the functional mechanisms of this system have not been clarified in the musical domain. In this study, we explored the hypothesis that the MD system is involved in a comprehensive music-related behavior known as musical improvisation. Under a functional magnetic resonance imaging (fMRI) paradigm, 29 composers were recruited to improvise melodies through visual imagery tasks according to familiar and unfamiliar cues. We found that the main regions of the MD system were significantly activated during both musical improvisation conditions. However, only a greater involvement of the intraparietal sulcus (IPS) within the MD system was shown when improvising with unfamiliar cues. Our results revealed that the MD system strongly participated in musical improvisation through processing the novelty of melodies, working memory, and attention. In particular, improvising with unfamiliar cues required more musical transposition manipulations. Moreover, both functional and structural analyses indicated evidence of neuroplasticity in MD regions that could be associated with musical improvisation training. These findings can help unveil the functional mechanisms of the MD system in musical cognition, as well as improve our understanding of musical improvisation.

  5. Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

    Science.gov (United States)

    Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

    2016-01-27

    Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare

  6. Evidence for an ABC-Type Riboflavin Transporter System in Pathogenic Spirochetes

    Science.gov (United States)

    Deka, Ranjit K.; Brautigam, Chad A.; Biddy, Brent A.; Liu, Wei Z.; Norgard, Michael V.

    2013-01-01

    ABSTRACT Bacterial transporter proteins are involved in the translocation of many essential nutrients and metabolites. However, many of these key bacterial transport systems remain to be identified, including those involved in the transport of riboflavin (vitamin B2). Pathogenic spirochetes lack riboflavin biosynthetic pathways, implying reliance on obtaining riboflavin from their hosts. Using structural and functional characterizations of possible ligand-binding components, we have identified an ABC-type riboflavin transport system within pathogenic spirochetes. The putative lipoprotein ligand-binding components of these systems from three different spirochetes were cloned, hyperexpressed in Escherichia coli, and purified to homogeneity. Solutions of all three of the purified recombinant proteins were bright yellow. UV-visible spectra demonstrated that these proteins were likely flavoproteins; electrospray ionization mass spectrometry and thin-layer chromatography confirmed that they contained riboflavin. A 1.3-Å crystal structure of the protein (TP0298) encoded by Treponema pallidum, the syphilis spirochete, demonstrated that the protein’s fold is similar to the ligand-binding components of ABC-type transporters. The structure also revealed other salient details of the riboflavin binding site. Comparative bioinformatics analyses of spirochetal genomes, coupled with experimental validation, facilitated the discovery of this new ABC-type riboflavin transport system(s). We denote the ligand-binding component as riboflavin uptake transporter A (RfuA). Taken together, it appears that pathogenic spirochetes have evolved an ABC-type transport system (RfuABCD) for survival in their host environments, particularly that of the human host. PMID:23404400

  7. Evolution of the Campanian Ignimbrite Magmatic System II: Trace Element and Th Isotopic Evidence for Open-System Processes

    Science.gov (United States)

    Bohrson, W. A.; Spera, F. J.; Fowler, S.; Belkin, H.; de Vivo, B.

    2005-12-01

    The Campanian Ignimbrite, a large volume (~200 km3 DRE) trachytic to phonolitic ignimbrite was deposited at ~39.3 ka and represents the largest of a number of highly explosive volcanic events in the region near Naples, Italy. Thermodynamic modeling of the major element evolution using the MELTS algorithm (see companion contribution by Fowler et al.) provides detailed information about the identity of and changes in proportions of solids along the liquid line of descent during isobaric fractional crystallization. We have derived trace element mass balance equations that explicitly accommodate changing mineral-melt bulk distribution coefficients during crystallization and also simultaneously satisfy energy and major element mass conservation. Although major element patterns are reasonably modeled assuming closed system fractional crystallization, modeling of trace elements that represent a range of behaviors (e.g. Zr, Nb, Th, U, Rb, Sm, Sr) yields trends for closed system fractionation that are distinct from those observed. These results suggest open-system processes were also important in the evolution of the Campanian magmatic system. Th isotope data yield an apparent isochron that is ~20 kyr younger than the age of the deposit, and age-corrected Th isotope data indicate that the magma body was an open-system at the time of eruption. Because open-system processes can profoundly change isotopic characteristics of a magma body, these results illustrate that it is critical to understand the contribution that open-system processes make to silicic magma bodies prior to assigning relevance to age or timescale information derived from isotope systematics. Fluid-magma interaction has been proposed as a mechanism to change isotopic and elemental characteristics of magma bodies, but an evaluation of the mass and thermal constraints on such a process suggest large-scale fluid-melt interaction at liquidus temperatures is unlikely. In the case of the magma body associated with

  8. Impact of Basel Accord on Banking System(Evidence from Islamic Banks of Pakistan)

    OpenAIRE

    Muhammad Mehtab Azeem; Akin Marsap; Cigdem Ozari

    2015-01-01

    Banks and bank regulatory authorities are vital players for the stability of economy and financial system in potential way. Basel III and its related to capital¡¯s requirement obligations have been effective useful tool for the banking system. Since, this is tough job for the bankers to maintain the liquidity for hedging the future risk but it also been expensive for bankers to keep the extra capital and become more liquid since this discourage the provision of loans but promote the credit ra...

  9. Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes).

    Science.gov (United States)

    Farsalinos, Konstantinos E; Le Houezec, Jacques

    2015-01-01

    Tobacco smoking is the largest single preventable cause of many chronic diseases and death. Effective treatments exist; however, few smokers use them and most try to quit by themselves. Most of the tobacco cigarette's toxicity is related to the combustion process. Models of harm reduction applied to tobacco suggest that switching from inhalation of combustible products to a noncombustible nicotine delivery product would likely result in a vast reduction in tobacco-related death and illness. Currently available evidence raises no doubt that electronic cigarettes (e-cigs) are by far less harmful than smoking (although probably not absolutely safe) and have the potential to be the most effective tobacco harm reduction products due to their unique property of resembling smoking and providing satisfaction to the user. A lot of controversy is surrounding e-cigs and their regulation, much of which is based on the precautionary principle. Although monitoring and further research is definitely needed, the arguments used to implement severe restrictions or bans are mostly hypothetical, weakly supported by evidence, and, in some cases, derived from mispresentation or misinterpretation of the study findings. Regulators should keep in mind that the target population is smokers who want to reduce or quit their deadly tobacco consumption. To achieve this goal, smokers should be honestly informed on the relative harmfulness of the different products. E-cigs are not tobacco products and are not used as medications. For this reason, a specific regulatory scheme is needed, separate from tobacco or medicinal products regulation. Regulation should implement specific quality criteria for products, rules for the exclusion of chemicals of reasonable concern, and appropriate testing for possible contaminants. Additionally, manufacturing standards derived from the food industry should be implemented and adjusted for specific conditions related to e-cigs. Finding the appropriate balance

  10. New Evidence for Quaternary Strain Partitioning Along the Queen Charlotte Fault System, Southeastern Alaska

    Science.gov (United States)

    Walton, M. A. L.; Miller, N. C.; Brothers, D. S.; Kluesner, J.; Haeussler, P. J.; Conrad, J. E.; Andrews, B. D.; Ten Brink, U. S.

    2017-12-01

    The Queen Charlotte Fault (QCF) is a fast-moving ( 53 mm/yr) transform plate boundary fault separating the Pacific Plate from the North American Plate along western Canada and southeastern Alaska. New high-resolution bathymetric data along the fault show that the QCF main trace accommodates nearly all strike-slip plate motion along a single narrow deformation zone, though questions remain about how and where smaller amounts of oblique convergence are accommodated along-strike. Obliquity and convergence rates are highest in the south, where the 2012 Haida Gwaii, British Columbia MW 7.8 thrust earthquake was likely caused by Pacific underthrusting. In the north, where obliquity is lower, aftershocks from the 2013 Craig, Alaska MW 7.5 strike-slip earthquake also indicate active convergent deformation on the Pacific (west) side of the plate boundary. Off-fault structures previously mapped in legacy crustal-scale seismic profiles may therefore be accommodating part of the lesser amounts of Quaternary convergence north of Haida Gwaii. Between 2015 and 2017, the USGS acquired more than 8,000 line-km of offshore high-resolution multichannel seismic (MCS) data along the QCF to better understand plate boundary deformation. The new MCS data show evidence for Quaternary deformation associated with a series of elongate ridges located within 30 km of the QCF main trace on the Pacific side. These ridges are anticlinal structures flanked by growth faults, with recent deformation and active fluid flow characterized by seafloor scarps and seabed gas seeps at ridge crests. Structural and morphological evidence for contractional deformation decreases northward along the fault, consistent with a decrease in Pacific-North America obliquity along the plate boundary. Preliminary interpretations suggest that plate boundary transpression may be partitioned into distinctive structural domains, in which convergent stress is accommodated by margin-parallel thrust faulting, folding, and ridge

  11. A behavioural perspective on the effects of using performance measurement systems in the companies: Evidence from a case study

    Directory of Open Access Journals (Sweden)

    Lampreia, João

    2017-05-01

    Full Text Available The effects of Performance Measurement Systems (PMS on people’s behaviour are relevant for an organization performance and success. Yet motivational and behavioural consequences of PMS are far from being understood. This study aims to go further regarding the consequences on people’s behaviour of using PMS in organizations. In order to collect data researchers conducted a case study in a Portuguese multi-national company. Evidence shows that the way in which managers understand a PMS influences in a significant way how they behave. The data also lends support to the claim that PMS influence motivation, perceptions, participation and job-related stress of managers.

  12. Change and diversity in smallholder rice-fish systems: Recent evidence and policy lessons from Bangladesh

    NARCIS (Netherlands)

    Dey, M.M.; Spielman, D.J.; Haque, A.B.M.M.; Rahman, M.S.; Valmonte-Santos, R.

    2013-01-01

    Efforts to unlock the genetic potential of both rice and fish, when combined with improvements in the management of rice-fish systems, can potentially increase agricultural productivity and food security in some of the poorest and most populous countries in Asia. In Bangladesh, estimates suggest

  13. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    F. J. Valenzuela

    2016-01-01

    Full Text Available The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1–3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined.

  14. Improving Student Retention through Evidence Based Proactive Systems at the Open University (UK)

    Science.gov (United States)

    Gibbs, Graham; Regan, Peter; Simpson, Ormond

    2007-01-01

    The Open University has been undertaking an extended initiative to improve student retention through enhanced support for at-risk students. This initiative has evolved through a series of stages from ad hoc small scale local interventions relying largely on tutors and student self-referral, to an institution-wide pro-active system implemented by…

  15. Functional evidence for alternative ANG II-forming pathways in hamster cardiovascular system

    NARCIS (Netherlands)

    Nishimura, H; Buikema, H; Baltatu, O; Ganten, D; Urata, H

    1998-01-01

    Like human chymase, hamster chymase is an ANG II-forming enzyme, but pathophysiological roles of chymase are still unknown. We determined the functional conversion of ANG I and [Pro(11), D-Ala(12)]ANG I, a chymase-selective substrate, to ANG II in the hamster cardiovascular system. ANG I and

  16. Deliberation in the Motor System: Reflex Gains Track Evolving Evidence Leading to a Decision

    NARCIS (Netherlands)

    Selen, L.P.J.; Shadlen, M.N.; Wolpert, D.M.

    2012-01-01

    Both decision making and sensorimotor control require real-time processing of noisy information streams. Historically these processes were thought to operate sequentially: cognitive processing leads to a decision, and the outcome is passed to the motor system to be converted into action. Recently,

  17. Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors. Research Brief

    Science.gov (United States)

    Leuschner, Kristin J.

    2010-01-01

    During the past two decades, performance-based accountability systems (PBASs), which link financial or other incentives to measured performance as a means of improving services, have gained popularity among policymakers. Although PBASs can vary widely across sectors, they share three main components: goals (i.e., one or more long-term outcomes to…

  18. Inferences on the evidence for radioactive 53Mn in the early Solar System

    International Nuclear Information System (INIS)

    Typhoon Lee

    1986-01-01

    Time-scales for various processes during the formation of the early Solar System have been inferred from data on several now-extinct radionuclides. The author examines recently reported data on an extinct nuclide, 53 Mn, and shows that the data are inconsistent with the predictions of a single-stage evolution model. Alternative interpretations of the inconsistency are discussed. (U.K.)

  19. Reassessing the WIC Effect: Evidence from the Pregnancy Nutrition Surveillance System

    Science.gov (United States)

    Joyce, Ted; Racine, Andrew; Yunzal-Butler, Cristina

    2008-01-01

    Recent analyses differ on how effective the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is at improving infant health. We use data from nine states that participate in the Pregnancy Nutrition Surveillance System to address limitations in previous work. With information on the mother's timing of WIC enrollment, we…

  20. Imaging Evidence for Disturbances in Multiple Learning and Memory Systems in Persons with Autism Spectrum Disorders

    Science.gov (United States)

    Goh, Suzanne; Peterson, Bradley S.

    2012-01-01

    Aim: The aim of this article is to review neuroimaging studies of autism spectrum disorders (ASD) that examine declarative, socio-emotional, and procedural learning and memory systems. Method: We conducted a search of PubMed from 1996 to 2010 using the terms "autism,""learning,""memory," and "neuroimaging." We limited our review to studies…

  1. Impact of product platforms on lean production systems : evidence from industrial machinery manufacturing

    NARCIS (Netherlands)

    Alblas, A.A.; Wortmann, J.C.

    2012-01-01

    The present study describes the effects of product platform changes on lean production systems. Current research into product platforms focuses mostly on the development stage. However, although the initial development of platforms is an important issue, product platforms often evolve during later

  2. Maltreatment, Academic Difficulty, and Systems-Involved Youth: Current Evidence and Opportunities

    Science.gov (United States)

    Stone, Susan; Zibulsky, Jamie

    2015-01-01

    Youth involved in child-serving systems of care (e.g., child welfare and juvenile justice) often exhibit specific academic performance problems. The magnitude of academic risk among these students is a serious concern given that school attachment, performance, and attainment closely relate to indicators of well-being across the lifespan. It is…

  3. The approximate number system and its relation to early math achievement: evidence from the preschool years.

    Science.gov (United States)

    Bonny, Justin W; Lourenco, Stella F

    2013-03-01

    Humans rely on two main systems of quantification; one is nonsymbolic and involves approximate number representations (known as the approximate number system or ANS), and the other is symbolic and allows for exact calculations of number. Despite the pervasiveness of the ANS across development, recent studies with adolescents and school-aged children point to individual differences in the precision of these representations that, importantly, have been shown to relate to symbolic math competence even after controlling for general aspects of intelligence. Such findings suggest that the ANS, which humans share with nonhuman animals, interfaces specifically with a uniquely human system of formal mathematics. Other findings, however, point to a less straightforward picture, leaving open questions about the nature and ontogenetic origins of the relation between these two systems. Testing children across the preschool period, we found that ANS precision correlated with early math achievement but, critically, that this relation was nonlinear. More specifically, the correlation between ANS precision and math competence was stronger for children with lower math scores than for children with higher math scores. Taken together, our findings suggest that early-developing connections between the ANS and mathematics may be fundamentally discontinuous. Possible mechanisms underlying such nonlinearity are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Evidence for the presence of restriction/modification systems in Lactobacillus delbrueckii.

    Science.gov (United States)

    Suárez, Viviana; Zago, Miriam; Giraffa, Giorgio; Reinheimer, Jorge; Quiberoni, Andrea

    2009-11-01

    The bacteriophages Cb1/204 and Cb1/342 were obtained by induction from the commercial strain Lactobacillus delbrueckii subsp. lactis Cb1, and propagated on Lactobacillus delbrueckii subsp. lactis 204 (Lb.l 204) and Lactobacillus delbrueckii subsp. bulgaricus 342 (Lb.b 342), respectively. By cross sensitivity, it was possible to detect a delay in the lysis of Lb.l 204 with Cb1/342 phage, while the adsorption rate was high (99.5%). Modified and unmodified phages were isolated using phage Cb1/342 and strain Lb.l 204. The EOP (Efficiency of Plaquing) values for the four phages (Cb1/204, Cb1/342, Cb1/342modified and Cb1/342unmodified) suggested that an R/M system modified the original temperate phage, and the BglII-DNA restriction patterns of these phages might point out the presence of a Type II R/M system. Also, the existence of a Type I R/M system was demonstrated by PCR and nucleotide sequence, being the percentages of alignment homology with Type I R/M systems reported previously higher than 95%. In this study it was possible to demonstrate that the native phage resistant mechanisms and the occurrence of prophages in commercial host strains, contribute strongly to diversify the phage population in a factory environment.

  5. An approach to combining unreliable pieces of evidence and their propagation in a system response analysis

    International Nuclear Information System (INIS)

    Kozine, Igor O.; Utkin, Lev V.

    2004-01-01

    The paper describes an approach to representing, aggregating and propagating aleatory and epistemic uncertainty through computational models. The framework for the approach employs the theory of imprecise coherent probabilities. The approach is exemplified by a simple algebraic system, the inputs of which are uncertain. Six different uncertainty situations are considered, including mixtures of epistemic and aleatory uncertainty

  6. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

    Directory of Open Access Journals (Sweden)

    Xavier Bosch-Capblanch

    Full Text Available In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

  7. Lead isotope evidence for a young formation age of the Earth–Moon system

    DEFF Research Database (Denmark)

    Connelly, James; Bizzarro, Martin

    2016-01-01

    A model of a giant impact between two planetary bodies is widely accepted to account for the Earth–Moon system. Despite the importance of this event for understanding early Earth evolution and the inventory of Earth's volatiles critical to life, the timing of the impact is poorly constrained. We...

  8. Primary immune system responders to nucleus pulposus cells: evidence for immune response in disc herniation

    Directory of Open Access Journals (Sweden)

    K Murai

    2010-01-01

    Full Text Available Although intervertebral disc herniation and associated sciatica is a common disease, its molecular pathogenesis is not well understood. Immune responses are thought to be involved. This study provides direct evidence that even non-degenerated nucleus pulposus (NP cells elicit immune responses. An in vitro colony forming inhibition assay demonstrated the suppressive effects of autologous spleen cells on NP cells and an in vitro cytotoxicity assay showed the positive cytotoxic effects of natural killer (NK cells and macrophages on NP cells. Non-degenerated rat NP tissues transplanted into wild type rats and immune-deficient mice demonstrated a significantly higher NP cell survival rate in immune-deficient mice. Immunohistochemical staining showed the presence of macrophages and NK cells in the transplanted NP tissues. These results suggest that even non-degenerated autologous NP cells are recognized by macrophages and NK cells, which may have an immunological function in the early phase of disc herniation. These findings contribute to understanding resorption and the inflammatory reaction to disc herniation.

  9. Evidence-based research on the value of school nurses in an urban school system.

    Science.gov (United States)

    Baisch, Mary J; Lundeen, Sally P; Murphy, M Kathleen

    2011-02-01

    With the increasing acuity of student health problems, growing rates of poverty among urban families, and widening racial/ethnic health disparities in child and adolescent health indicators, the contributions of school nurses are of increasing interest to policymakers. This study was conducted to evaluate the impact of school nurses on promoting a healthy school environment and healthy, resilient learners. A mixed-methods approach was used for this study. Using a cross-sectional design, surveys captured the level of satisfaction that school staff had with the nurse in their school, as well as their perceptions of the impact of the nurse on the efficient management of student health concerns. Using a quasi-experimental design, data from electronic school records were used to compare rates of immunization and completeness of health records in schools with nurses. This study provides evidence that school nurses positively influenced immunization rates, the accuracy of student health records, and management of student health concerns. This research demonstrates that teachers and other staff consider nurse interventions vital to eliminating barriers to student learning and improving overall school health. A cost analysis revealed the estimated annual cost per school for the time staff spent managing health concerns. In an environment of scarce resources, school boards need quality evaluation data to justify hiring and retaining school nurses to support improved school health environments. © 2011, American School Health Association.

  10. Spontaneous Time Symmetry Breaking in System with Mixed Strategy Nash Equilibrium: Evidences in Experimental Economics Data

    Science.gov (United States)

    Wang, Zhijian; Xu, Bin; Zhejiang Collaboration

    2011-03-01

    In social science, laboratory experiment with human subjects' interaction is a standard test-bed for studying social processes in micro level. Usually, as in physics, the processes near equilibrium are suggested as stochastic processes with time-reversal symmetry (TRS). To the best of our knowledge, near equilibrium, the breaking time symmetry, as well as the existence of robust time anti-symmetry processes, has not been reported clearly in experimental economics till now. By employing Markov transition method to analysis the data from human subject 2x2 Games with wide parameters and mixed Nash equilibrium, we study the time symmetry of the social interaction process near Nash equilibrium. We find that, the time symmetry is broken, and there exists a robust time anti-symmetry processes. We also report the weight of the time anti-symmetry processes in the total processes of each the games. Evidences in laboratory marketing experiments, at the same time, are provided as one-dimension cases. In these cases, time anti-symmetry cycles can also be captured. The proposition of time anti-symmetry processes is small, but the cycles are distinguishable.

  11. Genetic evidence implicates the immune system and cholesterol metabolism in the aetiology of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Lesley Jones

    2010-11-01

    Full Text Available Late Onset Alzheimer's disease (LOAD is the leading cause of dementia. Recent large genome-wide association studies (GWAS identified the first strongly supported LOAD susceptibility genes since the discovery of the involvement of APOE in the early 1990s. We have now exploited these GWAS datasets to uncover key LOAD pathophysiological processes.We applied a recently developed tool for mining GWAS data for biologically meaningful information to a LOAD GWAS dataset. The principal findings were then tested in an independent GWAS dataset.We found a significant overrepresentation of association signals in pathways related to cholesterol metabolism and the immune response in both of the two largest genome-wide association studies for LOAD.Processes related to cholesterol metabolism and the innate immune response have previously been implicated by pathological and epidemiological studies of Alzheimer's disease, but it has been unclear whether those findings reflected primary aetiological events or consequences of the disease process. Our independent evidence from two large studies now demonstrates that these processes are aetiologically relevant, and suggests that they may be suitable targets for novel and existing therapeutic approaches.

  12. Nitrergic system and plasmatic methylarginines: Evidence of their role in the perinatal programming of cardiovascular diseases.

    Science.gov (United States)

    Bassareo, Pier Paolo; Mussap, Michele; Bassareo, Valentina; Flore, Giovanna; Mercuro, Giuseppe

    2015-12-07

    Atherosclerosis, in turn preceded by endothelial dysfunction, underlies a series of important cardiovascular diseases. Reduced bioavailability of endothelial nitric oxide, by increasing vascular tone and promoting platelet aggregation, leukocyte adhesion, and smooth muscle cell proliferation, plays a key role in the onset of the majority of cardiovascular diseases. In addition, high blood levels of asymmetric dimethylarginine, a potent inhibitor of nitric oxide synthesis, are associated with future development of adverse cardiovascular events and cardiac death. Recent reports have demonstrated that another methylarginine, i.e., symmetric dimethylarginine, is also involved in the onset of endothelial dysfunction and hypertension. Almost a decade ago, prematurity at birth and intrauterine growth retardation were first associated with a potential negative influence on the cardiovascular apparatus, thus constituting risk factors or leading to early onset of cardiovascular diseases. This condition is referred to as cardiovascular perinatal programming. Accordingly, cardiovascular morbidity and mortality are higher among former preterm adults than in those born at term. The aim of this paper was to undertake a comprehensive literature review focusing on cellular and biochemical mechanisms resulting in both reduced nitric oxide bioavailability and increased methylarginine levels in subjects born preterm. Evidence of the involvement of these compounds in the perinatal programming of cardiovascular risk are also discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Electrophysiological evidence of cerebellar fiber system involvement in the Miller Fisher syndrome.

    Science.gov (United States)

    Lo, Y L; Fook-Chong, S; Chan, L L; Ong, W Y; Ratnagopal, P

    2010-01-15

    In the Miller Fisher syndrome (MFS), ataxia may be due involvement of Ia afferents and the cerebellum. Transcranial magnetic stimulation (TMS) over the cerebellum is known to interfere transiently with normal function. In this study, we utilized a previously described TMS protocol over the cerebellum in combination with ballistic movements to investigate cerebellar dysfunction in MFS patients. The agonist (biceps) reaction time in MFS patients during a motor cancellation task was not significantly reduced during the initial TMS study. However, during the repeat TMS study, significant reduction was seen for all patients, in tandem with clinical recovery. There was significant correlation between anti-GQ1b IgG titers and change in agonist reaction time between the initial and repeat TMS studies. TMS likely affected horizontally orientated parallel fibers in the cerebellar molecular layer. During disease onset, antibody binding may have interfered with facilitation of reaction time during motor cancellation tasks seen in normal subjects. Normalization of reaction time facilitation corresponded to resolution of antibody-mediated interference in the molecular layer. Our study has provided evidence suggesting parallel fiber involvement in MFS, and suggested a role of anti-GQ1b IgG antibody in these changes.

  14. Ontology supported system for searching evidence of wild animals trafficking in social network posts

    Directory of Open Access Journals (Sweden)

    Rafael da Silva Carrasco

    2014-04-01

    Full Text Available O comércio ilegal de animais silvestres é uma das atividades criminais mais lucrativas da atualidade. No Brasil, a grande variedade de fauna nativa tem alimentado o mercado ilegal, o que gera sérias implicações ambientais e sociais. A luta contra o comércio ilegal de animais silvestres é crucial para ajudar a proteger os recursos naturais e evitar a disseminação de outras formas de crime. Esse tipo de comércio ilegal usa cada vez mais, a internet para realizar suas atividades. A fim de combater tal crime, um sistema automático de monitorização é essencial. No entanto, para realizar essa tarefa de forma eficaz, o sistema deve ser capaz de analisar as mensagens trocadas durante essa prática. Para isso, é necessário o conhecimento dos conceitos e relações que ocorrem nesse domínio. Este artigo apresenta um sistema multiagente apoiado por ontologia de domínio e frames semânticos para buscar evidências de comércio ilegal de animais silvestres. No artigo, é mostrado como o sistema pode ser usado na tarefa de rastreamento do comércio ilegal de animais silvestres, além de apresentar os resultados da aplicação do sistema em um pequeno corpus.

  15. [Medicinal cannabis for diseases of the nervous system: no convincing evidence of effectiveness].

    Science.gov (United States)

    Killestein, J; Bet, P M; van Loenen, A C; Polman, C H

    2004-11-27

    --In 1996, the Netherlands Health Council issued a negative recommendation regarding the use of medication on the basis of cannabis (marihuana). However, interest in medicinal cannabis has certainly not waned since. --The neurological diseases for which cannabis could presently be used therapeutically are: multiple sclerosis, chronic (neuropathic) pain and the syndrome of Gilles de la Tourette. --Since September 2003, the Dutch Ministry of Health, Welfare and Sport delivers medicinal cannabis to Dutch pharmacies, so that now for the first time, medicinal cannabis can be given to patients on a prescription basis within the framework of the Opium Law. The result of this is that doctors and patients now assume that this is a medication for which the efficacy and safety have been established. --The question arises whether new scientific data have become available since 1996 that provide scientific support for the current Governmental policy. --In a recent clinical trial that has aroused much discussion, patients with multiple sclerosis and problematic spasticity were treated with oral cannabis or a placebo. There was no significant effect of treatment on the primary outcome measure, i.e. objectively determined spasticity. Nevertheless, it was concluded that the mobility was improved and that the pain was subjectively decreased. --Until now, convincing scientific evidence that cannabinoids are effective in neurological conditions is still lacking. --However, it is also not possible to conclude definitely that cannabinoids are ineffective; still, this is no basis for official stimulation of their use.

  16. An evidence-based approach to pre-pregnancy counselling for patients with systemic lupus erythematosus.

    Science.gov (United States)

    Teng, Y K Onno; Bredewold, Edwin O W; Rabelink, Ton J; Huizinga, Tom W J; Eikenboom, H C Jeroen; Limper, Maarten; Fritsch-Stork, Ruth D E; Bloemenkamp, Kitty W M; Sueters, Marieke

    2017-11-20

    Patients with SLE are often young females of childbearing age and a pregnancy wish in this patient group is common. However, SLE patients are at high risk for adverse pregnancy outcomes that require adequate guidance. It is widely acknowledged that pre-pregnancy counselling is the pivotal first step in the management of SLE patients with a wish to become pregnant. Next, management of these patients is usually multidisciplinary and often requires specific expertise from the different physicians involved. Very recently a EULAR recommendation was published emphasizing the need for adequate preconception counselling and risk stratification. Therefore the present review specifically addresses the issue of pre-pregnancy counselling for SLE patients with an evidence-based approach. The review summarizes data retrieved from recently published, high-quality cohort studies that have contributed to a better understanding and estimation of pregnancy-related risks for SLE patients. The present review categorizes risks from a patient-oriented point of view, that is, the influence of pregnancy on SLE, of SLE on pregnancy, of SLE on the foetus/neonate and of SLE-related medication. Lastly, pre-pregnancy counselling of SLE patients with additional secondary APS is reviewed. Collectively these data can guide clinicians to formulate appropriate preventive strategies and patient-tailored monitoring plans during pre-pregnancy counselling of SLE patients. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

    Science.gov (United States)

    Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

    2017-01-01

    Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

  18. The magmatic model for the origin of Archean Au-quartz vein ore systems: an assessment of the evidence

    International Nuclear Information System (INIS)

    Spooner, E.T.C.

    1991-01-01

    The magmatic model for the origin of Archean Au-quartz vein ore systems suggests that Au was derived by partition between silicate (± sulphide) melts of certain compositions and H 2 O-CO 2 -NaCl magmatic fluids. Supporting evidence includes partial/structural geological relationships, timing relationships, H and C isotope geochemistry, probable primary Au enrichment in the Lamaque stocks, and fluid inclusion volatile geochemistry. Evidence is currently negative with respect to various within- and sub-greenstone belt metamorphic/deep crustal fluid models for primary Au mineralization; however a U-Pb age for vein stage 3 sphene from the Camflo deposit, Quebec which is ∼ 55-60 Ma younger than the host stock at 2685-2680 Ma indicates dissolution/reprecipitation of Au by late, (?) upper crustal saline fluids. Evidence is accumulating that epithermal-meso thermal Au-Ag mineralization in island arc and cordilleran settings may also have been magmatically derived ± high level fluid mixing from calc-alkaline, shoshonitic and other igneous compositions. (author)

  19. Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol.

    Science.gov (United States)

    Stahmer, Aubyn C; Suhrheinrich, Jessica; Schetter, Patricia L; McGee Hassrick, Elizabeth

    2018-01-08

    This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs. Research focuses primarily on teacher training, without attention to contextual factors (e.g., implementation climate, attitudes toward EBPs, resource allocation, and social networks) that may impact outcomes. Using an implementation science framework, this project will prospectively examine relations between system-wide factors and teachers' use of EBPs and student education outcomes. Survey data will be collected from approximately 85 regional special education directors, 170 regional program specialists, 265 district special education directors, 265 behavior specialists, 925 school principals, 3538 special education teachers, and 2700 paraprofessionals. Administrative data for the students with ASD served by participating teachers will be examined. A total of 79 regional-, district-, and school-level personnel will also participate in social network interviews. Mixed methods, including surveys, administrative data, and observational checklists, will be used to gather in-depth information about system-wide malleable factors that relate to positive teacher implementation of EBPs and student outcomes. Multi-level modeling will be used to assess system-wide malleable factors related to EBP implementation which will be linked to the trainer, teacher, and student outcomes and examined based on moderators (e.g., district size, Special Education Local Plan Area structure

  20. Strategies and Systems-Level Interventions to Combat or Prevent Drug Counterfeiting: A Systematic Review of Evidence Beyond Effectiveness.

    Science.gov (United States)

    Fadlallah, Racha; El-Jardali, Fadi; Annan, Farah; Azzam, Hayat; Akl, Elie A

    2016-01-01

    A recent systematic review suggested that drug registrations and onsite quality inspections may be effective in reducing the prevalence of counterfeit and substandard drugs. However, simply replicating the most effective interventions is problematic, as it denotes implementing the intervention without further adaptation. The aim was to systematically review the evidence beyond effectiveness for systems-level interventions to combat or prevent drug counterfeiting. We conducted an extensive search, including an electronic search of 14 databases. We included studies examining the efficiency, feasibility, reliability, and economic outcomes of the interventions, as well as barriers and facilitators to their implementation. Two reviewers selected eligible studies and abstracted data in duplicate and independently. We synthesized the results narratively, stratified by type of intervention. Of 10,220 captured citations, 19 met our inclusion criteria. The findings suggest that the following may strengthen regulatory measures (e.g., registration): minimizing drug diversion, enhancing lines of communications, ensuring feedback on drug quality, and promoting strict licensing criteria. There is evidence that onsite quality surveillance and inspection systems may be efficient and cost-effective for preliminary testing of large samples of drugs. Laws and legislation need to be specific to counterfeit drugs, include firm penalties, address online purchasing of drugs, and be complemented by education of judges and lawyers. Public awareness and education should rely on multiple platforms and comprehensive and dedicated content. While product authentication technologies may be efficient and reliable in detecting counterfeit drugs in the supply chain, they require a strong information system infrastructure. As for pharmacovigilance systems, it is critical to tackle the issue of underreporting, to enhance their chances of success. Several factors are critical to the successful design

  1. Do emerging markets matter in the world oil pricing system? Evidence of imported crude by China and India

    International Nuclear Information System (INIS)

    Hong Li; Lin Xiaowen, Sharon

    2011-01-01

    This paper provides empirical evidence on the changing structure of world oil price system by identifying an additional driver-emerging market factor. We choose China and India as a representative of emerging markets to examine if the quantity of crude oil imported by China and India is significant in the existing oil pricing system (. Our data starts from January 2002 and ends in March 2010, which includes the oil shock of 2007-2008. We utilize cointegration and error correction model framework developed by and in the analysis. Our results indicate that demand from emerging markets has become a significant factor in the world oil pricing system since 2003. This result is significant as it lends empirical support to the widely held conjecture that the oil shock of 2007-2008 is a demand-led shock (). Our result also has significant policy implications that go beyond the oil shock. The emerging market factor is there to stay and reflects the changing power between emerging and developed economies in the world economic system as a result of decades of fast economic development in the former. It will certainly influence policy issues related to oil and beyond. - Highlights: → We test the existing oil price modelling with data from 2002-2010. → We find evidence of structural breaks in the world oil pricing model. → We find that emerging market factor is a new driver in the world oil pricing system since 2003. → The emerging market factor lends empirical support to 'consumption-led' conjecture of oil shock. → New factor reflects significant changes of oil demand landscape following shifting economic power.

  2. Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system.

    Science.gov (United States)

    Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

    2016-10-01

    Audit and Feedback (A&F) is a widely used quality improvement technique that measures clinicians' clinical performance and reports it back to them. Computerised A&F (e-A&F) system interfaces may consist of four key components: (1) Summaries of clinical performance; (2) Patient lists; (3) Patient-level data; (4) Recommended actions. There is a lack of evidence regarding how to best design e-A&F interfaces; establishing such evidence is key to maximising usability, and in turn improving patient safety. To evaluate the usability of a novel theoretically-informed and research-led e-A&F system for primary care (the Performance Improvement plaN GeneratoR: PINGR). (1) Describe PINGR's design, rationale and theoretical basis; (2) Identify usability issues with PINGR; (3) Understand how these issues may interfere with the cognitive goals of end-users; (4) Translate the issues into recommendations for the user-centred design of e-A&F systems. Eight experienced health system evaluators performed a usability inspection using an innovative hybrid approach consisting of five stages: (1) Development of representative user tasks, Goals, and Actions; (2) Combining Heuristic Evaluation and Cognitive Walkthrough methods into a single protocol to identify usability issues; (3) Consolidation of issues; (4) Severity rating of consolidated issues; (5) Analysis of issues according to usability heuristics, interface components, and Goal-Action structure. A final list of 47 issues were categorised into 8 heuristic themes. The most error-prone heuristics were 'Consistency and standards' (13 usability issues; 28% of the total) and 'Match between system and real world' (n=10, 21%). The recommended actions component of the PINGR interface had the most usability issues (n=21, 45%), followed by patient-level data (n=5, 11%), patient lists (n=4, 9%), and summaries of clinical performance (n=4, 9%). The most error-prone Actions across all user Goals were: (1) Patient selection from a list; (2) Data

  3. Impact of the Accounting Information System on Corporate Governance: Evidence from Turkish Non-Listed Companies

    Directory of Open Access Journals (Sweden)

    Ali Uyar

    2017-03-01

    Full Text Available the abuses of managers have the ability to create major problems. In order to avoid future scandals, this study investigates the association between the accounting information system and corporate governance. We hope that these findings will contribute towards the enhancement of good corporate governance created by the accounting function of business organizations. The results of empirical analyses indicate that bookkeeping, financial reporting, and the budgeting system have a positive impact on the corporate governance level, whereas the adoption of Turkish Accounting / Financial Reporting Standards do not. Thus, in order to foster corporate governance, managers should establish internal reporting procedures as well as internal control and monitoring devices before attempting external control through independent auditing.

  4. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail...... and Metro system resulting from the construction of a new terminal Metro station connecting southern townships to Copenhagen city centre. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  5. A cognitive neuroscience perspective on psychopathy: evidence for paralimbic system dysfunction.

    Science.gov (United States)

    Kiehl, Kent A

    2006-06-15

    Psychopathy is a complex personality disorder that includes interpersonal and affective traits such as glibness, lack of empathy, guilt or remorse, shallow affect, and irresponsibility, and behavioral characteristics such as impulsivity, poor behavioral control, and promiscuity. Much is known about the assessment of psychopathy; however, relatively little is understood about the relevant brain disturbances. The present review integrates data from studies of behavioral and cognitive changes associated with focal brain lesions or insults and results from psychophysiology, cognitive psychology and cognitive and affective neuroscience in health and psychopathy. The review illustrates that the brain regions implicated in psychopathy include the orbital frontal cortex, insula, anterior and posterior cingulate, amygdala, parahippocampal gyrus, and anterior superior temporal gyrus. The relevant functional neuroanatomy of psychopathy thus includes limbic and paralimbic structures that may be collectively termed 'the paralimbic system'. The paralimbic system dysfunction model of psychopathy is discussed as it relates to the extant literature on psychopathy.

  6. CREDIT RISK ASSESSMENT IN THE ROMANIAN BANKING SYSTEM. EVIDENCE FROM THE RECENT FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Anamaria Avadanei

    2011-12-01

    Full Text Available The financial crisis followed by the recession has adversely affected the quality of Romanian banking assets. The aim of this paper is to point out the implications of credit risk in the Romanian banking system following the accelerate dynamics of credit activity before the financial crisis and the effects vs. solutions proposed and implemented in recent years. Structured on four parts, the study presents the recent contributions in the crisis-lending relationship, the main features of the Romanian banking system, the evaluation of credit risk in terms of numbers, facts, actions and a short analysis of the correlation between credit indicators (consumer credit, credit risk ratio, medium exchange rate and the number of employees in the economy. To conclude, we propose to define the key points of the future Romanian banking activity.

  7. Systemic-constructivist couple therapy (SCCT): Description of approach, theoretical advances, and published longitudinal evidence.

    Science.gov (United States)

    Reid, David W; Doell, Faye K; Dalton, E Jane; Ahmad, Saunia

    2008-12-01

    The systemic-constructivist approach to studying and benefiting couples was derived from qualitative and quantitative research on distressed couples over the past 10 years. Systemic-constructivist couple therapy (SCCT) is the clinical intervention that accompanies the approach. SCCT guides the therapist to work with both the intrapersonal and the interpersonal aspects of marriage while also integrating the social-environmental context of the couple. The theory that underlies SCCT is explained, including concepts such as we-ness and interpersonal processing. The primary components of the therapy are described. Findings described previously in an inaugural monograph containing extensive research demonstrating the long-term utility of SCCT are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  8. Evidence for multiple sources of 10Be in the early solar system

    DEFF Research Database (Denmark)

    Wielandt, Daniel Kim Peel; Nagashima, Kazuhide; Krot, Alexander N.

    2012-01-01

    Beryllium-10 is a short-lived radionuclide (t 1/2 = 1.4 Myr) uniquely synthesized by spallation reactions and inferred to have been present when the solar system's oldest solids (calcium-aluminum-rich inclusions, CAIs) formed. Yet, the astrophysical site of 10Be nucleosynthesis is uncertain. We...... in the gaseous CAI-forming reservoir, or in the inclusions themselves: this indicates at least two nucleosynthetic sources of 10Be in the early solar system. The most promising locale for 10Be synthesis is close to the proto-Sun during its early mass-accreting stages, as these are thought to coincide...

  9. Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.

    Science.gov (United States)

    Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P

    2014-03-01

    Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The home health prospective payment system in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes

    Directory of Open Access Journals (Sweden)

    Farsalinos KE

    2015-09-01

    Full Text Available Konstantinos E Farsalinos,1,2 Jacques Le Houezec3,4 1Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, 2Department of Pharmacy, University of Patras, Patras, Greece; 3Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, England, UK; 4Addiction Research Unit, INSERM 1178 (Mental and Public Health, Paris, France Abstract: Tobacco smoking is the largest single preventable cause of many chronic diseases and death. Effective treatments exist; however, few smokers use them and most try to quit by themselves. Most of the tobacco cigarette's toxicity is related to the combustion process. Models of harm reduction applied to tobacco suggest that switching from inhalation of combustible products to a noncombustible nicotine delivery product would likely result in a vast reduction in tobacco-related death and illness. Currently available evidence raises no doubt that electronic cigarettes (e-cigs are by far less harmful than smoking (although probably not absolutely safe and have the potential to be the most effective tobacco harm reduction products due to their unique property of resembling smoking and providing satisfaction to the user. A lot of controversy is surrounding e-cigs and their regulation, much of which is based on the precautionary principle. Although monitoring and further research is definitely needed, the arguments used to implement severe restrictions or bans are mostly hypothetical, weakly supported by evidence, and, in some cases, derived from mispresentation or misinterpretation of the study findings. Regulators should keep in mind that the target population is smokers who want to reduce or quit their deadly tobacco consumption. To achieve this goal, smokers should be honestly informed on the relative harmfulness of the different products. E-cigs are not tobacco products and are not used as medications. For this reason, a specific regulatory

  11. Effects of terlipressin on the aquaretic system. Evidence of antidiuretic effects

    DEFF Research Database (Denmark)

    Krag, Aleksander Ahm; Bendtsen, Flemming; Pedersen, Erling B.

    2008-01-01

    Background and aims: The vasopressin analogue terlipressin is believed selectively to cause vasoconstriction by a V1-receptor stimulation. However, a possible antidiuretic effect by V2-receptors stimulation has never been ruled out. Patients and methods: 22 patients with ascites, including 7 with...... is a clear indication of activation of the antidiuretic system (V2 receptor effect). Key words: aquaporine-2, vasopressin, hepatorenal syndrome, cirrhosis....

  12. A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems: Technical Areas

    Science.gov (United States)

    2016-03-01

    autonomous tractor-trailer, the natural next evolution of the self - driving cars under development today. The tractor-trailer must be able to drive safely...letting other teens drive the vehicle , etc.) In this example, gradual permission for additional licensure and extended autonomous driving privileges under...to achieve a quasi-structured goal such as landing an airplane or driving a vehicle . This kind of autonomous system begins with core

  13. Developing the evidence base for mainstreaming adaptation of stormwater systems to climate change.

    Science.gov (United States)

    Gersonius, B; Nasruddin, F; Ashley, R; Jeuken, A; Pathirana, A; Zevenbergen, C

    2012-12-15

    In a context of high uncertainty about hydro-climatic variables, the development of updated methods for climate impact and adaptation assessment is as important, if not more important than the provision of improved climate change data. In this paper, we introduce a hybrid method to facilitate mainstreaming adaptation of stormwater systems to climate change: i.e., the Mainstreaming method. The Mainstreaming method starts with an analysis of adaptation tipping points (ATPs), which is effect-based. These are points of reference where the magnitude of climate change is such that acceptable technical, environmental, societal or economic standards may be compromised. It extends the ATP analysis to include aspects from a bottom-up approach. The extension concerns the analysis of adaptation opportunities in the stormwater system. The results from both analyses are then used in combination to identify and exploit Adaptation Mainstreaming Moments (AMMs). Use of this method will enhance the understanding of the adaptive potential of stormwater systems. We have applied the proposed hybrid method to the management of flood risk for an urban stormwater system in Dordrecht (the Netherlands). The main finding of this case study is that the application of the Mainstreaming method helps to increase the no-/low-regret character of adaptation for several reasons: it focuses the attention on the most urgent effects of climate change; it is expected to lead to potential cost reductions, since adaptation options can be integrated into infrastructure and building design at an early stage instead of being applied separately; it will lead to the development of area-specific responses, which could not have been developed on a higher scale level; it makes it possible to take account of local values and sensibilities, which contributes to increased public and political support for the adaptive strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Is the human mirror neuron system plastic? Evidence from a transcranial magnetic stimulation study.

    Science.gov (United States)

    Mehta, Urvakhsh Meherwan; Waghmare, Avinash V; Thirthalli, Jagadisha; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2015-10-01

    Virtual lesions in the mirror neuron network using inhibitory low-frequency (1Hz) transcranial magnetic stimulation (TMS) have been employed to understand its spatio-functional properties. However, no studies have examined the influence of neuro-enhancement by using excitatory high-frequency (20Hz) repetitive transcranial magnetic stimulation (HF-rTMS) on these networks. We used three forms of TMS stimulation (HF-rTMS, single and paired pulse) to investigate whether the mirror neuron system facilitates the motor system during goal-directed action observation relative to inanimate motion (motor resonance), a marker of putative mirror neuron activity. 31 healthy individuals were randomized to receive single-sessions of true or sham HF-rTMS delivered to the left inferior frontal gyrus - a component of the human mirror system. Motor resonance was assessed before and after HF-rTMS using three TMS cortical reactivity paradigms: (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke motor evoked potential of 1-millivolt amplitude (SI1mV) and (c) a short latency paired pulse paradigm. Two-way RMANOVA showed a significant group (true versus sham) X occasion (pre- and post-HF-rTMS motor resonance) interaction effect for SI1mV [F(df)=6.26 (1, 29), p=0.018] and 120% RMT stimuli [F(df)=7.01 (1, 29), p=0.013] indicating greater enhancement of motor resonance in the true HF-rTMS group than the sham-group. This suggests that HF-rTMS could adaptively modulate properties of the mirror neuron system. This neuro-enhancement effect is a preliminary step that can open translational avenues for novel brain stimulation therapeutics targeting social-cognition deficits in schizophrenia and autism. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Comparative analyses of olfactory systems in terrestrial crabs (Brachyura: evidence for aerial olfaction?

    Directory of Open Access Journals (Sweden)

    Jakob Krieger

    2015-12-01

    Full Text Available Adaptations to a terrestrial lifestyle occurred convergently multiple times during the evolution of the arthropods. This holds also true for the “true crabs” (Brachyura, a taxon that includes several lineages that invaded land independently. During an evolutionary transition from sea to land, animals have to develop a variety of physiological and anatomical adaptations to a terrestrial life style related to respiration, reproduction, development, circulation, ion and water balance. In addition, sensory systems that function in air instead of in water are essential for an animal’s life on land. Besides vision and mechanosensory systems, on land, the chemical senses have to be modified substantially in comparison to their function in water. Among arthropods, insects are the most successful ones to evolve aerial olfaction. Various aspects of terrestrial adaptation have also been analyzed in those crustacean lineages that evolved terrestrial representatives including the taxa Anomala, Brachyura, Amphipoda, and Isopoda. We are interested in how the chemical senses of terrestrial crustaceans are modified to function in air. Therefore, in this study, we analyzed the brains and more specifically the structure of the olfactory system of representatives of brachyuran crabs that display different degrees of terrestriality, from exclusively marine to mainly terrestrial. The methods we used included immunohistochemistry, detection of autofluorescence- and confocal microscopy, as well as three-dimensional reconstruction and morphometry. Our comparative approach shows that both the peripheral and central olfactory pathways are reduced in terrestrial members in comparison to their marine relatives, suggesting a limited function of their olfactory system on land. We conclude that for arthropod lineages that invaded land, evolving aerial olfaction is no trivial task.

  16. Medicare's prospective payment system for hospitals: new evidence on transitions among health care settings

    OpenAIRE

    Qian, Xufeng; Russell, Louise B.; Valiyeva, Elmira; Miller, Jane E.

    2007-01-01

    Previous studies of Medicare’s prospective payment system for hospitals (PPS), introduced in 1983, evaluated only its first few years, using data collected during the hospital stay to control for patients’ health. We examine transitions among health care settings over a full decade following implementation of PPS, using survival models and a national longitudinal survey with independent information on health. We find that the rate of discharge from hospitals to nursing homes continued to rise...

  17. The nervous system and metabolic dysregulation: emerging evidence converges on ketogenic diet therapy

    Directory of Open Access Journals (Sweden)

    David N. Ruskin

    2012-03-01

    Full Text Available A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high-fat, low-carbohydrate ketogenic diet debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, ketogenic diet therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. More recently, cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders - although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a ketogenic diet and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a ketogenic diet on cognition and recent data on the effects of a ketogenic diet on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system.

  18. Imaging evidence for disturbances in multiple learning and memory systems in persons with autism spectrum disorders.

    Science.gov (United States)

    Goh, Suzanne; Peterson, Bradley S

    2012-03-01

    The aim of this article is to review neuroimaging studies of autism spectrum disorders (ASD) that examine declarative, socio-emotional, and procedural learning and memory systems. We conducted a search of PubMed from 1996 to 2010 using the terms 'autism,''learning,''memory,' and 'neuroimaging.' We limited our review to studies correlating learning and memory function with neuroimaging features of the brain. The early literature supports the following preliminary hypotheses: (1) abnormalities of hippocampal subregions may contribute to autistic deficits in episodic and relational memory; (2) disturbances to an amygdala-based network (which may include the fusiform gyrus, superior temporal cortex, and mirror neuron system) may contribute to autistic deficits in socio-emotional learning and memory; and (3) abnormalities of the striatum may contribute to developmental dyspraxia in individuals with ASD. Characterizing the disturbances to learning and memory systems in ASD can inform our understanding of the neural bases of autistic behaviors and the phenotypic heterogeneity of ASD. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  19. The self-adjusting file (SAF) system: An evidence-based update

    Science.gov (United States)

    Metzger, Zvi

    2014-01-01

    Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics. PMID:25298639

  20. Immunoediting: evidence of the multifaceted role of the immune system in self-metastatic tumor growth.

    Science.gov (United States)

    Enderling, Heiko; Hlatky, Lynn; Hahnfeldt, Philip

    2012-07-28

    The role of the immune system in tumor progression has been a subject for discussion for many decades. Numerous studies suggest that a low immune response might be beneficial, if not necessary, for tumor growth, and only a strong immune response can counter tumor growth and thus inhibit progression. We implement a cellular automaton model previously described that captures the dynamical interactions between the cancer stem and non-stem cell populations of a tumor through a process of self-metastasis. By overlaying on this model the diffusion of immune reactants into the tumor from a peripheral source to target cells, we simulate the process of immune-system-induced cell kill on tumor progression. A low cytotoxic immune reaction continuously kills cancer cells and, although at a low rate, thereby causes the liberation of space-constrained cancer stem cells to drive self-metastatic progression and continued tumor growth. With increasing immune system strength, however, tumor growth peaks, and then eventually falls below the intrinsic tumor sizes observed without an immune response. With this increasing immune response the number and proportion of cancer stem cells monotonically increases, implicating an additional unexpected consequence, that of cancer stem cell selection, to the immune response. Cancer stem cells and immune cytotoxicity alone are sufficient to explain the three-step "immunoediting" concept - the modulation of tumor growth through inhibition, selection and promotion.

  1. Performance of the internal audit department under ERP systems: empirical evidence from Taiwanese firms

    Science.gov (United States)

    Tsai, Wen-Hsien; Chen, Hui-Chiao; Chang, Jui-Chu; Leu, Jun-Der; Chao Chen, Der; Purbokusumo, Yuyun

    2015-10-01

    In this study, the performance of the internal audit department (IAD) and its contribution to a company under enterprise resource planning (ERP) systems was examined. It is anticipated that this will provide insight into the factors perceived to be crucial to a company's effectiveness. A theoretical framework was developed and tested using the sample of Taiwanese companies. Using mail survey procedures, we elicited perceptions from key internal auditors about the ERP system and auditing software, as well as their opinions concerning the IAD's effectiveness and its contribution within a company. Data were analysed using the partial least square (PLS) regression to test the hypotheses. Drawing upon a sample of Taiwanese firms, the study suggests that a firm can improve the performance of the IAD through an enterprise-wide integrated, effective ERP system and appropriate auditing software. At the same time, the performance of the IAD can also contribute significantly to the company. The results also show that investments in computer-assisted auditing techniques (CAATs) are crucial due to their tremendous effectiveness in regard to the performance of the IAD and for the contributions CAATs can make to a company.

  2. The self-adjusting file (SAF) system: An evidence-based update.

    Science.gov (United States)

    Metzger, Zvi

    2014-09-01

    Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics.

  3. A novel statistical approach shows evidence for multi-system physiological dysregulation during aging.

    Science.gov (United States)

    Cohen, Alan A; Milot, Emmanuel; Yong, Jian; Seplaki, Christopher L; Fülöp, Tamàs; Bandeen-Roche, Karen; Fried, Linda P

    2013-03-01

    Previous studies have identified many biomarkers that are associated with aging and related outcomes, but the relevance of these markers for underlying processes and their relationship to hypothesized systemic dysregulation is not clear. We address this gap by presenting a novel method for measuring dysregulation via the joint distribution of multiple biomarkers and assessing associations of dysregulation with age and mortality. Using longitudinal data from the Women's Health and Aging Study, we selected a 14-marker subset from 63 blood measures: those that diverged from the baseline population mean with age. For the 14 markers and all combinatorial sub-subsets we calculated a multivariate distance called the Mahalanobis distance (MHBD) for all observations, indicating how "strange" each individual's biomarker profile was relative to the baseline population mean. In most models, MHBD correlated positively with age, MHBD increased within individuals over time, and higher MHBD predicted higher risk of subsequent mortality. Predictive power increased as more variables were incorporated into the calculation of MHBD. Biomarkers from multiple systems were implicated. These results support hypotheses of simultaneous dysregulation in multiple systems and confirm the need for longitudinal, multivariate approaches to understanding biomarkers in aging. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    Science.gov (United States)

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, pscorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  5. The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

    Science.gov (United States)

    Ruskin, David N.; Masino, Susan A.

    2012-01-01

    A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system. PMID:22470316

  6. What role can information play in improved equity in Pakistan's irrigation system? Evidence from an experimental game in Punjab

    Directory of Open Access Journals (Sweden)

    Andrew Reid. Bell

    2015-03-01

    Full Text Available The Indus Basin Irrigation System suffers significant inequity in access to surface water across its millions of users. Information, i.e., monitoring and reporting of water availability, may be of value in improving conditions across the basin, and we investigated this via an experimental game of water distribution in Punjab, Pakistan. We found evidence that flow information allowed players to take more effective action to target overuse, and that overall activities that might bring social disapproval were reduced with information. However, we did not find any overall improvement in equity across the system, suggesting that information on its own might not be sufficient to lead to better water distribution among irrigators.

  7. The mirror neuron system as revealed through neonatal imitation: presence from birth, predictive power and evidence of plasticity.

    Science.gov (United States)

    Simpson, Elizabeth A; Murray, Lynne; Paukner, Annika; Ferrari, Pier F

    2014-01-01

    There is strong evidence that neonates imitate previously unseen behaviours. These behaviours are predominantly used in social interactions, demonstrating neonates' ability and motivation to engage with others. Research on neonatal imitation can provide a wealth of information about the early mirror neuron system (MNS), namely its functional characteristics, its plasticity from birth and its relation to skills later in development. Although numerous studies document the existence of neonatal imitation in the laboratory, little is known about its natural occurrence during parent-infant interactions and its plasticity as a consequence of experience. We review these critical aspects of imitation, which we argue are necessary for understanding the early action-perception system. We address common criticisms and misunderstandings about neonatal imitation and discuss methodological differences among studies. Recent work reveals that individual differences in neonatal imitation positively correlate with later social, cognitive and motor development. We propose that such variation in neonatal imitation could reflect important individual differences of the MNS. Although postnatal experience is not necessary for imitation, we present evidence that neonatal imitation is influenced by experience in the first week of life.

  8. FMRI evidence for the involvement of the procedural memory system in morphological processing of a second language.

    Directory of Open Access Journals (Sweden)

    Christos Pliatsikas

    Full Text Available Behavioural evidence suggests that English regular past tense forms are automatically decomposed into their stem and affix (played  = play+ed based on an implicit linguistic rule, which does not apply to the idiosyncratically formed irregular forms (kept. Additionally, regular, but not irregular inflections, are thought to be processed through the procedural memory system (left inferior frontal gyrus, basal ganglia, cerebellum. It has been suggested that this distinction does not to apply to second language (L2 learners of English; however, this has not been tested at the brain level. This fMRI study used a masked-priming task with regular and irregular prime-target pairs (played-play/kept-keep to investigate morphological processing in native and highly proficient late L2 English speakers. No between-groups differences were revealed. Compared to irregular pairs, regular pairs activated the pars opercularis, bilateral caudate nucleus and the right cerebellum, which are part of the procedural memory network and have been connected with the processing of morphologically complex forms. Our study is the first to provide evidence for native-like involvement of the procedural memory system in processing of regular past tense by late L2 learners of English.

  9. Hydrological deformation signals in karst systems: new evidence from the European Alps

    Science.gov (United States)

    Serpelloni, E.; Pintori, F.; Gualandi, A.; Scoccimarro, E.; Cavaliere, A.; Anderlini, L.; Belardinelli, M. E.; Todesco, M.

    2017-12-01

    The influence of rainfall on crustal deformation has been described at local scales, using tilt and strain meters, in several tectonic settings. However, the literature on the spatial extent of rainfall-induced deformation is still scarce. We analyzed 10 years of displacement time-series from 150 continuous GPS stations operating across the broad zone of deformation accommodating the N-S Adria-Eurasia convergence and the E-ward escape of the Eastern Alps toward the Pannonian basin. We applied a blind-source-separation algorithm based on a variational Bayesian Independent Component Analysis method to the de-trended time-series, being able to characterize the temporal and spatial features of several deformation signals. The most important ones are a common mode annual signal, with spatially uniform response in the vertical and horizontal components and a time-variable, non-cyclic, signal characterized by a spatially variable response in the horizontal components, with stations moving (up to 8 mm) in the opposite directions, reversing the sense of movement in time. This implies a succession of extensional/compressional strains, with variable amplitudes through time, oriented normal to rock fractures in karst areas. While seasonal displacements in the vertical component (with an average amplitude of 4 mm over the study area) are satisfactorily reproduced by surface hydrological loading, estimated from global assimilation models, the non seasonal signal is associated with groundwater flow in karst systems, and is mainly influencing the horizontal component. The temporal evolution of this deformation signal is correlated with cumulated precipitation values over periods of 200-300 days. This horizontal deformation can be explained by pressure changes associated with variable water levels within vertical fractures in the vadose zones of karst systems, and the water level changes required to open or close these fractures are consistent with the fluctuations of precipitation

  10. Iodine mobilization in groundwater system at Datong basin, China: Evidence from hydrochemistry and fluorescence characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Li, Junxia; Wang, Yanxin, E-mail: yx.wang@cug.edu.cn; Guo, Wei; Xie, Xianjun; Zhang, Liping; Liu, Yaqing; Kong, Shuqiong

    2014-01-01

    Characterizing the speciation of iodine in groundwater is essential for understanding its hydrogeochemical behavior in aquifer systems. To quantify the variations in iodine speciation and assess factors controlling the distribution and transformation of iodine, 82 groundwater samples and 1 rain water were collected from the Datong basin, northern China in this study. Factor analysis (FA) and excitation emission matrix with parallel factor analysis (EEM–PARAFAC) were used to clarify the potential relationships among iodine species and other hydrochemical parameters. The iodine concentrations of groundwater range from 6.23 to 1380 μg L{sup −1} with 47% of samples exceeding its drinking water level of 150 μg L{sup −1} as recommended by the Chinese government. 57% of samples have ratios of iodate to total iodine greater than 60%, while iodide as the major species in 22% of the samples. Significant amounts of organic iodine with concentrations higher than 100 μg L{sup −1} were observed in 9 groundwater samples. Redox conditions of groundwater system strongly affect iodine concentration and speciation of inorganic iodine in groundwater, and extremely reducing condition restricts the iodine release from sediments into groundwater. The results of FA show that iodine mobilization in groundwater is related to the nature of dissolved organic matter. EEM-PARAFAC model demonstrates the dominance of terrestrial DOM sources and the presence of microbial activities in groundwater system of the Datong basin. It is proposed that degradation of organic matter and reductive dissolution of iron oxyhydroxides are major hydrogeochemical processes responsible for the mobilization of iodine release and the genesis of organic iodine. - Highlights: • Iodine species in groundwater was studied from Datong basin, northern China. • Weakly alkaline environment favors the accumulation of iodine in groundwater. • Iodate is the major species of iodine in groundwater from Datong

  11. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail ...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  12. Short-term retention of pictures and words: evidence for dual coding systems.

    Science.gov (United States)

    Pellegrino, J W; Siegel, A W; Dhawan, M

    1975-03-01

    The recall of picture and word triads was examined in three experiments that manipulated the type of distraction in a Brown-Peterson short-term retention task. In all three experiments recall of pictures was superior to words under auditory distraction conditions. Visual distraction produced high performance levels with both types of stimuli, whereas combined auditory and visual distraction significantly reduced picture recall without further affecting word recall. The results were interpreted in terms of the dual coding hypothesis and indicated that pictures are encoded into separate visual and acoustic processing systems while words are primarily acoustically encoded.

  13. Chorea in systemic lupus erythematosus: evidence for bilateral putaminal hypermetabolism on F-18 FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Wook Jang; Chung, Son Mi; Koh, Su Jin; Lee, Chang Keun; Yoo, Bin; Moon, Hee Bom [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of); Kim, Jae Seung; Im, Joo Hyuk [Asan Medical Center, Seoul (Korea, Republic of)

    2003-10-01

    We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECT also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE.

  14. Physiological complexity and system adaptability: evidence from postural control dynamics of older adults.

    Science.gov (United States)

    Manor, Brad; Costa, Madalena D; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C K; Novak, Vera; Lipsitz, Lewis A

    2010-12-01

    The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.

  15. Targeting the Glutamatergic System to Treat Pathological Gambling: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Mauro Pettorruso

    2014-01-01

    Full Text Available Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.

  16. Knowledge Organisations and High-Tech Regional Innovation Systems in Developing Countries: Evidence from Argentina

    Directory of Open Access Journals (Sweden)

    Carolina Pasciaroni

    2016-06-01

    Full Text Available In the globally and knowledge based economy, the universities and other knowledge organisations are valued for their ability to contribute to the regional innovation processes. This is particularly relevant for the developing countries in South America since their R&D spending is highly concentrated on the public knowledge infrastructure. However, there are few studies examining the role of knowledge organizations at regional level in Latin America. The proposed study aims to analyse the role played by knowledge organisations in the formation of a high-tech Regional Innovation Systems in Argentina. This country has a number of attractive features relative to the positive evolution of its R&D spending and the recent implementation of a policy that promotes cooperation between firms and knowledge organisations among high-tech sectors. As evidenced in developed regions, the organisations under study play a key role in the promotion of a high-tech Regional Innovation Systems. However, this prominent role is not based on those local factors identified in the literature, such as organisational and institutional local assets, but on national science and technology policies and individual initiatives conducted by the faculties involved.

  17. Management Control Systems and Strategy: A Resource based Perspective. Evidence from Greece

    Directory of Open Access Journals (Sweden)

    Nikolaos Theriou

    2017-06-01

    Full Text Available Purpose: The purpose of this paper is to empirically examine from the resource-based perspective, the relationship between the use of management control systems (MCS and organisational capabilities in the Greek context. Design/Methodology/Approach: The study follows Henri's (2006 methodology and explores the relationships between the diagnostic and interactive uses of performance measurement systems (PMS and the five capabilities (e.g. market orientation, organisational learning, entrepreneurship, innovativeness and market responsiveness leading to strategic choice. Structural equation modelling represents the relationships between the variables and data collected from the survey, which was analysed as a statistical tool with AMOS. Findings: Results revealed that diagnostic use of PMS negatively influence only the organisational learning, while the interactive use positively interacts with most of the capabilities. Research limitations/implications: This study can be further extended by incorporating more factors in the proposed model, such as environmental uncertainty, size and organisational culture, and examine their possible effect on the relationship between PMS uses, organisational capabilities and performance. Originality/Value: There is no similar empirical research in the context of Greece.

  18. Concurrent performance of two memory tasks: evidence for domain-specific working memory systems.

    Science.gov (United States)

    Cocchini, Gianna; Logie, Robert H; Della Sala, Sergio; MacPherson, Sarah E; Baddeley, Alan D

    2002-10-01

    Previous studies of dual-task coordination in working memory have shown a lack of dual-task interference when a verbal memory task is combined with concurrent perceptuomotor tracking. Two experiments are reported in which participants were required to perform pairwise combinations of (1) a verbal memory task, a visual memory task, and perceptuomotor tracking (Experiment 1), and (2) pairwise combinations of the two memory tasks and articulatory suppression (Experiment 2). Tracking resulted in no disruption of the verbal memory preload over and above the impact of a delay in recall and showed only minimal disruption of the retention of the visual memory load. Performing an ongoing verbal memory task had virtually no impact on retention of a visual memory preload or vice versa, indicating that performing two demanding memory tasks results in little mutual interference. Experiment 2 also showed minimal disruption when the two memory tasks were combined, although verbal memory (but not visual memory) was clearly disrupted by articulatory suppression interpolated between presentation and recall. These data suggest that a multiple-component working memory model provides a better account for performance in concurrent immediate memory tasks than do theories that assume a single processing and storage system or a limited-capacity attentional system coupled with activated memory traces.

  19. Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system.

    Science.gov (United States)

    Mascia, Daniele; Di Vincenzo, Fausto; Cicchetti, Americo

    2012-05-01

    Policymakers stimulate competition in universalistic health-care systems while encouraging the formation of service provision networks among hospital organizations. This article addresses a gap in the extant literature by empirically analyzing simultaneous collaboration and competition between hospitals within the Italian National Health Service, where important procompetition reforms have been implemented. To explore how rising competition between hospitals relates to their propensity to collaborate with other local providers. Longitudinal data on interhospital collaboration and competition collected in an Italian region from 2003 to 2007 are analyzed. Social network analysis techniques are applied to study the structure and dynamics of interhospital collaboration. Negative binomial regressions are employed to explore how interhospital competition relates to the collaborative network over time. Competition among providers does not hinder interhospital collaboration. Collaboration is primarily local, with resource complementarity and differentials in the volume of activity and hospital performance explaining the propensity to collaborate. Formation of collaborative networks among hospitals is not hampered by reforms aimed at fostering market forces. Because procompetition reforms elicit peculiar forms of managed competition in universalistic health systems, studies are needed to clarify whether the positive association between interhospital competition and collaboration can be generalized to other health-care settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Evidence for inhibition of cholinesterases in insect and mammalian nervous systems by the insect repellent deet

    Directory of Open Access Journals (Sweden)

    Dimitrov Mitko

    2009-08-01

    Full Text Available Abstract Background N,N-Diethyl-3-methylbenzamide (deet remains the gold standard for insect repellents. About 200 million people use it every year and over 8 billion doses have been applied over the past 50 years. Despite the widespread and increased interest in the use of deet in public health programmes, controversies remain concerning both the identification of its target sites at the olfactory system and its mechanism of toxicity in insects, mammals and humans. Here, we investigated the molecular target site for deet and the consequences of its interactions with carbamate insecticides on the cholinergic system. Results By using toxicological, biochemical and electrophysiological techniques, we show that deet is not simply a behaviour-modifying chemical but that it also inhibits cholinesterase activity, in both insect and mammalian neuronal preparations. Deet is commonly used in combination with insecticides and we show that deet has the capacity to strengthen the toxicity of carbamates, a class of insecticides known to block acetylcholinesterase. Conclusion These findings question the safety of deet, particularly in combination with other chemicals, and they highlight the importance of a multidisciplinary approach to the development of safer insect repellents for use in public health.

  1. INTERFEROMETRIC EVIDENCE FOR RESOLVED WARM DUST IN THE DQ TAU SYSTEM

    International Nuclear Information System (INIS)

    Boden, Andrew F.; Sargent, Anneila I.; Carpenter, John M.; Akeson, Rachel L.; Ciardi, David R.; Bary, Jeffrey S.; Skrutskie, Michael F.

    2009-01-01

    We report on near-infrared (IR) interferometric observations of the double-lined pre-main sequence binary system DQ Tau. We model these data with a visual orbit for DQ Tau supported by the spectroscopic orbit and analysis of Mathieu et al. Further, DQ Tau exhibits significant near-IR excess; modeling our data requires inclusion of near-IR light from an 'excess' source. Remarkably, the excess source is resolved in our data, similar in scale to the binary itself (∼0.2 AU at apastron), rather than the larger circumbinary disk (∼0.4 AU radius). Our observations support the Mathieu et al. and Carr et al. inference of significant warm material near the DQ Tau binary.

  2. Prevalence of Smoking and Associated Factors: Evidence From the CHILILAB Demographic Surveillance System in Vietnam.

    Science.gov (United States)

    Thi Thanh Huong, Le; Khanh Long, Tran; Xuan Son, Phung; Thi Tuyet-Hanh, Tran

    2017-07-01

    This study analyzed secondary data from Chi Linh Health and Demographic Surveillance System (CHILILAB) database to identify smoking prevalence and associated demographic factors. Data were extracted from the database of the CHILILAB 2016, which included information on individual smoking behaviors, as well as individual and household demographic data. Descriptive and binary logistic regression analyses were performed with significance level of 0.05. The smoking prevalences were 34.7%, 0.9%, and 16.1% for men, women, and both genders, respectively. A total of 78.2% of current smokers smoked daily inside their houses. Lower smoking status was associated with younger age, being student, rich, and/or single. Future efforts should not only spend on further reduction of smoking rate in Chi Linh Town but should also pay special attention on reducing the prevalence of in-home smoking. This will help to decrease the risk of nonsmokers being exposed to secondhand smoke in their home environment.

  3. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence.

    Science.gov (United States)

    Frei, Remo; Akdis, Mübeccel; O'Mahony, Liam

    2015-03-01

    The intestinal immune system is constantly exposed to foreign antigens, which for the most part should be tolerated. Certain probiotics, prebiotics, and synbiotics are able to influence immune responses. In this review, we highlight the recent publications (within the last 2 years) that have substantially progressed this field. The immunological mechanisms underpinning probiotics, prebiotics, and synbiotics effects continue to be better defined with novel mechanisms being described for dendritic cells, epithelial cells, T regulatory cells, effector lymphocytes, natural killer T cells, and B cells. Many of the mechanisms being described are bacterial strain or metabolite specific, and should not be extrapolated to other probiotics or prebiotics. In addition, the timing of intervention seems to be important, with potentially the greatest effects being observed early in life. In this review, we discuss the recent findings relating to probiotics, prebiotics, and synbiotics, specifically their effects on immunological functions.

  4. The Third Pillar of the Basel Accord: Evidence of borrower discipline in the Kyrgyz banking system

    Directory of Open Access Journals (Sweden)

    Edgar Demetrio Tovar-García

    2016-07-01

    Full Text Available We empirically study the asset side of market discipline in the banking system of the Kyrgyz Republic, examining whether borrowers are willing to pay higher interest rates to high-quality banks. Based on dynamic panel models and a dataset with bank information from 23 banks over the period 2010–2012, our findings suggest the presence of market discipline induced by borrowers. In other words, banks with higher capital ratios and liquidity charge higher interest rates on loans. This result has several implications for the banking policy in Kyrgyzstan, where we can recommend to policymakers a disclosure policy following the Third Pillar of Basel III, because not only can the bank's creditors use bank information to penalize the excessive bank risk, but borrowers can also use this information to discipline their banks.

  5. New evidence on the state of stress of the san andreas fault system.

    Science.gov (United States)

    Zoback, M D; Zoback, M L; Mount, V S; Suppe, J; Eaton, J P; Healy, J H; Oppenheimer, D; Reasenberg, P; Jones, L; Raleigh, C B; Wong, I G; Scotti, O; Wentworth, C

    1987-11-20

    Contemporary in situ tectonic stress indicators along the San Andreas fault system in central California show northeast-directed horizontal compression that is nearly perpendicular to the strike of the fault. Such compression explains recent uplift of the Coast Ranges and the numerous active reverse faults and folds that trend nearly parallel to the San Andreas and that are otherwise unexplainable in terms of strike-slip deformation. Fault-normal crustal compression in central California is proposed to result from the extremely low shear strength of the San Andreas and the slightly convergent relative motion between the Pacific and North American plates. Preliminary in situ stress data from the Cajon Pass scientific drill hole (located 3.6 kilometers northeast of the San Andreas in southern California near San Bernardino, California) are also consistent with a weak fault, as they show no right-lateral shear stress at approximately 2-kilometer depth on planes parallel to the San Andreas fault.

  6. Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

    Directory of Open Access Journals (Sweden)

    McLean SM

    2016-04-01

    Full Text Available Sionnadh Mairi McLean,1 Andrew Booth,2 Melanie Gee,3 Sarah Salway,2 Mark Cobb,4 Sadiq Bhanbhro,3 Susan A Nancarrow5 1Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 2School of Health and Related Research, University of Sheffield, Sheffield, UK; 3Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK; 4Therapeutics & Palliative Care, Sheffield Teaching Hospitals, Sheffield, UK; 5School of Health and Human Science, Southern Cross University, East Lismore, NSW, Australia Abstract: Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and

  7. Isotopic coherence of refractory inclusions from CV and CK meteorites: Evidence from multiple isotope systems

    Science.gov (United States)

    Shollenberger, Quinn R.; Borg, Lars E.; Render, Jan; Ebert, Samuel; Bischoff, Addi; Russell, Sara S.; Brennecka, Gregory A.

    2018-05-01

    Calcium-aluminum-rich inclusions (CAIs) are the oldest dated materials in the Solar System and numerous previous studies have revealed nucleosynthetic anomalies relative to terrestrial rock standards in many isotopic systems. However, most of the isotopic data from CAIs has been limited to the Allende meteorite and a handful of other CV3 chondrites. To better constrain the isotopic composition of the CAI-forming region, we report the first Sr, Mo, Ba, Nd, and Sm isotopic compositions of two CAIs hosted in the CK3 desert meteorites NWA 4964 and NWA 6254 along with two CAIs from the CV3 desert meteorites NWA 6619 and NWA 6991. After consideration of neutron capture processes and the effects of hot-desert weathering, the Sr, Mo, Ba, Nd, and Sm stable isotopic compositions of the samples show clearly resolvable nucleosynthetic anomalies that are in agreement with previous results from Allende and other CV meteorites. The extent of neutron capture, as manifested by shifts in the observed 149Sm-150Sm isotopic composition of the CAIs is used to estimate the neutron fluence experienced by some of these samples and ranges from 8.40 × 1013 to 2.11 × 1015 n/cm2. Overall, regardless of CAI type or host meteorite, CAIs from CV and CK chondrites have similar nucleosynthetic anomalies within analytical uncertainty. We suggest the region that CV and CK CAIs formed was largely uniform with respect to Sr, Mo, Ba, Nd, and Sm isotopes when CAIs condensed and that CAIs hosted in CV and CK meteorites are derived from the same isotopic reservoir.

  8. Provincial Health Accounts in Kerman, Iran: An Evidence of a “Mixed” Healthcare Financing System

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    Mohammad Hossein Mehrolhassani

    2014-02-01

    Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor

  9. EVIDENCE FOR MULTIPLE SOURCES OF 10Be IN THE EARLY SOLAR SYSTEM

    International Nuclear Information System (INIS)

    Wielandt, Daniel; Krot, Alexander N.; Bizzarro, Martin; Nagashima, Kazuhide; Huss, Gary R.; Ivanova, Marina A.

    2012-01-01

    Beryllium-10 is a short-lived radionuclide (t 1/2 = 1.4 Myr) uniquely synthesized by spallation reactions and inferred to have been present when the solar system's oldest solids (calcium-aluminum-rich inclusions, CAIs) formed. Yet, the astrophysical site of 10 Be nucleosynthesis is uncertain. We report Li-Be-B isotope measurements of CAIs from CV chondrites, including CAIs that formed with the canonical 26 Al/ 27 Al ratio of ∼5 × 10 –5 (canonical CAIs) and CAIs with Fractionation and Unidentified Nuclear isotope effects (FUN-CAIs) characterized by 26 Al/ 27 Al ratios much lower than the canonical value. Our measurements demonstrate the presence of four distinct fossil 10 Be/ 9 Be isochrons, lower in the FUN-CAIs than in the canonical CAIs, and variable within these classes. Given that FUN-CAI precursors escaped evaporation-recondensation prior to evaporative melting, we suggest that the 10 Be/ 9 Be ratio recorded by FUN-CAIs represents a baseline level present in presolar material inherited from the protosolar molecular cloud, generated via enhanced trapping of galactic cosmic rays. The higher and possibly variable apparent 10 Be/ 9 Be ratios of canonical CAIs reflect additional spallogenesis, either in the gaseous CAI-forming reservoir, or in the inclusions themselves: this indicates at least two nucleosynthetic sources of 10 Be in the early solar system. The most promising locale for 10 Be synthesis is close to the proto-Sun during its early mass-accreting stages, as these are thought to coincide with periods of intense particle irradiation occurring on timescales significantly shorter than the formation interval of canonical CAIs.

  10. Evidence against a systemic humoral factor controlling the intestinal compensatory response following X-irradiation

    International Nuclear Information System (INIS)

    Sharp, J.G.; Osborne, J.W.; Iowa Univ., Iowa City

    1981-01-01

    The investigation was devised to determine whether changes noted in the unirradiated duodenum and colon of single rats after X-irradiation of only the exteriorized rat jejunum and ileum are mediated by a systemic humoral factor. Littermate Holtzman male rats were joined in parabiosis and one month later, the temporarily exteriorized jejunum and ileum of one member was exposed to 1.000 R of 250 kVp X-irradiation. Two days after X-irradiation, and 1, 12 and 24 h after 1 μCi/g bodyweight 3 H-thymidine was injected i.p. rats were sacrificed and appropriate tissues removed. Single rats which had the exteriorized jejunum and ileum irradiated were studied from 1-3 days after irradiation. Crypt cell migration rates were determined employing autoradiography. Tritium content and columnar cell migration rate in duodenum and colon of unirradiated rats compared to irradiated rats indicated that irradiation of one member of the pair had no effect on tritium incorporation or epithelial cell migration in the duodenum or colon of the unirradiated partner. Epithelial cell proliferation and crypt cell migration were increased in unirradiated duodenum and colon of single intestine-irradiated rats. Essentially the same changes were seen in the irradiated member of a parabiotic pair, but none of these changes were noted in the unirradiated member. The absence of stimulation in the unirradiated parabiont suggests that either a systemic humoral factor is not present after X-irradiation or is not present in sufficient concentration to be detected by these methods. (orig./MG)

  11. Social roles and performance of social-ecological systems: evidence from behavioral lab experiments

    Directory of Open Access Journals (Sweden)

    Irene Perez

    2015-09-01

    Full Text Available Social roles are thought to play an important role in determining the capacity for collective action in a community regarding the use of shared resources. Here we report on the results of a study using a behavioral experimental approach regarding the relationship between social roles and the performance of social-ecological systems. The computer-based irrigation experiment that was the basis of this study mimics the decisions faced by farmers in small-scale irrigation systems. In each of 20 rounds, which are analogous to growing seasons, participants face a two-stage commons dilemma. First they must decide how much to invest in the public infrastructure, e.g., canals and water diversion structures. Second, they must decide how much to extract from the water made available by that public infrastructure. Each round begins with a 60-second communication period before the players make their investment and extraction decisions. By analyzing the chat messages exchanged among participants during the communication stage of the experiment, we coded up to three roles per participant using the scheme of seven roles known to be important in the literature: leader, knowledge generator, connector, follower, moralist, enforcer, and observer. Our study supports the importance of certain social roles (e.g., connector previously highlighted by several case study analyses. However, using qualitative comparative analysis we found that none of the individual roles was sufficient for groups to succeed, i.e., to reach a certain level of group production. Instead, we found that a combination of at least five roles was necessary for success. In addition, in the context of upstream-downstream asymmetry, we observed a pattern in which social roles assumed by participants tended to differ by their positions. Although our work generated some interesting insights, further research is needed to determine how robust our findings are to different action situations, such as

  12. Provincial health accounts in Kerman, Iran: an evidence of a "mixed" healthcare financing system.

    Science.gov (United States)

    Mehrolhassani, Mohammad Hossein; Jafari, Mohammad; Zeinali, Javad; Ansari, Mina

    2014-02-01

    Provincial Health Accounts (PHA) as a subset of National Health Accounts (NHA) present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC). This study aimed to examine Health Accounts in Kerman Province. The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General's office. In order to classify the data, the International Classification for Health Accounts (ICHA) method was used, in which data set was adjusted for the province. During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41) was related to private household funds, of which the Out-of-Pocket (OOP) payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs) (65.19%) was related to curative services. The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By emphasizing on Social Determinant of Health (SDH) approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor initiatives and reforms in healthcare sector.

  13. Photometric and spectroscopic evidence for a dense ring system around Centaur Chariklo

    Science.gov (United States)

    Duffard, R.; Pinilla-Alonso, N.; Ortiz, J. L.; Alvarez-Candal, A.; Sicardy, B.; Santos-Sanz, P.; Morales, N.; Colazo, C.; Fernández-Valenzuela, E.; Braga-Ribas, F.

    2014-08-01

    Context. A stellar occultation observed on 3rd June 2013 revealed the presence of two dense and narrow rings separated by a small gap around the Centaur object (10 199) Chariklo. The composition of these rings is not known. We suspect that water ice is present in the rings, as is the case for Saturn and other rings around the giant planets. Aims: In this work, we aim to determine if the variability in the absolute magnitude of Chariklo and the temporal variation of the spectral ice feature, even when it disappeared in 2007, can be explained by an icy ring system whose aspect angle changes with time. Methods: We explained the variations on the absolute magnitude of Chariklo and its ring by modeling the light reflected by a system as the one described above. Using X-shooter at VLT, we obtained a new reflectance spectra. We compared this new set of data with the ones available in the literature. We showed how the water ice feature is visible in 2013 in accordance with the ring configuration, which had an opening angle of nearly 34° in 2013. Finally, we also used models of light scattering to fit the visible and near-infrared spectra that shows different characteristics to obtain information on the composition of Chariklo and its rings. Results: We showed that absolute photometry of Chariklo from the literature and new photometric data that we obtained in 2013 can be explained by a ring of particles whose opening angle changes as a function of time. We used the two possible pole solutions for the ring system and found that only one of them, α = 151.30 ± 0.5, δ = 41.48 ± 0.2° (λ = 137.9 ± 0.5, β = 27.7 ± 0.2°), provides the right variation of the aspect angle with time to explain the photometry, whereas the other possible pole solution fails to explain the photometry. From spectral modeling, we derived the composition of the Chariklo surface and that of the rings using the result on the pole solution. Chariklo surface is composed with about 60% of amorphous

  14. Consumers' Response to an On-Shelf Nutrition Labelling System in Supermarkets: Evidence to Inform Policy and Practice.

    Science.gov (United States)

    Hobin, Erin; Bollinger, Bryan; Sacco, Jocelyn; Liebman, Eli; Vanderlee, Lana; Zuo, Fei; Rosella, Laura; L'abbe, Mary; Manson, Heather; Hammond, David

    2017-09-01

    Policy Points: On-shelf nutrition labelling systems in supermarkets, such as the Guiding Stars system, are intended to provide consumers with simple, standardized nutrition information to support more informed and healthier food choices. Policies that support the provision of simplified nutrition labelling systems may encourage consumers to make positive shifts in food-purchasing behaviors. The shifts in consumer food-purchasing patterns observed in our study after the introduction of the Guiding Stars system in supermarkets translated into measurable nutritional benefits, including more items purchased with slightly less trans fat and sugar and more fiber and omega-3 fatty acids. This study is one of the first to report the positive impact of an on-shelf nutrition labelling system on supermarket sales and revenues-key information that was specifically requested by the US National Academies, as such labelling interventions may be more sustainable if they lead to higher revenues. Providing a nutrition rating system on the front of food packages or on retail shelf tags has been proposed as a policy strategy for supporting healthier food choices. Guiding Stars is an on-shelf nutrition labelling system that scores foods in a supermarket based on nutritional quality; scores are then translated into ratings of 0 to 3 stars. It is consistent with evidence-informed recommendations for well-designed labels, except for not labelling 0-star products. The largest supermarket retailer in Canada rolled out the Guiding Stars system in supermarkets across Ontario, Canada. The aim of our study was to examine the extent to which consumers respond to an on-shelf nutrition labelling system in supermarkets to inform current and future nutrition labelling policies and practices. Capitalizing on a natural experiment, we conducted a quasi-experimental study across 3 supermarket banners (or "chains") in Ontario, one of which implemented the Guiding Stars system in 2012. We used aggregated

  15. Evidence for alternative quaternary structure in a bacterial Type III secretion system chaperone

    Energy Technology Data Exchange (ETDEWEB)

    Barta, Michael L.; Zhang, Lingling; Picking, Wendy L.; Geisbrecht, Brian V. (UMKC); (OKLU)

    2010-10-05

    Type III secretion systems are a common virulence mechanism in many Gram-negative bacterial pathogens. These systems use a nanomachine resembling a molecular needle and syringe to provide an energized conduit for the translocation of effector proteins from the bacterial cytoplasm to the host cell cytoplasm for the benefit of the pathogen. Prior to translocation specialized chaperones maintain proper effector protein conformation. The class II chaperone, Invasion plasmid gene (Ipg) C, stabilizes two pore forming translocator proteins. IpgC exists as a functional dimer to facilitate the mutually exclusive binding of both translocators. In this study, we present the 3.3 {angstrom} crystal structure of an amino-terminally truncated form (residues 10-155, denoted IpgC10-155) of the class II chaperone IpgC from Shigella flexneri. Our structure demonstrates an alternative quaternary arrangement to that previously described for a carboxy-terminally truncated variant of IpgC (IpgC{sup 1-151}). Specifically, we observe a rotationally-symmetric 'head-to-head' dimerization interface that is far more similar to that previously described for SycD from Yersinia enterocolitica than to IpgC1-151. The IpgC structure presented here displays major differences in the amino terminal region, where extended coil-like structures are seen, as opposed to the short, ordered alpha helices and asymmetric dimerization interface seen within IpgC{sup 1-151}. Despite these differences, however, both modes of dimerization support chaperone activity, as judged by a copurification assay with a recombinant form of the translocator protein, IpaB. Conclusions: From primary to quaternary structure, these results presented here suggest that a symmetric dimerization interface is conserved across bacterial class II chaperones. In light of previous data which have described the structure and function of asymmetric dimerization, our results raise the possibility that class II chaperones may

  16. Periodontal Systemic Connections-Novel Associations-A Review of the Evidence with Implications for Medical Practitioners.

    Science.gov (United States)

    Kalakonda, Butchibabu; Koppolu, Pradeep; Baroudi, Kusai; Mishra, Ashank

    2016-04-01

    Periodontal diseases, considered as inflammatory diseases have proved to have a spectrum of systemic implications. Earliest research has associated periodontal disease with common systemic aliments such as hypertension, diabetes, osteoporosis, rheumatoid arthritis to name a few. The evolution of advanced diagnostic aids let researchers make vast inroads in linking periodontal diseases to systemic diseases like Alzheimer's disease (AD) and even Schizophrenia. Our aim was to review and critically evaluate comprehensive literature and provide knowledge to medical practitioners on these associations so as to pave way for closer interactions between medical and dental practitioners in implementing better health care. Electronic databases such as PubMed, Google Scholar and Cochrane databases were used as source of the data for relevant studies published from 2005 up to 2015 with the following keywords, "'Periodontal disease", "systemic conditions", "periodontal disease and Alzheimer's", "Periodontal disease and Schizophrenia", "Periodontal disease and Psoriasis" and "Periodontal disease and erectile dysfunction". The evidence presented ascertains that a reasonable and modest association does exist between Periodontal disease and Alzheimer's, Schizophrenia, Erectile dysfunction, as well as Psoriasis and thus establishes periodontal disease as a potential risk factor.

  17. Aligning Leadership Across Systems and Organizations to Develop Strategic Climate to for Evidence-Based Practice Implementation

    Science.gov (United States)

    Aarons, Gregory A.; Farahnak, Lauren R.; Ehrhart, Mark G.; Sklar, Marisa

    2015-01-01

    There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs) and their availability and delivery in order to improve public health impact of such practices. In seeking to capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that healthcare is delivered within the outer context of public health systems, and the inner context of healthcare organizations and workgroups. Leaders have a key role in determining the nature of system and organizational context. This article will addresses the role of leadership across levels in developing strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of healthcare. Within the framework of Edgar Schein’s “climate embedding mechanisms,” we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop a strategic climates that support the implementation and sustainment of EBP in healthcare and allied healthcare settings. PMID:24641560

  18. Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation.

    Science.gov (United States)

    Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Sklar, Marisa

    2014-01-01

    There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs), and the availability and delivery of EBPs in order to improve the public health impact of such practices. To capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups. Leaders play a key role in determining the nature of system and organizational contexts. This article addresses the role of leadership and actions that leaders can take at and across levels in developing a strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of health care. Within the framework of Edgar Schein's "climate embedding mechanisms," we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop strategic climates that support the implementation and sustainment of EBP in health care and allied health care settings.

  19. KAMUTHE video microanalysis system for use in Brazil: translation, cross-cultural adaptation and evidence of validity and reliability

    Directory of Open Access Journals (Sweden)

    Gustavo Schulz Gattino

    2016-11-01

    Full Text Available Background KAMUTHE is a video microanalysis system which observes preverbal communication within the music therapy setting. This system is indicated for children with autism spectrum disorder (ASD or multiple disabilities. The purpose of this study was to translate, adapt to Brazilian Portuguese language and analyze some psychometric properties (reliability and validity evidence of KAMUTHE administration in Brazil for individuals with ASD. Participants and procedure Translation, back translation, analysis by judges, and pilot application were performed to obtain evidence of content and face validity. The second part of this study was to administer KAMUTHE in 39 consecutive children with ASD. An individual session of improvisational music therapy was applied to assess the different behaviors included in KAMUTHE. The intra-rater reliability, concurrent validity and convergent validity were analyzed. Results Translation and cross-cultural adaptation were followed and some cultural adaptations were needed. Inter-rater reliability was very good (ICCs 0.95-0.99 for the three child’s behaviors analyzed. Criteria validity with a moderate negative association was found (r = –.38, p = .017 comparing the behavior “Gazes at therapist” and the level of ASD along with the Childhood Autism Rating Scale (CARS. Convergent validity was established between the behavior “Gazes at therapist” and the two nonlinguistic communication scales (social interaction and interests of the Children’s Communication Checklist (CCC with a moderate correlation (r = –.43, p = .005. Conclusions The administration of the KAMUTHE video microanalysis system showed positive results in children with ASD. Further studies are needed to improve the reliability and validity of the instrument in Brazil.

  20. Reassessment of the evidence for postcranial skeletal pneumaticity in Triassic archosaurs, and the early evolution of the avian respiratory system.

    Directory of Open Access Journals (Sweden)

    Richard J Butler

    Full Text Available Uniquely among extant vertebrates, birds possess complex respiratory systems characterised by the combination of small, rigid lungs, extensive pulmonary air sacs that possess diverticula that invade (pneumatise the postcranial skeleton, unidirectional ventilation of the lungs, and efficient crosscurrent gas exchange. Crocodilians, the only other living archosaurs, also possess unidirectional lung ventilation, but lack true air sacs and postcranial skeletal pneumaticity (PSP. PSP can be used to infer the presence of avian-like pulmonary air sacs in several extinct archosaur clades (non-avian theropod dinosaurs, sauropod dinosaurs and pterosaurs. However, the evolution of respiratory systems in other archosaurs, especially in the lineage leading to crocodilians, is poorly documented. Here, we use µCT-scanning to investigate the vertebral anatomy of Triassic archosaur taxa, from both the avian and crocodilian lineages as well as non-archosaurian diapsid outgroups. Our results confirm previous suggestions that unambiguous evidence of PSP (presence of internal pneumatic cavities linked to the exterior by foramina is found only in bird-line (ornithodiran archosaurs. We propose that pulmonary air sacs were present in the common ancestor of Ornithodira and may have been subsequently lost or reduced in some members of the clade (notably in ornithischian dinosaurs. The development of these avian-like respiratory features might have been linked to inferred increases in activity levels among ornithodirans. By contrast, no crocodile-line archosaur (pseudosuchian exhibits evidence for unambiguous PSP, but many of these taxa possess the complex array of vertebral laminae and fossae that always accompany the presence of air sacs in ornithodirans. These laminae and fossae are likely homologous with those in ornithodirans, which suggests the need for further investigation of the hypothesis that a reduced, or non-invasive, system of pulmonary air sacs may be have

  1. Assessing the competitive conditions in the Italian banking system: some empirical evidence

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    Paolo Coccorese

    1998-06-01

    Full Text Available In the wake of European financial market integration, resulting from the elimination of controls on capital movements and the free access given to banks to other domestic markets within the EU, the Italian financial system has undergone a considerable transformation. In the aftermath of these new changes, however, has there been an increase in competition resulting in significant gains for consumers? Or rather, is unification alone, due to imperfections in financial markets, not enough to bring about stronger competition? Utilizing the Rosse-Panzar test, the author analyzes a sample of Italian banks from 1988-96 to evaluate the degree of competition in the industry. The findings suggest that the Italian banking industry operates under conditions of monopolistic competition and that European integration has yet to have a significant impact on industry conduct. However, the Author notes that due to the relative novelty of liberalization its long-term effect can not yet be known. Although the banking industry was far from equilibrium in the years examined, after the initiation of European integration there was a move towards it, however, it has yet to be attained.

  2. Social media as a student response system: new evidence on learning impact

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    Chelsea Liu

    2018-04-01

    Full Text Available The ubiquitousness of social media renders it a potentially powerful tool in higher education. This study explores the use of Twitter as a tool to enhance active learning and improve feedback during large-sized lectures. Students in a final-year undergraduate accounting course at an Australian university engaged in Twitter-based synchronous activities, including answering in-lecture quizzes and posting questions. This study explores two key questions: (1 ‘what encourages students to actively utilise social media in their learning process?’ and (2 ‘what pedagogical advantages are offered by social media in enhancing students’ learning experiences?’ Results of a student survey administered at the end of the course show that (1 students are more likely to participate in in-lecture Twitter activities if they are familiar with the technology, (2 Twitter activities encourage students to participate in active learning, (3 Twitter provides a platform enabling two-way student–instructor communication and (4 students find Twitter activities helpful regardless of whether they attend the lecture in real time or view online lecture recordings. These findings deepen our understanding of the pedagogical benefits of using Twitter as a student response system, which will assist educators to better harness the power of social media in the learning–teaching process.

  3. Local Government Systems and Decentralization: Evidence from Pakistan’s Devolution Plan

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    Muhammad Shakil Ahmad

    2013-03-01

    Full Text Available The discourse of governance and development practitioners continues to embrace community participation and community empowerment as an elementary means of building local capacity for poverty reduction, development and change at the local level. This article is a review of the decentralization initiatives of local government systems after the announcement of the devolution plan in Pakistan. It evaluates the initiatives’ participatory methods to ascertain the extent to which they have improved the process of community development at the local level. This article also measures the impact of community empowerment on the sustainability of community-driven projects implemented under the decentralization initiative through community-based organizations known as Citizen Community Boards (CCBs. Document analysis and literature review methodologies were employed to gain further insight into the decentralization phenomenon in Pakistan. The results describe human development, improvements in community empowerment and the sustainability of local projects; however, the sense of community has yet to be translated into shared benefits for rural communities. The fundamental goal of decentralization seems to be elusive because only power was transferred to the local level, whereas there is little support for community capacity building and community access to resources and the elites still control the electoral process. It is argued that community development initiatives in Pakistan require continuous support from local governments to boost local rural economies. Likewise, community-local government participatory development strategies can lead to strong local ownership and empowerment in rural communities.

  4. Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus.

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    Milette, Katherine; Hudson, Marie; Körner, Annett; Baron, Murray; Thombs, Brett D

    2013-09-01

    SSc is a rare autoimmune CTD characterized by thickening and fibrosis of skin and internal organs. There is significant mortality and no cure. Sleep disturbance has been identified as an important contributor to poor quality of life. The objective was to investigate socio-demographic and medical factors potentially associated with sleep disturbance in SSc. The sample consisted of patients from the Canadian Scleroderma Research Group's (CSRG) 15-centre, pan-Canadian Registry assessed with the 8-item Patient-Reported Outcome Measurement Information System (PROMIS) sleep disturbance scale short form, version 1.0. Pearson's correlations were used to assess bivariate association of socio-demographic and medical variables with PROMIS sleep scores. The independent association of PROMIS sleep disturbance scores and factors previously identified as associated with sleep disturbance in the general population, in SSc and other rheumatic diseases, was assessed using multiple linear regression. Among 397 patients in the study (88% female, mean age 57.5 years), 25% (n = 98) had diffuse cutaneous SSc. Mean duration since onset of non-RP symptoms was 10.6 years. Number of gastrointestinal symptoms (standardized regression coefficient β = 0.19, P = 0.001), pain severity (β = 0.21, P sleep disturbance. Gastrointestinal symptoms, pain and pruritus were associated with sleep disturbance in SSc. Additional research is needed on sleep in SSc so that well-informed sleep interventions can be developed and tested.

  5. Evidence of plutonium bioavailability in pristine freshwaters of a karst system of the Swiss Jura Mountains

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    Cusnir, Ruslan; Christl, Marcus; Steinmann, Philipp; Bochud, François; Froidevaux, Pascal

    2017-06-01

    The interaction of trace environmental plutonium with dissolved natural organic matter (NOM) plays an important role on its mobility and bioavailability in freshwater environments. Here we explore the speciation and biogeochemical behavior of Pu in freshwaters of the karst system in the Swiss Jura Mountains. Chemical extraction and ultrafiltration methods were complemented by diffusive gradients in thin films technique (DGT) to measure the dissolved and bioavailable Pu fraction in water. Accelerator mass spectrometry (AMS) was used to accurately determine Pu in this pristine environment. Selective adsorption of Pu (III, IV) on silica gel showed that 88% of Pu in the mineral water is found in +V oxidation state, possibly in a highly soluble [PuO2+(CO3)n]m- form. Ultrafiltration experiments at 10 kDa yielded a similar fraction of colloid-bound Pu in the organic-rich and in mineral water (18-25%). We also found that the concentrations of Pu measured by DGT in mineral water are similar to the bulk concentration, suggesting that dissolved Pu is readily available for biouptake. Sequential elution (SE) of Pu from aquatic plants revealed important co-precipitation of potentially labile Pu (60-75%) with calcite fraction within outer compartment of the plants. Hence, we suggest that plutonium is fully available for biological uptake in both mineral and organic-rich karstic freshwaters.

  6. Parasitic manipulation and neuroinflammation: Evidence from the system Microphallus papillorobustus (Trematoda - Gammarus (Crustacea

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    Thomas Frederic

    2010-04-01

    Full Text Available Abstract Background Neuropathological consequences of neuroinflammatory processes have been implicated in a wide range of diseases affecting the central nervous system (CNS. Glial cells, the resident immune cells of the CNS, respond to tissue injury by releasing proinflammatory cytokines and free radicals such as nitric oxide. We explored the possibility that neuroimmune responses are involved in parasitic manipulation of host behavior in a trematode-crustacean association. The cerebral larva of the flatworm Microphallus papillorobustus alters responses to environmental stimuli - and thus reflex pathways - in the crustacean Gammarus insensibilis, in a way that enhances predation of the crustacean by birds, definitive hosts of the parasite. Results Immunocytochemical experiments followed by confocal microscopy were performed to study the distribution of glutamine synthetase, a glial cell marker, and nitric oxide synthase in the brain of gammarids. Astrocyte-like glia and their processes were abundant at the surface of the parasites while levels of nitric oxide synthase were elevated at the host-parasite interface in the brain of gammarids harboring mature cerebral larvae and demonstrating altered behavior. Conclusion Taken together these results lend support to the neuroinflammation hypothesis whereby a chronic CNS specific immune response induced by the parasite plays a role in the disruption of neuromodulation, neuronal integrity, and behavior in infected hosts.

  7. Nanofibrous scaffolds supporting optimal central nervous system regeneration: an evidence-based review

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    Kamudzandu M

    2015-12-01

    Full Text Available Munyaradzi Kamudzandu, Paul Roach, Rosemary A Fricker, Ying Yang Institute for Science and Technology in Medicine, School of Medicine, Keele University, Stoke-on-Trent, UK Abstract: Restoration of function following damage to the central nervous system (CNS is severely restricted by several factors. These include the hindrance of axonal regeneration imposed by glial scars resulting from inflammatory response to damage, and limited axonal outgrowth toward target tissue. Strategies for promoting CNS functional regeneration include the use of nanotechnology. Due to their structural similarity, synthetic nanofibers could play an important role in regeneration of CNS neural tissue toward restoration of function following injury. Two-dimensional nanofibrous scaffolds have been used to provide contact guidance for developing brain and spinal cord neurites, particularly from neurons cultured in vitro. Three-dimensional nanofibrous scaffolds have been used, both in vitro and in vivo, for creating cell adhesion permissive milieu, in addition to contact guidance or structural bridges for axons, to control reconnection in brain and spinal cord injury models. It is postulated that nanofibrous scaffolds made from biodegradable and biocompatible materials can become powerful structural bridges for both guiding the outgrowth of neurites and rebuilding glial circuitry over the “lesion gaps” resulting from injury in the CNS. Keywords: scaffold, nanofibrous scaffold, CNS, regeneration, alignment

  8. Acceptance and willingness to pay for solar home system: Survey evidence from northern area of Pakistan

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    Abdullah

    2017-11-01

    Full Text Available The importance of solar energy has been accepted worldwide for the generation of electricity, but unfortunately, Pakistan has yet to exert efforts on the development of this source of energy. The purpose of this research is to explore the public acceptance and interest in solar home system (SHS. Moreover, the expectations of the public towards SHS development in Pakistan and the difficulties they face in SHS usage are identified. The result of the survey indicates that about 81% of the respondents show higher interest in SHS. However, many respondents claim that some hindrances obstruct them from using SHS which includes; high cost of solar panels, lack of information and trust on solar panel providers. Almost 60% of the respondents expect that government provision of incentives could be the best way to boost the usage of SHS countrywide. For the successful implementation of new SHS policy, the government of Pakistan needs to establish solar power plants, increase installation of solar panels, provides funding and full information for conducting independent research. In addition, almost 90% of the respondents believe that government should take the lead in developing the SHS sector. Therefore, this study provides some valuable references for SHS promotion in Pakistan.

  9. Evidence of arsenic release promoted by disinfection by-products within drinking-water distribution systems.

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    Andra, Syam S; Makris, Konstantinos C; Botsaris, George; Charisiadis, Pantelis; Kalyvas, Harris; Costa, Costas N

    2014-02-15

    Changes in disinfectant type could trigger a cascade of reactions releasing pipe-anchored metals/metalloids into finished water. However, the effect of pre-formed disinfection by-products on the release of sorbed contaminants (arsenic-As in particular) from drinking water distribution system pipe scales remains unexplored. A bench-scale study using a factorial experimental design was performed to evaluate the independent and interaction effects of trihalomethanes (TTHM) and haloacetic acids (HAA) on arsenic (As) release from either scales-only or scale-biofilm conglomerates (SBC) both anchored on asbestos/cement pipe coupons. A model biofilm (Pseudomonas aeruginosa) was allowed to grow on select pipe coupons prior experimentation. Either TTHM or HAA individual dosing did not promote As release from either scales only or SBC, detecting water. In the case of scales-only coupons, the combination of the highest spike level of TTHM and HAA significantly (pwater in pipe networks remains to be investigated in the field. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Preliminary evidence for a change in spectral sensitivity of the circadian system at night

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    Parsons Robert H

    2005-12-01

    Full Text Available Abstract Background It is well established that the absolute sensitivity of the suprachiasmatic nucleus to photic stimulation received through the retino-hypothalamic tract changes throughout the 24-hour day. It is also believed that a combination of classical photoreceptors (rods and cones and melanopsin-containing retinal ganglion cells participate in circadian phototransduction, with a spectral sensitivity peaking between 440 and 500 nm. It is still unknown, however, whether the spectral sensitivity of the circadian system also changes throughout the solar day. Reported here is a new study that was designed to determine whether the spectral sensitivity of the circadian retinal phototransduction mechanism, measured through melatonin suppression and iris constriction, varies at night. Methods Human adult males were exposed to a high-pressure mercury lamp [450 lux (170 μW/cm2 at the cornea] and an array of blue light emitting diodes [18 lux (29 μW/cm2 at the cornea] during two nighttime experimental sessions. Both melatonin suppression and iris constriction were measured during and after a one-hour light exposure just after midnight and just before dawn. Results An increase in the percentage of melatonin suppression and an increase in pupil constriction for the mercury source relative to the blue light source at night were found, suggesting a temporal change in the contribution of photoreceptor mechanisms leading to melatonin suppression and, possibly, iris constriction by light in humans. Conclusion The preliminary data presented here suggest a change in the spectral sensitivity of circadian phototransduction mechanisms at two different times of the night. These findings are hypothesized to be the result of a change in the sensitivity of the melanopsin-expressing retinal ganglion cells to light during the night.

  11. Obese adults have visual attention bias for food cue images: evidence for altered reward system function.

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    Castellanos, E H; Charboneau, E; Dietrich, M S; Park, S; Bradley, B P; Mogg, K; Cowan, R L

    2009-09-01

    The major aim of this study was to investigate whether the motivational salience of food cues (as reflected by their attention-grabbing properties) differs between obese and normal-weight subjects in a manner consistent with altered reward system function in obesity. A total of 18 obese and 18 normal-weight, otherwise healthy, adult women between the ages of 18 and 35 participated in an eye-tracking paradigm in combination with a visual probe task. Eye movements and reaction time to food and non-food images were recorded during both fasted and fed conditions in a counterbalanced design. Eating behavior and hunger level were assessed by self-report measures. Obese individuals had higher scores than normal-weight individuals on self-report measures of responsiveness to external food cues and vulnerability to disruptions in control of eating behavior. Both obese and normal-weight individuals demonstrated increased gaze duration for food compared to non-food images in the fasted condition. In the fed condition, however, despite reduced hunger in both groups, obese individuals maintained the increased attention to food images, whereas normal-weight individuals had similar gaze duration for food and non-food images. Additionally, obese individuals had preferential orienting toward food images at the onset of each image. Obese and normal-weight individuals did not differ in reaction time measures in the fasted or fed condition. Food cue incentive salience is elevated equally in normal-weight and obese individuals during fasting. Obese individuals retain incentive salience for food cues despite feeding and decreased self-report of hunger. Sensitization to food cues in the environment and their dysregulation in obese individuals may play a role in the development and/or maintenance of obesity.

  12. Control Problems in Distribution Channels: Empirical Evidence of Management Control Systems Contributions.

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    José M. Sánchez Vázqez

    2006-12-01

    Full Text Available As part of the supply chain, manufacturing firms are increasingly placing greater emphasis on the management of their outsourced distribution channels (DCs. However, the role that interorganizational Management Control Systems (MCS can play in managing DC problems is still not clearly understood. Through an exploratory case study, we show how intra-organizational control problems persist in an inter-organizational context, rooted in informational asymmetries and conflicts of interest and aggravated by interdependencies. Likewise, the case study illustrates the way in which MCS assists the manufacturing firm to communicate to its representatives what the organization wants from them, motivating them and transferring capabilities. Thus, MCS can help to complement and re-orientate inter-firm agreements and constitutes a key tool for managing DCs in a flexible way.Como parte de la cadena de suministros, las empresas productoras están poniendo mayor énfasis en la gestión de sus canales de distribución externalizados (DCs. Sin embargo, aún no existe una clara comprensión sobre el papel que los Sistemas de Control de Gestión inter-organizativos (MCS pueden desarrollar en la gestión de los problemas de los DCs. A través de un estudio de caso, se muestra cómo los problemas de control intra-organizativos persisten en un contexto inter-organizativo, causados por las asimetrías informativas y el conflicto de intereses, y agravándose por las interdependencias. Asimismo, se expone cómo los MCS ayudan a la empresa productora a comunicar a sus distribuidores lo que la organización desea de ellos, motivándolos y capacitándolos. De esta forma, los MCS pueden ayudar a completar y redirigir acuerdos entre firmas y constituir una herramienta clave en la gestión flexible de los DCs.

  13. Further Evidence of Subphenotype Association with Systemic Lupus Erythematosus Susceptibility Loci: A European Cases Only Study

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    Alonso-Perez, Elisa; Suarez-Gestal, Marian; Calaza, Manuel; Ordi-Ros, Josep; Balada, Eva; Bijl, Marc; Papasteriades, Chryssa; Carreira, Patricia; Skopouli, Fotini N.; Witte, Torsten; Endreffy, Emöke; Marchini, Maurizio; Migliaresi, Sergio; Sebastiani, Gian Domenico; Santos, Maria Jose; Suarez, Ana; Blanco, Francisco J.; Barizzone, Nadia; Pullmann, Rudolf; Ruzickova, Sarka; Lauwerys, Bernard R.; Gomez-Reino, Juan J.; Gonzalez, Antonio

    2012-01-01

    Introduction Systemic Lupus Erythematosus (SLE) shows a spectrum of clinical manifestations that complicate its diagnosis, treatment and research. This variability is likely related with environmental exposures and genetic factors among which known SLE susceptibility loci are prime candidates. The first published analyses seem to indicate that this is the case for some of them, but results are still inconclusive and we aimed to further explore this question. Methods European SLE patients, 1444, recruited at 17 centres from 10 countries were analyzed. Genotypes for 26 SLE associated SNPs were compared between patients with and without each of 11 clinical features: ten of the American College of Rheumatology (ACR) classification criteria (except ANAs) and age of disease onset. These analyses were adjusted for centre of recruitment, top ancestry informative markers, gender and time of follow-up. Overlap of samples with previous studies was excluded for assessing replication. Results There were three new associations: the SNPs in XKR6 and in FAM167A-BLK were associated with lupus nephritis (OR = 0.76 and 1.30, Pcorr = 0.007 and 0.03, respectively) and the SNP of MECP2, which is in chromosome X, with earlier age of disease onset in men. The previously reported association of STAT4 with early age of disease onset was replicated. Some other results were suggestive of the presence of additional associations. Together, the association signals provided support to some previous findings and to the characterization of lupus nephritis, autoantibodies and age of disease onset as the clinical features more associated with SLE loci. Conclusion Some of the SLE loci shape the disease phenotype in addition to increase susceptibility to SLE. This influence is more prominent for some clinical features than for others. However, results are only partially consistent between studies and subphenotype specific GWAS are needed to unravel their genetic component. PMID:23049788

  14. Evidence of new risk genetic factor to systemic lupus erythematosus: the UBASH3A gene.

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    Lina-Marcela Diaz-Gallo

    Full Text Available The ubiquitin associated and Src-homology 3 (SH3 domain containing A (UBASH3a is a suppressor of T-cell receptor signaling, underscoring antigen presentation to T-cells as a critical shared mechanism of diseases pathogenesis. The aim of the present study was to determine whether the UBASH3a gene influence the susceptibility to systemic lupus erythematosus (SLE in Caucasian populations. We evaluated five UBASH3a polymorphisms (rs2277798, rs2277800, rs9976767, rs13048049 and rs17114930, using TaqMan® allelic discrimination assays, in a discovery cohort that included 906 SLE patients and 1165 healthy controls from Spain. The SNPs that exhibit statistical significance difference were evaluated in a German replication cohort of 360 SLE patients and 379 healthy controls. The case-control analysis in the Spanish population showed a significant association between the rs9976767 and SLE (Pc = 9.9E-03 OR = 1.21 95%CI = 1.07-1.37 and a trend of association for the rs2277798 analysis (P = 0.09 OR = 0.9 95%CI = 0.79-1.02. The replication in a German cohort and the meta-analysis confirmed that the rs9976767 (Pc = 0.02; Pc = 2.4E-04, for German cohort and meta-analysis, respectively and rs2277798 (Pc = 0.013; Pc = 4.7E-03, for German cohort and meta-analysis, respectively UBASH3a variants are susceptibility factors for SLE. Finally, a conditional regression analysis suggested that the most likely genetic variation responsible for the association was the rs9976767 polymorphism. Our results suggest that UBASH3a gene plays a role in the susceptibility to SLE. Moreover, our study indicates that UBASH3a can be considered as a common genetic factor in autoimmune diseases.

  15. Dysfunction of the Human Mirror Neuron System in Ideomotor Apraxia: Evidence from Mu Suppression.

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    Frenkel-Toledo, Silvi; Liebermann, Dario G; Bentin, Shlomo; Soroker, Nachum

    2016-06-01

    Stroke patients with ideomotor apraxia (IMA) have difficulties controlling voluntary motor actions, as clearly seen when asked to imitate simple gestures performed by the examiner. Despite extensive research, the neurophysiological mechanisms underlying failure to imitate gestures in IMA remain controversial. The aim of the current study was to explore the relationship between imitation failure in IMA and mirror neuron system (MNS) functioning. Mirror neurons were found to play a crucial role in movement imitation and in imitation-based motor learning. Their recruitment during movement observation and execution is signaled in EEG recordings by suppression of the lower (8-10 Hz) mu range. We examined the modulation of EEG in this range in stroke patients with left (n = 21) and right (n = 15) hemisphere damage during observation of video clips showing different manual movements. IMA severity was assessed by the DeRenzi standardized diagnostic test. Results showed that failure to imitate observed manual movements correlated with diminished mu suppression in patients with damage to the right inferior parietal lobule and in patients with damage to the right inferior frontal gyrus pars opercularis-areas where major components of the human MNS are assumed to reside. Voxel-based lesion symptom mapping revealed a significant impact on imitation capacity for the left inferior and superior parietal lobules and the left post central gyrus. Both left and right hemisphere damages were associated with imitation failure typical of IMA, yet a clear demonstration of relationship to the MNS was obtained only in the right hemisphere damage group. Suppression of the 8-10 Hz range was stronger in central compared with occipital sites, pointing to a dominant implication of mu rather than alpha rhythms. However, the suppression correlated with De Renzi's apraxia test scores not only in central but also in occipital sites, suggesting a multifactorial mechanism for IMA, with a possible

  16. [Low-grade systemic inflammation and the development of metabolic diseases: from the molecular evidence to the clinical practice].

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    León-Pedroza, José Israel; González-Tapia, Luis Alonso; del Olmo-Gil, Esteban; Castellanos-Rodríguez, Diana; Escobedo, Galileo; González-Chávez, Antonio

    2015-01-01

    Systemic inflammation is characterised by high circulating levels of inflammatory cytokines and increased macrophage infiltration in peripheral tissues. Most importantly, this inflammatory state does not involve damage or loss of function of the infiltrated tissue, which is a distinctive feature of the low-grade systemic inflammation. The term "meta-inflammation" has also been used to refer to the low-grade systemic inflammation due to its strong relationship with the development of cardio-metabolic diseases in obesity. A review is presented on the recent clinical and experimental evidence concerning the role of adipose tissue inflammation as a key mediator of low-grade systemic inflammation. Furthermore, the main molecular mechanisms involved in the inflammatory polarization of macrophages with the ability to infiltrate both the adipose tissue and the vascular endothelium via activation of toll-like receptors by metabolic damage-associated molecular patterns, such as advanced glycation-end products and oxidized lipoproteins, is discussed. Finally, a review is made of the pathogenic mechanisms through which the low-grade systemic inflammation contributes to develop insulin resistance, dyslipidaemia, atherogenesis, type 2 diabetes, and hypertension in obese individuals. A better understanding of the molecular mechanisms of low-grade systemic inflammation in promoting cardio-metabolic diseases is necessary, in order to further design novel anti-inflammatory therapies that take into consideration clinical data, as well as the circulating levels of cytokines, immune cells, and metabolic damage-associated molecular patterns in each patient. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  17. Evidence of linked biogeochemical and hydrological processes in homogeneous and layered vadose zone systems

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    McGuire, J. T.; Hansen, D. J.; Mohanty, B. P.

    2010-12-01

    flux. No such mineral bands developed in the sterilized column. As a consequence, water content in the lenses of the sterilized column was half that of the other column and flow rates through the lenses were an order of magnitude lower. This flow impedance limited the interaction and mixing of groundwater with infiltrating vadose zone water and led to the formation of geochemically distinct water masses residing in relatively close proximity to one another. Results provide a specific examples of the direct impact of biogeochemical cycling on water flow in the vadose zone and vice versa. In addition, these demonstrate that the presence of layers in vadose zone environments may be an important control on overall chemical fate and transport in subsurface systems.

  18. Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials

    Science.gov (United States)

    Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T. J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Timothy E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; Purdy, James

    2012-01-01

    Background In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute (NCI) sponsored a two day workshop to examine the challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. Lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities like proton beam therapy, and the international harmonization of clinical trial QA. Results Four recommendations were made: 1) Develop a tiered (and more efficient) system for radiotherapy QA and tailor intensity of QA to clinical trial objectives. Tiers include (i) general credentialing, (ii) trial specific credentialing, and (iii) individual case review; 2) Establish a case QA repository; 3) Develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and 4) Explore the feasibility of consolidating clinical trial QA in the United States. Conclusion Radiotherapy QA may impact clinical trial accrual, cost, outcomes and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. PMID:22425219

  19. Evidence from stable isotopes and 10Be for solar system formation triggered by a low-mass supernova

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    Banerjee, Projjwal; Qian, Yong-Zhong; Heger, Alexander; Haxton, W. C.

    2016-11-01

    About 4.6 billion years ago, some event disturbed a cloud of gas and dust, triggering the gravitational collapse that led to the formation of the solar system. A core-collapse supernova, whose shock wave is capable of compressing such a cloud, is an obvious candidate for the initiating event. This hypothesis can be tested because supernovae also produce telltale patterns of short-lived radionuclides, which would be preserved today as isotopic anomalies. Previous studies of the forensic evidence have been inconclusive, finding a pattern of isotopes differing from that produced in conventional supernova models. Here we argue that these difficulties either do not arise or are mitigated if the initiating supernova was a special type, low in mass and explosion energy. Key to our conclusion is the demonstration that short-lived 10Be can be readily synthesized in such supernovae by neutrino interactions, while anomalies in stable isotopes are suppressed.

  20. Representation of complex vocalizations in the Lusitanian toadfish auditory system: evidence of fine temporal, frequency and amplitude discrimination

    Science.gov (United States)

    Vasconcelos, Raquel O.; Fonseca, Paulo J.; Amorim, M. Clara P.; Ladich, Friedrich

    2011-01-01

    Many fishes rely on their auditory skills to interpret crucial information about predators and prey, and to communicate intraspecifically. Few studies, however, have examined how complex natural sounds are perceived in fishes. We investigated the representation of conspecific mating and agonistic calls in the auditory system of the Lusitanian toadfish Halobatrachus didactylus, and analysed auditory responses to heterospecific signals from ecologically relevant species: a sympatric vocal fish (meagre Argyrosomus regius) and a potential predator (dolphin Tursiops truncatus). Using auditory evoked potential (AEP) recordings, we showed that both sexes can resolve fine features of conspecific calls. The toadfish auditory system was most sensitive to frequencies well represented in the conspecific vocalizations (namely the mating boatwhistle), and revealed a fine representation of duration and pulsed structure of agonistic and mating calls. Stimuli and corresponding AEP amplitudes were highly correlated, indicating an accurate encoding of amplitude modulation. Moreover, Lusitanian toadfish were able to detect T. truncatus foraging sounds and A. regius calls, although at higher amplitudes. We provide strong evidence that the auditory system of a vocal fish, lacking accessory hearing structures, is capable of resolving fine features of complex vocalizations that are probably important for intraspecific communication and other relevant stimuli from the auditory scene. PMID:20861044

  1. Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice.

    Science.gov (United States)

    Chandler, Jacqueline; Rycroft-Malone, Jo; Hawkes, Claire; Noyes, Jane

    2016-02-01

    To examine the application of core concepts from Complexity Theory to explain the findings from a process evaluation undertaken in a trial evaluating implementation strategies for recommendations about reducing surgical fasting times. The proliferation of evidence-based guidance requires a greater focus on its implementation. Theory is required to explain the complex processes across the multiple healthcare organizational levels. This social healthcare context involves the interaction between professionals, patients and the organizational systems in care delivery. Complexity Theory may provide an explanatory framework to explain the complexities inherent in implementation in social healthcare contexts. A secondary thematic analysis of qualitative process evaluation data informed by Complexity Theory. Seminal texts applying Complexity Theory to the social context were annotated, key concepts extracted and core Complexity Theory concepts identified. These core concepts were applied as a theoretical lens to provide an explanation of themes from a process evaluation of a trial evaluating the implementation of strategies to reduce surgical fasting times. Sampled substantive texts provided a representative spread of theoretical development and application of Complexity Theory from late 1990's-2013 in social science, healthcare, management and philosophy. Five Complexity Theory core concepts extracted were 'self-organization', 'interaction', 'emergence', 'system history' and 'temporality'. Application of these concepts suggests routine surgical fasting practice is habituated in the social healthcare system and therefore it cannot easily be reversed. A reduction to fasting times requires an incentivised new approach to emerge in the surgical system's priority of completing the operating list. The application of Complexity Theory provides a useful explanation for resistance to change fasting practice. Its utility in implementation research warrants further attention and

  2. Are mirror neurons the basis of speech perception? Evidence from five cases with damage to the purported human mirror system

    Science.gov (United States)

    Rogalsky, Corianne; Love, Tracy; Driscoll, David; Anderson, Steven W.; Hickok, Gregory

    2013-01-01

    The discovery of mirror neurons in macaque has led to a resurrection of motor theories of speech perception. Although the majority of lesion and functional imaging studies have associated perception with the temporal lobes, it has also been proposed that the ‘human mirror system’, which prominently includes Broca’s area, is the neurophysiological substrate of speech perception. Although numerous studies have demonstrated a tight link between sensory and motor speech processes, few have directly assessed the critical prediction of mirror neuron theories of speech perception, namely that damage to the human mirror system should cause severe deficits in speech perception. The present study measured speech perception abilities of patients with lesions involving motor regions in the left posterior frontal lobe and/or inferior parietal lobule (i.e., the proposed human ‘mirror system’). Performance was at or near ceiling in patients with fronto-parietal lesions. It is only when the lesion encroaches on auditory regions in the temporal lobe that perceptual deficits are evident. This suggests that ‘mirror system’ damage does not disrupt speech perception, but rather that auditory systems are the primary substrate for speech perception. PMID:21207313

  3. AIMD - a validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

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    Peter Bragge

    2017-03-01

    Full Text Available Abstract Background Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery]. Methods Framework validity was evaluated against terminology schemas (n = 51; primary studies (n = 37; and reporting guidelines (n = 10. Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals. Results There was variation in representativeness of the components across the three types of literature, in particular for the component ‘causal mechanisms’. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1 Aims: what do you want your intervention to achieve and for whom? (2 Ingredients: what comprises the intervention? (3 Mechanisms: how do you propose the intervention will

  4. Reflection Paper on a Ubiquitous English Vocabulary Learning System: Evidence of Active/Passive Attitude vs. Usefulness/Ease-of-Use

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    Lim, Jeff

    2013-01-01

    "A ubiquitous English vocabulary learning system: evidence of active/passive attitudes vs. usefulness/ease-of-use" introduces and develops "Ubiquitous English Vocabulary Learning" (UEFL) system. It introduces to the memorization using the video clips. According to their paper the video clip gives a better chance for students to…

  5. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

    Science.gov (United States)

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-07-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.

  6. Modeling the Construct of an Expert Evidence-Adaptive Knowledge Base for a Pressure Injury Clinical Decision Support System

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    Peck Chui Betty Khong

    2017-07-01

    Full Text Available The selection of appropriate wound products for the treatment of pressure injuries is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatments by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products into the consumer market. A clinical decision support system for pressure injury (PI-CDSS was built to facilitate effective decision-making and selection of optimal wound treatments. This paper describes the development of PI-CDSS with an expert knowledge base using an interactive development environment, Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation, and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The construct of the PI-CDSS is adaptive, with scalable capabilities for expansion to include other CDSSs and interoperability to interface with other existing clinical and administrative systems. The algorithm was formatively evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s proposed by the wound experts. The overall agreement exceeded 90% between the wound experts and the generated treatment modalities for the choice of wound products, instructions, and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses, based on the best evidence available.

  7. Impact of a computerized system for evidence-based diabetes care on completeness of records: a before–after study

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    Roshanov Pavel S

    2012-07-01

    Full Text Available Abstract Background Physicians practicing in ambulatory care are adopting electronic health record (EHR systems. Governments promote this adoption with financial incentives, some hinged on improvements in care. These systems can improve care but most demonstrations of successful systems come from a few highly computerized academic environments. Those findings may not be generalizable to typical ambulatory settings, where evidence of success is largely anecdotal, with little or no use of rigorous methods. The purpose of our pilot study was to evaluate the impact of a diabetes specific chronic disease management system (CDMS on recording of information pertinent to guideline-concordant diabetes care and to plan for larger, more conclusive studies. Methods Using a before–after study design we analyzed the medical record of approximately 10 patients from each of 3 diabetes specialists (total = 31 who were seen both before and after the implementation of a CDMS. We used a checklist of key clinical data to compare the completeness of information recorded in the CDMS record to both the clinical note sent to the primary care physician based on that same encounter and the clinical note sent to the primary care physician based on the visit that occurred prior to the implementation of the CDMS, accounting for provider effects with Generalized Estimating Equations. Results The CDMS record outperformed by a substantial margin dictated notes created for the same encounter. Only 10.1% (95% CI, 7.7% to 12.3% of the clinically important data were missing from the CDMS chart compared to 25.8% (95% CI, 20.5% to 31.1% from the clinical note prepared at the time (p p  Conclusions The CDMS chart captured information important for the management of diabetes more often than dictated notes created with or without its use but we were unable to detect a difference in completeness between notes dictated in CDMS-associated and usual-care encounters. Our sample of

  8. Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis.

    Science.gov (United States)

    Carr, Alan; Hartnett, Dan; Brosnan, Eileen; Sharry, John

    2017-09-01

    Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front-line mental health and educational professionals. © 2016 Family Process Institute.

  9. New Evidence for the Dynamical Decay of a Multiple System in the Orion Kleinmann–Low Nebula

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    Luhman, K. L. [Department of Astronomy and Astrophysics, The Pennsylvania State University, University Park, PA 16802 (United States); Robberto, M.; Gabellini, M. Giulia Ubeira; Ubeda, L. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Tan, J. C. [Department of Astronomy, University of Florida, Gainesville, FL 32611 (United States); Andersen, M. [Gemini Observatory, Casilla 603, La Serena (Chile); Manara, C. F. [Scientific Support Office, Directorate of Science, European Space Research and Technology Centre, Keplerlaan 1, NL-2201 AZ Noordwijk (Netherlands); Platais, I., E-mail: kluhman@astro.psu.edu [Johns Hopkins University, Department of Physics and Astronomy, 3400 North Charles Street, Baltimore, MD 21218 (United States)

    2017-03-20

    We have measured astrometry for members of the Orion Nebula Cluster with images obtained in 2015 with the Wide Field Camera 3 on board the Hubble Space Telescope . By comparing those data to previous measurements with the Near-Infrared Camera and Multi-Object Spectrometer on Hubble in 1998, we have discovered that a star in the Kleinmann–Low Nebula, source x from Lonsdale et al., is moving with an unusually high proper motion of 29 mas yr{sup −1}, which corresponds to 55 km s{sup −1} at the distance of Orion. Previous radio observations have found that three other stars in the Kleinmann–Low Nebula (the Becklin–Neugebauer object and sources I and n) have high proper motions (5–14 mas yr{sup −1}) and were near a single location ∼540 years ago, and thus may have been members of a multiple system that dynamically decayed. The proper motion of source x is consistent with ejection from that same location 540 years ago, which provides strong evidence that the dynamical decay did occur and that the runaway star BN originated in the Kleinmann–Low Nebula rather than the nearby Trapezium cluster. However, our constraint on the motion of source n is significantly smaller than the most recent radio measurement, which indicates that it did not participate in the event that ejected the other three stars.

  10. Sedimentary evidence of historical and prehistorical earthquakes along the Venta de Bravo Fault System, Acambay Graben (Central Mexico)

    Science.gov (United States)

    Lacan, Pierre; Ortuño, María; Audin, Laurence; Perea, Hector; Baize, Stephane; Aguirre-Díaz, Gerardo; Zúñiga, F. Ramón

    2018-03-01

    The Venta de Bravo normal fault is one of the longest structures in the intra-arc fault system of the Trans-Mexican Volcanic Belt. It defines, together with the Pastores Fault, the 80 km long southern margin of the Acambay Graben. We focus on the westernmost segment of the Venta de Bravo Fault and provide new paleoseismological information, evaluate its earthquake history, and assess the related seismic hazard. We analyzed five trenches, distributed at three different sites, in which Holocene surface faulting offsets interbedded volcanoclastic, fluvio-lacustrine and colluvial deposits. Despite the lack of known historical destructive earthquakes along this fault, we found evidence of at least eight earthquakes during the late Quaternary. Our results indicate that this is one of the major seismic sources of the Acambay Graben, capable of producing by itself earthquakes with magnitudes (MW) up to 6.9, with a slip rate of 0.22-0.24 mm yr- 1 and a recurrence interval between 1940 and 2390 years. In addition, a possible multi-fault rupture of the Venta de Bravo Fault together with other faults of the Acambay Graben could result in a MW > 7 earthquake. These new slip rates, earthquake recurrence rates, and estimation of slips per event help advance our understanding of the seismic hazard posed by the Venta de Bravo Fault and provide new parameters for further hazard assessment.

  11. Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan.

    Science.gov (United States)

    Chen, Chi-Chen; Cheng, Shou-Hsia

    2010-11-01

    To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan. Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care. The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; pcompetition. A similar association was found for the perceived clinical competence (coefficient of -0.457; p=0.001). Quality of care from the patients' perspective is sensitive to the degree of competition. By using patient-reported data, this study provides new evidence concerning competition and quality of care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Evidence for a role of orexin/hypocretin system in vestibular lesion-induced locomotor abnormalities in rats

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    Leilei Pan

    2016-07-01

    Full Text Available Vestibular damage can induce locomotor abnormalities in both animals and humans. Rodents with bilateral vestibular loss showed vestibular deficits syndrome such as circling, opisthotonus as well as locomotor and exploratory hyperactivity. Previous studies have investigated the changes in the dopamine system after vestibular loss, but the results are inconsistent and inconclusive. Numerous evidences indicate that the orexin system is implicated in central motor control. We hypothesized that orexin may be potentially involved in vestibular loss-induced motor disorders. In this study, we examined the effects of arsanilate- or 3, 3′-iminodipropionitrile (IDPN-induced vestibular lesion (AVL or IVL on the orexin-A (OXA labeling in rat hypothalamus using immunohistochemistry. The vestibular lesion-induced locomotor abnormalities were recorded and verified using a histamine H4 receptor antagonist JNJ7777120 (20 mg/kg, i.p.. The effects of the orexin receptor type 1 antagonist SB334867 (16 μg, i.c.v. on these behavior responses were also investigated. At 72 h post-AVL and IVL, animals exhibited vestibular deficit syndrome and locomotor hyperactivity in the home cages. These responses were significantly alleviated by JNJ7777120 which also eliminated AVL-induced increases in exploratory behavior in an open field. The numbers of OXA-labeled neurons in the hypothalamus were significantly increased in the AVL animals at 72 h post-AVL and in the IVL animals at 24, 48 and 72 h post-IVL. SB334867 significantly attenuated the vestibular deficit syndrome and locomotor hyperactivity at 72 h post-AVL and IVL. It also decreased exploratory behavior in the AVL animals. These results suggested that the alteration of OXA expression might contribute to locomotor abnormalities after acute vestibular lesion. The orexin receptors might be the potential therapeutic targets for vestibular disorders.

  13. High-performance work systems in health care management, part 1: development of an evidence-informed model.

    Science.gov (United States)

    Garman, Andrew N; McAlearney, Ann Scheck; Harrison, Michael I; Song, Paula H; McHugh, Megan

    2011-01-01

    : Although management practices are recognized as important factors in improving health care quality and efficiency, most research thus far has focused on individual practices, ignoring or underspecifying the contexts within which these practices are operating. Research from other industries, which has increasingly focused on systems rather than individual practices, has yielded results that may benefit health services management. : Our goal was to develop a conceptual model on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations within health care. : Using theoretical frameworks from A. Donabedian (1966), P. M. Wright, T. M. Gardner, and L. M. Moynihan (2003), and B. Schneider, D. B. Smith, and H. W. Goldstein (2000) and review methods adapted from R. Pawson (2006b), we reviewed relevant research from peer-reviewed and other industry-relevant sources to inform our model. The model we developed was then reviewed with a panel of practitioners, including experts in quality and human resource management, to assess the applicability of the model to health care settings. : The resulting conceptual model identified four practice bundles, comprising 14 management practices as well as nine factors influencing adoption and perceived sustainability of these practices. The mechanisms by which these practices influence care outcomes are illustrated using the example of hospital-acquired infections. In addition, limitations of the current evidence base are discussed, and an agenda for future research in health care settings is outlined. : Results may help practitioners better conceptualize management practices as part of a broader system of work practices. This may, in turn, help practitioners to prioritize management improvement efforts more systematically.

  14. High-performance work systems in health care management, part 2: qualitative evidence from five case studies.

    Science.gov (United States)

    McAlearney, Ann Scheck; Garman, Andrew N; Song, Paula H; McHugh, Megan; Robbins, Julie; Harrison, Michael I

    2011-01-01

    : A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that the methodical use of evidence-based management practices (also known as high-performance work practices [HPWPs]), such as systematic personnel selection and incentive compensation, serves to attract and retain well-qualified health care staff and that HPWPs may represent an important and underutilized strategy for improving quality of care and patient safety. : The aims of this study were to improve our understanding about the use of HPWPs in health care organizations and to learn about their contribution to quality of care and patient safety improvements. : Guided by a model of HPWPs developed through an extensive literature review and synthesis, we conducted a series of interviews with key informants from five U.S. health care organizations that had been identified based on their exemplary use of HPWPs. We sought to explore the applicability of our model and learn whether and how HPWPs were related to quality and safety. All interviews were recorded, transcribed, and subjected to qualitative analysis. : In each of the five organizations, we found emphasis on all four HPWP subsystems in our conceptual model-engagement, staff acquisition/development, frontline empowerment, and leadership alignment/development. Although some HPWPs were common, there were also practices that were distinctive to a single organization. Our informants reported links between HPWPs and employee outcomes (e.g., turnover and higher satisfaction/engagement) and indicated that HPWPs made important contributions to system- and organization-level outcomes (e.g., improved recruitment, improved ability to address safety concerns, and lower turnover). : These case studies suggest that the systematic use of HPWPs may improve performance in health care organizations and provide examples of how HPWPs can impact quality and safety in health care. Further research is needed to specify

  15. Patients at the Centre: Methodological Considerations for Evaluating Evidence from Health Interventions Involving Patients Use of Web-Based Information Systems

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-01-01

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions. Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences. Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the ‘patient at the centre’ by engaging them in their own care and/or ‘empowering’ them through the use of information systems. This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients’ interests and outcomes are measured, defined and evaluated within health interventions that involve them using web

  16. Patients at the centre: methodological considerations for evaluating evidence from health interventions involving patients use of web-based information systems.

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-09-15

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions.Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences.Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the 'patient at the centre' by engaging them in their own care and/or 'empowering' them through the use of information systems.This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients' interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based information systems

  17. Three-dimensional evidence network plot system: covariate imbalances and effects in network meta-analysis explored using a new software tool.

    Science.gov (United States)

    Batson, Sarah; Score, Robert; Sutton, Alex J

    2017-06-01

    The aim of the study was to develop the three-dimensional (3D) evidence network plot system-a novel web-based interactive 3D tool to facilitate the visualization and exploration of covariate distributions and imbalances across evidence networks for network meta-analysis (NMA). We developed the 3D evidence network plot system within an AngularJS environment using a third party JavaScript library (Three.js) to create the 3D element of the application. Data used to enable the creation of the 3D element for a particular topic are inputted via a Microsoft Excel template spreadsheet that has been specifically formatted to hold these data. We display and discuss the findings of applying the tool to two NMA examples considering multiple covariates. These two examples have been previously identified as having potentially important covariate effects and allow us to document the various features of the tool while illustrating how it can be used. The 3D evidence network plot system provides an immediate, intuitive, and accessible way to assess the similarity and differences between the values of covariates for individual studies within and between each treatment contrast in an evidence network. In this way, differences between the studies, which may invalidate the usual assumptions of an NMA, can be identified for further scrutiny. Hence, the tool facilitates NMA feasibility/validity assessments and aids in the interpretation of NMA results. The 3D evidence network plot system is the first tool designed specifically to visualize covariate distributions and imbalances across evidence networks in 3D. This will be of primary interest to systematic review and meta-analysis researchers and, more generally, those assessing the validity and robustness of an NMA to inform reimbursement decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

    Directory of Open Access Journals (Sweden)

    Samuelina S. Arthur

    2015-10-01

    Full Text Available Background: Nutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Objective: To perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH of health and demographic surveillance systems (HDSSs over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs. Methods: Relevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed. Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study. Results: The INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition. Conclusions: Although INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research

  19. Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

    Science.gov (United States)

    Arthur, Samuelina S.; Nyide, Bongiwe; Soura, Abdramane Bassiahi; Kahn, Kathleen; Weston, Mark; Sankoh, Osman

    2015-01-01

    Background Nutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Objective To perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) of health and demographic surveillance systems (HDSSs) over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs). Methods Relevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed). Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study. Results The INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition. Conclusions Although INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research in LMICs in order to

  20. The Behavioral Approach System (BAS) Model of Vulnerability to Bipolar Disorder: Evidence of a Continuum in BAS Sensitivity across Adolescence.

    Science.gov (United States)

    Liu, Richard T; Burke, Taylor A; Abramson, Lyn Y; Alloy, Lauren B

    2017-11-04

    Behavioral Approach System (BAS) sensitivity has been implicated in the development of a variety of different psychiatric disorders. Prominent among these in the empirical literature are bipolar spectrum disorders (BSDs). Given that adolescence represents a critical developmental stage of risk for the onset of BSDs, it is important to clarify the latent structure of BAS sensitivity in this period of development. A statistical approach especially well-suited for delineating the latent structure of BAS sensitivity is taxometric analysis, which is designed to evaluate whether the latent structure of a construct is taxonic (i.e., categorical) or dimensional (i.e., continuous) in nature. The current study applied three mathematically non-redundant taxometric procedures (i.e., MAMBAC, MAXEIG, and L-Mode) to a large community sample of adolescents (n = 12,494) who completed two separate measures of BAS sensitivity: the BIS/BAS Scales Carver and White (Journal of Personality and Social Psychology, 67, 319-333. 1994) and the Sensitivity to Reward and Sensitivity to Punishment Questionnaire (Torrubia et al. Personality and Individual Differences, 31, 837-862. 2001). Given the significant developmental changes in reward sensitivity that occur across adolescence, the current investigation aimed to provide a fine-grained evaluation of the data by performing taxometric analyses at an age-by-age level (14-19 years; n for each age ≥ 883). Results derived from taxometric procedures, across all ages tested, were highly consistent, providing strong evidence that BAS sensitivity is best conceptualized as dimensional in nature. Thus, the findings suggest that BAS-related vulnerability to BSDs exists along a continuum of severity, with no natural cut-point qualitatively differentiating high- and low-risk adolescents. Clinical and research implications for the assessment of BSD-related vulnerability are discussed.

  1. Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

    Science.gov (United States)

    Mercer, Alec; Khan, Mobarak Hossain; Daulatuzzaman, Muhammad; Reid, Joanna

    2004-07-01

    This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.

  2. The Importance of Sample Return in Establishing Chemical Evidence for Life on Mars or Other Solar System Bodies

    Science.gov (United States)

    Glavin, D. P.; Conrad, P.; Dworkin, J. P.; Eigenbrode, J.; Mahaffy, P. R.

    2011-01-01

    The search for evidence of life on Mars and elsewhere will continue to be one of the primary goals of NASA s robotic exploration program over the next decade. NASA and ESA are currently planning a series of robotic missions to Mars with the goal of understanding its climate, resources, and potential for harboring past or present life. One key goal will be the search for chemical biomarkers including complex organic compounds important in life on Earth. These include amino acids, the monomer building blocks of proteins and enzymes, nucleobases and sugars which form the backbone of DNA and RNA, and lipids, the structural components of cell membranes. Many of these organic compounds can also be formed abiotically as demonstrated by their prevalence in carbonaceous meteorites [1], though, their molecular characteristics may distinguish a biological source [2]. It is possible that in situ instruments may reveal such characteristics, however, return of the right sample (i.e. one with biosignatures or having a high probability of biosignatures) to Earth would allow for more intensive laboratory studies using a broad array of powerful instrumentation for bulk characterization, molecular detection, isotopic and enantiomeric compositions, and spatially resolved chemistry that may be required for confirmation of extant or extinct Martian life. Here we will discuss the current analytical capabilities and strategies for the detection of organics on the Mars Science Laboratory (MSL) using the Sample Analysis at Mars (SAM) instrument suite and how sample return missions from Mars and other targets of astrobiological interest will help advance our understanding of chemical biosignatures in the solar system.

  3. Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

    Science.gov (United States)

    Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

    2011-05-01

    HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these

  4. Genome scan of human systemic lupus erythematosus: Evidence for linkage on chromosome 1q in African-American pedigrees

    Science.gov (United States)

    Moser, Kathy L.; Neas, Barbara R.; Salmon, Jane E.; Yu, Hua; Gray-McGuire, Courtney; Asundi, Neeraj; Bruner, Gail R.; Fox, Jerome; Kelly, Jennifer; Henshall, Stephanie; Bacino, Debra; Dietz, Myron; Hogue, Robert; Koelsch, Gerald; Nightingale, Lydia; Shaver, Tim; Abdou, Nabih I.; Albert, Daniel A.; Carson, Craig; Petri, Michelle; Treadwell, Edward L.; James, Judith A.; Harley, John B.

    1998-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by production of autoantibodies against intracellular antigens including DNA, ribosomal P, Ro (SS-A), La (SS-B), and the spliceosome. Etiology is suspected to involve genetic and environmental factors. Evidence of genetic involvement includes: associations with HLA-DR3, HLA-DR2, Fcγ receptors (FcγR) IIA and IIIA, and hereditary complement component deficiencies, as well as familial aggregation, monozygotic twin concordance >20%, λs > 10, purported linkage at 1q41–42, and inbred mouse strains that consistently develop lupus. We have completed a genome scan in 94 extended multiplex pedigrees by using model-based linkage analysis. Potential [log10 of the odds for linkage (lod) > 2.0] SLE loci have been identified at chromosomes 1q41, 1q23, and 11q14–23 in African-Americans; 14q11, 4p15, 11q25, 2q32, 19q13, 6q26–27, and 12p12–11 in European-Americans; and 1q23, 13q32, 20q13, and 1q31 in all pedigrees combined. An effect for the FcγRIIA candidate polymorphism) at 1q23 (lod = 3.37 in African-Americans) is syntenic with linkage in a murine model of lupus. Sib-pair and multipoint nonparametric analyses also support linkage (P 2.0). Our results are consistent with the presumed complexity of genetic susceptibility to SLE and illustrate racial origin is likely to influence the specific nature of these genetic effects. PMID:9843982

  5. ETF Yearbook 2012: Evaluation and Monitoring of Vocational Education and Training Systems and the Role of Evidence-Based Policy in Their Reforms

    Science.gov (United States)

    European Training Foundation, 2012

    2012-01-01

    The "ETF Yearbook 2012" continues the tradition of highlighting a thematic field of particular importance to the work of the European Training Foundation (ETF). The theme of this yearbook is evaluation and monitoring of vocational education and training (VET) systems and the role of evidence-based policy in VET reforms in ETF partner…

  6. Climate for evidence-informed health systems: a profile of systematic review production in 41 low- and middle-income countries, 1996-2008.

    Science.gov (United States)

    Law, Tyler; Lavis, John; Hamandi, Ali; Cheung, Andrew; El-Jardali, Fadi

    2012-01-01

    To describe systematic review production in 41 countries in Africa, the Americas, Asia and the eastern Mediterranean to understand one dimension of the climate for evidence-informed health systems and to provide a baseline for an evaluation of knowledge translation initiatives. Our focus was systematic reviews published between 1996 and 2008 that had a corresponding author based in, or that appeared to target, one of the countries in these regions. We searched both Medline and Embase using validated search strategies, identified citations with a country name in the corresponding author's institutional affiliation or as a textword (i.e., an explicit mention in the title or abstract) or keyword, and coded articles describing a systematic review. We followed the same citation identification procedure for Health Systems Evidence, a database containing systematic reviews about health systems. Systematic review production increased between three-fold (for Africa in Medline) and 110-fold (for Asia in Embase) between the first period (1996-2002) and second period (2003-2008). In the second period, China was more often the home of corresponding authors and the target of reviews than any other country. No systematic reviews were produced by a corresponding author based in nine countries, or appeared to target five countries. Only 48 reviews identified through Medline and Embase addressed health systems, and 35 health systems reviews identified through Health Systems Evidence addressed these countries. In many countries, those seeking to support evidence-informed health systems cannot turn to experienced local systematic reviewers to help them to find and use systematic reviews or to conduct reviews on high priority topics when none exists. These findings suggest the need for local capacity-building initiatives.

  7. A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System.

    Science.gov (United States)

    Beidas, Rinad S; Stewart, Rebecca E; Adams, Danielle R; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J; Aarons, Gregory A; Hoagwood, Kimberly E; Evans, Arthur C; Hurford, Matthew O; Rubin, Ronnie; Hadley, Trevor; Mandell, David S; Barg, Frances K

    2016-11-01

    Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.

  8. Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

    Science.gov (United States)

    Wandersman, Abraham; Chien, Victoria H; Katz, Jason

    2012-12-01

    An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

  9. Systems Thinking Tools for Improving Evidence-Based Practice: A Cross-Case Analysis of Two High School Leadership Teams

    Science.gov (United States)

    Kensler, Lisa A. W.; Reames, Ellen; Murray, John; Patrick, Lynne

    2012-01-01

    Teachers and administrators have access to large volumes of data but research suggests that they lack the skills to use data effectively for continuous school improvement. This study involved a cross-case analysis of two high school leadership teams' early stages of evidence-based practice development; differing forms of external support were…

  10. Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

    Science.gov (United States)

    Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

    2016-02-01

    Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

  11. Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

    Science.gov (United States)

    Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

    2017-07-01

    Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

  12. Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers

    Directory of Open Access Journals (Sweden)

    El-Jardali Fadi

    2012-01-01

    Full Text Available Abstract Background Limited research exists on researchers' knowledge transfer and exchange (KTE in the eastern Mediterranean region (EMR. This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE. Methods Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions. Results A total of 238 researchers were asked to complete the survey (response rate 56%. Researchers indicated transferring results to other researchers (67.2% and policymakers in the government (40.5%. Less than one-quarter stated that they produced policy briefs (14.5%, disseminated messages that specified possible actions (24.4%, interacted with policymakers and stakeholders in priority-setting (16%, and involved them in their research (19.8%. Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%, practical constraints to implementation (66%, non-receptive policy environment (61.3%, and politically sensitive findings (57.7% hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance. Conclusions Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to

  13. Ethics issues in scientific data and service provision: evidence and challenges for the European Plate Observing System (EPOS)

    Science.gov (United States)

    Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos

    2016-04-01

    Addressing Ethics issues is nowadays a relevant challenge for any initiative, program or project dealing with scientific data and products provision, access to services for scientific purposes and communication with different stakeholders, including society. This is corroborated by the evidence that Ethics has very high priority in EU funded research. Indeed, all the activities carried out under Horizon 2020 must comply with ethical principles and national, Union and international legislation. This implies that "For all activities funded by the European Union, Ethics is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence." Here, we present the experience of EPOS, a public pan-European research infrastructure. EPOS aims at integrating data, data products, services and software (DDSS) for solid Earth science generated and provided by monitoring networks, observing systems and facilities belonging to European countries. EPOS fosters the integrated use of multidisciplinary solid Earth data to improve the understanding of physical and chemical processes controlling earthquakes, volcanic eruptions, tsunamis as well as those driving tectonics and surface dynamics. The EPOS integration plan will make significant contributions to understanding and mitigating geo-hazards, yielding data for hazard assessment, data products for engaging different stakeholders, and services for training, education and communication to society. Numerous national research infrastructures engaged in EPOS are deployed for the monitoring of areas prone to geo-hazards and for the surveillance of the national territory including areas used for exploiting geo-resources. The EPOS community is therefore already trained to provide services to public (civil defence agencies, local and national authorities) and private (petroleum industry, mining industry, geothermal companies, aviation security) stakeholders. Our ability to

  14. Comorbidity ascertainment from the ESRD Medical Evidence Report and Medicare claims around dialysis initiation: a comparison using US Renal Data System data.

    Science.gov (United States)

    Krishnan, Mahesh; Weinhandl, Eric D; Jackson, Scott; Gilbertson, David T; Lacson, Eduardo

    2015-11-01

    The end-stage renal disease Medical Evidence Report serves as a source of comorbid condition data for risk adjustment of quality metrics. We sought to compare comorbid condition data in the Medical Evidence Report around dialysis therapy initiation with diagnosis codes in Medicare claims. Observational cohort study using US Renal Data System data. Medicare-enrolled elderly (≥66 years) patients who initiated maintenance dialysis therapy July 1 to December 31, 2007, 2008, or 2009. 12 comorbid conditions ascertained from claims during the 6 months before dialysis therapy initiation, the Medical Evidence Report, and claims during the 3 months after dialysis therapy initiation. None. Comorbid condition prevalence according to claims before dialysis therapy initiation generally exceeded prevalence according to the Medical Evidence Report. The κ statistics for comorbid condition designations other than diabetes ranged from 0.06 to 0.43. Discordance of designations was associated with age, race, sex, and end-stage renal disease Network. During 23,930 patient-years of follow-up from 4 to 12 months after dialysis therapy initiation (8,930 deaths), designations from claims during the 3 months after initiation better discriminated risk of death than designations from the Medical Evidence Report (C statistics of 0.674 vs 0.616). Between the Medical Evidence Report and claims, standardized mortality ratios changed by >10% for more than half the dialysis facilities. Neither the Medical Evidence Report nor diagnosis codes in claims constitute a gold standard of comorbid condition data; results may not apply to nonelderly patients or patients without Medicare coverage. Discordance of comorbid condition designations from the Medical Evidence Report and claims around dialysis therapy initiation was substantial and significantly associated with patient characteristics, including location. These patterns may engender bias in risk-adjusted quality metrics. In lieu of the Medical

  15. Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

    Science.gov (United States)

    Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

    2017-09-01

    Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. The Collapse of the United States Banking System During the Great Depression, 1929 to 1933. New Archival Evidence

    Directory of Open Access Journals (Sweden)

    Gary Richardson

    2007-03-01

    Full Text Available During the Great Depression, one third of all banks in the United States failed. Scholarsdispute reason for their demise. This essay analyzes new evidence on the sources of bankdistress. The data demonstrates that contagion via correspondent networks and bank runspropagated the initial banking panics in the fall of 1930. As the depression deepened and assetvalues declined, insolvency loomed as the principal threat to depository institutions. Thesepatterns corroborate some and question other conjectures concerning the causes andconsequences of the financial crisis during the Great Contraction.

  17. Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

    Science.gov (United States)

    Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

    2016-08-02

    Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover

  18. Perceived effectiveness of environmental decision support systems in participatory planning: Evidence from small groups of end-users

    NARCIS (Netherlands)

    Inman, D.; Blind, M.; Ribarova, I.; Krause, A.; Roosenschoon, O.R.; Kassahun, A.; Scholten, H.; Arampatzis, G.; Abrami, G.; McIntosh, B.S.; Jeffrey, P.

    2011-01-01

    The challenges associated with evaluating the effectiveness of environmental decision support systems (EDSS) based on the perceptions of only a small sample of end-users are well understood. Although methods adopted from Management Information Systems (MISs) evaluation research have benefited from

  19. Social Ecology of Asthma: Engaging Stakeholders in Integrating Health Behavior Theories and Practice-Based Evidence through Systems Mapping

    Science.gov (United States)

    Gillen, Emily M.; Hassmiller Lich, Kristen; Yeatts, Karin B.; Hernandez, Michelle L.; Smith, Timothy W.; Lewis, Megan A.

    2014-01-01

    This article describes a process for integrating health behavior and social science theories with practice-based insights using participatory systems thinking and diagramming methods largely inspired by system dynamics methods. This integration can help close the gap between research and practice in health education and health behavior by offering…

  20. Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions.

    NARCIS (Netherlands)

    Brug, J.; Dale, D. van; Lanting, L.; Kremers, S.; Veenhof, C.; Leurs, M.; Yperen, T. van; Kok, G.

    2010-01-01

    Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals

  1. Protocol for the Quick Clinical study: a randomised controlled trial to assess the impact of an online evidence retrieval system on decision-making in general practice

    Directory of Open Access Journals (Sweden)

    Kidd Michael R

    2006-08-01

    Full Text Available Abstract Background Online information retrieval systems have the potential to improve patient care but there are few comparative studies of the impact of online evidence on clinicians' decision-making behaviour in routine clinical work. Methods/design A randomized controlled parallel design is employed to assess the effectiveness of an online evidence retrieval system, Quick Clinical (QC in improving clinical decision-making processes in general practice. Eligible clinicians are randomised either to receive access or not to receive access to QC in their consulting rooms for 12 months. Participants complete pre- and post trial surveys. Two-hundred general practitioners are recruited. Participants must be registered to practice in Australia, have a computer with Internet access in their consulting room and use electronic prescribing. Clinicians planning to retire or move to another practice within 12 months or participating in any other clinical trial involving electronic extraction of prescriptions data are excluded from the study. The primary end-points for the study is clinician acceptance and use of QC and the resulting change in decision-making behaviour. The study will examine prescribing patterns related to frequently prescribed medications where there has been a recent significant shift in recommendations regarding their use based upon new evidence. Secondary outcome measures include self-reported changes in diagnosis, patient education, prescriptions written, investigations and referrals. Discussion A trial under experimental conditions is an effective way of examining the impact of using QC in routine general practice consultations.

  2. Is there a domain-general cognitive structuring system? Evidence from structural priming across music, math, action descriptions, and language.

    Science.gov (United States)

    Van de Cavey, Joris; Hartsuiker, Robert J

    2016-01-01

    Cognitive processing in many domains (e.g., sentence comprehension, music listening, and math solving) requires sequential information to be organized into an integrational structure. There appears to be some overlap in integrational processing across domains, as shown by cross-domain interference effects when for example linguistic and musical stimuli are jointly presented (Koelsch, Gunter, Wittfoth, & Sammler, 2005; Slevc, Rosenberg, & Patel, 2009). These findings support theories of overlapping resources for integrational processing across domains (cfr. SSIRH Patel, 2003; SWM, Kljajevic, 2010). However, there are some limitations to the studies mentioned above, such as the frequent use of unnaturalistic integrational difficulties. In recent years, the idea has risen that evidence for domain-generality in structural processing might also be yielded though priming paradigms (cfr. Scheepers, 2003). The rationale behind this is that integrational processing across domains regularly requires the processing of dependencies across short or long distances in the sequence, involving respectively less or more syntactic working memory resources (cfr. SWM, Kljajevic, 2010), and such processing decisions might persist over time. However, whereas recent studies have shown suggestive priming of integrational structure between language and arithmetics (though often dependent on arithmetic performance, cfr. Scheepers et al., 2011; Scheepers & Sturt, 2014), it remains to be investigated to what extent we can also find evidence for priming in other domains, such as music and action (cfr. SWM, Kljajevic, 2010). Experiment 1a showed structural priming from the processing of musical sequences onto the position in the sentence structure (early or late) to which a relative clause was attached in subsequent sentence completion. Importantly, Experiment 1b showed that a similar structural manipulation based on non-hierarchically ordered color sequences did not yield any priming effect

  3. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  4. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

    Science.gov (United States)

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

    2008-01-01

    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  5. The Effect of E-commerce on Malaysian Tax System: an Empirical Evidence From Academicians and Malaysian Tax Practitioners

    OpenAIRE

    Palil, Mohd Rizal

    2004-01-01

    The explosion of information technology (IT) nowadays has created new phenomena in shopping activities. Consumers can easily buy products via Internet. Within a minute, the products will be delivered instantly and accurately. This scenario is known as e-commerce. The emergence of e-commerce affects consumers' shopping behavior as well as taxation system. The objective of this research is to reveal the effects of e-commerce upon Malaysian taxation system by emphasizing in scope of charge 'deri...

  6. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Grégory; Bouchard, Gisèle; Ouimet, Mathieu; Grimshaw, Jeremy M; Lavis, John N

    2014-12-05

    Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to

  7. Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers.

    Science.gov (United States)

    El-Jardali, Fadi; Lavis, John N; Ataya, Nour; Jamal, Diana

    2012-01-11

    Limited research exists on researchers' knowledge transfer and exchange (KTE) in the eastern Mediterranean region (EMR). This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE. Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen) were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions. A total of 238 researchers were asked to complete the survey (response rate 56%). Researchers indicated transferring results to other researchers (67.2%) and policymakers in the government (40.5%). Less than one-quarter stated that they produced policy briefs (14.5%), disseminated messages that specified possible actions (24.4%), interacted with policymakers and stakeholders in priority-setting (16%), and involved them in their research (19.8%). Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%), practical constraints to implementation (66%), non-receptive policy environment (61.3%), and politically sensitive findings (57.7%) hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance. Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to improve the use of research evidence emphasize two

  8. Comparing a Mobile Decision Support System Versus the Use of Printed Materials for the Implementation of an Evidence-Based Recommendation: Protocol for a Qualitative Evaluation.

    Science.gov (United States)

    Camacho, Jhon; Medina Ch, Ana María; Landis-Lewis, Zach; Douglas, Gerald; Boyce, Richard

    2018-04-13

    The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. Our study will further the understanding of the role of mobile decision support systems in the implementation

  9. Integration of an Evidence Base into a Probabilistic Risk Assessment Model. The Integrated Medical Model Database: An Organized Evidence Base for Assessing In-Flight Crew Health Risk and System Design

    Science.gov (United States)

    Saile, Lynn; Lopez, Vilma; Bickham, Grandin; FreiredeCarvalho, Mary; Kerstman, Eric; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) database, which is an organized evidence base for assessing in-flight crew health risk. The database is a relational database accessible to many people. The database quantifies the model inputs by a ranking based on the highest value of the data as Level of Evidence (LOE) and the quality of evidence (QOE) score that provides an assessment of the evidence base for each medical condition. The IMM evidence base has already been able to provide invaluable information for designers, and for other uses.

  10. A Universal Velocity Dispersion Profile for Pressure Supported Systems: Evidence for MONDian Gravity across Seven Orders of Magnitude in Mass

    Energy Technology Data Exchange (ETDEWEB)

    Durazo, R.; Hernandez, X.; Sánchez, S. F. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apartado Postal 70-264 C.P. 04510 México D.F., México (Mexico); Sodi, B. Cervantes [Instituto de Radioastronomía y Astrofísica, Universidad Nacional Autónoma de México, Campus Morelia, A.P. 3-72, C.P. 58089 Michoacán, México (Mexico)

    2017-03-10

    For any MONDian extended theory of gravity where the rotation curves of spiral galaxies are explained through a change in physics rather than the hypothesis of dark matter, a generic dynamical behavior is expected for pressure supported systems: an outer flattening of the velocity dispersion profile occurring at a characteristic radius, where both the amplitude of this flat velocity dispersion and the radius at which it appears are predicted to show distinct scalings with the total mass of the system. By carefully analyzing the dynamics of globular clusters and elliptical galaxies, we are able to significantly extend the astronomical diversity of objects in which MONDian gravity has been tested, from spiral galaxies to the much larger mass range covered by pressure supported systems. We show that a universal projected velocity dispersion profile accurately describes various classes of pressure supported systems, and further, that the expectations of extended gravity are met across seven orders of magnitude in mass. These observed scalings are not expected under dark matter cosmology, and would require particular explanations tuned at the scales of each distinct astrophysical system.

  11. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  12. Orbital motion of the secondary in three AM Her systems: evidence for low-mass white dwarfs

    Energy Technology Data Exchange (ETDEWEB)

    Mukai, K; Charles, P A

    1987-05-01

    In an earlier paper the spectroscopic detection was reported of the secondaries in the three AM Her type systems, CW1103+254, PG1550+191 and E2003+225. In this paper, high-resolution spectrophotometry of these stars is presented in the wavelength region lambda lambda 7550-8850. In all three cases, the radial velocity variation of the second star has been detected using the Na I doublet at lambda lambda 8183-94. Combined with values for each system's inclination estimated from polarimetry, constraints on the white dwarf masses are derived. The average of our best estimates for the white dwarf masses in these systems and AM Her itself is approx.0.6 solar masses, essentially coincident with the masses of isolated white dwarfs.

  13. The Role of Nature and Nurture for Individual Differences in Primary Emotional Systems: Evidence from a Twin Study.

    Directory of Open Access Journals (Sweden)

    Christian Montag

    Full Text Available The present study investigated for the first time the relative importance of genetics and environment on individual differences in primary emotionality as measured with the Affective Neuroscience Personality Scales (ANPS by means of a twin-sibling study design. In N = 795 participants (n = 303 monozygotic twins, n = 172 dizygotic twins and n = 267 non-twin full siblings, moderate to strong influences of genetics on individual differences in these emotional systems are observed. Lowest heritability estimates are presented for the SEEKING system (33% and highest for the PLAY system (69%. Further, multivariate genetic modeling was applied to the data showing that associations among the six ANPS scales were influences by both, a genetic as well as an environmental overlap between them. In sum, the study underlines the usefulness of the ANPS for biologically oriented personality psychology research.

  14. Joint impact of ERP systems and non financial performance indicators on corporate financial performance: Evidence from French listed companies

    Directory of Open Access Journals (Sweden)

    Ahmed Kouki

    2015-01-01

    Full Text Available This paper aims to examine the joint impact of Enterprise Resource Planning systems (ERP systems and Non Financial Performance Indicators (NFPI on corporate financial performance. Our study is based on a comparative analysis between firms that adopt ERP only, firms that use NFPI only and firms that combining both strategies (ERP and NFPI during the period from 2001 to 2006.The implementation process remains highly uncertain. In fact, the use of Non Financial performance indicators is an important determinant of corporate financial performance. At the operational level, combining ERP systems with NFPI reflects a long-term business strategy to improve business process. In summary, the ERP and NFPI literatures demonstrate the vital importance of aligning business process, information technologies and key performance indicators with the strategic objectives of the firm. Results support the hypothesis in which firms that combining ERP and NFPI have significantly higher ROA than either ERP-only or NFPI-only firms.

  15. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-04-13

    Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

  16. Evidence for the essentiality of arachidonic and docosahexaenoic acid in the postnatal maternal and infant diet for the development of the infant's immune system early in life.

    Science.gov (United States)

    Richard, Caroline; Lewis, Erin D; Field, Catherine J

    2016-05-01

    Long-chain polyunsaturated fatty acids (LCPUFA), especially the balance between arachidonic (AA) and docosahexaenoic (DHA) acids are known to have important immunomodulatory roles during the postnatal period when the immune system is rapidly developing. AA and DHA are required in infant formula in many countries but are optional in North America. The rationale for adding these LCPUFA to full-term formula is based on their presence in breast milk and randomized controlled studies that suggest improved cognitive function in preterm infants, but results are more variable in full-term infants. Recently, the European Food Safety Authority has proposed, based on a lack of functional evidence, that AA is not required in infant formula for full-term infants during the first year of life but DHA should remain mandatory. The purpose of this review is to review the evidence from epidemiological and intervention studies regarding the essentiality of AA and DHA in the postnatal infant and maternal diet (breast-feeding) for the immune system development early in life. Although studies support the essentiality of DHA for the immune system development, more research is needed to rule out the essentiality of AA. Nevertheless, intervention studies have demonstrated improvement in many markers of immune function in infants fed formula supplemented with AA and DHA compared with unsupplemented formula, which appears to consistently result in beneficial health outcomes including reduction in the risk of developing allergic and atopic disease early in life.

  17. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

    Science.gov (United States)

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

    2014-08-01

    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies

  18. Seasonality, water use and community management of water systems in rural settings: Qualitative evidence from Ghana, Kenya, and Zambia.

    Science.gov (United States)

    Kelly, Emma; Shields, Katherine F; Cronk, Ryan; Lee, Kristen; Behnke, Nikki; Klug, Tori; Bartram, Jamie

    2018-07-01

    The sustainability of rural, community-managed water systems in sub-Saharan Africa depends in part on the ability of local water committees to repair breakdowns and carry out the operation and maintenance (O&M) of the system. Much of sub-Saharan Africa has two distinct seasons that affect the availability of water sources and how people use water. Little is known about how seasonality affects water system management. This qualitative study is based on 320 interviews and focus group discussions and examines the effects of season on community water use and management in Ghana, Kenya and Zambia. Participants revealed that seasonality affects water availability, water system breakdowns, resource mobilization, committee activity, and external support availability. In the rainy season, participants typically reported spending less time and money on water collection because rainwater harvesting and seasonal streams, ponds, wells and reservoirs are available. In the dry season, people used improved groundwater sources more often and spent more money and time collecting water. Although seasonal changes in household water demand and use have been examined previously, our data suggest that seasonality also influences community management through differential water system use, system breakdowns and management characteristics. We found that water committees generally have less money, time and access to external support during the rainy season, making them less able to carry out O&M. Our results suggest that community engagement should take place over a long period of time so that seasonal patterns in management can be understood and incorporated into water committee training. External support actors should make a more targeted effort to understand the cultural and economic patterns in a community in order to train committees with appropriate management strategies. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Development of electronic document management system for scientific and technical design administration automation (evidence from European Organization for Nuclear Research)

    International Nuclear Information System (INIS)

    Titov, R.N.

    2011-01-01

    The new principles and methods of electronic document management system construction are developed. The software package for electronic document handling is made, it provides automation of work flow management and permits to trace and correct on-line the flow of documents. The formal models of electronic documents describing complex hierarchic structures of data with the use of XML-trees are considered. On the base of investigations conducted the CERN electronic document management system has been upgraded, it allowed to shorten more than twofold the time for automation of new business processes [ru

  20. The Territory, a Container of Local Specificities: Evidence by Analysis of the Local Productive System of Ksar-Hellal

    Directory of Open Access Journals (Sweden)

    MAKRAM GAALICHE

    2013-01-01

    Full Text Available This article aims to highlight the relevance of the territory in the experience of local development. Indeed, by an application on a Tunisian case, it was shown that the territory of Ksar-Hellal is implicated in the functioning of its local production system, specializing in textile and clothing. It turned out that the Hilalian territory is abundant in specific economic resources such as competition, complementarity, and non-economic such as cooperation, technological externalities and social values. Those resources that are specific to the Hilalian territory are essential to stimulate the local dynamics of the productive system in question.

  1. National systems of innovation: determinants and industrial policy measures, empirical evidence for OECD; Sistemas nacionales de innovacion: determinantes y acciones de politica industrial. Evidencia empirica para la OCDE

    Energy Technology Data Exchange (ETDEWEB)

    Hervas, J. L.; Rojas, R.; Sempere, F.; Albors, J.

    2012-11-01

    The paper presents an attempt to tackle the main gaps in the national innovation systems (NIS) literature: the problem specifying the boundaries of the NIS and the lack of connection between theory and empirics. For this purpose, the paper uses 55 countries as sample and constructs an NIS index based on a factor analysis of 28 variables. Empirical evidence shows that a firm's strategies, technology infrastructure, government governance, education and linkages are the main components of the NIS. The implications are important for policy-makers and the academia. (Author) 49 refs.

  2. Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

    Science.gov (United States)

    Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

    2015-07-01

    Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

  3. Reduced mu suppression and altered motor resonance in euthymic bipolar disorder: Evidence for a dysfunctional mirror system?

    Science.gov (United States)

    Andrews, Sophie C; Enticott, Peter G; Hoy, Kate E; Thomson, Richard H; Fitzgerald, Paul B

    2016-01-01

    Social cognitive difficulties are common in the acute phase of bipolar disorder and, to a lesser extent, during the euthymic stage, and imaging studies of social cognition in euthymic bipolar disorder have implicated mirror system brain regions. This study aimed to use a novel multimodal approach (i.e., including both transcranial magnetic stimulation (TMS) and electroencephalogram (EEG)) to investigate mirror systems in bipolar disorder. Fifteen individuals with euthymic bipolar disorder and 16 healthy controls participated in this study. Single-pulse TMS was applied to the optimal site in the primary motor cortex (M1), which stimulates the muscle of interest during the observation of hand movements (goal-directed or interacting) designed to elicit mirror system activity. Single EEG electrodes (C3, CZ, C4) recorded mu rhythm modulation concurrently. Results revealed that the patient group showed significantly less mu suppression compared to healthy controls. Surprisingly, motor resonance was not significantly different overall between groups; however, bipolar disorder participants showed a pattern of reduced reactivity on some conditions. Although preliminary, this study indicates a potential mirror system deficit in euthymic bipolar disorder, which may contribute to the pathophysiology of the disorder.

  4. A paradoxical improvement of misreaching in optic ataxia: new evidence for two separate neural systems for visual localization.

    Science.gov (United States)

    Milner, A D; Paulignan, Y; Dijkerman, H C; Michel, F; Jeannerod, M

    1999-11-07

    We tested a patient (A. T.) with bilateral brain damage to the parietal lobes, whose resulting 'optic ataxia' causes her to make large pointing errors when asked to locate single light emitting diodes presented in her visual field. We report here that, unlike normal individuals, A. T.'s pointing accuracy improved when she was required to wait for 5 s before responding. This counter-intuitive result is interpreted as reflecting the very brief time-scale on which visuomotor control systems in the superior parietal lobe operate. When an immediate response was required, A. T.'s damaged visuomotor system caused her to make large errors; but when a delay was required, a different, more flexible, visuospatial coding system--presumably relatively intact in her brain--came into play, resulting in much more accurate responses. The data are consistent with a dual processing theory whereby motor responses made directly to visual stimuli are guided by a dedicated system in the superior parietal and premotor cortices, while responses to remembered stimuli depend on perceptual processing and may thus crucially involve processing within the temporal neocortex.

  5. Changes in cost system design and intensity of use in times of crisis: Evidence from Dutch local government

    NARCIS (Netherlands)

    Schoute, M.; Budding, G.T.

    2017-01-01

    Purpose: This study examines whether changes in environmental and funding uncertainty during the first three years after the outbreak of the global financial crisis (which we presume to have increased significantly) are associated with changes in cost system design and intensity of use.

  6. Silica Debris Star Systems — Spitzer Evidence for Lunar Formation Events & Crustal Stripping or Magma Oceans & Late Heavy Bombardments?

    Science.gov (United States)

    Lisse, C. M.; Chen, C. H.; Wyatt, M. C.; Morlok, A.; Thebault, P.; Orton, G. S.; Fletcher, L. N.; Fujiwara, H.; Bridges, J. C.; Elkins-Tanton, L. T.; Gaidos, E. J.; Trang, D.

    2010-03-01

    Recent work (Lisse et al., 2009) has detected amorphous silica and SiO gas around 12-m.y.-old HD172555, at the right age to form rocky planets. Here we discuss the location, lifetime, and source of the material, using inferences gleaned from HD172555 and three new silica systems.

  7. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

    Blum, Johannes; Lockwood, Diana N. J.; Visser, Leo; Harms, Gundel; Bailey, Mark S.; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P. A. M.; Morizot, Gloria; Hatz, Christoph; Buffet, Pierre

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  8. Evidence for a transgressive barrier within a regressive strandplain system : Implications for a complex coastal response to environmental change

    NARCIS (Netherlands)

    Hein, Christopher J.; FitzGerald, Duncan M.; Cleary, William J.; Boechat Albernaz, M.; Menezes, João Thadeu de; Klein, Antonio H. da F.

    2013-01-01

    Clastic, depositional strandplain systems have the potential to record changes in the primary drivers of coastal evolution: climate, sea-level, and the frequency of major meteorological and oceanographic events. This study seeks to use one such record from a southern Brazilian strandplain to

  9. Evidence of the St. Clair-Detroit River system as a dispersal corridor and nursery habitat for transient larval burbot

    Science.gov (United States)

    McCullough, Darrin E.; Roseman, Edward F.; Keeler, Kevin M.; DeBruyne, Robin L.; Pritt, Jeremy J.; Thompson, Patricia A.; Ireland, Stacey A.; Ross, Jason E.; Bowser, Dustin; Hunter, Robert D.; Castle, Dana Kristina; Fischer, Jason; Provo, Stacy A.

    2015-01-01

    Burbot Lota lota are distributed across the Laurentian Great Lakes where they occupy a top piscivore role. The St. Clair-Detroit River System is known to provide a migration corridor as well as spawning and nursery habitat for many indigenous fishes of economic and ecological significance. However, knowledge is scant of the early life history of burbot and the importance of this system in their dispersal, survival, and recruitment. In order to assess the role of the St. Clair-Detroit River System to burbot ecology, we collected larval burbot during ichthyoplankton surveys in this system from 2010 to 2013 as part of a habitat restoration monitoring program. More and larger burbot larvae were found in the St. Clair River than in the lower Detroit River, although this may be due to differences in sampling methods between the two rivers. Consistent with existing studies, larval burbot exhibited ontogenesis with a distinct transition from a pelagic zooplankton-based diet to a benthic macroinvertebrate-based diet. Our results demonstrate that the St. Clair-Detroit Rivers provide food resources, required habitat, and a migration conduit between the upper and lower Great Lakes, but the contribution of these fish to the lower lakes requires further examination.

  10. Mapping the Identity of a Viewed Hand in the Motor System: Evidence from Stimulus-Response Compatibility

    Science.gov (United States)

    Vainio, Lari; Mustonen, Terhi

    2011-01-01

    Brain-imaging research has shown that a viewed acting hand is mapped to the observer's hand representation that corresponds with the identity of the hand. In contrast, behavioral research has suggested that rather than representing a seen hand in relation to one's own manual system, it is represented in relation to the midline of an imaginary…

  11. Case Study of Ecstatic Meditation: fMRI and EEG Evidence of Self-Stimulating a Reward System

    Directory of Open Access Journals (Sweden)

    Michael R. Hagerty

    2013-01-01

    Full Text Available We report the first neural recording during ecstatic meditations called jhanas and test whether a brain reward system plays a role in the joy reported. Jhanas are Altered States of Consciousness (ASC that imply major brain changes based on subjective reports: (1 external awareness dims, (2 internal verbalizations fade, (3 the sense of personal boundaries is altered, (4 attention is highly focused on the object of meditation, and (5 joy increases to high levels. The fMRI and EEG results from an experienced meditator show changes in brain activity in 11 regions shown to be associated with the subjective reports, and these changes occur promptly after jhana is entered. In particular, the extreme joy is associated not only with activation of cortical processes but also with activation of the nucleus accumbens (NAc in the dopamine/opioid reward system. We test three mechanisms by which the subject might stimulate his own reward system by external means and reject all three. Taken together, these results demonstrate an apparently novel method of self-stimulating a brain reward system using only internal mental processes in a highly trained subject.

  12. A Longitudinal Study of State Strategies and Policies to Accelerate Evidence-Based Practices in the Context of Systems Transformation

    Science.gov (United States)

    Rieckmann, Traci; Abraham, Amanda; Zwick, Janet; Rasplica, Caitlin; McCarty, Dennis

    2015-01-01

    Objective To profile state agency efforts to promote implementation of three evidence-based practices (EBPs): screening and brief intervention (SBIRT), psychosocial interventions, and medication-assisted treatment (MAT). Data Sources/Study Setting Primary data collected from representatives of 50 states and the District of Columbia’s Single State Authorities from 2007 to 2009. Study Design/Data Collection The study used mixed methods, in-depth, semistructured interviews and quantitative surveys. Interviews assessed state and provider strategies to accelerate implementation of EBPs. Principal Findings Statewide implementation of psychosocial interventions and MAT increased significantly over 3 years. In the first two assessments, states that contracted directly with providers were more likely to link use of EBPs to reimbursement, and states with indirect contract, through counties and other entities, increased recommendations, and some requirements for provision of specific EBPs. The number of states using legislation as a policy lever to promote EBPs was unchanged. Conclusions Health care reform and implementation of parity in coverage increases access to treatment for alcohol and drug use. Science-based substance abuse treatment will become even more crucial as payers seek consistent quality of care. This study provides baseline data on service delivery, contracting, and financing as state agencies and treatment providers prepare for implementation of the Affordable Care Act. PMID:25532616

  13. Further evidence for the absence of a hypoxic fraction in the 9L rat tumour multicellular spheroid system

    International Nuclear Information System (INIS)

    Gutin, P.H.; Barcellos, M.H.; Shrieve, D.C.; Sano, Y.; Bernstein, M.; Deen, D.F.

    1982-01-01

    The 9L gliosarcoma is an N-methylnitrosourea-induced rat brain tumour that has served as a predictive model for the efficacy of various chemotherapeutic agents against human brain tumours. Because it is one of two known animal tumour models that has no hypoxic fraction, the 9L model is of questionable value for the study of the radiobiology of hypoxic cell sensitizers. Hypoxic 9L monolayer cells are sensitive to misonidazole, as shown by the abrupt decrease in survival after a 2-4 h radiation exposure. However, when 9L spheroids in the size ranges of 200-300, 300-400, 500-600 and 1027+-33μm were incubated in euoxic spinner culture for up to 96 h in 1.5 or 3.0 mM misonidazole, there was no effect on the survival of the dissociated cells over a dose range 0-20 Gy. It is concluded that, in view of the demonstrated sensitivity to misonidazole of hypoxic 9L cells in monolayer culture, this finding provides further evidence that there are no hypoxic cells even in large 9L spheroids with a histologically distinct zone of central necrosis. Moreover, 9L spheroids irradiated in the presence of 3.0 mM misonidazole showed no dose enhancement. (U.K.)

  14. VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

    Directory of Open Access Journals (Sweden)

    Claudia Marotta

    2017-10-01

    Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

  15. Study of very heavy systems by means of INDRA: First evidence for a volume effect in the nuclear multifragmentation process

    International Nuclear Information System (INIS)

    Frankland, John David

    1998-01-01

    We present a study of Gd+U collisions at 36 AMeV measured with the INDRA multidetector, permitting almost complete detection (over 80%) of all the reaction products. We show that events exist which correspond to the multifragmentation of a single system comprising the majority of the nucleons for a cross-section of 2.6 mbarn, by isolating reactions for which the emitted fragments have lost all memory of the entrance channel. Such reactions correspond to neither the most central collisions nor the most isotropic events (in the fragments' momentum space), and therefore cannot be correctly distinguished from the dominant binary deeply-inelastic collisions using these criteria. An initial comparison of the selected data with a statistical code indicates that fragments are formed in a dilute, compact system, undergoing a self-similar expansion corresponding to a collective energy of between 1 and 1.5 MeV. Comparison with the same type of events observed in Xe+Sn collisions at 32 AMeV reveals the existence of a scaling law for the multifragmentation of systems of different mass at the same excitation energy per nucleon: fragment Z distributions are identical while their multiplicity increases proportionally to the mass of the multi-fragmenting system. This observation is interpreted as an experimental signal that this multifragmentation originates in a bulk instability of low-density nuclear matter (spinodal region). A complete semi-classical microscopic calculation for the two reactions, including the formation and multifragmentation by spinodal decomposition of very heavy, low-density systems, reproduces very well not only the experimental fragment multiplicities and Z distributions but also their mean kinetic energies, as well as the size distributions of the largest fragments. (author)

  16. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  17. The Impact of Urban Transit Systems on Property Values: A Model and Some Evidences from the City of Naples

    Directory of Open Access Journals (Sweden)

    Mariano Gallo

    2018-01-01

    Full Text Available A hedonic model for estimating the effects of transit systems on real estate values is specified and calibrated for the city of Naples. The model is used to estimate the external benefits concerning property values which may be attributed to the Naples metro at the present time and in two future scenarios. The results show that only high-frequency metro lines have appreciable effects on real estate values, while low-frequency metro lines and bus lines produce no significant impacts. Our results show that the impacts on real estate values of the metro system in Naples are significant, with corresponding external benefits estimated at about 7.2 billion euros or about 8.5% of the total value of real estate assets.

  18. Assessing organizational culture in complex sociotechnical systems. Methodological evidence from studies in nuclear power plant maintenance organizations

    International Nuclear Information System (INIS)

    Reiman, T.

    2007-03-01

    Failures in industrial organizations dealing with hazardous technologies can have widespread consequences for the safety of the workers and the general population. Psychology can have a major role in contributing to the safe and reliable operation of these technologies. Most current models of safety management in complex sociotechnical systems such as nuclear power plant maintenance are either non-contextual or based on an overly-rational image of an organization. Thus, they fail to grasp either the actual requirements of the work or the socially-constructed nature of the work in question. The general aim of the present study is to develop and test a methodology for contextual assessment of organizational culture in complex sociotechnical systems. This is done by demonstrating the findings that the application of the emerging methodology produces in the domain of maintenance of a nuclear power plant (NPP). The concepts of organizational culture and organizational core task (OCT) are operationalized and tested in the case studies

  19. Stroop color-word interference and electroencephalogram activation: evidence for age-related decline of the anterior attention system.

    Science.gov (United States)

    West, R; Bell, M A

    1997-07-01

    Groups of healthy, community-dwelling younger and older adults performed a Stroop task in which color and word could be congruent or incongruent and spatially integrated or separated. During the task, continuous electroencephalogram (EEG) was recorded from frontal, parietal, and occipital regions. The magnitude of the Stroop interference effect and task-related EEG activation was greater for older than younger adults when stimuli were integrated. This effect was significant over medial and lateral frontal and parietal, but not occipital, regions. In comparison, interference and EEG activation did not differ for younger and older adults when stimuli were separated. These findings support the hypothesis that the anterior attention system is more sensitive to the effects of increasing age than the posterior attention system.

  20. Experimental evidence for simultaneous relaxation processes in super spin glass γ-Fe2O3 nanoparticle system

    Science.gov (United States)

    Nikolic, V.; Perovic, M.; Kusigerski, V.; Boskovic, M.; Mrakovic, A.; Blanusa, J.; Spasojevic, V.

    2015-03-01

    Spherical γ-Fe2O3 nanoparticles with the narrow size distribution of (5 ± 1) nm were synthesized by the method of thermal decomposition from iron acetyl acetonate precursor. The existence of super spin-glass state at low temperatures and in low applied magnetic fields was confirmed by DC magnetization measurements on a SQUID magnetometer. The comprehensive investigation of magnetic relaxation dynamics in low-temperature region was conducted through the measurements of single-stop and multiple stop ZFC memory effects, ZFC magnetization relaxation, and AC susceptibility measurements. The experimental findings revealed the peculiar change of magnetic relaxation dynamics at T ≈ 10 K, which arose as a consequence of simultaneous existence of different relaxation processes in Fe2O3 nanoparticle system. Complementarity of the applied measurements was utilized in order to single out distinct relaxation processes as well as to elucidate complex relaxation mechanisms in the investigated interacting nanoparticle system.

  1. Assessing organizational culture in complex sociotechnical systems. Methodological evidence from studies in nuclear power plant maintenance organizations

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, T.

    2007-03-15

    Failures in industrial organizations dealing with hazardous technologies can have widespread consequences for the safety of the workers and the general population. Psychology can have a major role in contributing to the safe and reliable operation of these technologies. Most current models of safety management in complex sociotechnical systems such as nuclear power plant maintenance are either non-contextual or based on an overly-rational image of an organization. Thus, they fail to grasp either the actual requirements of the work or the socially-constructed nature of the work in question. The general aim of the present study is to develop and test a methodology for contextual assessment of organizational culture in complex sociotechnical systems. This is done by demonstrating the findings that the application of the emerging methodology produces in the domain of maintenance of a nuclear power plant (NPP). The concepts of organizational culture and organizational core task (OCT) are operationalized and tested in the case studies

  2. Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System.

    Science.gov (United States)

    Emina, Jacques; Beguy, Donatien; Zulu, Eliya M; Ezeh, Alex C; Muindi, Kanyiva; Elung'ata, Patricia; Otsola, John K; Yé, Yazoumé

    2011-06-01

    The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

  3. Firm-based Training and Innovative Strategies in the Manufacturing Sector. Empirical Evidence for a local industrial System

    OpenAIRE

    Giovanni Guidetti; Massimiliano Mazzanti

    2005-01-01

    The paper investigates the driving factors of firm training using a survey-based dataset concerning manufacturing firms in the Emilia Romagna Region, located in Northern Italy. Data derive from a structured questionnaire administered in 2002 to the management of a representative sample of firms with more than 50 employees in a highly industrialised local production system. The applied analysis explores the linkages between firm training activities and its driving forces. The main potential fa...

  4. The role of domain-general frontal systems in language comprehension: evidence from dual-task interference and semantic ambiguity.

    Science.gov (United States)

    Rodd, Jennifer M; Johnsrude, Ingrid S; Davis, Matthew H

    2010-12-01

    Neuroimaging studies have shown that the left inferior frontal gyrus (LIFG) plays a critical role in semantic and syntactic aspects of speech comprehension. It appears to be recruited when listeners are required to select the appropriate meaning or syntactic role for words within a sentence. However, this region is also recruited during tasks not involving sentence materials, suggesting that the systems involved in processing ambiguous words within sentences are also recruited for more domain-general tasks that involve the selection of task-relevant information. We use a novel dual-task methodology to assess whether the cognitive system(s) that are engaged in selecting word meanings are also involved in non-sentential tasks. In Experiment 1, listeners were slower to decide whether a visually presented letter is in upper or lower case when the sentence that they are simultaneously listening to contains words with multiple meanings (homophones), compared to closely matched sentences without homophones. Experiment 2 indicates that this interference effect is not tied to the occurrence of the homophone itself, but rather occurs when listeners must reinterpret a sentence that was initially misparsed. These results suggest some overlap between the cognitive system involved in semantic disambiguation and the domain-general process of response selection required for the case-judgement task. This cognitive overlap may reflect neural overlap in the networks supporting these processes, and is consistent with the proposal that domain-general selection processes in inferior frontal regions are critical for language comprehension. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. The Plio-Pleistocene Evolution of the Indian Ocean Monsoonal System: Evidence from the Arabian Sea and East Africa

    Science.gov (United States)

    Wilson, K. E.; Maslin, M. A.; Mackay, A. W.; Leng, M. J.; Kingston, J.; Deino, A.

    2011-12-01

    It is important to identify the teleconnections between high latitude forcing and tropical monsoonal circulation in order to understand climate change in East Africa during the Plio-Pleistocene. Here we present a record of aeolian dust transport to the Arabian Sea between approximately 2.9 and 2.3 million years ago (Ma), constructed from the high-resolution XRF scanning of sediment cores from ODP Sites 721 and 722. Variations in the delivery of aeolian dust to the Arabian Sea, reflected in normalised flux of titanium, show that monsoonal circulation prior to 2.6 Ma, and after 2.5 Ma, was highly variable and primarily driven by orbitally-forced changes in tropical summer insolation, strongly modulated by the 400,000 year cycle of orbital eccentricity. This is confirmed by the presence of lakes in the East African Rift Valley during key eccentricity maxima. The dust record is coupled with the analysis of a well-dated series of diatomite units from the Baringo-Bogoria Basin which document the rhythmic cycling of large, precessionally-driven freshwater lakes which periodically occupied the Central Kenyan Rift Valley between 2.7 and 2.58 Ma. Analysis of one of these lake sequences using stable oxygen isotope measurements of diatom silica, combined with the XRF analysis of whole-sample geochemistry, reveals that the deep lake phase was characterised by fluctuations in rainfall and lake depth over cycles lasting, on average, 1,400 years. The presence of these millennial-scale fluctuations is confirmed by evidence of abrupt climate cycles in the oceanic dust record from the Arabian Sea.

  6. Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.

    Science.gov (United States)

    Ahlers, M O; Jakstat, H A

    2005-07-01

    The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published

  7. Long-term exposure to microwave radiation provokes cancer growth: evidences from radars and mobile communication systems.

    Science.gov (United States)

    Yakymenko, I; Sidorik, E; Kyrylenko, S; Chekhun, V

    2011-06-01

    In this review we discuss alarming epidemiological and experimental data on possible carcinogenic effects of long term exposure to low intensity microwave (MW) radiation. Recently, a number of reports revealed that under certain conditions the irradiation by low intensity MW can substantially induce cancer progression in humans and in animal models. The carcinogenic effect of MW irradiation is typically manifested after long term (up to 10 years and more) exposure. Nevertheless, even a year of operation of a powerful base transmitting station for mobile communication reportedly resulted in a dramatic increase of cancer incidence among population living nearby. In addition, model studies in rodents unveiled a significant increase in carcinogenesis after 17-24 months of MW exposure both in tumor-prone and intact animals. To that, such metabolic changes, as overproduction of reactive oxygen species, 8-hydroxi-2-deoxyguanosine formation, or ornithine decarboxylase activation under exposure to low intensity MW confirm a stress impact of this factor on living cells. We also address the issue of standards for assessment of biological effects of irradiation. It is now becoming increasingly evident that assessment of biological effects of non-ionizing radiation based on physical (thermal) approach used in recommendations of current regulatory bodies, including the International Commission on Non-Ionizing Radiation Protection (ICNIRP) Guidelines, requires urgent reevaluation. We conclude that recent data strongly point to the need for re-elaboration of the current safety limits for non-ionizing radiation using recently obtained knowledge. We also emphasize that the everyday exposure of both occupational and general public to MW radiation should be regulated based on a precautionary principles which imply maximum restriction of excessive exposure.

  8. Experimental investigation of alternative transmission functions: Quantitative evidence for the importance of nonlinear transmission dynamics in host-parasite systems.

    Science.gov (United States)

    Orlofske, Sarah A; Flaxman, Samuel M; Joseph, Maxwell B; Fenton, Andy; Melbourne, Brett A; Johnson, Pieter T J

    2018-05-01

    Understanding pathogen transmission is crucial for predicting and managing disease. Nonetheless, experimental comparisons of alternative functional forms of transmission remain rare, and those experiments that are conducted are often not designed to test the full range of possible forms. To differentiate among 10 candidate transmission functions, we used a novel experimental design in which we independently varied four factors-duration of exposure, numbers of parasites, numbers of hosts and parasite density-in laboratory infection experiments. We used interactions between amphibian hosts and trematode parasites as a model system and all candidate models incorporated parasite depletion. An additional manipulation involving anaesthesia addressed the effects of host behaviour on transmission form. Across all experiments, nonlinear transmission forms involving either a power law or a negative binomial function were the best-fitting models and consistently outperformed the linear density-dependent and density-independent functions. By testing previously published data for two other host-macroparasite systems, we also found support for the same nonlinear transmission forms. Although manipulations of parasite density are common in transmission studies, the comprehensive set of variables tested in our experiments revealed that variation in density alone was least likely to differentiate among competing transmission functions. Across host-pathogen systems, nonlinear functions may often more accurately represent transmission dynamics and thus provide more realistic predictions for infection. © 2017 The Authors. Journal of Animal Ecology published by John Wiley & Sons Ltd on behalf of British Ecological Society.

  9. Evidence of bottom-up limitations in nearshore marine systems based on otolith proxies of fish growth

    Science.gov (United States)

    von Biela, Vanessa R.; Kruse, Gordon H.; Mueter, Franz J.; Black, Bryan A.; Douglas, David C.; Helser, Thomas E.; Zimmerman, Christian E.

    2015-01-01

    Fish otolith growth increments were used as indices of annual production at nine nearshore sites within the Alaska Coastal Current (downwelling region) and California Current (upwelling region) systems (~36–60°N). Black rockfish (Sebastes melanops) and kelp greenling (Hexagrammos decagrammus) were identified as useful indicators in pelagic and benthic nearshore food webs, respectively. To examine the support for bottom-up limitations, common oceanographic indices of production [sea surface temperature (SST), upwelling, and chlorophyll-a concentration] during summer (April–September) were compared to spatial and temporal differences in fish growth using linear mixed models. The relationship between pelagic black rockfish growth and SST was positive in the cooler Alaska Coastal Current and negative in the warmer California Current. These contrasting growth responses to SST among current systems are consistent with the optimal stability window hypothesis in which pelagic production is maximized at intermediate levels of water column stability. Increased growth rates of black rockfish were associated with higher chlorophyll concentrations in the California Current only, but black rockfish growth was unrelated to the upwelling index in either current system. Benthic kelp greenling growth rates were positively associated with warmer temperatures and relaxation of downwelling (upwelling index near zero) in the Alaska Coastal Current, while none of the oceanographic indices were related to their growth in the California Current. Overall, our results are consistent with bottom-up forcing of nearshore marine ecosystems—light and nutrients constrain primary production in pelagic food webs, and temperature constrains benthic food webs.

  10. Pyruvate kinase M2 overexpression and poor prognosis in solid tumors of digestive system: evidence from 16 cohort studies.

    Science.gov (United States)

    Wu, Jiayuan; Hu, Liren; Chen, Manyu; Cao, Wenjun; Chen, Haicong; He, Taiping

    2016-01-01

    The expression of pyruvate kinase M2 (PKM2) has been linked to tumor formation and invasion. Specifically, the relationship between high PKM2 expression and prognosis has been evaluated in solid tumors of digestive system. However, the prognostic value of PKM2 remains controversial. A literature search of PubMed, Embase, and Cochrane databases was conducted until October 2015. The end point focused on overall survival (OS). The pooled hazard ratio (HR) or odds ratio and the 95% confidence intervals were calculated to correlate PKM2 overexpression with OS and clinicopathological characteristics by employing fixed- or random-effects models, depending on the heterogeneity of the included studies. We identified 18 cohorts in 16 studies involving 2,812 patients for this meta-analysis. Overall, the combined HR for OS in all tumor types was 1.74 (1.44-2.11; Pdigestive system, thereby suggesting that PKM2 might be an indicator of poor prognosis in digestive system cancers.

  11. Increase in peripheral oxidative stress during hypercholesterolemia is not reflected in the central nervous system: evidence from two mouse models.

    Science.gov (United States)

    Ding, Tao; Yao, Yeumang; Praticò, Domenico

    2005-05-01

    In recent years oxidative stress has been widely implicated as a pathogenetic mechanism of several diseases, and a variety of indices and assays have been developed to assess this phenomenon in complex biological systems. Most of these biomarkers can be measured virtually in every biological fluid and tissue, providing us with the opportunity to assess their formation at local site of oxidative injury. However, despite their widespread use, it is still not completely clear how their peripheral formation correlates with the levels measured in the central nervous system. For this reason, we utilized two well-characterized animal models of chronic peripheral oxidative stress, low-density lipoprotein receptor (LDLR)-deficient and C57BL/6 mice on a high fat diet. After 8 weeks on the diet, we assessed isoprostane, marker of lipid peroxidation, and carbonyls, marker of protein oxidation, in several organs of these animals. Compared with animals on chow, mice on the high fat diet showed a significant increase in both biomarkers in plasma, heart, aorta and liver but not in brain tissues. This observation was confirmed by the selective accumulation of radioactivity in the peripheral organs but not in the brains of mice injected with tritiated isoprostane. Our findings indicate that in hypercholesterolemia the peripheral formation of oxidative products does not contribute to their levels found in the central nervous system.

  12. Signed language and human action processing: evidence for functional constraints on the human mirror-neuron system.

    Science.gov (United States)

    Corina, David P; Knapp, Heather Patterson

    2008-12-01

    In the quest to further understand the neural underpinning of human communication, researchers have turned to studies of naturally occurring signed languages used in Deaf communities. The comparison of the commonalities and differences between spoken and signed languages provides an opportunity to determine core neural systems responsible for linguistic communication independent of the modality in which a language is expressed. The present article examines such studies, and in addition asks what we can learn about human languages by contrasting formal visual-gestural linguistic systems (signed languages) with more general human action perception. To understand visual language perception, it is important to distinguish the demands of general human motion processing from the highly task-dependent demands associated with extracting linguistic meaning from arbitrary, conventionalized gestures. This endeavor is particularly important because theorists have suggested close homologies between perception and production of actions and functions of human language and social communication. We review recent behavioral, functional imaging, and neuropsychological studies that explore dissociations between the processing of human actions and signed languages. These data suggest incomplete overlap between the mirror-neuron systems proposed to mediate human action and language.

  13. Creating a Statewide Educational Data System for Accountability and Improvement: A Comprehensive Information and Assessment System for Making Evidence-Based Change at School, District, and Policy Levels

    Science.gov (United States)

    Felner, Robert D.; Bolton, Natalie; Seitsinger, Anne M.; Brand, Stephen; Burns, Amy

    2008-01-01

    This article reports on one ongoing statewide effort to create a high-quality data reporting and utilization system (i.e., High-Performance Learning Community [HiPlaces] Assessment) to inform educational accountability and improvement efforts system. This effort has undergoing refinement for more than a decade. The article describes the features…

  14. History of Plant Phenological Observation in Hungary and Plans for Renewal of System to detect Evidence of the Climate Change

    Science.gov (United States)

    Hunkar, M.; Dunkel, Z.

    2009-04-01

    The first plant protection warning was issued 1760 by the Senate of the Town of Debrecen concerning the destruction of caterpillar's nest. In the middle of the 19th century the first responsible Hungarian Government issued a note in which the minister takes measurements for the phytosanitary safety of agricultural products. Though Hungary had not got independent institutional system for plant protection at the end of the 19th c., still in the middle of the 1870s, the territory of the country was protected with harmonised quarantine measures from the introduction of Colorado beetle. A new era started both in Europe and in Hungary with the devastation caused by Phylloxera vastatrix in vineyards. In 1876, the Act 29 definitely specified the measures to be taken for preventing the spread of the pest and the damages caused by it; and it was proclaimed in both Chambers of the Parliament. This incident resulted basically in the launching for the establishment of an independent plant protection institution. In l880, the National Committee on Phylloxera, then in 1881, the National Experimental Station for Phylloxera was set up, this latter considered as the first nucleus of the Hungarian plant protection organisation. The international plant protection convention, concluded in 1929 and signed by our country, had a great role in the history of the development of the plant protection organisation. Hungary agreed to establish an official plant protection organization which should consist of a plant protection service and a research institute. In compliance with the Ministerial Decree 49.000/1932 the Hungarian Plant Protection Service was set up which can now be taken for the first organisation of the uniform national plant protection administration system. Plant protection stations were established in 1954. The plant phenological observation network was run by the plant protection administration but financially was maintained by OMSZ therefore the main aim of the phenological

  15. A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system

    Science.gov (United States)

    Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A.; Evans, Arthur C.; Hurford, Matthew O.; Hadley, Trevor; Adams, Danielle R.; Walsh, Lucia M.; Babbar, Shaili; Barg, Frances; Mandell, David S.

    2015-01-01

    Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout. PMID:26179469

  16. Spectral Evidence for an Inner Carbon-rich Circumstellar Belt in the Young HD 36546 A-star System

    Energy Technology Data Exchange (ETDEWEB)

    Lisse, C. M. [JHU-APL, 11100 Johns Hopkins Road, Laurel, MD 20723 (United States); Sitko, M. L. [Department of Physics, University of Cincinnati, Cincinnati, OH 45221-0011 and Space Science Institute, Boulder, CO 80301 (United States); Russell, R. W. [The Aerospace Corporation, Los Angeles, CA 90009 (United States); Marengo, M. [Department of Physics and Astronomy, 12 Physics Hall, Iowa State University, Ames, IA 50010 (United States); Currie, T. [Subaru Telescope, National Astronomical Observatory of Japan, National Institutes of Natural Sciences, Hilo, HI 96720 (United States); Melis, C. [Center for Astrophysics and Space Sciences, University of California, San Diego, CA 92093-0424 (United States); Mittal, T. [Department of Earth and Planetary Sciences, McCone Hall, University of California at Berkeley, Berkeley, CA 94720 (United States); Song, I., E-mail: carey.lisse@jhuapl.edu, E-mail: ron.vervack@jhuapl.edu, E-mail: sitkoml@ucmail.uc.edu, E-mail: ray.russell@aero.org, E-mail: mmarengo@iastate.edu, E-mail: currie@naoj.org, E-mail: cmelis@ucsd.edu, E-mail: tmittal2@berkeley.edu, E-mail: song@physast.uga.edu [Department of Physics and Astronomy, University of Georgia, Athens, GA 30602-2451 (United States)

    2017-05-10

    Using the NASA/IRTF SpeX and BASS spectrometers we have obtained 0.7–13 μ m observations of the newly imaged 3–10 Myr old HD 36546 disk system. The SpeX spectrum is most consistent with the photospheric emission expected from an L {sub *} ∼ 20 L {sub ⊙}, solar abundance A1.5V star with little to no extinction, and excess emission from circumstellar dust detectable beyond 4.5 μ m. Non-detections of CO emission lines and accretion signatures point to the gas-poor circumstellar environment of a very old transition disk. Combining the SpeX + BASS spectra with archival WISE / AKARI / IRAS / Herschel photometry, we find an outer cold dust belt at ∼135 K and 20–40 au from the primary, likely coincident with the disk imaged by Subaru, and a new second inner belt with a temperature ∼570 K and an unusual, broad SED maximum in the 6–9 μ m region, tracing dust at 1.1–2.2 au. An SED maximum at 6–9 μ m has been reported in just two other A-star systems, HD 131488 and HD 121191, both of ∼10 Myr age. From Spitzer , we have also identified the ∼12 Myr old A7V HD 148657 system as having similar 5–35 μ m excess spectral features. The Spitzer data allows us to rule out water emission and rule in carbonaceous materials—organics, carbonates, SiC—as the source of the 6–9 μ m excess. Assuming a common origin for the four young A-star systems’ disks, we suggest they are experiencing an early era of carbon-rich planetesimal processing.

  17. The geochemistry of Don Juan Pond: Evidence for a deep groundwater flow system in Wright Valley, Antarctica

    Science.gov (United States)

    Toner, J. D.; Catling, D. C.; Sletten, R. S.

    2017-09-01

    Don Juan Pond (DJP), Antarctica, is one of the most unusual surface waters on Earth because of its CaCl2-rich composition. To investigate the evolution of pond waters during closed-basin evaporation and to understand the source of brines responsible for the chemistry of DJP, we apply a newly developed low-temperature aqueous model in the Na-K-Ca-Mg-Cl system to DJP. By modeling the closed-basin evaporation of DJP and comparing ionic ratios between DJP surface water, deep groundwater, shallow groundwater, and other surface chemistries in Wright Valley, we find that DJP is best explained by upwelling deep groundwater, as opposed to recent hypotheses proposing shallow groundwater sources. The early closed-basin evolution of brines in our model accurately predicts observed chemistries in DJP; however, late-stage closed-basin evaporation produces Mg-K-rich brines and salts that do not match the CaCl2-rich brine in DJP. Based on groundwater inflow rates to DJP, we estimate that even the most concentrated brines in DJP have undergone closed-basin evaporation for less than a year. To explain the observed lack of Mg2+ and K+ accumulation in DJP over time, and the surprisingly young age for the brines, we deduce that DJP is a localized upwelling from a regional groundwater flow-through system in which evaporated DJP brines are recycled back into the subsurface over yearly timescales. The existence of a regional groundwater flow system beneath DJP has implications for water and solute budgets in cold desert ecosystems, and may provide clues for the formation of groundwater and aqueous flows on Mars.

  18. Evidence-based librarianship: searching for the needed EBL evidence.

    Science.gov (United States)

    Eldredge, J D

    2000-01-01

    This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

  19. The role of information systems in non-routine transit use of university students: Evidence from Brazil and Denmark

    DEFF Research Database (Denmark)

    Kaplan, Sigal; Monteiro, Mayara Moraes; Anderson, Marie Karen

    2017-01-01

    In this study we seek to understand the relation between travel information, transit use intentions and night travel. We hypothesize that transit use is related to the perceived usefulness and the ease-of-use of the system, which are related to information quality and real-time information...... and the latent constructs. The results show that: (i) information search quality and source explain transit use; (ii) information quality underlies level-of-service and familiarity; (iii) the use of real-time information links to information quality and familiarity; (iv) general transit use and non-routine use...

  20. From Augustine of Hippo's Memory Systems to Our Modern Taxonomy in Cognitive Psychology and Neuroscience of Memory: A 16-Century Nap of Intuition before Light of Evidence.

    Science.gov (United States)

    Cassel, Jean-Christophe; Cassel, Daniel; Manning, Lilianne

    2013-03-01

    Over the last half century, neuropsychologists, cognitive psychologists and cognitive neuroscientists interested in human memory have accumulated evidence showing that there is not one general memory function but a variety of memory systems deserving distinct (but for an organism, complementary) functional entities. The first attempts to organize memory systems within a taxonomic construct are often traced back to the French philosopher Maine de Biran (1766-1824), who, in his book first published in 1803, distinguished mechanical memory, sensitive memory and representative memory, without, however, providing any experimental evidence in support of his view. It turns out, however, that what might be regarded as the first elaborated taxonomic proposal is 14 centuries older and is due to Augustine of Hippo (354-430), also named St Augustine, who, in Book 10 of his Confessions, by means of an introspective process that did not aim at organizing memory systems, nevertheless distinguished and commented on sensible memory, intellectual memory, memory of memories, memory of feelings and passion, and memory of forgetting. These memories were envisaged as different and complementary instances. In the current study, after a short biographical synopsis of St Augustine, we provide an outline of the philosopher's contribution, both in terms of questions and answers, and focus on how this contribution almost perfectly fits with several viewpoints of modern psychology and neuroscience of memory about human memory functions, including the notion that episodic autobiographical memory stores events of our personal history in their what, where and when dimensions, and from there enables our mental time travel. It is not at all meant that St Augustine's elaboration was the basis for the modern taxonomy, but just that the similarity is striking, and that the architecture of our current viewpoints about memory systems might have preexisted as an outstanding intuition in the philosopher

  1. Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.

    Science.gov (United States)

    Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos

    2016-07-07

    Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). ClinicalTrials.gov, https://clinicaltrials.gov/ct2

  2. Evidence of relationships between texture and structure in smectite systems by small angle synchrotron X ray scattering

    International Nuclear Information System (INIS)

    Pons, Charles-Henri

    1980-01-01

    Phyllosilicates are major constituents of soils, and their partially swelled or dispersed states play an important role in sedimentary geology, in soil science, in biochemistry, and also in various technological applications (drilling sludge, oil synthesis catalysts). Properties of these systems are also in direct relationship with problems such as fixation of pollutants by soil (pesticides, heavy metals, radioactive materials, so on). After having recalled works performed during the past forty years on water-smectite dispersions to define prevailing factors of processes of formation of colloidal states, the author presents the different phyllosilicates which have been studied, and recalls the determining factors of inflation and dispersion mechanisms. Then, he recalls methods of interpretation of X diffraction diagrams and of small angle scattering. He reports the detailed study of the inflation mechanism in the case of montmorillonite- Na, and discusses results obtained with other phyllosilicates or with other cations than sodium. In appendix, the author reports the study of bi-ionic (Na-Ca) montmorillonite suspensions prepared by two different methods. He also discusses the method of interpretation of neutron small angle scattering which had been used on similar systems, and shows why this method leads to questionable conclusions

  3. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014.

    Directory of Open Access Journals (Sweden)

    Shalini Rudra

    Full Text Available AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.

  4. Old Wine in New Bottles: Decanting Systemic Family Process Research in the Era of Evidence-Based Practice†

    Science.gov (United States)

    Rohrbaugh, Michael J.

    2015-01-01

    Social cybernetic (systemic) ideas from the early Family Process era, though emanating from qualitative clinical observation, have underappreciated heuristic potential for guiding quantitative empirical research on problem maintenance and change. The old conceptual wines we have attempted to repackage in new, science-friendly bottles include ironic processes (when “solutions” maintain problems), symptom-system fit (when problems stabilize relationships), and communal coping (when we-ness helps people change). Both self-report and observational quantitative methods have been useful in tracking these phenomena, and together the three constructs inform a team-based family consultation (FAMCON) approach to working with difficult health and behavior problems. In addition, a large-scale, quantitatively focused effectiveness trial of family therapy for adolescent drug abuse highlights the importance of treatment fidelity and qualitative approaches to examining it. In this sense, echoing the history of family therapy research, our experience with juxtaposing quantitative and qualitative methods has gone full circle – from qualitative to quantitative observation and back again. PMID:24905101

  5. Old wine in new bottles: decanting systemic family process research in the era of evidence-based practice.

    Science.gov (United States)

    Rohrbaugh, Michael J

    2014-09-01

    Social cybernetic (systemic) ideas from the early Family Process era, though emanating from qualitative clinical observation, have underappreciated heuristic potential for guiding quantitative empirical research on problem maintenance and change. The old conceptual wines we have attempted to repackage in new, science-friendly bottles include ironic processes (when "solutions" maintain problems), symptom-system fit (when problems stabilize relationships), and communal coping (when we-ness helps people change). Both self-report and observational quantitative methods have been useful in tracking these phenomena, and together the three constructs inform a team-based family consultation approach to working with difficult health and behavior problems. In addition, a large-scale, quantitatively focused effectiveness trial of family therapy for adolescent drug abuse highlights the importance of treatment fidelity and qualitative approaches to examining it. In this sense, echoing the history of family therapy research, our experience with juxtaposing quantitative and qualitative methods has gone full circle-from qualitative to quantitative observation and back again. © 2014 FPI, Inc.

  6. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

    Science.gov (United States)

    2017-01-01

    AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care. PMID:28472197

  7. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Directory of Open Access Journals (Sweden)

    Marinaccio Alessandro

    2012-07-01

    Full Text Available Abstract Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational. In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM and the Italian workers’ compensation authority (INAIL archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%; 91.2% (1,482 of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates. The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.

  8. Evidence of a field-induced Berezinskii-Kosterlitz-Thouless scenario in a two-dimensional spin-dimer system.

    Science.gov (United States)

    Tutsch, U; Wolf, B; Wessel, S; Postulka, L; Tsui, Y; Jeschke, H O; Opahle, I; Saha-Dasgupta, T; Valentí, R; Brühl, A; Remović-Langer, K; Kretz, T; Lerner, H-W; Wagner, M; Lang, M

    2014-10-27

    Two-dimensional (2D) systems with continuous symmetry lack conventional long-range order because of thermal fluctuations. Instead, as pointed out by Berezinskii, Kosterlitz and Thouless (BKT), 2D systems may exhibit so-called topological order driven by the binding of vortex-antivortex pairs. Signatures of the BKT mechanism have been observed in thin films, specially designed heterostructures, layered magnets and trapped atomic gases. Here we report on an alternative approach for studying BKT physics by using a chemically constructed multilayer magnet. The novelty of this approach is to use molecular-based pairs of spin S=½ ions, which, by the application of a magnetic field, provide a gas of magnetic excitations. On the basis of measurements of the magnetic susceptibility and specific heat on a so-designed material, combined with density functional theory and quantum Monte Carlo calculations, we conclude that these excitations have a distinct 2D character, consistent with a BKT scenario, implying the emergence of vortices and antivortices.

  9. The Examination of the Corporate Governance System at Supplier Companies: Empirical Evidence from Hungarian Automotive Industry Ercsey Ida

    Directory of Open Access Journals (Sweden)

    Ercsey Ida

    2016-06-01

    Full Text Available Information management and the organizational structure can contribute to the firms’ competitive advantage and business success. In the first part of our study we summarize the results we obtained by analyzing the corporate governance system in connection with the structure of enterprises and their decision making. Then we have an insight into the leadership style of the suppliers from the point of view of the participation of the staff in decision making. In the second part we analyze the information management of the supplier companies on the basis of the answers from the management. We evaluate the strategic and the operational concept of information management, proceeding from the strategy-making activity. The accomplishment of permanent renewal and willingness to innovate are both indispensable for achieving elasticity in organizations. We explore how the suppliers introduce innovation in connection with the firm structure and the information system. Finally, we consider how some essential company characteristics, namely company size, ownership, region, and the width of the product assortment, affect various company functions.

  10. The Defense Messaging System (DMS) in the Navy Regional Enterprise Messaging System (NREMS) environment evidence that size does matter in DoD business process engineering

    OpenAIRE

    Ramsey, Avonna S.

    2007-01-01

    Since the migration of DOD messaging to the DMS has been mandated, implementation has been less than ideal and otherwise unsuccessful. DMS users have reported dissatisfaction with the systems maintenance and security support burdens in the current client-server model. NREMS introduces a networked environment capable of push technology and centralized database and security management which should significantly reduce the DMS shortfalls that have made the system lack appeal to the end user. As ...

  11. Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia

    Directory of Open Access Journals (Sweden)

    Kendra Siekmans

    2017-01-01

    Full Text Available Abstract Background Trained community health workers (CHW enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. Methods A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16, government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Results Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. “No touch” integrated community case management (iCCM guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Conclusions Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea

  12. Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia.

    Science.gov (United States)

    Siekmans, Kendra; Sohani, Salim; Boima, Tamba; Koffa, Florence; Basil, Luay; Laaziz, Saïd

    2017-01-17

    Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. "No touch" integrated community case management (iCCM) guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea during the Ebola outbreak, making communities more resilient when

  13. Dermal inorganic gadolinium concentrations: evidence for in vivo transmetallation and long-term persistence in nephrogenic systemic fibrosis

    DEFF Research Database (Denmark)

    Abraham, J L; Thakral, C; Skov, L

    2008-01-01

    BACKGROUND: Gadolinium (Gd)-based magnetic resonance contrast agents (GBMCA), including gadodiamide, have been identified as the probable causative agents of the serious disease, nephrogenic systemic fibrosis (NSF). OBJECTIVES: To investigate retained Gd-containing deposits in skin biopsies from...... patients with NSF and to determine their relative concentrations over time from administration of GBMCA. METHODS: An investigator-blinded retrospective study, analysing 43 skin biopsies from 20 patients with gadodiamide-related NSF and one NSF-negative gadodiamide-exposed dialysis patient, ranging from 16...... days to 1991 days after Gd contrast dose. Utilizing automated quantitative scanning electron microscopy/energy-dispersive X-ray spectroscopy we determined the concentration of Gd and associated elements present as insoluble deposits in situ in the tissues. RESULTS: We detected Gd in skin lesions of all...

  14. [Violence and accidents among older and younger adults: evidence from the Surveillance System for Violence and Accidents (VIVA), Brazil].

    Science.gov (United States)

    Luz, Tatiana Chama Borges; Malta, Deborah Carvalho; Sá, Naíza Nayla Bandeira de; Silva, Marta Maria Alves da; Lima-Costa, Maria Fernanda

    2011-11-01

    Data from the Brazilian Surveillance System for Violence and Accidents (VIVA) in 2009 were used to examine socio-demographic characteristics, outcomes, and types of accidents and violence treated at 74 sentinel emergency services in 23 Brazilian State capitals and the Federal District. The analysis included 25,201 individuals aged > 20 years (10.1% > 60 years); 89.3% were victims of accidents and 11.9% victims of violence. Hospitalization was the outcome in 11.1% of cases. Compared to the general population, there were more men and non-white individuals among victims of accidents, and especially among victims of violence. As compared to younger adults (20-59 years), accidents and violence against elderly victims showed less association with alcohol, a higher proportion of domestic incidents, more falls and pedestrian accidents, and aggression by family members. Policies for the prevention of accidents and violence should consider the characteristics of these events in the older population.

  15. Research on early warning of food security using a system dynamics model: evidence from Jiangsu province in China.

    Science.gov (United States)

    Xu, Jianling; Ding, Yi

    2015-01-01

    Analyzing the early warning of food security, this paper sets the self-sufficiency rate as the principal indicator in a standpoint of supplement. It is common to use the quantitative methods to forecast and warning the insecurity. However, this paper considers more about the probable outcome when the government intervenes. By constructing the causal feedbacks among grain supplement, demand, productive input, and the policy factors to simulate the future food security in Jiangsu province, conclusions can be drawn as the following: (1) The situation of food security is insecure if the self-sufficiency rate is under 68.3% according to the development of system inertia. (2) it is difficult to guarantee the food security in Jiangsu just depending on the increase of grain sown area. (3) The valid solution to ensure the food security in Jiangsu is to improve the productivity. © 2015 Institute of Food Technologists®

  16. Is There Evidence of Cost Benefits of Electronic Medical Records, Standards, or Interoperability in Hospital Information Systems? Overview of Systematic Reviews.

    Science.gov (United States)

    Reis, Zilma Silveira Nogueira; Maia, Thais Abreu; Marcolino, Milena Soriano; Becerra-Posada, Francisco; Novillo-Ortiz, David; Ribeiro, Antonio Luiz Pinho

    2017-08-29

    Electronic health (eHealth) interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized health information systems. However, interoperability among systems depends on the adoption of information standards. Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for stakeholders. The objective of this study was to assess cost-effectiveness of the use of electronically available inpatient data systems, health information exchange, or standards to support interoperability among systems. An overview of systematic reviews was conducted, assessing the MEDLINE, Cochrane Library, LILACS, and IEEE Library databases to identify relevant studies published through February 2016. The search was supplemented by citations from the selected papers. The primary outcome sought the cost-effectiveness, and the secondary outcome was the impact on quality of care. Independent reviewers selected studies, and disagreement was resolved by consensus. The quality of the included studies was evaluated using a measurement tool to assess systematic reviews (AMSTAR). The primary search identified 286 papers, and two papers were manually included. A total of 211 were systematic reviews. From the 20 studies that were selected after screening the title and abstract, 14 were deemed ineligible, and six met the inclusion criteria. The interventions did not show a measurable effect on cost-effectiveness. Despite the limited number of studies, the heterogeneity of electronic systems reported, and the types of intervention in hospital routines, it was possible to identify some preliminary benefits in quality of care. Hospital information systems, along with information sharing, had the potential to improve clinical practice by reducing staff errors or incidents, improving automated harm detection

  17. Is the motor system necessary for processing action and abstract emotion words? Evidence from focal brain lesions

    Directory of Open Access Journals (Sweden)

    Felix R. Dreyer

    2015-11-01

    Full Text Available Neuroimaging and neuropsychological experiments suggest that modality-preferential cortices, including motor- and somatosensory areas contribute to the semantic processing of action related concrete words. In contrast, a possible role of modality-preferential – including sensorimotor – areas in processing abstract meaning remains under debate. However, recent fMRI studies indicate an involvement of the left sensorimotor cortex in the processing of abstract-emotional words (e.g. love. But are these areas indeed necessary for processing action-related and abstract words? The current study now investigates word processing in two patients suffering from focal brain lesion in the left frontocentral motor system. A speeded lexical decision task (LDT on meticulously matched word groups showed that the recognition of nouns from different semantic categories – related to food, animals, tools and abstract-emotional concepts – was differentially affected. Whereas patient HS with a lesion in dorsolateral central sensorimotor cortex next to the hand area showed a category-specific deficit in recognizing tool words, patient CA suffering from lesion centered in the left SMA was primarily impaired in abstract-emotional word processing. These results point to a causal role of the motor cortex in the semantic processing of both action-related object concepts and abstract-emotional concepts and therefore suggest that the motor areas previously found active in action-related and abstract word processing can serve a meaning-specific necessary role in word recognition. The category-specific nature of the observed dissociations is difficult to reconcile with the idea that sensorimotor systems are somehow peripheral or ‘epiphenomenal’ to meaning and concept processing. Rather, our results are consistent with the claim that cognition is grounded in action and perception and based on distributed action perception circuits reaching into sensorimotor areas.

  18. Evidence for the involvement of the CXCL12 system in the adaptation of skeletal muscles to physical exercise.

    Science.gov (United States)

    Puchert, Malte; Adams, Volker; Linke, Axel; Engele, Jürgen

    2016-09-01

    The chemokine CXCL12 and its primary receptor, CXCR4, not only promote developmental myogenesis, but also muscle regeneration. CXCL12 chemoattracts CXCR4-positive satellite cells/blood-borne progenitors to the injured muscle, promotes myoblast fusion, partially with existing myofibers, and induces angiogenesis in regenerating muscles. Interestingly, the mechanisms underlying muscle regeneration are in part identical to those involved in muscular adaptation to intensive physical exercise. These similarities now prompted us to determine whether physical exercise would impact the CXCL12 system in skeletal muscle. We found that CXCL12 and CXCR4 are upregulated in the gastrocnemius muscle of rats that underwent a four-week period of constrained daily running exercise on a treadmill. Double-staining experiments confirmed that CXCL12 and CXCR4 are predominantly expressed in MyHC-positive muscle fibers. Moreover, these training-dependent increases in CXCL12 and CXCR4 expression also occurred in rats with surgical coronary artery occlusion, implying that the muscular CXCL12 system is still active in skeletal myopathy resulting from chronic heart failure. Expression of the second CXCL12 receptor, CXCR7, which presumably acts as a scavenger receptor in muscle, was not affected by training. Attempts to dissect the molecular events underlying the training-dependent effects of CXCL12 revealed that the CXCL12-CXCR4 axis activates anabolic mTOR-p70S6K signaling and prevents upregulation of the catabolic ubiquitin ligase MurF-1 in C2C12 myotubes, eventually increasing myotube diameters. Together, these findings point to a pivotal role of the CXCL12-CXCR4 axis in exercise-induced muscle maintenance and/or growth. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Exploring the link between products and services in low-income markets—Evidence from solar home systems

    International Nuclear Information System (INIS)

    Friebe, Christian A.; Flotow, Paschen von; Täube, Florian A.

    2013-01-01

    One of the key challenges of energy access in emerging markets and developing countries is how to reach households and communities that are unlikely to get a grid connection in the long term or those that are connected to the grid but suffer from regular blackouts or low voltage. By surveying entrepreneurs selling Solar Home Systems (SHSs) on a commercial basis in emerging and developing countries, this study is one of the first attempts to quantify the key elements of four potential Product Service Systems (PSSs): Cash, Credit, Leasing and Fee-for-Service. Whereas the Fee-for-Service approach was found to be suitable only under certain conditions, all PSSs share two key elements for successful market deployment: one or more years of maintenance, and customer support in financing these customers' new asset. Moreover, it appears that private sector companies are in principle able to deliver SHSs to households with incomes greater than USD 1000 per year. The implications for policy makers and development aid agencies are, first, to include maintenance services into public programmes or public–private partnerships and, second, to explicitly consider financial risks for entrepreneurs (e.g., customer commitment and repayment conditions). - Highlights: ► Explorative quantitative study among entrepreneurs across different low-income markets. ► Specific combinations of product and service are identified and evaluated. ► Cash, Credit and Leasing can be feasible from a private sector point of view. ► Fee-for-Service is very challenging for the private sector without any policy support. ► Combining the SHS with services such as finance and maintenance is key to success.

  20. Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2014-07-01

    Full Text Available Background: Hospital management information systems (HMIS is a key component of national health information systems (HIS, and actions required of hospital management to support information generation in Kenya are articulated in specific policy documents. We conducted an evaluation of core functions of data generation and reporting within hospitals in Kenya to facilitate interpretation of national reports and to provide guidance on key areas requiring improvement to support data use in decision making. Design: The survey was a cross-sectional, cluster sample study conducted in 22 hospitals in Kenya. The statistical analysis was descriptive with adjustment for clustering. Results: Most of the HMIS departments complied with formal guidance to develop departmental plans. However, only a few (3/22 had carried out a data quality audit in the 12 months prior to the survey. On average 3% (range 1–8% of the total hospital income was allocated to the HMIS departments. About half of the records officer positions were filled and about half (13/22 of hospitals had implemented some form of electronic health record largely focused on improving patient billing and not linked to the district HIS. Completeness of manual patient registers varied, being 90% (95% CI 80.1–99.3%, 75.8% (95% CI 68.7–82.8%, and 58% (95% CI 50.4–65.1% in maternal child health clinic, maternity, and pediatric wards, respectively. Vital events notification rates were low with 25.7, 42.6, and 71.3% of neonatal deaths, infant deaths, and live births recorded, respectively. Routine hospital reports suggested slight over-reporting of live births and under-reporting of fresh stillbirths and neonatal deaths. Conclusions: Study findings indicate that the HMIS does not deliver quality data. Significant constraints exist in data quality assurance, supervisory support, data infrastructure in respect to information and communications technology application, human resources, financial

  1. THE EFFECT OF E-COMMERCE ON MALAYSIAN TAX SYSTEM: AN EMPIRICAL EVIDENCE FROM ACADEMICIANS AND MALAYSIAN TAX PRACTITIONERS

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Palil

    2004-01-01

    Full Text Available The explosion of information technology (IT nowadays has created new phenomena in shopping activities. Consumers can easily buy products via Internet. Within a minute, the products will be delivered instantly and accurately. This scenario is known as e-commerce. The emergence of e-commerce affects consumers' shopping behavior as well as taxation system. The objective of this research is to reveal the effects of e-commerce upon Malaysian taxation system by emphasizing in scope of charge 'derive and remittance'. Research was conducted through questionnaires of 82 tax practitioners and 22 academicians. The research findings shown that derive and remittance basis is no longer appropriate in e-commerce environment. Scope of charge derives and remittances, which are practicing in Malaysia right now, are unable to maximized e-commerce tax revenue. Abstract in Bahasa Indonesia : Perkembangan dalam dunia teknologi akhir-akhir ini telah membawa banyak arus perubahan terutamanya dalam aktivitas belanja. Konsumen dapat membeli barang dengan mudah melalui internet. Dalam waktu beberapa menit, barang sampai di tangan konsumen. Skenario demikian dikenal sebagai perdagangan elektronis. Kemunculan perdagangan elektronis mengubah prilaku belanja konsumen serta sistem perpajakan di Malaysia. Tujuan penelitian ini adalah untuk mengetahui efek perdagangan elektronis terhadap sistem perpajakan di Malaysia dengan penekanan pada pengenaan pajak dan hak pemajakan. Penelitian dilakukan dengan menggunakan 82 sample praktisi perpajakan dan 22 akademisi. Hasil penelitian menunjukkan, bahwa praktek pengenaan pajak dalam perdagangan elektronis belum sesuai dengan aturan yang berlaku, sehingga tidak dapat memaksimalkan penerimaan pajak dari perdagangan elektronis. Kata kunci: sistem perpajakan Malaysia, perdagangan elektronik, akademik, praktisi perpajakan, pengenaan pajak.

  2. Treatment decision-making processes in the systemic treatment of ovarian cancer: review of the scientific evidence.

    Science.gov (United States)

    Luketina, Hrvoje; Fotopoulou, Christina; Luketina, Ruzica-Rosalia; Pilger, Adak; Sehouli, Jalid

    2012-09-01

    The systemic treatment of epithelial ovarian cancer (OC) is one of the cornerstones in the multimodal management of advanced OC in both primary and recurrent stages of this disease. In most situations various treatment options are available but only few data exists about the treatment decision-making process. Therefore, we conducted a review of the current literature regarding the decision-making process concerning the systemic therapy in patients with advanced ovarian cancer. The electronic database MEDLINE (PubMed) was systematically reviewed for studies that evaluate the treatment decision-making processes in patients with advanced OC. The PubMed database was searched in detail for all titles and abstracts of potentially relevant studies published between 1995 and 2011. An initial search identified 15 potentially relevant studies, but only seven met all inclusion criteria. Factors that influence treatment decisions in patients with OC include not only rational arguments and medical reasons, but also individual attitudes, fears, existential questions, various projections resulting from the physician patient relationship and the social environment. The physician's personal experience with OC treatment seems to be an important factor, followed by previous personal experience with medical issues, and the fear of side-effects and future metastases. Family and self-support organisations also seem to play a significant role in the treatment decision-making process. This review underlines the need for more research activities to explore the treatment decision-making process to enable the best individual support for patients in treatment decision-making. It is a challenge for clinicians to determine the individual information needs of women with OC and to involve them during the decision-making process to the extent they wish.

  3. Evidence for tectonic, lithologic, and thermal controls on fracture system geometries in an andesitic high-temperature geothermal field

    Science.gov (United States)

    Massiot, Cécile; Nicol, Andrew; McNamara, David D.; Townend, John

    2017-08-01

    Analysis of fracture orientation, spacing, and thickness from acoustic borehole televiewer (BHTV) logs and cores in the andesite-hosted Rotokawa geothermal reservoir (New Zealand) highlights potential controls on the geometry of the fracture system. Cluster analysis of fracture orientations indicates four fracture sets. Probability distributions of fracture spacing and thickness measured on BHTV logs are estimated for each fracture set, using maximum likelihood estimations applied to truncated size distributions to account for sampling bias. Fracture spacing is dominantly lognormal, though two subordinate fracture sets have a power law spacing. This difference in spacing distributions may reflect the influence of the andesitic sequence stratification (lognormal) and tectonic faults (power law). Fracture thicknesses of 9-30 mm observed in BHTV logs, and 1-3 mm in cores, are interpreted to follow a power law. Fractures in thin sections (˜5 μm thick) do not fit this power law distribution, which, together with their orientation, reflect a change of controls on fracture thickness from uniform (such as thermal) controls at thin section scale to anisotropic (tectonic) at core and BHTV scales of observation. However, the ˜5% volumetric percentage of fractures within the rock at all three scales suggests a self-similar behavior in 3-D. Power law thickness distributions potentially associated with power law fluid flow rates, and increased connectivity where fracture sets intersect, may cause the large permeability variations that occur at hundred meter scales in the reservoir. The described fracture geometries can be incorporated into fracture and flow models to explore the roles of fracture connectivity, stress, and mineral precipitation/dissolution on permeability in such andesite-hosted geothermal systems.

  4. Archaeological Evidence for Resilience of Pacific Northwest Salmon Populations and the Socioecological System over the last ~7,500 years

    Directory of Open Access Journals (Sweden)

    Sarah K. Campbell

    2010-03-01

    Full Text Available Archaeological data on the long history of interaction between indigenous people and salmon have rarely been applied to conservation management. When joined with ethnohistoric records, archaeology provides an alternative conceptual view of the potential for sustainable harvests and can suggest possible social mechanisms for managing human behavior. Review of the ~7,500-year-long fish bone record from two subregions of the Pacific Northwest shows remarkable stability in salmon use. As major changes in the ecological and social system occurred over this lengthy period, persistence in the fishery is not due simply to a lack of perturbation, but rather indicates resilience in the ecological-human system. Of several factors possibly contributing to resilience, low human population size and harvesting pressure, habitat enhancement, and suppression of competing predators do not appear to be of major importance. Flexible resource use, including human use of a range of local resources, many of which are linked in a food web with salmon, likely contributed to resilience. Most important were the beliefs and social institutions (including ownership, regulation, rituals, and monitoring that placed restraints on salmon use as a common pool resource. In contrast, only a small fraction of our modern society relies economically on or has direct interaction with the fish, which limits our concern and willingness to fundamentally change behaviors that contribute to habitat degradation and loss, the main challenges facing salmon populations today. Salmon recovery efforts may benefit substantially from investing more resources into establishing links between community groups and actual fish populations, which would create a sense of proprietorship, one of the keys to resilience in the indigenous salmon fishery.

  5. Perceptual-motor skill learning in Gilles de la Tourette syndrome. Evidence for multiple procedural learning and memory systems.

    Science.gov (United States)

    Marsh, Rachel; Alexander, Gerianne M; Packard, Mark G; Zhu, Hongtu; Peterson, Bradley S

    2005-01-01

    Procedural learning and memory systems likely comprise several skills that are differentially affected by various illnesses of the central nervous system, suggesting their relative functional independence and reliance on differing neural circuits. Gilles de la Tourette syndrome (GTS) is a movement disorder that involves disturbances in the structure and function of the striatum and related circuitry. Recent studies suggest that patients with GTS are impaired in performance of a probabilistic classification task that putatively involves the acquisition of stimulus-response (S-R)-based habits. Assessing the learning of perceptual-motor skills and probabilistic classification in the same samples of GTS and healthy control subjects may help to determine whether these various forms of procedural (habit) learning rely on the same or differing neuroanatomical substrates and whether those substrates are differentially affected in persons with GTS. Therefore, we assessed perceptual-motor skill learning using the pursuit-rotor and mirror tracing tasks in 50 patients with GTS and 55 control subjects who had previously been compared at learning a task of probabilistic classifications. The GTS subjects did not differ from the control subjects in performance of either the pursuit rotor or mirror-tracing tasks, although they were significantly impaired in the acquisition of a probabilistic classification task. In addition, learning on the perceptual-motor tasks was not correlated with habit learning on the classification task in either the GTS or healthy control subjects. These findings suggest that the differing forms of procedural learning are dissociable both functionally and neuroanatomically. The specific deficits in the probabilistic classification form of habit learning in persons with GTS are likely to be a consequence of disturbances in specific corticostriatal circuits, but not the same circuits that subserve the perceptual-motor form of habit learning.

  6. THE THREE-DIMENSIONAL STRUCTURE OF THE M31 SATELLITE SYSTEM; STRONG EVIDENCE FOR AN INHOMOGENEOUS DISTRIBUTION OF SATELLITES

    International Nuclear Information System (INIS)

    Conn, A. R.; Parker, Q. A.; Zucker, D. B.; Lewis, G. F.; Ibata, R. A.; Martin, N. F.; McConnachie, A. W.; Valls-Gabaud, D.; Tanvir, N.; Irwin, M. J.; Ferguson, A. M. N.; Chapman, S. C.

    2013-01-01

    We undertake an investigation into the spatial structure of the M31 satellite system utilizing the distance distributions presented in a previous publication. These distances make use of the unique combination of depth and spatial coverage of the Pan-Andromeda Archaeological Survey to provide a large, homogeneous sample consisting of 27 of M31's satellites, as well as M31 itself. We find that the satellite distribution, when viewed as a whole, is no more planar than one would expect from a random distribution of equal size. A disk consisting of 15 of the satellites is however found to be highly significant, and strikingly thin, with an rms thickness of just 12.34 +0.75 -0.43 kpc. This disk is oriented approximately edge-on with respect to the Milky Way and almost perpendicular to the Milky Way disk. It is also roughly orthogonal to the disk-like structure regularly reported for the Milky Way satellite system and in close alignment with M31's Giant Stellar Stream. A similar analysis of the asymmetry of the M31 satellite distribution finds that it is also significantly larger than one would expect from a random distribution. In particular, it is remarkable that 20 of the 27 satellites most likely lie on the Milky Way side of the galaxy, with the asymmetry being most pronounced within the satellite subset forming the aforementioned disk. This lopsidedness is all the more intriguing in light of the apparent orthogonality observed between the satellite disk structures of the Milky Way and M31.

  7. Biometric System Vulnerability as a Compromising Factor for Integrity of Chain of Custody and Admissibility ofDigitalEvidence in Court of Justice: Analysis and Improvement Proposal

    Directory of Open Access Journals (Sweden)

    Zoran Cosic

    2014-06-01

    Full Text Available Biometric systems play an important role in digital investigation process as a important factor of authentication and verification applications, since they are strongly linked to the holder of a biometric  traits  and  possible  suspect.  Thus  it  is  important  that  biometric  systems  can  be designed  to  withstand  attacks  when  employed  in  security-critical  applications,  especially  in unattended  remote  applications  such  as  energy  plants,  access  to  borders  at  airports,  ecommerce  etc.  Biometric  recognition  either  raises  important  legal  issues  of  remediation, authority,  and  reliability,  and,  of  course,  privacy.  The  standard  assumptions  of  the technologists  who  design  new  techniques,  capabilities,  and  systems  are  very  different  from those embedded in the legal  system.  Legal precedent on the  use of biometric technology is growing, with some key cases going back decades and other more recent cases having raised serious questions about the admissibility of biometric evidence in court. In this paper authors is about to explain influence of reliability of biometric system on general acceptance of digital evidence  in  Court  of  Justice  process.  Through  paper  authors  are  also  about  to  propose vulnerability assessment of biometric system as improvementfactor of reliability of existing methodology  for  preserving  chain  of  custody  of  digital  evidence  called  DEMF  (Digital Evidence Management Framework. Improvement proposal is presented as an introduction of phase  of  biometric  vulnerability  evaluation  methodology  within  proposedframework called APDEMF (Admissibility procedure of DEMF. Using UML (Universal Modeling Language modeling  methodology  authors  are  about  to  represent  a  APDEMF  framework  which  will describe essential phases of the same process.

  8. Stratigraphic evolution of the Late Jurassic Hanifa Formation along the Tuwaiq Escarpment, Saudi Arabia: Evidence for a carbonate ramp system

    Science.gov (United States)

    Fallatah, Mohammed I.; Kerans, Charles

    2018-01-01

    A sequence stratigraphic framework of the Late Jurassic (Oxfordian) Hanifa Formation at its exposure in Central Arabia is presented for the first time. This study offers the first high-resolution stratigraphic framework of the Hanifa along the Tuwaiq Escarpment by measuring 15 sections ( 770 m total thickness) over an oblique-to-dip distance of 260 km and collecting 295 samples for petrographic analysis. On the basis of these data, the Hanifa Formation can be subdivided into eight facies; 1) tabular cross-bedded quartz-peloidal-skeletal grainstone, 2) cross-bedded skeletal-peloidal grainstone, 3) bioturbated foraminiferal wackestone/mud-dominated packstone, 4) oncolitic rudstone, 5) stromatoporoid-coral biostrome/bioherm, 6) peloidal/composite-grain grain-dominated packstone/grainstone, 7) bioturbated spiculitic wackestone/mud-dominated packstone, and 8) thinly-bedded argillaceous mudstone/wackestone. The vertical and lateral distributions of these facies along the exposure define their sequence setting using the principals of sequence stratigraphy. By recognizing erosional surfaces, facies offset, and changes in facies proportions, five third-order sequences, with an average duration of 1.1 Myr, are interpreted for the Hanifa Formation. The correlation of the sequences across the study area shows that only four sequences are preserved in the north where shallow-water deposits are well-developed. Facies trends within these sequences are further illustrated in depositional models representing the highstand systems tracts (HST) and the transgressive systems tracts (TST) of the Hanifa Formation. These proposed models represent depositional settings of a carbonate ramp with normal open-marine conditions. The HST depositional model is characterized by a high-energy shoreline and depicts the presence of an offshore, structurally controlled skeletal-peloidal shoal body described here for the first time at the Hanifa exposure in the Hozwa area. This work provides a

  9. Antidepressant-like effect of the organoselenium compound ebselen in mice: evidence for the involvement of the monoaminergic system.

    Science.gov (United States)

    Posser, Thaís; Kaster, Manuella P; Baraúna, Sara Cristiane; Rocha, João B T; Rodrigues, Ana Lúcia S; Leal, Rodrigo B

    2009-01-05

    Ebselen [2-phenyl-1,2-benzisoselenazol-3(2H)-one] is a seleno-organic compound which possesses a potent antioxidant activity and has been shown to exert neuroprotective effects in vitro and in vivo in a variety of pro-oxidative insults. The present study investigates a possible antidepressant activity of ebselen using two predictive tests for antidepressant activity in rodents: the forced swimming test and tail suspension test. Additionally, the mechanisms involved in the antidepressant-like effect of ebselen in mice were also assessed. Ebselen (10 mg/kg, s.c.) decreased the immobility time in the forced swimming test without accompanying changes in ambulation in the open-field test. In contrast, the administration of ebselen (10-30 mg/kg) did not produce any effect in the tail suspension test. The anti-immobility effect of ebselen (10 mg/kg, s.c.) was not prevented by pre-treatment of mice with p-chlorophenylalanine (PCPA, 100 mg/kg, i.p., an inhibitor of serotonin synthesis, 4 consecutive days), NAN-190 (0.5 mg/kg, i.p., a serotonin 5-HT(1A) receptor antagonist) or ketanserin (5 mg/kg, i.p., a serotonin 5-HT(2A/2C) receptor antagonist). On the other hand, the pre-treatment of mice with prazosin (1 mg/kg, i.p., an alpha(1)-adrenoceptor antagonist), yohimbine (1 mg/kg, i.p., an alpha(2)-adrenoceptor antagonist), SCH23390 (0.05 mg/kg, s.c., a dopamine D(1) receptor antagonist) or sulpiride (50 mg/kg, i.p., a dopamine D(2) receptor antagonist) completely blocked the antidepressant-like effect of ebselen (10 mg/kg, s.c.) in the forced swimming test. It may be concluded that ebselen produces an antidepressant-like effect in the forced swimming test that seems to be dependent on its interaction with the noradrenergic and dopaminergic systems, but not with the serotonergic system.

  10. Assessment of Physician's Systemic Treatment Preferences for Patients with Advanced Desmoid-Type Fibromatosis: Experience-Based Medicine in the Absence of High-Level Evidence.

    Science.gov (United States)

    Schöffski, Patrick; Requilé, Annelies; van Cann, Tom

    2018-01-01

    The treatment of advanced desmoid-type fibromatosis (DF) is poorly standardized and primarily based on physician's choice. We assessed systemic treatment preferences for advanced DF among European experts, with the aim to define a control treatment for prospective randomized trials. A structured questionnaire was sent to a group of physicians involved in DF treatment. 54 experts from 14 countries (Europe, Israel) responded. Disease progression and failure of local therapy were typical indications for systemic therapy. Treatment preferences for patients with sporadic DF versus DF associated with Gardner's syndrome were similar. Physicians use at least 5 different classes of drugs (27 agents). The most frequently used compounds were anti-estrogens and non-steroidal anti-inflammatory agents (NSAIDs), in combination or as single agents. The second and third most common systemic approach was chemotherapy based on methotrexate or an anthracycline. Trial activity was limited to 1 country/1 multicentric study. There is an unmet medical need for evidence-based treatments and well-designed studies. Clinical trials with systemic agents should ideally select a homogeneous DF population with advanced, progressive, ideally symptomatic disease and/or functional impairment after failure of wait-and-see and/or local treatments, and should be randomized, with placebo, anti-estrogens, NSAIDs, or physician's choice as comparator. © 2018 S. Karger GmbH, Freiburg.

  11. The Early Diagnosis of Boys and Girls in Academic Risk Using the Perceptual-Motor Diagnostic System: A Longitudinal Retrospective Study of Evidences of its Effectiveness

    Directory of Open Access Journals (Sweden)

    Emmanuel Herrera-González

    2015-09-01

    Full Text Available The main objective in this study is to evidence the efficiency of the Peques System as a useful tool to diagnose, at an early stage, possible difficulties which will affect the academic performance. In a 3-year longitudinal study, the Perceptual-Motor Diagnostic System (Peques was applied to a sample of 149 participants (77 boys and 72 girls, who were beginning preschool education. Peques classified 38 children with a high risk to lose a year at primary school level. After a three-year follow-up (first primary school level, it was determined that 23 of the 127 who remained in the study (18%, had failed the first, second or third school year. From the high-risk group diagnosed by the Peques System, an 83% indeed lost a school year. These boys and girls had difficulties in different aspects, such as their information processing capacity, motor development, corporal image, Gestalt development and corporal coordination. We concluded that Peques System was able to predict the academic failure in the primary school level, based on the perceptual-motor development reached at preschool level. Further, based on this experience it is recommended to pay special attention to perceptual-motor development, since it plays a basic role in the academic success of boys and girls.

  12. Evidence for degassing of fresh magma during the 2004-2008 eruption of Mount St. Helens: Subtle signals from the hydrothermal system

    Science.gov (United States)

    Bergfeld, Deborah; Evans, William C.; Spicer, Kurt R.; Hunt, Andrew G.; Kelly, Peter

    2017-01-01

    Results from chemical and isotopic analyses of water and gas collected between 2002 and 2016 from sites on and around Mount St. Helens are used to assess magmatic degassing related to the 2004-2008 eruption. During 2005 the chemistry of hot springs in The Breach of Mount St. Helens showed no obvious response to the eruption, and over the next few years, changes were subtle, giving only slight indications of perturbations in the system. By 2010 however, water chemistry, temperatures, and isotope compositions (δD and δ18O) clearly indicated some inputs of volatiles and heat associated with the eruption, but the changes were such that they could be attributed to a pre-existing, gas depleted magma. An increase of ~ 1.5‰ in the δ13C values of dissolved carbon in the springs was noted in 2006 and continued through 2009, a change that was mirrored by a similar shift in δ13C-CO2 in bubble gas emissions. These changes require input of a new source of carbon to the hydrothermal system and provide clear evidence of CO2 from an undegassed body of magma. Rising trends in 3He/4He ratios in gas also accompanied the increases in δ13C. Since 2011 maximum RC/RA values are ≥ 6.4 and are distinctly higher than 5 samples collected between 1986 and 2002, and provide additional evidence for some involvement of new magma as early as 2006, and possibly earlier, given the unknown time needed for CO2 and He to traverse the system and arrive at the springs.

  13. Evidence for chronic inflammation as a component of the interstitial lung disease associated with progressive systemic sclerosis

    International Nuclear Information System (INIS)

    Rossi, G.A.; Bitterman, P.B.; Rennard, S.I.; Ferrans, V.J.; Crystal, R.G.

    1985-01-01

    Progressive systemic sclerosis (PSS) is a generalized disorder characterized by fibrosis of many organs including the lung parenchyma. Unlike most other interstitial disorders, traditional concepts of the interstitial lung disease associated with PSS have held it to be a ''pure'' fibrotic disorder without a significant inflammatory component. To directly evaluate whether an active alveolitis is associated with this disorder, patients with chronic interstitial lung disease and PSS were studied by open lung biopsy, gallium-67 scanning, and bronchoalveolar lavage. Histologic evaluation of the biopsies demonstrated that the interstitial fibrosis of PSS is clearly associated with the presence of macrophages, lymphocytes, and polymorphonuclear leukocytes, both in the interstitium and on the alveolar epithelial surface. Gallium-67 scans were positive in 77% of the patients, showing diffuse, primarily lower zone uptake, suggestive of active inflammation. Consistent with the histologic findings, bronchoalveolar lavage studies demonstrated a mild increase in the proportions of neutrophils and eosinophils with occasional increased numbers of lymphocytes. Importantly, alveolar macrophages from patients with PSS showed increased release of fibronectin and alveolar-macrophage-derived growth factor, mediators that together stimulate lung fibroblasts to proliferate, thus suggesting at least one mechanism modulating the lung fibrosis of these patients

  14. Reduction of ferric iron by acidophilic heterotrophic bacteria: evidence for constitutive and inducible enzyme systems in Acidiphilium spp.

    Science.gov (United States)

    Johnson, D B; Bridge, T A M

    2002-01-01

    To compare the abilities of two obligately acidophilic heterotrophic bacteria, Acidiphilium acidophilum and Acidiphilium SJH, to reduce ferric iron to ferrous when grown under different culture conditions. Bacteria were grown in batch culture, under different aeration status, and in the presence of either ferrous or ferric iron. The specific rates of ferric iron reduction by fermenter-grown Acidiphilium SJH were unaffected by dissolved oxygen (DO) concentrations, while iron reduction by A. acidophilum was highly dependent on DO concentrations in the growth media. The ionic form of iron present (ferrous or ferric) had a minimal effect on the abilities of harvested cells to reduce ferric iron. Whole cell protein profiles of Acidiphilium SJH were very similar, regardless of the DO status of the growth medium, while additional proteins were present in A. acidophilum grown microaerobically compared with aerobically-grown cells. The dissimilatory reduction of ferric iron is constitutive in Acidiphilium SJH while it is inducible in A. acidophilum. Ferric iron reduction by Acidiphilium spp. may occur in oxygen-containing as well as anoxic acidic environments. This will detract from the effectiveness of bioremediation systems where removal of iron from polluted waters is mediated via oxidation and precipitation of the metal.

  15. Ilaj bil hijamah (cupping therapy) in the Unani system of medicine: anecdotal practice to evidence based therapy.

    Science.gov (United States)

    Abbas Zaidi, S M; Jameel, S S; Jafri, Kehkashan; Khan, Shariq A; Ahmad, Ehsan

    2016-08-01

    Cupping (Hijamah) therapy is very well documented as a result of several thousand years of clinical experiences in Unani medicine. In this procedure, suction is created by various means either with or without bloodletting. Though this therapy is being widely practiced across the globe for treating many chronic and intractable ailments but many reports reveal its unscientific and improper practices which results in many complications. Therefore to develop standard operative procedures and to propose protocols of cupping therapy in various diseases is the need of hour. A thorough literature review of relevant journals and textbooks was performed to gather the maximum available data on cupping therapy. This paper seeks to introduce the general concepts of cupping therapy in Unani medicine and other traditional systems of medicine, shortcomings and limitations of the currently published studies and suggest ways to improve these technical/methodological flaws. In addition, the authors have also attempted to provide the cupping related materials, hypotheses, observations which will provide the researchers the base for evaluating their usefulness in future clinical trials.

  16. Is processing of symbols and words influenced by writing system? Evidence from Chinese, Korean, English, and Greek.

    Science.gov (United States)

    Altani, Angeliki; Georgiou, George K; Deng, Ciping; Cho, Jeung-Ryeul; Katopodi, Katerina; Wei, Wei; Protopapas, Athanassios

    2017-12-01

    We examined cross-linguistic effects in the relationship between serial and discrete versions of digit naming and word reading. In total, 113 Mandarin-speaking Chinese children, 100 Korean children, 112 English-speaking Canadian children, and 108 Greek children in Grade 3 were administered tasks of serial and discrete naming of words and digits. Interrelations among tasks indicated that the link between rapid naming and reading is largely determined by the format of the tasks across orthographies. Multigroup path analyses with discrete and serial word reading as dependent variables revealed commonalities as well as significant differences between writing systems. The path coefficient from discrete digits to discrete words was greater for the more transparent orthographies, consistent with more efficient sight-word processing. The effect of discrete word reading on serial word reading was stronger in alphabetic languages, where there was also a suppressive effect of discrete digit naming. However, the effect of serial digit naming on serial word reading did not differ among the four language groups. This pattern of relationships challenges a universal account of reading fluency acquisition while upholding a universal role of rapid serial naming, further distinguishing between multi-element interword and intraword processing. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Mating System Evolution under Strong Pollen Limitation: Evidence of Disruptive Selection through Male and Female Fitness in Clarkia xantiana.

    Science.gov (United States)

    Briscoe Runquist, Ryan D; Geber, Monica A; Pickett-Leonard, Michael; Moeller, David A

    2017-05-01

    Selection on floral traits in hermaphroditic plants is determined by both male and female reproductive success. However, predictions regarding floral trait and mating system evolution are often based solely on female fitness. Selection via male fitness has the potential to affect the outcomes of floral evolution. In this study, we used paternity analysis to assess individual selfing rates and selection on floral traits via male and female fitness in an experimental population of Clarkia xantiana where pollen limitation of seed set was strong. We detected selection through both female and male fitness with reinforcing or noninterfering patterns of selection through the two sex functions. For female fitness, selection favored reduced herkogamy and protandry, traits that promote increased autonomous selfing. For male fitness, selection on petal area was disruptive, with higher trait values conferring greater pollinator attraction and outcross siring success and smaller trait values leading to higher selfed siring success. Combining both female and male fitness, selection on petal area and protandry was disruptive because intermediate phenotypes were less successful as both males and females. Finally, functional relationships among male and female fertility components indicated that selfing resulted in seed discounting and pollen discounting. Under these functional relationships, the evolutionarily stable selfing rate can be intermediate or predominantly selfing or outcrossing, depending on the segregating load of deleterious mutations.

  18. Keweenaw hot spot: Geophysical evidence for a 1.1 Ga mantle plume beneath the Midcontinent Rift System

    Science.gov (United States)

    Hutchinson, D.R.; White, R.S.; Cannon, W.F.; Schulz, K.J.

    1990-01-01

    The Proterozoic Midcontinent Rift System of North America is remarkably similar to Phanerozoic rifted continental margins and flood basalt provinces. Like the younger analogues, the volcanism within this older rift can be explained by decompression melting and rapid extrusion of igneous material during lithospheric extension above a broad, asthenospheric, thermal anomaly which we call the Keweenaw hot spot. Great Lakes International Multidisciplinary Program on Crustal Evolution seismic reflection profiles constrain end-member models of melt thickness and stretching factors, which yield an inferred mantle potential temperature of 1500°–1570°C during rifting. Combined gravity modeling and subsidence calculations are consistent with stretching factors that reached 3 or 4 before rifting ceased, and much of the lower crust beneath the rift consists of relatively high density intruded or underplated synrift igneous material. The isotopic signature of Keweenawan volcanic rocks, presented in a companion paper by Nicholson and Shirey (this issue), is consistent with our model of passive rifting above an asthenospheric mantle plume.

  19. Do attitudes toward societal structure predict beliefs about free will and achievement? Evidence from the Indian caste system.

    Science.gov (United States)

    Srinivasan, Mahesh; Dunham, Yarrow; Hicks, Catherine M; Barner, David

    2016-01-01

    Intuitive theories about the malleability of intellectual ability affect our motivation and achievement in life. But how are such theories shaped by the culture in which an individual is raised? We addressed this question by exploring how Indian children's and adults' attitudes toward the Hindu caste system--and its deterministic worldview--are related to differences in their intuitive theories. Strikingly, we found that, beginning at least in middle school and continuing into adulthood, individuals who placed more importance on caste were more likely to adopt deterministic intuitive theories. We also found a developmental change in the scope of this relationship, such that in children, caste attitudes were linked only to abstract beliefs about personal freedom, but that by adulthood, caste attitudes were also linked to beliefs about the potential achievement of members of different castes, personal intellectual ability, and personality attributes. These results are the first to directly relate the societal structure in which a person is raised to the specific intuitive theories they adopt. © 2015 John Wiley & Sons Ltd.

  20. Pb isotope evidence for contaminant-metal dispersal in an international river system: The lower Danube catchment, Eastern Europe

    International Nuclear Information System (INIS)

    Bird, Graham; Brewer, Paul A.; Macklin, Mark G.; Nikolova, Mariyana; Kotsev, Tsvetan; Mollov, Mihail; Swain, Catherine

    2010-01-01

    Lead isotope signatures ( 207 Pb/ 206 Pb, 208 Pb/ 206 Pb, 208 Pb/ 204 Pb, 206 Pb/ 204 Pb), determined by magnetic sector ICP-MS in river channel sediment, metal ores and mine waste, have been used as geochemical tracers to quantify the delivery and dispersal of sediment-associated metals in the lower Danube River catchment. Due to a diverse geology and range of ore-body ages, Pb isotope signatures in ore-bodies within the lower Danube River catchment show considerable variation, even within individual metallogenic zones. It is also possible to discriminate between the Pb isotopic signatures in mine waste and river sediment within river systems draining individual ore bodies. Lead isotopic data, along with multi-element data; were used to establish the provenance of river sediments and quantify sedimentary contributions to mining-affected tributaries and to the Danube River. Data indicate that mining-affected tributaries in Serbia and Bulgaria contribute up to 30% of the river channel sediment load of the lower Danube River. Quantifying relative sediment contributions from mining-affected tributaries enables spatial patterns in sediment-associated metal and As concentrations to be interpreted in terms of key contaminant sources. Combining geochemical survey data with that regarding the provenance of contaminated sediments can therefore be used to identify foci for remediation and environmental management strategies.

  1. Evidence that platelet-derived growth factor may be a novel endogenous pyrogen in the central nervous system.

    Science.gov (United States)

    Pelá, I R; Ferreira, M E; Melo, M C; Silva, C A; Coelho, M M; Valenzuela, C F

    2000-05-01

    Platelet-derived growth factor (PDGF) exerts neurotrophic and neuromodulatory actions in the mammalian central nervous system (CNS). Like the cytokines, PDGF primarily signals through tyrosine phosphorylation-dependent pathways that activate multiple intracellular molecules including Janus family kinases. We previously showed that microinjection of PDGF-BB into the lateral ventricle induced a febrile response in rats that was reduced by pretreatment with Win 41662, a potent inhibitor of PDGF receptors (Pelá IR, Ferreira MES, Melo MCC, Silva CAA, and Valenzuela CF. Ann NY Acad Sci 856: 289-293, 1998). In this study, we further characterized the role of PDGF-BB in the febrile response in rats. Microinjection of PDGF-BB into the third ventricle produced a dose-dependent increase in colonic temperature that peaked 3-4 h postinjection. Win 41662 attenuated fever induced by intraperitoneal injection of bacterial lipopolysaccharide, suggesting that endogenous PDGF participates in the febrile response to this exogenous pyrogen. Importantly, febrile responses induced by tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 were unchanged by Win 41662. Both indomethacin and dexamethasone blocked the PDGF-BB-induced increase in colonic temperature, and, therefore, we postulate that PDGF-BB may act via prostaglandin- and/or inducible enzyme-dependent pathways. Thus our findings suggest that PDGF-BB is an endogenous CNS mediator of the febrile response in rats.

  2. Preliminary analysis of the very early diagnosis of systemic sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis.

    NARCIS (Netherlands)

    Minier, T.; Guiducci, S.; Bellando-Randone, S.; Bruni, C.; Lepri, G.; Czirjak, L.; Distler, O.; Walker, U.A.; Fransen, J.; Allanore, Y.; Denton, C.; Cutolo, M.; Tyndall, A.; Muller-Ladner, U.; Matucci-Cerinic, M.

    2014-01-01

    OBJECTIVES: The EULAR (European League Against Rheumatism) Scleroderma Trials and Research Group (EUSTAR) has identified preliminary criteria for very early diagnosis of systemic sclerosis (SSc). Our aim was to assess the prevalence of each proposed diagnostic item in a large observational patient

  3. Assessment of the Anticipated Environmental Footprint of Future Nuclear Energy Systems. Evidence of the Beneficial Effect of Extensive Recycling

    Directory of Open Access Journals (Sweden)

    Jérôme Serp

    2017-09-01

    Full Text Available In this early 21st century, our societies have to face a tremendous and increasing energy need while mitigating the global climate change and preserving the environment. Addressing this challenge requires an energy transition from the current fossil energy-based system to a carbon-free energy production system, based on a relevant energy mix combining renewables and nuclear energy. However, such an energy transition will only occur if it is accepted by the population. Powerful and reliable tools, such as life cycle assessments (LCA, aiming at assessing the respective merits of the different energy mix for most of the environmental impact indicators are therefore mandatory for supporting a risk-informed decision-process at the societal level. Before studying the deployment of a given energy mix, a prerequisite is to perform LCAs on each of the components of the mix. This paper addresses two potential nuclear energy components: a nuclear fuel cycle based on the Generation III European Pressurized Reactors (EPR and a nuclear fuel cycle based on the Generation IV Sodium Fast Reactors (SFR. The basis of this study relies on the previous work done on the current French nuclear fuel cycle using the bespoke NELCAS tool specifically developed for studying nuclear fuel cycle environmental impacts. Our study highlights that the EPR already brings a limited improvement to the current fuel cycle thanks to a higher efficiency of the energy transformation and a higher burn-up of the nuclear fuel (−20% on most of the chosen indicators whereas the introduction of the GEN IV fast reactors will bring a significant breakthrough by suppressing the current front-end of the fuel cycle thanks to the use of depleted uranium instead of natural enriched uranium (this leads to a decrease of the impact from 17% on water consumption and withdrawal and up to 96% on SOx emissions. The specific case of the radioactive waste is also studied, showing that only the partitioning

  4. Prevalence and healthcare costs of obesity-related comorbidities: evidence from an electronic medical records system in the United States.

    Science.gov (United States)

    Li, Qian; Blume, Steven W; Huang, Joanna C; Hammer, Mette; Ganz, Michael L

    2015-01-01

    This study estimated the economic burden of obesity-related comorbidities (ORCs) in the US, at both the person and population levels. The Geisinger Health System provided electronic medical records and claims between January 2004 and May 2013 for a sample of 153,561 adults (50% males and 97% white). Adults with A total of 21 chronic conditions, with established association with obesity in the literature, were identified by diagnosis codes and/or lab test results. The total healthcare costs were measured in each year. The association between annual costs and ORCs was assessed by a regression, which jointly considered all the ORCs. The per-person incremental costs of a single comorbidity, without any of the other ORCs, were calculated. The population-level economic burden was the product of each ORC's incremental costs and the annual prevalence of the ORC among 100,000 individuals. The prevalence of ORCs was stratified by obesity status to estimate the economic burden among 100,000 individuals with obesity and among those without. This study identified 56,895 adults (mean age = 47 years; mean BMI = 29.6 kg/m(2)). The annual prevalence of ORCs ranged from 0.5% for pulmonary embolism (PE) to 41.8% for dyslipidemia. The per-person annual incremental costs of a single ORC ranged from $120 for angina to $1665 for PE. Hypertensive diseases (HTND), dyslipidemia, and osteoarthritis were the three most expensive ORCs at the population level; each responsible for ≥$18 million annually among 100,000 individuals. HTND and osteoarthritis were much more costly among individuals with obesity than those without obesity. Data were from a small geographic region. ORCs are associated with substantial economic burden, especially for those requiring continuous treatments.

  5. Application of an almost ideal demand system (AIDS) to Ethiopian rural residential energy use: Panel data evidence

    International Nuclear Information System (INIS)

    Guta, Dawit Diriba

    2012-01-01

    It is well known that poor rural households in low-income economies are reliant on traditional fuels to meet basic domestic energy needs, but little is known about the specific underlying socio-economic drivers of residential fuel choices in Ethiopia. I used the linear approximation almost ideal demand system (LAAIDS) with normalized prices to compute expenditure elasticity and a multinomial logit model (MLM) to examine household fuel use. The LAAIDS model result showed that expenditure was elastic for modern fuels, but inelastic for traditional fuels. Regression results from the MLM indicated that fuel choice behaviour of rural households could be more accurately described as ‘fuel stacking’ behaviour as opposed to the ‘energy ladder’ hypothesis. In rural areas household fuel choice may be constrained by limited access to commercial fuels and efficient cook stoves, supply dependency and affordability, consumer preferences and a web of other intricate factors. Rural households had less incentive for fuel switching due to underlying factors and the availability of fuel wood without direct financial cost. With continued deforestation and receding forests, households are expected to develop inter fuel substitution and switching behaviour conditional on access to modern energy technologies. - Highlights: ► Two step LAAIDS model and MLM were applied to analysis of residential fuel use. ► I examined issues of ‘energy ladder’ versus ‘fuel stacking’ behavior of households. ► Controlling other factors increase in welfare increases demand for modern fuel. ► Traditional fuels are income inelastic but not necessarily cheaper. ► Residential fuel choice is determined by intricate web of socio-economic factors.

  6. Understanding Regolith Physical Properties of Atmosphereless Solar System Bodies Based on Remote Sensing Photopolarimetric Observations: Evidence for Europa's Porous Surface

    Science.gov (United States)

    Nelson, R. M.; Boryta, M. D.; Hapke, B. W.; Manatt, K. S.; Shkuratov, Y.; Psarev, V.; Vandervoort, K.; Kroner, D. O.; Nebedum, A.; Vides, C.; Quinones, J.

    2017-12-01

    We studied the polarization and reflective properties of a suite of planetary regolith analogues with physical characteristics that might be expected to be found on a high albedo atmosphereless solar system body (ASSB). The angular scattering properties of thirteen well-sorted particle size fractions of aluminum oxide (Al2O3) were measured in the laboratory with a goniometric photopolarimeter (GPP) of unique design. Our results provide insight in support of efforts to understand the unusual reflectance and negative polarization behavior observed near small phase angles that has been reported over several decades on highly reflective ASSBs such as the asteroids 44 Nysa, 64 Angelina (Harris et al., 1989) and the Galilean satellites Io, Europa and Ganymede (Rosenbush et al., 1997; Mishchenko et al., 2006). Our measurements are consistent with the hypothesis that the surfaces of these ASSBs effectively scatter electromagnetic radiation as if they were extremely fine grained with void space > 95%, and grain sizes of the order landing on Europa's surface would require wheel or footpads that would protect it from settling deeply into the surface. These results also have relevance to the field of terrestrial geo-engineering particularly to proposals for modifying Earth's radiation balance by injecting high albedo Al2O3 particulates into Earth's atmosphere for the purpose of Solar Radiation Management by reflecting sunlight back into space hence, offsetting the global warming effects of anthropogenic greenhouse gas emissions such as carbon dioxide(Teller et al., 1997). This work partially supported by the Cassini Saturn Orbiter Progrem Harris et al., 1989 . Icarus 81, 365-374. Mishchenko et al., 2006 Applied Optics, 45, 4459-4463. Rosenbush et al, 1997, Astrophys. J. 487, 402-414. Teller et al., 1997. UCRL-JC-128715.

  7. Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change

    Directory of Open Access Journals (Sweden)

    Tae-Jin Lee

    2017-11-01

    Full Text Available Objectives To relieve the financial burden faced by households, the Korean National Health Insurance (NHI system introduced a “copayment ceiling,” which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients’ income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

  8. Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change.

    Science.gov (United States)

    Lee, Tae-Jin; Cheong, Chelim

    2017-11-01

    To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

  9. Secondary foundation species as drivers of trophic and functional diversity: evidence from a tree-epiphyte system.

    Science.gov (United States)

    Angelini, Christine; Silliman, Brian R

    2014-01-01

    Facilitation cascades arise where primary foundation species facilitate secondary (dependent) foundation species, and collectively, they increase habitat complexity and quality to enhance biodiversity. Whether such phenomena occur in nonmarine systems and if secondary foundation species enhance food web structure (e.g., support novel feeding guilds) and ecosystem function (e.g., provide nursery for juveniles) remain unclear. Here we report on field experiments designed to test whether trees improve epiphyte survival and epiphytes secondarily increase the number and diversity of adult and juvenile invertebrates in a potential live oak-Tillandsia usneoides (Spanish moss) facilitation cascade. Our results reveal that trees reduce physical stress to facilitate Tillandsia, which, in turn, reduces desiccation and predation stress to facilitate invertebrates. In experimental removals, invertebrate total density, juvenile density, species richness and H' diversity were 16, 60, 1.7, and 1.5 times higher, and feeding guild richness and H' were 5 and 11 times greater in Tillandsia-colonized relative to Tillandsia-removal limb plots. Tillandsia enhanced communities similarly in a survey across the southeastern United States. These findings reveal that a facilitation cascade organizes this widespread terrestrial assemblage and expand the role of secondary foundation species as drivers of trophic structure and ecosystem function. We conceptualize the relationship between foundation species' structural attributes and associated species abundance and composition in a Foundation Species-Biodiversity (FSB) model. Importantly, the FSB predicts that, where secondary foundation species form expansive and functionally distinct structures that increase habitat availability and complexity within primary foundation species, they generate and maintain hot spots of biodiversity and trophic interactions.

  10. Evidence of solitary chemosensory cells in a large mammal: the diffuse chemosensory system in Bos taurus airways

    Science.gov (United States)

    Tizzano, Marco; Merigo, Flavia; Sbarbati, Andrea

    2006-01-01

    The diffuse chemosensory system (DCS) of the respiratory apparatus is composed of solitary chemosensory cells (SCCs) that resemble taste cells but are not organized in end organs. The discovery of the DCS may open up new approaches to respiratory diseases. However, available data on mammalian SCCs have so far been collected from rodents, the airways of which display some differences from those of large mammals. Here we investigated the presence of the DCS and of SCCs in cows and bulls (Bos taurus), in which the airway cytology is similar to that in humans, focusing our attention on detection in the airways of molecules involved in the transduction cascade of taste [i.e. α-gustducin and phospholipase C of the β2 subtype (PLCβ2)]. The aim of the research was to extend our understanding of airway chemoreceptors and to compare the organization of the DCS in a large mammal with that in rodents. Using immunocytochemistry for α-gustducin, the taste buds of the tongue and arytenoid were visualized. In the trachea and bronchi, α-gustducin-immunoreactive SCCs were frequently found. Using immunocytochemistry for PLCβ2, the staining pattern was generally similar to those seen for α-gustducin. Immunoblotting confirmed the expression of α-gustducin in the tongue and in all the airway regions tested. The study demonstrated the presence of SCCs in cows and bulls, suggesting that DCSs are present in many mammalian species. The description of areas with a high density of SCCs in bovine bronchi seems to indicate that the view of the DCS as made up of isolated cells totally devoid of ancillary elements is probably an oversimplification. PMID:16928202

  11. Evidence for sites of methylmercury formation in a flowing water system: Impact of anthropogenic barriers and water management

    Energy Technology Data Exchange (ETDEWEB)

    Pizarro-Barraza, Claudia [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States); Gustin, Mae Sexauer, E-mail: mgustin@cabnr.unr.edu [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States); Peacock, Mary [Department of Biology, University of Nevada-Reno, Reno, NV 89557 (United States); Miller, Matthieu [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States)

    2014-04-01

    The Truckee River, California-Nevada, USA is impacted by mercury (Hg) contamination associated with legacy gold mining. In this work, we investigated the potential for hot-spots of methylmercury (MeHg) formation in the river. Mercury concentrations in multiple media were also used to assess the impacts of anthropogenic barriers, restoration, and water management in this flowing water ecosystem. Water samples were collected on a seasonal time step over 3 years, and analyzed for total Hg (THg) and MeHg concentrations, along with a variety of other water quality parameters. In addition, we measured THg and MeHg in sediments, THg in macroinvertebrates, and THg and δ{sup 15}N and δ{sup 13}C concentrations in fish. Differences in stable isotopes and Hg concentrations in fish were applied to understand the mobility of fish in the river. Mercury concentrations of specific macroinvertebrate species were used to identify sites of MeHg production. In general, loads of Hg and nutrients in the river reach above the Reno–Sparks metropolitan area were similar to that reported for pristine systems, while within and below the city, water quality impacts were observed. Fish isotope data showed that in the city reach food resources were different than those upriver and downriver. Based on Hg and isotope data, mobility of the fish in the river is impacted by anthropogenic obstructions and water manipulation. Below the city, particle bound Hg, derived from the legacy mining, continues to be input to the Truckee River. This Hg is deposited in riparian habitats and areas of river restoration, where it is methylated and becomes available to biota. During spring, when flows were highest, MeHg produced and stored in the sediments is mobilized and transported downriver. Fish and macroinvertebrate concentrations increased downriver indicating passive uptake from water. The information presented here could be useful for those doing river restoration and water manipulation in mercury

  12. Evidence for sites of methylmercury formation in a flowing water system: Impact of anthropogenic barriers and water management

    International Nuclear Information System (INIS)

    Pizarro-Barraza, Claudia; Gustin, Mae Sexauer; Peacock, Mary; Miller, Matthieu

    2014-01-01

    The Truckee River, California-Nevada, USA is impacted by mercury (Hg) contamination associated with legacy gold mining. In this work, we investigated the potential for hot-spots of methylmercury (MeHg) formation in the river. Mercury concentrations in multiple media were also used to assess the impacts of anthropogenic barriers, restoration, and water management in this flowing water ecosystem. Water samples were collected on a seasonal time step over 3 years, and analyzed for total Hg (THg) and MeHg concentrations, along with a variety of other water quality parameters. In addition, we measured THg and MeHg in sediments, THg in macroinvertebrates, and THg and δ 15 N and δ 13 C concentrations in fish. Differences in stable isotopes and Hg concentrations in fish were applied to understand the mobility of fish in the river. Mercury concentrations of specific macroinvertebrate species were used to identify sites of MeHg production. In general, loads of Hg and nutrients in the river reach above the Reno–Sparks metropolitan area were similar to that reported for pristine systems, while within and below the city, water quality impacts were observed. Fish isotope data showed that in the city reach food resources were different than those upriver and downriver. Based on Hg and isotope data, mobility of the fish in the river is impacted by anthropogenic obstructions and water manipulation. Below the city, particle bound Hg, derived from the legacy mining, continues to be input to the Truckee River. This Hg is deposited in riparian habitats and areas of river restoration, where it is methylated and becomes available to biota. During spring, when flows were highest, MeHg produced and stored in the sediments is mobilized and transported downriver. Fish and macroinvertebrate concentrations increased downriver indicating passive uptake from water. The information presented here could be useful for those doing river restoration and water manipulation in mercury contaminated

  13. Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System.

    Science.gov (United States)

    Soura, Abdramane Bassiahi; Lankoande, Bruno; Millogo, Roch; Bangha, Martin

    2014-01-01

    The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates) that have full access to public utilities (electricity and water services), and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities. To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS). The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA) questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02) to arrive at the causes of death. Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years) in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs) are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods. The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of cardiovascular diseases and neoplasms most of which are preventable and

  14. Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System

    Directory of Open Access Journals (Sweden)

    Abdramane Bassiahi Soura

    2014-10-01

    Full Text Available Background: The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates that have full access to public utilities (electricity and water services, and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities. Objective: To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS. Design: The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02 to arrive at the causes of death. Results: Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods. Conclusions: The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of

  15. Identification, mapping, and analysis of possible evidences of active petroleum systems in the Colorado Basin, offshore Argentina, South America

    Science.gov (United States)

    Loegering, Markus; Anka, Zahie; Rodriguez, Jorge; Marchal, Denis; di Primio, Rolando; Vallejo, Eduardo; Kohler, Guillermina; Pangaro, Francisco

    2010-05-01

    analysed in relation to structural and stratigraphic elements present within the syn-rift and post-rift successions. The main observed features consist of seismic vertical pipes where the seismic signal is strongly disturbed. The diameter of mapped seismic pipes ranges from 100 m up to 2000 m. Preliminary classification of these features shows two families of seismic pipes: (1) the first and principal family is mostly concentrated in the centre and innermost part of the basin and seems to be mainly controlled by the stratigraphy, ending in the Elvira Fm (Eocene). Many of these features are linked to the presence of volcanics, as demonstrated by some wells; (2) the second family is located on the oceanward outer part of the basin, reaching the seafloor and resulting in pockmark depressions or seabed mounds. These features represent possible candidates for gas chimneis. Other kinds of gas escape structures as seismic wipe-out zones and hydraulic brecciation are also tentatively observed. The present-day bathymetry from 3D seismic reflection data indicates the presence of seabed pockmarks and submarine channels on the slope of the basin. The circular to near-circular seafloor depressions initially identified on the 2D seismic-reflection profiles correspond to circular-to-elongate pockmarks mapped on the high-resolution bathymetry. Most of the pockmarks present a diameter from 200 m to 900 m and vertical length between 20 m to 100 m, and occur close to submarine channels, which range from 1000 m to 5000 m in width and from 100 m to 500 m in depth. A highly-dense vertically-faulted interval has been identified within the Colorado (Campanian) and Pedro Luro (Paleocene) Formations in the slope region of the basin. These faults correspond to polygonal fault systems that could breach Paleocene/Eocene sealing sequences, allowing fluids to flow vertically or sub-vertically across the seal. Numerical modelling of hydrocarbon generation and migration, calibrated to the observations on

  16. Experimental evidence of a dual endocrine control of biosynthesis in the main nidamental glands of Sepia officinalis L. by factors from the central nervous system and the ovary.

    Science.gov (United States)

    Henry, J; Boucaud-Camou, E

    1993-12-01

    1. A rapid, reliable and quantitative in vitro bioassay was developed to study the endocrine control of the biosynthesis of the egg capsule: incorporation of 14C-labelled D-glucose in polysaccharides and glycoproteins increased in dispersed-cell suspensions of main nidamental glands from maturing females. 2. Brain, optic lobes (OL) and ovary extracts from mature and maturing females stimulated the incorporation of 14C-labelled D-glucose in polysaccharidic and glycoproteic fractions of a nidamental cell suspension, whereas optic gland (OG) had no effect. 3. These results bring the first experimental evidence that one of the spawning events (egg-capsule edification) is controlled by the central nervous system and the ovary in a cephalopod.

  17. Counterbalancing patient demands with evidence: results from a pan-Canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus.

    Science.gov (United States)

    Dobkin, Patricia L; Da Costa, Deborah; Joseph, Lawrence; Fortin, Paul R; Edworthy,