Residential proximity to urban centres, local-area walkability and change in waist circumference among Australian adults.

PubMed

Sugiyama, Takemi; Niyonsenga, Theo; Howard, Natasha J; Coffee, Neil T; Paquet, Catherine; Taylor, Anne W; Daniel, Mark

2016-12-01

Consistent associations have been observed between macro-level urban sprawl and overweight/obesity, but whether residential proximity to urban centres predicts adiposity change over time has not been established. Further, studies of local-area walkability and overweight/obesity have generated mixed results. This study examined 4-year change in adults' waist circumference in relation to proximity to city centre, proximity to closest suburban centre, and local-area walkability. Data were from adult participants (n=2080) of a cohort study on chronic conditions and health risk factors in Adelaide, Australia. Baseline data were collected in 2000-03 with a follow-up in 2005-06. Multilevel regression models examined in 2015 the independent and joint associations of the three environmental measures with change in waist circumference, accounting for socio-demographic covariates. On average, waist circumference rose by 1.8cm over approximately 4years. Greater distance to city centre was associated with a greater increase in waist circumference. Participants living in distal areas (20km or further from city centre) had a greater increase in waist circumference (mean increase: 2.4cm) compared to those in proximal areas (9km or less, mean increase: 1.2cm). Counterintuitively, living in the vicinity of a suburban centre was associated with a greater increase in adiposity. Local-area walkability was not significantly associated with the outcome. Residential proximity to city centre appears to be protective against excessive increases in waist circumference. Controlled development and targeted interventions in the urban fringe may be needed to tackle obesity. Additional research needs to assess behaviours that mediate relationships between sprawl and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Realisation of a joint consumer engagement strategy in the Nepean Blue Mountains region.

PubMed

Blignault, Ilse; Aspinall, Diana; Reay, Lizz; Hyman, Kay

2017-02-15

Ensuring consumer engagement at different levels of the health system - direct care, organisational design and governance and policy - has become a strategic priority. This case study explored, through interviews with six purposively selected 'insiders' and document review, how one Medicare Local (now a Primary Health Network, PHN) and Local Health District worked together with consumers, to establish a common consumer engagement structure and mechanisms to support locally responsive, integrated and consumer-centred services. The two healthcare organisations worked as partners across the health system, sharing ownership and responsibility. Critical success factors included a consumer champion working with other highly motivated consumers concerned with improving the health system, a budget, and ongoing commitment from the Medicare Local or PHN and the Local Health District at executive and board level. Shared boundaries were an enormous advantage. Activities were jointly planned and executed, with consumer participation paramount. Training and mentoring enhanced consumer capacity and confidence. Bringing everyone on board and building on existing structures required time, effort and resources. The initiative produced immediate and lasting benefits, with consumer engagement now embedded in organisational governance and practice.

Knee arthroscopy routines and practice.

PubMed

Brattwall, M; Jacobson, E; Forssblad, M; Jakobsson, J

2010-12-01

Knee arthroscopy is one of most commonly performed day-case orthopaedic procedures, thus consuming huge medical resources. The aim of the present questionnaire survey was to study knee arthroscopy routines and practice. An electronic web-based survey including questions around pre-, per- and postoperative routines for elective knee arthroscopy was send to all orthopaedic units associated to the Swedish Arthroscopic Society (n = 60). Responses covering 37 centres out of 60 (response rate 62%) were returned. Preoperative radiograph routines varied considerable between centres; conventional radiograph varied between 5 and 100% and preoperative MRI between 5 and 80% of patients. General anaesthesia was the preferred intra-operative technique used in all centres (median 79% of patients), local anaesthesia with or without light sedation was used in all 28 out of the 37 centres responding (median 10% of cases) and spinal anaesthesia was used in 15 centres (median 5% of cases). Intra-articular local anaesthesia was provided in all but one of centres. Perioperative administration of oral NSAIDs was common (31 out 37), 6 centres (all teaching hospitals) did not routinely give pre- or postoperative NSAID. Analgesic prescription was provided on a regular base in 18 (49%) of centres; an NSAID being the most commonly prescribed. All but one centre provided written information and instruction at discharge. Referral to physiotherapy, prescribed sick leave and scheduled follow-up in the outpatient clinic diverged considerably. Routines and practice associated to elective knee arthroscopy differed; however, no clear differences in practice were seen between teaching centres, general or local hospitals apart from a lower usage of NSAID for perioperative analgesia. There is an obvious room for further standardisation in the routine handling of patients undergoing elective arthroscopy of the knee.

How Good Is Our School? The Child at the Centre: The Health Promoting School--The Role of Local Authorities and Their Partners. Self-Evaluation Series

ERIC Educational Resources Information Center

Her Majesty's Inspectorate of Education, 2004

2004-01-01

To become effective health promoting establishments which achieve the maximum impact on children, young people and families and on the local community, schools and pre-school centres need to operate within a strategic framework developed at the highest levels within their local council and community area. Effective councils are committed to…

Evidence for triple-junction rifting focussed on local magmatic centres along Parga Chasma, Venus

NASA Astrophysics Data System (ADS)

Graff, J. R.; Ernst, R. E.; Samson, C.

2018-05-01

Parga Chasma is a discontinuous rift system marking the southern boundary of the Beta-Atla-Themis (BAT) region on Venus. Along a 1500 km section of Parga Chasma, detailed mapping of Magellan Synthetic Aperture Radar images has revealed 5 coronae, 11 local rift zones distinct from a regional extension pattern, and 47 graben-fissure systems with radiating (28), linear (12) and circumferential (7) geometries. The magmatic centres of these graben-fissure systems typically coincide with coronae or large volcanoes, although a few lack any central magmatic or tectonic feature (i.e. are cryptic). Some of the magmatic centres are interpreted as the foci of triple-junction rifting that form the 11 local rift zones. Cross-cutting relationships between graben-fissure systems and local rift faults reveal synchronous formation, implying a genetic association. Additionally, cross-cutting relationships show that local rifting events postdate the regional extension along Parga Chasma, further indicating multiple stages of rifting. Evidence for multiple centres of younger magmatism and local rifting against a background of regional extension provides an explanation for the discontinuous morphology of Parga Chasma. Examination of the Atlantic Rift System (prior to ocean opening) on Earth provides an analogue to the rift morphologies observed on Venus.

Organic Farming and Landscape Structure: Effects on Insect-Pollinated Plant Diversity in Intensively Managed Grasslands

PubMed Central

Power, Eileen F.; Kelly, Daniel L.; Stout, Jane C.

2012-01-01

Parallel declines in insect-pollinated plants and their pollinators have been reported as a result of agricultural intensification. Intensive arable plant communities have previously been shown to contain higher proportions of self-pollinated plants compared to natural or semi-natural plant communities. Though intensive grasslands are widespread, it is not known whether they show similar patterns to arable systems nor whether local and/or landscape factors are influential. We investigated plant community composition in 10 pairs of organic and conventional dairy farms across Ireland in relation to the local and landscape context. Relationships between plant groups and local factors (farming system, position in field and soil parameters) and landscape factors (e.g. landscape complexity) were investigated. The percentage cover of unimproved grassland was used as an inverse predictor of landscape complexity, as it was negatively correlated with habitat-type diversity. Intensive grasslands (organic and conventional) contained more insect-pollinated forbs than non-insect pollinated forbs. Organic field centres contained more insect-pollinated forbs than conventional field centres. Insect-pollinated forb richness in field edges (but not field centres) increased with increasing landscape complexity (% unimproved grassland) within 1, 3, 4 and 5km radii around sites, whereas non-insect pollinated forb richness was unrelated to landscape complexity. Pollination systems within intensive grassland communities may be different from those in arable systems. Our results indicate that organic management increases plant richness in field centres, but that landscape complexity exerts strong influences in both organic and conventional field edges. Insect-pollinated forb richness, unlike that for non-insect pollinated forbs, showed positive relationships to landscape complexity reflecting what has been documented for bees and other pollinators. The insect-pollinated forbs, their pollinators and landscape context are clearly linked. This needs to be taken into account when managing and conserving insect-pollinated plant and pollinator communities. PMID:22666450

Partners for the optimal organisation of the healthcare continuum for high users of health and social services: protocol of a developmental evaluation case study design

PubMed Central

Hudon, Catherine; Chouinard, Maud-Christine; Couture, Martine; Brousselle, Astrid; Couture, Eva Marjorie; Dubois, Marie-France; Fortin, Martin; Freund, Tobias; Loignon, Christine; Mireault, Jean; Pluye, Pierre; Roberge, Pasquale; Rodriguez, Charo

2014-01-01

Introduction Case management allows us to respond to the complex needs of a vulnerable clientele through a structured approach that promotes enhanced interaction between partners. Syntheses on the subject converge towards a need for a better description of the relationships between programmes and their local context, as well as the characteristics of the clienteles and programmes that contribute to positive impacts. The purpose of this project is thus to describe and evaluate the case management programmes of four health and social services centres in the Saguenay-Lac- Saint-Jean region of Québec, Canada, in order to inform their improvement while creating knowledge on case management that can be useful in other contexts. Methods and analysis This research relies on a multiple embedded case study design based on a developmental evaluation approach. We will work with the case management programme for high users of hospital services of each centre. Three different units of analysis will be interwoven to obtain an in-depth understanding of each case, that is: (1) health and social services centre and local services network, (2) case management programme and (3) patients who are high users of services. Two strategies for programme evaluation (logic models and implementation analysis) will guide the mixed data collection based on qualitative and quantitative methods. This data collection will rely on: (1) individual interviews and focus groups; (2) participant observation; (3) document analysis; (4) clinical and administrative data and (5) questionnaires. Description and comparison of cases, and integration of qualitative and quantitative data will be used to guide the data analysis. Ethics and dissemination The study protocol was approved by the Ethics Research Boards of the four health and social services centres (HSSCs) involved. Findings will be disseminated by publications in peer-reviewed journals, conferences, and policy and practice partners in local and national government. PMID:25468510

Myanmar: The Community Learning Centre Experience.

ERIC Educational Resources Information Center

Middelborg, Jorn; Duvieusart, Baudouin, Ed.

A community learning centre (CLC) is a local educational institution outside the formal education system, usually set up and managed by local people. CLCs were first introduced in Myanmar in 1994, and by 2001 there were 71 CLCs in 11 townships. The townships are characterized by remoteness, landlessness, unemployment, dependency on one cash crop,…

Constructing Learning Spaces? Videoconferencing at Local Learning Centres in Sweden

ERIC Educational Resources Information Center

Logdlund, Ulrik

2010-01-01

This article explores videoconferencing in the context of local learning centres in Sweden. The practice is described as a "learning space" in which adult learners construct socio-spatial relations. The study goes beyond a sociological apprehension of actors and opposes the idea of the material as neutral, passive and conformed by…

VizieR Online Data Catalog: VEGAS-SSS photometry of NGC3115 (Cantiello+, 2015)

NASA Astrophysics Data System (ADS)

Cantiello, M.; Capaccioli, M.; Napolitano, N.; Grado, A.; Limatola, L.; Paolillo, M.; Iodice, E.; Romanowsky, A. J.; Forbes, D. A.; Raimondo, G.; Spavone, M.; La Barbera, F.; Puzia, T. H.; Schipani, P.

2015-03-01

We present g and i band photometry for ~47000 extended and point-like objects in the ~0.8 square degree area centred on NGC3115. For ~30000 object in the catalogue, structural parameters are also available. For each object equatorial coordinates, galactocentric distance from the photometric center of NGC3115, magnitudes in g and i bands (SDSS calibrated), colour, local extinction and sctructural parameters. (1 data file).

BBMRI-ERIC as a resource for pharmaceutical and life science industries: the development of biobank-based Expert Centres.

PubMed

van Ommen, Gert-Jan B; Törnwall, Outi; Bréchot, Christian; Dagher, Georges; Galli, Joakim; Hveem, Kristian; Landegren, Ulf; Luchinat, Claudio; Metspalu, Andres; Nilsson, Cecilia; Solesvik, Ove V; Perola, Markus; Litton, Jan-Eric; Zatloukal, Kurt

2015-07-01

Biological resources (cells, tissues, bodily fluids or biomolecules) are considered essential raw material for the advancement of health-related biotechnology, for research and development in life sciences, and for ultimately improving human health. Stored in local biobanks, access to the human biological samples and related medical data for transnational research is often limited, in particular for the international life science industry. The recently established pan-European Biobanking and BioMolecular resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC) aims to improve accessibility and interoperability between academic and industrial parties to benefit personalized medicine, disease prevention to promote development of new diagnostics, devices and medicines. BBMRI-ERIC is developing the concept of Expert Centre as public-private partnerships in the precompetitive, not-for-profit field to provide a new structure to perform research projects that would face difficulties under currently established models of academic-industry collaboration. By definition, Expert Centres are key intermediaries between public and private sectors performing the analysis of biological samples under internationally standardized conditions. This paper presents the rationale behind the Expert Centres and illustrates the novel concept with model examples.

BBMRI-ERIC as a resource for pharmaceutical and life science industries: the development of biobank-based Expert Centres

PubMed Central

van Ommen, Gert-Jan B; Törnwall, Outi; Bréchot, Christian; Dagher, Georges; Galli, Joakim; Hveem, Kristian; Landegren, Ulf; Luchinat, Claudio; Metspalu, Andres; Nilsson, Cecilia; Solesvik, Ove V; Perola, Markus; Litton, Jan-Eric; Zatloukal, Kurt

2015-01-01

Biological resources (cells, tissues, bodily fluids or biomolecules) are considered essential raw material for the advancement of health-related biotechnology, for research and development in life sciences, and for ultimately improving human health. Stored in local biobanks, access to the human biological samples and related medical data for transnational research is often limited, in particular for the international life science industry. The recently established pan-European Biobanking and BioMolecular resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC) aims to improve accessibility and interoperability between academic and industrial parties to benefit personalized medicine, disease prevention to promote development of new diagnostics, devices and medicines. BBMRI-ERIC is developing the concept of Expert Centre as public–private partnerships in the precompetitive, not-for-profit field to provide a new structure to perform research projects that would face difficulties under currently established models of academic–industry collaboration. By definition, Expert Centres are key intermediaries between public and private sectors performing the analysis of biological samples under internationally standardized conditions. This paper presents the rationale behind the Expert Centres and illustrates the novel concept with model examples. PMID:25407005

US quality control in Italy: present and future

NASA Astrophysics Data System (ADS)

Balbis, S.; Musacchio, C.; Guiot, C.; Spagnolo, R.

2011-02-01

US diagnostic equipments are widely diffused in Italy but, in spite of recommendations (e.g. ISPESL-Ministry of Health (1999) and SIRM (Società Italiana di Radiologia Medica, 2004), US quality controls are restricted to only a few public sanitary structure and a national (or even regional) quality assurance program for testing the performances of the US equipments is still missing. A joint Research Centre among the three Piedmontese Universities and INRIM, partially funded by Regione Piemonte, has been established in 2009 as Reference Centre for Medical Ultrasounds (CRUM). In addition to research, development and training tasks, the Centre aims at the local diffusion of the quality assurance in clinical US equipments. According to data from the Ministry of Health (2006), around 7 % of the Italian US diagnostic equipments (946 over 13526) are located in Piedmont: mostly (75.6%) in public hospitals, 9.3 % in conventionated hospitals, 4.3% in public and 10.8% in private territorial structures. The goal is the provision of a regional database, which progressively includes data related to acceptance test, status and QC tests and maintenance, in order to drive equipment turnover and carefully monitoring the overall equipment efficiency. Moreover, facilities are available at CRUM for monitoring both beam geometry and acoustic power and performing quantitative assessment of the delivered energy intensity.

Proton transfer and hydrogen bonding in the organic solid state: a combined XRD/XPS/ssNMR study of 17 organic acid-base complexes.

PubMed

Stevens, Joanna S; Byard, Stephen J; Seaton, Colin C; Sadiq, Ghazala; Davey, Roger J; Schroeder, Sven L M

2014-01-21

The properties of nitrogen centres acting either as hydrogen-bond or Brønsted acceptors in solid molecular acid-base complexes have been probed by N 1s X-ray photoelectron spectroscopy (XPS) as well as (15)N solid-state nuclear magnetic resonance (ssNMR) spectroscopy and are interpreted with reference to local crystallographic structure information provided by X-ray diffraction (XRD). We have previously shown that the strong chemical shift of the N 1s binding energy associated with the protonation of nitrogen centres unequivocally distinguishes protonated (salt) from hydrogen-bonded (co-crystal) nitrogen species. This result is further supported by significant ssNMR shifts to low frequency, which occur with proton transfer from the acid to the base component. Generally, only minor chemical shifts occur upon co-crystal formation, unless a strong hydrogen bond is formed. CASTEP density functional theory (DFT) calculations of (15)N ssNMR isotropic chemical shifts correlate well with the experimental data, confirming that computational predictions of H-bond strengths and associated ssNMR chemical shifts allow the identification of salt and co-crystal structures (NMR crystallography). The excellent agreement between the conclusions drawn by XPS and the combined CASTEP/ssNMR investigations opens up a reliable avenue for local structure characterization in molecular systems even in the absence of crystal structure information, for example for non-crystalline or amorphous matter. The range of 17 different systems investigated in this study demonstrates the generic nature of this approach, which will be applicable to many other molecular materials in organic, physical, and materials chemistry.

A soft X-ray spectroscopic perspective of electron localization and transport in tungsten doped bismuth vanadate single crystals.

PubMed

Jovic, Vedran; Rettie, Alexander J E; Singh, Vijay R; Zhou, Jianshi; Lamoureux, Bethany; Buddie Mullins, C; Bluhm, Hendrik; Laverock, Jude; Smith, Kevin E

2016-11-23

Doped BiVO 4 is a promising photoelectrochemical water splitting anode, whose activity is hampered by poor charge transport. Here we use a set of X-ray spectroscopic methods to probe the origin and nature of localized electron states in W:BiVO 4 . Furthermore, using the polarized nature of the X-rays, we probe variations in the electronic structure along the crystal axes. In this manner, we reveal aspects of the electronic structure related to electron localization and observations consistent with conductivity anisotropy between the ab-plane and c-axis. We verify that tungsten substitutes as W 6+ for V 5+ in BiVO 4 . This is shown to result in the presence of inter-band gap states related to electrons at V 4+ sites of e symmetry. The energetic position of the states in the band gap suggest that they are highly localized and may act as recombination centres. Polarization dependent X-ray absorption spectra reveal anisotropy in the electronic structure between the ab-plane and c-axis. Results show the superior hybridization between V 3d and O 2p states, higher V wavefunction overlap and broader conduction bands in the ab-plane than in the c-axis. These insights into the electronic structure are discussed in the context of existing experimental and theoretical reports regarding charge transport in BiVO 4 .

Barriers to community-based drug dependence treatment: implications for police roles, collaborations and performance indicators

PubMed Central

Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong

2016-01-01

Introduction Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust between them fostered, using community-based treatment centres as mediators. The preliminary success of the take-home methadone maintenance treatment pilot can serve as an example of how collaboration with the police and other government agencies can meet the needs of PWUD and contribute to the success of community-based treatment. PMID:27435714

Barriers to community-based drug dependence treatment: implications for police roles, collaborations and performance indicators.

PubMed

Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong

2016-01-01

Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust between them fostered, using community-based treatment centres as mediators. The preliminary success of the take-home methadone maintenance treatment pilot can serve as an example of how collaboration with the police and other government agencies can meet the needs of PWUD and contribute to the success of community-based treatment.

Measurement of HbA1c in multicentre diabetes trials - should blood samples be tested locally or sent to a central laboratory: an agreement analysis.

PubMed

Arch, Barbara N; Blair, Joanne; McKay, Andrew; Gregory, John W; Newland, Paul; Gamble, Carrol

2016-10-24

Glycated haemoglobin (HbA1c) is an important outcome measure in diabetes clinical trials. For multicentre designs, HbA1c can be measured locally at participating centres or by sending blood samples to a central laboratory. This study analyses the agreement between local and central measurements, using 1-year follow-up data collected in a multicentre randomised controlled trial (RCT) of newly diagnosed children with type I diabetes. HbA1c measurements were routinely analysed both locally and centrally at baseline and then at 3, 6, 9 and 12 months and the data reported in mmol/mol. Agreement was assessed by calculating the bias and 95 % limits of agreement, using the Bland-Altman analysis method. A predetermined benchmark for clinically acceptable margin of error between measurements was subjectively set as ±10 % for HbA1c. The percentage of pairs of measurements that were classified as clinically acceptable was calculated. Descriptive statistics were used to examine the agreement within centres. Treatment group was not considered. Five hundred and ninety pairs of measurement, representing 255 children and 15 trial centres across four follow-up time points, were compared. There was no significant bias: local measurements were an average of 0.16 mmol/mol (SD = 4.5, 95 % CI -0.2 to 0.5) higher than central. The 95 % limits of agreement were -8.6 to 9.0 mmol/mol (local minus central). Eighty percent of local measurements were within ±10 % of corresponding central measurements. Some trial centres were more varied in the differences observed between local and central measurements: IQRs ranging from 3 to 9 mmol/mol; none indicated systematic bias. Variation in agreement between HbA1c measurements was greater than had been expected although no overall bias was detected and standard deviations were similar. Discrepancies were present across all participating centres. These findings have implications for the comparison of standards of clinical care between centres, the design of future multicentre RCTs and existing quality assurance processes for HbA1c measurements. We recommend that centralised HbA1c measurement is preferable in the multicentre clinical trial setting. Eudract No. 2010-023792-25 , registered on 4 November 2010.

A Study of Self and Task Performance in Childcare Centres as Perceived by Caregivers under Local Administrative Organisations in Thailand

ERIC Educational Resources Information Center

Bhulpat, Cheerapan

2011-01-01

The purpose of this research was to study the opinions toward self and task performance in childcare centres as perceived by caregivers under the jurisdiction of the Local Administrative Organization. The four areas evaluated were caregiver characteristics, task performance, objectives of caregiving and educating young children and problems and…

Synthesis, crystal structure analysis, molecular docking studies and density functional theory predictions of the local reactive properties and degradation properties of a novel halochalcone

NASA Astrophysics Data System (ADS)

Arshad, Suhana; Pillai, Renjith Raveendran; Zainuri, Dian Alwani; Khalib, Nuridayanti Che; Razak, Ibrahim Abdul; Armaković, Stevan; Armaković, Sanja J.

2017-09-01

In the present study, single crystals of E)-3-(3,5-dichlorophenyl)-1-(4-fluorophenyl)prop-2-en-1-one, were prepared and structurally characterized by single crystal X-ray diffraction analysis. The molecular structure crystallized in monoclinic crystal system with P21/c space group. Sensitivity of the title molecule towards electrophilic attacks has been examined by calculations of average localized ionization energies (ALIE) and their mapping to electron density surface. Further determination of atoms that could be important reactive centres has been performed by calculations of Fukui functions. Sensitivity of title molecule towards autoxidation and hydrolysis mechanisms has been assessed by calculations of bond dissociation energies and radial distribution functions (RDF), respectively. Also, in order to explore possible binding mode of the title compound towards Dihydrofolate reductase enzyme, we have utilized in silico molecular docking to explore possible binding modes of the title compound with the DHFR enzyme.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Papashvili, A G; Smetanin, S N; Doroshenko, M E

A study of spectral and laser properties of the LiF : F{sub 2}{sup -} crystal at low temperatures has revealed an electronic – vibrational interaction of electrons of the F{sub 2}{sup -} centre with the local vibration of the centre, which occurs against the background of coupling between electrons of F{sub 2}{sup -} centres and lattice phonons. The interaction of electrons with the local vibration manifests itself in spectra in the form of narrow lines superimposed on wide electron – phonon lines that are due to the electron – lattice interaction. An anomalous behaviour of spectral LiF : F{sub 2}{supmore » -} laser lines is also found at liquid nitrogen temperature upon selective excitation; this behaviour is explained by the difference in the probabilities of the lattice and local interactions. (active media)« less

The Local Bubble: a magnetic veil to our Galaxy

NASA Astrophysics Data System (ADS)

Alves, M. I. R.; Boulanger, F.; Ferrière, K.; Montier, L.

2018-04-01

The magnetic field in the local interstellar medium does not follow the large-scale Galactic magnetic field. The local magnetic field has probably been distorted by the Local Bubble, a cavity of hot ionized gas extending all around the Sun and surrounded by a shell of cold neutral gas and dust. However, so far no conclusive association between the local magnetic field and the Local Bubble has been established. Here we develop an analytical model for the magnetic field in the shell of the Local Bubble, which we represent as an inclined spheroid, off-centred from the Sun. We fit the model to Planck dust polarized emission observations within 30° of the Galactic poles. We find a solution that is consistent with a highly deformed magnetic field, with significantly different directions towards the north and south Galactic poles. This work sets a methodological framework for modelling the three-dimensional (3D) structure of the magnetic field in the local interstellar medium, which is a most awaited input for large-scale Galactic magnetic field models.

Theoretical studies of the dependence of EPR g-factors on local structure for the trigonal Er3+-VK centres in KMgF3 and KZnF3

NASA Astrophysics Data System (ADS)

Chai, Rui-Peng; Kuang, Xiao-Yu; Liang, Liang; Yu, Geng-Hua

2015-05-01

The dependence of the EPR g-factors on the local structural parameter for a 4f11 configuration ion Er3+ in a trigonal crystal-field has been studied by diagonalizing the 364×364 complete energy matrices. Our studies indicate that the EPR spectra of the trigonal Er3+-VK centers in KMgF3 and KZnF3 may be attributed to the translation of the cubic Kramers doublet Γ7. Furthermore, the EPR g-factors of the trigonal Er3+-VK centers may be interpreted reasonably by the shifts ΔZ≈0.340 Å and ΔZ≈0.303 Å of the Er3+ ions toward the charge compensator VK along the C3 axis for the KMgF3:Er3+ and the KZnF3:Er3+ systems respectively.

A stable compound of helium and sodium at high pressure

DOE PAGES

Dong, Xiao; Oganov, Artem R.; Goncharov, Alexander F.; ...

2017-02-06

Helium is generally understood to be chemically inert and this is due to its extremely stable closed-shell electronic configuration, zero electron affinity and an unsurpassed ionization potential. It is not known to form thermodynamically stable compounds, except a few inclusion compounds. Here, using the ab initio evolutionary algorithm USPEX and subsequent high-pressure synthesis in a diamond anvil cell, we report the discovery of a thermodynamically stable compound of helium and sodium, Na 2He, which has a fluorite-type structure and is stable at pressures >113 GPa. We show that the presence of He atoms causes strong electron localization and makes thismore » material insulating. This phase is an electride, with electron pairs localized in interstices, forming eight-centre two-electron bonds within empty Na 8 cubes. As a result, we also predict the existence of Na 2HeO with a similar structure at pressures above 15 GPa.« less

A stable compound of helium and sodium at high pressure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dong, Xiao; Oganov, Artem R.; Goncharov, Alexander F.

Helium is generally understood to be chemically inert and this is due to its extremely stable closed-shell electronic configuration, zero electron affinity and an unsurpassed ionization potential. It is not known to form thermodynamically stable compounds, except a few inclusion compounds. Here, using the ab initio evolutionary algorithm USPEX and subsequent high-pressure synthesis in a diamond anvil cell, we report the discovery of a thermodynamically stable compound of helium and sodium, Na 2He, which has a fluorite-type structure and is stable at pressures >113 GPa. We show that the presence of He atoms causes strong electron localization and makes thismore » material insulating. This phase is an electride, with electron pairs localized in interstices, forming eight-centre two-electron bonds within empty Na 8 cubes. We also predict the existence of Na 2HeO with a similar structure at pressures above 15 GPa.« less

A stable compound of helium and sodium at high pressure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dong, Xiao; Oganov, Artem R.; Goncharov, Alexander F.

Helium is generally understood to be chemically inert and this is due to its extremely stable closed-shell electronic configuration, zero electron affinity and an unsurpassed ionization potential. It is not known to form thermodynamically stable compounds, except a few inclusion compounds. Here, using the ab initio evolutionary algorithm USPEX and subsequent high-pressure synthesis in a diamond anvil cell, we report the discovery of a thermodynamically stable compound of helium and sodium, Na 2He, which has a fluorite-type structure and is stable at pressures >113 GPa. We show that the presence of He atoms causes strong electron localization and makes thismore » material insulating. This phase is an electride, with electron pairs localized in interstices, forming eight-centre two-electron bonds within empty Na 8 cubes. As a result, we also predict the existence of Na 2HeO with a similar structure at pressures above 15 GPa.« less

The contributions of community learning centres (CLCs) to personal and community development in Myanmar

NASA Astrophysics Data System (ADS)

Le, Ai Tam Pham

2018-05-01

Community learning centres (CLCs) have been widely established in the Asia-Pacific region as locally managed institutions that offer non-formal educational opportunities and community development activities. Myanmar officially has more than 3,000 centres, which is one of the highest numbers in the region. This article examines the operation of CLCs and their contributions to personal and community development in Padaung, Myanmar. The author's research is based on six weeks of fieldwork in Myanmar for data collection including semi-structured interviews, focus group discussions and informal conversations. Her findings suggest that CLCs can contribute to the improvement of both individuals' quality of life and communities' social capital, which facilitates mutually beneficial collective action. The findings also support the conclusion that CLCs can provide additional educational opportunities beyond the formal system, especially for adults and members of rural communities, e.g. farmers. However, due to constraints in terms of budget, implementing capacity and socio-economic factors, the outreach of CLC activities is still somewhat limited and has yet to reach its full potential.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lorente-Crespo, M.; Mateo-Segura, C., E-mail: C.Mateo-Segura@hw.ac.uk

Nanoantennas enhance the conversion between highly localized electromagnetic fields and far-field radiation. Here, we investigate the response of a nano-patch partially reflective surface backed with a silver mirror to an optical source embedded at the centre of the structure. Using full wave simulations, we demonstrate a two orders of magnitude increased directivity compared to the isotropic radiator, 50% power confinement to a 13.8° width beam and a ±16 nm bandwidth. Our antenna does not rely on plasmonic phenomena thus reducing non-radiative losses and conserving source coherence.

Laboratory information management system for membrane protein structure initiative--from gene to crystal.

PubMed

Troshin, Petr V; Morris, Chris; Prince, Stephen M; Papiz, Miroslav Z

2008-12-01

Membrane Protein Structure Initiative (MPSI) exploits laboratory competencies to work collaboratively and distribute work among the different sites. This is possible as protein structure determination requires a series of steps, starting with target selection, through cloning, expression, purification, crystallization and finally structure determination. Distributed sites create a unique set of challenges for integrating and passing on information on the progress of targets. This role is played by the Protein Information Management System (PIMS), which is a laboratory information management system (LIMS), serving as a hub for MPSI, allowing collaborative structural proteomics to be carried out in a distributed fashion. It holds key information on the progress of cloning, expression, purification and crystallization of proteins. PIMS is employed to track the status of protein targets and to manage constructs, primers, experiments, protocols, sample locations and their detailed histories: thus playing a key role in MPSI data exchange. It also serves as the centre of a federation of interoperable information resources such as local laboratory information systems and international archival resources, like PDB or NCBI. During the challenging task of PIMS integration, within the MPSI, we discovered a number of prerequisites for successful PIMS integration. In this article we share our experiences and provide invaluable insights into the process of LIMS adaptation. This information should be of interest to partners who are thinking about using LIMS as a data centre for their collaborative efforts.

From gene to structure: The protein factory of the NBICS Centre of Kurchatov Institute

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boyko, K. M.; Lipkin, A. V.; Popov, V. O., E-mail: vpopov@inbi.ras.ru

2013-05-15

The Protein Factory was established at the Centre for Nano, Bio, Info, Cognitive, and Social Sciences and Technologies (NBICS Centre) of the National Research Centre 'Kurchatov Institute' in 2010. The Protein Factory, together with the Centre for Synchrotron Radiation and Nanotechnology, promote research on structural biology. This paper presents the technology platforms developed at the Protein Factory and the facilities available for researchers. The main projects currently being performed at the Protein Factory are briefly described.

[Storage and transport of isolated M. tuberculosis at public and private health institutions in Japan].

PubMed

Ohkado, Akihiro; Takahashi, Chieko; Horiba, Masahide; Murase, Yoshiro; Mitarai, Satoshi

2008-08-01

To obtain basic data about the present practices on storage and transport of isolated M. tuberculosis at public and private health institutions in Japan. Survey forms regarding the practices on storage and transport of isolated M. tuberculosis were distributed and collected by post-mail in January 2007 to 76 local public health institutions, 145 public health centres, and 150 public or private hospitals. The questionnaire was adopted from the guidelines proposed by the Ministry of Health, Labour, and Welfare in 2006 on storage and transport of isolated M. tuberculosis. The respondents of the survey were as follows: 96.1% (73/76) from local public health institutions, 93.8% (136/145) from public health centres, and 73.3% (110/150) from hospitals. In general, local public health institutions conformed well to the proposed standards, however public health centres and hospitals were not compliant to some standards. Based on the survey conducted on the practice of storage and transport of isolated M. tuberculosis, certain discrepancy was found among public health centres and hospitals.

Safety and predictability of conscious sedation in dentistry -- a multi-centre regional audit: South and West Wales experience.

PubMed

Muthukrishnan, A; McGregor, J; Thompson, S

2013-10-01

There are no previously published reports of audits in conscious sedation from a group comprising the general dental services (GDS), community dental services (CDS) and hospital dental services (HDS). The main aim of this audit was to assess current practice within the group in relation to the safety and predictability of dental treatment undertaken with the aid of conscious sedation. A total of nine centres collected data prospectively on 1,037 sedation episodes over the course of one year. Audit standards were locally agreed based on current evidence and local experience. They were set at a completion rate of 90% and an adverse incident rate of 2% or less. Based on the data collected, a completion rate of 92% and a minor adverse incident rate of 2.6% were recorded. The participating centres met the standards set locally for this audit. Current practice in the participating centres was found to be safe and predictable. The audit tool is being refined to improve the quality of data collection. Further research and service evaluation is recommended.

Partners for the optimal organisation of the healthcare continuum for high users of health and social services: protocol of a developmental evaluation case study design.

PubMed

Hudon, Catherine; Chouinard, Maud-Christine; Couture, Martine; Brousselle, Astrid; Couture, Eva Marjorie; Dubois, Marie-France; Fortin, Martin; Freund, Tobias; Loignon, Christine; Mireault, Jean; Pluye, Pierre; Roberge, Pasquale; Rodriguez, Charo

2014-12-02

Case management allows us to respond to the complex needs of a vulnerable clientele through a structured approach that promotes enhanced interaction between partners. Syntheses on the subject converge towards a need for a better description of the relationships between programmes and their local context, as well as the characteristics of the clienteles and programmes that contribute to positive impacts. The purpose of this project is thus to describe and evaluate the case management programmes of four health and social services centres in the Saguenay-Lac- Saint-Jean region of Québec, Canada, in order to inform their improvement while creating knowledge on case management that can be useful in other contexts. This research relies on a multiple embedded case study design based on a developmental evaluation approach. We will work with the case management programme for high users of hospital services of each centre. Three different units of analysis will be interwoven to obtain an in-depth understanding of each case, that is: (1) health and social services centre and local services network, (2) case management programme and (3) patients who are high users of services. Two strategies for programme evaluation (logic models and implementation analysis) will guide the mixed data collection based on qualitative and quantitative methods. This data collection will rely on: (1) individual interviews and focus groups; (2) participant observation; (3) document analysis; (4) clinical and administrative data and (5) questionnaires. Description and comparison of cases, and integration of qualitative and quantitative data will be used to guide the data analysis. The study protocol was approved by the Ethics Research Boards of the four health and social services centres (HSSCs) involved. Findings will be disseminated by publications in peer-reviewed journals, conferences, and policy and practice partners in local and national government. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway.

PubMed

Kongsvik, Trond; Halvorsen, Kristin; Osmundsen, Tonje; Gjøsund, Gudveig

2016-08-30

Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories. A qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel. The LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers. As a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.

Valuing Children's Expression: A First Attempt at Displaying Preschool Art in an Early Childhood Centre

ERIC Educational Resources Information Center

Itzkowitz, Selina

2013-01-01

A local childcare centre embarks on a first-time project to exhibit preschool children's artworks, acknowledging the importance of art-based activities in the development of young children. In the planning and implementation of a successful afternoon event, the centre's children, along with parents, other family members, friends, and educators,…

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England

PubMed Central

Abma, Inger; Jayanti, Anuradha; Bayer, Steffen; Mitra, Sandip; Barlow, James

2014-01-01

Objective The objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices. Design The study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures. Participants Participants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed. Setting Participants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (<3%), medium (5–8%) and high (>8%) prevalence, with at least one centre in each one of these categories at the time of selection. Results While the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices. Conclusions The impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small. PMID:24523426

Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England.

PubMed

Abma, Inger; Jayanti, Anuradha; Bayer, Steffen; Mitra, Sandip; Barlow, James

2014-02-12

The objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices. The study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures. Participants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed. Participants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (<3%), medium (5-8%) and high (>8%) prevalence, with at least one centre in each one of these categories at the time of selection. While the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices. The impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small.

Structural evolution in the crystallization of rapid cooling silver melt

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tian, Z.A., E-mail: ze.tian@gmail.com; Laboratory for Simulation and Modelling of Particulate Systems School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052; Dong, K.J.

2015-03-15

The structural evolution in a rapid cooling process of silver melt has been investigated at different scales by adopting several analysis methods. The results testify Ostwald’s rule of stages and Frank conjecture upon icosahedron with many specific details. In particular, the cluster-scale analysis by a recent developed method called LSCA (the Largest Standard Cluster Analysis) clarified the complex structural evolution occurred in crystallization: different kinds of local clusters (such as ico-like (ico is the abbreviation of icosahedron), ico-bcc like (bcc, body-centred cubic), bcc, bcc-like structures) in turn have their maximal numbers as temperature decreases. And in a rather wide temperaturemore » range the icosahedral short-range order (ISRO) demonstrates a saturated stage (where the amount of ico-like structures keeps stable) that breeds metastable bcc clusters. As the precursor of crystallization, after reaching the maximal number bcc clusters finally decrease, resulting in the final solid being a mixture mainly composed of fcc/hcp (face-centred cubic and hexagonal-closed packed) clusters and to a less degree, bcc clusters. This detailed geometric picture for crystallization of liquid metal is believed to be useful to improve the fundamental understanding of liquid–solid phase transition. - Highlights: • A comprehensive structural analysis is conducted focusing on crystallization. • The involved atoms in our analysis are more than 90% for all samples concerned. • A series of distinct intermediate states are found in crystallization of silver melt. • A novelty icosahedron-saturated state breeds the metastable bcc state.« less

Improving accountability through alignment: the role of academic health science centres and networks in England.

PubMed

Ovseiko, Pavel V; Heitmueller, Axel; Allen, Pauline; Davies, Stephen M; Wells, Glenn; Ford, Gary A; Darzi, Ara; Buchan, Alastair M

2014-01-20

As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the "unlinked partners" model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues.

Improving accountability through alignment: the role of academic health science centres and networks in England

PubMed Central

2014-01-01

Background As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the “unlinked partners” model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. Discussion This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. Summary At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues. PMID:24438592

Issues in the Development of Children's Centres on Nursery and Primary School Sites

ERIC Educational Resources Information Center

Lewis, Jane; Finnegan, Cathy; West, Anne

2011-01-01

This paper explores the development of children's centres in England between 2004 and 2008, focusing on the newly created centres that have been located on primary and nursery school sites. Using both an analysis of policy documents and interview data from three urban local authorities, we examine the use of premises and the differing priorities…

Using practice development methodology to develop children's centre teams: ideas for the future.

PubMed

Hemingway, Ann; Cowdell, Fiona

2009-09-01

The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children's Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children's centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality.

Clusters of Galaxies

NASA Astrophysics Data System (ADS)

Huchtmeier, W. K.; Richter, O. G.; Materne, J.

1981-09-01

The large-scale structure of the universe is dominated by clustering. Most galaxies seem to be members of pairs, groups, clusters, and superclusters. To that degree we are able to recognize a hierarchical structure of the universe. Our local group of galaxies (LG) is centred on two large spiral galaxies: the Andromeda nebula and our own galaxy. Three sr:naller galaxies - like M 33 - and at least 23 dwarf galaxies (KraanKorteweg and Tammann, 1979, Astronomische Nachrichten, 300, 181) can be found in the evironment of these two large galaxies. Neighbouring groups have comparable sizes (about 1 Mpc in extent) and comparable numbers of bright members. Small dwarf galaxies cannot at present be observed at great distances.

Teaching clinical skills in developing countries: are clinical skills centres the answer?

PubMed

Stark, Patsy; Fortune, F

2003-11-01

There is growing international interest in teaching clinical skills in a variety of contexts, one of which is Clinical Skills Centres. The drivers for change making Skills Centres an important adjunct to ward and ambulatory teaching come both from within and outside medical education. Educationally, self-directed learning is becoming the accepted norm, encouraging students to seek and maximize learning opportunities. There are global changes in health care practice, increased consumerism and increasing student numbers. In some countries, professional recommendations influence what is taught. Increasingly, core skills curricula and outcome objectives are being defined. This explicit definition encourages assessment of the core skills. In turn, all students require equal opportunities to learn how to practise the skills safely and competently. The moves towards interprofessional education make joint learning in a"neutral" setting, like a Clinical Skills Centre, appear particularly attractive. To discuss the potential role of Clinical Skills Centres in skills training in developing countries and to consider alternative options. Many developing countries seek to establish Clinical Skills Centres to ensure effective and reliable skills teaching. However, the model may not be appropriate,because fully equipped Clinical Skills Centres are expensive to set up, staff; and run. They are not the only way to achieve high quality clinical teaching. Suggested options are based on the philosophy and teaching methods successfully developed in Clinical Skills Centres that may fulfil the local needs to achieve low cost and high quality clinical teaching which is reflective of the local health needs and cultural expectations.

The CRASH report: emergency management dilemmas facing acute physicians in patients with pulmonary arterial hypertension.

PubMed

Price, Laura C; Dimopoulos, Konstantinos; Marino, Philip; Alonso-Gonzalez, Rafael; McCabe, Colm; Kemnpy, Aleksander; Swan, Lorna; Boutsikou, Maria; Al Zahrani, Ahmed; Coghlan, Gerry J; Schreiber, Benjamin E; Howard, Luke S; Davies, Rachel; Toshner, Mark; Pepke-Zaba, Joanna; Church, Alistair C; Peacock, Andrew; Corris, Paul A; Lordan, James L; Gaine, Sean; Condliffe, Robin; Kiely, David G; Wort, Stephen John

2017-11-01

Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH. Thereafter, a review of the literature was performed centred on these specified topics and a management approach was developed based on best available evidence and expert consensus. Management protocols were developed on the following PAH emergencies: chest pain (including myocardial ischaemia), right ventricular failure, arrhythmias, sepsis, haemoptysis ('CRASH'), as well as considerations relevant to surgery, anaesthesia and pregnancy. Emergencies are not uncommon in PAH. While expertise in PAH management is essential, all physicians involved in acute care should be aware of the principles of acute management of PAH emergencies. A multidisciplinary approach is necessary, with physicians from tertiary PH centres supporting care locally and planning safe transfer of patients to PH centres when appropriate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Diffraction evidence for the structure of cellulose microfibrils in bamboo, a model for grass and cereal celluloses.

PubMed

Thomas, Lynne H; Forsyth, V Trevor; Martel, Anne; Grillo, Isabelle; Altaner, Clemens M; Jarvis, Michael C

2015-06-23

Cellulose from grasses and cereals makes up much of the potential raw material for biofuel production. It is not clear if cellulose microfibrils from grasses and cereals differ in structure from those of other plants. The structures of the highly oriented cellulose microfibrils in the cell walls of the internodes of the bamboo Pseudosasa amabilis are reported. Strong orientation facilitated the use of a range of scattering techniques. Small-angle neutron scattering provided evidence of extensive aggregation by hydrogen bonding through the hydrophilic edges of the sheets of chains. The microfibrils had a mean centre-to-centre distance of 3.0 nm in the dry state, expanding on hydration. The expansion on hydration suggests that this distance between centres was through the hydrophilic faces of adjacent microfibrils. However in the other direction, perpendicular to the sheets of chains, the mean, disorder-corrected Scherrer dimension from wide-angle X-ray scattering was 3.8 nm. It is possible that this dimension is increased by twinning (crystallographic coalescence) of thinner microfibrils over part of their length, through the hydrophobic faces. The wide-angle scattering data also showed that the microfibrils had a relatively large intersheet d-spacing and small monoclinic angle, features normally considered characteristic of primary-wall cellulose. Bamboo microfibrils have features found in both primary-wall and secondary-wall cellulose, but are crystallographically coalescent to a greater extent than is common in celluloses from other plants. The extensive aggregation and local coalescence of the microfibrils are likely to have parallels in other grass and cereal species and to influence the accessibility of cellulose to degradative enzymes during conversion to liquid biofuels.

External audits of electron beams using mailed TLD dosimetry: preliminary results.

PubMed

Gomola, I; Van Dam, J; Isern-Verdum, J; Verstraete, J; Reymen, R; Dutreix, A; Davis, B; Huyskens, D

2001-02-01

A feasibility study has been performed to investigate the possibility of using mailed thermoluminescence dosimetry (TLD) for external audits of clinical electron beams in Europe. In the frame of the EC Network Project for Quality Assurance in Radiotherapy, instruction sheets and mailing procedures have been defined for mailed TLD dosimetry using the dedicated holder developed by a panel of experts of the International Atomic Energy Agency (IAEA). Three hundred and thirty electron beam set-ups have been checked in the reference centres and some local centres of the EC Network Project and in addition through the centres participating to the EORTC Radiotherapy Group trial 22922. The mean ratio of measured dose to stated dose is 0.2% and the standard deviation of measured dose to stated dose is 3.2%. In seven beam set-ups, deviations greater than 10% were observed (max. 66%), showing the usefulness of these checks. The results of this feasibility study (instruction sheets, mailing procedures, holder) are presently endorsed by the EQUAL-ESTRO structure in order to offer in the future to all ESTRO members the possibility to request external audits of clinical electron beams.

Investigating the Impact of Working in Multi-Agency Service Delivery Settings in the UK on Early Years Practitioners' Beliefs and Practices

ERIC Educational Resources Information Center

Anning, Angela

2005-01-01

In the UK Centres of Excellence were funded by the DfES to model high quality, multi-agency, early years services for young children and their families. They were precursors to Children's Centres to be established across the UK. Early Excellence Centres were evaluated at national and local levels. This article will draw on data from local…

Perceptual centres in speech - an acoustic analysis

NASA Astrophysics Data System (ADS)

Scott, Sophie Kerttu

Perceptual centres, or P-centres, represent the perceptual moments of occurrence of acoustic signals - the 'beat' of a sound. P-centres underlie the perception and production of rhythm in perceptually regular speech sequences. P-centres have been modelled both in speech and non speech (music) domains. The three aims of this thesis were toatest out current P-centre models to determine which best accounted for the experimental data bto identify a candidate parameter to map P-centres onto (a local approach) as opposed to the previous global models which rely upon the whole signal to determine the P-centre the final aim was to develop a model of P-centre location which could be applied to speech and non speech signals. The first aim was investigated by a series of experiments in which a) speech from different speakers was investigated to determine whether different models could account for variation between speakers b) whether rendering the amplitude time plot of a speech signal affects the P-centre of the signal c) whether increasing the amplitude at the offset of a speech signal alters P-centres in the production and perception of speech. The second aim was carried out by a) manipulating the rise time of different speech signals to determine whether the P-centre was affected, and whether the type of speech sound ramped affected the P-centre shift b) manipulating the rise time and decay time of a synthetic vowel to determine whether the onset alteration was had more affect on P-centre than the offset manipulation c) and whether the duration of a vowel affected the P-centre, if other attributes (amplitude, spectral contents) were held constant. The third aim - modelling P-centres - was based on these results. The Frequency dependent Amplitude Increase Model of P-centre location (FAIM) was developed using a modelling protocol, the APU GammaTone Filterbank and the speech from different speakers. The P-centres of the stimuli corpus were highly predicted by attributes of the increase in amplitude within one output channel of the filterbank. When this was used to make predictions of the P-centres for all the stimuli used in the thesis, 85[percent] of the observed variance was accounted for. The FAIM approach combines aspects of previous, speech and non speech models (Gordon 1987, Marcus 1981, Vos and Rasch 1981). P-centre were thus modelled in a non speech specific, local manner.

Local properties of the large-scale peaks of the CMB temperature

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marcos-Caballero, A.; Martínez-González, E.; Vielva, P., E-mail: marcos@ifca.unican.es, E-mail: martinez@ifca.unican.es, E-mail: vielva@ifca.unican.es

2017-05-01

In the present work, we study the largest structures of the CMB temperature measured by Planck in terms of the most prominent peaks on the sky, which, in particular, are located in the southern galactic hemisphere. Besides these large-scale features, the well-known Cold Spot anomaly is included in the analysis. All these peaks would contribute significantly to some of the CMB large-scale anomalies, as the parity and hemispherical asymmetries, the dipole modulation, the alignment between the quadrupole and the octopole, or in the case of the Cold Spot, to the non-Gaussianity of the field. The analysis of the peaks ismore » performed by using their multipolar profiles, which characterize the local shape of the peaks in terms of the discrete Fourier transform of the azimuthal angle. In order to quantify the local anisotropy of the peaks, the distribution of the phases of the multipolar profiles is studied by using the Rayleigh random walk methodology. Finally, a direct analysis of the 2-dimensional field around the peaks is performed in order to take into account the effect of the galactic mask. The results of the analysis conclude that, once the peak amplitude and its first and second order derivatives at the centre are conditioned, the rest of the field is compatible with the standard model. In particular, it is observed that the Cold Spot anomaly is caused by the large value of curvature at the centre.« less

Factors influencing plasma transfusion practices in paediatric intensive care units around the world.

PubMed

Karam, O; Demaret, P; Duhamel, A; Shefler, A; Spinella, P C; Tucci, M; Leteurtre, S; Stanworth, S J

2017-02-01

Plasma transfusions are a frequent treatment worldwide, but many studies have reported a wide variation in the indications to transfuse. Recently, an international paediatric study also showed wide variation in frequency in the use of plasma transfusions: 25% of the centres transfused plasma to >5% of their patients, whereas another 25% transfused plasma to <1% of their patients. The objective of this study was to explore the factors associated with different plasma transfusion practices in these centres. Online survey sent to the local investigators of the 101 participating centres, in February 2016. Four areas were explored: beliefs regarding plasma transfusion, patients' case-mix in each unit, unit's characteristics, and local blood product transfusion policies and processes. The response rate was 82% (83/101). 43% of the respondents believed that plasma transfusions can arrest bleeding, whereas 27% believe that plasma transfusion can prevent bleeding. Centres with the highest plasma transfusion rate were more likely to think that hypovolaemia and mildly abnormal coagulation tests are appropriate indications for plasma transfusions (P = 0·02 and P = 0·04, respectively). Case-mix, centre characteristics or local transfusion services were not identified as significant relevant factors. Factors influencing plasma transfusion practices reflect beliefs about indications and the efficacy of transfusion in the prevention and management of bleeding as well as effects on coagulation tests. Educational and other initiatives to target these beliefs should be the focus of research. © 2017 International Society of Blood Transfusion.

Turbulent structure of three-dimensional flow behind a model car: 1. Exposed to uniform approach flow

NASA Astrophysics Data System (ADS)

Kozaka, Orçun E.; Özkan, Gökhan; Özdemir, Bedii I.

2004-01-01

Turbulent structure of flow behind a model car is investigated with local velocity measurements with emphasis on large structures and their relevance to aerodynamic forces. Results show that two counter-rotating helical vortices, which are formed within the inner wake region, play a key role in determining the flux of kinetic energy. The turbulence is generated within the outermost shear layers due to the instabilities, which also seem to be the basic drive for these relatively organized structures. The measured terms of the turbulent kinetic energy production, which are only part of the full expression, indicate that vortex centres act similar to the manifolds draining the energy in the streamwise direction. As the approach velocity increases, the streamwise convection becomes the dominant means of turbulent transport and, thus, the acquisition of turbulence by relatively non-turbulent flow around the wake region is suppressed.

Tunable photonic crystals with partial bandgaps from blue phase colloidal crystals and dielectric-doped blue phases.

PubMed

Stimulak, Mitja; Ravnik, Miha

2014-09-07

Blue phase colloidal crystals and dielectric nanoparticle/polymer doped blue phases are demonstrated to combine multiple components with different symmetries in one photonic material, creating a photonic crystal with variable and micro-controllable photonic band structure. In this composite photonic material, one contribution to the band structure is determined by the 3D periodic birefringent orientational profile of the blue phases, whereas the second contribution emerges from the regular array of the colloidal particles or from the dielectric/nanoparticle-doped defect network. Using the planewave expansion method, optical photonic bands of the blue phase I and II colloidal crystals and related nanoparticle/polymer doped blue phases are calculated, and then compared to blue phases with no particles and to face-centred-cubic and body-centred-cubic colloidal crystals in isotropic background. We find opening of local band gaps at particular points of Brillouin zone for blue phase colloidal crystals, where there were none in blue phases without particles or dopants. Particle size and filling fraction of the blue phase defect network are demonstrated as parameters that can directly tune the optical bands and local band gaps. In the blue phase I colloidal crystal with an additionally doped defect network, interestingly, we find an indirect total band gap (with the exception of one point) at the entire edge of SC irreducible zone. Finally, this work demonstrates the role of combining multiple - by symmetry - differently organised components in one photonic crystal material, which offers a novel approach towards tunable soft matter photonic materials.

In the Field: The Canadian Ecology Centre.

ERIC Educational Resources Information Center

Magee, Clare

2000-01-01

The Canadian Ecology Centre (Ontario) offers year-round residential and day programs in outdoor and environmental education for secondary students, field placement and internship opportunities for college students, and ecotourism programs, while providing employment and tax revenues to the local community. Dubbed consensus environmentalism, the…

High dose rate brachytherapy source measurement intercomparison.

PubMed

Poder, Joel; Smith, Ryan L; Shelton, Nikki; Whitaker, May; Butler, Duncan; Haworth, Annette

2017-06-01

This work presents a comparison of air kerma rate (AKR) measurements performed by multiple radiotherapy centres for a single HDR 192 Ir source. Two separate groups (consisting of 15 centres) performed AKR measurements at one of two host centres in Australia. Each group travelled to one of the host centres and measured the AKR of a single 192 Ir source using their own equipment and local protocols. Results were compared to the 192 Ir source calibration certificate provided by the manufacturer by means of a ratio of measured to certified AKR. The comparisons showed remarkably consistent results with the maximum deviation in measurement from the decay-corrected source certificate value being 1.1%. The maximum percentage difference between any two measurements was less than 2%. The comparisons demonstrated the consistency of well-chambers used for 192 Ir AKR measurements in Australia, despite the lack of a local calibration service, and served as a valuable focal point for the exchange of ideas and dosimetry methods.

Implementing healthy lifestyle promotion in primary care: a quasi-experimental cross-sectional study evaluating a team initiative.

PubMed

Thomas, Kristin; Krevers, Barbro; Bendtsen, Preben

2015-01-22

Non-communicable diseases are a leading cause of death and can largely be prevented by healthy lifestyles. Health care organizations are encouraged to integrate healthy lifestyle promotion in routine care. This study evaluates the impact of a team initiative on healthy lifestyle promotion in primary care. A quasi-experimental, cross-sectional design compared three intervention centres that had implemented lifestyle teams with three control centres that used a traditional model of care. Outcomes were defined using the RE-AIM framework: reach, the proportion of patients receiving lifestyle promotion; effectiveness, self-reported attitudes and competency among staff; adoption, proportion of staff reporting regular practice of lifestyle promotion; implementation, fidelity to the original lifestyle team protocol. Data collection methods included a patient questionnaire (n = 888), a staff questionnaire (n = 120) and structured interviews with all practice managers and, where applicable, team managers (n = 8). The chi square test and problem-driven content analysis was used to analyse the questionnaire and interview data, respectively. Reach: patients at control centres (48%, n = 211) received lifestyle promotion significantly more often compared with patients at intervention centres (41%, n = 169). Effectiveness: intervention staff was significantly more positive towards the effectiveness of lifestyle promotion, shared competency and how lifestyle promotion was prioritized at their centre. Adoption: 47% of staff at intervention centres and 58% at control centres reported that they asked patients about their lifestyle on a daily basis. all intervention centres had implemented multi-professional teams and team managers and held regular meetings but struggled to implement in-house referral structures for lifestyle promotion, which was used consistently among staff. Intervention centres did not show higher rates than control centres on reach of patients or adoption among staff at this stage. All intervention centres struggled to implement working referral structures for lifestyle promotion. Intervention centres were more positive on effectiveness outcomes, attitudes and competency among staff, however. Thus, lifestyle teams may facilitate lifestyle promotion practice in terms of increased responsiveness among staff, illustrated by positive attitudes and perceptions of shared competency. More research is needed on lifestyle promotion referral structures in primary care regarding their configuration and implementation.

PubMed Central

Rodrigue, Jean

1990-01-01

For the most part, doctors working in Quebec's local community service centres (or CLSCs) receive a fixed amount for their services. This type of remuneration is often associated with employee status. In the case of the CLSC doctors, however, their status is determined by the nature of their relationship with the centre's administration. It is evident from the conditions under which they practise that the CLSC doctors are not employees. Their autonomy is determined by the mission, orientation, and operation of the centre in a way that is similar to that of doctors paid on a fee-for-services basis in the province's hospital centres. PMID:21233900

A 17-billion-solar-mass black hole in a group galaxy with a diffuse core.

PubMed

Thomas, Jens; Ma, Chung-Pei; McConnell, Nicholas J; Greene, Jenny E; Blakeslee, John P; Janish, Ryan

2016-04-21

Quasars are associated with and powered by the accretion of material onto massive black holes; the detection of highly luminous quasars with redshifts greater than z = 6 suggests that black holes of up to ten billion solar masses already existed 13 billion years ago. Two possible present-day 'dormant' descendants of this population of 'active' black holes have been found in the galaxies NGC 3842 and NGC 4889 at the centres of the Leo and Coma galaxy clusters, which together form the central region of the Great Wall--the largest local structure of galaxies. The most luminous quasars, however, are not confined to such high-density regions of the early Universe; yet dormant black holes of this high mass have not yet been found outside of modern-day rich clusters. Here we report observations of the stellar velocity distribution in the galaxy NGC 1600--a relatively isolated elliptical galaxy near the centre of a galaxy group at a distance of 64 megaparsecs from Earth. We use orbit superposition models to determine that the black hole at the centre of NGC 1600 has a mass of 17 billion solar masses. The spatial distribution of stars near the centre of NGC 1600 is rather diffuse. We find that the region of depleted stellar density in the cores of massive elliptical galaxies extends over the same radius as the gravitational sphere of influence of the central black holes, and interpret this as the dynamical imprint of the black holes.

Meeting the privacy requirements for the development of a multi-centre patient registry in Canada: the Rick Hansen Spinal Cord Injury Registry.

PubMed

Noonan, Vanessa K; Thorogood, Nancy P; Joshi, Phalgun B; Fehlings, Michael G; Craven, B Catharine; Linassi, Gary; Fourney, Daryl R; Kwon, Brian K; Bailey, Christopher S; Tsai, Eve C; Drew, Brian M; Ahn, Henry; Tsui, Deborah; Dvorak, Marcel F

2013-05-01

Privacy legislation addresses concerns regarding the privacy of personal information; however, its interpretation by research ethics boards has resulted in significant challenges to the collection, management, use and disclosure of personal health information for multi-centre research studies. This paper describes the strategy used to develop the national Rick Hansen Spinal Cord Injury Registry (RHSCIR) in accordance with privacy statutes and benchmarked against best practices. An analysis of the regional and national privacy legislation was conducted to determine the requirements for each of the 31 local RHSCIR sites and the national RHSCIR office. A national privacy and security framework was created for RHSCIR that includes a governance structure, standard operating procedures, training processes, physical and technical security and privacy impact assessments. The framework meets a high-water mark in ensuring privacy and security of personal health information nationally and may assist in the development of other national or international research initiatives. Copyright © 2013 Longwoods Publishing.

Meeting the Privacy Requirements for the Development of a Multi-Centre Patient Registry in Canada: The Rick Hansen Spinal Cord Injury Registry

PubMed Central

Noonan, Vanessa K.; Thorogood, Nancy P.; Joshi, Phalgun B.; Fehlings, Michael G.; Craven, B. Catharine; Linassi, Gary; Fourney, Daryl R.; Kwon, Brian K.; Bailey, Christopher S.; Tsai, Eve C.; Drew, Brian M.; Ahn, Henry; Tsui, Deborah; Dvorak, Marcel F.

2013-01-01

Privacy legislation addresses concerns regarding the privacy of personal information; however, its interpretation by research ethics boards has resulted in significant challenges to the collection, management, use and disclosure of personal health information for multi-centre research studies. This paper describes the strategy used to develop the national Rick Hansen Spinal Cord Injury Registry (RHSCIR) in accordance with privacy statutes and benchmarked against best practices. An analysis of the regional and national privacy legislation was conducted to determine the requirements for each of the 31 local RHSCIR sites and the national RHSCIR office. A national privacy and security framework was created for RHSCIR that includes a governance structure, standard operating procedures, training processes, physical and technical security and privacy impact assessments. The framework meets a high-water mark in ensuring privacy and security of personal health information nationally and may assist in the development of other national or international research initiatives. PMID:23968640

Patient safety during radiological examinations: a nationwide survey of residency training hospitals in Taiwan.

PubMed

Lee, Yuan-Hao; Chen, Clayton Chi-Chang; Lee, San-Kan; Chen, Cheng-Yu; Wan, Yung-Liang; Guo, Wan-Yuo; Cheng, Amy; Chan, Wing P

2016-09-20

Variations in radiological examination procedures and patient load lead to variations in standards of care related to patient safety and healthcare quality. To understand the status of safety measures to protect patients undergoing radiological examinations at residency training hospitals in Taiwan, a follow-up survey evaluating the full spectrum of diagnostic radiology procedures was conducted. Questionnaires covering 12 patient safety-related themes throughout the examination procedures were mailed to the departments of diagnostic radiology with residency training programmes in 19 medical centres (with >500 beds) and 17 smaller local institutions in Taiwan. After receiving the responses, all themes in 2014 were compared between medical centres and local institutions by using χ(2) or 2-sample t-tests. Radiology Directors or Technology Chiefs of medical centres and local institutions in Taiwan participated in this survey by completing and returning the questionnaires. The response rates of medical centres and local institutions were 95% and 100%, respectively. As indicated, large medical centres carried out more frequent clinically ordered, radiologist-guided patient education to prepare patients for specific examinations (CT, 28% vs 6%; special procedures, 78% vs 44%) and incident review and analysis (89% vs 47%); however, they required significantly longer access time for MRI examinations (7.00±29.50 vs 3.50±3.50 days), had more yearly incidents of large-volume contrast-medium extravasation (2.75±1.00 vs 1.00±0.75 cases) and blank radiographs (41% vs 8%), lower monthly rates of suboptimal (but interpretable) radiographs (0.00±0.01% vs 0.64±1.84%) and high-risk reminder reporting (0.01±0.16% vs 1.00±1.75%) than local institutions. Our study elucidates the status of patient safety in diagnostic radiology in Taiwan, thereby providing helpful information to improve patient safety guidelines needed for medical imaging in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Highly restricted gene flow and deep evolutionary lineages in the giant clam Tridacna maxima

NASA Astrophysics Data System (ADS)

Nuryanto, A.; Kochzius, M.

2009-09-01

The tropical Indo-West Pacific is the biogeographic region with the highest diversity of marine shallow water species, with its centre in the Indo-Malay Archipelago. However, due to its high endemism, the Red Sea is also considered as an important centre of evolution. Currently, not much is known about exchange among the Red Sea, Indian Ocean and West Pacific, as well as connectivity within the Indo-Malay Archipelago, even though such information is important to illuminate ecological and evolutionary processes that shape marine biodiversity in these regions. In addition, the inference of connectivity among populations is important for conservation. This study aims to test the hypothesis that the Indo-Malay Archipelago and the Red Sea are important centres of evolution by studying the genetic population structure of the giant clam Tridacna maxima. This study is based on a 484-bp fragment of the cytochrome c oxidase I gene from 211 individuals collected at 14 localities in the Indo-West Pacific to infer lineage diversification and gene flow as a measure for connectivity. The analysis showed a significant genetic differentiation among sample sites in the Indo-West Pacific (Φst = 0.74, P < 0.001) and across the Indo-Malay Archipelago (Φst = 0.72, P < 0.001), indicating restricted gene flow. Hierarchical AMOVA revealed the highest fixation index (Φct = 0.8, P < 0.001) when sample sites were assigned to the following regions: (1) Red Sea, (2) Indian Ocean and Java Sea, (3) Indonesian throughflow and seas in the East of Sulawesi, and (4) Western Pacific. Geological history as well as oceanography are important factors that shape the genetic structure of T. maxima in the Indo-Malay Archipelago and Red Sea. The observed deep evolutionary lineages might include cryptic species and this result supports the notion that the Indo-Malay Archipelago and the Red Sea are important centres of evolution.

Practice variation in the structure of stroke rehabilitation in four rehabilitation centres in the Netherlands.

PubMed

Groeneveld, Iris F; Meesters, Jorit J L; Arwert, Henk J; Roux-Otter, Nienke; Ribbers, Gerard M; van Bennekom, Coen A M; Goossens, Paulien H; Vliet Vlieland, Thea P M

2016-03-01

To describe practice variation in the structure of stroke rehabilitation in 4 specialized multidisciplinary rehabilitation centres in the Netherlands. A multidisciplinary expert group formulated a set of 23 elements concerning the structure of inpatient and outpatient stroke rehabilitation, categorized into 4 domains: admission-related (n = 7), treatment-related (n = 10), client involvement-related (n = 2), and facilities-related (n = 4). In a cross-sectional study in 4 rehabilitation centres data on the presence and content of these elements were abstracted from treatment programmes and protocols. In a structured expert meeting consensus was reached on the presence of practice variation per element. Practice variation was observed in 22 of the 23 structure elements. The element "strategies for patient involvement" appeared similar in all rehabilitation centres, whereas differences were found in the elements regarding admission, exclusion and discharge criteria, patient subgroups, care pathways, team meetings, clinical assessments, maximum time to admission, aftercare and return to work modules, health professionals, treatment facilities, and care-giver involvement. Practice variation was found in a wide range of aspects of the structure of stroke rehabilitation.

LIS–lnterlink—connecting laboratory information systems to remote primary health–care centres via the Internet

PubMed Central

Clark, Barry; Wachowiak, Bartosz; Crawford, Ewan W.; Jakubowski, Zenon; Kabata, Janusz

1998-01-01

A pilot study was performed to evaluate the feasibility of using the Internet to securely deliver patient laboratory results, and the system has subsequently gone into routine use in Poland. The system went from design to pilot and then to live implementation within a four-month period, resulting in the LIS-Interlink software product. Test results are retrieved at regular intervals from the BioLinkTM LIS (Laboratory Information System), encrypted and transferred to a secure area on the Web server. The primary health-care centres dial into the Internet using a local-cell service provided by Polish Telecom (TP), obtain a TCP/IP address using the TP DHCP server, and perform HTTP ‘get’ and ‘post’ operations to obtain the files by secure handshaking. The data are then automatically inserted into a local SQL database (with optional printing of incoming reports)for cumulative reporting and searching functions. The local database is fully multi-user and can be accessed from different clinics within the centres by a variety of networking protocols. PMID:18924820

LIS-lnterlink-connecting laboratory information systems to remote primary health-care centres via the Internet.

PubMed

Clark, B; Wachowiak, B; Crawford, E W; Jakubowski, Z; Kabata, J

1998-01-01

A pilot study was performed to evaluate the feasibility of using the Internet to securely deliver patient laboratory results, and the system has subsequently gone into routine use in Poland. The system went from design to pilot and then to live implementation within a four-month period, resulting in the LIS-Interlink software product. Test results are retrieved at regular intervals from the BioLink(TM) LIS (Laboratory Information System), encrypted and transferred to a secure area on the Web server. The primary health-care centres dial into the Internet using a local-cell service provided by Polish Telecom (TP), obtain a TCP/IP address using the TP DHCP server, and perform HTTP 'get' and 'post' operations to obtain the files by secure handshaking. The data are then automatically inserted into a local SQL database (with optional printing of incoming reports)for cumulative reporting and searching functions. The local database is fully multi-user and can be accessed from different clinics within the centres by a variety of networking protocols.

Implementing Responsibility Centre Budgeting

ERIC Educational Resources Information Center

Vonasek, Joseph

2011-01-01

Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

A Case for Community-Run Pre-Schools and Daycare Centres.

ERIC Educational Resources Information Center

Renard, Rosamunde

This booklet advocates and describes the establishment of community run preschool and day care centers. The type described is based on the Laborie Community Education Centre in Saint Lucia, West Indies. Chapter 1 advocates establishing small, local institutions that are community managed, community owned, concerned with quality, and sustainable.…

Cedar Ridge Camp: Using the Local Environment

ERIC Educational Resources Information Center

Burke, Grayson

2007-01-01

In 2007 Cedar Ridge Camp opened for its first season as a traditional co-ed summer camp and year-round outdoor education and recreation centre. The mission would centre on creating a program that would encourage personal development and growth through a shared outdoor experience. Cedar Ridge's main goals were to promote the formation of close…

A holistic approach to the mycetoma management.

PubMed

Bakhiet, Sahar Mubarak; Fahal, Ahmed Hassan; Musa, Ahmed Mudawi; Mohamed, El Samani Wadaa; Omer, Rowa Fathelrahman; Ahmed, Eiman Siddig; El Nour, Mustafa; Mustafa, El Rayah Mohamed; Sheikh A Rahman, Manar El; Suliman, Suliman Hussein; El Mamoun, Mohamed A Gadir; El Amin, Hajo Mohamed

2018-05-01

Mycetoma, one of the badly neglected tropical diseases, it is a localised chronic granulomatous inflammatory disease characterised by painless subcutaneous mass and formation of multiple sinuses that produce purulent discharge and grains. If untreated early and appropriately, it usually spread to affect the deep structures and bone resulting in massive damage, deformities and disabilities. It can also spread via the lymphatics and blood leading to distant secondary satellites associated with high morbidity and mortality. To date and despite progress in mycetoma research, a huge knowledge gap remains in mycetoma pathogenesis and epidemiology resulting in the lack of objective and effective control programmes. Currently, the available disease control method is early case detection and proper management. However, the majority of patients present late with immense disease and for many of them, heroic substantial deforming surgical excisions or amputation are the only prevailing treatment options. In this communication, the Mycetoma Research Center (MRC), Sudan shares its experience in implementing a new holistic approach to manage mycetoma patients locally at the village level. The MRC in collaboration with Sennar State Ministry of Health, Sudan had established a region mycetoma centre in one of the endemic mycetoma villages in the state. The patients were treated locally in that centre, the local medical and health personals were trained on early case detection and management, the local community was trained on mycetoma advocacy, and environmental conditions improvement. This comprehensive approach had also addressed the patients' socioeconomic constraints that hinder early presentation and treatment. This approach has also included the active local health authorities, community and civil society participation and contributions to deliver the best management. This holistic approach for mycetoma patients' management proved to be effective for early case detection and management, optimal treatment and treatment outcome and favourable disease prognosis. During the study period, the number of patients with massive lesions and the amputation rate had dropped and that had reduced the disease medical and socioeconomic burdens on patients and families.

Business Centre Development Model of Airport Area in Supporting Airport Sustainability in Indonesia

NASA Astrophysics Data System (ADS)

Setiawan, MI; Surjokusumo, S.; Ma'soem, DM; Johan, J.; Hasyim, C.; Kurniasih, N.; Sukoco, A.; Dhaniarti, I.; Suyono, J.; Sudapet, IN; Nasihien, RD; Mudjanarko, SW; Wulandari, A.; Ahmar, Ansari S.; Wajdi, MBN

2018-01-01

Airport is expected to play the role in enhancing the economic level of the region, especially the local people around the airport. The Aero City concept in developing an airport might also develop a city centreed in the airport that combining airport oriented business development, business actors and local people around the airport area. This study aims to generate development model of business centre at the airports in Indonesia. This is a mixed method based study. The population includes 296 airports under government management, government subsidiary and military. By using stratified random sampling, there were 151 sample airports. The results show that business centre development in the airport area will be related with the airport management and the commercial property (business centre) growth at the airport. Aero City in Indonesia can be developed by partnership system between government and private sector that consists of construction, development, and implementation of commercial property such as hotel, apartment, retail, office, etc. Based on the result of T-Value test, Airport Performance variable predicted to have significant influence on Gross Regional Domestic Product Central Business District performance.

Prevention of secondary household transmission during Shiga toxin-producing Escherichia coli outbreaks.

PubMed

Tokuda, K; Yahata, Y; Sunagawa, T

2016-10-01

Prevention of secondary household transmission of Shiga toxin-producing Escherichia coli (STEC) is important in outbreak settings. We examined factors contributing to secondary household transmission during STEC outbreaks in daycare centres in Japan. Suspected STEC outbreaks in daycare centres were identified by the National Epidemiological Surveillance of Infectious Diseases. Questionnaires were sent to local health centres that responded to outbreaks. Secondary household transmission rates were calculated, and factors affecting secondary household transmission rate were analysed by multilevel analysis. The secondary household transmission rates in 16 outbreaks ranged from 0% to 34·4% (median 4·4%). The highest rate (23·0%) was observed in siblings aged 6-9 years, and the infection rate was significantly higher for mothers than for fathers and grandparents (P < 0·05). Using multilevel analysis, the following variables were selected in the best model: information provided face-to-face (vs. letter or telephone) to families of children in daycare centres (at initial response), STEC type and lag time (days) between onset and providing information. Early response and hygiene education by visiting local health centre staff may be effective measures to prevent secondary household transmission in STEC outbreaks. Hygiene education should be emphasized for children aged 6-9 years, as well as for younger children.

Ellipsoidal analysis of coordination polyhedra

PubMed Central

Cumby, James; Attfield, J. Paul

2017-01-01

The idea of the coordination polyhedron is essential to understanding chemical structure. Simple polyhedra in crystalline compounds are often deformed due to structural complexity or electronic instabilities so distortion analysis methods are useful. Here we demonstrate that analysis of the minimum bounding ellipsoid of a coordination polyhedron provides a general method for studying distortion, yielding parameters that are sensitive to various orders in metal oxide examples. Ellipsoidal analysis leads to discovery of a general switching of polyhedral distortions at symmetry-disallowed transitions in perovskites that may evidence underlying coordination bistability, and reveals a weak off-centre ‘d5 effect' for Fe3+ ions that could be exploited in multiferroics. Separating electronic distortions from intrinsic deformations within the low temperature superstructure of magnetite provides new insights into the charge and trimeron orders. Ellipsoidal analysis can be useful for exploring local structure in many materials such as coordination complexes and frameworks, organometallics and organic molecules. PMID:28146146

Digital structural

USGS Publications Warehouse

Dohm, J.M.; Anderson, R.C.; Tanaka, K.L.

1998-01-01

Magmatic and tectonic activity have both contributed significantly to the surface geology of Mars. Digital structural mapping techniques have now been used to classify and date centers of tectonic activity in the western equatorial region. For example, our results show a center of tectonic activity at Valles Marineris, which may be associated with uplift caused by intrusion. Such evidence may help explain, in part, the development of the large troughs and associated outflow channels and chaotic terrain. We also find a local centre of tectonic activity near the source region of Warrego Valles. Here, we suggest that the valley system may have resulted largely from intrusive-related hydrothermal activity. We hope that this work, together with the current Mars Global Surveyor mission, will lead to a better understanding of the geological processes that shaped the Martian surface.

Crystal structure of a c-kit promoter quadruplex reveals the structural role of metal ions and water molecules in maintaining loop conformation.

PubMed

Wei, Dengguo; Parkinson, Gary N; Reszka, Anthony P; Neidle, Stephen

2012-05-01

We report here the 1.62 Å crystal structure of an intramolecular quadruplex DNA formed from a sequence in the promoter region of the c-kit gene. This is the first reported crystal structure of a promoter quadruplex and the first observation of localized magnesium ions in a quadruplex structure. The structure reveals that potassium and magnesium ions have an unexpected yet significant structural role in stabilizing particular quadruplex loops and grooves that is distinct from but in addition to the role of potassium ions in the ion channel at the centre of all quadruplex structures. The analysis also shows how ions cluster together with structured water molecules to stabilize the quadruplex arrangement. This particular quadruplex has been previously studied by NMR methods, and the present X-ray structure is in accord with the earlier topology assignment. However, as well as the observations of potassium and magnesium ions, the crystal structure has revealed a highly significant difference in the dimensions of the large cleft in the structure, which is a plausible target for small molecules. This difference can be understood by the stabilizing role of structured water networks.

Atmospheric Gravity Waves (AGWs) as the driver of seismo-ionospheric coupling: recent major earthquakes of Nepal and Imphal - case study

NASA Astrophysics Data System (ADS)

Chakraborty, Suman; Chakrabarti, Sandip Kumar; Sasmal, Sudipta

2016-07-01

An important channel of the lithosphere-atmosphere-ionosphere coupling (LAIC) is the acoustic and gravity wave channel where the atmospheric gravity waves (AGW) play the most important part. Atmospheric waves are excited due to seismic gravitational vibrations before earthquakes and their effects on the atmosphere are the sources for seismo-ionospheric coupling which are manifested as perturbations in Very Low Frequency (VLF)/Low Frequency (LF) signal (amplitude/phase). For our study, we chose the recent major earthquakes that took place in Nepal and Imphal. The Nepal earthquake occurred on 12th May, 2015 at 12:50 pm local time (07:05 UTC) with Richter scale magnitude of M = 7.3 and depth 10 km (6.21 miles) at southeast of Kodari. The Imphal earthquake occurred on 4th January, 2016 at 4:35 am local time (23:05 UTC , 3rd January, UTC) with Richter scale magnitude of M = 6.7 and depth 55 km (34.2 miles). The data has been collected from Ionospheric and Earthquake Research Centre (IERC) of Indian Centre for Space Physics (ICSP) transmitted from JJI station of Japan. We performed both Fast Fourier Transform (FFT) and wavelet analysis on the VLF data for a couple of days before and after the major earthquakes. For both earthquakes, we observed wave like structures with periods of almost an hour before and after the earthquake day. The wave like oscillations after the earthquake may be due to the aftershock effects. We also observed that the amplitude of the wave like structures depends on the location of the epicenter between the transmitting and the receiving points and also on the depth of the earthquake.

Structural approaches to knowledge exchange: comparing practices across five centres of excellence in public health.

PubMed

Van der Graaf, P; Francis, O; Doe, E; Barrett, E; O'Rorke, M; Docherty, G

2018-03-01

In 2008, five UKCRC Public Health Research Centres of Excellence were created to develop a coordinated approach to policy and practice engagement and knowledge exchange. The five Centres have developed their own models and practices for achieving these aims, which have not been compared in detail to date. We applied an extended version of Saner's model for the interface between science and policy to compare five case studies of knowledge exchanges, one from each centre. We compared these practices on three dimensions within our model (focus, function and type/scale) to identify barriers and facilitators for knowledge exchange. The case studies shared commonalities in their range of activities (type) but illustrated different ways of linking these activities (function). The Centres' approaches ranged from structural to more organic, and varied in the extent that they engaged internal audiences (focus). Each centre addressed policymakers at different geographical levels and scale. This article emphasizes the importance of linking a range of activities that engage policymakers at different levels, intensities and points in their decision-making processes to build relationships. Developing a structural approach to knowledge exchange activities in different contexts presents challenges of resource, implementation and evaluation.

Velocity anti-correlation of diametrically opposed galaxy satellites in the low-redshift Universe.

PubMed

Ibata, Neil G; Ibata, Rodrigo A; Famaey, Benoit; Lewis, Geraint F

2014-07-31

Recent work has shown that the Milky Way and the Andromeda galaxies both possess the unexpected property that their dwarf satellite galaxies are aligned in thin and kinematically coherent planar structures. It is interesting to evaluate the incidence of such planar structures in the larger galactic population, because the Local Group may not be a representative environment. Here we report measurements of the velocities of pairs of diametrically opposed satellite galaxies. In the local Universe (redshift z < 0.05), we find that satellite pairs out to a distance of 150 kiloparsecs from the galactic centre are preferentially anti-correlated in their velocities (99.994 per cent confidence level), and that the distribution of galaxies in the larger-scale environment (out to distances of about 2 megaparsecs) is strongly clumped along the axis joining the inner satellite pair (>7σ confidence). This may indicate that planes of co-rotating satellites, similar to those seen around the Andromeda galaxy, are ubiquitous, and their coherent motion suggests that they represent a substantial repository of angular momentum on scales of about 100 kiloparsecs.

Investigating the local structure of B-site cations in (1-x)BaTiO3-xBiScO3 and (1-x)PbTiO3-xBiScO3 using X-ray absorption spectroscopy

NASA Astrophysics Data System (ADS)

Blanchard, Peter E. R.; Grosvenor, Andrew P.

2018-05-01

The structural properties of (1-x)BaTiO3-xBiScO3 and (1-x)PbTiO3-xBiScO3 were investigated using powder X-ray diffraction and X-ray absorption spectroscopy. Diffraction measurements confirmed that substituting small amounts of BiScO3 into BaTiO3 initially stabilizes a cubic phase at x = 0.2 before impurity phases begin to form at x = 0.5. BiScO3 substitution also resulted in noticeable changes in the local coordination environment of Ti4+. X-ray absorption near-edge spectroscopy (XANES) analysis showed that replacing Ti4+ with Sc3+ results in an increase in the off-centre displacement of Ti4+ cations. Surprisingly, BiScO3 substitution has no effect on the displacement of the Ti4+ cation in the (1-x)PbTiO3-xBiScO3 solid solution.

Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome.

PubMed

Campbell, J; Hudson, H; Lumley, J; Morris, N; Rao, J; Spensley, J

1981-10-03

A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

Influence of induced colour centres on the frequency - angular spectrum of a light bullet of mid-IR radiation in lithium fluoride

NASA Astrophysics Data System (ADS)

Chekalin, S. V.; Kompanets, V. O.; Dormidonov, A. E.; Kandidov, V. P.

2017-04-01

The influence of the occurrence of a structure consisting of long-lived colour centres, formed in an LiF crystal upon filamentation of femtosecond mid-IR radiation, on the supercontinuum characteristics is investigated. With an increase in the number of incident pulses, the length and transverse size of the structure of colour centres induced in LiF increase, and the supercontinuum spectrum in the short-wavelength region is markedly transformed due to the occurrence of the waveguide propagation regime, absorption, and scattering of radiation from the newly formed structure of colour centres. Under these conditions, the intensity of the anti-Stokes wing decreases by two orders of magnitude after several tens of pulses. Spectral components arise in the visible range, the angular divergence of which increases with increasing wavelength.

Crystallographic Data Centre Services and Publications.

ERIC Educational Resources Information Center

Cambridge Univ. (England). Chemical Lab.

The Cambridge Crystallographic Data Centre is concerned with the retrieval, evaluation, synthesis, and dissemination of structural data based on diffraction methods. The source of input is almost entirely primary journals. Bibliographic information and numeric data on crystal and molecular structures are on magnetic tapes. The bibliographic file…

Standard requirements for GCP-compliant data management in multinational clinical trials.

PubMed

Ohmann, Christian; Kuchinke, Wolfgang; Canham, Steve; Lauritsen, Jens; Salas, Nader; Schade-Brittinger, Carmen; Wittenberg, Michael; McPherson, Gladys; McCourt, John; Gueyffier, Francois; Lorimer, Andrea; Torres, Ferràn

2011-03-22

A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials. International, European and national regulations and guidelines relevant to GCP, data security and IT infrastructures, as well as ECRIN documents produced previously, were evaluated to provide a starting point for the development of standard requirements. The requirements were produced by expert consensus of the ECRIN Working group on Data Centres, using a structured and standardised process. The requirements were divided into two main parts: an IT part covering standards for the underlying IT infrastructure and computer systems in general, and a Data Management (DM) part covering requirements for data management applications in clinical trials. The standard developed includes 115 IT requirements, split into 15 separate sections, 107 DM requirements (in 12 sections) and 13 other requirements (2 sections). Sections IT01 to IT05 deal with the basic IT infrastructure while IT06 and IT07 cover validation and local software development. IT08 to IT015 concern the aspects of IT systems that directly support clinical trial management. Sections DM01 to DM03 cover the implementation of a specific clinical data management application, i.e. for a specific trial, whilst DM04 to DM12 address the data management of trials across the unit. Section IN01 is dedicated to international aspects and ST01 to the competence of a trials unit's staff. The standard is intended to provide an open and widely used set of requirements for GCP-compliant data management, particularly in academic trial units. It is the intention that ECRIN will use these requirements as the basis for the certification of ECRIN data centres.

Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre.

PubMed

Raymont, Antony; Boyd, Mary-Anne; Malloy, Timothy; Malloy, Nancy

2015-12-01

Primary health care is critical, particularly in rural areas distant from secondary care services. To describe the development of Coast to Coast Health Centre (CTCHC) at Wellsford, north of Auckland, New Zealand and reflect on its achievements and ongoing challenges. Interviews were conducted with staff and management of CTCHC and with other health service providers. Surveys of staff and a sample of enrolled patients were undertaken. Numerical data on service utilisation were obtained from the practice and from national datasets. The CTCHC provides a wide range of services, including after-hours care, maternity and radiology, across a network of electronically connected sites, as well as interdisciplinary training for a range of health students. General practitioner (GP) recruitment is problematic and nursing roles have been expanded. Staff report positively on the work environment. Consultation rates are higher than in comparable practices, especially consultations with nurses. Rates of hospital admission are relatively low. The development of the CTCHC was assisted by formation of a local primary health organisation (PHO) and by recognition by the local district health board (DHB). Issues with poor coordination of local services, and less service provision than is characteristic in urban areas, remain. Contracting processes with the DHB were complex and time-consuming. The merging of the local PHO into a larger PHO within the Waitemata DHB catchment inhibited progression towards more complete locality planning. A dedicated and locally controlled provider was able to generate a more than usually complete community health service for Wellsford and area.

Mind the Gap: Global Quality Norms, National Policy Interpretations and Local Praxis in Timor-Leste

ERIC Educational Resources Information Center

Shah, Ritesh; Quinn, Marie

2016-01-01

Increasingly, the imperative for improving educational quality in schooling systems throughout the developing world is harnessed to a particular set of teaching and learning practices, such as child-centred, child-friendly or learner-centred pedagogy (LCP). Such was the case in Timor-Leste where, after independence, LCP was heavily promoted as a…

Critiquing Child-Centred Pedagogy to Bring Children and Early Childhood Educators into the Centre of a Democratic Pedagogy

ERIC Educational Resources Information Center

Langford, Rachel

2010-01-01

Child-centred pedagogy is both an enduring approach and a revered concept in Western-based teacher preparation. This article weaves together major critiques of child-centred pedagogy that draw on critical feminist, postmodernist and post-structural theories. These critiques have particular relevance for conceptualizing what it can mean to be, and…

Psychiatric rehabilitation in community-based day centres: motivation and satisfaction.

PubMed

Eklund, Mona; Tjörnstrand, Carina

2013-11-01

This study investigated attendees' motivation and motives for participation in day centres and their satisfaction with the rehabilitation, while also addressing the influence of day centre orientation (work- or meeting-place orientation), gender and age. Ninety-three Swedish day centre attendees participated in a cross-sectional study and completed questionnaires about motivation, motives, and satisfaction with the rehabilitation. Data were analysed with non-parametric statistics. The participants were highly motivated for going to the day centre and set clear goals for their rehabilitation. Female gender, but not age, was associated with stronger motivation. The strongest motives for going to the day centre were getting structure to the day and socializing. Attendees at work-oriented day centres more often expressed that they went there to get structure to the day and gain social status. Satisfaction with the rehabilitation was high, and the most common wishes for further opportunities concerned earning money and learning new things. The rehabilitation largely seemed to meet the attendees' needs, but the findings indicated that further developments were desired, such as participation in work on the open market and more work-like occupations in the day centre, accompanied by some kind of remuneration.

The new European Competence Centre for Moor and Climate - A European initiative for practical peat bog and climate protection

NASA Astrophysics Data System (ADS)

Smidt, Geerd; Tänzer, Detlef

2013-04-01

The new European Competence Centre for Moor and Climate (EFMK) is an initiative by different local communities, environmental protection NGOs, agricultural services, and partners from the peat and other industries in Lower Saxony (Germany). The Centre aims to integrate practical peat bog conservation with a focus on green house gas emission after drainage and after water logging activities. Together with our partners we want to break new ground to protect the remaining bogs in the region. Sphagnum mosses will be produced in paludiculture on-site in cooperation with the local peat industry to provide economic and ecologic alternatives for peat products used in horticulture business. Land-use changes are needed in the region and will be stimulated in cooperation with agricultural services via compensation money transfers from environmental protection funds. On a global scale the ideas of Carbon Credit System have to be discussed to protect the peat bogs for climate protection issues. Environmental education is an important pillar of the EFMK. The local society is invited to explore the unique ecosystem and to participate in peat bog protection activities. Future generations will be taught to understand that the health of our peat bogs is interrelated with the health of the local and global climate. Besides extracurricular classes for schools the centre will provide infrastructure for Master and PhD students, as well for senior researchers for applied research in the surrounding moor. International partners in the scientific and practical fields of peat bog ecology, renaturation, green house gas emissions from peat bogs, and environmental policy are invited to participate in the European Competence Center for Moor and Climate.

Determinants of eating at local and western fast-food venues in an urban Asian population: a mixed methods approach.

PubMed

Naidoo, Nasheen; van Dam, Rob M; Ng, Sheryl; Tan, Chuen Seng; Chen, Shiqi; Lim, Jia Yi; Chan, Mei Fen; Chew, Ling; Rebello, Salome A

2017-05-25

Like several Southeast Asian countries, Singapore has a complex eating-out environment and a rising eating-out prevalence. However the determinants and drivers of eating-out in urban Asian environments are poorly understood. We examined the socio-demographic characteristics of persons who frequently ate away from home in local eateries called hawker centres and Western fast-food restaurants, using data from 1647 Singaporean adults participating in the National Nutrition Survey (NNS) 2010. We also assessed the underlying drivers of eating out and evaluated if these were different for eating at local eateries compared to Western fast-food restaurants using 18 focus group discussions of women (130 women). Participants reported a high eating-out frequency with 77.3% usually eating either breakfast, lunch or dinner at eateries. Main venues for eating-out included hawker centres (61.1% usually ate at least 1 of 3 daily meals at this venue) and school/workplace canteens (20.4%). A minority of participants (1.9%) reported usually eating at Western fast-food restaurants. Younger participants and those of Chinese and Malay ethnicity compared to Indians were more likely to eat at Western fast-food restaurants. Chinese and employed persons were more likely to eat at hawker centres. The ready availability of a large variety of affordable and appealing foods appeared to be a primary driver of eating out, particularly at hawker centres. Our findings highlight the growing importance of eating-out in an urban Asian population where local eating venues play a more dominant role compared with Western fast-food chains. Interventions focusing on improving the food quality at venues for eating out are important to improve the diet of urban Asian populations.

Internationalization and localization: evaluating and testing a Website for Asian users.

PubMed

Rau, Pei-Luen Patrick; Liang, Sheau-Farn Max

2003-01-15

The objective of this study was to combine internationalization and localization of Websites and improvement of Website usability with user-centred design methods. This study designed for internationalization and localization of Websites for Asian users, and implemented usability engineering into every phase of Website usability testing, based on the internationalization and localization perspectives of the honeywell.com/your home Website. The first step was to develop the usage scenarios. Three Asian usability specialists carried out one heuristic evaluation session for the current honeywell.com/your home Website. The usability problems were analysed and possible solutions to these problems were discussed. In the next phase, cluster analysis was utilized to test current information architecture. The results provided options for future information architecture development for this Website. Finally, a performance measurement test was conducted to investigate the performance for Asian users. Based on the results, suggestions for improving the Website usability from the localization perspective were provided. The results demonstrate the user-centred design (UCD) approach and stress international and local issues in Website development to Website designers.

Beginning community engagement at a busy biomedical research programme: Experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya

PubMed Central

Marsh, Vicki; Kamuya, Dorcas; Rowa, Yvonne; Gikonyo, Caroline; Molyneux, Sassy

2008-01-01

There is wide acknowledgement of the need for community engagement in biomedical research, particularly in international settings. Recent debates have described theoretical approaches to identifying situations where this is most critical and potential mechanisms to achieve it. However, there is relatively little published experience of community engagement in practice. A major component of the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme is centred on Kilifi District General Hospital and surrounding community of 240,000 local residents. Documented community perceptions of the research centre are generally positive, but many indicate a low understanding of research and therapeutic misconceptions of its activities. As in other settings, these misunderstandings have contributed to concerns and rumours, and potentially undermine ethical aspects of research and local trust in the institution. Through a series of consultative activities, a community engagement strategy has been developed in Kilifi to strengthen mutual understanding between community members and the Centre. One important component is the establishment of a representative local resident network in different geographic locations commonly involved in research, to supplement existing communication channels. Early implementation of the strategy has provided new and diverse opportunities for dialogue, interaction and partnership building. Through the complex social interactions inherent in the community engagement strategy, the centre aims to build context specific ethical relations with local residents and to strengthen understanding of how ethical principles can be applied in practice. Evaluations over time will assess the effectiveness and sustainability of these strategies, provide generalisable information for similar research settings, and contribute to debates on the universality of ethical principles for research. This paper aims to summarise the rationale for community engagement in research, drawing on published literature and local findings, to outline the process of community engagement in Kilifi and to describe issues emerging from its development and early implementation. PMID:18375028

Density functional calculations of carbon substituting for Zr in barium zirconate

NASA Astrophysics Data System (ADS)

Al-Hadidi, Meaad; Goss, J. P.; Al-Ani, Oras A.; Briddon, P. R.; Rayson, M. J.

2017-06-01

Oxide perovskites such as BaZrO3 possess many significant properties which render them useful in many technological and scientific applications such as sensors, optoelectronics, laser frequency doubling and high capacity memory cells. Several methods are used to grow BaZrO3 crystal, and organic species that may be present during growth lead to carbon contamination. We have investigated, using density-functional theory, the role of carbon impurities on the structural, electrical and electronic properties of carbon substituting of Zr in cubic barium zirconate. The local vibrational modes of the defect centre has been calculated and we suggest it is a feasible route to experimental identification

Cambridge Crystallographic Data Centre. II. Structural Data File

ERIC Educational Resources Information Center

Allen, F. H.; And Others

1973-01-01

The Cambridge Crystallographic Data Centre is concerned with the retrieval, evaluation, synthesis, and dissemination of structural data obtained by diffraction methods. This article (Part I is EJ053033) describes the work of the center and deals with the organization and maintenance of a computerized file of numeric crystallographic structural…

Factors Affecting the Involvement of Day Centre Care Staff in the Delivery of Physiotherapy to Adults with Intellectual Disabilities: An Exploratory Study in One London Borough

ERIC Educational Resources Information Center

Middleton, M. -J.; Kitchen, S. S.

2008-01-01

Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff,…

Climate and local abundance in freshwater fishes

PubMed Central

Knouft, Jason H.; Anthony, Melissa M.

2016-01-01

Identifying factors regulating variation in numbers of individuals among populations across a species' distribution is a fundamental goal in ecology. A common prediction, often referred to as the abundant-centre hypothesis, suggests that abundance is highest near the centre of a species' range. However, because of the primary focus on the geographical position of a population, this framework provides little insight into the environmental factors regulating local abundance. While range-wide variation in population abundance associated with environmental conditions has been investigated in terrestrial species, the relationship between climate and local abundance in freshwater taxa across species' distributions is not well understood. We used GIS-based temperature and precipitation data to determine the relationships between climatic conditions and range-wide variation in local abundance for 19 species of North American freshwater fishes. Climate predicted a portion of the variation in local abundance among populations for 18 species. In addition, the relationship between climatic conditions and local abundance varied among species, which is expected as lineages partition the environment across geographical space. The influence of local habitat quality on species persistence is well documented; however, our results also indicate the importance of climate in regulating population sizes across a species geographical range, even in aquatic taxa. PMID:27429769

An Investigation into Why Students from Regional South Australia Choose to Study Business Programs in the Capital City

ERIC Educational Resources Information Center

Sawyer, Janet; Ellis, Bronwyn

2011-01-01

Although Business undergraduate studies are available at the University of South Australia's (UniSA) Centre for Regional Engagement (CRE), both at the Whyalla Campus and the Mount Gambier Regional Centre (MGRC), many students from regional South Australia choose to undertake Business degrees in Adelaide, the state capital, rather than locally.…

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems.

PubMed

Olivier de Sardan, Jean-Pierre; Diarra, Aïssa; Koné, Félix Yaouaga; Yaogo, Maurice; Zerbo, Roger

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed.

[The behavioral determinants for health centers in health districts of urban Africa: results of a survey of households in Kinshasa, Congo].

PubMed

Manzambi, J K; Tellier, V; Bertrand, F; Albert, A; Reginster, J Y; Van Balen, E H

2000-08-01

This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P = 0.05) when looking for quality care, reasonable prices and the availability of varied services. On the other hand, concern about the geographical proximity in relation to the family's residence calls for using the private dispensary. When looking for a doctor or the existence of a 'convention', families are more inclined to choose a private officially recognized outpatients' clinic. Those who had been looking for a solution to a special type of illness opted primarily for a traditional practitioner. In conclusion, the results of this study show that if people choose the care offered by health centres, it is because they judge it to be of good quality. The integrated care offered by the same technician, with a required training, is a major asset in the acceptability of the first line of primary health care in Kinshasa. This study suggests that it would no doubt be beneficial to integrate non-official private care structures into the primary health care system, as far as it is possible for them to achieve a level of quality comparable to that of the health centres. In order that the traditional practitioner might play an important complementary role in the realization of primary health care, even in urban areas, the possibility of promoting sites of communication should be studied. Moreover, considering the weak buying power of the city's inhabitants and the previous existence of tontines out of solidarity, the 'conventions' providing relief of health care costs, under the leadership of the local communities, should be integrated into the organization of the urban health system.

Turnaround in an aged persons' mental health service in crisis: a case study of organisational renewal.

PubMed

Stafrace, Simon; Lilly, Alan

2008-08-01

This case study demonstrates how leadership was harnessed to turn around a decline in the performance of an aged persons' mental health service - the Namarra Nursing Home at Caulfield General Medical Centre in Melbourne, Australia. In 2000 the nursing home faced a crisis of public confidence due to failings in the management of quality, clinical risk and human resources within the service. These problems reflected structural and operational shortcomings in the clinical directorate and wider organisation. In this article, we detail the process of turnaround from the perspective of senior executive managers with professional and operational responsibility for the service. This turnaround required attention to local clinical accountability and transformation of the mental health program from a collocated but operationally isolated service to one integrated within the governance structures of the auspicing organisation.

Correlations of charge neutrality level with electronic structure and p-d hybridization

PubMed Central

Das, Arkaprava; Gautam, Subodh K.; Shukla, D. K.; Singh, Fouran

2017-01-01

The formation of charge neutrality level (CNL) in highly conducting Cadmium oxide (CdO) thin films is demonstarted by the observed variation in the band gap upon annealing and doping. It may be explained by the observation that Tin (Sn) doping breaks the perfect periodicity of CdO cubic crystal structure and creates virtual gap states (ViGS). The level of local CNL resides at the branch point of ViGS, making the energy at which native defect’s character changes from predominantly donor-like below CNL to predominantly acceptor-like above the CNL and a schematic band diagram is developed to substantiate the same. Further investigations using soft x-ray absorption spectroscopy (SXAS) at Oxygen and Cadmium edges show the reduction of Sn4+ to Sn2+. The analysis of the spectral features has revealed an evidence of p-d interaction between O 2p and Cd 4d orbitals that pushes the valence band minima at higher energies which is symmetry forbidden at г point and causing a positive valance band dispersion away from the zone centre in the г ~ L, K direction. Thus, origin of the CNL is attributed to the high density of the Oxygen vacancies as confirmed by the change in the local electronic structure and p-d hybridization of orbitals. PMID:28102312

Correlations of charge neutrality level with electronic structure and p-d hybridization

NASA Astrophysics Data System (ADS)

Das, Arkaprava; Gautam, Subodh K.; Shukla, D. K.; Singh, Fouran

2017-01-01

The formation of charge neutrality level (CNL) in highly conducting Cadmium oxide (CdO) thin films is demonstarted by the observed variation in the band gap upon annealing and doping. It may be explained by the observation that Tin (Sn) doping breaks the perfect periodicity of CdO cubic crystal structure and creates virtual gap states (ViGS). The level of local CNL resides at the branch point of ViGS, making the energy at which native defect’s character changes from predominantly donor-like below CNL to predominantly acceptor-like above the CNL and a schematic band diagram is developed to substantiate the same. Further investigations using soft x-ray absorption spectroscopy (SXAS) at Oxygen and Cadmium edges show the reduction of Sn4+ to Sn2+. The analysis of the spectral features has revealed an evidence of p-d interaction between O 2p and Cd 4d orbitals that pushes the valence band minima at higher energies which is symmetry forbidden at г point and causing a positive valance band dispersion away from the zone centre in the г ~ L, K direction. Thus, origin of the CNL is attributed to the high density of the Oxygen vacancies as confirmed by the change in the local electronic structure and p-d hybridization of orbitals.

A canonical stability-elasticity relationship verified for one million face-centred-cubic structures.

PubMed

Maisel, Sascha B; Höfler, Michaela; Müller, Stefan

2012-11-29

Any thermodynamically stable or metastable phase corresponds to a local minimum of a potentially very complicated energy landscape. But however complex the crystal might be, this energy landscape is of parabolic shape near its minima. Roughly speaking, the depth of this energy well with respect to some reference level determines the thermodynamic stability of the system, and the steepness of the parabola near its minimum determines the system's elastic properties. Although changing alloying elements and their concentrations in a given material to enhance certain properties dates back to the Bronze Age, the systematic search for desirable properties in metastable atomic configurations at a fixed stoichiometry is a very recent tool in materials design. Here we demonstrate, using first-principles studies of four binary alloy systems, that the elastic properties of face-centred-cubic intermetallic compounds obey certain rules. We reach two conclusions based on calculations on a huge subset of the face-centred-cubic configuration space. First, the stiffness and the heat of formation are negatively correlated with a nearly constant Spearman correlation for all concentrations. Second, the averaged stiffness of metastable configurations at a fixed concentration decays linearly with their distance to the ground-state line (the phase diagram of an alloy at zero Kelvin). We hope that our methods will help to simplify the quest for new materials with optimal properties from the vast configuration space available.

Muonium as a model for interstitial hydrogen in the semiconducting and semimetallic elements

NASA Astrophysics Data System (ADS)

Cox, S. F. J.

2009-11-01

Although the interstitial hydrogen atom would seem to be one of the simplest defect centres in any lattice, its solid state chemistry is in fact unknown in many materials, not least amongst the elements. In semiconductors, the realization that hydrogen can profoundly influence electronic properties even as a trace impurity has prompted its study by all available means—but still only in the functionally important or potentially important materials—for the elements, Si, Ge and diamond. Even here, it was not studies of hydrogen itself but of its pseudo-isotope, muonium, that first provided the much needed microscopic pictures of crystallographic site and local electronic structure—now comprehensively confirmed by ab initio computation and such data as exists for monatomic, interstitial hydrogen centres in Si. Muonium can be formed in a variety of neutral paramagnetic states when positive muons are implanted into non-metals. The simple trapped atom is commonly only metastable. It coexists with or reacts to give defect centres with the unpaired electron in somewhat more extended orbitals. Indications of complete delocalization into effective mass states are discussed for B, α-Sn, Bi and even Ge, but otherwise all the muonium centres seen in the elemental semiconductors are deep and relatively compact. These are revealed, distinguished and characterized by μSR spectroscopy—muon spin rotation and resonance informing on sites and spin-density distributions, muon spin relaxation on motional dynamics and charge-state transitions. This Report documents the progress of μSR studies for all the semiconductors and semimetals of the p-block elements, Groups III-VI of the Periodic Table. The striking spectra and originally unanticipated results for Group IV are for the most part well known but deserve summarizing and updating; the sheer diversity of muonium states found is still remarkable, especially in carbon allotropes. The interplay of crystallographic site and charge state in Si and Ge at high temperatures, or under illumination, reflects the capture and loss of charge carriers that should model the electrical activity of monatomic hydrogen but still challenges theoretical descriptions. Spin-flip scattering of conduction electrons by the paramagnetic centres is revealed in heavily doped n-type material, as well as some modification of the local electronic structures. The corresponding spectroscopy for the solid elements of Groups III, V and VI is rather less well known and is reviewed here for the first time; a good deal of previously unpublished data is also included. Theoretical expectations and computational modelling are sparse, here. Recent results for B suggest a relatively shallow centre with molecular character; P and As show deeper quasi-atomic states, but still with substantial overlap of spin density onto surrounding host atoms. Particular attention is paid to the chalcogens. Muonium centres in Te show charge-state transitions already around room temperature; the identification of those in S and Se has been complicated by unusual spin dynamics of a different character, here attributed to spin-orbit coupling and interstitial reorientation. In the metals and semimetals, muonium is not formed as a paramagnetic centre. Here the implanted muons mimic interstital protons and interest shifts to a variety of other topics, including aspects of charge screening (α-Sn, Sb, Bi), site preference and quantum mobility (Al, β-Sn, Pb). The post-transition metals receive only a brief mention, by way of contrast with the nonmetals. Systematic studies of local susceptibility via measurements of muon Knight shifts extends in favourable cases to revealing the elusive high-field Condon domains (Al, Sn, Pb, Bi). Some new information is available on the superconducting phases. Appendices include a derivation of the spin Hamiltonian for paramagnetic muonium centres or molecular radicals having varying admixtures of orbital angular momentum, including the extreme case of orbital degeneracy, and examine the consequences of significant spin-orbit coupling for μSR spectroscopy and muon spin relaxation. This is the framework for the tentative assignments made here for the muonium defect centres formed in sulphur and selenium, namely diatomic species resembling the chalcogen monohydrides. Equally, it provides guidelines for eventual solid-state detection of OMu—the elusive muoniated hydroxyl radical.

Subjective parameters markedly limit the referral of transplantation candidates to liver transplant centres.

PubMed

Vidal-Trécan, Gwenaëlle; Kone, Victoria; Pilette, Christophe; Nousbaum, Jean-Baptiste; Doll, Jacques; Buffet, Catherine; Eugene, Claude; Podevin, Philippe; Boutet, Olivier; Puyeo, Jacques; Conti, Filomena; Calmus, Yvon

2016-04-01

Equality of access to organ transplantation is a mandatory public health requirement. Referral from a local to a university hospital and then registration on the national waiting list are the two key steps enabling access to liver transplantation (LT). Although the latter procedure is well defined using the Model for End-stage Liver Disease score that improves equality of access, the former is mostly reliant on the practices of referring physicians. The aim of this study was to clarify the factors determining this initial step. This observational study included consecutive inpatients with cirrhosis of whatever origin in a cohort constituted between 2003 and 2008, using medical records and structured questionnaires concerning patient characteristics and the opinions of hospital clinicians. Candidates for LT were defined in line with these opinions. Four hundred and thirty-three patients, mostly affected by alcoholic cirrhosis, were included, 21.0% of whom were considered to be candidates for LT. Factors independently associated with their candidature were: physician empathy [odds ratio (OR) = 10.8; 95% CI: 4.0-29.5], adherence to treatment (OR = 16.6; 95% CI: 3.7-75.2), geographical area (OR = 6.8; 95% CI: 2.2-21.3) and the patient's physiological age (OR = 2.3; 95% CI: 1.1-4.7). Several subjective markers restrict the referral of patients from local hospitals to liver transplant centres. Their advancement to this second step is thus markedly weakened by initial subjectivity. The development of objective guidelines for local hospital physicians to assist them with their initial decision-making on LT is now necessary. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bifurcations and degenerate periodic points in a three dimensional chaotic fluid flow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, L. D., E-mail: lachlan.smith@monash.edu; CSIRO Mineral Resources, Clayton, Victoria 3800; Rudman, M.

2016-05-15

Analysis of the periodic points of a conservative periodic dynamical system uncovers the basic kinematic structure of the transport dynamics and identifies regions of local stability or chaos. While elliptic and hyperbolic points typically govern such behaviour in 3D systems, degenerate (parabolic) points also play an important role. These points represent a bifurcation in local stability and Lagrangian topology. In this study, we consider the ramifications of the two types of degenerate periodic points that occur in a model 3D fluid flow. (1) Period-tripling bifurcations occur when the local rotation angle associated with elliptic points is reversed, creating a reversalmore » in the orientation of associated Lagrangian structures. Even though a single unstable point is created, the bifurcation in local stability has a large influence on local transport and the global arrangement of manifolds as the unstable degenerate point has three stable and three unstable directions, similar to hyperbolic points, and occurs at the intersection of three hyperbolic periodic lines. The presence of period-tripling bifurcation points indicates regions of both chaos and confinement, with the extent of each depending on the nature of the associated manifold intersections. (2) The second type of bifurcation occurs when periodic lines become tangent to local or global invariant surfaces. This bifurcation creates both saddle–centre bifurcations which can create both chaotic and stable regions, and period-doubling bifurcations which are a common route to chaos in 2D systems. We provide conditions for the occurrence of these tangent bifurcations in 3D conservative systems, as well as constraints on the possible types of tangent bifurcation that can occur based on topological considerations.« less

A scalable architecture for online anomaly detection of WLCG batch jobs

NASA Astrophysics Data System (ADS)

Kuehn, E.; Fischer, M.; Giffels, M.; Jung, C.; Petzold, A.

2016-10-01

For data centres it is increasingly important to monitor the network usage, and learn from network usage patterns. Especially configuration issues or misbehaving batch jobs preventing a smooth operation need to be detected as early as possible. At the GridKa data and computing centre we therefore operate a tool BPNetMon for monitoring traffic data and characteristics of WLCG batch jobs and pilots locally on different worker nodes. On the one hand local information itself are not sufficient to detect anomalies for several reasons, e.g. the underlying job distribution on a single worker node might change or there might be a local misconfiguration. On the other hand a centralised anomaly detection approach does not scale regarding network communication as well as computational costs. We therefore propose a scalable architecture based on concepts of a super-peer network.

The obtaining relative position of lunar centre masses and centre of the figure in selenocentric catalogues

NASA Astrophysics Data System (ADS)

Nefedjev, Yu. A.; Valeev, S. G.; Rizvanov, N. G.; Mikeev, R. R.; Varaksina, N. Yu.

2010-05-01

The relative position of lunar center masses relative to center of the figure in Kazan and Kiev selenocentric catalogues was customized. The expansions by spherical harmonics N=5 degree and order of the lunar function h(λ, β) with using the package ASNI USTU were executed. Module of the expansion of the local area to surfaces to full sphere was used. The parameters of cosmic missions are given for comparison (SAI; Bills, Ferrari). The normalized coefficients from expansions for eight sources hypsometric information are obtained: - Clementine (N=40), - Kazan (N=5), - Kiev (N=5), - SAI (N=10; Chuikova (1975)), - Bills, Ferrari, - Каguуа (Selena, Japan mission), - ULCN (The Uuified Lunaz Control Network 2005). The displacements of the lunar centre figure relative to lunar centre of the masses were defined from equations (Chuikova (1975)). The results of the obtaining relative position of the lunar centre masses and centre of the figure in Kazan selenocentric catalogue give good agreement with modern cosmic mission data.

C2-C6 background hydrocarbon concentrations monitored at a roof top and green park site, in Dublin City centre.

PubMed

O'Donoghue, R T; Broderick, B M

2007-09-01

A 5 week monitoring campaign was carried out in Dublin City centre, to establish which site gave a more accurate background city centre estimation: a roof-top or green field site. This background represented a conservative estimate of HC exposure in Dublin City centre, useful for quantifying health effects related to this form of pollution and also for establishing a local background relative to the four surrounding main roads when the wind direction is travelling towards each road with the background receptor upwind. Over the entire monitoring campaign, the lowest concentrations and relative standard deviations were observed at the green field site, regardless of time of day or meteorological effects.

Locally infiltrative inflammatory fibroid polyp of the ileum: report of a case showing transmural proliferation.

PubMed

Tajima, Shogo; Koda, Kenji

2016-06-10

Morphologically, an inflammatory fibroid polyp (IFP) is usually centred in the submucosa. Extension of an IFP to the subserosa with destruction of the muscularis propria is exceedingly rare. Herein, we describe a 70-year-old woman who presented with right lower abdominal pain but was finally diagnosed with an IFP. Contrast-enhanced computed tomography revealed a target-like structure with a hypovascular mass at the leading edge, which was consistent with intussusception due to a tumour. Following surgery, the resected specimen displayed a mass measuring 4 × 3 × 3 cm that was protruding into the lumen. Microscopically, the mass was centred in the submucosa, extending up to the mucosal surface and down to the subserosa and serosa. The muscularis mucosae and muscularis propria were destroyed focally. A PDGFRA gene mutation in exon 2 (1837_1851 del) that was found in this case, as well as a highly infiltrative growth pattern, strongly supported the neoplastic nature of IFP. © The Author(s) 2016. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University.

Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study

PubMed Central

Leung, Angela Yee Man; Bo, Ai; Hsiao, Hsin-Yi; Wang, Song Song; Chi, Iris

2014-01-01

Objectives To investigate why first-generation Chinese immigrants with diabetes have difficulty obtaining, processing and understanding diabetes related information despite the existence of translated materials and translators. Design This qualitative study employed purposive sampling. Six focus groups and two individual interviews were conducted. Each group discussion lasted approximately 90 min and was guided by semistructured and open-ended questions. Setting Data were collected in two community health centres and one elderly retirement village in Los Angeles, California. Participants 29 Chinese immigrants aged ≥45 years and diagnosed with type 2 diabetes for at least 1 year. Results Eight key themes were found to potentially affect Chinese immigrants' capacity to obtain, communicate, process and understand diabetes related health information and consequently alter their decision making in self-care. Among the themes, three major categories emerged: cultural factors, structural barriers, and personal barriers. Conclusions Findings highlight the importance of cultural sensitivity when working with first-generation Chinese immigrants with diabetes. Implications for health professionals, local community centres and other potential service providers are discussed. PMID:25406155

Desert rose: building material of cupolas in the Souf in Algeria

NASA Astrophysics Data System (ADS)

Azil, C.; Djebri, B.; Rovero, L.

2018-05-01

In the Souf of Algeria, the roofs of all constructions are arranged like corbelled domes, built with local particular material to this region, which is the desert rose. These cupolas describe a unique landscape of historic centres. Such constructions include a widespread and precious heritage that deserves protection to save this urban landscape which constitutes an element of identity of heritage built upon the material as well as the immaterial of the local know-how. Unfortunately, these architectural elements have undergone alterations that devalue the urban landscape and destabilize the buildings. However, the structural system that provides stability and endurance to this day remains an open question. In this, paper, we describe the role of desert rose cupolas in the construction of a single urban landscape and we contribute to this knowledge. Then, we explain the role of the availability of the materials locals (desert rose and tafza) to appearance ad emergence of construction with cupolas typology. In addition, we describe these materials locals, and the method to them usage. In the end, we have traced the process of construction of these cupolas by corbelling which is mounted by successive courses of the desert rose and the plaster mortar.

PMD2HD--a web tool aligning a PubMed search results page with the local German Cancer Research Centre library collection.

PubMed

Bohne-Lang, Andreas; Lang, Elke; Taube, Anke

2005-06-27

Web-based searching is the accepted contemporary mode of retrieving relevant literature, and retrieving as many full text articles as possible is a typical prerequisite for research success. In most cases only a proportion of references will be directly accessible as digital reprints through displayed links. A large number of references, however, have to be verified in library catalogues and, depending on their availability, are accessible as print holdings or by interlibrary loan request. The problem of verifying local print holdings from an initial retrieval set of citations can be solved using Z39.50, an ANSI protocol for interactively querying library information systems. Numerous systems include Z39.50 interfaces and therefore can process Z39.50 interactive requests. However, the programmed query interaction command structure is non-intuitive and inaccessible to the average biomedical researcher. For the typical user, it is necessary to implement the protocol within a tool that hides and handles Z39.50 syntax, presenting a comfortable user interface. PMD2HD is a web tool implementing Z39.50 to provide an appropriately functional and usable interface to integrate into the typical workflow that follows an initial PubMed literature search, providing users with an immediate asset to assist in the most tedious step in literature retrieval, checking for subscription holdings against a local online catalogue. PMD2HD can facilitate literature access considerably with respect to the time and cost of manual comparisons of search results with local catalogue holdings. The example presented in this article is related to the library system and collections of the German Cancer Research Centre. However, the PMD2HD software architecture and use of common Z39.50 protocol commands allow for transfer to a broad range of scientific libraries using Z39.50-compatible library information systems.

Population level usage of health services, and HIV testing and care, prior to decentralization of antiretroviral therapy in Agago District in rural Northern Uganda.

PubMed

Abongomera, G; Kiwuwa-Muyingo, S; Revill, P; Chiwaula, L; Mabugu, T; Phillips, A; Katabira, E; Musiime, V; Gilks, C; Chan, A; Hakim, J; Colebunders, R; Kityo, C; Gibb, D M; Seeley, J; Ford, D

2015-11-28

Decentralization of ART services scaled up significantly with the country wide roll out of option B plus in Uganda. Little work has been undertaken to examine population level access to HIV care particularly in hard to reach areas in rural Africa. Most work on ART scale up has been done at health facility level which omits people not accessing healthcare in the community. This study describes health service usage, particularly HIV testing and care in 2/6 parishes of Lapono sub-county of northern Uganda, prior to introduction of ART services in Lira Kato Health Centre (a local lower-level health centre III), as part of ART decentralization. Household and individual questionnaires were administered to household members (aged 15-59 years). Logit random effects models were used to test for differences in proportions (allowing for clustering within villages). 2124 adults from 1351 households were interviewed (755 [36%] males, 1369 [64 %] females). 2051 (97%) participants reported seeking care locally for fever, most on foot and over half at Lira Kato Health Centre. 574 (76%) men and 1156 (84%) women reported ever-testing for HIV (P < 0.001 for difference); 34/574 (6%) men and 102/1156 (9%) women reported testing positive (P = 0.04). 818/850 (96%) women who had given birth in the last 5 years had attended antenatal care in their last pregnancy: 7 women were already diagnosed with HIV (3 on ART) and 790 (97%) reported being tested for HIV (34 tested newly positive). 124/136 (91%) HIV-positive adults were in HIV-care, 123/136 (90 %) were taking cotrimoxazole and 74/136 (54%) were on ART. Of adults in HIV-care, most were seen at Kalongo hospital (n = 87), Patongo Health Centre (n = 7) or Lira Kato Health Centre (n = 23; no ART services). 58/87, 5/7 and 20/23 individuals walked to Kalongo hospital (56 km round-trip, District Health Office information), Patongo Health Centre (76 km round-trip, District Health Office information) and Lira Kato Health Centre (local) respectively. 8 HIV-infected children were reported; only 2 were diagnosed aged <24 months: 7/8 were in HIV-care including 3 on ART. Higher proportions of women compared to men reported ever-testing for HIV and testing HIV-positive, similar to other surveys. HIV-infected men and women travelled considerable distances for ART services. Children appeared to be under-accessing testing and referral for treatment. Decentralization of ART services to a local health facility would decrease travel time and transport costs, making care and treatment more easily accessible.

A Foreign Model of Teacher Education and Its Local Appropriation: The English Teachers' Centres in Spain

ERIC Educational Resources Information Center

Groves, Tamar

2015-01-01

This article explores the implementation of the English model of teachers' centres in the context of 1980s Spain. Originally it was a top-down plan initiated by a national government. However, from the very beginning its fate was dependent on a bottom-up educational project carried out by pedagogical social movements. The first part of the article…

"Building the Natural Society of the Future": The Peckham Experiment (1943) as an Anarchist Account of Childhood and Education

ERIC Educational Resources Information Center

Charkin, Emily

2014-01-01

"The Peckham Experiment" (Innes H. Pearse and Lucy H. Crocker, Edinburgh: Scottish Academic Press, 1985) is a book about the Peckham Health Centre (1935-1950), which was a scientific experiment and community centre set up to identify and foster conditions of good health for local working-class families in South London. The book was…

Transforming Readers: Teachers and Children in the Centre for Literacy in Primary Education Power of Reading Project

ERIC Educational Resources Information Center

O'Sullivan, Olivia; McGonigle, Sue

2010-01-01

This paper presents findings from a national project in England, The Power of Reading (Centre for Literacy in Primary Education), which has involved to date 41 projects over 5 years, in 16 Local Authorities nationally, with 900 schools and 1,350 teachers. The paper presents findings for the first 4 years. Our data demonstrate how professional…

[Census of the renal and dialysis units by Italian Society of Nephrology: structure and organization for renal patient assistance in Italy (2014-2015)].

PubMed

Quintaliani, Giuseppe; Di Luca, Marina; Di Napoli, Anteo; Viglino, Giusto; Postorino, Maurizio; Amore, Alessandro; Andrulli, Simeone; Bellasi, Antonio; Brunori, Giuliano; Buongiorno, Erasmo; Castellino, Santina; D'Amelio, Alessandro; De Nicola, Luca; Gesualdo, Loreto; Di Landro, Domenico; Feriozzi, Sandro; Strippoli, Giovanni; Teatini, Ugo; Santoro, Antonio

2016-01-01

Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted a census of the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to the year 2014. An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit. 615 renal units were identified. From these 615 units, 332 were public renal centres (of which 318 centres answered to the census) and 283 were private dialysis centres (of which 113 centres answered to the census). The results show 6 public renal units pmp. Renal biopsies were 4624 (81 pmp). The nephrology beds are about 41 pmp. There are 7.304 nurses working in HD wards, 1.692 in the nephrology wards and only 613 for outpatients clinics. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.

Retrofitting the suburbs to increase walking: evidence from a land-use-travel study.

PubMed

Boarnet, Marlon G; Joh, Kenneth; Siembab, Walter; Fulton, William; Nguyen, Mai Thi

2011-01-01

This paper reports results from a detailed travel diary survey of 2125 residents in the South Bay area of Los Angeles County - a mature, auto-oriented suburban region. Study areas were divided into four centres, typical of compact development or smart growth, and four linear, auto-oriented corridors. Results show substantial variation in the amount of walking across study areas. Trips are shorter and more likely to be via walking in centres. A key to the centres' increased walking travel is the concentration of local shopping and service destinations in a commercial core. Yet the amount of business concentration that is associated with highly pedestrian-oriented neighbourhoods is from three to four times as large as what can be supported by the local resident base, suggesting that pedestrian-oriented neighbourhoods necessarily import shopping trips, and hence driving trips, from larger surrounding catchment areas. The results suggest both land use and mobility strategies that can be appropriate for suburban regions.

The methodology for defining the European Standards for the certification of Haemophilia Centres in Europe

PubMed Central

Candura, Fabio; Menichini, Ivana; Calizzani, Gabriele; Giangrande, Paul; Mannucci, Pier Mannuccio; Makris, Michael

2014-01-01

Introduction Work Package 4 Development of the standardisation criteria of the European Haemophilia Network project has the main objective of implementing a common and shared European strategy for a certification system for two levels of Haemophilia Centres: European Haemophilia Treatment Centres and European Haemophilia Comprehensive Care Centres in the Member States of the European Union. Materials and methods An inclusive and participatory process for developing shared standards and criteria for the management of patients with inherited bleeding disorders has been carried out. The process has been implemented through four different consultation events involving the entire European community of stakeholders that significantly contributed in the drafting of the European Guidelines for the certification of Haemophilia Centres. Results The Guidelines set the standards for the designation of centres that provide specialised and multidisciplinary care (Haemophilia Comprehensive Care Centres) as well as local routine care (Haemophilia Treatment Centres). Standards cover several issues such as: general requirements; patient care; advisory services; laboratory; networking of clinical and specialised services. Conclusions The drafting of the European Guidelines for the certification of Haemophilia Centres was performed adopting a rigorous methodological approach. In order to build the widest possible consensus to the quality standards, the main institutional and scientific stakeholders have been involved. The resulting document will significantly contribute in promoting standardisation in the quality of diagnosis and treatment in European Haemophilia Centres. PMID:24922292

Initiating head development in mouse embryos: integrating signalling and transcriptional activity.

PubMed

Arkell, Ruth M; Tam, Patrick P L

2012-03-01

The generation of an embryonic body plan is the outcome of inductive interactions between the progenitor tissues that underpin their specification, regionalization and morphogenesis. The intercellular signalling activity driving these processes is deployed in a time- and site-specific manner, and the signal strength must be precisely controlled. Receptor and ligand functions are modulated by secreted antagonists to impose a dynamic pattern of globally controlled and locally graded signals onto the tissues of early post-implantation mouse embryo. In response to the WNT, Nodal and Bone Morphogenetic Protein (BMP) signalling cascades, the embryo acquires its body plan, which manifests as differences in the developmental fate of cells located at different positions in the anterior-posterior body axis. The initial formation of the anterior (head) structures in the mouse embryo is critically dependent on the morphogenetic activity emanating from two signalling centres that are juxtaposed with the progenitor tissues of the head. A common property of these centres is that they are the source of antagonistic factors and the hub of transcriptional activities that negatively modulate the function of WNT, Nodal and BMP signalling cascades. These events generate the scaffold of the embryonic head by the early-somite stage of development. Beyond this, additional tissue interactions continue to support the growth, regionalization, differentiation and morphogenesis required for the elaboration of the structure recognizable as the embryonic head.

Single 23S rRNA mutations at the ribosomal peptidyl transferase centre confer resistance to valnemulin and other antibiotics in Mycobacterium smegmatis by perturbation of the drug binding pocket.

PubMed

Long, Katherine S; Poehlsgaard, Jacob; Hansen, Lykke H; Hobbie, Sven N; Böttger, Erik C; Vester, Birte

2009-03-01

Tiamulin and valnemulin target the peptidyl transferase centre (PTC) on the bacterial ribosome. They are used in veterinary medicine to treat infections caused by a variety of bacterial pathogens, including the intestinal spirochetes Brachyspira spp. Mutations in ribosomal protein L3 and 23S rRNA have previously been associated with tiamulin resistance in Brachyspira spp. isolates, but as multiple mutations were isolated together, the roles of the individual mutations are unclear. In this work, individual 23S rRNA mutations associated with pleuromutilin resistance at positions 2055, 2447, 2504 and 2572 (Escherichia coli numbering) are introduced into a Mycobacterium smegmatis strain with a single rRNA operon. The single mutations each confer a significant and similar degree of valnemulin resistance and those at 2447 and 2504 also confer cross-resistance to other antibiotics that bind to the PTC in M. smegmatis. Antibiotic footprinting experiments on mutant ribosomes show that the introduced mutations cause structural perturbations at the PTC and reduced binding of pleuromutilin antibiotics. This work underscores the fact that mutations at nucleotides distant from the pleuromutilin binding site can confer the same level of valnemulin resistance as those at nucleotides abutting the bound drug, and suggests that the former function indirectly by altering local structure and flexibility at the drug binding pocket.

Neoadjuvant/adjuvant treatment of high-risk retinoblastoma: a report from the German Retinoblastoma Referral Centre.

PubMed

Künkele, Annette; Wilm, Josephine; Holdt, Markus; Lohmann, Dietmar; Bornfeld, Norbert; Eggert, Angelika; Temming, Petra; Schulte, Johannes H

2015-07-01

Retinoblastoma can extend beyond the structures of the eye, where cells can enter the bloodstream and cause metastases. Various types of protocols for adjuvant treatment risk-adapted according to histopathological risk factors are used worldwide. Between 1997 and 2009, 420 children were diagnosed with retinoblastoma at the German Retinoblastoma Referral Centre and risk factors were assessed. Patients with post-laminar optic nerve infiltration or choroid or minor scleral invasion received six courses of adjuvant chemotherapy using vincristine, etoposide, carboplatin and cyclophosphamide (group 1). Patients with microscopic extension beyond the sclera to the resection margin of the optic nerve or potential spread due to vitrectomy received chemotherapy plus orbital radiotherapy (group 2). Neoadjuvant chemotherapy was performed in patients with local extraocular invasion detected on MRI. Following this protocol, 42 of the 420 patients and 21 referred from other centres showed high-risk histopathological factors qualifying for adjuvant therapy (57 in group 1 and 6 in group 2). Seven of the 63 patients received neoadjuvant and adjuvant treatment. During a mean follow-up of 5.8 (range 0.4-15.4) years, one of six patients in group 2 developed metastases and died. No patients died from toxicity. The 5-year overall survival was 100% for group 1 and 80% for group 2. This retrospective single-site study reveals a 10% incidence of high-risk features in children with retinoblastoma diagnosed at the German Retinoblastoma Referral Centre. Overall survival rates of 98.3% underline the safety of this adjuvant chemotherapy protocol and its efficiency in preventing metastasis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effects of closure of an urban level I trauma centre on adjacent hospitals and local injury mortality: a retrospective, observational study.

PubMed

Crandall, Marie; Sharp, Douglas; Wei, Xiong; Nathens, Avery; Hsia, Renee Y

2016-05-10

To determine the association of the Martin Luther King Jr Hospital (MLK) closure on the distribution of admissions on adjacent trauma centres, and injury mortality rates in these centres and within the county. Observational, retrospective study. Non-public patient-level data from the state of California were obtained for all trauma patients from 1999 to 2009. Geospatial analysis was used to visualise the redistribution of trauma patients to other hospitals after MLK closed. Variance of observed to expected injury mortality using multivariate logistic regression was estimated for the study period. A total of 37 131 trauma patients were admitted to the five major south Los Angeles trauma centres from the MLK service area between 1999 and 2009. (1) Number and type of trauma admissions to trauma centres in closest proximity to MLK; (2) inhospital injury mortality of trauma patients after the trauma centre closure. During and after the MLK closure, trauma admissions increased at three of the four nearby hospitals, particularly admissions for gunshot wounds (GSWs). This redistribution of patient load was accompanied by a dramatic change in the payer mix for surrounding hospitals; one hospital's share of uninsured more than tripled from 12.9% in 1999 to 44.6% by 2009. Overall trauma mortality did not significantly change, but GSW mortality steadily and significantly increased after the closure from 5.0% in 2007 to 7.5% in 2009. Though local hospitals experienced a dramatic increase in trauma patient volume, overall mortality for trauma patients did not significantly change after MLK closed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Structure and interstitial iodide migration in hybrid perovskite methylammonium lead iodide

NASA Astrophysics Data System (ADS)

Minns, J. L.; Zajdel, P.; Chernyshov, D.; van Beek, W.; Green, M. A.

2017-05-01

Hybrid perovskites form an emerging family of exceptional light harvesting compounds. However, the mechanism underpinning their photovoltaic effect is still far from understood, which is impeded by a lack of clarity on their structures. Here we show that iodide ions in the methylammonium lead iodide migrate via interstitial sites at temperatures above 280 K. This coincides with temperature dependent static distortions resulting in pseudocubic local symmetry. Based on bond distance analysis, the migrating and distorted iodines are at lengths consistent with the formation of I2 molecules, suggesting a 2I--->I2+2e- redox couple. The actual formula of this compound is thus (CH3NH3)PbI3-2x(I2)x where x~0.007 at room temperature. A crucial feature of the tetragonal structure is that the methylammonium ions do not sit centrally in the A-site cavity, but disordered around two off-centre orientations that facilitate the interstitial ion migration via a gate opening mechanism.

Home or away?

PubMed Central

Zelek, Barbara; Orrantia, Eliseo; Poole, Heather; Strike, Jessica

2007-01-01

OBJECTIVE To investigate the factors that influence women to deliver their babies in small rural communities rather than in larger centres that have more comprehensive obstetric services, including cesarean section capability and epidural anesthesia. DESIGN Self-administered survey. SETTING Marathon, Ont, a rural community of 4500 in north western Ontario that offers low-risk obstetric services and has no local cesarean section capability. The closest referral centre, Thunder Bay, is 300 km away. PARTICIPANTS Sixty-four women between 16 and 40 years old living in Marathon. MAIN OUTCOME MEASURES The relative importance of personal and systemic factors and of beliefs that influence women to choose to give birth in Marathon ratherthan a larger centre. How well informed women are about local obstetric services. How likely women would be to choose to deliver in Marathon if they had low-risk pregnancies. RESULTS Beliefs were more important than personal and systemic factors in influencing women’s decisions. Respondents were moderately well informed about local obstetric services (mean proportion of correct responses was 66%). Most women with low-risk pregnancies would choose to deliver in Marathon (77.8%). CONCLUSION For women in Marathon, beliefs are much more important than personal and systemic factors in influencing the decision to give birth in this small rural community. PMID:17872613

Stimulated luminescence emission from localized recombination in randomly distributed defects.

PubMed

Jain, Mayank; Guralnik, Benny; Andersen, Martin Thalbitzer

2012-09-26

We present a new kinetic model describing localized electronic recombination through the excited state of the donor (d) to an acceptor (a) centre in luminescent materials. In contrast to the existing models based on the localized transition model (LTM) of Halperin and Braner (1960 Phys. Rev. 117 408-15) which assumes a fixed d → a tunnelling probability for the entire crystal, our model is based on nearest-neighbour recombination within randomly distributed centres. Such a random distribution can occur through the entire volume or within the defect complexes of the dosimeter, and implies that the tunnelling probability varies with the donor-acceptor (d-a) separation distance. We first develop an 'exact kinetic model' that incorporates this variation in tunnelling probabilities, and evolves both in spatial as well as temporal domains. We then develop a simplified one-dimensional, semi-analytical model that evolves only in the temporal domain. An excellent agreement is observed between thermally and optically stimulated luminescence (TL and OSL) results produced from the two models. In comparison to the first-order kinetic behaviour of the LTM of Halperin and Braner (1960 Phys. Rev. 117 408-15), our model results in a highly asymmetric TL peak; this peak can be understood to derive from a continuum of several first-order TL peaks. Our model also shows an extended power law behaviour for OSL (or prompt luminescence), which is expected from localized recombination mechanisms in materials with random distribution of centres.

Training Opportunities and Employee Exhaustion in Call Centres: Mediation by Psychological Contract Fulfilment

ERIC Educational Resources Information Center

Chambel, Maria Jose; Castanheira, Filipa

2012-01-01

The aim of this study is to analyse psychological contract fulfilment as a mechanism through which training affects stress in call centres. The hypotheses were tested on a sample of 412 call centre operators, using structural equation modelling to analyse their survey responses. Our results demonstrated that training is negatively related to…

Regional Workshop on Strengthening Linkages and Networks through Community Learning Centres (CLCs) (Bandung, Indonesia, September 5-9, 2005)

ERIC Educational Resources Information Center

Online Submission, 2006

2006-01-01

The Community Learning Centre (CLC) Project has been carried out since 1998 within the framework of the Asia Pacific Program of Education for All (APPEAL). CLC is a multi-purpose learning center that serves as a local venue for adults, youth and children to engage in all kinds of learning. After a few years' implementation, some countries have…

Re-Engaging 'Youth at Risk' of Disengaging from Schooling through Rugby League Club Partnership: Unpacking the Pedagogic Practices of the Titans Learning Centre

ERIC Educational Resources Information Center

Whatman, Susan L.; Main, Katherine

2018-01-01

The youth learning re-engagement program known as the Titans Learning Centre (or TLC) is an approved alternative schooling program, developed in partnership with state education and a local National Rugby League (NRL) club, the 'Titans'. Students typically in Grade Three or Four complete a 10 week program, interacting with professional A grade NRL…

The ESFRI Instruct Core Centre Frankfurt: automated high-throughput crystallization suited for membrane proteins and more.

PubMed

Thielmann, Yvonne; Koepke, Juergen; Michel, Hartmut

2012-06-01

Structure determination of membrane proteins and membrane protein complexes is still a very challenging field. To facilitate the work on membrane proteins the Core Centre follows a strategy that comprises four labs of protein analytics and crystal handling, covering mass spectrometry, calorimetry, crystallization and X-ray diffraction. This general workflow is presented and a capacity of 20% of the operating time of all systems is provided to the European structural biology community within the ESFRI Instruct program. A description of the crystallization service offered at the Core Centre is given with detailed information on screening strategy, screens used and changes to adapt high throughput for membrane proteins. Our aim is to constantly develop the Core Centre towards the usage of more efficient methods. This strategy might also include the ability to automate all steps from crystallization trials to crystal screening; here we look ahead how this aim might be realized at the Core Centre.

Centring and Marginalizing: The "Soft Middle" and Japanese Minority Education

ERIC Educational Resources Information Center

Bondy, Christopher

2014-01-01

Examining the gap between national level minority education policies and local implementation in Japan, this paper considers this gap as a "soft middle" whereby local communities and schools have considerable leeway in how they implement policies. In particular, this paper focuses on Japan's largest minority group, the…

The Philippine Department of Education: Challenges of Policy Implementation amidst Corruption

ERIC Educational Resources Information Center

Reyes, Vicente Chua

2010-01-01

This inquiry interrogates the experiences of local implementation actors of the Philippine Department of Education as they navigate through reform efforts within systemic corruption. Departing from dominant analytical paradigms centred on patron-client frameworks, the article introduces the typology of complex linkages where local actors play…

Competitiveness of Romanian Regions in the Spatial Structure of the EU

NASA Astrophysics Data System (ADS)

Török, Ibolya

2017-12-01

In the last years, in order to enhance the competitiveness of the regions, researchers and decision makers alike attribute a special role to supporting entrepreneurial activity, strengthening the SME sector, attracting foreign working capital into the local economy, but also to the territorial concentration of R&D centres. Within the present study, I have considered all relevant economic factors, which might influence competitiveness, having at the same time an impact on the position of the Romanian regions within in the economic structure of the European Union. In the study have managed to prove that Romania is in a rather disadvantaged situation in the case of the three main elements, with a significant impact on the competitiveness of regions: the GDP per capita, the employment rate and labour productivity. Only the Bucharest-Ilfov region is in a more favourable position, but its development level remains far behind the central regions of the EU.

Standard requirements for GCP-compliant data management in multinational clinical trials

PubMed Central

2011-01-01

Background A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials. Methods International, European and national regulations and guidelines relevant to GCP, data security and IT infrastructures, as well as ECRIN documents produced previously, were evaluated to provide a starting point for the development of standard requirements. The requirements were produced by expert consensus of the ECRIN Working group on Data Centres, using a structured and standardised process. The requirements were divided into two main parts: an IT part covering standards for the underlying IT infrastructure and computer systems in general, and a Data Management (DM) part covering requirements for data management applications in clinical trials. Results The standard developed includes 115 IT requirements, split into 15 separate sections, 107 DM requirements (in 12 sections) and 13 other requirements (2 sections). Sections IT01 to IT05 deal with the basic IT infrastructure while IT06 and IT07 cover validation and local software development. IT08 to IT015 concern the aspects of IT systems that directly support clinical trial management. Sections DM01 to DM03 cover the implementation of a specific clinical data management application, i.e. for a specific trial, whilst DM04 to DM12 address the data management of trials across the unit. Section IN01 is dedicated to international aspects and ST01 to the competence of a trials unit's staff. Conclusions The standard is intended to provide an open and widely used set of requirements for GCP-compliant data management, particularly in academic trial units. It is the intention that ECRIN will use these requirements as the basis for the certification of ECRIN data centres. PMID:21426576

Review of paediatric cardiology services in district general hospitals in the United Kingdom.

PubMed

Andrews, Hannah; Singh, Yogen

2016-03-01

Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

Research on the development of space target detecting system and three-dimensional reconstruction technology

NASA Astrophysics Data System (ADS)

Li, Dong; Wei, Zhen; Song, Dawei; Sun, Wenfeng; Fan, Xiaoyan

2016-11-01

With the development of space technology, the number of spacecrafts and debris are increasing year by year. The demand for detecting and identification of spacecraft is growing strongly, which provides support to the cataloguing, crash warning and protection of aerospace vehicles. The majority of existing approaches for three-dimensional reconstruction is scattering centres correlation, which is based on the radar high resolution range profile (HRRP). This paper proposes a novel method to reconstruct the threedimensional scattering centre structure of target from a sequence of radar ISAR images, which mainly consists of three steps. First is the azimuth scaling of consecutive ISAR images based on fractional Fourier transform (FrFT). The later is the extraction of scattering centres and matching between adjacent ISAR images using grid method. Finally, according to the coordinate matrix of scattering centres, the three-dimensional scattering centre structure is reconstructed using improved factorization method. The three-dimensional structure is featured with stable and intuitive characteristic, which provides a new way to improve the identification probability and reduce the complexity of the model matching library. A satellite model is reconstructed using the proposed method from four consecutive ISAR images. The simulation results prove that the method has gotten a satisfied consistency and accuracy.

Luminescence and ESR studies of relationships between O(-)-centres and structural iron in natural and synthetically hydrated kaolinites

NASA Technical Reports Server (NTRS)

Coyne, L. M.; Costanzo, P. M.; Theng, B. K.

1989-01-01

Luminescence, induced by dehydration and by wetting with hydrazine and unsymmetrically substituted hydrazine, and related ESR spectra have been observed from several kaolinites, synthetically hydrated kaolinites, and metahalloysites. The amine-wetting luminescence results suggest that intercalation, not a chemiluminescence reaction, is the luminescence trigger. Correlation between hydration-induced luminescence and g = 2 ESR signals associated with O(-)-centres in several natural halloysites, and concurrent diminution of the intensity of both these signal types as a function of aging in two 8.4 angstroms synthetically hydrated, kaolinites, confirm a previously-reported relationship between the luminescence induced by dehydration and in the presence of O(-)-centres (holes, i.e., electron vacancies) in the tetrahedral sheet. Furthermore, the ESR spectra of the 8.4 angstroms hydrate showed a concurrent change in the line shape of the g = 4 signal from a shape usually associated with structural Fe in an ordered kaolinite, to a simpler one typically observed in more disordered kaolinite, halloysite, and montmorillonite. Either structural Fe centres and the O(-)-centres interact, or both are subject to factors previously associated with degree of order. The results question the long-term stability of the 8.4 angstroms hydrate, although XRD does not indicate interlayer collapse over this period. Complex inter-relationships are shown between intercalation, stored energy, structural Fe, and the degree of hydration which may be reflected in catalytic as well as spectroscopic properties of the clays.

Together and Alone a Study of Interactions between Toddlers and Childcare Providers during Mealtime in Norwegian Childcare Centres

ERIC Educational Resources Information Center

Klette, Trine; Drugli, May Britt; Aandahl, Ann Mari

2018-01-01

The study investigated the quality of interactions between childcare providers and toddlers during a lunch in childcare centres. Meals in childcare centres are semi-structured adult-led situations where the children not only eat, but are also provided with opportunities for implicit learning and interactions. Participants were 13 toddlers aged…

Evaluation of the Response of the Swedish Healthcare System to the Tsunami Disaster in South East Asia.

PubMed

Lennquist, Sten; Hodgetts, Timothy

2008-10-01

When the tsunami in South East Asia hit the coast of Thailand on December 26, 2004, approximately 20,000 Swedish tourists were in the disaster zone. Of these, 548 died or were lost and more than 1500 were injured. The aim of this study was to evaluate the response of the Swedish health care system to the disaster in terms of assessment and support in the disaster zone, evacuation back to Sweden and continued treatment in Sweden. The evaluation was carried out based on (1) structured questionnaires to the staff of Thai hospitals, injured Swedish citizens and Swedish voluntary workers in the disaster zone; (2) semi-structured interviews with representatives of involved authorities, regional health care centres in Thailand and Sweden, hospital command centres, individuals treated for injuries and volunteer workers involved with supporting the injured; (3) on-site visits in the disaster zone; (4) analysis of reports following the tsunami. A total of 11,000 injured were treated during the first 3 days following the tsunami at the six major hospitals in the Phang Nga, Phuket and Krabi provinces where the majority of the Swedish citizens were primarily taken care of. Of these 11,000, 3000 required hospital admission against a total bed capacity of 1400. Almost 1500 surgical operations were performed during the first 3 days across 33 operating theatres. Thai health care representatives and staff confirmed the requirement for teams from countries with many tourists in the area for practical and psychological support, interpretation, assessment for evacuation and undertaking early evacuation to home nations to release local health care resources. This need was also supported by the injured. Sweden, having the highest number of injured citizens next to the host country, was very late compared to other countries in sending assessment teams to the area and in supplying the needed support. With increased international travelling, many countries today have large numbers of their citizens in other parts of the world. For Sweden, this has been estimated to be 400,000 at any one time, often in areas known to be risk zones for natural disasters and terrorism. This fact of modern-day life demands welldesigned plans to support both citizens in the area and the local health care in several ways: non-medical support by mediating contact between injured and local medical staff, psychological and practical support, support in evacuating own citizens from the area to release local health care and (under specific conditions) medical support. This planning has to include prepared assessment teams that can be rapidly deployed to the scene and a command structure permitting rapid and accurate decisions on a governmental level.

Case Report: Using a Remote Presence Robot to Improve Access to Physical Therapy for People with Chronic Back Disorders in an Underserved Community.

PubMed

Lovo Grona, Stacey; Bath, Brenna; Bustamante, Luis; Mendez, Ivar

2017-01-01

Purpose: The purpose of this case study was to evaluate the delivery of an inter-professional (IP) spinal triage management approach to chronic back disorders using remote presence robotic technology as an innovative form of telerehabilitation in a northern Saskatchewan community. Methods: The IP team, consisting of a local nurse practitioner (NP) and a physical therapist in an urban centre, completed a comprehensive neuromusculoskeletal assessment of, and one follow-up visit with, a post-surgical spinal patient. Treatment included detailed education regarding self-management after spinal surgery, provision and progression of home exercises, and reassurance. The patient was then referred to regional, in-person physical therapy care to complete her treatment. Results: A semi-structured interview with the NP revealed a high level of satisfaction; qualitative themes included the value of IP practice and the benefit to the patient of telerehabilitation achieved through patient-centred care. In a post-treatment survey, the patient expressed a high level of satisfaction with and appreciation for the patient-centred approach and the IP team. Objective clinical improvements in spinal and straight-leg raise movements were noted at the final telerehabilitation session. Conclusion: This report demonstrates the feasibility of delivering IP spinal triage management using telerehabilitation, specifically remote presence robotics, in a remote setting. Further research should include larger scale studies that investigate health, system, and economic outcomes as well as comparative studies for other forms of telehealth technology.

Average and local atomic-scale structure in BaZrxTi(1-x)O3 (x = 0. 10, 0.20, 0.40) ceramics by high-energy x-ray diffraction and Raman spectroscopy.

PubMed

Buscaglia, Vincenzo; Tripathi, Saurabh; Petkov, Valeri; Dapiaggi, Monica; Deluca, Marco; Gajović, Andreja; Ren, Yang

2014-02-12

High-resolution x-ray diffraction (XRD), Raman spectroscopy and total scattering XRD coupled to atomic pair distribution function (PDF) analysis studies of the atomic-scale structure of archetypal BaZrxTi(1-x)O3 (x = 0.10, 0.20, 0.40) ceramics are presented over a wide temperature range (100-450 K). For x = 0.1 and 0.2 the results reveal, well above the Curie temperature, the presence of Ti-rich polar clusters which are precursors of a long-range ferroelectric order observed below TC. Polar nanoregions (PNRs) and relaxor behaviour are observed over the whole temperature range for x = 0.4. Irrespective of ceramic composition, the polar clusters are due to locally correlated off-centre displacement of Zr/Ti cations compatible with local rhombohedral symmetry. Formation of Zr-rich clusters is indicated by Raman spectroscopy for all compositions. Considering the isovalent substitution of Ti with Zr in BaZrxTi1-xO3, the mechanism of formation and growth of the PNRs is not due to charge ordering and random fields, but rather to a reduction of the local strain promoted by the large difference in ion size between Zr(4+) and Ti(4+). As a result, non-polar or weakly polar Zr-rich clusters and polar Ti-rich clusters are randomly distributed in a paraelectric lattice and the long-range ferroelectric order is disrupted with increasing Zr concentration.

Anomaly in the band centre of the one-dimensional Anderson model

NASA Astrophysics Data System (ADS)

Kappus, M.; Wegner, F.

1981-03-01

We calculate the density of states and various characteristic lengths of the one-dimensional Anderson model in the limit of weak disorder. All these quantities show anomalous fluctuations near the band centre. This has already been observed for the density of states in a different model by Gorkov and Dorokhov, and is in close agreement with a Monte-Carlo calculation for the localization length by Czycholl, Kramer and Mac-Kinnon.

Use of a "secure room" and a security guard in the management of the violent, aggressive or suicidal patient in a rural hospital: a 3-year audit.

PubMed

Brock, Gordon; Gurekas, Vydas; Gelinas, Anne-Fredrique; Rollin, Karina

2009-01-01

Little has been published on the management of psychiatric crises in rural areas, and little is known of the security needs or use of "secure rooms" in rural hospitals. We conducted a 3-year retrospective chart audit on the use of our secure room/security guard system at a rural hospital in a town of 3500, located 220 km from our psychiatric referral centre. Use of our secure room/security guard system occurred at the rate of 1.1 uses/1000 emergency department visits, with the most common indication being physician perception of risk of patient suicide or self-harm. Concern for staff safety was a factor in 10% of uses. Eighty percent of patients were treated locally, with most being released from the secure room after 2 days or less. Fourteen percent of patients required ultimate transfer to our psychiatric referral centre and 6% to a detoxification centre. The average annual cost of security was $16 259.61. A secure room can provide the opportunity for close observation of a potentially self-harming patient, additional security for staff and early warning if a patient flees the hospital. Most admissions were handled locally, obviating the need for transfer to distant psychiatric referral centres. Most patients who were admitted were already known as having a psychiatric illness and 80% of the patients required the use of the secure room/security guard system for less than a 2-night stay, suggesting that most rural mental health crises pass quickly. Most patients admitted to a rural hospital with a mental health crisis can be managed locally if an adequate secure room/security guard system is available.

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

PubMed Central

2011-01-01

Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations. PMID:21575159

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: a case study.

PubMed

Pieper, Hans-Olaf; Clerkin, Pauline; MacFarlane, Anne

2011-05-15

Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

[Purchase of local foods for school meals in Andalusia, the Canary Islands and the Principality of Asturias (Spain)].

PubMed

Soares, Panmela; Caballero, Pablo; Davó-Blanes, Mari Carmen

To explore and compare the characteristics of Primary Education Centres (PEC) in Andalusia, the Canary Islands and the Principality of Asturias depending on whether or not they make local food purchases (LFP) for school meals and to explore the opinion of cafeteria managers about the benefits and challenges of this type of purchase. Information on the characteristics of 186 PECs and opinions of cafeteria managers about the benefits/challenges of LFP was collected through an electronic questionnaire. Data were stratified according to how the products were purchased (LFP: yes/no), and the chi square test was applied. 38.2% of the PECs studied make LFP. This is more frequent in rural areas (51.0 with self-managed cafeterias (80.0%), and their own kitchen (65.5%). These centres have less expensive menus than their peers (69.8%), participate more frequently in healthy eating programmes (81.5%) and purchase more organic food products (65.8%). According to the majority of the participants whose centres engage in LFP, the benefits include: supporting the local economy (97.2%), the offer of fresh foods (97.2%) and environmental sustainability (93.0%). The challenges include: productive capacity of the region (50.7%), the seasonal variation in food production (71.8%), and the lack of support (42.3%) and information from the government (46.5%). The location of the centres, the management of the cafeteria and the availability of a kitchen on site can influence the development of LFP in schools. Government support could help to integrate LFP in schools, improving school meals at a lower economic and environmental cost. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

First results of the Nordic and Baltic GNSS Analysis Centre

NASA Astrophysics Data System (ADS)

Lahtinen, Sonja; Pasi, Häkli; Jivall, Lotti; Kempe, Christina; Kollo, Karin; Kosenko, Ksenija; Pihlak, Priit; Prizginiene, Dalia; Tangen, Oddvar; Weber, Mette; Paršeliūnas, Eimuntas; Baniulis, Rimvydas; Galinauskas, Karolis

2018-03-01

The Nordic Geodetic Commission (NKG) has launched a joint NKG GNSS Analysis Centre that aims to routinely produce high qualityGNSS solutions for the common needs of the NKG and the Nordic and Baltic countries. A consistent and densified velocity field is needed for the constraining of the gla-cial isostatic adjustment (GIA) modelling that is a key component of maintaining the national reference frame realisations in the area. We described the methods of the NKG GNSS Analysis Centre including the defined processing setup for the local analysis centres (LAC) and for the combination centres.We analysed the results of the first 2.5 years (2014.5-2016). The results showed that different subnets were consistent with the combined solution within 1-2 mm level. We observed the so called network effect affecting our reference frame alignment. However, the accuracy of the reference frame alignment was on a few millimetre level in the area of the main interest (Nordic and Baltic Countries). TheNKGGNSS AC was declared fully operational in April 2017.

Local configurations and atomic intermixing in as-quenched and annealed Fe1-xCrx and Fe1-xMox ribbons

NASA Astrophysics Data System (ADS)

Stanciu, A. E.; Greculeasa, S. G.; Bartha, C.; Schinteie, G.; Palade, P.; Kuncser, A.; Leca, A.; Filoti, G.; Birsan, A.; Crisan, O.; Kuncser, V.

2018-04-01

Local atomic configuration, phase composition and atomic intermixing in Fe-rich Fe1-xCrx and Fe1-xMox ribbons (x = 0.05, 0.10, 0.15), of potential interest for high-temperature applications and nuclear devices, are investigated in this study in relation to specific processing and annealing routes. The Fe-based thin ribbons have been prepared by induction melting, followed by melt spinning and further annealed in He at temperatures up to 1250 °C. The complex structural, compositional and atomic configuration characterisation has been performed by means of X-ray diffraction (XRD), transmission Mössbauer spectroscopy and differential scanning calorimetry (TG-DSC). The XRD analysis indicates the formation of the desired solid solutions with body-centred cubic (bcc) structure in the as-quenched state. The Mössbauer spectroscopy results have been analysed in terms of the two-shell model. The distribution of Cr/Mo atoms in the first two coordination spheres is not homogeneous, especially after annealing, as supported by the short-range order parameters. In addition, high-temperature annealing treatments give rise to oxidation of Fe (to haematite, maghemite and magnetite) at the surface of the ribbons. Fe1-xCrx alloys are structurally more stable than the Mo counterpart under annealing at 700 °C. Annealing at 1250 °C in He enhances drastically the Cr clustering around Fe nuclei.

The Satah Mountain and Baldface Mountain Volcanic Fields, Chilcotin Highland, West-Central British Columbia

NASA Astrophysics Data System (ADS)

Kuehn, C.; Guest, B.

2012-12-01

A large number of volcanic features, including stratovolcanoes, cinder cones, domes, flows and erosional remnants of these exist in the Satah Mountain Volcanic Field (SMVF) and Baldface Mountain Volcanic Fields (BMVF), located near the Itcha Ranges in the Chilcotin Highland of west-central British Columbia. Petrographical, geochemical and geochronological studies are hoped to clarify the volcano-tectonic association of these fields and their relation with the nearby Anahim Volcanic Belt (AVB) and possibly provide a confirmation for the hot-spot that has been proposed as the source of magmatism in the area from the mid-Miocene to the Holocene. During field work, 20 centres in the SMVF aligned on a NNW-SSE trending topographic high and seven centres in the BMVF were studied with a focus on geochemistry and ages of the lavas erupted. With the exception of Satah Mountain, the most prominent and best-preserved edifice, individual centres are generally small in height (200-300 m) and volume. There is clear evidence for glacial modification of edifices, which likely removed most of the once-existing pyroclastic material, and water-magma interaction could be observed at one centre as well. Extensive coverage by glacial till limits outcrops to cliffs on the edifices' flanks or to local "windows" in the Quaternary deposits. This makes stratigraphic relationships, both within the fields and the surrounding volcanic rocks of the Anahim Volcanic Belt (AVB) and Chilcotin Flood Basalts (CFB), unclear. Preliminary XRF results indicate a high variability of the lavas, even between centres close to each other. Erupted lavas range from undersaturated basanites (44 wt% SiO2), trachybasalts and trachytes to high-alkali phonolites (14 wt% Na2O+K2O). In general, larger structures in the SMVF appear to have erupted more evolved rocks whereas smaller centres, often just remnants of plugs and necks, and centres in the BMVF erupted more primitive rocks. In addition, whole-rock ages were determined using the Ar-Ar method for eight SMVF centres and four in the BMVF, with clusters around 1.79 Ma for the former and 2.36 Ma for the latter. These ages coincide with existing K-Ar ages for the nearby Itcha Ranges and fit well with the hot-spot hypothesis for the AVB. The prevalence of evolved rocks in the SMVF and BMVF might also indicate a relationship to the high-alkaline rocks of the AVB. Further studies will focus (1) on the geochemistry and ages of additional centres, including the yet-unstudied southern part of the Rainbow Range shield volcano in the AVB, and (2) the isotopic composition of the lavas to identify possible source regions of the erupted magmas.

Understanding the role of local management in vegetation recovery around pastoral settlements in northern Kenya.

PubMed

Roba, Hassan G; Oba, Gufu

2013-04-01

The recent greening of the Sahel region and increase in vegetation cover around pastoral settlements previously described as "man-made deserts", have raised important questions on the permanency of land degradation associated with the over-exploitation of woody plants. Evidence presented is mostly on increased wetness, while management by local communities has received limited attention. This study evaluated changes in woody vegetation cover around the settlements of Kargi and Korr in northern Kenya, using satellite imagery (1986/2000), ecological ground surveys and interviews with local elders, in order to understand long-term changes in vegetation cover and the role of local community in vegetation dynamics. At both settlements, there were increments in vegetation cover and reduction in the extent of bare ground between 1986 and 2000. At Kargi settlement, there were more tree seedlings in the centre of settlement than further away. Mature tree class was more abundant in the centre of Korr than outside the settlement. The success of the regeneration and recovery of tree cover was attributed to the actions of vegetation management initiative including stringent measures by the local Environmental Management Committees. This study provides good evidence that local partnership is important for sustainable management of resources especially in rural areas where the effectiveness of government initiative is lacking.

Autonomy and Governance in Local Authority Provision for Children and Young People

ERIC Educational Resources Information Center

Boyask, Ruth; Donkin, Arnet; Waite, Sue; Lawson, Hazel

2013-01-01

The role of local government in addressing issues of social equity is undergoing significant reconstruction in current educational policy reforms in England. The current conceptualisation of social provision places individual rights at the centre of policy, and social responsibility is represented as the work of individuals. Drawing upon a…

Applying Psychology in Local Authority Emergency Planning Processes

ERIC Educational Resources Information Center

Posada, Susan E.

2006-01-01

This article describes the work of two EPs involved in a multi-agency project to produce Local Authority (LA) guidelines on psycho/social support following critical incidents and disasters. EPs were involved as participant observers during a simulation of setting up and running a LA reception centre for evacuees. A questionnaire was then…

Rational use of medicines: assessing progress using primary health centres in Shomolu local government area of Lagos, Nigeria.

PubMed

Oyeyemi, A S; Ogunleye, O A

2013-01-01

Medicines (drugs) are a critical component in the prevention and treatment of diseases. Their rational use is important to maximize their benefits and prevent undesirable effects. This study was conducted to assess progress with rational use of medicines at primary care level using recommended indicators. The cross-sectional descriptive study was conducted in four primary health centres in Somolu Local Government Area (LGA) of Lagos State, Nigeria. It employed retrospective and prospective data collection methods. From the four centres, prescription notes of 600 clinical encounters spanning one year were analyzed for prescribing indicators and a checklist was administered for facility indicators. For the 600 clinical encounters studied, 2802 drugs were prescribed. The mean number of drugs per encounter was 4.7 ± 2.1; 75.6% of drugs were prescribed by generic name; prescriptions containing at least an antibiotic averaged 48.5%, while those with at least an injection prescribed were 21%. Of all the drugs prescribed, 83.2% were from the National Essential Drugs List (NEDL). On the average, 86.5% of key essential drugs were available in the health centres but none of the centres had a copy of the NEDL or drug formulary. There were wide variations in some of the indicators across the four facilities. The study showed progress in some indicators when compared with previous studies but gaps still exist. We recommend training on rational use of medicines for health workers in the facilities and distribution of copies of NEDL to all the facilities.

Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines.

PubMed

Usonis, Vytautas; Ivaskevicius, Rimvydas; Diez-Domingo, Javier; Esposito, Susanna; Falup-Pecurariu, Oana G; Finn, Adam; Rodrigues, Fernanda; Spoulou, Vana; Syrogiannopoulos, George A; Greenberg, David

2016-01-01

The aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO). A questionnaire was developed and distributed by the Community-Acquired Pneumonia Paediatric Research Initiative (CAP-PRI) working group and distributed to medical centres across Europe. Out of 19 European centres, 6 (31.6 %) used WHO guidelines (3 in combination with other guidelines), 5 (26.3 %) used national guidelines, and 5 (26.3 %) used local guidelines. Chest radiograph and complete blood count were the most common diagnostic examinations, while evaluation of clinical symptoms and laboratory tests varied significantly. Tachypnoea and chest recession were considered criteria for diagnosis in all three guidelines. In US and UK guidelines blood cultures, atypical bacterial and viral detection tests were recommended. In European centres in outpatient settings, amoxicillin was used in 16 (84 %) centers, clarithromycin in 9 (37 %) centers and azithromycin in 7 (47 %) centers, whereas in hospital settings antibiotic treatment varied widely. Amoxicillin is recommended as the first drug of choice for outpatient treatment in all guidelines. Although local variations in clinical criteria, laboratory tests, and antibiotic resistance rates may necessitate some differences in standard empirical antibiotic regimens, there is considerable scope for standardisation across European centres for the diagnosis and treatment of CAP.

Mapping the evolving strain field during continental breakup from crustal anisotropy in the Afar Depression

PubMed Central

Keir, Derek; Belachew, M.; Ebinger, C.J.; Kendall, J.-M.; Hammond, J.O.S.; Stuart, G.W.; Ayele, A.; Rowland, J.V.

2011-01-01

Rifting of the continents leading to plate rupture occurs by a combination of mechanical deformation and magma intrusion, yet the spatial and temporal scales over which these alternate mechanisms localize extensional strain remain controversial. Here we quantify anisotropy of the upper crust across the volcanically active Afar Triple Junction using shear-wave splitting from local earthquakes to evaluate the distribution and orientation of strain in a region of continental breakup. The pattern of S-wave splitting in Afar is best explained by anisotropy from deformation-related structures, with the dramatic change in splitting parameters into the rift axis from the increased density of dyke-induced faulting combined with a contribution from oriented melt pockets near volcanic centres. The lack of rift-perpendicular anisotropy in the lithosphere, and corroborating geoscientific evidence of extension dominated by dyking, provide strong evidence that magma intrusion achieves the majority of plate opening in this zone of incipient plate rupture. PMID:21505441

[The natural resources of the expedition bay as a basis for the creation of the health resort centre at the coast of the Peter the Great Bay, the Sea of Japan].

PubMed

Vasil'chenko, V F; Badalov, N G; Derkacheva, L N

2014-01-01

The present article presents characteristics of the therapeutic and health promoting potential of the Expedition Bay, (part of the Peter the Great Bay, the Sea of Japan), known to be a deposit of therapeutic sea muds. The great variety of local therapeutic natural resources, viz. sea muds, sea weeds, friendly climate, beeches, etc., can be used for the treatment and prevention of various diseases. The Expedition Bay was designated as a local area of recreational and therapeutic value that can be used as a basis for the creation and further development of the multi-field health resort centre (or medical spa) that would attract patients from other regions of Russia and the surrounding countries. The future centre would provide medical services based in the first place on the classical methods of climatic and peloid therapy, thalassotherapy (heliotherapy, aeroionotherapy, bathing, marine algae therapy, etc.) as well as the modern balneotherapeutic and spa technologies, therapeutic tourism for the purpose of rehabilitation and health promotion.

Electron-microscopical localization of gelsolin in various crustacean muscles.

PubMed

Unger, Andreas; Hinssen, Horst

2010-08-01

Gelsolin was localized by immunoelectron microscopy in fast and slow cross-striated muscles of the lobster Homarus americanus. When ultrathin sections of the muscles were labelled with anti-gelsolin and a gold-conjugated second antibody, 90% of all gold particles in the myoplasm were detected on myofibrils, preferentially in the I-band and AI-region of the sarcomeres. Both the region of the H-zone (lacking thin filaments) and the Z-disc contained no or little gold label. Under physiological conditions, a close association of gelsolin with the thin filaments was observed for both muscle types. The preferential localization of particles in the I- and AI-region indicated that gelsolin was distributed randomly over the whole length of the thin filaments. Preincubation of muscle strips with Ringer solution containing 0.5 mM EGTA resulted in a significantly different distribution pattern; gold particles were now localized preferentially in the cell periphery close to the sarcolemma, with significantly decreased abundance in the centre of the cell. Compared with the muscle under physiological conditions, the number of gold particles over sarcomeric structures was significantly reduced. Thus, binding of gelsolin to the thin filaments is apparently reversible in vivo and depends on the presence of calcium ions. We assume a functional role for gelsolin in the actin turnover processes in invertebrate muscle systems.

X-ray structural studies of the fungal laccase from Cerrena maxima.

PubMed

Lyashenko, Andrey V; Bento, Isabel; Zaitsev, Viatcheslav N; Zhukhlistova, Nadezhda E; Zhukova, Yuliya N; Gabdoulkhakov, Azat G; Morgunova, Ekaterina Y; Voelter, Wolfgang; Kachalova, Galina S; Stepanova, Elena V; Koroleva, Ol'ga V; Lamzin, Victor S; Tishkov, Vladimir I; Betzel, Christian; Lindley, Peter F; Mikhailov, Al'bert M

2006-11-01

Laccases are members of the blue multi-copper oxidase family. These enzymes oxidize substrate molecules by accepting electrons at a mononuclear copper centre and transferring them to a trinuclear centre. Dioxygen binds to the trinuclear centre and following the transfer of four electrons is reduced to two molecules of water. The X-ray structure of a laccase from Cerrena maxima has been elucidated at 1.9 A resolution using synchrotron data and the molecular replacement technique. The final refinement coefficients are Rcryst = 16.8% and Rfree = 23.0%, with root mean square deviations on bond lengths and bond angles of 0.015 A and 1.51 degrees , respectively. The type 1 copper centre has an isoleucine residue at the axial position and the "resting" state of the trinuclear centre comprises a single oxygen (OH) moiety asymmetrically disposed between the two type 3 copper ions and a water molecule attached to the type 2 ion. Several carbohydrate binding sites have been identified and the glycan chains appear to promote the formation of well-ordered crystals. Two tyrosine residues near the protein surface have been found in a nitrated state.

Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study.

PubMed

Leung, Angela Yee Man; Bo, Ai; Hsiao, Hsin-Yi; Wang, Song Song; Chi, Iris

2014-11-18

To investigate why first-generation Chinese immigrants with diabetes have difficulty obtaining, processing and understanding diabetes related information despite the existence of translated materials and translators. This qualitative study employed purposive sampling. Six focus groups and two individual interviews were conducted. Each group discussion lasted approximately 90 min and was guided by semistructured and open-ended questions. Data were collected in two community health centres and one elderly retirement village in Los Angeles, California. 29 Chinese immigrants aged ≥45 years and diagnosed with type 2 diabetes for at least 1 year. Eight key themes were found to potentially affect Chinese immigrants' capacity to obtain, communicate, process and understand diabetes related health information and consequently alter their decision making in self-care. Among the themes, three major categories emerged: cultural factors, structural barriers, and personal barriers. Findings highlight the importance of cultural sensitivity when working with first-generation Chinese immigrants with diabetes. Implications for health professionals, local community centres and other potential service providers are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Critical needs for piston engine overhaul centre in Malaysia

NASA Astrophysics Data System (ADS)

Khairuddin, M. H.; Yahya, M. Y.; Johari, M. K.

2017-12-01

Piston engine overhaul centre (PEOC) is the branch of aviation Maintenance, Repair and Overhaul (MRO) providers, which plays a pivotal role in maintaining the fleet of business and commercial aircraft in the world. The centre typically offers three main MRO capabilities: airframe, engine and component services. Companies holding a PEOC(s) are all subjected to stringent procedures and conditions regulated and audited by the International Civil Aviation Organization. Currently, piston engine maintenance and repair for Asian countries is conducted only in Singapore. The focus of this study is to establish the needs for a PEOC in Malaysia, which will cater almost all small local aircraft companies such as transport and flying school companies.

A clinical audit programme for diagnostic radiology: the approach adopted by the International Atomic Energy Agency.

PubMed

Faulkner, K; Järvinen, H; Butler, P; McLean, I D; Pentecost, M; Rickard, M; Abdullah, B

2010-01-01

The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to the clinical audit programme and the IAEA clinical audit protocol.

Profiles of men-who-have-sex-with-men seeking anonymous voluntary HIV counseling and testing at a community-based centre in Malaysia.

PubMed

Koh, K C; Kamarulzaman, A

2011-12-01

Community-based HIV voluntary counseling and testing (VCT) services is an effective alternative for mapping the local demographics of at-risk populations for HIV as well as provide an acceptable and reliable means of early detection of HIV. We describe the profiles of men-who-have-sex-with-men (MSM) who sought VCT services in a community based centre in Kuala Lumpur.

Delineating risk zones and evaluation of shelter centres for flood disaster management along the Pahang River Basin, Malaysia

PubMed Central

Isahak, Anizan; Siwar, Chamhuri; Ismail, Shaharuddin M.; Hanafi, Zulkifli; Zainuddin, Mohd S.

2018-01-01

Shelter centres are important locations to safeguard people from helpless situations and are an integral part of disaster risk reduction (DRR), particularly for flood DRR. The establishment of shelter centres, and their design based on scientific assessment, is crucial. Yet, they are very much related to the geographic location, socio-economic conditions and the livelihoods of the affected communities. However, many parts of the developing world are still lagging behind in ensuring such scientific design. Considering the flood disaster in 2014 that affected the residents living along the Pahang River Basin, in this study we delineate the communities at risk and evaluate the existing shelter centres to determine how they reduce people’s vulnerability to the risks associated with rural and urban landscapes. We used spatial analysis tools to delineate risk zones and to evaluate existing evacuation systems. A flood disaster risk map was produced to determine which communities are living with risks. Subsequently, the distribution of shelter centres examined whether they are able to support people living at the flood risk zones. These centres were also evaluated using a set of international guidelines for effective disaster shelters. This reveals that the number of shelter centres is not adequate. The designation and designing of shelter centres are not being done scientifically. The maps produced here have a lot of potential to support disaster management decisions, in particular site selection and the prioritisation of centres. The study concludes with a set of guidelines and recommendations for structural and non-structural measures, such as alternative livelihoods and the potential of ecotourism, which may improve the resilience among flood-affected communities; and the decision-making process for the overall flood DRR initiatives.

Electron paramagnetic resonance of deep boron in silicon carbide

NASA Astrophysics Data System (ADS)

Baranov, P. G.; Mokhov, E. N.

1996-04-01

In this article we report the first EPR observation of deep boron centres in silicon carbide. A direct identification of the boron atom involved in the defect centre, considered as deep boron, has been established by the presence of a hyperfine interaction with 0268-1242/11/4/005/img1 and 0268-1242/11/4/005/img2 nuclei in isotope-enriched 6H-SiC:B crystals. Deep boron centres were shown from EPR spectra to have axial symmetry along the hexagonal axis. A correspondence between the EPR spectra and the luminescence, ODMR and DLTS spectra of deep boron centres has been indicated. The structural model for a deep boron centre as a boron - vacancy pair is presented and the evidence for bistable behaviour of deep boron centres is discussed.

Displacement-length scaling of brittle faults in ductile shear.

PubMed

Grasemann, Bernhard; Exner, Ulrike; Tschegg, Cornelius

2011-11-01

Within a low-grade ductile shear zone, we investigated exceptionally well exposed brittle faults, which accumulated antithetic slip and rotated into the shearing direction. The foliation planes of the mylonitic host rock intersect the faults approximately at their centre and exhibit ductile reverse drag. Three types of brittle faults can be distinguished: (i) Faults developing on pre-existing K-feldspar/mica veins that are oblique to the shear direction. These faults have triclinic flanking structures. (ii) Wing cracks opening as mode I fractures at the tips of the triclinic flanking structures, perpendicular to the shear direction. These cracks are reactivated as faults with antithetic shear, extend from the parent K-feldspar/mica veins and form a complex linked flanking structure system. (iii) Joints forming perpendicular to the shearing direction are deformed to form monoclinic flanking structures. Triclinic and monoclinic flanking structures record elliptical displacement-distance profiles with steep displacement gradients at the fault tips by ductile flow in the host rocks, resulting in reverse drag of the foliation planes. These structures record one of the greatest maximum displacement/length ratios reported from natural fault structures. These exceptionally high ratios can be explained by localized antithetic displacement along brittle slip surfaces, which did not propagate during their rotation during surrounding ductile flow.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Datta, Kaustuv; Neder, Reinhard B.; Chen, Jun

Revelation of unequivocal structural information at the atomic level for complex systems is uniquely important for deeper and generic understanding of the structure property connections and a key challenge in materials science. Here in this paper we report an experimental study of the local structure by applying total elastic scattering and Raman scattering analyses to an important non-relaxor ferroelectric solid solution exhibiting the so-called composition-induced morphotropic phase boundary (MPB), where concomitant enhancement of physical properties have been detected. The powerful combination of static and dynamic structural probes enabled us to derive direct correspondence between the atomic-level structural correlations and reportedmore » properties. The atomic pair distribution functions obtained from the neutron total scattering experiments were analysed through big-box atom-modelling implementing reverse Monte Carlo method, from which distributions of magnitudes and directions of off-centred cationic displacements were extracted. We found that an enhanced randomness of the displacement-directions for all ferroelectrically active cations combined with a strong dynamical coupling between the A- and B-site cations of the perovskite structure, can explain the abrupt amplification of piezoelectric response of the system near MPB. Finally, altogether this provides a more fundamental basis in inferring structure-property connections in similar systems including important implications in designing novel and bespoke materials.« less

Displacement–length scaling of brittle faults in ductile shear

PubMed Central

Grasemann, Bernhard; Exner, Ulrike; Tschegg, Cornelius

2011-01-01

Within a low-grade ductile shear zone, we investigated exceptionally well exposed brittle faults, which accumulated antithetic slip and rotated into the shearing direction. The foliation planes of the mylonitic host rock intersect the faults approximately at their centre and exhibit ductile reverse drag. Three types of brittle faults can be distinguished: (i) Faults developing on pre-existing K-feldspar/mica veins that are oblique to the shear direction. These faults have triclinic flanking structures. (ii) Wing cracks opening as mode I fractures at the tips of the triclinic flanking structures, perpendicular to the shear direction. These cracks are reactivated as faults with antithetic shear, extend from the parent K-feldspar/mica veins and form a complex linked flanking structure system. (iii) Joints forming perpendicular to the shearing direction are deformed to form monoclinic flanking structures. Triclinic and monoclinic flanking structures record elliptical displacement–distance profiles with steep displacement gradients at the fault tips by ductile flow in the host rocks, resulting in reverse drag of the foliation planes. These structures record one of the greatest maximum displacement/length ratios reported from natural fault structures. These exceptionally high ratios can be explained by localized antithetic displacement along brittle slip surfaces, which did not propagate during their rotation during surrounding ductile flow. PMID:26806996

Assessment of schistosomiasis and soil-transmitted helminths prevalence in school-aged children and opportunities for integration of control in local health services in Kwilu Province, the Democratic Republic of the Congo.

PubMed

Inocencio da Luz, R; Linsuke, S; Lutumba, P; Hasker, E; Boelaert, M

2017-11-01

To determine the prevalence of schistosomiasis (SCH) and soil-transmitted helminths (STH) in the Democratic Republic of Congo, and to assess the capacity of the local health centres for diagnosis and treatment. Cross-sectional school-based survey in two health districts in the Province of Kwilu. We collected a stool and a urine sample for parasitological examination. Urine filtration and duplicate Kato-Katz thick smears were used for the diagnosis of SCH. Health centres were evaluated using a structured questionnaire. In total, 526 children participated in the study and the overall prevalence of Schistosoma mansoni infection was 8.9% (95% CI: 3.5-13.2) in both districts. The prevalence was higher in Mosango (11.7%; 95% CI: 8.9-14.8) than Yasa Bonga district (6.2%; 95% CI: 1.1-11.4). Urine filtration showed that Schistosoma haematobium infection was not present. The combined STH infection prevalence was 58.1% in both districts; hookworm infection was the most common STH found in 52.9% (95% CI: 29.3-62.4) of subjects, followed by Ascaris lumbricoides 9.3% (95% CI: 5.8-15.5) and Trichuris trichiura 2.1% (95% CI: 0.9-4.9). Mixed STH infections were observed as well as SCH-STH coinfection. Further mapping of both SCH and STH burden is needed, and coverage of preventive chemotherapy in school-aged children should be increased. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Optimisation of the usage of LHC and local computing resources in a multidisciplinary physics department hosting a WLCG Tier-2 centre

NASA Astrophysics Data System (ADS)

Barberis, Stefano; Carminati, Leonardo; Leveraro, Franco; Mazza, Simone Michele; Perini, Laura; Perlz, Francesco; Rebatto, David; Tura, Ruggero; Vaccarossa, Luca; Villaplana, Miguel

2015-12-01

We present the approach of the University of Milan Physics Department and the local unit of INFN to allow and encourage the sharing among different research areas of computing, storage and networking resources (the largest ones being those composing the Milan WLCG Tier-2 centre and tailored to the needs of the ATLAS experiment). Computing resources are organised as independent HTCondor pools, with a global master in charge of monitoring them and optimising their usage. The configuration has to provide satisfactory throughput for both serial and parallel (multicore, MPI) jobs. A combination of local, remote and cloud storage options are available. The experience of users from different research areas operating on this shared infrastructure is discussed. The promising direction of improving scientific computing throughput by federating access to distributed computing and storage also seems to fit very well with the objectives listed in the European Horizon 2020 framework for research and development.

System-centred tobacco management: from 'whole-person' to 'whole-system' change.

PubMed

Bonevski, Billie

2014-01-01

Patient-centred tobacco management is a pragmatic approach for helping smokers achieve their goals in terms of either cessation or harm reduction. However, the success of the approach is dependent on clinicians embracing and delivering it as intended. There are a number of structural and systemic organisational barriers which are limiting clinician-delivered patient-centred tobacco dependence. In response, 'whole system' approaches which help support clinicians in the delivery of patient-centred tobacco management are required. Health system changes to support clinicians and facilitate the delivery of patient-centred tobacco management are worth further investigation, particularly in settings where tobacco smoking rates are high. © 2013 Australasian Professional Society on Alcohol and other Drugs.

Provincially and Locally Initiated Curriculum Program Assessment, Final Report.

ERIC Educational Resources Information Center

1999

This report is an independent assessment of the Provincially Initiated Curriculum (PIC) and Locally Initiated Curriculum (LIC) for British Columbia's Centre for Curriculum, Transfer and Technology (C2T2), which manages both PIC and LIC projects. The report makes four recommendations for C2T2's consideration: (1) a renewed emphasis on communication…

Education and Local Development in Australian Rural Areas. Research Study No. 74.

ERIC Educational Resources Information Center

Stoessiger, Rex

The study provides an overview of the Education and Local Development (ELD) projects conducted in Western Australia, Victoria, New South Wales, and Tasmania as part of the OECD/CERI (Organisation for Economic Co-operation and Development/Centre for Educational Research and Innovation) project. The CERI ELD project was planned to investigate: the…

Crystallography with online optical and X-ray absorption spectroscopies demonstrates an ordered mechanism in copper nitrite reductase.

PubMed

Hough, Michael A; Antonyuk, Svetlana V; Strange, Richard W; Eady, Robert R; Hasnain, S Samar

2008-04-25

Nitrite reductases are key enzymes that perform the first committed step in the denitrification process and reduce nitrite to nitric oxide. In copper nitrite reductases, an electron is delivered from the type 1 copper (T1Cu) centre to the type 2 copper (T2Cu) centre where catalysis occurs. Despite significant structural and mechanistic studies, it remains controversial whether the substrates, nitrite, electron and proton are utilised in an ordered or random manner. We have used crystallography, together with online X-ray absorption spectroscopy and optical spectroscopy, to show that X-rays rapidly and selectively photoreduce the T1Cu centre, but that the T2Cu centre does not photoreduce directly over a typical crystallographic data collection time. Furthermore, internal electron transfer between the T1Cu and T2Cu centres does not occur, and the T2Cu centre remains oxidised. These data unambiguously demonstrate an 'ordered' mechanism in which electron transfer is gated by binding of nitrite to the T2Cu. Furthermore, the use of online multiple spectroscopic techniques shows their value in assessing radiation-induced redox changes at different metal sites and demonstrates the importance of ensuring the correct status of redox centres in a crystal structure determination. Here, optical spectroscopy has shown a very high sensitivity for detecting the change in T1Cu redox state, while X-ray absorption spectroscopy has reported on the redox status of the T2Cu site, as this centre has no detectable optical absorption.

European hospital managers' perceptions of patient-centred care.

PubMed

Taylor, Angelina; Groene, Oliver

2015-01-01

The spotlight has recently been placed on managers' responsibility for patient-centred care as a result of Mid Staffordshire NHS Foundation Trust failings. In previous research, clinicians reported that managers do not have an adequate structured plan for implementing patient-centred care. The purpose of this paper is to assess the perceptions of European hospital management with respect to factors affecting the implementation of a patient-centred approach. In total, 15 semi-structured interviews were conducted with hospital managers (n=10), expert country informants (n=2), patient organisations (n=2) and a user representative (n=1) from around Europe. Participants were purposively and snowball sampled. Interviews were analysed using framework analysis. Most participants felt that current levels of patient-centred care are inadequate, but accounted that there were a number of macro, meso and micro challenges they faced in implementing this approach. These included budget constraints, political and historical factors, the resistance of clinicians and other frontline staff. Organisational culture emerged as a central theme, shaped by these multi-level factors and influencing the way in which patient-centred care was borne out in the hospital. Participants proposed that the needs of patients might be better met through increasing advocacy by patient organisations and greater staff contact with patients. This study is the first of its kind to obtain management views from around Europe. It offers an insight into different models of how patient-centred care is realised by management. It indicates that managers see the value of a patient-centred approach but that they feel restricted by a number of factors at multiple levels.

A prospective health impact assessment of the international astronomy and space exploration centre.

PubMed

Winters, L Y

2001-06-01

Assess the potential health impacts of the proposed International Astronomy and Space Exploration Centre on the population of New Wallasey. Contribute to the piloting of health impact assessment methods. Prospective health impact assessment involving brainstorming sessions and individual interviews with key informants and a literature review. New Wallasey Single Regeneration Budget 4 area. Key stakeholders including local residents' groups selected through purposeful snowball sampling. Recommendations are made that cover issues around: transport and traffic; civic design; security; public safety, employment and training. Health impact assessment is a useful pragmatic tool for facilitating wide consultation. In particular engaging the local population in the early planning stages of a proposed development, and assisting in highlighting changes to maximise the positive health influences on affected communities.

Case mix management education in a Canadian hospital.

PubMed

Moffat, M; Prociw, M

1992-01-01

The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure--the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.

WA29 "we are all one" compassionate cities "a global community joined for care".

PubMed

Molina, Emilio Herrera; Flores, Silvia Librada

2015-04-01

The NewHealth Foundation, a Spanish non-for-profit organisation, is leading the project Compassionate Cities. "We are all one". The project aims to involve citizens in creating communities of care to help people at the end of life phase. To design and develop a practical model to engage communities in the process of improving the quality of public palliative care. To empower key advocates of end-of-life care. To evaluate communities' interventions, their feasibility and impact in terms of shared benefit for stakeholders. Identification and recruitment of key advocates of care. Design of an innovative model of compassionate cities. Define community of care activities through a triple-dimension methodology: [To Want - To Know - To Do]. An innovative model has been developed: The Collaborating Centre (schools, colleges, cultural centres, professional's associations, patient's associations, NGOs, brotherhoods, churches, etc.) organises the agenda of training events and promotes networking. Citizens set up "care clusters", becoming available to provide care. The Beneficiaries Centres (hospices, nursing homes, residential centres, patient organisations, hospitals, health and social care centres, etc.) contact the clusters when care needs of patients are identified. The palliative care specialist supports Compassionate Communities training and refer patients to clusters. Local Government (also a collaborating centre) encourages awareness campaigns and provides institutional support. Companies collaborate in promoting and funding the project. Six cities in Spain and 3 in Colombia have already been selected and local initiatives are already being promoted (more results to be provided at the Congress). This model supports people to become the real co-producers of services, as they know which services best respond to their needs. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pit and fissure sealants in dental public health – application criteria and general policy in Finland

PubMed Central

Kervanto-Seppälä, Sari; Pietilä, Ilpo; Meurman, Jukka H; Kerosuo, Eero

2009-01-01

Background Pit and fissure sealants (sealants) are widely used as a non-operative preventive method in public dental health in Finland. Most children under 19 years of age attend the community-organized dental health services free of charge. The aims of this study were to find out to what extent sealants were applied, what the attitudes of dental professionals towards sealant application were, and whether any existing sealant policies could be detected among the health centres or among the respondents in general. The study evaluated changes that had taken place in the policies used during a ten year period (1991–2001). Methods A questionnaire was mailed to each chief dental officer (CDO) of the 265 public dental health centres in Finland, and to a group of general dentists (GDP) applying sealants in these health centres, giving a total of 434 questionnaires with 22 questions. The response rate was 80% (N = 342). Results A majority of the respondents reported to application of sealants on a systematic basis for children with increased caries risk. The criteria for applying sealants and the actual strategies seemed to vary locally between the dentists within the health centres and between the health centres nationwide. The majority of respondents believed sealants had short- and long-term effects. The overall use of sealants decreased towards the end of the ten year period. The health centres (N = 28) choosing criteria to seal over detected or suspected enamel caries lesion had a DMFT value of 1.0 (SD ± 0.49) at age 12 (year 2000) compared to a value of 1.2 (SD ± 0.47) for those health centres (N = 177) applying sealants by alternative criteria (t-test, p < 0.05). Conclusion There seems to be a need for defined guidelines for sealant application criteria and policy both locally and nationwide. Occlusal caries management may be improved by shifting the sealant policy from the traditional approach of prevention to interception, i.e. applying the sealants over detected or suspected enamel caries lesions instead of sealing sound teeth. PMID:19193239

The collaboration of general practitioners and nurses in primary care: a comparative analysis of concepts and practices in Slovenia and Spain.

PubMed

Hämel, Kerstin; Vössing, Carina

2017-09-01

Aim A comparative analysis of concepts and practices of GP-nurse collaborations in primary health centres in Slovenia and Spain. Cross-professional collaboration is considered a key element for providing high-quality comprehensive care by combining the expertise of various professions. In many countries, nurses are also being given new and more extensive responsibilities. Implemented concepts of collaborative care need to be analysed within the context of care concepts, organisational structures, and effective collaboration. Background review of primary care concepts (literature analysis, expert interviews), and evaluation of collaboration in 'best practice' health centres in certain regions of Slovenia and Spain. Qualitative content analysis of expert interviews, presentations, observations, and group discussions with professionals and health centre managers. Findings In Slovenian health centres, the collaboration between GPs and nurses has been strongly shaped by their organisation in separate care units and predominantly case-oriented functions. Conventional power structures between professions hinder effective collaboration. The introduction of a new cross-professional primary care concept has integrated advanced practice nurses into general practice. Conventional hierarchies still exist, but a shared vision of preventive care is gradually strengthening attitudes towards team-oriented care. Formal regulations or incentives for teamwork have yet to be implemented. In Spain, health centres were established along with a team-based care concept that encompasses close physician-nurse collaboration and an autonomous role for nurses in the care process. Nurses collaborate with GPs on more equal terms with conflicts centring on professional disagreements. Team development structures and financial incentives for team achievements have been implemented, encouraging teams to generate their own strategies to improve teamwork. Clearly defined structures, shared visions of care and team development are important for implementing and maintaining a good collaboration. Central prerequisites are advanced nursing education and greater acceptance of advanced nursing practice.

Online measurement of fluence and position for protontherapy beams

NASA Astrophysics Data System (ADS)

Benati, C.; Boriano, A.; Bourhaleb, F.; Cirio, R.; Cirrone, G. A. P.; Cornelius, I.; Cuttone, G.; Donetti, M.; Garelli, E.; Giordanengo, S.; Guérin, L.; La Rosa, A.; Luparia, A.; Marchetto, F.; Martin, F.; Meyroneinc, S.; Peroni, C.; Pittà, G.; Raffaele, L.; Sabini, M. G.; Valastro, L.

2004-09-01

Tumour therapy with proton beams has been used for several decades in many centres with very good results in terms of local control and overall survival. Typical pathologies treated with this technique are located in head and neck, eye, prostate and in general at big depths or close to critical organs. The Experimental Physics Department of the University of Turin and the local Section of INFN, in collaboration with INFN Laboratori Nazionali del Sud Catania and Centre de Protontherapie de Orsay Paris, have developed detector systems that allow the measurement of beam position and fluence, obtained in real time during beam delivery. The centre in Catania (CATANA: Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) has been treating patients with eye pathologies since spring 2002 using a superconducting cyclotron accelerating protons up to 62 MeV.This kind of treatments need high-resolution monitor systems and for this reason we have developed a 256-strip segmented ionisation chamber, each strip being 400 μm wide, with a total sensitive area 13×13 cm2. The Centre de Protontherapie de Orsay (CPO) has been operational since 1991 and features a synchrocyclotron used for eye and head and neck tumours with proton beams up to 200 MeV. The monitor system has to work on a large surface and for this purpose we have designed a pixel-segmented ionisation chamber, each pixel being 5×5 mm2, for a total active area of 16×16 cm2. The results obtained with two prototypes of the pixel and strip chambers demonstrate that the detectors allow the measurement of fluence and centre of gravity as requested by clinical specifications.

It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

PubMed

May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

2017-12-01

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Improving local health through community health workers in Cambodia: challenges and solutions.

PubMed

Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

2018-01-06

Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently, the health of community members. CHWs presented with the opportunity to share learning and develop ideas in a supportive environment would benefit health initiatives.

[Groups of female workers with lowered adaptation to the working conditions in footwear industry].

PubMed

Datsenko, M F; Poguda, A A; Nuromskaia, O A

1991-01-01

The Republican Centre for Occupational Diseases was set in Estonia in 1971. The Centre performs administrative and methodological guidance for the republican clinical institutions in diagnostics, prevention and treatment of occupational diseases. The Centre also runs an out-patient department and a 40-bed in-patient stationary. In the occupational diseases structure, communicable diseases are prevalent (particularly, erysipeloid), followed by occupational hypoacusis, vibration related and allergic diseases.

The Hayes principles: learning from the national pilot of information technology and core generalisable theory in informatics.

PubMed

de Lusignan, Simon; Krause, Paul

2010-01-01

There has been much criticism of the NHS national programme for information technology (IT); it has been an expensive programme and some elements appear to have achieved little. The Hayes report was written as an independent review of health and social care IT in England. To identify key principles for health IT implementation which may have relevance beyond the critique of NHS IT. We elicit ten principles from the Hayes report, which if followed may result in more effective IT implementation in health care. They divide into patient-centred, subsidiarity and strategic principles. The patient-centred principles are: 1) the patient must be at the centre of all information systems; 2) the provision of patient-level operational data should form the foundation - avoid the dataset mentality; 3) store health data as close to the patient as possible; 4) enable the patient to take a more active role with their health data within a trusted doctor-patient relationship. The subsidiarity principles set out to balance the local and health-system-wide needs: 5) standardise centrally - patients must be able to benefit from interoperability; 6) provide a standard procurement package and an approved process that ensures safety standards and provision of interoperable systems; 7) authorise a range of local suppliers so that health providers can select the system best meeting local needs; 8) allow local migration from legacy systems, as and when improved functionality for patients is available. And finally the strategic principles: 9) evaluate health IT systems in terms of measureable benefits to patients; 10) strategic planning of systems should reflect strategic goals for the health of patients/the population. Had the Hayes principles been embedded within our approach to health IT, and in particular to medical record implementation, we might have avoided many of the costly mistakes with the UK national programme. However, these principles need application within the modern IT environment. Closeness to the patient must not be interpreted as physical but instead as a virtual patient-centred space; data will be secure within the cloud and we should dump the vault and infrastructure mentality. Health IT should be developed as an adaptive ecosystem.

NATO Advanced Study Institute on Spectroscopy

NASA Technical Reports Server (NTRS)

DiBartolo, Baldassare; Barnes, James (Technical Monitor)

2001-01-01

This booklet presents an account of the course 'Spectroscopy of Systems with Spatially Confined Structures' held in Erice-Sicily, Italy, from June 15 to June 30, 2001. This meeting was organized by the International School of Atomic and Molecular Spectroscopy of the 'Ettore Majorana' Centre for Scientific Culture. The purpose of this course was to present and discuss nanometer-scale physics, a rapidly progressing field. The top-down approach of semiconductor technology will soon meet the scales of the bottom-up approaches of supramolecular chemistry and of spatially localized excitations in ionic crystals. This course dealt with the fabrication, measurement and understanding of the relevant structures and brought together the scientific communities responsible for these development. The advances in this area of physics have already let to applications in optoelectronics and will likely lead to many more. The subjects of the course included spatially resolved structures such as quantum wells, quantum wires and quantum dots, single atoms and molecules, clusters, fractal systems, and the development of related techniques like near-field spectroscopy and confocal microscopy to study such systems.

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Manley, Stephen, E-mail: stephen.manley@ncahs.health.nsw.gov.au; Last, Andrew; Fu, Kenneth

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of ourmore » conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.« less

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

PubMed Central

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-01-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients. PMID:26229680

Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards.

PubMed

Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

2015-06-01

Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

Data-driven high-throughput prediction of the 3-D structure of small molecules: review and progress. A response to the letter by the Cambridge Crystallographic Data Centre.

PubMed

Baldi, Pierre

2011-12-27

A response is presented to sentiments expressed in "Data-Driven High-Throughput Prediction of the 3-D Structure of Small Molecules: Review and Progress. A Response from The Cambridge Crystallographic Data Centre", recently published in the Journal of Chemical Information and Modeling, (1) which may give readers a misleading impression regarding significant impediments to scientific research posed by the CCDC.

Au generation centres doped n+-Si: hole-injection adjustable anode for efficient organic light emission

NASA Astrophysics Data System (ADS)

Li, Y. Z.; Ran, G. Z.; Zhao, W. Q.; Qin, G. G.

2008-08-01

An organic light-emitting diode (OLED) with an n-Si-anode usually has an efficiency evidently lower than the OLED with the same structure with a p-Si-anode due to insufficient hole injection from the n-Si anode compared with the p-Si-anode. In this study, we find that introducing Au as generation centres with a suitable concentration into the n+-Si anode can enhance hole injection to match electron injection and then considerably promote the power efficiency. With optimizing Au generation centre concentration in the n+-Si anode, the OLED with a structure of n+-Si: Au/NPB/AlQ/Sm/Au reaches a highest power efficiency of 1.0 lm W-1, evidently higher than the reported highest power efficiency of 0.2 lm W-1 for its p-Si-anode counterpart. Furthermore, when the electron injection is enhanced by adopting BPhen:Cs2CO3 partly instead of AlQ as the electron transport material, and the Au generation centre concentration in the n+-Si anode is promoted correspondingly, then a highest power efficiency of 1.8 lm W-1 is reached. The role of Au generation centres in the n+-Si anode is discussed.

[The evaluation of organizational structure and work hygiene in milk kitchen centers in Poland on the basis of questionnaire].

PubMed

Weker, H; Rudzka-Kańtoch, Z

1999-01-01

On the basis of available publications and obligatory legal regulations regarding the organisation of collective feeding patterns in Social Service Health Centres a questionnaire study was established to examine the way milk kitchen function in Poland. The study covered 533 milk kitchen centres (in hospitals, orphanages and crèches) from February to December 1997. The afore-mentioned study analysed the general characteristics of the milk kitchen centre, its type of work, supervisory methods and the personnel's hygiene. From the results of this research it can be concluded that the organisational structure of the milk centres was appropriate, appliances and equipment in the majority centres were adequate but basis utensils were insufficient. It is obvious that dietetic feeding methods for this particular group of children are insufficiently applied. Only 22.2% of the centres apply the recommended proposals i.e. without boiling, without pasteurisation, ready for consumption when preparing, infant formulae, follow-up formulae and other mixed products. Work hygiene and health quality of production in the milk kitchen centres is subject to systematic controls by competent individuals from the State Sanitary Inspection services. In the years 1995-96, 72 samples of infant food that mainly came from hospital milk kitchen centres were taken due to the poor microbiological quality of the food. The considerable changes that have taken place over the last few years as far as infant feeding is concerned, for example, the promotion of breast-feeding, taking advantage of prepared dietetic products for infants (infant formulae, follow-up formulae, vegetable products, fruits, vegetable-meat products, cereal products) require changes at the organisational level of infant collective feeding which was confirmed by the afore-mentioned study.

Nanodiamond-based nanostructures for coupling nitrogen-vacancy centres to metal nanoparticles and semiconductor quantum dots

DOE PAGES

Gong, Jianxiao; Steinsultz, Nat; Ouyang, Min

2016-06-08

The ability to control the interaction between nitrogen-vacancy centres in diamond and photonic and/or broadband plasmonic nanostructures is crucial for the development of solid-state quantum devices with optimum performance. However, existing methods typically employ top-down fabrication, which restrict scalable and feasible manipulation of nitrogen-vacancy centres. Here, we develop a general bottom-up approach to fabricate an emerging class of freestanding nanodiamond-based hybrid nanostructures with external functional units of either plasmonic nanoparticles or excitonic quantum dots. Precise control of the structural parameters ( including size, composition, coverage and spacing of the external functional units) is achieved, representing a pre-requisite for exploring themore » underlying physics. Fine tuning of the emission characteristics through structural regulation is demonstrated by performing single-particle optical studies. Lastly, this study opens a rich toolbox to tailor properties of quantum emitters, which can facilitate design guidelines for devices based on nitrogen vacancy centres that use these freestanding hybrid nanostructures as building blocks.« less

Nanodiamond-based nanostructures for coupling nitrogen-vacancy centres to metal nanoparticles and semiconductor quantum dots

NASA Astrophysics Data System (ADS)

Gong, Jianxiao; Steinsultz, Nat; Ouyang, Min

2016-06-01

The ability to control the interaction between nitrogen-vacancy centres in diamond and photonic and/or broadband plasmonic nanostructures is crucial for the development of solid-state quantum devices with optimum performance. However, existing methods typically employ top-down fabrication, which restrict scalable and feasible manipulation of nitrogen-vacancy centres. Here, we develop a general bottom-up approach to fabricate an emerging class of freestanding nanodiamond-based hybrid nanostructures with external functional units of either plasmonic nanoparticles or excitonic quantum dots. Precise control of the structural parameters (including size, composition, coverage and spacing of the external functional units) is achieved, representing a pre-requisite for exploring the underlying physics. Fine tuning of the emission characteristics through structural regulation is demonstrated by performing single-particle optical studies. This study opens a rich toolbox to tailor properties of quantum emitters, which can facilitate design guidelines for devices based on nitrogen-vacancy centres that use these freestanding hybrid nanostructures as building blocks.

How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey.

PubMed

Potpara, Tatjana S; Pison, Laurent; Larsen, Torben B; Estner, Heidi; Madrid, Antonio; Blomström-Lundqvist, Carina

2015-03-01

This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21-30 and 11-20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a structured patient education programme for stroke prevention. Individual patient stroke risk was assessed at every visit in 69.2% of the centres; 46.1% of centres had a hospital-based anticoagulation clinic. Information about non-vitamin K oral anticoagulants (NOACs) was communicated to all AF patients eligible for oral anticoagulation (38.5% of centres) or to warfarin-naive/unstable patients (42.3%). Only two centres (3.8%) had a structured NOAC adherence follow-up programme; in eight centres (15.4%) patients were requested to sign the statement they have been informed about the risks of non-adherence to NOAC therapy, and three centres (5.8%) had a patient education programme. Patient preferences were of the highest relevance regarding oral anticoagulation and AF ablation (64.7 and 49.0% of centres, respectively). This EP Wire Survey shows that in Europe considerable amount of time and resources are used in daily clinical practice to inform AF patients about their risk profile and available therapies. However, a diversity of strategies used across the European hospitals was noted, and further research is needed to better define optimal strategies for informing AF patients about their risk profile and treatment options. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Pathways to high and low performance: factors differentiating primary care facilities under performance-based financing in Nigeria

PubMed Central

Mabuchi, Shunsuke; Sesan, Temilade; Bennett, Sara C

2018-01-01

Abstract The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centres (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices. We used a multiple case study where we compared two high-performing PHCCs and two low-performing PHCCs for each of the two PBF target states. Two teams of two trained local researchers spent 1 week at each PHCC and collected semi-structured interview, observation and documentary data. Data from interviews were transcribed, translated and coded using a framework approach. The data for each PHCC were synthesized to understand dynamic interactions of different elements in each case. We then compared the characteristics of high and low performers. The areas in which critical differences between high and low-performers emerged were: community engagement and support; and performance and staff management. We also found that (i) contextual and health system factors particularly staffing, access and competition with other providers; (ii) health centre management including community engagement, performance management and staff management; and (iii) community leader support interacted and drove performance improvement among the PHCCs. Among them, we found that good health centre management can overcome some contextual and health system barriers and enhance community leader support. This study findings suggest a strong need to select capable and motivated health centre managers, provide long-term coaching in managerial skills, and motivate them to improve their practices. The study also highlights the need to position engagement with community leaders as a key management practice and a central element of interventions to improve PHCC performance. PMID:29077844

Sanctions and childhood mortality in Iraq.

PubMed

Ali, M M; Shah, I H

2000-05-27

In 1999 UNICEF, in cooperation with the government of Iraq and the local authorities in the "autonomous" (northern Kurdish) region, conducted two similar surveys to provide regionally representative and reliable estimates of child mortality (the subject of this paper) and maternal mortality. In a cross-sectional household survey in the south/centre of Iraq in February and March, 1999, 23105 ever-married women aged 15-49 years living in sampled households were interviewed by trained interviewers with a structured questionnaire that was developed using the Demographic and Health Surveys questionnaire and following a pre-test. In a similar survey in the autonomous region in April and May 14 035 ever-married women age 15-49 were interviewed. In the south/centre, infant and under-5 mortality increased during the 10 years before the survey, which roughly corresponds to the period following the Gulf conflict and the start of the United Nations sanctions. Infant mortality rose from 47 per 1000 live births during 1984-89 to 108 per 1000 in 1994-99, and under-5 mortality rose from 56 to 131 per 1000 live births. In the autonomous region during the same period, infant mortality declined from 64 to 59 per 1000 and under-5 mortality fell from 80 to 72 per 1000. Childhood mortality was higher among children born in rural areas, children born to women with no education, and in boys, and these differentials were broadly similar in the two regions. Childhood mortality clearly increased after the Gulf conflict and under UN sanctions in the south/centre of Iraq, but in the autonomous region since the start of the Oil-for-Food Programme childhood mortality has begun to decline. Better food and resource allocation to the autonomous region contributed to the continued gains in lower mortality, whereas the situation in the south/centre deteriorated despite the high level of literacy in that region.

Partnership Creates Centre for Union Studies

ERIC Educational Resources Information Center

Smart, Carol; Roman, Stephen

1978-01-01

A unique cooperative venture between the city of Coventry and local trade unions is establishing a library collection of books, periodicals, historical documents, tapes, and films dealing with unions, labor studies, and industrial problems. (JAB)

Do Independent Sector Treatment Centres (ISTC) impact on specialist registrar training in primary hip and knee arthroplasty?

PubMed

Clamp, Jonathan A; Baiju, Dean; Copas, David P; Hutchinson, James W; Rowles, John M

2008-09-01

The introduction of Modernising Medical Careers (MMC) is likely to reduce specialist registrar (SpR) operative experience during higher surgical training (HST). A further negative impact on training by local Independent Sector Treatment Centres (ISTCs) could reduce experience, and thus competence, in primary joint arthroplasty at completion of higher surgical training. Retrospective case note and radiograph analysis of patients receiving primary hip and knee arthroplasty in a teaching hospital, before and after the establishment of a local ISTC. Patients and operative details were recorded from the selected case notes. Corresponding radiographs were assessed and the severity of the disease process assessed. Fewer primary hip and knee replacements were performed by SpRs in the time period after the establishment of an ISTC. ISTCs may adversely affect SpR training in primary joint arthroplasty.

Becoming Heritage: A Place-Making Study of Old Neighbourhood Marketplace in Bandung

NASA Astrophysics Data System (ADS)

Ekomadyo, A. S.; Nurfadillah, A.; Kartamihardja, A.; Cungwin, A. J.

2018-05-01

The urban architectural heritages of Bandung represents the city’s historical layers. A unique urban architectural element found in Bandung is the heritage neighborhood marketplace. In the style of European post-renaissance urban design, a heritage neighborhood marketplace is initially designed as housing clusters with open spaces as neighborhood centre to create community privacy. But along the time, the neighborhood centre open their enclosed spaces and landmark buildings, transforming itself into small marketplaces with intensively daily activities. Through everyday place-making methods, this article investigates the history and meaning of neighborhood marketplace as everyday urban artefacts through observation, historical study, and interview. The study reveals are three main forces assembling the current form of neighborhood marketplaces in Bandung: Dutch-Indies colonialization, Chinese society trading network, and local traders’ tradition. Dutch-Indies colonialization in Bandung brought European architectural knowledge into neighborhood morphological design that contributed well-defined urban spaces. The Chinese trading network has been at place since the diaspora era and is still continued until now, bridging past and present life through economic activities. Local traders, who came after Dutch-Indies colonialization, fill the empty spaces of neighborhood centres with intensive formal and informal economic activities. Bandung heritage neighborhood marketplaces represent the city’s urban constellation, where global and local political-economic and socio-cultural forces meet in an urban process. Here, the urban heritage is redefined as living artefacts experienced in everyday urban life. Keywords: urban heritage, place making, neighborhood marketplace, Bandung, urban assemblage, living artefacts.

Re-audit of clients from ethnic and local communities in Greater Manchester attending St. Mary's Sexual Assault Referral Centre.

PubMed

McLean, Iain Andrew

2007-04-01

A re-audit was conducted at St. Mary's Sexual Assault Referral Centre to assess recording of clients' ethnicity, area of residence and assault type following training that drew on results of an initial audit. This also reassesses the ethnic and local community representation of clients in the light of more recent census data for Greater Manchester. Performances of recording ethnicity, area of residence, and assault type relevant to all new clients in 2003 (n=805) were measured against standards. Figures relating to local and ethnic populations were also compared to 2001 census data as a guide. Recording clients' ethnicity improved considerably, but recording area of residence slipped just below standard, and recording assault type dropped markedly. Overall ethnic minority representation was above general population figures, but differences existed within communities. Manchester city resident clients were over-represented compared to other county boroughs. Numbers of all clients seen at the centre had increased sharply since the original audit. Staff training following the original audit appeared to improve recording of ethnicity, whilst the heavy drop in assault type was largely attributed to an increase of referrals where the clients were not fully unconscious during the assault. The high number of Black and dual-heritage clients accounted for the 'over-representation' of ethnic minorities, masking under-representation of other ethnic communities, especially Asians. The 'over-representation' of Manchester city residents was seen to persist.

Visual grading characteristics and ordinal regression analysis during optimisation of CT head examinations.

PubMed

Zarb, Francis; McEntee, Mark F; Rainford, Louise

2015-06-01

To evaluate visual grading characteristics (VGC) and ordinal regression analysis during head CT optimisation as a potential alternative to visual grading assessment (VGA), traditionally employed to score anatomical visualisation. Patient images (n = 66) were obtained using current and optimised imaging protocols from two CT suites: a 16-slice scanner at the national Maltese centre for trauma and a 64-slice scanner in a private centre. Local resident radiologists (n = 6) performed VGA followed by VGC and ordinal regression analysis. VGC alone indicated that optimised protocols had similar image quality as current protocols. Ordinal logistic regression analysis provided an in-depth evaluation, criterion by criterion allowing the selective implementation of the protocols. The local radiology review panel supported the implementation of optimised protocols for brain CT examinations (including trauma) in one centre, achieving radiation dose reductions ranging from 24 % to 36 %. In the second centre a 29 % reduction in radiation dose was achieved for follow-up cases. The combined use of VGC and ordinal logistic regression analysis led to clinical decisions being taken on the implementation of the optimised protocols. This improved method of image quality analysis provided the evidence to support imaging protocol optimisation, resulting in significant radiation dose savings. • There is need for scientifically based image quality evaluation during CT optimisation. • VGC and ordinal regression analysis in combination led to better informed clinical decisions. • VGC and ordinal regression analysis led to dose reductions without compromising diagnostic efficacy.

Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

PubMed

Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

2018-02-01

The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

Force-induced chemical reactions on the metal centre in a single metalloprotein molecule.

PubMed

Zheng, Peng; Arantes, Guilherme M; Field, Martin J; Li, Hongbin

2015-06-25

Metalloproteins play indispensable roles in biology owing to the versatile chemical reactivity of metal centres. However, studying their reactivity in many metalloproteins is challenging, as protein three-dimensional structure encloses labile metal centres, thus limiting their access to reactants and impeding direct measurements. Here we demonstrate the use of single-molecule atomic force microscopy to induce partial unfolding to expose metal centres in metalloproteins to aqueous solution, thus allowing for studying their chemical reactivity in aqueous solution for the first time. As a proof-of-principle, we demonstrate two chemical reactions for the FeS4 centre in rubredoxin: electrophilic protonation and nucleophilic ligand substitution. Our results show that protonation and ligand substitution result in mechanical destabilization of the FeS4 centre. Quantum chemical calculations corroborated experimental results and revealed detailed reaction mechanisms. We anticipate that this novel approach will provide insights into chemical reactivity of metal centres in metalloproteins under biologically more relevant conditions.

Force-induced chemical reactions on the metal centre in a single metalloprotein molecule

PubMed Central

Zheng, Peng; Arantes, Guilherme M.; Field, Martin J.; Li, Hongbin

2015-01-01

Metalloproteins play indispensable roles in biology owing to the versatile chemical reactivity of metal centres. However, studying their reactivity in many metalloproteins is challenging, as protein three-dimensional structure encloses labile metal centres, thus limiting their access to reactants and impeding direct measurements. Here we demonstrate the use of single-molecule atomic force microscopy to induce partial unfolding to expose metal centres in metalloproteins to aqueous solution, thus allowing for studying their chemical reactivity in aqueous solution for the first time. As a proof-of-principle, we demonstrate two chemical reactions for the FeS4 centre in rubredoxin: electrophilic protonation and nucleophilic ligand substitution. Our results show that protonation and ligand substitution result in mechanical destabilization of the FeS4 centre. Quantum chemical calculations corroborated experimental results and revealed detailed reaction mechanisms. We anticipate that this novel approach will provide insights into chemical reactivity of metal centres in metalloproteins under biologically more relevant conditions. PMID:26108369

Ultrastructural findings in Hashimoto's thyroiditis and focal lymphocytic thyroiditis with reference to giant cell formation.

PubMed

Knecht, H; Hedinger, C E

1982-09-01

Ultrastructural findings in two cases of Hashimoto's disease and two cases of focal lymphocytic thyroiditis are reported. Stimulated thyrocytes, oncocytes and degenerating thyrocytes were observed in all cases. Multinucleated thyrocytes and epithelial pseudogiant cells were identified in Hashimoto's disease only. Infiltrating lymphocytes, plasma cells, monocytes and macrophages were present in all cases. The ultrastructure of germinal centres was similar to that seen in lymphatic organs. Giant cells of both intra- and extrafollicular localization were seen in Hashimoto's disease. Most of the giant cells were macrophage-derived. Two different ways of giant cell formation were identified: besides the familiar dissolution of plasma membranes of adjacent macrophages, another mechanism of fusion was observed. At sites of contact, peculiar membrane structures were developed and disintegration of plasma membranes occurred in parts adjacent to these structures. These are not identical to desmosomes and are different from Langerhans' granules. They probably represent special organelles for the initiation of cellular fusion.

The relationship between African easterly waves and equatorial waves and the influence from the Southern Hemisphere

NASA Astrophysics Data System (ADS)

Methven, John; Guiying, Yang; Hodges, Kevin; Woolnough, Steve

2017-04-01

There is strong intraseasonal and interannual variability in African easterly waves (AEWs). AEWs are crucial to precipitation across West Africa, but also generate positive vorticity centres that sometimes develop into tropical storms which can in turn spin-up into hurricanes in the easterlies across the North Atlantic. In this paper we show that there are connections between African easterly waves (AEWs), equatorial Rossby (R1 and R2) waves and westward-moving mixed Rossby gravity (WMRG) waves and that the conditions for propagation of equatorial waves may have a major influence on AEW and hence tropical cyclone variability. Two analysis approaches are taken using ERA-Interim data from 1979-2010: i) positive vorticity centres within AEWs are tracked at 600 hPa over West Africa to the Atlantic region and ii) the re-analysis data is filtered using a broad frequency and zonal wavenumber band and the filtered meridional wind is projected onto the horizontal structure functions derived from equatorial wave theory. The tracked vorticity centres are part of AEWs and are found to move along with features in the meridional wind projecting onto R1 and R2 waves. In contrast, the structures projecting onto WMRG waves move westwards at a faster rate. The projection is calculated independently on each pressure level to create composite cross-sections of each wave mode in the zonal-height plane, shown relative to the 600 hPa vorticity centres. The R2 waves tilt in the sense necessary for baroclinic growth and amplify from east to west, indicating that R2 horizontal structure captures the baroclinic wave component of AEWs. The composites show that the R2 structures have a wavelength matching the spacing between vorticity centres, while R1 and WMRG waves are longer. Intriguingly, the WMRG component has very strong cross-equatorial flow immediately to the east of positive vorticity centres developing on the AEJ. Although the WMRG propagates faster to the west and gets ahead of the original vorticity centre, the next AEW vorticity centre to the east develops with cross-equatorial flow in the same phase. This flow brings moist air from the southern hemisphere at low levels on the eastern flank of the vorticity centre, while there is an upper tropospheric "return flow" into the southern hemisphere above. Thus, there is a strong cross-equatorial component to the developing tropical storm outflow. WMRG waves may aid the initiation and development of AEW vorticity centres. Over West Africa, regressions show that the eastward group propagation of a WMRG packet precedes the genesis of vorticity centres on the AEJ. In years with stronger AEW activity, the upper tropospheric easterlies are stronger at the equator and extend further into the southern hemisphere. It is shown that stronger easterlies provide a waveguide for SH westward-moving Rossby waves in the upper troposphere to penetrate into the tropics, exciting equatorial WMRG waves and hence stronger AEW activity via the lower tropospheric cross-equatorial flow associated with WMRG waves.

Patient-centred care: a review for rehabilitative audiologists.

PubMed

Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

2014-02-01

This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer.

PubMed

Clark, C H; Miles, E A; Urbano, M T Guerrero; Bhide, S A; Bidmead, A M; Harrington, K J; Nutting, C M

2009-07-01

The purpose of this study was to compare conventional radiotherapy with parotid gland-sparing intensity-modulated radiation therapy (IMRT) using the PARSPORT trial. The validity of such a trial depends on the radiotherapy planning and delivery meeting a defined standard across all centres. At the outset, many of the centres had little or no experience of delivering IMRT; therefore, quality assurance processes were devised to ensure consistency and standardisation of all processes for comparison within the trial. The pre-trial quality assurance (QA) programme and results are described. Each centre undertook exercises in target volume definition and treatment planning, completed a resource questionnaire and produced a process document. Additionally, the QA team visited each participating centre. Each exercise had to be accepted before patients could be recruited into the trial. 10 centres successfully completed the quality assurance exercises. A range of treatment planning systems, linear accelerators and delivery methods were used for the planning exercises, and all the plans created reached the standard required for participation in this multicentre trial. All 10 participating centres achieved implementation of a comprehensive and robust IMRT programme for treatment of head and neck cancer.

Education in nuclear decommissioning in the north of Scotland

DOE Office of Scientific and Technical Information (OSTI.GOV)

Catlow, F.; Reeves, G.M.

2007-07-01

This paper describes the work covered and experience gained in the first two years of operation of DERC, a Centre for Decommissioning and Environmental Remediation in the Highlands of Scotland. The Centre is a unique development which was set up to teach nuclear decommissioning as a separate discipline, address the problem of a declining skills base in the field of nuclear technologies and to take advantage of the unique and exceptional innovative, technical and research opportunities offered through the decommissioning of Britain's fast reactor site at Dounreay. The Centre is an offshoot from North Highland College which is a membermore » of UHI, the University in embryo of the Highlands and Islands. The Centre currently supports ten PhD students completing various diverse projects mainly in the field of nuclear environmental remediation. In addition there area number of full and part time MSc students who participate in NTEC (Nuclear Technology Education Consortium) a consortium of British Universities set up specifically to engender interest and skills in nuclear technology at postgraduate level. At undergraduate level, courses are offered in Nuclear Decommissioning and related subjects as part of Electrical and Mechanical degree courses. In addition to our relationship with the United Kingdom Atomic Energy Authority (UKAEA) the Dounreay site licensee, we have links with Rolls-Royce and the Ministry of Defence who also share the Dounreay site and with other stakeholders such as, the UK regulator (HSE/NII), the Scottish Environmental Protection Agency (SEPA), local and international contractors and we liaise with the newly formed Nuclear Decommissioning Authority (NDA), who provide some sponsorship and support. We possess our own equipment and laboratories for taking and analysing soil samples and for conducting environmental surveys. Recently we commissioned an aerial survey of contamination in the locality from natural sources, other background levels such as Chernobyl fall out and any local activity from Dounreay. (authors)« less

Challenges to the implementation of health sector decentralization in Tanzania: experiences from Kongwa district council

PubMed Central

Frumence, Gasto; Nyamhanga, Tumaini; Mwangu, Mughwira; Hurtig, Anna-Karin

2013-01-01

Background During the 1990s, the government of Tanzania introduced the decentralization by devolution (D by D) approach involving the transfer of functions, power and authority from the centre to the local government authorities (LGAs) to improve the delivery of public goods and services, including health services. Objective This article examines and documents the experiences facing the implementation of decentralization of health services from the perspective of national and district officials. Design The study adopted a qualitative approach, and data were collected using semi-structured interviews and were analysed for themes and patterns. Results The results showed several benefits of decentralization, including increased autonomy in local resource mobilization and utilization, an enhanced bottom-up planning approach, increased health workers’ accountability and reduction of bureaucratic procedures in decision making. The findings also revealed several challenges which hinder the effective functioning of decentralization. These include inadequate funding, untimely disbursement of funds from the central government, insufficient and unqualified personnel, lack of community participation in planning and political interference. Conclusion The article concludes that the central government needs to adhere to the principles that established the local authorities and grant more autonomy to them, offer special incentives to staff working in the rural areas and create the capacity for local key actors to participate effectively in the planning process. PMID:23993021

Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2014-12-01

To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

Optimal service using Matlab - simulink controlled Queuing system at call centers

NASA Astrophysics Data System (ADS)

Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.

2018-04-01

This paper presents graphical integrated model based academic research on telephone call centres. This paper introduces an important feature of impatient customers and abandonments in the queue system. However the modern call centre is a complex socio-technical system. Queuing theory has now become a suitable application in the telecom industry to provide better online services. Through this Matlab-simulink multi queuing structured models provide better solutions in complex situations at call centres. Service performance measures analyzed at optimal level through Simulink queuing model.

Re-Shaping Teacher Identity? The Liverpool Teachers' Centre 1973-1976

ERIC Educational Resources Information Center

Williams, Keith

2014-01-01

Between 1972 and 1975 Eric Midwinter, Principal of the Liverpool Teachers' Centre, established a unified organisational structure responsible for delivering continuing professional development (CPD) to Liverpool schools. His ambition was to embed community education practices across the city's entire teaching force. However, during a seven-week…

Centre for Applied Language Studies, University of Limerick, Ireland

ERIC Educational Resources Information Center

Chambers, Angela; Atkinson, David; Farr, Fiona

2015-01-01

The Centre for Applied Language Studies (CALS), founded in 1997, brings together researchers and postgraduate students from several disciplines in language studies, and is structured in three research clusters: New learning environments; Discourse, society and identity; and Plurilingualism and language policy. There is a certain amount of…

Assessing the drivers shaping global patterns of urban vegetation landscape structure.

PubMed

Dobbs, C; Nitschke, C; Kendal, D

2017-08-15

Vegetation is one of the main resources involve in ecosystem functioning and providing ecosystem services in urban areas. Little is known on the landscape structure patterns of vegetation existing in urban areas at the global scale and the drivers of these patterns. We studied the landscape structure of one hundred cities around the globe, and their relation to demography (population), socioeconomic factors (GDP, Gini Index), climate factors (temperature and rain) and topographic characteristics (altitude, variation in altitude). The data revealed that the best descriptors of landscape structure were amount, fragmentation and spatial distribution of vegetation. Populated cities tend to have less, more fragmented, less connected vegetation with a centre of the city with low vegetation cover. Results also provided insights on the influence of socioeconomics at a global scale, as landscape structure was more fragmented in areas that are economically unequal and coming from emergent economies. This study shows the effects of the social system and climate on urban landscape patterns that gives useful insights for the distribution in the provision of ecosystem services in urban areas and therefore the maintenance of human well-being. This information can support local and global policy and planning which is committing our cities to provide accessible and inclusive green space for all urban inhabitants. Copyright © 2017 Elsevier B.V. All rights reserved.

Current status of kilovoltage (kV) radiotherapy in the UK: installed equipment, clinical workload, physics quality control and radiation dosimetry.

PubMed

Palmer, Antony L; Pearson, Michael; Whittard, Paul; McHugh, Katie E; Eaton, David J

2016-12-01

To assess the status and practice of kilovoltage (kV) radiotherapy in the UK. 96% of the radiotherapy centres in the UK responded to a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical treatment sites, quality control (QC) testing and radiation dosimetry processes were undertaken. 73% of UK centres have at least one kV treatment unit, with 58 units installed across the UK. Although 35% of units are over 10 years old, 39% units have been installed in the last 5 years. Approximately 6000 patients are treated with kV units in the UK each year, the most common site (44%) being basal cell carcinoma. A benchmark of QC practice in the UK is presented, against which individual centres can compare their procedures, frequency of testing and acceptable tolerance values. We propose the use of internal "notification" and "suspension" levels for analysis. All surveyed centres were using recommended Codes of Practice for kV dosimetry in the UK; approximately the same number using in-air and in-water methodologies for medium energy, with two-thirds of all centres citing "clinical relevance" as the reason for choice of code. 64% of centres had hosted an external dosimetry audit within the last 3 years, with only one centre never being independently audited. The majority of centres use locally measured applicator factors and published backscatter factors for treatments. Monitor unit calculations are performed using software in only 36% of centres. A comprehensive review of current kV practice in the UK is presented. Advances in knowledge: Data and discussion on contemporary kV radiotherapy in the UK, with a particular focus on physics aspects.

Current status of kilovoltage (kV) radiotherapy in the UK: installed equipment, clinical workload, physics quality control and radiation dosimetry

PubMed Central

Pearson, Michael; Whittard, Paul; McHugh, Katie E; Eaton, David J

2016-01-01

Objective: To assess the status and practice of kilovoltage (kV) radiotherapy in the UK. Methods: 96% of the radiotherapy centres in the UK responded to a comprehensive survey. An analysis of the installed equipment base, patient numbers, clinical treatment sites, quality control (QC) testing and radiation dosimetry processes were undertaken. Results: 73% of UK centres have at least one kV treatment unit, with 58 units installed across the UK. Although 35% of units are over 10 years old, 39% units have been installed in the last 5 years. Approximately 6000 patients are treated with kV units in the UK each year, the most common site (44%) being basal cell carcinoma. A benchmark of QC practice in the UK is presented, against which individual centres can compare their procedures, frequency of testing and acceptable tolerance values. We propose the use of internal “notification” and “suspension” levels for analysis. All surveyed centres were using recommended Codes of Practice for kV dosimetry in the UK; approximately the same number using in-air and in-water methodologies for medium energy, with two-thirds of all centres citing “clinical relevance” as the reason for choice of code. 64% of centres had hosted an external dosimetry audit within the last 3 years, with only one centre never being independently audited. The majority of centres use locally measured applicator factors and published backscatter factors for treatments. Monitor unit calculations are performed using software in only 36% of centres. Conclusion: A comprehensive review of current kV practice in the UK is presented. Advances in knowledge: Data and discussion on contemporary kV radiotherapy in the UK, with a particular focus on physics aspects. PMID:27730839

Integrating public health and medical intelligence gathering into homeland security fusion centres.

PubMed

Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

Natural-product-derived fragments for fragment-based ligand discovery

NASA Astrophysics Data System (ADS)

Over, Björn; Wetzel, Stefan; Grütter, Christian; Nakai, Yasushi; Renner, Steffen; Rauh, Daniel; Waldmann, Herbert

2013-01-01

Fragment-based ligand and drug discovery predominantly employs sp2-rich compounds covering well-explored regions of chemical space. Despite the ease with which such fragments can be coupled, this focus on flat compounds is widely cited as contributing to the attrition rate of the drug discovery process. In contrast, biologically validated natural products are rich in stereogenic centres and populate areas of chemical space not occupied by average synthetic molecules. Here, we have analysed more than 180,000 natural product structures to arrive at 2,000 clusters of natural-product-derived fragments with high structural diversity, which resemble natural scaffolds and are rich in sp3-configured centres. The structures of the cluster centres differ from previously explored fragment libraries, but for nearly half of the clusters representative members are commercially available. We validate their usefulness for the discovery of novel ligand and inhibitor types by means of protein X-ray crystallography and the identification of novel stabilizers of inactive conformations of p38α MAP kinase and of inhibitors of several phosphatases.

Notch-signalling is required for head regeneration and tentacle patterning in Hydra.

PubMed

Münder, Sandra; Tischer, Susanne; Grundhuber, Maresa; Büchels, Nathalie; Bruckmeier, Nadine; Eckert, Stefanie; Seefeldt, Carolin A; Prexl, Andrea; Käsbauer, Tina; Böttger, Angelika

2013-11-01

Local self-activation and long ranging inhibition provide a mechanism for setting up organising regions as signalling centres for the development of structures in the surrounding tissue. The adult hydra hypostome functions as head organiser. After hydra head removal it is newly formed and complete heads can be regenerated. The molecular components of this organising region involve Wnt-signalling and β-catenin. However, it is not known how correct patterning of hypostome and tentacles are achieved in the hydra head and whether other signals in addition to HyWnt3 are needed for re-establishing the new organiser after head removal. Here we show that Notch-signalling is required for re-establishing the organiser during regeneration and that this is due to its role in restricting tentacle activation. Blocking Notch-signalling leads to the formation of irregular head structures characterised by excess tentacle tissue and aberrant expression of genes that mark the tentacle boundaries. This indicates a role for Notch-signalling in defining the tentacle pattern in the hydra head. Moreover, lateral inhibition by HvNotch and its target HyHes are required for head regeneration and without this the formation of the β-catenin/Wnt dependent head organiser is impaired. Work on prebilaterian model organisms has shown that the Wnt-pathway is important for setting up signalling centres for axial patterning in early multicellular animals. Our data suggest that the integration of Wnt-signalling with Notch-Delta activity was also involved in the evolution of defined body plans in animals. © 2013 Elsevier Inc. All rights reserved.

The Contribution of OLG Data and Analysis Centre to EPOS

NASA Astrophysics Data System (ADS)

Stangl, Günter; Krauss, Sandro

2013-04-01

OLG (Observatory Lustbuehel Graz) as a joint venture of the Austrian Academy of Sciences and the Federal Office of Metrology and Surveying works as a GNSS data centre and analyses GNSS data for reference maintenance, geokinematics and ionosphere research. Due to the change from epoch to permanent sites regions in Africa, Asia and Europe are investigated since 1995. Presently, observations from about 300 GNSS stations are used for analysis. Most of the stations are public and are retrieved from different global, regional and local data centres. In addition some institutions provide their private data to the OLG. After presenting the main regions Austria, Central Europe, the Eastern Mediterranean and the Western Indian Ocean the question will be how these data and products could be included into EPOS.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 10: Results from Canada Wide Survey on Total Body Irradiation Practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Studinski, Ryan; Fraser, Danielle; Samant, Rajiv

Purpose: Total Body Irradiation (TBI) is delivered to a relatively small number of patients with a variety of techniques; it has been a challenge to develop consensus studies for best practice. This survey was created to assess the current state of TBI in Canada. Methods: The survey was created with questions focusing on the radiation prescription, delivery technique and resources involved. The survey was circulated electronically to the heads of every clinical medical physics department in Canada. Responses were gathered and collated, and centres that were known to deliver TBI were urged to respond. Results: Responses from 20 centres weremore » received, including 12 from centres that perform TBI. Although a variety of TBI dose prescriptions were reported, 12 Gy in 6 fractions was used in 11 centres while 5 centres use unique prescriptions. For dose rate, a range of 9 to 51 cGy/min was reported. Most centres use an extended SSD technique, with the patient standing or lying down against a wall. The rest use either a “sweeping” technique or a more complicated multi-field technique. All centres but one indicated that they shield the lungs, and only a minority shield other organs. The survey also showed that considerable resources are used for TBI including extra staffing, extended planning and treatment times and the use of locally developed hardware or software. Conclusions: This survey highlights that both similarities and important discrepancies exist between TBI techniques across the country, and is an opportunity to prompt more collaboration between centres.« less

Ecologies of security: On the everyday security tactics of female sex workers in Nairobi, Kenya.

PubMed

Lorway, Robert; Lazarus, Lisa; Chevrier, Claudyne; Khan, Shamshad; Musyoki, Helgar K; Mathenge, John; Mwangi, Peninah; Macharia, Pascal; Bhattacharjee, Parinita; Isac, Shajy; Kimani, Joshua; Gaaki, Gloria; Becker, Marissa; Moses, Stephen; Blanchard, James

2018-03-05

This paper highlights important environmental dimensions of HIV vulnerability by describing how the sex trade operates in Nairobi, Kenya. Although sex workers there encounter various forms of violence and harassment, as do sex workers globally, we highlight how they do not merely fall victim to a set of environmental risks but also act upon their social environment, thereby remaking it, as they strive to protect their health and financial interests. In so doing, we illustrate the mutual constitution of 'agency' and 'structure' in social network formations that take shape in everyday lived spaces. Our findings point to the need to expand the focus of interventions to consider local ecologies of security in order to place the local knowledges, tactics, and capacities that communities might already possess on centre stage in interventions. Planning, implementing, and monitoring interventions with a consideration of these ecologies would tie interventions not only to the risk reduction goals of global public health policy, but also to the very real and grounded financial priorities of what it means to try to safely earn a living through sex work.

[Solutions to problems in other countries].

PubMed

Wendehorst, C

2000-12-01

The costs of public health in Germany are permanently increasing due to changes in the age-structure of the population, the development of new and expensive methods of medical treatment, the appearance of new diseases and other causes. There is a vivid discussion about how we could rationalize and/or restructure the public health system. In order to find solutions we should consider the provision of public health in other countries, for example in Sweden, Great Britain, the USA and Italy. Sweden has introduced a primary care system and fostered ambulatory care, with general practitioners and specialists working hand in hand in public health centres. In the USA costs have been reduced through the instruments of "Managed Care": global fees, global budgeting in hospital services, avoidance of hospitalization and efficiency checks. In Great Britain, medical care is centralized in the "National Health Service", which is paid out of the tax revenue. In Italy, there are local primary care centres, and secondary care is provided only on referral by a primary care physician. For drugs, a positive list has been introduced. Some of the instruments referred to could be implemented in Germany and help economize the provision of public health. However, the liberties of doctors and patients would probably be restricted.

Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

PubMed

Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

2011-08-01

Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Development and implementation of an outpatient clinic at an initial reception centre for asylum seekers in the German federal state of Baden-Wuerttemberg].

PubMed

Nikendei, Christoph; Huhn, Daniel; Adler, Guido; von Rose, Peta Becker; Eckstein, Torsten M; Fuchs, Birgit; Gewalt, Sandra C; Greiner, Bernhard; Günther, Thomas; Herzog, Wolfgang; Junghanss, Thomas; Krczal, Thomas; Lorenzen, Detlef; Lutz, Thomas; Manigault, Meryl A; Reinhart, Nico; Rodenberg, Michiko; Schelletter, Iris; Szecsenyi, Joachim; Steen, Rainer; Straßner, Cornelia; Thomsen, Mirjam; Wahedi, Katharina; Bozorgmehr, Kayvan

2017-10-01

In 2015, more than 890,000 asylum seekers were registered in Germany. The provision of medical and psychosocial care for asylum seekers is facing numerous obstacles. Access to health care is mostly insufficient, particularly in initial reception centres. The present article describes the development and implementation of an interdisciplinary outpatient clinic for asylum seekers at the main registration authority in the state of Baden-Wuerttemberg operated by physicians of the University Hospital of Heidelberg and the local Medical Association in Heidelberg. A steering committee was appointed to plan and implement the interdisciplinary outpatient clinic. Semi-structured interviews with nine steering committee members were conducted to elucidate perceived barriers during the planning and implementation phase. The steering committee's strong personal commitment and the health authorities' impartial management were cited as the main contributing factors to the success of the implementation process. Significant barriers were seen in the funding of personnel, equipment, and language mediation as well as in legal liability and billing-related aspects. Results are discussed with a focus on financing, administrative and legal framework as well as language mediation, documentation and further matters that are essential to ensure high-quality care. Copyright © 2017. Published by Elsevier GmbH.

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

PubMed

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a charity community centre in Romania. The "Healthcare Access Barriers for Vulnerable Populations" (HABVP) model is proposed as an adaption to the existing HCAB model to account for the unique perceived barriers to healthcare for this population. Recommendations for future resolution of these identified barriers are proposed.

Safety and feasibility of breast lesion localization using magnetic seeds (Magseed): a multi-centre, open-label cohort study.

PubMed

Harvey, James R; Lim, Yit; Murphy, John; Howe, Miles; Morris, Julie; Goyal, Amit; Maxwell, Anthony J

2018-06-01

Wire localization has several disadvantages, notably wire migration and difficulty scheduling the procedure close to surgery. Radioactive seed localization overcomes these disadvantages, but implementation is limited due to radiation safety requirements. Magnetic seeds potentially offer the logistical benefits and transcutaneous detection equivalence of a radioactive seed, with easier implementation. This study was designed to evaluate the feasibility and safety of using magnetic seeds for breast lesion localization. A two-centre open-label cohort study to assess the feasibility and safety of magnetic seed (Magseed) localization of breast lesions. Magseeds were placed under radiological guidance into women having total mastectomy surgery. The primary outcome measure was seed migration distance. Secondary outcome measures included accuracy of placement, ease of transcutaneous detection, seed integrity and safety. Twenty-nine Magseeds were placed into the breasts of 28 patients under ultrasound guidance. There was no migration of the seeds between placement and surgery. Twenty-seven seeds were placed directly in the target lesion with the other seeds being 2 and 3 mm away. All seeds were detectable transcutaneously in all breast sizes and at all depths. There were no complications or safety issues. Magnetic seeds are a feasible and safe method of breast lesion localization. They can be accurately placed, demonstrate no migration in this feasibility study and are detectable in all sizes and depths of breast tissue. Now that safety and feasibility have been demonstrated, further clinical studies are required to evaluate the seed's effectiveness in wide local excision surgery.

'Act on oncology' as a new comprehensive approach to assess prostate cancer centres--method description and results of a pilot study.

PubMed

Voigt, Wieland; Hoellthaler, Josef; Magnani, Tiziana; Corrao, Vito; Valdagni, Riccardo

2014-01-01

Multidisciplinary care of prostate cancer is increasingly offered in specialised cancer centres. It requires the optimisation of medical and operational processes and the integration of the different medical and non-medical stakeholders. To develop a standardised operational process assessment tool basing on the capability maturity model integration (CMMI) able to implement multidisciplinary care and improve process quality and efficiency. Information for model development was derived from medical experts, clinical guidelines, best practice elements of renowned cancer centres, and scientific literature. Data were organised in a hierarchically structured model, consisting of 5 categories, 30 key process areas, 172 requirements, and more than 1500 criteria. Compliance with requirements was assessed through structured on-site surveys covering all relevant clinical and management processes. Comparison with best practice standards allowed to recommend improvements. 'Act On Oncology'(AoO) was applied in a pilot study on a prostate cancer unit in Europe. Several best practice elements such as multidisciplinary clinics or advanced organisational measures for patient scheduling were observed. Substantial opportunities were found in other areas such as centre management and infrastructure. As first improvements the evaluated centre administration described and formalised the organisation of the prostate cancer unit with defined personnel assignments and clinical activities and a formal agreement is being worked on to have structured access to First-Aid Posts. In the pilot study, the AoO approach was feasible to identify opportunities for process improvements. Measures were derived that might increase the operational process quality and efficiency.

A research agenda for a people-centred approach to energy access in the urbanizing global south

NASA Astrophysics Data System (ADS)

Broto, Vanesa Castán; Stevens, Lucy; Ackom, Emmanuel; Tomei, Julia; Parikh, Priti; Bisaga, Iwona; To, Long Seng; Kirshner, Joshua; Mulugetta, Yacob

2017-10-01

Energy access is typically viewed as a problem for rural areas, but people living in urban settings also face energy challenges that have not received sufficient attention. A revised agenda in research and practice that puts the user and local planning complexities centre stage is needed to change the way we look at energy access in urban areas, to understand the implications of the concentration of vulnerable people in slums and to identify opportunities for planned management and innovation that can deliver urban energy transitions while leaving no one behind. Here, we propose a research agenda focused on three key issues: understanding the needs of urban energy users; enabling the use of context-specific, disaggregated data; and engaging with effective modes of energy and urban governance. This agenda requires interdisciplinary scholarship across the social and physical sciences to support local action and deliver large-scale, inclusive transformations.

A prospective health impact assessment of the international astronomy and space exploration centre

PubMed Central

Winters, L

2001-01-01

STUDY OBJECTIVES—Assess the potential health impacts of the proposed International Astronomy and Space Exploration Centre on the population of New Wallasey. Contribute to the piloting of health impact assessment methods.
DESIGN—Prospective health impact assessment involving brainstorming sessions and individual interviews with key informants and a literature review.
SETTING—New Wallasey Single Regeneration Budget 4 area.
PARTICIPANTS—Key stakeholders including local residents' groups selected through purposeful snowball sampling.
MAIN RESULTS—Recommendations are made that cover issues around: transport and traffic; civic design; security; public safety, employment and training.
CONCLUSIONS—Health impact assessment is a useful pragmatic tool for facilitating wide consultation. In particular engaging the local population in the early planning stages of a proposed development, and assisting in highlighting changes to maximise the positive health influences on affected communities.


Keywords: health impact assessment; health determinants PMID:11351002

Quasi-local gravitational angular momentum and centre of mass from generalised Witten equations

NASA Astrophysics Data System (ADS)

Wieland, Wolfgang

2017-03-01

Witten's proof for the positivity of the ADM mass gives a definition of energy in terms of three-surface spinors. In this paper, we give a generalisation for the remaining six Poincaré charges at spacelike infinity, which are the angular momentum and centre of mass. The construction improves on certain three-surface spinor equations introduced by Shaw. We solve these equations asymptotically obtaining the ten Poincaré charges as integrals over the Nester-Witten two-form. We point out that the defining differential equations can be extended to three-surfaces of arbitrary signature and we study them on the entire boundary of a compact four-dimensional region of spacetime. The resulting quasi-local expressions for energy and angular momentum are integrals over a two-dimensional cross-section of the boundary. For any two consecutive such cross-sections, conservation laws are derived that determine the influx (outflow) of matter and gravitational radiation.

Do Independent Sector Treatment Centres (ISTC) Impact on Specialist Registrar Training in Primary Hip and Knee Arthroplasty?

PubMed Central

Clamp, Jonathan A; Baiju, Dean SR; Copas, David P; Hutchinson, James W; Rowles, John M

2008-01-01

INTRODUCTION The introduction of Modernising Medical Careers (MMC) is likely to reduce specialist registrar (SpR) operative experience during higher surgical training (HST). A further negative impact on training by local Independent Sector Treatment Centres (ISTCs) could reduce experience, and thus competence, in primary joint arthroplasty at completion of higher surgical training. PATIENTS AND METHODS Retrospective case note and radiograph analysis of patients receiving primary hip and knee arthroplasty in a teaching hospital, before and after the establishment of a local ISTC. Patients and operative details were recorded from the selected case notes. Corresponding radiographs were assessed and the severity of the disease process assessed. RESULTS Fewer primary hip and knee replacements were performed by SpRs in the time period after the establishment of an ISTC. Conclusions ISTCs may adversely affect SpR training in primary joint arthroplasty. PMID:18765029

Localized emission from laser-irradiated defects in 2D hexagonal boron nitride

NASA Astrophysics Data System (ADS)

Hou, Songyan; Danang Birowosuto, Muhammad; Umar, Saleem; Ange Anicet, Maurice; Yingjie Tay, Roland; Coquet, Philippe; Tay, Beng Kang; Wang, Hong; Teo, Edwin Hang Tong

2018-01-01

Hexagonal boron nitride (hBN) has emerged as a promising two-dimensional (2D) material for photonics device due to its large bandgap and flexibility in nanophotonic circuits. Here, we report bright and localized luminescent centres can be engineered in hBN monolayers and flakes using laser irradiation. The transition from hBN to cBN emerges in laser irradiated hBN large monolayers while is absent in processed hBN flakes. Remarkably, the colour centres in hBN flakes exhibit room temperature cleaner single photon emissions with g 2(0) ranging from 0.20 to 0.42, a narrower line width of 1.4 nm and higher brightness compared with monolayers. Our results pave the way to engineering deterministic defects in hBN induced by laser pulse and show great prospect for application of defects in hBN used as nano-size light source in photonics.

MAGNETIC FIELD OF THE VELA C MOLECULAR CLOUD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kusune, Takayoshi; Sugitani, Koji; Nakamura, Fumitaka

We have performed extensive near-infrared ( JHK {sub s}) imaging polarimetry toward the Vela C molecular cloud, which covers the five high-density sub-regions (North, Centre-Ridge, Centre-Nest, South-Ridge, and South-Nest) with distinct morphological characteristics. The obtained polarization vector map shows that three of these sub-regions have distinct plane-of-the-sky (POS) magnetic-field characteristics according to the morphological characteristics. (1) In the Centre-Ridge sub-region, a dominating ridge, the POS magnetic field is mostly perpendicular to the ridge. (2) In the Centre-Nest sub-region, a structure having a slightly extended nest of filaments, the POS magnetic field is nearly parallel to its global elongation. (3) Inmore » the South-Nest sub-region, which has a network of small filaments, the POS magnetic field appears to be chaotic. By applying the Chandrasekhar–Fermi method, we derived the POS magnetic field strength as ∼70–310 μ G in the Centre-Ridge, Centre-Nest, and South-Ridge sub-regions. In the South-Nest sub-region, the dispersion of polarization angles is too large to apply the C-F method. Because the velocity dispersion in this sub-region is not greater than those in the other sub-regions, we suggest that the magnetic field in this sub-region is weaker than those in other sub-regions. We also discuss the relationship between the POS magnetic field (configuration and strength) and the cloud structure of each sub-region.« less

Patient engagement in the process of planning and designing outpatient care improvements at the Veterans Administration Health-care System: findings from an online expert panel.

PubMed

Khodyakov, Dmitry; Stockdale, Susan E; Smith, Nina; Booth, Marika; Altman, Lisa; Rubenstein, Lisa V

2017-02-01

There is a strong interest in the Veterans Administration (VA) Health-care System in promoting patient engagement to improve patient care. We solicited expert opinion using an online expert panel system with a modified Delphi structure called ExpertLens ™ . Experts reviewed, rated and discussed eight scenarios, representing four patient engagement roles in designing and improving VA outpatient care (consultant, implementation advisor, equal stakeholder and lead stakeholder) and two VA levels (local and regional). Rating criteria included desirability, feasibility, patient ability, physician/staff acceptance and impact on patient-centredness and care quality. Data were analysed using the RAND/UCLA Appropriateness Method for determining consensus. Experts rated consulting with patients at the local level as the most desirable and feasible patient engagement approach. Engagement at the local level was considered more desirable than engagement at the regional level. Being an equal stakeholder at the local level received the highest ratings on the patient-centredness and health-care quality criteria. Our findings illustrate expert opinion about different approaches to patient engagement and highlight the benefits and challenges posed by each. Although experts rated local consultations with patients on an as-needed basis as most desirable and feasible, they rated being an equal stakeholder at the local level as having the highest potential impact on patient-centredness and care quality. This result highlights a perceived discrepancy between what is most desirable and what is potentially most effective, but suggests that routine local engagement of patients as equal stakeholders may be a desirable first step for promoting high-quality, patient-centred care. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study.

PubMed

Cederwall, Carl-Johan; Olausson, Sepideh; Rose, Louise; Naredi, Silvana; Ringdal, Mona

2018-06-01

To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

A trans-cultural comparison of the organisation of care at headache centres world-wide.

PubMed

Bhola, Ria; Goadsby, Peter J

2011-02-01

The need to provide better outcomes for patients with headache, and to minimise the costs involved in doing so, has prompted the search for new modes of service delivery by exploring the service organisation and nursing role from various cultural, economic and global perspectives. This study was based on comparisons with the UK headache service up to 2007, the point at which this study was set up. This UK service was based at the National Hospital for Neurology and Neurosurgery (NHNN, UCLH Trust). Data were obtained from US headache centres in 2008 and from centres in Copenhagen, Bangkok, Sydney and Porto Alegre in 2009. A comparison shows the key components of services at all centres showing the team structure and size of service. Prominent features at the centres included: team-working, regular meetings, educational input, good access and communication among team members, headache-trained neurologists, specialist nursing at most centres, and the input of psychological and physical therapists at some centres. The problems of tertiary headache care are very similar throughout the world and seem to transcend ethnic, cultural and economic considerations.

Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

ERIC Educational Resources Information Center

Vitus, Kathrine

2010-01-01

This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

R&D Centres in Mexico in an Open Economy: Redefining Operating Practices

ERIC Educational Resources Information Center

de Gortari Rabiela, Rebeca; Corral, Maria Josefa Santos

2004-01-01

Structural changes in Mexico's economy and trade policies have influenced firms' efforts to achieve technological innovation and improve their learning processes. In this context, R&D centres face new challenges in responding to firms' technological needs. The authors analyse how this new environment is affecting the operating practices of R&D…

Ancient deuterostome origins of vertebrate brain signalling centres.

PubMed

Pani, Ariel M; Mullarkey, Erin E; Aronowicz, Jochanan; Assimacopoulos, Stavroula; Grove, Elizabeth A; Lowe, Christopher J

2012-03-14

Neuroectodermal signalling centres induce and pattern many novel vertebrate brain structures but are absent, or divergent, in invertebrate chordates. This has led to the idea that signalling-centre genetic programs were first assembled in stem vertebrates and potentially drove morphological innovations of the brain. However, this scenario presumes that extant cephalochordates accurately represent ancestral chordate characters, which has not been tested using close chordate outgroups. Here we report that genetic programs homologous to three vertebrate signalling centres-the anterior neural ridge, zona limitans intrathalamica and isthmic organizer-are present in the hemichordate Saccoglossus kowalevskii. Fgf8/17/18 (a single gene homologous to vertebrate Fgf8, Fgf17 and Fgf18), sfrp1/5, hh and wnt1 are expressed in vertebrate-like arrangements in hemichordate ectoderm, and homologous genetic mechanisms regulate ectodermal patterning in both animals. We propose that these genetic programs were components of an unexpectedly complex, ancient genetic regulatory scaffold for deuterostome body patterning that degenerated in amphioxus and ascidians, but was retained to pattern divergent structures in hemichordates and vertebrates. © 2012 Macmillan Publishers Limited. All rights reserved

Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance.

PubMed

Schmidt, C; Potter, N; Porceddu, S; Panizza, B

2017-07-01

Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.

Low Decision Space Means No Decentralization in Fiji Comment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

PubMed

Faguet, Jean-Paul

2016-06-22

Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decision-making in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited. This paper invokes Faguet's (2012) model of local government responsiveness and accountability to explain why this is so - not only for Fiji, but in any country that decentralizes workloads but not the decision space of local governments. A competitive dynamic between economic and civic actors that interact to generate an open, competitive politics, which in turn produces accountable, responsive government can only occur where real power and resources have been devolved to local governments. Where local decision space is lacking, by contrast, decentralization is bound to fail because it has not really happened in the first place. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities.

PubMed

Breeze, Penny; Womack, Robert; Pryce, Robert; Brennan, Alan; Goyder, Elizabeth

2018-01-01

We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB's. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB.

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

PubMed Central

Fundowicz, Magdalena; Macia, Miguel; Marin, Susanna; Bogusz-Czerniewicz, Marta; Konstanty, Ewelina; Modolel, Ignaci; Malicki, Julian; Guedea, Ferran

2014-01-01

Background We performed a clinical audit of preoperative rectal cancer treatment at two European radiotherapy centres (Poland and Spain). The aim was to independently verify adherence to a selection of indicators of treatment quality and to identify any notable inter-institutional differences. Methods A total of 162 patients, in Catalan Institute of Oncology (ICO) 68 and in Greater Poland Cancer Centre (GPCC) 94, diagnosed with locally advanced rectal cancer and treated with preoperative radiotherapy or radio-chemotherapy were included in retrospective study. A total of 7 quality control measures were evaluated: waiting time, multidisciplinary treatment approach, portal verification, in vivo dosimetry, informed consent, guidelines for diagnostics and therapy, and patient monitoring during treatment. Results Several differences were observed. Waiting time from pathomorphological diagnosis to initial consultation was 31 (ICO) vs. 8 (GPCC) days. Waiting time from the first visit to the beginning of the treatment was twice as long at the ICO. At the ICO, 82% of patient experienced treatment interruptions. The protocol for portal verification was the same at both institutions. In vivo dosimetry is not used for this treatment localization at the ICO. The ICO utilizes locally-developed guidelines for diagnostics and therapy, while the GPCC is currently developing its own guidelines. Conclusions An independent external clinical audit is an excellent approach to identifying and resolving deficiencies in quality control procedures. We identified several procedures amenable to improvement. Both institutions have since implemented changes to improve quality standards. We believe that all radiotherapy centres should perform a comprehensive clinical audit to identify and rectify deficiencies. PMID:24991212

Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland.

PubMed

Fundowicz, Magdalena; Macia, Miguel; Marin, Susanna; Bogusz-Czerniewicz, Marta; Konstanty, Ewelina; Modolel, Ignaci; Malicki, Julian; Guedea, Ferran

2014-06-01

We performed a clinical audit of preoperative rectal cancer treatment at two European radiotherapy centres (Poland and Spain). The aim was to independently verify adherence to a selection of indicators of treatment quality and to identify any notable inter-institutional differences. A total of 162 patients, in Catalan Institute of Oncology (ICO) 68 and in Greater Poland Cancer Centre (GPCC) 94, diagnosed with locally advanced rectal cancer and treated with preoperative radiotherapy or radio-chemotherapy were included in retrospective study. A total of 7 quality control measures were evaluated: waiting time, multidisciplinary treatment approach, portal verification, in vivo dosimetry, informed consent, guidelines for diagnostics and therapy, and patient monitoring during treatment. Several differences were observed. Waiting time from pathomorphological diagnosis to initial consultation was 31 (ICO) vs. 8 (GPCC) days. Waiting time from the first visit to the beginning of the treatment was twice as long at the ICO. At the ICO, 82% of patient experienced treatment interruptions. The protocol for portal verification was the same at both institutions. In vivo dosimetry is not used for this treatment localization at the ICO. The ICO utilizes locally-developed guidelines for diagnostics and therapy, while the GPCC is currently developing its own guidelines. An independent external clinical audit is an excellent approach to identifying and resolving deficiencies in quality control procedures. We identified several procedures amenable to improvement. Both institutions have since implemented changes to improve quality standards. We believe that all radiotherapy centres should perform a comprehensive clinical audit to identify and rectify deficiencies.

The changing interface between district hospital cardiology and the major cardiac centres

PubMed Central

1997-01-01

The national priority for reducing mortality and morbidity from cardiovascular disease, the resulting expansion in the number of consultant cardiologists, and the reforms of the National Health Service have produced significant changes in delivery of care for cardiac patients and in the relations between district general hospitals (DGH) and the old regional cardiac centres. 1.2 The British Cardiac Society, the Medical Royal Colleges of Physicians of London and Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow established a working group to make recommendations on the most appropriate evolution of these changes to secure high quality care in a cost-effective and professionally rewarding environment. The principal conclusions of the working group were: i) The establishment of new cardiac catheterisation laboratories in DGHs remote from a major cardiac centre should be encouraged provided the workload is adequate to ensure efficient use of the facility. ii) Cardiologists working in districts close to a major centre should be encouraged to catheterise their patients at the centre. iii) Close liaison of the district cardiologist with a cardiac surgeon and interventionist is vitally important. iv) The centres will be required to provide tertiary care for emergency and urgent cases from their traditional catchment area, specialised expertise for the management of rare and difficult cases, and angioplasty. Some centres will also offer complex electrophysiology, and ablation techniques. v) The centres must also provide routine cardiology services for their local district, facilities for cardiac catheterisation for DGH cardiologists, and training for doctors, nurses, technicians, and radiographers. vi) Some centres will be linked with paediatric cardiology and paediatric cardiac surgical units. vii) District cardiac centres will be required to provide a full non-invasive diagnostic service and emergency care for patients referred by general practitioners and hospital colleagues as well as facilities for preventative and rehabilitation cardiology. Arrangements for invasive investigation and treatment of their patients will vary according mainly to the distance from the major centre. viii) Both the major centres and the district cardiac units should participate in training and research. 


 PMID:9415018

Structures and bonding of C2X2Y q (X=Si,Ge,Sn,Pb; Y=C,Si,Ge,Sn,Pb; q = +1,0,-1): π-type templates for planar tetracoordinate heavier group 14 atoms

NASA Astrophysics Data System (ADS)

Yu, Shuang; Sui, Jing-jing; Xu, Jing; Ding, Yi-hong

2018-05-01

Contrasting the big family of the planar tetracoordinate carbon (ptC), species featuring the planar tetracoordinate heavier group element M (ptM) have been largely limited. Effective structural frameworks to accommodate such ptM centres are thus highly desired. In the present article, we report an extensive computational study on 60 pentatomic systems C2X2Yq (X=Si,Ge,Sn,Pb; Y=C,Si,Ge,Sn,Pb; q = +1,0,-1) covering both the low and high spin states. Up to 34 systems were shown to have the very low-lying singlet planar tetracoordinate heavier group 14 (ptM with M=Si,Ge,Sn,Pb) structures bearing the 19 (q = +1), 20 (q = 0) and 21 (q = -1) valence electrons (ve). Structural and bonding analysis confirmed the effectiveness of the inherent π-type ligand skeleton XCCX or XCCY that each have several sets of π-bonding orbitals to stabilise the ptM centre. The structural and bonding motifs of these ptMs differ greatly from the classic ptMs, which have the σ-type ligand skeleton, smaller number of valence electrons (≤18ve), and the centre → ligand π-delocalisation.

Improving the layout of recycling centres by use of lean production principles.

PubMed

Sundin, Erik; Björkman, Mats; Eklund, Mats; Eklund, Jörgen; Engkvist, Inga-Lill

2011-06-01

There has been increased focus on recycling in Sweden during recent years. This focus can be attributed to external environmental factors such as tougher legislation, but also to the potential gains for raw materials suppliers. Recycling centres are important components in the Swedish total recycling system. Recycling centres are manned facilities for waste collection where visitors can bring, sort and discard worn products as well as large-sized, hazardous, and electrical waste. The aim of this paper was to identify and describe the main flows and layout types at Swedish recycling centres. The aim was also to adapt and apply production theory for designing and managing recycling centre operations. More specifically, this means using lean production principles to help develop guidelines for recycling centre design and efficient control. Empirical data for this research was primarily collected through interviews and questionnaires among both visitors and employees at 16 Swedish recycling centres. Furthermore, adapted observation protocols have been used in order to explore visitor activities. There was also close collaboration with a local recycling centre company, which shared their layout experiences with the researchers in this project. The recycling centres studied had a variety of problems such as queues of visitors, overloading of material and improper sorting. The study shows that in order to decrease the problems, the recycling centres should be designed and managed according to lean production principles, i.e. through choosing more suitable layout choices with visible and linear flows, providing better visitor information, and providing suitable technical equipment. Improvements can be achieved through proper planning of the layout and control of the flow of vehicles, with the result of increased efficiency and capacity, shorter visits, and cleaner waste fractions. The benefits of a lean production mindset include increased visitor capacity, waste flexibility, improved sorting quality, shorter time for visits and improved working conditions. Copyright © 2011 Elsevier Ltd. All rights reserved.

New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma.

PubMed

Müller, Hermann L; Merchant, Thomas E; Puget, Stephanie; Martinez-Barbera, Juan-Pedro

2017-05-01

Childhood-onset craniopharyngiomas are rare embryonic tumours of low-grade histological malignancy. Novel insights into the molecular pathogenesis of human adamantinomatous craniopharyngioma have started to unveil the possibility of testing novel treatments targeting pathogenic pathways. Hypothalamic involvement and/or treatment-related lesions result in impaired physical and social functionality and in severe neuroendocrine sequelae. Quality of survival in patients with craniopharyngioma with hypothalamic involvement is impaired by severe obesity, physical fatigue and non-optimal psychosocial development. Patients with craniopharyngioma involving hypothalamic structures have reduced 20-year overall survival, but overall and progression-free survival are not related to the degree of surgical resection. Irradiation is effective in the prevention of tumour progression and recurrence. For favourably localized craniopharyngiomas, the preferred treatment of choice is to attempt complete resection with preservation of visual, hypothalamic and pituitary function. For unfavourably localized tumours in close proximity to optic and/or hypothalamic structures, a radical neurosurgical strategy attempting complete resection is not recommended owing to potential severe sequelae. As expertise has been shown to have an impact on post-treatment morbidity, medical societies should establish criteria for adequate professional expertise for the treatment of craniopharyngioma. On the basis of these criteria, health authorities should organize the certification of centres of excellence that are authorized to treat and care for patients with this chronic disease.

Dying at home: experience of the Verdun local community service centre.

PubMed

Kiyanda, Brigitte Gagnon; Dechêne, Geneviève; Marchand, Robert

2015-04-01

To demonstrate that it is possible for a team of palliative care nurses in an urban centre to care for more than 50% of their terminally ill patients at home until they die, and that medical care delivered in the home is a determining factor in death at home versus death in a hospital. Analysis of place of death of terminally ill patients who died in 2012 and 2013 (N = 212) and who had been cared for by palliative care nurses, by type of medical care. The centre local de services communautaires (CLSC) in Verdun, Que, an urban neighbourhood in southwest Montreal. A total of 212 terminally ill patients. Rate of deaths at home. Of the 212 patients cared for at home by palliative care nurses, 56.6% died at home; 62.6% received medical home care from CLSC physicians, compared with 5.0% who did not receive medical home care from any physician. Combined with a straightforward restructuring of the nursing care delivered by CLSCs, development of medical services delivered in the home would enable the more than 50% of terminally ill patients in Quebec who are cared for by CLSCs to die at home--something that most of them wish for. Copyright© the College of Family Physicians of Canada.

Referrals for pediatric weight management: the importance of proximity.

PubMed

Ambler, Kathryn A; Hagedorn, Douglas W J; Ball, Geoff D C

2010-11-01

Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity. All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009. Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children. Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Information needs of people with low back pain for an online resource: a qualitative study of consumer views.

PubMed

Nielsen, Mandy; Jull, Gwendolen; Hodges, Paul W

2014-01-01

To identify the information needs of people with low back pain (LBP) in Australia, and the preferred methods to present this information online, as a basis for development of a patient-centred website. Available online LBP resources are limited in quality and content and it is not clear if they are meeting the needs of sufferers. Focus groups and semi-structured telephone interviews, involving 28 people with LBP. Seven categories of information were identified: reasons for LBP, treatment and management options, self-help information, psychological and social dimensions, lay stories, quality assurance of information and roles of different healthcare professionals and locally available services. Identified preferences for online presentation included: multimodality, emphasis on visual media, readability and interactivity. Participants had been unable to obtain desired LBP information using existing resources. This study provides important guidance for development of a patient-centred website grounded in the expressed needs and preferences of people with LBP. Understanding the breadth of patients' questions and concerns is essential for provision of patient-centred information and interventions. Incorporating these with the current evidence base would provide an accessible and relevant LBP patient education referral point, which is currently lacking. Implications for Rehabilitation Use of the internet to obtain health information is increasing, although there is little evidence that existing low back pain websites are meeting the expressed needs of health consumers. Our research suggests that people with low back pain have difficulty finding relevant and trustworthy information about the condition on the internet. Taking patient information needs and presentation preferences into account when designing online information material will provide people with low back pain an accessible and relevant educational resource that is currently lacking.

Evaluation of structural vacancies for 1/1-Al-Re-Si approximant crystals by positron annihilation spectroscopy

NASA Astrophysics Data System (ADS)

Yamada, K.; Suzuki, H.; Kitahata, H.; Matsushita, Y.; Nozawa, K.; Komori, F.; Yu, R. S.; Kobayashi, Y.; Ohdaira, T.; Oshima, N.; Suzuki, R.; Takagiwa, Y.; Kimura, K.; Kanazawa, I.

2018-01-01

The size of structural vacancies and structural vacancy density of 1/1-Al-Re-Si approximant crystals with different Re compositions were evaluated by positron annihilation lifetime and Doppler broadening measurements. Incident positrons were found to be trapped at the monovacancy-size open space surrounded by Al atoms. From a previous analysis using the maximum entropy method and Rietveld method, such an open space is shown to correspond to the centre of Al icosahedral clusters, which locates at the vertex and body centre. The structural vacancy density of non-metallic Al73Re17Si10 was larger than that of metallic Al73Re15Si12. The observed difference in the structural vacancy density reflects that in bonding nature and may explain that in the physical properties of the two samples.

Communication training for centre-based carers of children with severe or profound disabilities in the Western Cape, South Africa.

PubMed

Geiger, Martha

2012-01-01

The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings . Non-profit organisations (NPOs) have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers) and for further research are identified.

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study.

PubMed

Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-11-01

To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5-25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense.

What specifications for a centre or network of excellence in clinical research?

PubMed

Diebolt, Vincent; Lang, Marie; Thoby, Frédérique

2016-02-01

The Giens 2015 Workshop Round Table entitled "What specifications for a centre or network of excellence in clinical research?" took a viewpoint distinct from earlier work and studies on changes in clinical research activities in France. The purpose of the present work was to identify, starting from concrete examples, the main strengths and advantages of clinical research activity in France related, in part, to the background environment and also to the specific characteristics of the investigation centres considered to be among the most high-performance units in activity. The criteria retained were grouped into a set of specifications that could be used to establish a "label of excellence" upon which the different teams and clinical research centres could model themselves. It was thus considered that belonging to a centre or structured network with at least a national configuration, when this is possible for the medial topic in question, constitutes a real advantage. Four benchmarks were identified: the scientific and clinical expertise of the head investigator, as well as the qualification and operational capacity of the centre's team; definition and measurement of performance using clearly displayed indicators and evaluation procedures; the quality of the overall trial "process" and of each of its component steps; communication, because know-how and promotion go hand in hand, with the main objective of informing the professional and general public about the value of the research centre meeting the above-mentioned criteria, about its networks of competencies, and more generally, about the important assets of the background of clinical research in France. This sector of research is funded by the public authorities via calls for public grants, financial aids for structures supporting clinical research in the University Hospital Centres and other healthcare institutions allowing for a professionalization of the research occupations, and the national public health plans (cancer, rare disease, HIV). Copyright © 2016. Published by Elsevier Masson SAS.

Identification of different coordination geometries by XAFS in copper(II) complexes with trimesic acid

NASA Astrophysics Data System (ADS)

Gaur, A.; Klysubun, W.; Soni, Balram; Shrivastava, B. D.; Prasad, J.; Srivastava, K.

2016-10-01

X-ray absorption spectroscopy (XAS) is very useful in revealing the information about geometric and electronic structure of a transition-metal absorber and thus commonly used for determination of metal-ligand coordination. But XAFS analysis becomes difficult if differently coordinated metal centers are present in a system. In the present investigation, existence of distinct coordination geometries around metal centres have been studied by XAFS in a series of trimesic acid Cu(II) complexes. The complexes studied are: Cu3(tma)2(im)6 8H2O (1), Cu3(tma)2(mim)6 17H2O (2), Cu3(tma)2(tmen)3 8.5H2O (3), Cu3(tma) (pmd)3 6H2O (ClO4)3 (4) and Cu3(tma)2 3H2O (5). These complexes have not only Cu metal centres with different coordination but in complexes 1-3, there are multiple coordination geometries present around Cu centres. Using XANES spectra, different coordination geometries present in these complexes have been identified. The variation observed in the pre-edge features and edge features have been correlated with the distortion of the specific coordination environment around Cu centres in the complexes. XANES spectra have been calculated for the distinct metal centres present in the complexes by employing ab-initio calculations. These individual spectra have been used to resolve the spectral contribution of the Cu centres to the particular XANES features exhibited by the experimental spectra of the multinuclear complexes. Also, the variation in the 4p density of states have been calculated for the different Cu centres and then correlated with the features originated from corresponding coordination of Cu. Thus, these spectral features have been successfully utilized to detect the presence of the discrete metal centres in a system. The inferences about the coordination geometry have been supported by EXAFS analysis which has been used to determine the structural parameters for these complexes.

Analysis of the Use of Frame Construction and Modular Additions in City Centre

NASA Astrophysics Data System (ADS)

Milwicz, Roman; Milwicz, Natalia; Dubas, Sebastian

2017-10-01

The living urban fabric can be characterized by the continuous introduction of changes and additions. The city centre is subject to specific restrictions due to the conservation protection and high demand on aesthetics aspect, thermal insulation, construction cost and the ratio of usable area of the building area. This article presents a comparative analysis of traditional construction with light frame and modular construction for the above-mentioned issues. Timber frame structure technology was suggested as effective, economic and innovative solutions for modular additions on buildings in city centres.

Pleistocene Volcanic Fields in the Anahim Volcanic Belt: What, why, how? - Chilcotin Highland, West-Central British Columbia, Canada

NASA Astrophysics Data System (ADS)

Kuehn, Christian; Guest, Bernard

2013-04-01

A large number of volcanic features, including stratovolcanoes, cinder cones, domes, flows and erosional remnants of these exist in the eastern part of the Anahim Volcanic Belt (AVB) around Satah Mountain and Baldface Mountain. These two fields (abbreviated SMVF and BMVF below) are located south and east of the Itcha Ranges in the Chilcotin Highland of west-central British Columbia. Petrographic, geochemical and geochronological studies are hoped to clarify the volcano-tectonic association of these fields and if/how they relate to the nearby AVB. The studies might also provide corroboration of the hot-spot that has been proposed as the source of magmatism in the area, ranging from mid-Miocene ages in the western part of the AVB to Holocene ages at its eastern end at Nazko Cone. During two field campaigns, 20 centres in the SMVF aligned on a NNW-SSE trending topographic high and seven centres in the BMVF were studied with a focus on geochemistry and ages of the erupted lavas. With the exception of Satah Mountain, the most prominent and best-preserved edifice, individual centres are generally small in elevation (200-300 m) and volume. At almost all edifices, there is evidence for glacial modification, which likely removed most of the once-existing (?) pyroclastic material; water-magma interaction could be observed at one centre as well. Extensive coverage by glacial till limits outcrops to cliffs on the edifices' flanks or to local "windows" in the Quaternary deposits. This makes stratigraphic relationships, both within the fields and the surrounding volcanic rocks of the AVB and Chilcotin Flood Basalts (CFB), unclear. Preliminary XRF results indicate a high variability of the lavas, even between centres close to each other. Erupted lavas range from undersaturated basanites (44 wt% SiO2), trachybasalts and trachytes to high-alkali phonolites (14 wt% Na2O+K2O). In general, larger structures in the SMVF appear to have erupted more evolved rocks whereas smaller centres, often just remnants of plugs and necks, and centres in the more easterly BMVF, erupted more primitive rocks. In addition, all new whole-rock ages were determined using the Ar-Ar method for eleven SMVF centres and seven in the BMVF, with clusters around 1.85 Ma for the former and 2.22 Ma for the latter. These ages coincide with existing K-Ar ages for the nearby Itcha Ranges (3.5-1.1 Ma) and would fit well with the hot-spot hypothesis for the AVB. The prevalence of evolved rocks in the SMVF and BMVF might further indicate a relationship to the high-alkaline rocks of the AVB. Further studies will focus (1) on the geochemistry and ages of additional centres, including the yet-unstudied southern part of the Rainbow Range shield volcano in the AVB; (2) the isotopic composition of the lavas to identify possible source regions of the erupted magmas; (3) potential mechanisms and tectonic controls leading to magma ascent along the apparent W-E trend of the AVB, which heretofore has been explained by a mantle plume.

Collaboration, facilities and communities in day care services for older people.

PubMed

Adams, John

2001-05-01

Similarities and differences between day hospitals, run by the NHS, and day centres, run by local authorities or charitable organisations, have been widely discussed in the literature of gerontology for many years. The authors of this paper have undertaken a single blind, randomised-controlled trial to compare rehabilitation outcomes in the two settings, which was published in 1999. This research project involved augmenting the staff of day centres by visiting therapists. In addition to quantitative findings, their project also generated much qualitative data from interviews with health service and social service staff which provides the thought-provoking content. The themes identified included the reluctance of some patients to accept referral to a day centre, and the difficulties associated with discharging patients. Positive aspects included the opportunity to share skills, knowledge and resources. 29 references.

Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit.

PubMed

Misson-Yates, S; Gonzalez, R; McGovern, M; Greener, A

2015-05-01

This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth-dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of -1.6% and -6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation.

Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit

PubMed Central

Gonzalez, R; McGovern, M; Greener, A

2015-01-01

Objective: This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Methods: Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Results: Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth–dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of −1.6% and −6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. Conclusion: This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. Advances in knowledge: TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation. PMID:25761213

A unified picture of the crystal structures of metals

NASA Astrophysics Data System (ADS)

Söderlind, Per; Eriksson, Olle; Johansson, Börje; Wills, J. M.; Boring, A. M.

1995-04-01

THE crystal structures of the light actinides have intrigued physicists and chemists for several decades1. Simple metals and transition metals have close-packed, high-symmetry structures, such as body-centred cubic, face-centred cubic and hexagonal close packing. In contrast, the structures of the light actinides are very loosely packed and of low symmetry-tetragonal, orthorhombic and monoclinic. To understand these differences, we have performed total-energy calculations, as a function of volume, for both high-and low-symmetry structures of a simple metal (aluminium), a non-magnetic transition metal (niobium), a ferromagnetic transition metal (iron) and a light actinide (uranium). We find that the crystal structure of all of these metals is determined by the balance between electrostatic (Madelung) interactions, which favour high symmetry, and a Peierls distortion of the crystal lattice, which favours low symmetry. We show that simple metals and transition metals can adopt low-symmetry structures on expansion of the lattice; and we predict that, conversely, the light actinides will undergo transitions to structures of higher symmetry on compression.

Effective band structure of random III-V alloys

NASA Astrophysics Data System (ADS)

Popescu, Voicu; Zunger, Alex

2010-03-01

Random substitutional alloys have no long range order (LRO) or translational symmetry so rigorously speaking they have no E(k) band structure or manifestations thereof. Yet, many experiments on alloys are interpreted using the language of band theory, e.g. inferring Van Hove singularities, band dispersion and effective masses. Many standard alloy theories (VCA- or CPA-based) have the LRO imposed on the alloy Hamiltonian, assuming only on-site disorder, so they can not be used to judge the extent of LRO that really exists. We adopt the opposite way, by using large (thousand atom) randomly generated supercells in which chemically identical alloy atoms are allowed to have different local environments (a polymorphous representation). This then drives site-dependent atomic relaxation as well as potential fluctuations. The eigenstates from such supercells are then mapped onto the Brillouin zone (BZ) of the primitive cell, producing effective band dispersion. Results for (In,Ga)X show band-like behaviour only near the centre and faces of the BZ but rapidly lose such characteristics away from γ or for higher bands. We further analyse the effects of stoichiometry variation, internal relaxation, and short-range order on the alloy band structure.

Atomic-level structural correlations across the morphotropic phase boundary of a ferroelectric solid solution: xBiMg 1/2Ti 1/2O 3-(1$-$x)PbTiO 3

DOE PAGES

Datta, Kaustuv; Neder, Reinhard B.; Chen, Jun; ...

2017-03-28

Revelation of unequivocal structural information at the atomic level for complex systems is uniquely important for deeper and generic understanding of the structure property connections and a key challenge in materials science. Here in this paper we report an experimental study of the local structure by applying total elastic scattering and Raman scattering analyses to an important non-relaxor ferroelectric solid solution exhibiting the so-called composition-induced morphotropic phase boundary (MPB), where concomitant enhancement of physical properties have been detected. The powerful combination of static and dynamic structural probes enabled us to derive direct correspondence between the atomic-level structural correlations and reportedmore » properties. The atomic pair distribution functions obtained from the neutron total scattering experiments were analysed through big-box atom-modelling implementing reverse Monte Carlo method, from which distributions of magnitudes and directions of off-centred cationic displacements were extracted. We found that an enhanced randomness of the displacement-directions for all ferroelectrically active cations combined with a strong dynamical coupling between the A- and B-site cations of the perovskite structure, can explain the abrupt amplification of piezoelectric response of the system near MPB. Finally, altogether this provides a more fundamental basis in inferring structure-property connections in similar systems including important implications in designing novel and bespoke materials.« less

Investigation of surface-plasmon coupled red light emitting InGaN/GaN multi-quantum well with Ag nanostructures coated on GaN surface

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Yi; Liu, Bin, E-mail: bliu@nju.edu.cn, E-mail: rzhang@nju.edu.cn; Zhang, Rong, E-mail: bliu@nju.edu.cn, E-mail: rzhang@nju.edu.cn

Surface-plasmon (SP) coupled red light emitting InGaN/GaN multiple quantum well (MQW) structure is fabricated and investigated. The centre wavelength of 5-period InGaN/GaN MQW structure is about 620 nm. The intensity of photoluminescence (PL) for InGaN QW with naked Ag nano-structures (NS) is only slightly increased due to the oxidation of Ag NS as compared to that for the InGaN QW. However, InGaN QW with Ag NS/SiO{sub 2} structure can evidently enhance the emission efficiency due to the elimination of surface oxide layer of Ag NS. With increasing the laser excitation power, the PL intensity is enhanced by 25%–53% as compared tomore » that for the SiO{sub 2} coating InGaN QW. The steady-state electric field distribution obtained by the three-dimensional finite-difference time-domain method is different for both structures. The proportion of the field distributed in the Ag NS for the GaN/Ag NS/SiO{sub 2} structure is smaller as compared to that for the GaN/naked Ag NS structure. As a result, the energy loss of localized SP modes for the GaN/naked Ag NS structure will be larger due to the absorption of Ag layer.« less

Integrating data infrastructure to facilitate holistic approach to the investigations of anthropogenic hazards evoked by exploration and exploitation of geo-resources

NASA Astrophysics Data System (ADS)

Orlecka-Sikora, Beata; Kwiatek, Grzegorz; Olszewska, Dorota; Lasocki, Stanisław; Gasparini, Paolo; Kozlovskaya, Elena; Nevalainen, Jouni; Schmittbuhl, Jean; Grasso, Jean Robert; Schaming, Marc; Biggare, Pascal; Saccarotti, Gilberto; Garcia, Alexander; Cassidy, Nigel; Toon, Sam; Mutke, Grzegorz; Sterzel, Mariusz; Szepieniec, Tomasz

2016-04-01

The EPOS integration plan assumes a significant contribution to the research on anthropogenic hazards (AH) associated with the exploration and exploitation of geo-resources. These problems will be dealt in Thematic Core Service "Anthropogenic Hazards" (TCS AH). TCS AH is based on the prototype built in the framework of the IS-EPOS platform project (https://tcs.ah-epos.eu/), financed from Polish structural funds (POIG.02.03.00-14-090/13-00), with will be further developed within EPOS IP project (H2020-INFRADEV-1-2015-1, INFRADEV-3-2015). TCS AH aims to have a measurable impact on innovative research and development as well as on society by providing comprehensive, wide-scale and high quality AH research infrastructure. One of the main deliverables are numerous comprehensive induced seismicity datasets called "episodes". The episode is a comprehensive data description of a geophysical process, induced or triggered by technological activity, which under certain circumstances can become hazardous for people, infrastructure and the environment. In addition to the six episodes already implemented during the mentioned IS-EPOS project, at least 20 new episodes related to conventional hydrocarbon extraction, reservoir treatment, underground mining and geothermal energy production are being integrated into the e-environment of the TCS AH. The heterogeneous multi-disciplinary data are transformed to unified structures developed within IS-EPOS project, to form integrated and validated datasets. Dedicated visualization tools for multidisciplinary data comprising episodes are also implemented. These tools are capable to aggregate and combine different data types and facilitating specific visualization possibilities (e.g. combining seismic and technological information). The implementation process, tailored for each episode, consists of four steps: (i) Data revision, determination of its accuracy and limitations; (ii) Data preparation and homogenization to follow the TCS AH standards; (iii) Data collection - uploading the data to local data centres and (iv) Metadata preparation. Some web services for efficient data integration and reduction of the possible mistakes, have been already developed. The data sets will be also passing through quality control according to the established quality control scheme. The data quality control workflow includes five steps; the first three are done in the episode provider's local data centre, whereas the next two are accomplished on the TCS AH side: (1) Episode data are transferred to the local data centre; the control group roles are distributed and the workflow observer is appointed; (2) The data are standardized and formats are validated; the completeness and quality of the data is checked; (3) Metadata are prepared according to TCS AH metadata scheme; the published data and metadata are checked; (4) Contextual quality of the data is analysed and episode appears in TCS AH maintenance area; (5) The new episode data is available in TCS AH. TCS AH will also serve as an integration platform for the episodes gathered in the framework of "Shale gas exploration and exploitation induced risks" project (Horizon 2020, call LCE 16-2014).

Weld Metallurgy and Mechanical Properties of High Manganese Ultra-high Strength Steel Dissimilar Welds

NASA Astrophysics Data System (ADS)

Dahmen, Martin; Lindner, Stefan; Monfort, Damien; Petring, Dirk

The increasing demand for ultra-high strength steels in vehicle manufacturing leads to the application of new alloys. This poses a challenge on joining especially by fusion welding. A stainless high manganese steel sheet with excellent strength and deformation properties stands in the centre of the development. Similar and dissimilar welds with a metastable austenitic steel and a hot formed martensitic stainless steel were performed. An investigation of the mixing effects on the local microstructure and the hardness delivers the metallurgical features of the welds. Despite of carbon contents above 0.4 wt.% none of the welds have shown cracks. Mechanical properties drawn from tensile tests deliver high breaking forces enabling a high stiffness of the joints. The results show the potential for the application of laser beam welding for joining in assembly of structural parts.

Applied Research Centres at South African Universities. The Relationship between 'Base' Internal Structures and Network 'Superstructures'

ERIC Educational Resources Information Center

Cooper, David

2005-01-01

This article considers the way in which applied research centres and units at South African higher education institutions enhance their networks with industry, government and community organizations. The findings from 12 case studies of research groupings at higher education institutions in Cape Town support the author's argument for a more…

From Disconnection to Connection: "Race", Gender and the Politics of Therapy

ERIC Educational Resources Information Center

Chantler, Khatidja

2005-01-01

Person-centred therapy typically fails to address structural dimensions of inequality such as "race", gender and class. In this paper, I explore why this is, and what can be done about it ? at the levels of theory, practice and the organisation of services. Drawing on person-centred theory and practice, I discuss theoretical and…

Regional Centre of Expertise as Transformational Platform for Sustainability: A Case Study of Universiti Sains Malaysia, Penang

ERIC Educational Resources Information Center

Sanusi, Zainal Abidin; Khelghat-Doost, Hamoon

2008-01-01

Purpose: The purpose of this paper is to share the experience of Universiti Sains Malaysia in promoting the sustainable development agenda through its leadership role in the Regional Centre of Expertise (RCE) Penang using an "inside-out approach". Design/methodology/approach: This paper describes the institutional structure, policies and…

A Wireless Sensor Network for the Real-Time Remote Measurement of Aeolian Sand Transport on Sandy Beaches and Dunes

PubMed Central

Cappelli, Irene; Mecocci, Alessandro; Alquini, Fernanda

2018-01-01

Direct measurements of aeolian sand transport on coastal dunes and beaches is of paramount importance to make correct decisions about coast management. As most of the existing studies are mainly based on a statistical approach, the solution presented in this paper proposes a sensing structure able to orient itself according to wind direction and directly calculate the amount of wind-transported sand by collecting it and by measuring its weight. Measurements are performed remotely without requiring human action because the structure is equipped with a ZigBee radio module, which periodically sends readings to a local gateway. Here data are processed by a microcontroller and then transferred to a remote data collection centre, through GSM technology. The ease of installation, the reduced power consumption and the low maintenance required, make the proposed solution able to work independently, limiting human intervention, for all the duration of the expected experimental campaign. In order to analyze the cause-effect relationship between the transported sand and the wind, the sensing structure is integrated with a multi-layer anemoscope-anemometer structure. The overall sensor network has been developed and tested in the laboratory, and its operation has been validated in field through a 48 h measurement campaign. PMID:29518060

A Wireless Sensor Network for the Real-Time Remote Measurement of Aeolian Sand Transport on Sandy Beaches and Dunes.

PubMed

Pozzebon, Alessandro; Cappelli, Irene; Mecocci, Alessandro; Bertoni, Duccio; Sarti, Giovanni; Alquini, Fernanda

2018-03-08

Direct measurements of aeolian sand transport on coastal dunes and beaches is of paramount importance to make correct decisions about coast management. As most of the existing studies are mainly based on a statistical approach, the solution presented in this paper proposes a sensing structure able to orient itself according to wind direction and directly calculate the amount of wind-transported sand by collecting it and by measuring its weight. Measurements are performed remotely without requiring human action because the structure is equipped with a ZigBee radio module, which periodically sends readings to a local gateway. Here data are processed by a microcontroller and then transferred to a remote data collection centre, through GSM technology. The ease of installation, the reduced power consumption and the low maintenance required, make the proposed solution able to work independently, limiting human intervention, for all the duration of the expected experimental campaign. In order to analyze the cause-effect relationship between the transported sand and the wind, the sensing structure is integrated with a multi-layer anemoscope-anemometer structure. The overall sensor network has been developed and tested in the laboratory, and its operation has been validated in field through a 48 h measurement campaign.

‘Act on Oncology’ as a New Comprehensive Approach to Assess Prostate Cancer Centres – Method Description and Results of a Pilot Study

PubMed Central

Voigt, Wieland; Hoellthaler, Josef; Magnani, Tiziana; Corrao, Vito; Valdagni, Riccardo

2014-01-01

Background Multidisciplinary care of prostate cancer is increasingly offered in specialised cancer centres. It requires the optimisation of medical and operational processes and the integration of the different medical and non-medical stakeholders. Objective To develop a standardised operational process assessment tool basing on the capability maturity model integration (CMMI) able to implement multidisciplinary care and improve process quality and efficiency. Design, Setting, and Participants Information for model development was derived from medical experts, clinical guidelines, best practice elements of renowned cancer centres, and scientific literature. Data were organised in a hierarchically structured model, consisting of 5 categories, 30 key process areas, 172 requirements, and more than 1500 criteria. Compliance with requirements was assessed through structured on-site surveys covering all relevant clinical and management processes. Comparison with best practice standards allowed to recommend improvements. ‘Act On Oncology’(AoO) was applied in a pilot study on a prostate cancer unit in Europe. Results and Limitations Several best practice elements such as multidisciplinary clinics or advanced organisational measures for patient scheduling were observed. Substantial opportunities were found in other areas such as centre management and infrastructure. As first improvements the evaluated centre administration described and formalised the organisation of the prostate cancer unit with defined personnel assignments and clinical activities and a formal agreement is being worked on to have structured access to First-Aid Posts. Conclusions In the pilot study, the AoO approach was feasible to identify opportunities for process improvements. Measures were derived that might increase the operational process quality and efficiency. PMID:25192213

A French network of bipolar expert centres: a model to close the gap between evidence-based medicine and routine practice.

PubMed

Henry, Chantal; Etain, Bruno; Mathieu, Flavie; Raust, Aurélie; Vibert, Jean-Francois; Scott, Jan; Leboyer, Marion

2011-06-01

Bipolar disorders are a major public health concern. Efforts to provide optimal care by general practitioners and psychiatrists are undermined by the complexity of the disorder and difficulties in applying clinical practice guidelines and new research findings to the spectrum of cases seen in day to day practice. A national network of bipolar expert centres was established. Each centre has established strong links to local health services and provides support to clinicians in delivering personalized care plans derived from systematic case assessments undertaken at the centre. A common set of diagnostic and clinical assessment tools has been adopted at eight centres. Evaluations are undertaken by trained assessors and cross-centre reliability is monitored. A web application, e-bipolar© is used to record data in a common computerized medical file. Anonymized data is entered into a shared national database for use in multi-centre audit and research. Instead of offering treatment advice based on clinical practice guidelines recommendations for selected sub-populations of patients (a 'top-down' approach), the French bipolar network offers systematic, comprehensive, longitudinal, and multi-dimensional assessments of cases representative of general bipolar populations. This 'bottom-up' strategy may offer a more efficient and effective way to transfer knowledge and share expertise as the referrer can appreciate the rationale underpinning suggested treatment protocols and more readily apply such principles and approaches to other cases. The network also builds an infrastructure for clinical cohort and comparative-effectiveness research on more representative patient populations. Copyright © 2010 Elsevier B.V. All rights reserved.

Migration of the CERN IT Data Centre Support System to ServiceNow

NASA Astrophysics Data System (ADS)

Alvarez Alonso, R.; Arneodo, G.; Barring, O.; Bonfillou, E.; Coelho dos Santos, M.; Dore, V.; Lefebure, V.; Fedorko, I.; Grossir, A.; Hefferman, J.; Mendez Lorenzo, P.; Moller, M.; Pera Mira, O.; Salter, W.; Trevisani, F.; Toteva, Z.

2014-06-01

The large potential and flexibility of the ServiceNow infrastructure based on "best practises" methods is allowing the migration of some of the ticketing systems traditionally used for the monitoring of the servers and services available at the CERN IT Computer Centre. This migration enables the standardization and globalization of the ticketing and control systems implementing a generic system extensible to other departments and users. One of the activities of the Service Management project together with the Computing Facilities group has been the migration of the ITCM structure based on Remedy to ServiceNow within the context of one of the ITIL processes called Event Management. The experience gained during the first months of operation has been instrumental towards the migration to ServiceNow of other service monitoring systems and databases. The usage of this structure is also extended to the service tracking at the Wigner Centre in Budapest.

Mental health in Sexual Assault Referral Centres: A survey of forensic physicians.

PubMed

Brooker, Charlie; Paul, Sheila; Sirdifield, Coral

2018-05-22

A national survey of Forensic Physicians (FPs) working in Sexual Assault Referral Centres was undertaken. The survey was advertised in the weekly bulletin sent out by the Faculty of Forensic and Legal Medicine. Response was relatively low (n = 45). It is estimated that this figures represents about 12% of the workforce. The aim of the survey was to investigate FPs experience of accessing mental health pathways out of a SARC for complainants of all ages. The results concurred with a previous survey of SARC clinical managers with mental health services proving unresponsive. Informed co-commissioning between NHS England and Clinical Commissioning groups can only improve if aspects of complainant's mental health are routinely assessed within SARCs using structured outcome measures. Structured outcomes should be integrated into NHS England's Sexual Assault Referral Centres Indicators of Performance (SARCIP). Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Bacillus subtilis actin-like protein MreB influences the positioning of the replication machinery and requires membrane proteins MreC/D and other actin-like proteins for proper localization.

PubMed

Defeu Soufo, Hervé Joël; Graumann, Peter L

2005-03-03

Bacterial actin-like proteins have been shown to perform essential functions in several aspects of cellular physiology. They affect cell growth, cell shape, chromosome segregation and polar localization of proteins, and localize as helical filaments underneath the cell membrane. Bacillus subtilis MreB and Mbl have been shown to perform dynamic motor like movements within cells, extending along helical tracks in a time scale of few seconds. In this work, we show that Bacillus subtilis MreB has a dual role, both in the formation of rod cell shape, and in chromosome segregation, however, its function in cell shape is distinct from that of MreC. Additionally, MreB is important for the localization of the replication machinery to the cell centre, which becomes aberrant soon after depletion of MreB. 3D image reconstructions suggest that frequently, MreB filaments consist of several discontinuous helical filaments with varying length. The localization of MreB was abnormal in cells with decondensed chromosomes, as well as during depletion of Mbl, MreBH and of the MreC/MreD proteins, which we show localize to the cell membrane. Thus, proper positioning of MreB filaments depends on and is affected by a variety of factors in the cell. Our data provide genetic and cytological links between MreB and the membrane, as well as with other actin like proteins, and further supports the connection of MreB with the chromosome. The functional dependence on MreB of the localization of the replication machinery suggests that the replisome is not anchored at the cell centre, but is positioned in a dynamic manner.

CMS tier structure and operation of the experiment-specific tasks in Germany

NASA Astrophysics Data System (ADS)

Nowack, A.

2008-07-01

In Germany, several university institutes and research centres take part in the CMS experiment. Concerning the data analysis, a couple of computing centres at different Tier levels, ranging from Tier 1 to Tier 3, exists at these places. The German Tier 1 centre GridKa at the research centre at Karlsruhe serves all four LHC experiments as well as four non-LHC experiments. With respect to the CMS experiment, GridKa is mainly involved in central tasks. The Tier 2 centre in Germany consists of two sites, one at the research centre DESY at Hamburg and one at RWTH Aachen University, forming a federated Tier 2 centre. Both parts cover different aspects of a Tier 2 centre. The German Tier 3 centres are located at the research centre DESY at Hamburg, at RWTH Aachen University, and at the University of Karlsruhe. Furthermore the building of a German user analysis facility is planned. Since the CMS community in German is rather small, a good cooperation between the different sites is essential. This cooperation includes physical topics as well as technical and operational issues. All available communication channels such as email, phone, monthly video conferences, and regular personal meetings are used. For example, the distribution of data sets is coordinated globally within Germany. Also the CMS-specific services such as the data transfer tool PhEDEx or the Monte Carlo production are operated by people from different sites in order to spread the knowledge widely and increase the redundancy in terms of operators.

Purification, crystallization and preliminary X-ray study of the fungal laccase from Cerrena maxima

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lyashenko, Andrey V.; Zhukhlistova, Nadegda E.; Gabdoulkhakov, Azat G.

2006-10-01

The crystallization and preliminary X-ray structure at 1.9 Å resolution of the fungal laccase from C. maxima are presented. Laccases are members of the blue multi-copper oxidase family that oxidize substrate molecules by accepting electrons at a mononuclear copper centre and transferring them to a trinuclear centre. Dioxygen binds to the trinuclear centre and, following the transfer of four electrons, is reduced to two molecules of water. Crystals of the laccase from Cerrena maxima have been obtained and X-ray data were collected to 1.9 Å resolution using synchrotron radiation. A preliminary analysis shows that the enzyme has the typical laccasemore » structure and several carbohydrate sites have been identified. The carbohydrate chains appear to be involved in stabilization of the intermolecular contacts in the crystal structure, thus promoting the formation of well ordered crystals of the enzyme. Here, the results of an X-ray crystallographic study on the laccase from the fungus Cerrena maxima are reported. Crystals that diffract well to a resolution of at least 1.9 Å (R factor = 18.953%; R{sub free} = 23.835; r.m.s.d. bond lengths, 0.06 Å; r.m.s.d. bond angles, 1.07°) have been obtained despite the presence of glycan moieties. The overall spatial organization of C. maxima laccase and the structure of its copper-containing active centre have been determined by the molecular-replacement method using the laccase from Trametes versicolor (Piontek et al., 2002 ▶) as a structural template. In addition, four glycan-binding sites were identified and the 1.9 Å X-ray data were used to determine the previously unknown primary structure of this protein. The identity (calculated from sequence alignment) between the C. maxima laccase and the T. versicolor laccase is about 87%. Tyr196 and Tyr372 show significant extra density at the ortho positions and this has been interpreted in terms of NO{sub 2} substituents.« less

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

Biological impacts of local vs. regional land use on a small tributary of the Seine River (France): insights from a food web approach based on stable isotopes.

PubMed

Hette-Tronquart, Nicolas; Oberdorff, Thierry; Tales, Evelyne; Zahm, Amandine; Belliard, Jérôme

2017-03-23

As part of the landscape, streams are influenced by land use. Here, we contributed to the understanding of the biological impacts of land use on streams, investigating how landscape effects vary with spatial scales (local vs. regional). We adopted a food web approach integrating both biological structure and functioning, to focus on the overall effect of land use on stream biocœnosis. We selected 17 sites of a small tributary of the Seine River (France) for their contrasted land use, and conducted a natural experiment by sampling three organic matter sources, three macroinvertebrate taxa, and most of the fish community. Using stable isotope analysis, we calculated three food web metrics evaluating two major dimensions of the trophic diversity displayed by the fish community: (i) the diversity of exploited resources and (ii) the trophic level richness. The idea was to examine whether (1) land-use effects varied according to spatial scales, (2) land use affected food webs through an effect on community structure and (3) land use affected food webs through an effect on available resources. Beside an increase in trophic diversity from upstream to downstream, our empirical data showed that food webs were influenced by land use in the riparian corridors (local scale). The effect was complex, and depended on site's position along the upstream-downstream gradient. By contrast, land use in the catchment (regional scale) did not influence stream biocœnosis. At the local scale, community structure was weakly influenced by land use, and thus played a minor role in explaining food web modifications. Our results suggested that the amount of available resources at the base of the food web was partly responsible for food web modifications. In addition, changes in biological functioning (i.e. feeding interactions) can also explain another part of the land-use effect. These results highlight the role played by the riparian corridors as a buffer zone, and advocate that riparian corridor should be at the centre of water management attention.

[Local approval procedures act as a brake on RCTs].

PubMed

van der Stok, E P; Huiskens, J; Hemmes, B; Grünhagen, D J; van Gulik, T M; Verhoef, C; Punt, C J A

2016-01-01

Large multicentre randomised controlled trials (RCTs) in the Netherlands are increasingly being impeded by major differences between local approval procedures. However, no national agenda exists as yet to improve this situation. The existence of major local differences in processing time and documentation required has been reported previously but little is known about the costs incurred and whether or not specific certifications and research contracts are mandatory. The current study evaluated these aspects of local procedures for obtaining approval of two oncological multicentre RCTs. Retrospective, descriptive. All local procedures for obtaining approval of two randomised clinical trials were evaluated: the CAIRO5 and CHARISMA trials initiated by the Dutch Colorectal Cancer Group (DCCG). We objectified time between approval by the Medical Ethics Review Committee (METC) and final approval by the Board of Directors (RvB), the type and number of documents needed, and costs charged. The median time interval between the approval by the Medical Ethics Review Committee and the approval by the Board of Directors was 90 days (range 4-312). The number of documents required per centre ranged from 6-20. The costs charged ranged from € 0-€ 1750, and amounted to € 8575 for all procedures combined. No costs were charged by the majority of the centres. The approval procedures for multicentre clinical trials in the Netherlands demonstrate major differences. Processing times, documentation required and costs are unpredictable; greater uniformity is highly desirable in this context.

Coastal erosion management in Accra: Combining local knowledge and empirical research

PubMed Central

2016-01-01

Coastal erosion along the Accra coast has become a chronic phenomenon that threatens both life and property. The issue has assumed a centre stage of national debate in recent times because of its impact on the coastal communities. Lack of reliable geospatial data hinders effective scientific investigations into the changing trends in the shoreline position. However, knowledge about coastal erosion, by the local people, and how far the shoreline has migrated inland over time is high in the coastal communities in Accra. This opens a new chapter in coastal erosion research to include local knowledge of the local settlers in developing sustainable coastal management. This article adopted a scientific approach to estimate rate of erosion and tested the results against perceived erosion trend by the local settlers. The study used a 1974 digital topographic map and 1996 aerial photographs. The end point rate statistical method in DSAS was used to compute the rates of change. The short-term rate of change for the 22-year period under study was estimated as -0.91 m/annum ± 0.49 m/annum. It was revealed that about 79% of the shoreline is eroding, while the remaining 21% is either stabilised or accreting. It emerged, from semi-structured interviews with inhabitants in the Accra coastal communities, that an average of about 30 m of coastal lands are perceived to have been lost to erosion for a period of about 20 years. This translates to a historic rate of change of about 1.5 m/year, which corroborates the results of the scientific study. Again this study has established that the local knowledge of the inhabitants, about coastal erosion, can serve as reliable information under scarcity of scientific data for coastal erosion analyses in developing countries.

Ethnobotanical survey of medicinal plants used as insects repellents in six malaria endemic localities of Cameroon.

PubMed

Youmsi, Roger Ducos Fokouo; Fokou, Patrick Valère Tsouh; Menkem, Elisabeth Zeuko'o; Bakarnga-Via, Issakou; Keumoe, Rodrigue; Nana, Victor; Boyom, Fabrice Fekam

2017-06-08

The combined efforts to combat outdoor/indoor transmission of malaria parasites are hampered by the emerging vector resistance in a wide variety of malaria-endemic settings of Africa and the rest of the world, stressing the need for alternative control measures. This study aimed at documenting insect's repellent plant species used by indigenous populations of 6 localities of East, South, West and Centre regions of Cameroon. Information was gathered through face-to-face interviews guided by a semi-structured questionnaire on the knowledge of medicinal plants with insect repellent properties. A total of 182 informants aged from 25 to 75 years were recruited by convenience from May to June 2015. The informants had general knowledge about insects' repellent plants (78.6%). A total of 16 plant species were recorded as insects' repellents with 50% being trees. The most cited plants were Canarium schweinfurthii (Burseraceae) (in four localities, 58/182), Elaeis guineensis (Arecaceae) (in three localities, 38/182), Chromolaena odorata (Compositae) (16/182) and Citrus limon (Rutaceae) (11/182) in two localities each. Among the repellent plant species recorded, 50% were reported to be burnt to produce in-house smokes, 31.2% were mashed and applied on the body, and 18.8% were hung in the houses. The leaf was the most commonly used plant part (52.9%), followed by the bark (17.6%). This study has shown that rural populations of the 6 targeted localities possess indigenous knowledge on repellent plants that are otherwise cost-effective and better choice for repelling insects including malaria-transmitting mosquitoes. Meanwhile, such practices should be validated experimentally and promoted as sustainable malaria transmission control tools in the remotely located communities.

Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

PubMed

Wytenbroek, Lydia

2015-01-01

From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role.

Examining local-level factors shaping school nutrition policy implementation in Ontario, Canada.

PubMed

Vine, Michelle M; Elliott, Susan J

2014-06-01

Increasing numbers of overweight and obese youth draw attention to the school as an important setting for targeted nutrition interventions, given that it is where they spend a majority of their waking time. The objective of the present study was to explore local-level factors shaping the implementation of a school nutrition policy. In-depth, semi-structured interviews were conducted in person or via the telephone (a maximum of 60 min). An interview guide was informed by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, research objectives and literature. Key themes centred on policy implementation, including facilitators and barriers (i.e. resources, capacity), user satisfaction (i.e. students) and communication strategies. Secondary schools in Ontario, Canada. Twenty-two participants from local agencies supporting school nutrition programming (n 8) and secondary-school principals, vice principals and teachers (n 14) from nine schools across three Ontario school boards. Results are organized according to environments outlined in the ANGELO framework. The cost of healthy food for sale, revenue loss (economic), proximity of schools to off-site food outlets (physical), the restrictive nature of policy, the role of key stakeholders (political), the role of stigma and school culture (sociocultural) act as local-level barriers to policy implementation. Gaps in policy implementation include the high cost of food for sale and subsequent revenue generation, the close proximity of internal and external food environments, the need for consultation and communication between stakeholders, and strategies to reduce stigma and improve the school nutrition culture.

What is the degree of innovation routinely implemented in Dutch radiotherapy centres? A multicentre cross-sectional study

PubMed Central

Boersma, Liesbeth; Dekker, Andre; Bosmans, Geert; van Merode, Frits; Verhaegen, Frank; de Ruysscher, Dirk; Swart, Rachelle; Kengen, Cindy; Lambin, Philippe

2016-01-01

Objective: To study the implementation of innovation activities in Dutch radiotherapy (RT) centres in a broad sense (product, technological, market and organizational innovations). Methods: A descriptive cross-sectional study was conducted in 15 Dutch RT centres. A list of innovations implemented from 2011 to 2013 was drawn up for each centre using semi-structured interviews. These innovations were classified into innovation categories according to previously defined innovation indicators. Where applicable, each innovation was rated by each centre on the effort required to implement it and on its expected effects, to get an impression of how far reaching and radical the innovations were and to be able to compare the number of innovations between centres. Results: The participating RT centres in the Netherlands implemented 12 innovations per year on average (range 5–25); this number was not significantly different for academic (n = 13) or non-academic centres (n = 10). Several centres were dealing with the same innovations at the same time. The average required effort and expected output did not differ significantly between product, technological and organizational innovation or between academic and non-academic centres. Conclusion: The number of innovations observed per centre varied across a large range, with a large overlap in terms of the type of innovations that were implemented. Registering innovations using the innovation indicators applied in our study would make it possible to improve collaboration between centres, e.g. with common training modules, to avoid duplication of work. Advances in knowledge: This study is the first of its kind investigating innovation implementation in RT in a broad sense. PMID:27660890

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake.

PubMed

Awais, Syed; Saeed, Ayesha; Ch, Asad

2014-08-01

In the 2005 Pakistan earthquake, the great many injured with multiple fractures and open wounds provided a unique opportunity to practice damage-control orthopaedics. External fixators remain a time-tested tools for operating surgeons on such occasions. The locally manufactured, readily available Naseer-Awais (NA) external fixator filled such needs of this disaster with good outcome. This is a retrospective descriptive study of 19,700 patients that presented over seven months to the two centres established by the lead author (SMA) in Muzaffarabad and Mansehra just one night after the 2005 earthquake. A series of local and foreign orthopaedic surgeon teams operated in succession. The computerised patient data collection of 1,145 operations was retrospectively analysed. Of the 19,700 patients presenting to the SMA centres, 50% had limb injuries. Total fracture fixations were 1,145, of which 295 were external fixations: 185 were applied on the lower limb and 90 on upper limb, the majority were applied on tibia. External fixators are valuable damage-control tools in natural disasters and warfare injuries. The locally manufactured NA external fixator served the needs of the many limb injuries during the 2005 Pakistan earthquake.

Traffic-related particulate air pollution exposure in urban areas

NASA Astrophysics Data System (ADS)

Borrego, C.; Tchepel, O.; Costa, A. M.; Martins, H.; Ferreira, J.; Miranda, A. I.

In the last years, there has been an increase of scientific studies confirming that long- and short-term exposure to particulate matter (PM) pollution leads to adverse health effects. The development of a methodology for the determination of accumulated human exposure in urban areas is the main objective of the current work, combining information on concentrations at different microenvironments and population time-activity pattern data. A link between a mesoscale meteorological and dispersion model and a local scale air quality model was developed to define the boundary conditions for the local scale application. The time-activity pattern of the population was derived from statistical information for different sub-population groups and linked to digital city maps. Finally, the hourly PM 10 concentrations for indoor and outdoor microenvironments were estimated for the Lisbon city centre, which was chosen as the case-study, based on the local scale air quality model application for a selected period. This methodology is a first approach to estimate population exposure, calculated as the total daily values above the thresholds recommended for long- and short-term health effects. Obtained results reveal that in Lisbon city centre a large number of persons are exposed to PM levels exceeding the legislated limit value.

Breathing pulses in singularly perturbed reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Veerman, Frits

2015-07-01

The weakly nonlinear stability of pulses in general singularly perturbed reaction-diffusion systems near a Hopf bifurcation is determined using a centre manifold expansion. A general framework to obtain leading order expressions for the (Hopf) centre manifold expansion for scale separated, localised structures is presented. Using the scale separated structure of the underlying pulse, directly calculable expressions for the Hopf normal form coefficients are obtained in terms of solutions to classical Sturm-Liouville problems. The developed theory is used to establish the existence of breathing pulses in a slowly nonlinear Gierer-Meinhardt system, and is confirmed by direct numerical simulation.

Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana

PubMed Central

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-01-01

Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone. PMID:19825191

Local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural Ghana.

PubMed

Read, Ursula M; Adiibokah, Edward; Nyame, Solomon

2009-10-14

The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mental illness and their families. This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Chaining and beating of the mentally ill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentally ill in their facilities. Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone.

Kinematics and mass modelling of M33: Hα observations

NASA Astrophysics Data System (ADS)

Kam, Z. S.; Carignan, C.; Chemin, L.; Amram, P.; Epinat, B.

2015-06-01

As part of a long-term project to revisit the kinematics and dynamics of the large disc galaxies of the Local Group, we present the first deep, wide-field (˜42 arcmin × 56 arcmin) 3D-spectroscopic survey of the ionized gas disc of Messier 33. Fabry-Perot interferometry has been used to map its Hα distribution and kinematics at unprecedented angular resolution (≲3 arcsec) and resolving power (˜12 600), with the 1.6 m telescope at the Observatoire du Mont Mégantic. The ionized gas distribution follows a complex, large-scale spiral structure, unsurprisingly coincident with the already-known spiral structures of the neutral and molecular gas discs. The kinematical analysis of the velocity field shows that the rotation centre of the Hα disc is distant from the photometric centre by ˜168 pc (sky-projected distance) and that the kinematical major-axis position angle and disc inclination are in excellent agreement with photometric values. The Hα rotation curve agrees very well with the H I rotation curves for 0 < R < 6.5 kpc, but the Hα velocities are 10-20 km s-1 higher for R > 6.5 kpc. The reason for this discrepancy is not well understood. The velocity dispersion profile is relatively flat around 16 km s-1, which is at the low end of velocity dispersions of nearby star-forming galactic discs. A strong relation is also found between the Hα velocity dispersion and the Hα intensity. Mass models were obtained using the Hα rotation curve but, as expected, the dark matter halo's parameters are not very well constrained since the optical rotation curve only extends out to 8 kpc.

FunTree: advances in a resource for exploring and contextualising protein function evolution.

PubMed

Sillitoe, Ian; Furnham, Nicholas

2016-01-04

FunTree is a resource that brings together protein sequence, structure and functional information, including overall chemical reaction and mechanistic data, for structurally defined domain superfamilies. Developed in tandem with the CATH database, the original FunTree contained just 276 superfamilies focused on enzymes. Here, we present an update of FunTree that has expanded to include 2340 superfamilies including both enzymes and proteins with non-enzymatic functions annotated by Gene Ontology (GO) terms. This allows the investigation of how novel functions have evolved within a structurally defined superfamily and provides a means to analyse trends across many superfamilies. This is done not only within the context of a protein's sequence and structure but also the relationships of their functions. New measures of functional similarity have been integrated, including for enzymes comparisons of overall reactions based on overall bond changes, reaction centres (the local environment atoms involved in the reaction) and the sub-structure similarities of the metabolites involved in the reaction and for non-enzymes semantic similarities based on the GO. To identify and highlight changes in function through evolution, ancestral character estimations are made and presented. All this is accessible through a new re-designed web interface that can be found at http://www.funtree.info. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Advanced Ceramic Materials for Sharp Hot Structures: Material Development and On-Ground Arc-Jet Qualification Testing on Scaled Demonstrators

NASA Astrophysics Data System (ADS)

Scatteia, L.; Tomassetti, G.; Rufolo, G.; De Filippis, F.; Marino, G.

2005-02-01

This paper describes the work performed by the Italian Aerospace Research Centre (C.I.R.A. S.c.P.A.) in a technology project focused on the applicability of modified diboride compounds structures to the manufacturing of high performance and slender shaped hot structures for reusable launch vehicles. A prototypal multi-material structure, which couple reinforced diborides to a C/SiC frame, has been built with the aim to demonstrate the applicability of an innovative concept of nose cap to the fabrication of real parts to be installed ant subsequently tested on the flying test bed currently under development at CIRA. Particular relevance is given to the on-ground qualification test of the nose-cap scaled demonstrator which is underway at CIRA Arc-Jet facility SCIROCCO. Considering the specific typology of materials investigated, up to date, a consistent tests campaign at laboratory level has been performed and concluded in order to create a complete materials data base. The measured materials properties have been then used as input for the design phase that also used as inputs the aero-thermal loads associated with a reference re-entry mission. Our major preliminary findings indicate that the structure is thermally fully compliant with the environment requirements and shows local mechanical criticalities in specific areas such as the materials interfaces and hot/cold joining parts.

Genetic distinction between contiguous urban and rural multimammate mice in Tanzania despite gene flow.

PubMed

Gryseels, S; Goüy de Bellocq, J; Makundi, R; Vanmechelen, K; Broeckhove, J; Mazoch, V; Šumbera, R; Zima, J; Leirs, H; Baird, S J E

2016-10-01

Special conditions are required for genetic differentiation to arise at a local geographical scale in the face of gene flow. The Natal multimammate mouse, Mastomys natalensis, is the most widely distributed and abundant rodent in sub-Saharan Africa. A notorious agricultural pest and a natural host for many zoonotic diseases, it can live in close proximity to humans and appears to compete with other rodents for the synanthropic niche. We surveyed its population genetic structure across a 180-km transect in central Tanzania along which the landscape varied between agricultural land in a rural setting and natural woody vegetation, rivers, roads and a city (Morogoro). We sampled M. natalensis across 10 localities and genotyped 15 microsatellite loci from 515 individuals. Hierarchical STRUCTURE analyses show a K-invariant pattern distinguishing Morogoro suburbs (located in the centre of the transect) from nine surrounding rural localities. Landscape connectivity analyses in Circuitscape and comparison of rainfall patterns suggest that neither geographical isolation nor natural breeding asynchrony could explain the genetic differentiation of the urban population. Using the isolation-with-migration model implemented in IMa2, we inferred that a split between suburban and rural populations would have occurred recently (<150 years ago) with higher urban effective population density consistent with an urban source to rural sink of effective migration. The observed genetic differentiation of urban multimammate mice is striking given the uninterrupted distribution of the animal throughout the landscape and the high estimates of effective migration (2N e M = 3.0 and 29.7), suggesting a strong selection gradient across the urban boundary. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities

PubMed Central

Womack, Robert; Pryce, Robert; Brennan, Alan; Goyder, Elizabeth

2018-01-01

Background We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. Method Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). Findings We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB’s. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. Interpretation Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB. PMID:29847553

Person-Centred Reviews as a Mechanism for Planning the Post-School Transition of Young People with Intellectual Disability

ERIC Educational Resources Information Center

Kaehne, A.; Beyer, S.

2014-01-01

Background: Person-centred planning has played a key role in the transformation of intellectual disabilities services for more than a decade. The literature has identified clear advantages for service users when service delivery is planned around the individual rather than the user is made to fit into service structures. Researchers however have…

A Derridaean Reading of the Zone of Proximal Development (ZPD): The Monster in the Play of "Differance"

ERIC Educational Resources Information Center

Flint, Kevin J.

2009-01-01

The institutional machine of contemporary activity theory currently appears to be constrained by centring on the structure of mediated activity first voiced by Vygotsky. As a centring, such a principle, it is argued, continually restores the equilibrium of the institutional machine in alignment with its possible development in the polysemy of…

Parental Concerns Regarding a Centre-Based Early Intervention Programme for Down Syndrome in Malaysia: A Case Study

ERIC Educational Resources Information Center

Kunagaratnam, Nagasangari; Loh, Sau Cheong

2010-01-01

This qualitative study provides information on the concerns faced by parents having children with Down syndrome in a centre-based Early Intervention Programme in Malaysia and how they coped with these concerns. Semi-structured interviews were conducted with a total of five parents and two special educators. The interview and observation findings…

Comparing Quality of Childcare and Kindergarten Centres: The Need for a Strong and Equal Partnership in the Greek Early Childhood Education System

ERIC Educational Resources Information Center

Gregoriadis, A.; Tsigilis, N.; Grammatikopoulos, V.; Kouli, O.

2016-01-01

The purpose of this study was to examine whether kindergartens and childcare centres differ in terms of educational and caregiving components. More specifically, two aspects of the process quality of the early childhood education and care were examined regarding the "Activities" and the "Programme Structure." A multi-stage…

Electronic shell structure in Ga12 icosahedra and the relation to the bulk forms of gallium.

PubMed

Schebarchov, D; Gaston, N

2012-07-28

The electronic structure of known cluster compounds with a cage-like icosahedral Ga(12) centre is studied by first-principles theoretical methods, based on density functional theory. We consider these hollow metalloid nanostructures in the context of the polymorphism of the bulk, and identify a close relation to the α phase of gallium. This previously unrecognised connection is established using the electron localisation function, which reveals the ubiquitous presence of radially-pointing covalent bonds around the Ga(12) centre--analogous to the covalent bonds between buckled deltahedral planes in α-Ga. Furthermore, we find prominent superatom shell structure in these clusters, despite their hollow icosahedral motif and the presence of covalent bonds. The exact nature of the electronic shell structure is contrasted with simple electron shell models based on jellium, and we demonstrate how the interplay between gallium dimerisation, ligand- and crystal-field effects can alter the splitting of the partially filled 1F shell. Finally, in the unique compound where the Ga(12) centre is bridged by six phosphorus ligands, the electronic structure most closely resembles that of δ-Ga and there are no well-defined superatom orbitals. The results of this comprehensive study bring new insights into the nature of chemical bonding in metalloid gallium compounds and the relation to bulk gallium metal, and they may also guide the development of more general models for ligand-protected clusters.

Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy.

PubMed

Driessen, A; Schäfer, N; Albrecht, V; Schenk, M; Fröhlich, M; Stürmer, E K; Maegele, M

2015-08-01

Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. To assess local differences in infrastructure, logistics and clinical management of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. 446/1,540 delegates completed the questionnaire yielding a response rate of 29%. The majority specified to work as consultants/senior physicians (47.3%) in general (36.1%) or trauma/orthopaedic surgery (44.5%) of level I (70%) or level II (19%) trauma centres. Clinical assessment (>80%) and standard coagulation assays (74.6%) are the most frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30% of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69%) have implemented local protocols based on international and national guidelines using conventional blood products, e.g. packed red blood cell concentrates (93.3%), fresh frozen plasma concentrates (93.3%) and platelet concentrates (83%), and antifibrinolytics (100%). 89% considered the continuous intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma-associated coagulopathy amongst international centres. Ongoing work will focus on geographical differences.

Management of immunization solid wastes in Kano State, Nigeria

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oke, I.A.

Inadequate management of waste generated from injection activities can have a negative impact on the community and environment. In this paper, a report on immunization wastes management in Kano State (Nigeria) is presented. Eight local governments were selected randomly and surveyed by the author. Solid wastes generated during the Expanded Programme on Immunization were characterised using two different methods: one by weighing the waste and the other by estimating the volume. Empirical data was obtained on immunization waste generation, segregation, storage, collection, transportation, and disposal; and waste management practices were assessed. The study revealed that immunization offices were accommodated inmore » either in local government buildings, primary health centres or community health care centres. All of the stations demonstrated a high priority for segregation of the infectious wastes. It can be deduced from the data obtained that infectious waste ranged from 67.6% to 76.7% with an average of 70.1% by weight, and 36.0% to 46.1% with an average of 40.1% by volume. Non-infectious waste generated ranged from 23.3% to 32.5% with an average of 29.9% by weight and 53.9% to 64.0% with an average of 59.9% by volume. Out of non-infectious waste (NIFW) and infectious waste (IFW), 66.3% and 62.4% by weight were combustible and 33.7% and 37.6% were non-combustible respectively. An assessment of the treatment revealed that open pit burning and burial and small scale incineration were the common methods of disposal for immunization waste, and some immunization centres employed the services of the state or local government owned solid waste disposal board for final collection and disposal of their immunization waste at government approved sites.« less

Capacity building in anthelmintic drug discovery.

PubMed

Kron, Michael; Yousif, Fouad; Ramirez, Bernadette

2007-10-01

International collaboration in anthelmintic drug discovery holds special challenges compared with local or national discovery projects, and at the same time presents the opportunity to build capacity, forge long lasting inter-institutional relationships and strengthen infrastructure in multinational priority areas. This chapter discusses important issues that should be considered in the context of anthelmintic screening centre development and will give examples (Philippines and Egypt) of the productivity of developing country based screening centres. The positive outcomes of infrastructure building is realised in greater capacities for anthelmintic screening at institutions in the countries where the parasitic diseases are endemic and allows for optimum use of specialised resources for public health priority diseases that may be different from those in Western countries. Support for developing country based screening centres also can help countries optimise product development procedures and policies and can facilitate diffusion of desirable technology in corresponding global regions around the world.

Magnetic field effect on photoionization cross-section of hydrogen-like impurity in cylindrical quantum wire

NASA Astrophysics Data System (ADS)

Mughnetsyan, V. N.; Barseghyan, M. G.; Kirakosyan, A. A.

2008-01-01

We consider the photoionization of a hydrogen-like impurity centre in a quantum wire approximated by a cylindrical well of finite depth in a magnetic field directed along the wire axis. The ground state energy and the wave function of the electron localized on on-axis impurity centre are calculated using the variational method. The wave functions and energies of the final states in an one-dimensional conduction subband are also presented. The dependences of photoionization cross-section of a donor centre on magnetic field and frequency of incident radiation both for parallel and perpendicular polarizations and corresponding selection rules for the allowed transitions are found in the dipole approximation. The estimates of photoionization cross-section for various values of wire radius and magnetic field induction for GaAs quantum wire embedded in Ga 1-xAl 1-xAs matrix are given.

Pooling procurement in the Belgian hospital sector.

PubMed

Hebert, Guy

2011-01-01

The Belgian hospital sector is following the example of a number of other European countries and for more than ten years now, has been striving to pool its medical supplies and equipment purchases in a bid to reduce costs. The various experiments of which we are aware come under both opportunist purchases and initiatives which are designed to encourage local-regional contracts. These attempts have now all come to nothing or are struggling in the absence of a structured and professional approach. In 2005, the Saint Luc University Clinic in Brussels decided to set up a high-performance purchasing department, the aim being to centre its initiatives around TCO or Total Cost of Ownership. Following an analysis of the various experiments into pooling procurement in hospitals in Europe, the Saint Luc University Clinic decided on a central procurement agency model, in accordance with new legislation on public procurement. This article seeks to highlight the prerequisites which are vital for a procurement pooling initiative, without underestimating the risks and limitations of implementing such a change in procurement practices. The Mercure central procurement agency is now the largest interhospital purchasing structure in Belgium.

Landscape genetics, adaptive diversity and population structure in Phaseolus vulgaris.

PubMed

Rodriguez, Monica; Rau, Domenico; Bitocchi, Elena; Bellucci, Elisa; Biagetti, Eleonora; Carboni, Andrea; Gepts, Paul; Nanni, Laura; Papa, Roberto; Attene, Giovanna

2016-03-01

Here we studied the organization of genetic variation of the common bean (Phaseolus vulgaris) in its centres of domestication. We used 131 single nucleotide polymorphisms to investigate 417 wild common bean accessions and a representative sample of 160 domesticated genotypes, including Mesoamerican and Andean genotypes, for a total of 577 accessions. By analysing the genetic spatial patterns of the wild common bean, we documented the existence of several genetic groups and the occurrence of variable degrees of diversity in Mesoamerica and the Andes. Moreover, using a landscape genetics approach, we demonstrated that both demographic processes and selection for adaptation were responsible for the observed genetic structure. We showed that the study of correlations between markers and ecological variables at a continental scale can help in identifying local adaptation genes. We also located putative areas of common bean domestication in Mesoamerica, in the Oaxaca Valley, and the Andes, in southern Bolivia-northern Argentina. These observations are of paramount importance for the conservation and exploitation of the genetic diversity preserved within this species and other plant genetic resources. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

Structure of the initiation-competent RNA polymerase I and its implication for transcription

NASA Astrophysics Data System (ADS)

Pilsl, Michael; Crucifix, Corinne; Papai, Gabor; Krupp, Ferdinand; Steinbauer, Robert; Griesenbeck, Joachim; Milkereit, Philipp; Tschochner, Herbert; Schultz, Patrick

2016-07-01

Eukaryotic RNA polymerase I (Pol I) is specialized in rRNA gene transcription synthesizing up to 60% of cellular RNA. High level rRNA production relies on efficient binding of initiation factors to the rRNA gene promoter and recruitment of Pol I complexes containing initiation factor Rrn3. Here, we determine the cryo-EM structure of the Pol I-Rrn3 complex at 7.5 Å resolution, and compare it with Rrn3-free monomeric and dimeric Pol I. We observe that Rrn3 contacts the Pol I A43/A14 stalk and subunits A190 and AC40, that association re-organizes the Rrn3 interaction interface, thereby preventing Pol I dimerization; and Rrn3-bound and monomeric Pol I differ from the dimeric enzyme in cleft opening, and localization of the A12.2 C-terminus in the active centre. Our findings thus support a dual role for Rrn3 in transcription initiation to stabilize a monomeric initiation competent Pol I and to drive pre-initiation complex formation.

User-payment, decentralization and health service utilization in Zambia.

PubMed

Blas, E; Limbambala, M

2001-12-01

The study was undertaken to assess the impact of health sector reform from 1993 to 1997 in Zambia in respect of health care service utilization and the shift of caseload from hospitals to health centres. Four key indicators were chosen: general attendance, measles vaccinations, general admissions, and deliveries. Complete sets of district data were analyzed, covering 4.5 million people out of the total population in 1997 of 9.7 million. The results show, on the one hand, a dramatic decrease of about one-third in general attendance for both hospitals and health centres over a 2-year period, followed by a period with a continued but slower decrease. On the other hand, the results also show increases at health centres in measles vaccinations (up 40%), in admissions (up 25%) and in deliveries (up 60%). The study further documents a shift of caseload from hospitals to health centres for some key services. The health centre share increased from 72.2% to 79.8% for measles vaccinations, from 23.9% to 31.0% for general admissions, and from 22.9% to 32.4% for deliveries. However, the intended overall shift in outpatient caseload from hospitals to health centres did not materialize. The main lessons are: utilization patterns can be influenced by policies such as user-payment and decentralization; user payment in poor populations leads to dramatic declines in utilization of services; and decentralization with local control of resources could be an alternative to the traditional vertical disease programme approach for priority interventions.

MtDNA COI-COII marker and drone congregation area: an efficient method to establish and monitor honeybee (Apis mellifera L.) conservation centres.

PubMed

Bertrand, Bénédicte; Alburaki, Mohamed; Legout, Hélène; Moulin, Sibyle; Mougel, Florence; Garnery, Lionel

2015-05-01

Honeybee subspecies have been affected by human activities in Europe over the past few decades. One such example is the importation of nonlocal subspecies of bees which has had an adverse impact on the geographical repartition and subsequently on the genetic diversity of the black honeybee Apis mellifera mellifera. To restore the original diversity of this local honeybee subspecies, different conservation centres were set up in Europe. In this study, we established a black honeybee conservation centre Conservatoire de l'Abeille Noire d'Ile de France (CANIF) in the region of Ile-de-France, France. CANIF's honeybee colonies were intensively studied over a 3-year period. This study included a drone congregation area (DCA) located in the conservation centre. MtDNA COI-COII marker was used to evaluate the genetic diversity of CANIF's honeybee populations and the drones found and collected from the DCA. The same marker (mtDNA) was used to estimate the interactions and the haplotype frequency between CANIF's honeybee populations and 10 surrounding honeybee apiaries located outside of the CANIF. Our results indicate that the colonies of the conservation centre and the drones of the DCA show similar stable profiles compared to the surrounding populations with lower level of introgression. The mtDNA marker used on both DCA and colonies of the conservation centre seems to be an efficient approach to monitor and maintain the genetic diversity of the protected honeybee populations. © 2014 John Wiley & Sons Ltd.

Web-based information system design of agricultural management towards self-sufficiency local food in North Aceh

NASA Astrophysics Data System (ADS)

Salahuddin; Husaini; Anwar

2018-01-01

The agricultural sector, especially food crops and horticulture, is one of the sectors driving regional economic pillars in Aceh Utara Regency of Aceh Province. Some agricultural products and food crops that become excellent products in North Aceh regency are: rice, corn, peanuts, long beans, cassava and soybeans. The Local Government of North Aceh Regency has not been optimal in empowering and maximizing the potential of agriculture resources. One of the obstacles is caused by the North Aceh Regency Government does not have an adequate database and web information system/GIS (Geographic Information System) for data management of agricultural centre in North Aceh Regency. This research is expected to assist local government of North Aceh Regency in managing agriculture sector to realize local food independence the region in supporting national food security program. The method in this research is using waterfall method for designing and making information system by conducting sequential process starting from data collection stage, requirement analysis, design, coding, testing and implementation system. The result of this research is a web-based information system for the management of agriculture superior agricultural product centre in North Aceh. This application provides information mapping the location of agricultural superior product producers and mapping of potential locations for the development of certain commodities in North Aceh Regency region in realizing food self-sufficiency in the region.

Organisational culture and post-merger integration in an academic health centre: a mixed-methods study.

PubMed

Ovseiko, Pavel V; Melham, Karen; Fowler, Jan; Buchan, Alastair M

2015-01-22

Around the world, the last two decades have been characterised by an increase in the numbers of mergers between healthcare providers, including some of the most prestigious university hospitals and academic health centres. However, many mergers fail to bring the anticipated benefits, and successful post-merger integration in university hospitals and academic health centres is even harder to achieve. An increasing body of literature suggests that organisational culture affects the success of post-merger integration and academic-clinical collaboration. This paper reports findings from a mixed-methods single-site study to examine 1) the perceptions of organisational culture in academic and clinical enterprises at one National Health Service (NHS) trust, and 2) the major cultural issues for its post-merger integration with another NHS trust and strategic partnership with a university. From the entire population of 72 clinician-scientists at one of the legacy NHS trusts, 38 (53%) completed a quantitative Competing Values Framework survey and 24 (33%) also provided qualitative responses. The survey was followed up by semi-structured interviews with six clinician-scientists and a group discussion including five senior managers. The cultures of two legacy NHS trusts differed and were primarily distinct from the culture of the academic enterprise. Major cultural issues were related to the relative size, influence, and history of the legacy NHS trusts, and the implications of these for respective identities, clinical services, and finances. Strategic partnership with a university served as an important ameliorating consideration in reaching trust merger. However, some aspects of university entrepreneurial culture are difficult to reconcile with the NHS service delivery model and may create tension. There are challenges in preserving a more desirable culture at one of the legacy NHS trusts, enhancing cultures in both legacy NHS trusts during their post-merger integration, and in aligning academic and clinical cultures following strategic partnership with a university. The seeds of success may be found in current best practice, good will, and a near identical ideal of the future preferred culture. Strong, fair leadership will be required both nationally and locally for the success of mergers and post-merger integration in university hospitals and academic health centres.

Nutritional status and food security: winter nutrition monitoring in Sarajevo 1993-1994.

PubMed

Watson, F; Kulenovic, I; Vespa, J

1995-10-01

To monitor nutritional status and food security throughout the winter of 1993-1994 in order to provide early warning of any deterioration, identify the nutritionally vulnerable and so enable humanitarian agencies to respond appropriately. Four different household groups were prospectively followed: residents, refugees in collective centres, refugees in private accommodation and elderly living alone (either residents or refugees). Four local communities were purposively selected and two collective centres were randomly selected. Households were randomly selected within each community and collective centre. An additional sample of all elderly inhabitants of the old people's home were nutritionally assessed only. Monitoring was implemented in the besieged city of Sarajevo. 143 households with 90 children (< 18 years), 230 adults (18-59 years), and 94 elderly (60 + years) members, and 40 elderly inhabitants of the old people's home were monitored. Every month from December 1993 to March 1994, information on household food security was collected through structured questionnaires. All subjects were weighed and their heights measured. Weight for age Z scores in children (six months to 12 years) and body mass index (BMI) in adults and the elderly were calculated. While the nutritional status of adults and children consistently remained normal, high levels of undernutrition were detected among the elderly ranging from 16% to 21% (BMI < 18.5). Between December 1993 and February 1994, adults lost an average of 260 grams in weight (paired t test p = 0.005). Indicators of household food security (food stocks per person, market food prices and access to food aid) showed negative trends during the same time period. Whilst there was no nutritional disaster in Sarajevo over the winter 1993-1994, there were signs that capacity to cope was weakening in some groups. The elderly were identified as the most nutritionally vulnerable due to sickness, cold, stress and problems related to food preparation. The most food insecure group were refugees in collective centres who were highly dependent on food aid, were less likely to have relatives outside Sarajevo to support them, had fewer possessions to sell and were least likely to have gardens.

Perceptions of nursery staff and parent views of healthy eating promotion in preschool settings: an exploratory qualitative study.

PubMed

McSweeney, Lorraine A; Rapley, Tim; Summerbell, Carolyn D; Haighton, Catherine A; Adamson, Ashley J

2016-08-19

In the UK just over a fifth of all children start school overweight or obese and overweight 2-5 year olds are at least 4 times more likely to become overweight adults. This can lead to serious future health problems. The WHO have recently highlighted the preschool years as a critical time for obesity prevention, and have recommended preschools as an ideal setting for intervention. However, existing evidence suggests that the preschool environment, including the knowledge, beliefs and practices of preschool staff and parents of young children attending nurseries can be a barrier to the successful implementation of healthy eating interventions in this setting. This study examined the perceptions of preschool centre staff and parents' of preschool children of healthy eating promotion within preschool settings. The participants were preschool staff working in private and local authority preschool centres in the North East of England, and parents of preschool children aged 3-4 years. Preschool staff participated in semi-structured interviews (n = 16 female, 1 male). Parents completed a mapping activity interview (n = 14 mothers, 1 father). Thematic analysis was applied to interpret the findings. Complex communication issues surrounding preschool centre dietary 'rules' were apparent. The staff were keen to promote healthy eating to families and felt that parents needed 'education' and 'help'. The staff emphasised that school policies prohibited providing children with sugary or fatty snacks such as crisps, cakes, sweets and 'fizzy' drinks, however, some preschool centres appeared to have difficulty enforcing such guidelines. Parents were open to the idea of healthy eating promotion in preschool settings but were wary of being 'told what to do' and being thought of as 'bad parents'. There is a need to further explore nursery staff members' personal perceptions of health and how food policies which promote healthier food in preschool settings can be embedded and implemented. Family friendly healthy eating strategies and activities which utilise nudge theory should be developed and delivered in a manner that is sensitive to parents' concerns. Preschool settings may offer an opportunity for delivery of such activities.

A cost description of an adult cystic fibrosis unit and cost analyses of different categories of patients.

PubMed Central

Robson, M; Abbott, J; Webb, K; Dodd, M; Walsworth-Bell, J

1992-01-01

BACKGROUND: There is little information on the costs of running an adult cystic fibrosis centre. The aim of this study was to provide detailed costs to assist funding and planning for these patients. METHODS: The cost of a regional adult cystic fibrosis centre serving 119 cystic fibrosis patients, categorised according to four treatment regimens, was determined. District health authority, family health service authority, and voluntary resources used from April 1989 to March 1990 were determined, with appropriate bases for allocation of costs and patient based costs from local information. RESULTS: The total annual cost of treating the 119 patients was 980,646 pounds, with an average cost 8241 pounds per patient. An outpatient reviewed at three monthly intervals cost 2792 pounds a year; an outpatient receiving intravenous antibiotics cost 8606 pounds; an inpatient receiving intravenous antibiotics cost 13,501 pounds; and a patient needing a high level of care cost 19,955 pounds. Medication accounted for 57% (561,395 pounds) of the total cost. CONCLUSIONS: This analysis has helped us to secure funding for patients with cystic fibrosis and it facilitates the prediction of future requirements. The study also indicates the limitations of using average patient costs and difficulties as a result of the poorly structured British National Health Service accounting and information systems. PMID:1440461

Biogeographical and evolutionary importance of the European high mountain systems

PubMed Central

Schmitt, Thomas

2009-01-01

Europe is characterised by several high mountain systems dominating major parts of its area, and these structures have strongly influenced the evolution of taxa. For species now restricted to these high mountain systems, characteristic biogeographical patterns of differentiation exist. (i) Many local endemics are found in most of the European high mountain systems especially in the Alps and the more geographically peripheral regions of Europe. Populations isolated in these peripheral mountain ranges often have strongly differentiated endemic genetic lineages, which survived and evolved in the vicinity of these mountain areas over long time periods. (ii) Populations of taxa with wide distributions in the Alps often have two or more genetic lineages, which in some cases even have the status of cryptic species. In many cases, these lineages are the results of several centres of glacial survival in the perialpine areas. Similar patterns also apply to the other geographically extended European high mountain systems, especially the Pyrenees and Carpathians. (iii) Populations from adjoining high mountain systems often show similar genetic lineages, a phenomenon best explained by postglacial retreat to these mountains from one single differentiation centre between them. (iv) The populations of a number of species show gradients of genetic diversity from a genetically richer East to a poorer West. This might indicate better glacial survival conditions for this biogeographical group of species in the more eastern parts of Europe. PMID:19480666

Structural, mechanical, and magnetic properties of ferrite-austenite mixture in evaporated 304 stainless steel thin films

NASA Astrophysics Data System (ADS)

Merakeb, Noureddine; Messai, Amel; Djelloul, Abdelkader; Ayesh, Ahmad I.

2015-11-01

In this paper, we investigate the structure, composition, magnetic, and mechanical properties of stainless steel thin films formed by thermal evaporation technique. These thin films reveal novel structural and physical properties where they were found to consist of nanocrystals that are ~90 % body-centred cubic crystal structure which holds ferromagnetic properties (α-phase), and ~10 % face-centred cubic crystal structure which is paramagnetic at room temperature (γ-phase). The presence of the above phases was quantified by X-ray diffraction, transmission electron microscopy, and conversion electron Mössbauer spectroscopy. The magnetic properties were evaluated by a superconducting quantum interference device magnetometer, and they confirmed the dual-phase crystal structure of the stainless thin films, where the presence of γ-phase reduced the magnetization of the produced thin films. In addition, the fabricated stainless steel thin films did not contain micro-cracks, and they exhibit a tensile stress of about 1.7 GPa, hardness of 7.5 GPa, and elastic modulus of 104 GPa.

Sjögren's syndrome-associated myositis with germinal centre-like structures.

PubMed

Espitia-Thibault, Alexandra; Masseau, Agathe; Néel, Antoine; Espitia, Olivier; Toquet, Claire; Mussini, Jean-Marie; Hamidou, Mohamed

2017-02-01

Muscular impairment is a rare systemic manifestation of SS that is rarely described in the literature and classically non-specific, both clinically and histologically. We reviewed the cases of 4 patients with primary SS presenting with myositis and a common histologic pattern on muscular biopsy with germinal centre-like structures resembling that which occurs in salivary glands. We analysed the data files of patients with SS who had muscular manifestations and underwent a muscular biopsy. Among 23 patients with SS who had muscle biopsies, 13 had non-specific myositis and 10 (4 primary and 6 secondary SS) had a common histologic pattern consisting of germinal centre-like structures. We analysed the data files of the 4 patients with primary SS presenting with myositis with muscular germinal-centre like structures. The 4 patients had an unspecific clinical presentation, with myalgias, muscular weakness and normal or elevated values of CPK. In the four patients, SS-associated myositis had common histologic characteristics, with endomysial and perimysial inflammatory infiltrate. The cellular infiltrate was composed predominantly of CD4+ T lymphocytes and B lymphocytes. The B and T CD4+ cells infiltrates may gather into masses, even forming lymphoid follicles. Three patients were treated with corticosteroids and/or hydroxychloroquine with improvement of myositis and 1 patient was lost to follow-up. We describe four patients with a common histologic appearance of myositis with lymphoid follicles associated with primary SS. The clinical presentation was non-specific and non-severe, with favorable outcome with corticosteroids and/or hydroxycholoroquine. The discovery of this particular histologic appearance in a muscle biopsy independent of the final diagnosis should indicate the possibility of SS. Copyright © 2016 Elsevier B.V. All rights reserved.

Predictive validity of a selection centre testing non-technical skills for recruitment to training in anaesthesia.

PubMed

Gale, T C E; Roberts, M J; Sice, P J; Langton, J A; Patterson, F C; Carr, A S; Anderson, I R; Lam, W H; Davies, P R F

2010-11-01

Assessment centres are an accepted method of recruitment in industry and are gaining popularity within medicine. We describe the development and validation of a selection centre for recruitment to speciality training in anaesthesia based on an assessment centre model incorporating the rating of candidate's non-technical skills. Expert consensus identified non-technical skills suitable for assessment at the point of selection. Four stations-structured interview, portfolio review, presentation, and simulation-were developed, the latter two being realistic scenarios of work-related tasks. Evaluation of the selection centre focused on applicant and assessor feedback ratings, inter-rater agreement, and internal consistency reliability coefficients. Predictive validity was sought via correlations of selection centre scores with subsequent workplace-based ratings of appointed trainees. Two hundred and twenty-four candidates were assessed over two consecutive annual recruitment rounds; 68 were appointed and followed up during training. Candidates and assessors demonstrated strong approval of the selection centre with more than 70% of ratings 'good' or 'excellent'. Mean inter-rater agreement coefficients ranged from 0.62 to 0.77 and internal consistency reliability of the selection centre score was high (Cronbach's α=0.88-0.91). The overall selection centre score was a good predictor of workplace performance during the first year of appointment. An assessment centre model based on the rating of non-technical skills can produce a reliable and valid selection tool for recruitment to speciality training in anaesthesia. Early results on predictive validity are encouraging and justify further development and evaluation.

Learner-centred teaching in a non-learner-centred world: An interpretive phenomenological study of the lived experience of clinical nursing faculty.

PubMed

Oyelana, Olabisi; Martin, Donna; Scanlan, Judith; Temple, Beverley

2018-08-01

With the growing complexities in the contemporary health care system, there is a challenge of preparing nurses for the practice demands. To this end, learner-centred teaching has emerged in many nursing curricula in Canada and evidence indicates its effectiveness in developing the essential practice skills in nursing students. It is important to examine the experience of the clinical faculty members who implement learner-centred teaching, as doing so would provide an insight to the factors that may hinder the implementation of learner-centred teaching in the practice settings. This phenomenological study aimed to address two research questions: what does learner-centred teaching mean to clinical nurse faculty? What is the lived experience of clinical nursing faculty who incorporate learner-centred teaching? Ten clinical nurse faculty members who had at least two years of clinical teaching experience volunteered to participate in the study. Data were collected using a semi-structured interview guide and audio recorder. Additional data sources included a demographic survey and a reflective journal. Multiple sub-themes emerged from this study from which three significant themes were consolidated: diversity of meanings, facilitators of LCT, and barriers to LCT. However, an overarching theme of "learner-centred teaching in a non-learner-centred world" was coined from participants' accounts of their experiences of barriers in incorporating LCT in the practice settings. A collaborative effort between faculty and the stakeholders is paramount to a successful implementation of learner-centred teaching in practice settings. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health and demographic surveillance systems: contributing to an understanding of the dynamics in migration and health

PubMed Central

Gerritsen, Annette; Bocquier, Philippe; White, Michael; Mbacké, Cheikh; Alam, Nurul; Beguy, Donatien; Odhiambo, Frank; Sacoor, Charfudin; Phuc, Ho Dang; Punpuing, Sureeporn; Collinson, Mark A.

2013-01-01

Background Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration. Objective/design Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the age–sex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality. Results The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses. Conclusions HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on livelihoods. Future comparative evidence using standardised tools will help design policies for mitigating the negative effects, and enhancing the positive effects, of migration on health. PMID:23849188

The economic costs of intrapartum care in Tower Hamlets: A comparison between the cost of birth in a freestanding midwifery unit and hospital for women at low risk of obstetric complications.

PubMed

Schroeder, Liz; Patel, Nishma; Keeler, Michelle; Rocca-Ihenacho, Lucia; Macfarlane, Alison J

2017-02-01

to compare the economic costs of intrapartum maternity care in an inner city area for 'low risk' women opting to give birth in a freestanding midwifery unit compared with those who chose birth in hospital. micro-costing of health service resources used in the intrapartum care of mothers and their babies during the period between admission and discharge, data extracted from clinical notes. the Barkantine Birth Centre, a freestanding midwifery unit and the Royal London Hospital's consultant-led obstetric unit, both run by the former Barts and the London NHS Trust in Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. maternity records of 333 women who were resident in Tower Hamlets and who satisfied the Trust's eligibility criteria for using the Birth Centre. Of these, 167 women started their intrapartum care at the Birth Centre and 166 started care at the Royal London Hospital. women who planned their birth at the Birth Centre experienced continuous intrapartum midwifery care, higher rates of spontaneous vaginal delivery, greater use of a birth pool, lower rates of epidural use, higher rates of established breastfeeding and a longer post-natal stay, compared with those who planned for care in the hospital. The total average cost per mother-baby dyad for care where mothers started their intrapartum care at the Birth Centre was £1296.23, approximately £850 per patient less than the average cost per mother and baby who received all their care at the Royal London Hospital. These costs reflect intrapartum throughput using bottom up costing per patient, from admission to discharge, including transfer, but excluding occupancy rates and the related running costs of the units. the study showed that intrapartum throughput in the Birth Centre could be considered cost-minimising when compared to hospital. Modelling the financial viability of midwifery units at a local level is important because it can inform the appropriate provision of these services. This finding from this study contribute a local perspective and thus further weight to the evidence from the Birthplace Programme in support of freestanding midwifery unit care for women without obstetric complications. Copyright © 2016. Published by Elsevier Ltd.

Scapular dyskinesia: evolution towards a systems-based approach

PubMed Central

Smith, Michael J

2015-01-01

Historically, scapular dyskinesia has been used to describe an isolated clinical entity whereby an abnormality in positioning, movement or function of the scapula is present. Based upon this, treatment approaches have focused on addressing local isolated muscle activity. Recently, however, there has been a progressive move towards viewing the scapula as being part of a wider system of movement that is regulated and controlled by multiple factors, including the wider kinetic chain and individual patient-centred requirements. We therefore propose a paradigm shift whereby scapular dyskinesia is seen not in isolation but is considered within the broader context of patient-centred care and an entire neuromuscular system. PMID:27583003

Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

PubMed

Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

2012-07-01

16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

Building a discovery partnership with Sarawak Biodiversity Centre: a gateway to access natural products from the rainforests.

PubMed

Yeo, Tiong Chia; Naming, Margarita; Manurung, Rita

2014-03-01

The Sarawak Biodiversity Centre (SBC) is a state government agency which regulates research and promotes the sustainable use of biodiversity. It has a program on documentation of traditional knowledge (TK) and is well-equipped with facilities for natural product research. SBC maintains a Natural Product Library (NPL) consisting of local plant and microbial extracts for bioprospecting. The NPL is a core discovery platform for screening of bioactive compounds by researchers through a formal agreement with clear benefit sharing obligations. SBC aims to develop partnerships with leading institutions and the industries to explore the benefits of biodiversity.

Residual delay maps unveil global patterns of atmospheric nonlinearity and produce improved local forecasts

PubMed Central

Sugihara, George; Casdagli, Martin; Habjan, Edward; Hess, Dale; Dixon, Paul; Holland, Greg

1999-01-01

We use residual-delay maps of observational field data for barometric pressure to demonstrate the structure of latitudinal gradients in nonlinearity in the atmosphere. Nonlinearity is weak and largely lacking in tropical and subtropical sites and increases rapidly into the temperate regions where the time series also appear to be much noisier. The degree of nonlinearity closely follows the meridional variation of midlatitude storm track frequency. We extract the specific functional form of this nonlinearity, a V shape in the lagged residuals that appears to be a basic feature of midlatitude synoptic weather systems associated with frontal passages. We present evidence that this form arises from the relative time scales of high-pressure versus low-pressure events. Finally, we show that this nonlinear feature is weaker in a well regarded numerical forecast model (European Centre for Medium-Range Forecasts) because small-scale temporal and spatial variation is smoothed out in the grided inputs. This is significant, in that it allows us to demonstrate how application of statistical corrections based on the residual-delay map may provide marked increases in local forecast accuracy, especially for severe weather systems. PMID:10588685

Triassic-Jurassic sediments and multiple volcanic events in North Victoria Land, Antarctica: A revised stratigraphic model

USGS Publications Warehouse

Schöner, R.; Viereck-Goette, L.; Schneider, J.; Bomfleur, B.

2007-01-01

Field investigations in North Victoria Land, Antarctica during GANOVEX IX (2005/2006) allow the revision of the Triassic-Jurassic stratigraphy of ~300 m thick continental deposits in between the crystalline basement and the Kirkpatrick lava flows of the Ferrar Group. The lower stratigraphic unit (Section Peak Formation) is characterised by braided river-type quartzose sandstone deposits with intercalations of shale and coal occurring at the top. It is overlain by a homogeneous unit of reworked tuffs composed of fine-grained silicic shards, quartz and feldspar (new name: "Shafer Peak Formation"). These deposits can be correlated with parts of the Hanson Formation in the Central Transantarctic Mountains and require a distal yet unknown source of massive silicic volcanism. Clastic products of mafic volcanic eruptions, formerly described as a separate stratigraphic formation (Exposure Hill Formation), occur within local diatreme structures as well as intercalated at various stratigraphic levels within the sedimentary succession. These dominantly hydroclastic eruptions are the first subaerial expression of Ferrar magmatism. The initial Kirkpatrick lavas/pillow lavas were generated from local eruptive centres and again may be overlain by thin sediments, which are covered by the thick plateau lava succession known throughout the Transantarctic Mountain Range.

Dynamical evolution of stars and gas of young embedded stellar sub-clusters

NASA Astrophysics Data System (ADS)

Sills, Alison; Rieder, Steven; Scora, Jennifer; McCloskey, Jessica; Jaffa, Sarah

2018-06-01

We present simulations of the dynamical evolution of young embedded star clusters. Our initial conditions are directly derived from X-ray, infrared, and radio observations of local systems, and our models evolve both gas and stars simultaneously. Our regions begin with both clustered and extended distributions of stars, and a gas distribution that can include a filamentary structure in addition to gas surrounding the stellar sub-clusters. We find that the regions become spherical, monolithic, and smooth quite quickly, and that the dynamical evolution is dominated by the gravitational interactions between the stars. In the absence of stellar feedback, the gas moves gently out of the centre of our regions but does not have a significant impact on the motions of the stars at the earliest stages of cluster formation. Our models at later times are consistent with observations of similar regions in the local neighbourhood. We conclude that the evolution of young protostar clusters is relatively insensitive to reasonable choices of initial conditions. Models with more realism, such as an initial population of binary and multiple stars and ongoing star formation, are the next step needed to confirm these findings.

Learning globally to enhance local practice: an international programme in primary care & family health.

PubMed

Godoy-Ruiz, Paula; Rodas, Jamie; Talbot, Yves; Rouleau, Katherine

2016-09-01

In a global context of growing health inequities, international learning experiences have become a popular strategy for equipping health professionals with skills, knowledge, and competencies required to work with the populations they serve. This study sought to analyse the Chilean Interprofessional Programme in Primary Health Care (CIPPHC), a 5 week international learning experience funded by the Ministry of Health in Chile targeted at Chilean primary care providers and delivered in Toronto by the Department of Family and Community Medicine at the University of Toronto. The study focused on three cohorts of students (2010-2012). Anonymous programme evaluations were analysed and semi-structured interviews conducted with programme alumni. Simple descriptive statistics were gathered from the evaluations and the interviews were analysed via thematic content analysis. The majority of participants reported high levels of satisfaction with the training programme, knowledge gain, particularly in the areas of the Canadian model of primary care, and found the materials delivered to be applicable to their local context. The CIPPHC has proven to be a successful educational initiative and provides valuable lessons for other academic centres in developing international interprofessional training programmes for primary care health care providers.

Factors influencing the spreading of a low-discharge river plume

NASA Astrophysics Data System (ADS)

Mestres, M.; Sierra, J. P.; Sánchez-Arcilla, A.

2007-09-01

Coastal plumes resulting from the continuous discharge of brackish or fresh river water are common features of continental and shelf seas. They are important for several aspects of the coastal environment, and can influence the local socio-economy to some degree. It is known from many studies that the evolution of plumes depends on various factors, such as the local bathymetry, hydrodynamics and meteorological conditions; most of these works; however, have focused on medium to large-scale rivers, while the smaller-scale discharges commonly found in the microtidal environments of the Mediterranean Sea have been less studied. This paper is centred on the behaviour of a freshwater plume arising from one of such outflows, in terms of both the physical configuration of the waterbody and the characteristics of the main driving mechanisms (discharge rate and wind stress). The modelled cases correspond to an open shallow bay, limited at one end by a large headland, and into which a typical Mediterranean waterway discharges. This particular setup is representative of a number of different bays existing on the Eastern Spanish coast. The numerical results highlight the large influence of the bay's topography on the river plume's extension and inner structure.

NonTuberculous Mycobacteria infection and lung transplantation in cystic fibrosis: a worldwide survey of clinical practice.

PubMed

Tissot, Adrien; Thomas, Matthew F; Corris, Paul A; Brodlie, Malcolm

2018-05-22

In people with cystic fibrosis infection with NonTuberculous Mycobacteria is of increasing prevalence. Mycobacterium abscessus complex is of particular concern and has been associated with adverse clinical outcomes. Optimal treatment usually requires multiple antibiotics for over 12 months. When considering lung transplantation for patients with NonTuberculous Mycobacteria potential benefits must be balanced against the risks of uncontrolled infection post-transplant and significant side-effects associated with treatment. In this survey we assessed current international practice with regard to assessing and listing patients for lung transplantation. We designed a questionnaire enquiring about local practice regarding screening for NonTuberculous Mycobacteria infection, specific contra-indications to transplantation, management and segregation of patients pre- and post-transplant. The survey was sent via e-mail to 37 paediatric and adult lung transplant centres across Europe, North America and Australia. We gathered complete questionnaires from 21 centres (57% response rate). Few centres (29%) have a clear written policy regarding NonTuberculous Mycobacteria. Sixteen (76%) centres require molecular identification of NonTuberculous Mycobacteria species. Only four centres would consider infection with M. abscessus complex in itself a contra-indication for listing, however 76% regard it as a relative contra-indication. Eighty-six percent require treatment pre-transplantation. Finally, only 61% of centres had a clear policy regarding segration of patients pre-transplant and 48% post-transplant. The issue of NonTuberculous Mycobacteria infection in people with cystic fibrosis requiring lung transplantation is well-recognized however current international recommendations are not detailed and there is variation in practice between centres. There is an urgent requirement for high quality clinical data to inform decision-making.

Local sustainability and scaling up for user fee exemptions: medical NGOs vis-à-vis health systems

PubMed Central

2015-01-01

Free healthcare obviously works when a partner from abroad supplies a health centre or a health district with medicines and funding on a regular basis, provides medical, administrative and managerial training, and gives incentive bonuses and daily subsistence allowances to staff. The experiments by three international NGO in Burkina Faso, Mali and Niger have all been success stories. But withdrawing NGO support means that health centres that have enjoyed a time of plenty under NGO management will return to the fold of health centres run by the state in its present condition and the health system in its present condition, with the everyday consequences of late reimbursements and stock shortages. The local support given by international NGOs has more often than not an effect of triggering an addiction to aid instead of inducing local sustainability without infusion. In the same way, scaling up to the entire country a local pilot experiment conducted under an NGO involves its insertion into a national bureaucratic machine with its multiple levels, all of which are potential bottlenecks. Only experiments carried out under the "ordinary" management of the state are capable of laying bare the problems associated with this process. Without reformers 'on the inside' (within the health system itself and among health workers), no real reform of the health system induced by reformers 'from the outside' can succeed. The problems relating to the sustainability of public policies in Africa, especially when the policies benefit from development aid, in the area of health among others, are familiar to researchers and policy-makers. However, as far as user fee exemptions are concerned, debates about these problems have extended well beyond the narrow circle of experts and into the public domain in the countries concerned. Throughout our research, we have observed that the sustainability of free healthcare policies is a major concern of all the actors (health workers, users, managers and senior administrative staff), and an issue that has generated widespread scepticism, especially in Mali and Niger [1,2]. There is general unease about the state's ability to reimburse health centres and to provide essential inputs. The scepticism is fuelled by a two-fold negative experience: decades of incoherent public policies at national level, plagued by bad management and uncertain funding, on the one hand; and the endless U-turns by donors, the double binds of frequent contradictions in their funding policies and the short-term nature of the programmes they enact, on the other [3]. The first years of exemption policies, which were beset by late reimbursements and more or less chronic stock shortages, only added to the scepticism. The disquiet appears to be justified: despite their positive impact in terms of health centre attendance, without funding guaranteed over time, efficient management, secure supply channels and motivated staff, free healthcare policies fall foul of a host of adverse effects at every level of the health pyramid. PMID:26559444

Alternative systems in Malaysian drug rehabilitation: organization and control in comparative perspective.

PubMed

Lee, R L

1985-01-01

This paper examines four drug rehabilitation systems in Malaysia from an organizational perspective. It focuses on authority structures in rehabilitation centres and their impact on rehabilitees' identities. The findings show that there are important differences between government-run and private centres in terms of administration and approach to therapy. Some policy implications are derived from a comparison of these systems.

Polymeric Cd(II), trinuclear and mononuclear Ni(II) complexes of 5-methyl-4-phenyl-1,2,4-triazole-3-thione: Synthesis, structural characterization, thermal behaviour, fluorescence properties and antibacterial activity

NASA Astrophysics Data System (ADS)

Bharty, M. K.; Paswan, S.; Dani, R. K.; Singh, N. K.; Sharma, V. K.; Kharwar, R. N.; Butcher, R. J.

2017-02-01

Syntheses of a polymeric Cd(II) complex, [Cd(mptt)2]n (1), a trinuclear Ni(II) complex, [Ni3(μ-mptt)4(μ-H2O)2(H2O)2(ttfa)2]·3H2O (2) and a mononuclear Ni(II) complex [Ni(mptt)2(en)2] (3) have been performed using the ligand 5-methyl-4-phenyl-1,2,4-triazole-3-thione (Hmptt) and nickel(II)/cadmium(II) salts {ttfa = thenoyltrifluroacetonate). The ligand and the complexes have been characterized by various physicochemical methods in addition to their single crystal X-ray structure. The Cd centre in complex 1 adopts a distorted tetrahedral geometry with one sulfur atom and two mptt ligands provide three nitrogen atoms from three triazole units. The sulfur atom of the ligand binds covalently and overall the ligand acts as uninigative N,S/N,N bidentate moiety. The polymeric structure of complex 1 results from the N atoms of the neighboring triazole units coordinating with the Cd(II) centre. The three Ni(II) centres in the trinuclear Ni(II) complex 2 form a linear arrangement and all have six coordinated arrangements. The middle Ni(II) binds with four deprotonated triazole ring nitrogens and two water molecules form two bridges. The terminal Ni(II) centres bind through two thenoyl oxygens, two triazole nitrogens and water molecules that formed bridges with the middle Ni centre. In complex 3, the nickel(II) centre is covalently bonded through two deprotonated triazole ring nitrogens from two ligand moieties and other four sites are occupied by four nitrogens from two bidentate en ligands. Thermogravimetric analyses (TGA) of the complexes indicated for NiO as the final residue. The bioefficacy of the ligand and complexes 2 and 3 have been examined against the growth of bacteria to evaluate their anti-microbial potential. Complex 2 showed high antibacterial activity as compared to the ligand and complex 3. Complexes 1, 2 and 3 are fluorescent materials with maximum emissions at 425, 421 and 396 nm at an excitation wavelength of 323, 348 and 322 nm, respectively.

Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria

PubMed Central

Uzochukwu, Benjamin SC; Onwujekwe, Obinna E

2004-01-01

Background Malaria is one of the leading causes of mortality and morbidity in Nigeria. It is not known how user fees introduced under the Bamako Initiative (BI) system affect healthcare seeking among different socio-economic groups in Nigeria for diagnosis and treatment of malaria. Reliable information is needed to initiate new policy thrusts to protect the poor from the adverse effect of user fees. Methods Structured questionnaires were used to collect information from 1594 female household primary care givers or household head on their socio-economic and demographic status and use of malaria diagnosis and treatment services. Principal components analysis was used to create a socio-economic status index which was decomposed into quartiles and chi-square for trends was used to calculate for any statistical difference. Results The study showed that self diagnosis was the commonest form of diagnosis by the respondents. This was followed by diagnosis through laboratory tests, community health workers, family members and traditional healers. The initial choice of care for malaria was a visit to the patent medicine dealers for most respondents. This was followed by visit to the government hospitals, the BI health centres, traditional medicine healers, private clinics, community health workers and does nothing at home. Furthermore, the private health facilities were the initial choice of treatment for the majority with a decline among those choosing them as a second source of care and an increase in the utilization of public health facilities as a second choice of care. Self diagnosis was practiced more by the poorer households while the least poor used the patent medicine dealers and community health workers less often for diagnosis of malaria. The least poor groups had a higher probability of seeking treatment at the BI health centres (creating equity problem in BI), hospitals, and private clinics and in using laboratory procedures. The least poor also used the patent medicine dealers and community health workers less often for the treatment of malaria. The richer households complained more about poor staff attitude and lack of drugs as their reasons for not attending the BI health centres. The factors that encourage people to use services in BI health centres were availability of good services, proximity of the centres to the homes and polite health workers. Conclusions Factors deterring people from using BI centres should be eliminated. The use of laboratory services for the diagnosis of malaria by the poor should be encouraged through appropriate information, education and communication which at the long run will be more cost effective and cost saving for them while devising means of reducing the equity gap created. This could be done by granting a properly worked out and implemented fee exemptions to the poor or completely abolishing user fees for the diagnosis and treatment of malaria in BI health centres. PMID:15202941

The education on landslides through the "BE-SAFE-NET" web-portal on Disaster Awareness.

NASA Astrophysics Data System (ADS)

Maquaire, O.; Castaldini, D.; Malet, J.-P.; von Elverfeldt, K.; Pla, F.; Soldati, M.; Greco, R.; Pasuto, A.

2009-04-01

The website on Disaster Awareness with the use of the internet "BE-SAFE-NET" is developed within the framework of the FORM-OSE programme (European Training Programme for South, East and West) of the EUR-OPA Major Hazards Agreement, hosted by the European Centre for Disaster Awareness with the use of the internet (BE-SAFE-NET, Nicosia, Cyprus). The website is dedicated for school actors (school-level children, teachers, administrative and technical staff, families and local authorities) in order to: - Inform on regulations, on tools for raising awareness for natural and man-made risks and on preventative measures; - Train children, teachers, administrative and technical staff and local authorities; - Produce interactive figures, photographs, videos and games; - Interact with newsgroups and electronic conferences. Together with the EUR-OPA Centre of Nicosia, the project associates several centres of the Major Hazards Agreement network: the European University for the Cultural Heritage (CUEBC) of Ravello (Italy) the European Centre for Risk Prevention (ECRP) of Sofia (Bulgaria), and the European Centre on Geomorphological Hazards (CERG) of Strasbourg (France). "BE-SAFE-NET" is defined as a network among European countries in order to provide e-learning material on natural hazards and risks primarily for schools (secondary school teachers), but also for the public in general. On the webpage, teachers, pupils and the interested public should find information on disaster prevention, preparation, immediate reaction and rehabilitation. The aim of the paper is to present the structure and the organisation of the web-portal following the pilot project focused on landslides and managed by CERG. Some examples of landslides pedagogical material are also presented. The website is structured in five main sections: 1. About the initiative; 2. Definition of common concepts (e.g. hazard (natural and man made), vulnerability, risk, disaster); 3. Pedagogical material (e.g. case studies, photos, learning exercises); 4. Protect yourself; 5. Discussion forum. Based on the experience gained in preparing the landslide pedagogical documents, a clear guidelines for preparing material related to other risks (seismic, floods, snow avalanches, etc, ...) will be helpful for the ultimate goal of the website that is to provide information and material for secondary school teachers in order to prepare associated curricula (and consequently avoiding University grade documents). The proposed scheme for the X specific risk (X is an example of threat) is: 1. What is X? 2. What are the types of X? 3. Why do X occur? 4. Where do X occur, and what were the largest X in the World and in Europe? 5. What could be the consequences of X in terms of human, socio-economic and environmental loss? 6. Can the causes of X be influenced by human behaviour? 8. Can X be predicted? 9. Is there any option to prevent X? 10. Is there any option to mitigate the consequences of X? 11. What to do in case of X? 12. What type of maps on X exists? What is their use? Does the public have access to these maps and from where? For the 12 questions, the contributors were requested to propose a maximum of 20 lines on the main page (so called "first level") and links to specific page (so called "second level") with additional and more detailed information. They were also required to provide for every question additional available material, such as the description of pedagogic case studies, examples of lessons learnt, learning exercises, relevant images, videos and web links). The website is still in progress for further natural and man-made hazards. The landslide pilot section is now nearly complete.

Experiences from 10 years of school programmes at GEOMAR Kiel

NASA Astrophysics Data System (ADS)

Dengg, Joachim

2014-05-01

GEOMAR Helmholtz Centre for Ocean Research Kiel, Germany, started a programme of cooperations with secondary schools in 2003, which has been expanding continually since that time. By active involvement of teachers and students, the Centre's research topics are communicated to schools, and young people are encouraged to develop their interest for biogeosciences. The portfolio of activities includes: project work with schools over periods from one day to several months, individual student theses at the research centre, internships, a weekly "Research Club" allowing individual experiments, summer school programmes, teacher training courses, joint activities with international partners and a video-project in which students portray scientific aspects of oceanic oxygen minimum zones (in the context of the Collaborative Research Center SFB 754) to other students. Essential prerequisites for these activities are the direct involvement of the Centre's researchers who contribute their expertise and act as role-models for the students, dedicated staff for coordination and continuity, and financial and structural support both at the research centre and the schools.

Engaging women from South Asian communities in cardiac rehabilitation.

PubMed

Vishram, S; Crosland, A; Unsworth, J; Long, S

2007-01-01

This study sought to describe experiences and perceptions of cardiac rehabilitation among a sample of women from South Asian communities. Data were collected via eight semi-structured interviews with staff and a focus group discussion with nine clients from a community-based, culturally sensitive cardiac rehabilitation service. A number of individual, cultural and practical barriers to participation were identified. Facilitators centred on whether the format and content of the sessions could be considered "appropriate". For example, a women's dance group proved to be successful through the selection of a familiar local venue, supportive session leader, and activity that was felt to be both enjoyable and beneficial. This study has shown that it is possible to engage hard-to-reach groups in cardiac rehabilitation and physical activity. Further work is needed to explore whether this research is applicable in other ethnic groups and whether the lessons learned could be successfully incorporated into mainstream health services.

Astronomy of Nabta Playa

NASA Astrophysics Data System (ADS)

McK Mahille, J.; Schild, R.; Wendorf, F.; Brenmer, R.

2007-07-01

The repetitive orientation of megaliths, human burials, and cattle burials toward the northern regions of the sky reveals a very early symbolic connection to the heavens at Nabta Playa, Egypt. The groups of shaped stones facing north may have represented spirits of individuals who died on the trail or locally. A second piece of evidence for astronomy at Nabta Playa is the stone circle with its two sightlines toward the north and toward the rising sun at the June solstice. Finally, the five alignments of megaliths, which were oriented to bright stars in the fifth millennium, suggest an even more careful attention to the heavens. The "empty tombs" and deeply buried table rocks of the Complex Structures provide some of the greatest enigmas of Nabta Playa. The recurrent symbolism of the ceremonial centre involves issues that would have been of both practical and symbolic importance to the nomads: death, water, cattle, sun, and stars.

Electron transport in NH3/NO2 sensed buckled antimonene

NASA Astrophysics Data System (ADS)

Srivastava, Anurag; Khan, Md. Shahzad; Ahuja, Rajeev

2018-04-01

The structural and electronic properties of buckled antimonene have been analysed using density functional theory based ab-initio approach. Geometrical parameters in terms of bond length and bond angle are found close to the single ruffle mono-layer of rhombohedral antimony. Inter-frontier orbital analyses suggest localization of lone pair electrons at each atomic centre. Phonon dispersion along with high symmetry point of Brillouin zone does not signify any soft mode. With an electronic band gap of 1.8eV, the quasi-2D nano-surface has been further explored for NH3/NO2 molecules sensing and qualities of interaction between NH3/NO2 gas and antimonene scrutinized in terms of electronic charges transfer. A current-voltage characteristic has also been analysed, using Non Equilibrium Green's function (NEGF), for antimonene, in presence of incoming NH3/NO2 molecules.

Stibnite vein from Dębowina near Bardo (polish Sudetes)

NASA Astrophysics Data System (ADS)

Kotula, Piotr

2013-09-01

In the contact zone of the Bardo Structure and Kłodzko-Złoty Stok Intrusion and Kłodzko Metamorphic, metasomatic orebearing quartz-carbonate veins rich in Sb, Zn, Cu, Ag, Au, Pb are present. In 1771 the mine ,,Reiche Silber Gluck” within stibnite vein was founded in Dębowina near Bardo. Its entrance was discovered again in 2007. The stibnite vein is mainly build of stibnite and sphalerite and of quartz and dolomite rich in Mn. Stibnite crystallizes as columnar or forming radiate centres and aciculars. Its crystals reach size to 2 mm. Sphalerite appears as individual anhedral and polymineralic grained concentrations reaching size to 2,5 mm. Earlier pyrite and arsenopyrite crystallized - they occur locally in this deposit. There were found also in the deposit tetrahedrite rich in Ag, what wasn't reported earlier in studies from the mine in Dębowina.

Turbulent vertical diffusivity in the sub-tropical stratosphere

NASA Astrophysics Data System (ADS)

Pisso, I.; Legras, B.

2008-02-01

Vertical (cross-isentropic) mixing is produced by small-scale turbulent processes which are still poorly understood and paramaterized in numerical models. In this work we provide estimates of local equivalent diffusion in the lower stratosphere by comparing balloon borne high-resolution measurements of chemical tracers with reconstructed mixing ratio from large ensembles of random Lagrangian backward trajectories using European Centre for Medium-range Weather Forecasts analysed winds and a chemistry-transport model (REPROBUS). We focus on a case study in subtropical latitudes using data from HIBISCUS campaign. An upper bound on the vertical diffusivity is found in this case study to be of the order of 0.5 m2 s-1 in the subtropical region, which is larger than the estimates at higher latitudes. The relation between diffusion and dispersion is studied by estimating Lyapunov exponents and studying their variation according to the presence of active dynamical structures.

Incorporation of local structure into kriging models for the prediction of atomistic properties in the water decamer.

PubMed

Davie, Stuart J; Di Pasquale, Nicodemo; Popelier, Paul L A

2016-10-15

Machine learning algorithms have been demonstrated to predict atomistic properties approaching the accuracy of quantum chemical calculations at significantly less computational cost. Difficulties arise, however, when attempting to apply these techniques to large systems, or systems possessing excessive conformational freedom. In this article, the machine learning method kriging is applied to predict both the intra-atomic and interatomic energies, as well as the electrostatic multipole moments, of the atoms of a water molecule at the center of a 10 water molecule (decamer) cluster. Unlike previous work, where the properties of small water clusters were predicted using a molecular local frame, and where training set inputs (features) were based on atomic index, a variety of feature definitions and coordinate frames are considered here to increase prediction accuracy. It is shown that, for a water molecule at the center of a decamer, no single method of defining features or coordinate schemes is optimal for every property. However, explicitly accounting for the structure of the first solvation shell in the definition of the features of the kriging training set, and centring the coordinate frame on the atom-of-interest will, in general, return better predictions than models that apply the standard methods of feature definition, or a molecular coordinate frame. © 2016 The Authors. Journal of Computational Chemistry Published by Wiley Periodicals, Inc. © 2016 The Authors. Journal of Computational Chemistry Published by Wiley Periodicals, Inc.

Diabetes Literacy: Health and Adult Literacy Practitioners in Partnership

ERIC Educational Resources Information Center

Black, Stephen

2012-01-01

This paper describes pedagogy in a series of "diabetes literacy" programs involving culturally and linguistically diverse (CALD) communities. The programs were jointly delivered in local community sites, including neighbourhood centres and public housing halls, by qualified nutritionists from a public health service and adult literacy…

Taking the Lead

ERIC Educational Resources Information Center

Sedgmore, Lynne

2007-01-01

Adult and community learning (ACL) covers a wide range of educational provision, much of which is based locally within the community. Teaching staff often come from the same community and have empathy and understanding for learners. There is a strong focus on widening participation, flexible learning and learner-centred provision. It sometimes…

PROGRAMMED LEARNING IN CENTRAL AFRICAN CONTEXTS.

ERIC Educational Resources Information Center

HAWKRIDGE, D.G.

SINCE 1964, THE PROGRAMMED LEARNING CENTRE AT THE UNIVERSITY COLLEGE OF RHODESIA HAS BEEN INVESTIGATING THE POTENTIALITIES OF PROGRAMED LEARNING FOR CENTRAL AFRICA THROUGH A SERIES OF CONTROLLED EXPERIMENTS USING LOCALLY-WRITTEN AND PUBLISHED PROGRAMS. ASSESSMENT OF THE DESIRABILITY AND USEFULNESS OF PROGRAMS IN TEACHING, AND ASSESSMENT OF THEIR…

Relocalization of the calcium gradient and a dihydropyridine receptor is involved in upward bending by bulging of Chara protonemata, but not in downward bending by bowing of Chara rhizoids.

PubMed

Braun, M; Richter, P

1999-10-01

The localization of cytoplasmic free calcium and a dihydropyridine (DHP) receptor, a putative calcium channel, was recorded during the opposite graviresponses of tip-growing Chara rhizoids and Chara protonemata by using the calcium indicator Calcium Crimson and a fluorescently labeled dihydropyridine (FL-DHP). In upward (negatively gravitropically) growing protonemata and downward (positively gravitropically) growing rhizoids, a steep Ca2+ gradient and DHP receptors were found to be symmetrically localized in the tip. However, the localization of the Ca2+ gradient and DHP receptors differed considerably during the gravitropic responses upon horizontal positioning of the two cell types. During the graviresponse of rhizoids, a continuous bowing downward by differential flank growth, the Ca2+ gradient and DHP receptors remained symmetrically localized in the tip at the centre of growth. However, after tilting protonemata into a horizontal position, there was a drastic displacement of the Ca2+ gradient and FL-DHP to the upper flank of the apical dome. This displacement occurred after the apical intrusion and sedimentation of the statoliths but clearly before the change in the growth direction became evident. In protonemata, the reorientation of the growth direction started with the appearance of a bulge on that site of the upper flank which was predicted by the asymmetrically displaced Ca2+ gradient. With the upward shift of the cell tip, which is suggested to result from a statolith-induced displacement of the growth centre, the Ca2+ gradient and DHP receptors became symmetrically relocalized in the apical dome. No major asymmetrical rearrangement was observed during the following phase of gravitropic curvature which is characterized by slower rates of bending. Labeling with FL-DHP was completely inhibited by a non-fluorescently labeled dihydropyridine. From these results it is suggested that FL-DHP labels calcium channels in rhizoids and protonemata. In rhizoids, positive gravitropic curvature is caused by differential growth limited to the opposite subapical flanks of the apical dome, a process which does not involve displacement of the growth centre, the calcium gradient or calcium channels. In protonemata, however, it is proposed that a statolith-induced asymmetrical relocalization of calcium channels and the Ca2+ gradient precedes, and might mediate, the rearrangement of the centre of growth, most likely by the displacement of the Spitzenkorper, to the upper flank, which results in the negative gravitropic reorientation of the growth direction.

The German day-care study: multicomponent non-drug therapy for people with cognitive impairment in day-care centres supplemented with caregiver counselling (DeTaMAKS) - study protocol of a cluster-randomised controlled trial.

PubMed

Behrndt, Elisa-Marie; Straubmeier, Melanie; Seidl, Hildegard; Book, Stephanie; Graessel, Elmar; Luttenberger, Katharina

2017-07-17

It is the wish of both people with cognitive impairment and their informal caregivers for the impaired person to live at home for as long as possible. This is also in line with economic arguments about health. The existing structure of day-care services for the elderly can be used to achieve this. Due to the current lack of empirical evidence in this field, most day-care centres do not offer a scientifically evaluated, structured intervention, but instead offer a mixture of individual activities whose efficacy has not yet been established. Informal caregivers of people with dementia use day-care centres primarily to relieve themselves of their care tasks and as a support service. The present study therefore investigates the effectiveness of a combination of a multicomponent activation therapy for people with mild cognitive impairment (MCI) or mild to moderate dementia at day-care centres and a brief telephone intervention for their informal caregivers. The study is conducted as a cluster-randomised intervention trial at 34 day-care centres in Germany with a 6-month treatment phase. The centres in the waitlist control group provide "care as usual". A power analysis indicated that 346 people should initially be included in the study. The primary endpoints of the study include the ability to perform activities of daily living (ADL) and cognitive capacities on the side of the day-care centre users and the subjectively perceived burden and well-being of the informal caregivers. The total duration of the study is 3 years, during which data are collected both by the psychometric testing of the people with cognitive impairment and by telephone interviews with informal caregivers. The project has three distinctive quality features. First, it is embedded in real care situations since the day-care services have already been established for this target group. Second, due to the large number of cases and the fact that the participating day-care centres are spread across the entire country, the results can be expected to be generalisable. Third, the interventions can be assumed to be implementable as they required only a one-day training event for the staff already working at the centres. ISRCTN16412551 (Registration date: 30 July 2014, registered retrospectively).

Event-horizon-scale structure in the supermassive black hole candidate at the Galactic Centre.

PubMed

Doeleman, Sheperd S; Weintroub, Jonathan; Rogers, Alan E E; Plambeck, Richard; Freund, Robert; Tilanus, Remo P J; Friberg, Per; Ziurys, Lucy M; Moran, James M; Corey, Brian; Young, Ken H; Smythe, Daniel L; Titus, Michael; Marrone, Daniel P; Cappallo, Roger J; Bock, Douglas C-J; Bower, Geoffrey C; Chamberlin, Richard; Davis, Gary R; Krichbaum, Thomas P; Lamb, James; Maness, Holly; Niell, Arthur E; Roy, Alan; Strittmatter, Peter; Werthimer, Daniel; Whitney, Alan R; Woody, David

2008-09-04

The cores of most galaxies are thought to harbour supermassive black holes, which power galactic nuclei by converting the gravitational energy of accreting matter into radiation. Sagittarius A* (Sgr A*), the compact source of radio, infrared and X-ray emission at the centre of the Milky Way, is the closest example of this phenomenon, with an estimated black hole mass that is 4,000,000 times that of the Sun. A long-standing astronomical goal is to resolve structures in the innermost accretion flow surrounding Sgr A*, where strong gravitational fields will distort the appearance of radiation emitted near the black hole. Radio observations at wavelengths of 3.5 mm and 7 mm have detected intrinsic structure in Sgr A*, but the spatial resolution of observations at these wavelengths is limited by interstellar scattering. Here we report observations at a wavelength of 1.3 mm that set a size of 37(+16)(-10) microarcseconds on the intrinsic diameter of Sgr A*. This is less than the expected apparent size of the event horizon of the presumed black hole, suggesting that the bulk of Sgr A* emission may not be centred on the black hole, but arises in the surrounding accretion flow.

Theory-based practice in a major medical centre.

PubMed

Alligood, Martha Raile

2011-11-01

This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

Structural basis for cellobiose dehydrogenase action during oxidative cellulose degradation

NASA Astrophysics Data System (ADS)

Tan, Tien-Chye; Kracher, Daniel; Gandini, Rosaria; Sygmund, Christoph; Kittl, Roman; Haltrich, Dietmar; Hällberg, B. Martin; Ludwig, Roland; Divne, Christina

2015-07-01

A new paradigm for cellulose depolymerization by fungi focuses on an oxidative mechanism involving cellobiose dehydrogenases (CDH) and copper-dependent lytic polysaccharide monooxygenases (LPMO); however, mechanistic studies have been hampered by the lack of structural information regarding CDH. CDH contains a haem-binding cytochrome (CYT) connected via a flexible linker to a flavin-dependent dehydrogenase (DH). Electrons are generated from cellobiose oxidation catalysed by DH and shuttled via CYT to LPMO. Here we present structural analyses that provide a comprehensive picture of CDH conformers, which govern the electron transfer between redox centres. Using structure-based site-directed mutagenesis, rapid kinetics analysis and molecular docking, we demonstrate that flavin-to-haem interdomain electron transfer (IET) is enabled by a haem propionate group and that rapid IET requires a closed CDH state in which the propionate is tightly enfolded by DH. Following haem reduction, CYT reduces LPMO to initiate oxygen activation at the copper centre and subsequent cellulose depolymerization.

A crystallographic perspective on sharing data and knowledge

NASA Astrophysics Data System (ADS)

Bruno, Ian J.; Groom, Colin R.

2014-10-01

The crystallographic community is in many ways an exemplar of the benefits and practices of sharing data. Since the inception of the technique, virtually every published crystal structure has been made available to others. This has been achieved through the establishment of several specialist data centres, including the Cambridge Crystallographic Data Centre, which produces the Cambridge Structural Database. Containing curated structures of small organic molecules, some containing a metal, the database has been produced for almost 50 years. This has required the development of complex informatics tools and an environment allowing expert human curation. As importantly, a financial model has evolved which has, to date, ensured the sustainability of the resource. However, the opportunities afforded by technological changes and changing attitudes to sharing data make it an opportune moment to review current practices.

Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study

PubMed Central

Lee, Kun Yun; Ong, Tiong Kiam; Low, Ee Vien; Liow, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng Bang; Ali, Rosli Mohd; Ismail, Omar; Ahmad, Wan Azman Wan; Said, Mas Ayu; Dahlui, Maznah

2017-01-01

Objectives Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. Design This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. Setting Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. Participants The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. Primary and secondary outcome measures The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. Results The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. Conclusions Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations. Registration Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR). PMID:28552843

Hebbian learning of hand-centred representations in a hierarchical neural network model of the primate visual system.

PubMed

Born, Jannis; Galeazzi, Juan M; Stringer, Simon M

2017-01-01

A subset of neurons in the posterior parietal and premotor areas of the primate brain respond to the locations of visual targets in a hand-centred frame of reference. Such hand-centred visual representations are thought to play an important role in visually-guided reaching to target locations in space. In this paper we show how a biologically plausible, Hebbian learning mechanism may account for the development of localized hand-centred representations in a hierarchical neural network model of the primate visual system, VisNet. The hand-centered neurons developed in the model use an invariance learning mechanism known as continuous transformation (CT) learning. In contrast to previous theoretical proposals for the development of hand-centered visual representations, CT learning does not need a memory trace of recent neuronal activity to be incorporated in the synaptic learning rule. Instead, CT learning relies solely on a Hebbian learning rule, which is able to exploit the spatial overlap that naturally occurs between successive images of a hand-object configuration as it is shifted across different retinal locations due to saccades. Our simulations show how individual neurons in the network model can learn to respond selectively to target objects in particular locations with respect to the hand, irrespective of where the hand-object configuration occurs on the retina. The response properties of these hand-centred neurons further generalise to localised receptive fields in the hand-centred space when tested on novel hand-object configurations that have not been explored during training. Indeed, even when the network is trained with target objects presented across a near continuum of locations around the hand during training, the model continues to develop hand-centred neurons with localised receptive fields in hand-centred space. With the help of principal component analysis, we provide the first theoretical framework that explains the behavior of Hebbian learning in VisNet.

Hebbian learning of hand-centred representations in a hierarchical neural network model of the primate visual system

PubMed Central

Born, Jannis; Stringer, Simon M.

2017-01-01

A subset of neurons in the posterior parietal and premotor areas of the primate brain respond to the locations of visual targets in a hand-centred frame of reference. Such hand-centred visual representations are thought to play an important role in visually-guided reaching to target locations in space. In this paper we show how a biologically plausible, Hebbian learning mechanism may account for the development of localized hand-centred representations in a hierarchical neural network model of the primate visual system, VisNet. The hand-centered neurons developed in the model use an invariance learning mechanism known as continuous transformation (CT) learning. In contrast to previous theoretical proposals for the development of hand-centered visual representations, CT learning does not need a memory trace of recent neuronal activity to be incorporated in the synaptic learning rule. Instead, CT learning relies solely on a Hebbian learning rule, which is able to exploit the spatial overlap that naturally occurs between successive images of a hand-object configuration as it is shifted across different retinal locations due to saccades. Our simulations show how individual neurons in the network model can learn to respond selectively to target objects in particular locations with respect to the hand, irrespective of where the hand-object configuration occurs on the retina. The response properties of these hand-centred neurons further generalise to localised receptive fields in the hand-centred space when tested on novel hand-object configurations that have not been explored during training. Indeed, even when the network is trained with target objects presented across a near continuum of locations around the hand during training, the model continues to develop hand-centred neurons with localised receptive fields in hand-centred space. With the help of principal component analysis, we provide the first theoretical framework that explains the behavior of Hebbian learning in VisNet. PMID:28562618

Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey

PubMed Central

Koehler, Andreas; Dekker, Arne; Sehner, Susanne; Nieder, Timo O.

2017-01-01

This study investigates the needs and concerns transgender (short: trans) individuals have concerning trans healthcare (THC) in interdisciplinary THC centres. Trans individuals’ gender does not (fully/constantly) match their sex assigned at birth. To be able to live in their gender role and to prevent or minimise gender dysphoria, they might require a multidisciplinary set of transition related healthcare services. The current shift from the traditionally highly regulated, hierarchical and pathologising approach to THC towards a more patient-centred approach has highlighted the importance of trans patients’ satisfaction with treatment processes and results. As the still influential regulations have a negative effect on patient satisfaction, and might also keep trans individuals from seeking transition related treatment, it is crucial to investigate what trans individuals, whether patients or not, need and fear regarding transition related healthcare. Against the backdrop of mixed reactions received from the local trans community regarding the foundation of the Interdisciplinary Transgender Healthcare Centre Hamburg (ITHCCH), Germany, this study seeks to determine what trans individuals need with respect to THC in order to guarantee for high quality service provision at the ITHCCH. To this end, an online questionnaire was developed. The researchers employed a participatory approach to questionnaire development by involving a working group consisting of local trans support group representatives and (THC) specialists (N = 4). The sample consisted of N = 415 trans-identified individuals aged between 16 and 76. Most of them were based in Germany. 85.2% (n = 382) reported experience with transition related healthcare and 72.5% (n = 301) had (additional) treatments planned. Analysis revealed a need for communication and feedback opportunities. Furthermore, during the treatment process, addressing individual needs was considered crucial by participants. They agreed moderately with concerns towards THC centres. 96.5% of participants would like high decision-making power concerning treatment-associated decisions. The results demonstrate the importance of patient-centred THC that takes patients' individual needs and realities into consideration and involves patients in decision-making processes. PMID:28846715

Barriers and facilitators to the implementation of person-centred care in different healthcare contexts.

PubMed

Moore, Lucy; Britten, Nicky; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Wolf, Axel

2017-12-01

To empower patients and improve the quality of care, policy-makers increasingly adopt systems to enhance person-centred care. Although models of person-centredness and patient-centredness vary, respecting the needs and preferences of individuals receiving care is paramount. In Sweden, as in other countries, healthcare providers seek to improve person-centred principles and address gaps in practice. Consequently, researchers at the University of Gothenburg Centre for Person-Centred Care are currently delivering person-centred interventions employing a framework that incorporates three routines. These include eliciting the patient's narrative, agreeing a partnership with shared goals between patient and professional, and safeguarding this through documentation. To explore the barriers and facilitators to the delivery of person-centred care interventions, in different contexts. Qualitative interviews were conducted with a purposeful sample of 18 researchers from seven research studies across contrasting healthcare settings. Interviews were transcribed, translated and thematically analysed, adopting some basic features of grounded theory. The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Swedish Research Council. Barriers to the implementation of person-centred care covered three themes: traditional practices and structures; sceptical, stereotypical attitudes from professionals; and factors related to the development of person-centred interventions. Facilitators included organisational factors, leadership and training and an enabling attitude and approach by professionals. Trained project managers, patients taking an active role in research and adaptive strategies by researchers all helped person-centred care delivery. At the University of Gothenburg, a model of person-centred care is being initiated and integrated into practice through research. Knowledgeable, well-trained professionals facilitate the routines of narrative elicitation and partnership. Strong leadership and adaptive strategies are important for overcoming existing practices, routines and methods of documentation. This study provides guidance for practitioners when delivering and adapting person-centred care in different contexts. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Issues in conducting cross-cultural research: implementation of an agreed international protocol [corrected] designed by the WHOQOL Group for the conduct of focus groups eliciting the quality of life of older adults.

PubMed

Hawthorne, Graeme; Davidson, Natasha; Quinn, Kathryn; McCrate, Farah; Winkler, Ines; Lucas, Ramona; Kilian, Reinhold; Molzahn, Anita

2006-09-01

Multi-centre and cross-cultural research require the use of common protocols if the results are to be either pooled or compared. All too often adherence to protocols is not discussed in reports and where it is reported poor adherence is frequently noted. This paper discusses the use of international guidelines developed by WHOQOL Field Centres to conduct and report focus groups aimed at eliciting key concepts of quality of life among older adults. This was the first step in the development of the WHOQOL-OLD instrument. Although there was overall adherence to the agreed guidelines, there were some differences in the level of reporting, even after participating Field Centres had the opportunity to explain their reports. The reasons for these discrepancies are reported. It is concluded that because of local situations, it is difficult to achieve identical implementation of multi-centre cross-cultural protocols and that the highest standards of auditing are required if findings are to be compared. Suggestions for how such protocols can be improved are given.

Nosocomial infection in a Nigerian rural maternity centre: a series of nine cases.

PubMed

Okezie, O A; Onyemelukwe, N F

2007-02-01

An outbreak of urinary tract infection in a rural maternity hospital near Enugu, Nigeria led to bacteriological assessment which identified Serratia marcescens as the causative organism. An epidemiological investigation was done to trace the source of this organism. To investigate an outbreak of urinary tract infection in a rural maternity centre. A descriptive study. Maternity centre in a rural community near Enugu run by local midwives assisted by auxiliary nurses trained by the midwives. Nine patients at term with symptoms of urinary tract infection. In all nine cases, the pigmented form of Serratia marcescens was found to be the cause of the urinary tract infection and the source of this organism was traced to the auxillary nurse who shaved the patients and the instrument she used. Since the causative organism of the outbreak of urinary infection in these women was traced to the shaving instruments used and the fingers of the auxillary nurse who shaved them, there is the need for better hygiene practices in the health centre and the use of properly trained staff to attend to pregnant and parturient women. It is recommended that the practice of shaving parturient women should be discarded.

Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

PubMed Central

Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza

2015-01-01

Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support. PMID:26576154

Education of staff--a key factor for a safe environment in day care.

PubMed

Sellström, E; Bremberg, S

2000-05-01

In order to create a safe environment in day-care settings, an understanding of factors within the organization of day care, factors which influence safety, is essential. Day-care directors in 83 daycare centres completed a mail-in survey that contained questions about professional experience, the day-care centre's organization of child safety measures and a battery of questions designed to evaluate the directors' perceptions and beliefs about child safety. The day-care directors also carried out a safety inspection at their centre. The results were analysed using the multivariate logistic regression technique. The existence of a continuing plan for continued staff education in child safety was shown to be the strongest predictor of few safety hazards in day-care centres. The day-care directors' perceptions and beliefs about injury prevention were of less importance. This study indicates that in order to promote safety in day-care settings, an on-going plan for continued staff education in child safety should be a matter of routine. The introduction of such a plan should be the concern of the individual day-care directors, policy-makers and managers at the local and national level, and health professionals working in this field.

An almost head-on collision as the origin of two off-centre rings in the Andromeda galaxy.

PubMed

Block, D L; Bournaud, F; Combes, F; Groess, R; Barmby, P; Ashby, M L N; Fazio, G G; Pahre, M A; Willner, S P

2006-10-19

The unusual morphology of the Andromeda galaxy (Messier 31, the closest spiral galaxy to the Milky Way) has long been an enigma. Although regarded for decades as showing little evidence of a violent history, M31 has a well-known outer ring of star formation at a radius of ten kiloparsecs whose centre is offset from the galaxy nucleus. In addition, the outer galaxy disk is warped, as seen at both optical and radio wavelengths. The halo contains numerous loops and ripples. Here we report the presence of a second, inner dust ring with projected dimensions of 1.5 x 1 kiloparsecs and offset by about half a kiloparsec from the centre of the galaxy (based upon an analysis of previously-obtained data). The two rings appear to be density waves propagating in the disk. Numerical simulations indicate that both rings result from a companion galaxy plunging through the centre of the disk of M31. The most likely interloper is M32. Head-on collisions between galaxies are rare, but it appears nonetheless that one took place 210 million years ago in our Local Group of galaxies.

Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada.

PubMed

Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza

2015-01-01

Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

Surviving "Payment by Results": a simple method of improving clinical coding in burn specialised services in the United Kingdom.

PubMed

Wallis, Katy L; Malic, Claudia C; Littlewood, Sonia L; Judkins, Keith; Phipps, Alan R

2009-03-01

Coding inpatient episodes plays an important role in determining the financial remuneration of a clinical service. Insufficient or incomplete data may have very significant consequences on its viability. We created a document that improves the coding process in our Burns Centre. At Yorkshire Regional Burns Centre an inpatient summary sheet was designed to prospectively record and present essential information on a daily basis, for use in the coding process. The level of care was also recorded. A 3-month audit was conducted to assess the efficacy of the new forms. Forty-nine patients were admitted to the Burns Centre with a mean age of 27.6 years and TBSA ranging from 0.5% to 65%. The total stay in the Burns Centre was 758 days, of which 22% were at level B3-B5 and 39% at level B2. The use of the new discharge document identified potential income of about 500,000 GB pound sterling at our local daily tariffs for high dependency and intensive care. The new form is able to ensure a high quality of coding with a possible direct impact on the financial resources accrued for burn care.

Responding Electronically to Student Drafts on Campus: Dis/Encouraging Dialogue?

ERIC Educational Resources Information Center

Harran, M.; Knott, A.; Weir, C.

2011-01-01

This article reports on an investigation into whether writing centre (WC) respondents at an institution of Higher Education (HE) encourage or discourage draft dialogue (a conversation in writing) with students submitting drafts electronically to the WC for feedback. The writing respondents insert local feedback responses or comments directly onto…

Social Value and Adult Learning

ERIC Educational Resources Information Center

Lamb, Penny

2011-01-01

An examination of the current government policy discourse on social value and the capturing of social impact leads immediately into the centre of the fast-moving and transforming public-sector reform agenda. The thinking around social value takes an individual to the heart of contracting, localism, the relationship between the public sector and…

Lectures on School Building, Furniture and Equipment.

ERIC Educational Resources Information Center

Geursen, Thijs J.; Kamp, Kees

1978-01-01

The Information Centre for School Building (ICS) in the Netherlands works on commissions of the central authorities, but also for local authorities, school boards, and sometimes commercial firms. This publication contains papers by Thijs J. Geursen, the managing director of the ICS and by Kees Kamp, the deputy director. In "School Building…

Multiliteracies and Family Language Policy in an Urban Inuit Community

ERIC Educational Resources Information Center

Patrick, Donna; Budach, Gabriele; Muckpaloo, Igah

2013-01-01

This study investigates the intersection of family language policy with Indigenous multiliteracies and urban Indigeneity. It documents a grassroots Inuit literacy initiative in Ottawa, Canada and considers literacy practices among Inuit at a local Inuit educational centre, where maintaining connections between urban Inuit and their homeland…

Specialized Centres and the Local Home Community: Children with Disabilities Need Them Both.

ERIC Educational Resources Information Center

Serpell, Robert

1986-01-01

Community based rehabilitation for disabled persons in developing nations is contrasted with institutionally based rehabilitation. A strategy is proposed which combines the two approaches and includes greater economic realism, design of advanced training programs, provision of reliable transportation, and more outreach and follow-up activities by…

[The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

PubMed

Povazhnaia, E A; Bobrovnitskiĭ, I P

2013-01-01

The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

Using drama to improve person-centred dementia care.

PubMed

Kontos, Pia C; Mitchell, Gail J; Mistry, Bhavnita; Ballon, Bruce

2010-06-01

We implemented a 12-week drama-based educational intervention to introduce to dementia practitioners person-centred care that emphasizes the notion of embodied selfhood (defined as non-verbal self-expression). Person-centred dementia care guidelines emphasize the assessment of individual needs, and where appropriate, the use of non-pharmacological interventions before resorting to pharmacological management. However, dementia care is not consistent with these guidelines suggesting conceptual limitations and reliance on passive knowledge translation strategies. Focus groups and semi-structured interviews with practitioners (n = 24) in two nursing homes in central Canada were undertaken to assess the effectiveness of the drama-based components of the intervention. Our findings suggest that drama was effective as an educational modality, and helped implement the person-centred approach into practice. Significant practice outcomes included: new awareness that residents' body movements and dispositions can convey meaning; seeking biographical information from families; increased time efficiency; and supporting residents' independence. Our findings make an important contribution to person-centred dementia care by broadening the notion of personhood, and by facilitating implementation using drama. As an enhancement of person-centred care, the support of embodied selfhood may significantly improve residents' quality of life, quality of care, and practitioners' care-giving experience. © 2010 Blackwell Publishing Ltd.

Multidisciplinary breast centres in Germany: a review and update of quality assurance through benchmarking and certification.

PubMed

Wallwiener, Markus; Brucker, Sara Y; Wallwiener, Diethelm

2012-06-01

This review summarizes the rationale for the creation of breast centres and discusses the studies conducted in Germany to obtain proof of principle for a voluntary, external benchmarking programme and proof of concept for third-party dual certification of breast centres and their mandatory quality management systems to the German Cancer Society (DKG) and German Society of Senology (DGS) Requirements of Breast Centres and ISO 9001 or similar. In addition, we report the most recent data on benchmarking and certification of breast centres in Germany. Review and summary of pertinent publications. Literature searches to identify additional relevant studies. Updates from the DKG/DGS programmes. Improvements in surrogate parameters as represented by structural and process quality indicators suggest that outcome quality is improving. The voluntary benchmarking programme has gained wide acceptance among DKG/DGS-certified breast centres. This is evidenced by early results from one of the largest studies in multidisciplinary cancer services research, initiated by the DKG and DGS to implement certified breast centres. The goal of establishing a nationwide network of certified breast centres in Germany can be considered largely achieved. Nonetheless the network still needs to be improved, and there is potential for optimization along the chain of care from mammography screening, interventional diagnosis and treatment through to follow-up. Specialization, guideline-concordant procedures as well as certification and recertification of breast centres remain essential to achieve further improvements in quality of breast cancer care and to stabilize and enhance the nationwide provision of high-quality breast cancer care.

Assessment of primary health care in a rural health centre in Enugu South east Nigeria.

PubMed

M Chinawa, Josephat; T Chinawa, Awoere

2015-01-01

Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31(st) 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV(0) and HBV(1) in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system.

Has decentralisation affected child immunisation status in Indonesia?

PubMed

Maharani, Asri; Tampubolon, Gindo

2014-01-01

The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens' health. However, the consequences of this reform remain largely unknown. This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments.

Has decentralisation affected child immunisation status in Indonesia?

PubMed Central

Maharani, Asri; Tampubolon, Gindo

2014-01-01

Background The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens’ health. However, the consequences of this reform remain largely unknown. Objective This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. Design We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. Results The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. Conclusion These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments. PMID:25160515

Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy.

PubMed

Giorgetti, Chiara; Ferrito, Lucia; Zallocco, Federica; Iannilli, Antonio; Cherubini, Valentino

2015-10-08

The incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy. During 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres. A total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them. Great differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.

Rehabilitation for patients with rheumatic diseases: Patient experiences of a structured goal planning and tailored follow-up programme

PubMed Central

Dager, Turid Nygaard; Kjeken, Ingvild; Berdal, Gunnhild; Sand-Svartrud, Anne-Lene; Bø, Ingvild; Dingsør, Anne; Eppeland, Siv Grødal; Hagfors, Jon; Hamnes, Bente; Nielsen, Merete; Slungaard, Bente; Wigers, Sigrid Hørven; Hauge, Mona-Iren

2017-01-01

Objective: To explore the significance of the content of rehabilitation in terms of achieving a personal outcome, and to understand the significance of tailored follow-up interventions for individual efforts to prolong health behaviour change after rehabilitation. Design: Semi-structured interviews with patients who had received an extended rehabilitation programme. All interviews were transcribed verbatim. A thematic analysis was applied. Subjects: A purposeful sample of 18 patients with rheumatic diseases who had attended specialized multidisciplinary rehabilitation with an extended programme consisting of a self-help booklet, structured goal-setting talks and tailored follow-up calls based on motivational interviewing. Results: Four overarching and interrelated themes were identified. Experienced Person-centred interventions represented a basis for the patients’ motivation and personal outcomes. Confident self-management describes a new confident approach to exercise and illness management after rehabilitation with person-centred interventions. For many, this included reaching a different mindset, a change of illness perception. Continuity of the personal outcomes describes the importance of follow-up telephone calls to maintain the focus on goals and continued efforts. Building on established relationships and practising person-centred communication were essential. Conclusion: Tailoring of communication and rehabilitation interventions may be a premise for enhancing health behaviour, including a beneficial illness perception. Structured goal setting and follow-up telephone calls using motivational interviewing enhance motivation and may contribute to prolonged goal attainment. PMID:29163943

[Providing regular relief; considerations for palliative care in the Netherlands].

PubMed

Crul, B J; van Weel, C

2001-10-20

Over the last few decades the attention devoted to the palliative aspects of medicine, particularly those in hospital care, has declined due to the emphasis on medical technology. In Anglo-Saxon countries a review of this development resulted in structured palliative care that benefited terminally ill patients with a progressive fatal disease, especially cancer patients. Due to increasing national and international criticism of both the practice of euthanasia (assumed to be too liberal) and the lack of attention devoted to structured palliative care in the Netherlands, the Dutch government decided to improve the structure of palliative care. The government's viewpoint is based on the assumption that good palliative care that includes adequate pain control benefits patient care and might eventually lead to fewer requests for euthanasia. The improvements to palliative care should be realised by means of improvements in the structure, training and knowledge. Six academic medical clusters have been designated as Centres for the Development of Palliative Care (Dutch acronym: COPZ) for a 5-year period. Each COPZ must develop the various aspects needed to improve palliative care within the region it serves and ensure that its activities are carefully coordinated with those in the other centres. Research will focus on measuring the efficacy of palliative care as well as ethical and epidemiological aspects. A government committee will assess the appropriateness of the activities undertaken by each of the centres.

An intersecting chord method for minimum circumscribed sphere and maximum inscribed sphere evaluations of sphericity error

NASA Astrophysics Data System (ADS)

Liu, Fei; Xu, Guanghua; Zhang, Qing; Liang, Lin; Liu, Dan

2015-11-01

As one of the Geometrical Product Specifications that are widely applied in industrial manufacturing and measurement, sphericity error can synthetically scale a 3D structure and reflects the machining quality of a spherical workpiece. Following increasing demands in the high motion performance of spherical parts, sphericity error is becoming an indispensable component in the evaluation of form error. However, the evaluation of sphericity error is still considered to be a complex mathematical issue, and the related research studies on the development of available models are lacking. In this paper, an intersecting chord method is first proposed to solve the minimum circumscribed sphere and maximum inscribed sphere evaluations of sphericity error. This new modelling method leverages chord relationships to replace the characteristic points, thereby significantly reducing the computational complexity and improving the computational efficiency. Using the intersecting chords to generate a virtual centre, the reference sphere in two concentric spheres is simplified as a space intersecting structure. The position of the virtual centre on the space intersecting structure is determined by characteristic chords, which may reduce the deviation between the virtual centre and the centre of the reference sphere. In addition,two experiments are used to verify the effectiveness of the proposed method with real datasets from the Cartesian coordinates. The results indicate that the estimated errors are in perfect agreement with those of the published methods. Meanwhile, the computational efficiency is improved. For the evaluation of the sphericity error, the use of high performance computing is a remarkable change.

Electric fields induced in the human body by time-varying magnetic field gradients in MRI: numerical calculations and correlation analysis.

PubMed

Bencsik, Martin; Bowtell, Richard; Bowley, Roger

2007-05-07

The spatial distributions of the electric fields induced in the human body by switched magnetic field gradients in MRI have been calculated numerically using the commercial software package, MAFIA, and the three-dimensional, HUGO body model that comprises 31 different tissue types. The variation of |J|, |E| and |B| resulting from exposure of the body model to magnetic fields generated by typical whole-body x-, y- and z-gradient coils has been analysed for three different body positions (head-, heart- and hips-centred). The magnetic field varied at 1 kHz, so as to produce a rate of change of gradient of 100 T m(-1) s(-1) at the centre of each coil. A highly heterogeneous pattern of induced electric field and current density was found to result from the smoothly varying magnetic field in all cases, with the largest induced electric fields resulting from application of the y-gradient, in agreement with previous studies. By applying simple statistical analysis to electromagnetic quantities within axial planes of the body model, it is shown that the induced electric field is strongly correlated to the local value of resistivity, and the induced current density exhibits even stronger correlation with the local conductivity. The local values of the switched magnetic field are however shown to bear little relation to the local values of the induced electric field or current density.

People-centred health systems, a bottom-up approach: where theory meets empery.

PubMed

Sturmberg, Joachim P; Njoroge, Alice

2017-04-01

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program approaches in the poor neighbourhoods of Nairobi, Kenya. A small group of nurses and community health workers focused on the care of terminally ill HIV/AIDS patients. This work identified additional problems: tuberculosis (TB) was underdiagnosed and undertreated, a local TB-technician was trained to run a local lab, a courier services helped to reach all at need, collaboration with the Ministry of Health established local TB and HIV treatment programmes and philanthropists helped to supplement treatment with nutrition support. Maternal-to-child HIV-prevention and adolescent counselling services addressed additional needs. The 'theory of the healthcare vortex' indeed matches the 'empery of the real world experiences'. Locally developed and delivered adaptive, people-centred health systems, a bottom-up community and provider initiated approach, deliver highly effective and sustainable health care despite significant resource constraints. © 2016 John Wiley & Sons, Ltd.

Oxidative damage of 18S and 5S ribosomal RNA in digestive gland of mussels exposed to trace metals.

PubMed

Kournoutou, Georgia G; Giannopoulou, Panagiota C; Sazakli, Eleni; Leotsinidis, Michel; Kalpaxis, Dimitrios L

2017-11-01

Numerous studies have shown the ability of trace metals to accumulate in marine organisms and cause oxidative stress that leads to perturbations in many important intracellular processes, including protein synthesis. This study is mainly focused on the exploration of structural changes, like base modifications, scissions, and conformational changes, caused in 18S and 5S ribosomal RNA (rRNA) isolated from the mussel Mytilus galloprovincialis exposed to 40μg/L Cu, 30μg/L Hg, or 100μg/L Cd, for 5 or 15days. 18S rRNA and 5S rRNA are components of the small and large ribosomal subunit, respectively, found in complex with ribosomal proteins, translation factors and other auxiliary components (metal ions, toxins etc). 18S rRNA plays crucial roles in all stages of protein synthesis, while 5S rRNA serves as a master signal transducer between several functional regions of 28S rRNA. Therefore, structural changes in these ribosomal constituents could affect the basic functions of ribosomes and hence the normal metabolism of cells. Especially, 18S rRNA along with ribosomal proteins forms the decoding centre that ensures the correct codon-anticodon pairing. As exemplified by ELISA, primer extension analysis and DMS footprinting analysis, each metal caused oxidative damage to rRNA, depending on the nature of metal ion and the duration of exposure. Interestingly, exposure of mussels to Cu or Hg caused structural alterations in 5S rRNA, localized in paired regions and within loops A, B, C, and E, leading to a continuous progressive loss of the 5S RNA structural integrity. In contrast, structural impairments of 5S rRNA in mussels exposed to Cd were accumulating for the initial 5days, and then progressively decreased to almost the normal level by day 15, probably due to the parallel elevation of metallothionein content that depletes the pools of free Cd. Regions of interest in 18S rRNA, such as the decoding centre, sites implicated in the binding of tRNAs (A- and P-sites) or translation factors, and areas related to translation fidelity, were found to undergo significant metal-induced conformational alterations, leading either to loosening of their structure or to more compact folding. These modifications were associated with parallel alterations in the translation process at multiple levels, a fact suggesting that structural perturbations in ribosomes, caused by metals, pose significant hurdles in translational efficiency and fidelity. Copyright © 2017 Elsevier B.V. All rights reserved.

Three-dimensional Structures of Carotenoids by X-ray Crystallography

NASA Astrophysics Data System (ADS)

Helliwell, Madeleine

The number of crystal structures of carotenoid molecules and carotenoid derivatives deposited in the Cambridge Crystallographic Data Centre [1] is still relatively small, but has increased compared with the previous survey [2]. The list is summarized in Table 1.

Gravity drives the evolution of infrared dark hubs: JVLA observations of SDC13

NASA Astrophysics Data System (ADS)

Williams, G. M.; Peretto, N.; Avison, A.; Duarte-Cabral, A.; Fuller, G. A.

2018-05-01

Context. Converging networks of interstellar filaments, that is hubs, have been recently linked to the formation of stellar clusters and massive stars. Understanding the relationship between the evolution of these systems and the formation of cores and stars inside them is at the heart of current star formation research. Aims: The goal is to study the kinematic and density structure of the SDC13 prototypical hub at high angular resolution to determine what drives its evolution and fragmentation. Methods: We have mapped SDC13, a 1000 M⊙ infrared dark hub, in NH3(1,1) and NH3(2,2) emission lines, with both the Jansky Very Large Array and Green Bank Telescope. The high angular resolution achieved in the combined dataset allowed us to probe scales down to 0.07 pc. After fitting the ammonia lines, we computed the integrated intensities, centroid velocities and line widths, along with gas temperatures and H2 column densities. Results: The mass-per-unit-lengths of all four hub filaments are thermally super-critical, consistent with the presence of tens of gravitationally bound cores identified along them. These cores exhibit a regular separation of 0.37 ± 0.16 pc suggesting gravitational instabilities running along these super-critical filaments are responsible for their fragmentation. The observed local increase of the dense gas velocity dispersion towards starless cores is believed to be a consequence of such fragmentation process. Using energy conservation arguments, we estimate that the gravitational to kinetic energy conversion efficiency in the SDC13 cores is 35%. We see velocity gradient peaks towards 63% of cores as expected during the early stages of filament fragmentation. Another clear observational signature is the presence of the most massive cores at the filaments' junction, where the velocity dispersion is largest. We interpret this as the result of the hub morphology generating the largest acceleration gradients near the hub centre. Conclusions: We propose a scenario for the evolution of the SDC13 hub in which filaments first form as post-shock structures in a supersonic turbulent flow. As a result of the turbulent energy dissipation in the shock, the dense gas within the filaments is initially mostly sub-sonic. Then gravity takes over and starts shaping the evolution of the hub, both fragmenting filaments and pulling the gas towards the centre of the gravitational well. By doing so, gravitational energy is converted into kinetic energy in both local (cores) and global (hub centre) potential well minima. Furthermore, the generation of larger gravitational acceleration gradients at the filament junctions promotes the formation of more massive cores. The FITS files of the JVLA and GBT combined NH3(1,1) and NH3(2,2) data cubes are also available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/613/A11

The dispositions of things: the non-human dimension of power and ethics in patient-centred medicine.

PubMed

Gardner, John; Cribb, Alan

2016-09-01

This article explores power relations between clinicians, patients and families as clinicians engage in patient-centred ethical work. Specifically, we draw on actor-network theory to interrogate the role of non-human elements in distributing power relations in clinical settings, as clinicians attempt to manage the expectations of patients and families. Using the activities of a multidisciplinary team providing deep brain stimulation to children with severe movement disorders as an example, we illustrate how a patient-centred tool is implicated in establishing relations that constitute four modes of power: 'power over', 'power to', "power storage" and "power/discretion". We argue that understanding the role of non-human elements in structuring power relations can guide and inform bioethical discussions on the suitability of patient-centred approaches in clinical settings. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

BUILDING A PLATFORM FOR TRANSLATIONAL RESEARCH IN CHRONIC NON-COMMUNICABLE DISEASES TO ADDRESS POPULATION HEALTH IN PERU

PubMed Central

Miranda, J. Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cardenas, María K.; Carrillo-Larco, Rodrigo M.; Pesantes, M. Amalia; Araya, Ricardo; Boggio, Oscar; Checkley, William; García, Patricia J.; León-Velarde, Fabiola; Lescano, Andrés G.; Montori, Victor; Pan, William; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; García, Héctor H.; Gilman, Robert H.

2014-01-01

The CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia, was created in 2009 with support from the United States National Heart, Lung, and Blood Institute (NHLBI). The vision of CRONICAS is to build a globally recognised Centre of Excellence conducting quality and innovative research and generating high-impact evidence for health. The Centre’s identity is embedded in its core values: generosity, innovation, integrity, and quality. This review has been structured to describe the development of the CRONICAS Centre, with a focus on highlighting the ongoing translational research projects and capacity building strategies. The CRONICAS Centre of Excellence is not a risk-averse organisation: it benefits from past experiences, including past mistakes, and improves upon them, and thus challenges traditional research approaches. This ethos and environment is key to fostering innovation in research. PMID:25754562

[Determinants of strategic management of a health center].

PubMed

Huard, Pierre; Schaller, Philippe

2014-01-01

The article highlights the value of a strategic approach for the development of a primary care health centre. The method is adapted from corporate strategy: (i) analysis of the situation of the health centre and the obstacles to its development. (ii) selection of relations on which the strategy can be developed. (iii) elaboration of a system of interventions to create a cumulative development process. (iv) Illustration of the method by application to a case. The example illustrates the principles and method and highlights the importance of interpretations and choices in elaboration of a strategy, which is therefore always a unique construction. The strategic approach provides a framework that (i) provides a subject of discussion and negotiation between members of the health centre, (ii) strengthens the consistency of structural decisions, (iii) helps the health centre to overcome obstacles and initiate a development process.

[Sources of finance for provincial occupational health services. Theory and practice].

PubMed

Rydlewska-Liszkowska, I; Jugo, B

1999-01-01

The financing of occupational health services (OHS) at the provincial level is an important issue in view of the transformation process going on not only in OHS but also in the overall health care system in Poland. New principles of financing must be now based on the cost and effects analyses. Thus, the question arises on how to provide financial means adequate to needs of health care institutions resulting from their tasks and responsibilities. The gaps existing in the information system have encouraged us to examine the situation in regard to the structure of financing and internal allocation of financial means. The objectives were formulated as follows: to characterise the sources of financial means received by provincial OHS centres; to analyse the structure of financial means derived from various sources, taking into account forms of financial administration, using the data provided by selected centres; to define the relation between the financial means being at the disposal of OHS centres and the scope of their activities; The information on the financing system was collected using a questionnaire mailed to directors of selected OHS centres. The information collected proved to be a valuable source of knowledge on the above mentioned issues as well as on how far the new system of financing associated with a new form of financial administration--an independent public health institution--has already been implemented. The studies indicated that at the present stage of the OHS system transformation it is very difficult to formulate conclusions on the financing administration in provincial OHS centres.

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

Multilayer densities using a wavelet-based gravity method and their tectonic implications beneath the Tibetan Plateau

NASA Astrophysics Data System (ADS)

Xu, Chuang; Luo, Zhicai; Sun, Rong; Zhou, Hao; Wu, Yihao

2018-06-01

Determining density structure of the Tibetan Plateau is helpful in better understanding of tectonic structure and development. Seismic method, as traditional approach obtaining a large number of achievements of density structure in the Tibetan Plateau except in the centre and west, is primarily inhibited by the poor seismic station coverage. As the implementation of satellite gravity missions, gravity method is more competitive because of global homogeneous gravity coverage. In this paper, a novel wavelet-based gravity method with high computation efficiency and excellent local identification capability is developed to determine multilayer densities beneath the Tibetan Plateau. The inverted six-layer densities from 0 to 150 km depth can reveal rich tectonic structure and development of study area: (1) The densities present a clockwise pattern, nearly east-west high-low alternating pattern in the west and nearly south-north high-low alternating pattern in the east, which is almost perpendicular to surface movement direction relative to the stable Eurasia from the Global Positioning System velocity field; (2) Apparent fold structure approximately from 10 to 110 km depth can be inferred from the multilayer densities, the deformational direction of which is nearly south-north in the west and east-west in the east; (3) Possible channel flows approximately from 30 to 110 km depth can also be observed clearly during the multilayer densities. Moreover, the inverted multilayer densities are in agreement with previous studies, which verify the correctness and effectiveness of our method.

Green roof soil system affected by soil structural changes: A project initiation

NASA Astrophysics Data System (ADS)

Jelínková, Vladimíra; Dohnal, Michal; Šácha, Jan; Šebestová, Jana; Sněhota, Michal

2014-05-01

Anthropogenic soil systems and structures such as green roofs, permeable or grassed pavements comprise appreciable part of the urban watersheds and are considered to be beneficial regarding to numerous aspects (e.g. carbon dioxide cycle, microclimate, reducing solar absorbance and storm water). Expected performance of these systems is significantly affected by water and heat regimes that are primarily defined by technology and materials used for system construction, local climate condition, amount of precipitation, the orientation and type of the vegetation cover. The benefits and potencies of anthropogenic soil systems could be considerably threatened in case when exposed to structural changes of thin top soil layer in time. Extensive green roof together with experimental green roof segment was established and advanced automated monitoring system of micrometeorological variables was set-up at the experimental site of University Centre for Energy Efficient Buildings as an interdisciplinary research facility of the Czech Technical University in Prague. The key objectives of the project are (i) to characterize hydraulic and thermal properties of soil substrate studied, (ii) to establish seasonal dynamics of water and heat in selected soil systems from continuous monitoring of relevant variables, (iii) to detect structural changes with the use of X-ray Computed Tomography, (iv) to identify with the help of numerical modeling and acquired datasets how water and heat dynamics in anthropogenic soil systems are affected by soil structural changes. Achievements of the objectives will advance understanding of the anthropogenic soil systems behavior in conurbations with the temperate climate.

Co-ordination of the International Network of Nuclear Structure and Decay Data Evaluators; Summary Report of an IAEA Technical Meeting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abriola, D.; Tuli, J.

The IAEA Nuclear Data Section convened the 18th meeting of the International Network of Nuclear Structure and Decay Data Evaluators at the IAEA Headquarters, Vienna, 23 to 27 March 2009. This meeting was attended by 22 scientists from 14 Member States, plus IAEA staff, concerned with the compilation, evaluation and dissemination of nuclear structure and decay data. A summary of the meeting, recommendations/conclusions, data centre reports, and various proposals considered, modified and agreed by the participants are contained within this document. The International Network of Nuclear Structure and Decay Data (NSDD) Evaluators holds biennial meetings under the auspices of themore » IAEA, and consists of evaluation groups and data service centres in several countries. This network has the objective of providing up-to-date nuclear structure and decay data for all known nuclides by evaluating all existing experimental data. Data resulting from this international evaluation collaboration is included in the Evaluated Nuclear Structure Data File (ENSDF) and published in the journals Nuclear Physics A and Nuclear Data Sheets (NDS).« less

Chlamydia trachomatis infection in males in a juvenile detention facility in Switzerland.

PubMed

Haller, Dagmar M; Steiner, Anne-Sylvie S; Sebo, Paul; Gaspoz, Jean-Michel; Wolff, Hans

2011-07-18

Young offenders represent a group for which Chlamydia trachomatis infection screening is recommended in the US. In the absence of local epidemiological data it is difficult to assess whether such recommendations apply to the Swiss context. Our aim was to obtain local prevalence data for Chlamydia trachomatis infection among young male offenders as a basis for screening strategies in Swiss juvenile detention centres. This cross-sectional study was conducted in a juvenile detention facility in Geneva, Switzerland. Adolescent males aged 15-18 years admitted to the detention facility were invited to participate during a consultation with a nurse conducted within 48 hours of admission. Participants were asked to provide a first void urine sample for PCR detection of Chlamydia trachomatis infection and to complete a questionnaire on reproductive health behaviours. 72 males were considered for participation in the study. 13 were excluded (mainly due to the language barrier or a shorter than 3 days' stay in the facility) and 9 (15%) declined participation. Not being sexually active was the most common reason for declining participation. Most participants originated from Switzerland or the European Union and 68% reported having ≥2 sexual partners in the past year. Only one participant (18 years, asymptomatic) had Chlamydia trachomatis infection (2%; 95%CI: 0-6%). This study does not support screening for Chlamydia trachomatis among young offenders admitted to detention centres in Switzerland. Studies in other European detention centres should document the extent to which our findings are generalisable to the European context.

Revised seismic hazard map for the Kyrgyz Republic

NASA Astrophysics Data System (ADS)

Fleming, Kevin; Ullah, Shahid; Parolai, Stefano; Walker, Richard; Pittore, Massimiliano; Free, Matthew; Fourniadis, Yannis; Villiani, Manuela; Sousa, Luis; Ormukov, Cholponbek; Moldobekov, Bolot; Takeuchi, Ko

2017-04-01

As part of a seismic risk study sponsored by the World Bank, a revised seismic hazard map for the Kyrgyz Republic has been produced, using the OpenQuake-engine developed by the Global Earthquake Model Foundation (GEM). In this project, an earthquake catalogue spanning a period from 250 BCE to 2014 was compiled and processed through spatial and temporal declustering tools. The territory of the Kyrgyz Republic was divided into 31 area sources defined based on local seismicity, including a total area covering 200 km from the border. The results are presented in terms of Peak Ground Acceleration (PGA). In addition, macroseismic intensity estimates, making use of recent intensity prediction equations, were also provided, given that this measure is still widely used in Central Asia. In order to accommodate the associated epistemic uncertainty, three ground motion prediction equations were used in a logic tree structure. A set of representative earthquake scenarios were further identified based on historical data and the nature of the considered faults. The resulting hazard map, as expected, follows the country's seismicity, with the highest levels of hazard in the northeast, south and southwest of the country, with an elevated part around the centre. When considering PGA, the hazard is slightly greater for major urban centres than in previous works (e.g., Abdrakhmatov et al., 2003), although the macroseismic intensity estimates are less than previous studies, e.g., Ulomov (1999). For the scenario assessments, the examples that most affect the urban centres assessed are the Issyk Ata fault (in particular for Bishkek), the Chilik and Kemin faults (in particular Balykchy and Karakol), the Ferghana Valley fault system (in particular Osh, Jalah-Abad and Uzgen), the Oinik Djar fault (Naryn) and the central and western Talas-Ferghanafaukt (Talas). Finally, while site effects (in particular, those dependent on the upper-most geological structure) have an obvious effect on the final hazard level, this is still not fully accounted for, even if a nation-wide first order Vs30 model (i.e., from the USGS) is available. Abdrakhmatov, K., Havenith, H.-B., Delvaux, D., Jongsmans, D. and Trefois, P. (2003) Probabilistic PGA and Arias Intensity maps of Kyrgyzstan (Central Asia), Journal of Seismology, 7, 203-220. Ulomov, V.I., The GSHAP Region 7 working group (1999) Seismic hazard of Northern Eurasia, Annali di Geofisica, 42, 1012-1038.

Determining requirements for patient-centred care: a participatory concept mapping study.

PubMed

Ogden, Kathryn; Barr, Jennifer; Greenfield, David

2017-11-28

Recognition of a need for patient-centred care is not new, however making patient-centred care a reality remains a challenge to organisations. We need empirical studies to extend current understandings, create new representations of the complexity of patient-centred care, and guide collective action toward patient-centred health care. To achieve these ends, the research aim was to empirically determine what organisational actions are required for patient-centred care to be achieved. We used an established participatory concept mapping methodology. Cross-sector stakeholders contributed to the development of statements for patient-centred care requirements, sorting statements into groupings according to similarity, and rating each statement according to importance, feasibility, and achievement. The resultant data were analysed to produce a visual concept map representing participants' conceptualisation of patient-centred care requirements. Analysis included the development of a similarity matrix, multidimensional scaling, hierarchical cluster analysis, selection of the number of clusters and their labels, identifying overarching domains and quantitative representation of rating data. The outcome was the development of a conceptual map for the Requirements of Patient-Centred Care Systems (ROPCCS). ROPCCS incorporates 123 statements sorted into 13 clusters. Cluster labels were: shared responsibility for personalised health literacy; patient provider dynamic for care partnership; collaboration; shared power and responsibility; resources for coordination of care; recognition of humanity - skills and attributes; knowing and valuing the patient; relationship building; system review evaluation and new models; commitment to supportive structures and processes; elements to facilitate change; professional identity and capability development; and explicit education and learning. The clusters were grouped into three overarching domains, representing a cross-sectoral approach: humanity and partnership; career spanning education and training; and health systems, policy and management. Rating of statements allowed the generation of go-zone maps for further interrogation of the relative importance, feasibility, and achievement of each patient-centred care requirement and cluster. The study has empirically determined requirements for patient-centred care through the development of ROPCCS. The unique map emphasises collaborative responsibility of stakeholders to ensure that patient-centred care is comprehensively progressed. ROPCCS allows the complex requirements for patient-centred care to be understood, implemented, evaluated, measured, and shown to be occurring.

Exploring spatial evolution of economic clusters: A case study of Beijing

NASA Astrophysics Data System (ADS)

Yang, Zhenshan; Sliuzas, Richard; Cai, Jianming; Ottens, Henk F. L.

2012-10-01

An identification of economic clusters and analysing their changing spatial patterns is important for understanding urban economic space dynamics. Previous studies, however, suffer from limitations as a consequence of using fixed geographically areas and not combining functional and spatial dynamics. The paper presents an approach, based on local spatial statistics and the case of Beijing to understand the spatial clustering of industries that are functionally interconnected by common or complementary patterns of demand or supply relations. Using register data of business establishments, it identifies economic clusters and analyses their pattern based on postcodes at different time slices during the period 1983-2002. The study shows how the advanced services occupy the urban centre and key sub centres. The Information and Communication Technology (ICT) cluster is mainly concentrated in the north part of the city and circles the urban centre, and the main manufacturing clusters are evolved in the key sub centers. This type of outcomes improves understanding of urban-economic dynamics, which can support spatial and economic planning.

Lessons learnt from a measles outbreak in Madang Province, Papua New Guinea, June 2014 - March 2015.

PubMed

Kamac, Karoi; Paterson, Beverley; Flint, James

2017-01-01

This study examined measles vaccine wastage during an outbreak response in Madang Province of Papua New Guinea from June 2014 to March 2015. Vaccine wastage was defined as the number of doses received by a health centre minus the total number of doses administered during and returned following the outbreak vaccination campaign. Vaccine data were collected from the Provincial Health Information Office, the Provincial Vaccine Store register and clinic and health centre immunization registers for calculating the vaccine wastage. Interviews were conducted with all 48 health centres involved in the outbreak response using a structured questionnaire to explore the reasons for vaccine wastage. Of the 154 110 doses issued by Madang Province during the outbreak, a total of 85 236 (55%) doses were wasted. The wastage varied by district from 31% to 90%. The total cost of the vaccine wastage was estimated to be 589 810 Kina (US$ 196 604). None of the health centres maintained vaccine stock registers. Most health centres indicated multiple failures in cold chain logistics. Almost 40% of health centres reported incorrectly diluting vaccines. The same percentage of health centres reported using incorrect injection techniques. Regular audits of cold chain logistics, staff training and improved processes for recording vaccine administration and wastage will decrease vaccine wastage during vaccine-preventable disease outbreaks and also benefit routine immunization activities.

1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

ERIC Educational Resources Information Center

Hannikainen, Maritta

2010-01-01

This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

Thermodynamically accessible titanium clusters TiN, N = 2-32.

PubMed

Lazauskas, Tomas; Sokol, Alexey A; Buckeridge, John; Catlow, C Richard A; Escher, Susanne G E T; Farrow, Matthew R; Mora-Fonz, David; Blum, Volker W; Phaahla, Tshegofatso M; Chauke, Hasani R; Ngoepe, Phuti E; Woodley, Scott M

2018-05-10

We have performed a genetic algorithm search on the tight-binding interatomic potential energy surface (PES) for small TiN (N = 2-32) clusters. The low energy candidate clusters were further refined using density functional theory (DFT) calculations with the PBEsol exchange-correlation functional and evaluated with the PBEsol0 hybrid functional. The resulting clusters were analysed in terms of their structural features, growth mechanism and surface area. The results suggest a growth mechanism that is based on forming coordination centres by interpenetrating icosahedra, icositetrahedra and Frank-Kasper polyhedra. We identify centres of coordination, which act as centres of bulk nucleation in medium sized clusters and determine the morphological features of the cluster.

Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966.

PubMed

Näyhä, Simo; Lankila, Tiina; Rautio, Arja; Koiranen, Markku; Tammelin, Tuija H; Taanila, Anja; Rusanen, Jarmo; Laitinen, Jaana

2013-10-08

The effect of urban sprawl on body weight in Finland is not well known. To provide more information, we examined whether body mass index (BMI) and the prevalence of overweight are associated with an individual's distance to the local community centre and population density in his/her resident area. The sample consisted of 5363 men and women, members of the Northern Finland Birth Cohort 1966 (NFBC), who filled in a postal questionnaire and attended a medical checkup in 1997, at the age of 31 years. Body mass index (BMI; kg/m(2)) and the prevalence of overweight (BMI ≥ 25.0 kg/m(2)) were regressed on each subject's road distance to the resident commune's centre and on population density in the 1 km(2) geographical grid in which he/she resided, using a generalized additive model. Adjustments were made for sex, marital status, occupational class, education, leisure-time and occupational physical activity, alcohol consumption and smoking. The mean BMI among the subjects was 24.7 kg/m(2), but it increased by increasing road distance (by 1.3 kg/m(2) from 5-10 to 20-184 km) and by decreasing population density (by 1.7 kg/m(2) from 1000-19,192 to 1-5 inhabitants/km(2)). The respective increases in overweight (overall prevalence 41%) were 13 per cent units for distance and 14 per cent units for population density. Adjusted regressions based on continuous explanatory variables showed an inverse L-shaped pattern with a mean BMI of 24.6 kg/m(2) at distances shorter than 5 km and a rise of 2.6 kg/m(2) at longer distances, and an increase of 2.5 kg/m(2) from highest to lowest population density. The associations with road distance were stronger for women than men, while the sex difference in association with population density remained indeterminate. We conclude that young adults in Northern Finland who live far away from local centres or in the most sparsely populated areas are fatter than those who live close to local centres or in densely populated areas. The likely explanations include variations in everyday physical activity in different residential environments, although causality of the associations remains to be confirmed.

Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966

PubMed Central

2013-01-01

Background The effect of urban sprawl on body weight in Finland is not well known. To provide more information, we examined whether body mass index (BMI) and the prevalence of overweight are associated with an individual’s distance to the local community centre and population density in his/her resident area. Methods The sample consisted of 5363 men and women, members of the Northern Finland Birth Cohort 1966 (NFBC), who filled in a postal questionnaire and attended a medical checkup in 1997, at the age of 31 years. Body mass index (BMI; kg/m2) and the prevalence of overweight (BMI ≥ 25.0 kg/m2) were regressed on each subject’s road distance to the resident commune’s centre and on population density in the 1 km2 geographical grid in which he/she resided, using a generalized additive model. Adjustments were made for sex, marital status, occupational class, education, leisure-time and occupational physical activity, alcohol consumption and smoking. Results The mean BMI among the subjects was 24.7 kg/m2, but it increased by increasing road distance (by 1.3 kg/m2 from 5–10 to 20–184 km) and by decreasing population density (by 1.7 kg/m2 from 1000–19,192 to 1–5 inhabitants/km2). The respective increases in overweight (overall prevalence 41%) were 13 per cent units for distance and 14 per cent units for population density. Adjusted regressions based on continuous explanatory variables showed an inverse L-shaped pattern with a mean BMI of 24.6 kg/m2 at distances shorter than 5 km and a rise of 2.6 kg/m2 at longer distances, and an increase of 2.5 kg/m2 from highest to lowest population density. The associations with road distance were stronger for women than men, while the sex difference in association with population density remained indeterminate. Conclusions We conclude that young adults in Northern Finland who live far away from local centres or in the most sparsely populated areas are fatter than those who live close to local centres or in densely populated areas. The likely explanations include variations in everyday physical activity in different residential environments, although causality of the associations remains to be confirmed. PMID:24103455

Degassing during magma ascent in the Mule Creek vent (USA)

NASA Astrophysics Data System (ADS)

Stasiuk, Mark V.; Barclay, Jenni; Carroll, Michael R.; Jaupart, Claude; Ratté, James C.; Sparks, R. Stephen J.; Tait, Stephen R.

1996-09-01

The structures and textures of the rhyolite in the Mule Creek vent (New Mexico, USA) indicate mechanisms by which volatiles escape from silicic magma during eruption. The vent outcrop is a 300-m-high canyon wall comprising a section through the top of a feeder conduit, vent and the base of an extrusive lava dome. Field relations show that eruption began with an explosive phase and ended with lava extrusion. Analyses of glass inclusions in quartz phenocrysts from the lava indicate that the magma had a pre-eruptive dissolved water content of 2.5 3.0 wt% and, during eruption, the magma would have been water-saturated over the vertical extent of the present outcrop. However, the vesicularity of the rhyolite is substantially lower than that predicted from closed-system models of vesiculation under equilibrium conditions. At a given elevation in the vent, the volume fraction of primary vesicles in the rhyolite increases from zero close to the vent margin to values of 20 40 vol.% in the central part. In the centre the vesicularity increases upward from approximately 20 vol.% at 300 m below the canyon rim to approximately 40 vol.% at 200 m, above which it shows little increase. To account for the discrepancy between observed vesicularity and measured water content, we conclude that gas escaped during ascent, probably beginning at depths greater than exposed, by flow through the vesicular magma. Gas escape was most efficient near the vent margin, and we postulate that this is due both to the slow ascent of magma there, giving the most time for gas to escape, and to shear, favouring bubble coalescence. Such shear-related permeability in erupting magma is supported by the preserved distribution of textures and vesicularity in the rhyolite: Vesicles are flattened and overlapping near the dense margins and become progressively more isolated and less deformed toward the porous centre. Local zones have textures which suggest the coalescence of bubbles to form permeable, collapsing foams, implying the former existence of channels for gas migration. Local channelling of gas into the country rocks is suggested by the presence of sub-horizontal syn-eruptive rhyolitic tuffisite veins which depart from the vent margin and invade the adjacent country rock. In the central part of the vent, similar local channelling of gas is indicated by steep syn-eruption tuffisite veins which cut the rhyolite itself. We conclude that the suppression of explosive eruption resulted from gas separation from the ascending magma and vent structure by shear-related porous flow and channelling of gas through tuffisite veins. These mechanisms of gas loss may be responsible for the commonly observed transition from explosive to effusive behaviour during the eruption of silicic magma.

Degassing during magma ascent in the Mule Creek vent (USA)

USGS Publications Warehouse

Stasiuk, M.V.; Barclay, J.; Carroll, M.R.; Jaupart, Claude; Ratte, J.C.; Sparks, R.S.J.; Tait, S.R.

1996-01-01

The structures and textures of the rhyolite in the Mule Creek vent (New Mexico, USA) indicate mechanisms by which volatiles escape from silicic magma during eruption. The vent outcrop is a 300-m-high canyon wall comprising a section through the top of a feeder conduit, vent and the base of an extrusive lava dome. Field relations show that eruption began with an explosive phase and ended with lava extrusion. Analyses of glass inclusions in quartz phenocrysts from the lava indicate that the magma had a pre-eruptive dissolved water content of 2.5-3.0 wt% and, during eruption, the magma would have been water-saturated over the vertical extent of the present outcrop. However, the vesicularity of the rhyolite is substantially lower than that predicted from closed-system models of vesiculation under equilibrium conditions. At a given elevation in the vent, the volume fraction of primary vesicles in the rhyolite increases from zero close to the vent margin to values of 20-40 vol.% in the central part. In the centre the vesicularity increases upward from approximately 20 vol.% at 300 m below the canyon rim to approximately 40 vol.% at 200 m, above which it shows little increase. To account for the discrepancy between observed vesicularity and measured water content, we conclude that gas escaped during ascent, probably beginning at depths greater than exposed, by flow through the vesicular magma. Gas escape was most efficient near the vent margin, and we postulate that this is due both to the slow ascent of magma there, giving the most time for gas to escape, and to shear, favouring bubble coalescence. Such shear-related permeability in erupting magma is supported by the preserved distribution of textures and vesicularity in the rhyolite: Vesicles are flattened and overlapping near the dense margins and become progressively more isolated and less deformed toward the porous centre. Local zones have textures which suggest the coalescence of bubbles to form permeable, collapsing foams, implying the former existence of channels for gas migration. Local channelling of gas into the country rocks is suggested by the presence of sub-horizontal syn-eruptive rhyolitic tuffisite veins which depart from the vent margin and invade the adjacent country rock. In the central part of the vent, similar local channelling of gas is indicated by steep syn-eruption tuffisite veins which cut the rhyolite itself. We conclude that the suppression of explosive eruption resulted from gas separation from the ascending magma and vent structure by shear-related porous flow and channelling of gas through tuffisite veins. These mechanisms of gas loss may be responsible for the commonly observed transition from explosive to effusive behaviour during the eruption of silicic magma.

High resolution structure of cleaved Serpin 42 Da from Drosophila melanogaster.

PubMed

Ellisdon, Andrew M; Zhang, Qingwei; Henstridge, Michelle A; Johnson, Travis K; Warr, Coral G; Law, Ruby Hp; Whisstock, James C

2014-04-24

The Drosophila melanogaster Serpin 42 Da gene (previously Serpin 4) encodes a serine protease inhibitor that is capable of remarkable functional diversity through the alternative splicing of four different reactive centre loop exons. Eight protein isoforms of Serpin 42 Da have been identified to date, targeting the protease inhibitor to both different proteases and cellular locations. Biochemical and genetic studies suggest that Serpin 42 Da inhibits target proteases through the classical serpin 'suicide' inhibition mechanism, however the crystal structure of a representative Serpin 42 Da isoform remains to be determined. We report two high-resolution crystal structures of Serpin 42 Da representing the A/B isoforms in the cleaved conformation, belonging to two different space-groups and diffracting to 1.7 Å and 1.8 Å. Structural analysis reveals the archetypal serpin fold, with the major elements of secondary structure displaying significant homology to the vertebrate serpin, neuroserpin. Key residues known to have central roles in the serpin inhibitory mechanism are conserved in both the hinge and shutter regions of Serpin 42 Da. Furthermore, these structures identify important conserved interactions that appear to be of crucial importance in allowing the Serpin 42 Da fold to act as a versatile template for multiple reactive centre loops that have different sequences and protease specificities. In combination with previous biochemical and genetic studies, these structures confirm for the first time that the Serpin 42 Da isoforms are typical inhibitory serpin family members with the conserved serpin fold and inhibitory mechanism. Additionally, these data reveal the remarkable structural plasticity of serpins, whereby the basic fold is harnessed as a template for inhibition of a large spectrum of proteases by reactive centre loop exon 'switching'. This is the first structure of a Drosophila serpin reported to date, and will provide a platform for future mutational studies in Drosophila to ascertain the functional role of each of the Serpin 42 Da isoforms.

Supply chain management of health commodities for reducing global disease burden.

PubMed

Chukwu, Otuto Amarauche; Ezeanochikwa, Valentine Nnaemeka; Eya, Benedict Ejikeme

Reducing global disease burden requires improving access to medicines, thus the need for efficient and effective supply chain management for medicines. The Nigerian government came up with new policies on Mega Drug Distribution Centres and National Drug Distribution Guidelines to improve access to quality medicines with pharmacists having a key role to play. However, pharmacists in Nigeria seem not to be aware and adequately equipped to handle the medicines supply chain. This article aimed at assessing the awareness and readiness of Nigerian pharmacists on supply chain management practices for improving access to medicines. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics was used in data analysis. P values less than 0.05 were considered to be significant. 29.3%, 20.7% and 53.7% were not aware of supply chain management, National Drug Distribution Guidelines and Mega Drug Distribution Centres, respectively. 85.46% do not have a copy of the National Drug Distribution Guidelines. 78% were not aware that Mega Drug Distribution Centres are already operational. 35.4% have never been involved in any supply chain management practice. 69.5% often experience stock out of vital and essential medicines, of which 85.2% were in hospitals. 15.9% were successful in managing their facility's supply chains. 84.1% opined that pharmacists in Nigeria are not yet ready to handle the medicines supply chain. Findings showed limited awareness and readiness on supply chain management of medicines. This may be due to inadequate supply chain management skills and infrastructure, poor financing, lack of accountability and poor management. Tackling these as well as pharmacists showing more interest in the country's health policies and obtaining necessary postgraduate certifications will lead to improvements. This will improve access to quality medicines and thus help in the fight to reduce disease burden both locally and globally. Copyright © 2016 Elsevier Inc. All rights reserved.

A cluster randomised controlled trial of a brief couple-focused psychoeducational intervention to prevent common postnatal mental disorders among women: study protocol.

PubMed

Rowe, Heather; Wynter, Karen; Lorgelly, Paula; Amir, Lisa H; Ranasinha, Sanjeeva; Proimos, Jenny; Cann, Warren; Hiscock, Harriet; Bayer, Jordana; Burns, Joanna; Ride, Jemimah; Bobevski, Irene; Fisher, Jane

2014-09-23

Postnatal common mental disorders among women are an important public health problem internationally. Interventions to prevent postnatal depression have had limited success. What Were We Thinking (WWWT) is a structured, gender-informed, psychoeducational group programme for parents and their first infant that addresses two modifiable risks to postnatal mental health. This paper describes the protocol for a cluster randomised controlled trial to test the clinical effectiveness and cost-effectiveness of WWWT when implemented in usual primary care. 48 maternal and child health (MCH) centres from six diverse Local Government Areas, in Victoria, Australia are randomly allocated to the intervention group (usual care plus WWWT) or the control group (usual care). The required sample size is 184 women in each group. English-speaking primiparous women receiving postpartum healthcare in participating MCH centres complete two computer-assisted telephone interviews: baseline at 4 weeks and outcome at 6 months postpartum. Women attending intervention MCH centres are invited to attend WWWT in addition to usual care. The primary outcome is meeting Diagnostic and Statistical Manual-IV (DSM-IV) diagnostic criteria for major depressive episode; generalised anxiety disorder; panic disorder with or without agoraphobia, agoraphobia with or without panic, social phobia, adult separation anxiety or adjustment disorder with depressed mood, anxiety or mixed depressed mood and anxiety within the past 30 days at 6 months postpartum. Secondary outcomes are self-rated general and emotional health, infant sleep problems, method of infant feeding, quality of mother-infant relationship and intimate partner relationship, and healthcare costs and outcomes. Approval to conduct the study has been granted. A comprehensive dissemination plan has been devised. Australian New Zealand Clinical Trials Registry ACTRN12613000506796. UTN: U1111-1125-8208. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Personalized commissioning, public spaces: the limits of the market in English social care services

PubMed Central

2013-01-01

Background The article explores the implications of personal budgets within English social care services, which position the individual as market actor. Rooting the research in the broader personalization agenda, the study looks at the limitations of the market in relation to individual purchase of private goods (e.g. home care), in the pooling of funds to purchase group services and in the provision of public goods such as building-based services. Method The article takes a multi-method approach, combining an interpretive focus on the framing of the personal budget-holder by advocates of personalization with national evaluation data, and data from a small survey of day centre workers. Results The article identifies three framings of the individual budget-holder articulated by advocates of personalization. The first is that personal budget-holders will be empowered market actors, commissioning the services they need. The second is that budget-holders will pool resources with others to purchase group services in order to broaden the range of options available to them. The third is that services which cannot be disaggregated into individual or group budgets – such as day centres – are not valued by service users. The article looks at the evaluation data on these three claims in turn. It identifies four limitations to the capacity of people to purchase care goods on an individual basis: lack of transparency in allocating budgets, complexity in managing a budget, excessive auditing of spending and lack of responsiveness from the provider market. Pooling of budgets to purchase collective services is found to be underdeveloped, and hampered by the complexity which is a broader limitation on personal budgets. Day centres are found to be closing not in response to commissioning decisions by individual budget-holders but because of decommissioning by local authorities, minimising the scope for individuals to express a preference for this type of care. The survey highlights patterns of day centre closure, rising fees for attendance and reduced eligibility, and the underdevelopment of mechanisms to facilitate commissioning of new collective spaces. Conclusions The paper concludes that the transition to personal budgets – in the context of the accompanying financial crisis in local authorities – has led to inadequate attention to the potential for an undersupply of collective and public goods. The loss of day centre provision will be felt by personal budget holders but also by self-funders and people in residential accommodation who may no longer be eligible for, or able to afford, to access shared spaces. Local authorities are actively taking on the role of decommissioners without sufficient responsiveness to how and what individuals want them to commission. PMID:23735124

Primary School Students' Perceptions of Interactive Whiteboards

ERIC Educational Resources Information Center

Hall, Ian; Higgins, S

2005-01-01

Students involved in the interactive whiteboard (IWB) evaluation, sponsored by the Centre for British Teachers (CfBT), were interviewed in regard to their perceptions about IWBs. Twelve group interviews (72 students) were conducted between January and Easter 2004 with Year 6 students (between 10 and 11 years of age) in six Local Education…

Emergent Literacy as Sociocultural Practice: How Well Do New Zealand Parents Fit with "Te Whariki?"

ERIC Educational Resources Information Center

Zhang, Qilong

2017-01-01

A sociocultural approach to emergent literacy and growing concerns over the de-emphasis on literacy of the New Zealand early childhood education curriculum "Te Whariki" call for locally situated emergent literacy programmes co-constructed by teachers, parents and children. While teachers' approach to emergent literacy takes centre stage…

Linguistic Landscape in Singapore: What Shop Names Reveal about Singapore's Multilingualism

ERIC Educational Resources Information Center

Shang, Guowen; Guo, Libo

2017-01-01

The visibility and salience of specific languages in public spaces are important parameters of their ethnolinguistic vitality in a society. Drawing upon data from first-hand fieldwork, this paper explores the display of multiple languages in shop names presented in Singapore's neighbourhood centres in order to reveal how local shop owners address…

An Exploration of Female Travellers' Experiences of Guidance Counselling in Adult Education

ERIC Educational Resources Information Center

Doyle, Anne; Hearne, Lucy

2012-01-01

The proposed changes in the further education sector, including the rationalisation of the VEC into Local Education and Training Boards (LETBs) and the closures of the Senior Traveller Training Centres (STTCs), have implications for guidance counselling provision to the Traveller community. This article discusses female Travellers' experiences of…

Berlin's Adult Education Centres (Volkshochschulen) from 1945 to 1960.

ERIC Educational Resources Information Center

Rose, Karl Heinz; Korthaase, Werner

Two lectures on the development of Berlin's adult education centers after World War II are included. The lecture by Werner Korthaase begins by describing the situation prior to 1920, when Berlin was divided into independent districts, each with its own administrative authorities. It then describes the reestablishment of the local adult education…

Exploring the "Dragon's Graveyard"

ERIC Educational Resources Information Center

Ballard, Stuart

2007-01-01

Most schools visit Magna Science Adventure Centre on the back of careful planning and preparation. Magna is a fairly unique environment. "Steelos", the local name for the former Templeborough steelworks in Rotherham, West Yorkshire, was a vast plant. It became home to Magna in 2001. The building is over half a kilometre long and 45…

Discover Primary Science: Developing Primary Science in Ireland

ERIC Educational Resources Information Center

Horner, Margaret; Palmer, Marion

2007-01-01

"Discover Primary Science" is a major project in primary science education in Ireland. In 2006-2007 it involves 2400 primary schools, 45 host centres, and two government departments. However, it started out as a local initiative taken by one state agency in 2002 involving four Institutes of Technology and 40 primary schools. The aim of…

PSQM--Reflections of a PSQM Hub Leader

ERIC Educational Resources Information Center

Johnson, Sue

2011-01-01

Primary Science Quality Mark Scheme is a joint project led by the Association for Science Education, the national network of Science Learning Centres and Barnet Local Authority. The Primary Science Quality Mark is an award scheme to develop and celebrate the quality of science teaching and learning in primary schools. It encourages teachers to let…

Sedgemoor: A Suitable Case for Treatment? Heritage, Interpretation and Educational Process.

ERIC Educational Resources Information Center

Thompson, Lynne

A partnership between the Universities of Exeter and Bournemouth at their joint University Centre in Yeovil College, Somerset (England) allowed local students to participate in higher education via a BA degree in Heritage and Regional Studies. This program represents several disciplines including history, literature, and the visual arts. It aims…

Assessment of primary health care in a rural health centre in Enugu South east Nigeria

PubMed Central

M Chinawa, Josephat; T Chinawa, Awoere

2015-01-01

Objective: Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. Methods: This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31st 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Results: Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV0 and HBV1 in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. Conclusions: The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system. PMID:25878615

Rural medical education: five medical students spend a year in rural Port Lincoln, Australia.

PubMed

Baillie, Sue; Matena, Jenni; Yerxa, John; Newbury, Jonathan

2007-01-01

The University of Adelaide and the University of South Australia established the Spencer Gulf Rural Health School (SGRHS) as a joint venture to facilitate rural health professional education and research. Annually a cohort of medical students from the University of Adelaide volunteer and are placed in various SGRHS 'learning centres' throughout rural South Australia for the 5th year of their medical training. This article addresses the issues encountered in one of these 'learning centres' in Port Lincoln, rural South Australia. The challenge was to integrate five students into a general medical practice and the local hospital and to provide high quality medical education for the academic year. Medical practice, student and university requirements were identified and a range of strategies implemented to address these. To date, four groups of medical students have successfully completed their rural academic year in Port Lincoln since 2003. The local systems have evolved to allow five students to integrate into the practice and hospital using a range of teaching and learning methods and resources.

Su-Schrieffer-Heeger chain with one pair of [Formula: see text]-symmetric defects.

PubMed

Jin, L; Wang, P; Song, Z

2017-07-19

The topologically nontrivial edge states induce [Formula: see text] transition in Su-Schrieffer-Heeger (SSH) chain with one pair of gain and loss at boundaries. In this study, we investigated a pair of [Formula: see text]-symmetric defects located inside the SSH chain, in particular, the defects locations are at the chain centre. The [Formula: see text] symmetry breaking of the bound states leads to the [Formula: see text] transition, the [Formula: see text]-symmetric phases and the localized states were studied. In the broken [Formula: see text]-symmetric phase, all energy levels break simultaneously in topologically trivial phase; however, two edge states in topologically nontrivial phase are free from the influence of the [Formula: see text]-symmetric defects. We discovered [Formula: see text]-symmetric bound states induced by the [Formula: see text]-symmetric local defects at the SSH chain centre. The [Formula: see text]-symmetric bound states significantly increase the [Formula: see text] transition threshold and coalesce to the topologically protected zero mode with vanishing probabilities on every other site of the left-half chain and the right-half chain, respectively.

Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it; Lara, Christine Tunon de, E-mail: c.tunondelara@bordeaux.unicancer.fr; Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr

AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number ofmore » cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.« less

Landslides risk mitigation along lifelines

NASA Astrophysics Data System (ADS)

Capparelli, G.; Versace, P.; Artese, G.; Costanzo, S.; Corsonello, P.; Di Massa, G.; Mendicino, G.; Maletta, D.; Leone, S.; Muto, F.; Senatore, A.; Troncone, A.; Conte, E.; Galletta, D.

2012-04-01

The paper describes an integrated, innovative and efficient solution to manage risk issues associated to landslides interfering with infrastructures. The research project was submitted for financial support in the framework of the Multi -regional Operational Programme 2007-13: Research and Competitiveness funded by the Ministry of Research (MIUR) and co-funded by the European Regional Development Fund. The project is aimed to developing and demonstrating an integrated system of monitoring, early warning and mitigation of landslides risk. The final goal is to timely identify potentially dangerous landslides, and to activate all needed impact mitigation measures, including the information delivery. The essential components of the system include monitoring arrays, telecommunication networks and scenario simulation models, assisted by a data acquisition and processing centre, and a traffic control centres. Upon integration, the system will be experimentally validated and demonstrated over ca. 200 km of three highway sections, crossing the regions of Campania, Basilicata, Calabria and Sicily. Progress in the state of art is represented by the developments in the field of environmental monitoring and in the mathematical modeling of landslides and by the development of services for traffic management. The approach to the problem corresponds to a "systemic logics" where each developed component foresees different interchangeable technological solutions to maximize the operational flexibility. The final system may be configured as a simple to complex structure, including different configurations to deal with different scenarios. Specifically, six different monitoring systems will be realized: three "point" systems, made up of a network of locally measuring sensors, and three "area" systems to remotely measure the displacements of large areas. Each network will be fully integrated and connected to a unique data transmission system. Standardized and shared procedures for the identification of risk scenarios will be developed, concerning the surveys to be carried out, the procedures for each type of on-site testing and guidelines and dynamic templates for presentations of results, such as highway risk maps e.g. The setting up of data acquisition and processing centre and traffic control centre are the core of the integrated system. The DAC (data acquisition center, newly designed) will acquire and process data varying in intensity, dimensions, characteristics and information content. The Traffic Control Center (TCC) is meant to integrate the scientific and the management aspects of hydrological risk monitoring and early warning. The overall system is expected to benefit of the development of new, advanced mathematical models on landslide triggers and propagation. Triggering models will be empirical or hydrological, represented by simple empirical relationships, obtained by linking the antecedent rainfall and the landslide time occurrence, and complete models identified through more complex expressions that take into account different components as the specific site conditions, the mechanical, hydraulic and physical properties of soils and slopes, the local seepage conditions and their contribution to soil strength. The industrial partners of the University of Calabria are Autostrade Tech, Strago and TD Group, with the Universities of Firenze and Catania acting research Partners.

Malignant lymphoma simulating lymph node toxoplasmosis.

PubMed

Miettinen, M; Franssila, K

1982-03-01

On histological examination of 667 cases originally suspected of lymph node toxoplasmosis, 12 cases were diagnosed as malignant lymphoma and 15 cases as atypical hyperplasia (AH), suspicious of malignant lymphoma. All 12 malignant cases were of Hodgkin's disease: eight of the lymphocyte predominant nodular type, two of lymphocyte predominant diffuse type, and two of the nodular sclerosis type. In all cases, the lymph nodes contained small groups of epithelioid cells which were virtually indistinguishable from those seen in toxoplasmosis. In the differential diagnosis between lymph node toxoplasmosis and malignant lymphoma, the following features were found helpful. In toxoplasmosis the general structure is preserved and germinal centres are frequent, while in malignant lymphoma and in AH the general structure is destroyed. However, in some cases of toxoplasmosis germinal centres may be difficult to identify because their margins are indistinct due to clusters of epithelioid cells. Also, in some types of Hodgkin's disease and in some cases of AH with epithelioid cells, the general structure of the lymph node may be partially preserved. The occurrence of epithelioid cells within germinal centres seems to be a specific feature for toxoplasmosis; it was never seen in malignant lymphoma nor in AH. The occurrence of strands of monocytoid cells (unreife Sinushistiocytose) though a fairly typical feature of toxoplasmosis, was also occasionally seen in Hodgkin's disease or AH.

Unexpected agency on the threshold: Asylum seekers narrating from an asylum seeker centre

PubMed Central

Ghorashi, Halleh; de Boer, Marije; ten Holder, Floor

2017-01-01

Several studies have described the condition of asylum seekers as being on the threshold or in-between structures. Victor Turner’s concept of liminality and Agamben’s state of exception have been used extensively to analyse this condition, mostly to show the negative implications of the ambiguous legal (non-) status. This article argues that the condition of liminality provides an intensified doubleness of impossibility and possibility for action, which casts a different light on conceptualizing agency. Without disregarding the downside of this liminal, in-between condition, the article shows that the lack of ‘normalized’ connectedness to the new structure combined with physical distance from the past structure, enables reflection and feeds the power of imagination. This can lead to alternative (yet conditional) forms of agency, such as delayed agency and agency from marginal positions. Through the narratives of asylum seekers living in Dutch asylum seeker centres, the article shows the potential of transforming non-places, such as asylum seeker centres, into those in which existential meanings can emerge (even if partial). Considering these sources of agency has great implications for the short-term well-being of asylum seekers and the long-term inclusion of refugees in their countries of residence. PMID:29725136

Rare-earth transition-metal gallium chalcogenides RE3MGaCh7 (M=Fe, Co, Ni; Ch=S, Se)

NASA Astrophysics Data System (ADS)

Rudyk, Brent W.; Stoyko, Stanislav S.; Oliynyk, Anton O.; Mar, Arthur

2014-02-01

Six series of quaternary rare-earth transition-metal chalcogenides RE3MGaCh7 (M=Fe, Co, Ni; Ch=S, Se), comprising 33 compounds in total, have been prepared by reactions of the elements at 1050 °C (for the sulphides) or 900 °C (for the selenides). They adopt noncentrosymmetric hexagonal structures (ordered Ce3Al1.67S7-type, space group P63, Z=2) with cell parameters in the ranges of a=9.5-10.2 Å and c=6.0-6.1 Å for the sulphides and a=10.0-10.5 Å and c=6.3-6.4 Å for the selenides as refined from powder X-ray diffraction data. Single-crystal structures were determined for five members of the sulphide series RE3FeGaS7 (RE=La, Pr, Tb) and RE3CoGaS7 (RE=La, Tb). The highly anisotropic crystal structures consist of one-dimensional chains of M-centred face-sharing octahedra and stacks of Ga-centred tetrahedra all pointing in the same direction. Magnetic measurements on the sulphides reveal paramagnetic behaviour in some cases and long-range antiferromagnetic behaviour with low Néel temperatures (15 K or lower) in others. Ga L-edge XANES spectra support the presence of highly cationic Ga tetrahedral centres with a tendency towards more covalent Ga-Ch character on proceeding from the sulphides to the selenides. Band structure calculations on La3FeGaS7 indicate that the electronic structure is dominated by Fe 3d-based states near the Fermi level.

Facing the dilemma of patient-centred psoriasis care: a qualitative study identifying patient needs in dermatological outpatient clinics.

PubMed

Khoury, L R; Skov, L; Møller, T

2017-08-01

Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic. A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method. Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient-centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self-management skills. These central issues are as yet rarely addressed in clinical consultations. Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient-centred approach, health professionals should implement minor structural changes to dermatological services to meet patients' current needs and invite dialogue about the patients' emotional well-being and concerns that go beyond biomedical factors, as well as offer individualized health education. © 2016 British Association of Dermatologists.

Dialysis services for tourists to the Veneto Region: a qualitative study.

PubMed

Footman, Katharine; Mitrio, Silva; Zanon, Dario; Glonti, Ketevan; Risso-Gill, Isabelle; McKee, Martin; Knai, Cécile

2015-03-01

The European Union has an established mechanism which enables patients with end-stage kidney disease (ESKD) to receive dialysis abroad, allowing them to benefit from the legal right to freedom of movement. The number of patients seeking dialysis abroad has increased in recent years and the Veneto Region of Italy, a major tourist destination, has made significant investment in providing tourist haemodialysis services. To understand the issues involved in providing dialysis services for tourists moving within the European Union, such as the experience of patients using the service, the challenges faced by professionals and patients and continuity of care. Semi-structured interviews. Interviews were conducted with patients, health professionals and key stakeholders in two dialysis centres set up for tourists in the Veneto Region's Local Health Authority 10. The study uncovered high levels of patient satisfaction and a positive impact on patients' quality of life. However, the service faces a number of challenges relating to accessibility, language barriers and continuity of care for the patient when leaving Veneto. The study also demonstrates the importance of coordinating care prior to the tourists' stay. Tourist dialysis centres are necessary to make the right to freedom of movement for patients with ESKD a reality. The findings suggest that communicating and coordinating high-quality care across borders in the EU may be facilitated by increased standardisation of norms and documents for continuity of care, such as care plans and discharge summaries. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Becoming a health promoting school: key components of planning.

PubMed

Senior, Elizabeth

2012-03-01

This article looks at the practicalities of implementing the health promoting school (HPS) framework, including conducting a whole school audit, to enable a primary school to successfully adopt the HPS principles. A partnership agreement was signed, between EACH Social and Community Health which is a local Community Health Centre and a primary school in the Eastern suburbs of Melbourne, in Australia. An audit was conducted of the school community with four follow up focus groups of students from grades 3 to 6. Qualitative data was gathered from 20 teachers at the school at a professional development day facilitated by the health promotion staff of the Community Health Centre. The results of the school audit identified that students in grades 3 to 6 and parents valued the outside environment of the school most highly. The staff valued staff attributes most highly. Suggestions from students to improve the school included improving the canteen and outside environment. Staff were most concerned about fitness of both the staff and the students. Parents also identified lack of healthy eating as a concern. The school community sees the value of adopting the HPS framework, however on-going structured support is required if the school is to successfully adopt the HPS approach. The school community needs to understand that the move toward cultural and environmental change is slow. Successful adoption of the HPS model requires time and collaboration. The emphasis needs to be on supporting teachers to change their school from within. Relationships are important.

What factors influence physiotherapy service provision in rural communities? A pilot study.

PubMed

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

[Circumscribed palmar hypokeratosis (CPM): The diagnostic value of dermoscopy].

PubMed

Topin-Ruiz, S; Debarre, J-M; Blanchard, E; Kettani, S; Valmier, P-J; Martin, L; Le Corre, Y

2017-03-01

Circumscribed palmar hypokeratosis (CPH) is a rare skin disease, first described in 2002, associated with sudden localized reduction of the corneal layer. In most cases, it presents as an isolated rounded erythematous palmar lesion on the thenar eminence. We describe the dermoscopic semiology of CPH in 3 cases. Three patients between the ages of 59 and 72 presented very limited erythematous lesions suggestive of CPH. Dermoscopic examination of these lesions provided similar findings. Biopsy, which was performed in one patient, confirmed the diagnosis of CPH. Two dermoscopic elements of CPH are characteristic: (1) the sides of the lesion have a "stair step" or "geological strata" type of configuration, and the thickness of the different strata varies; (2) the centre of the lesion showed a homogeneous erythematous area with a vascular pattern composed of dotted vessels of the superficial dermis and sometime vascular loops. These dermoscopic aspects are characteristic and enable CPH to be differentiated from Bowen's disease or porokeratosis of Mibelli. In Bowen's disease, there is no stair step like aspect to the sides of lesions; further, the centre of the lesion shows glomerular vessels (coiled vessels) and/or globular vessels (small red clods). In porokeratosis, peripheral keratotic "white track" structures comprise a single pigmented channel or a double white line. There is no "stair step" or central vascular pattern. The dermoscopic semiology of CPH is highly characteristic and enables differentiation from Bowen's disease and porokeratosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The extent and intensity of the urban heat island in Iași city, Romania

NASA Astrophysics Data System (ADS)

Sfîcă, Lucian; Ichim, Pavel; Apostol, Liviu; Ursu, Adrian

2017-10-01

The study underlines the characteristics of the urban heat island of Iași (Iași's UHI) on the basis of 3 years of air temperature measurements obtained by fixed-point observations. We focus on the identification of UHI development and intensity as it is expressed by the temperature differences between the city centre and the rural surroundings. Annual, seasonal and daily characteristics of Iaşi's UHI are investigated at the level of the classical weather observation. In brief, an intensity of 0.8 °C of UHI and a spatial extension which corresponds to the densely built area of the city were delineated. The Iaşi UHI is stronger during summer calm nights—when the inner city is warmer with 2.5-3 °C than the surroundings—and is weaker during windy spring days. The specific features of Iași's UHI bear a profound connection to the specificity of the urban structure, the high atmospheric stability in the region and the local topography. Also, the effects of Iași's UHI upon some environmental aspects are presented as study cases. For instance, under the direct influence of UHI, we have observed that in the city centre, the apricot tree blossoms earlier (with up to 4 days) and the depth of the snow cover is significantly lower (with up to 10 cm for a rural snow depth of 30 cm) than in the surrounding areas.

Enhancing Environmental HPC Applications: The EnCompAS approach

NASA Astrophysics Data System (ADS)

Frank, Anton; Donners, John; Pursula, Antti; Seinstra, Frank; Kranzlmüller, Dieter

2015-04-01

Many HPC applications in geoscience are of very high scientific quality and highly optimized for supercomputers. However, some of these codes lack the uptake by other adjacent scientific communities or industry due to deficiencies in usability, quality, and availability. Since enhancing software by, e.g., adding a graphical user interface, respecting data standards, setting up a support structure, or writing an extensive documentation is not of direct and immediate scientific relevance, most developers are not willing to invest any additional effort in these issues. Furthermore, if scientists, who are not directly involved in the development of some scientific software, could make benefit from additional features or interfaces, respective requests are often turned down due to the lack of time and resources. On the other hand, such enhancements are crucial for the sustainability of the scientific assets as well as the widespread or even worldwide distribution of European environmental software. Closely collaborating with environmental scientists the national supercomputing and eScience centres in Helsinki, Amsterdam, and Munich have identified that an enhancement of HPC and data analysis software must be provided as a service to the scientists developing such software. Therefore, first steps have been taken to establish respective services at these centres. In this talk we will present the already existing and envisioned service portfolio, some first success stories, and the approach to harmonize the current status aiming to turn this local effort into a pan-European service offering for environmental science.

German cooperation-network 'equity in health'-health promotion in settings.

PubMed

Mielck, Andreas; Kilian, Holger; Lehmann, Frank; Richter-Kornweitz, Antje; Kaba-Schönstein, Lotte

2018-04-01

In 2003, the German Federal Centre for Health Education (BZgA) initiated the national Cooperation-Network (CN) 'Equity in Health'. The CN is constantly increasing in size and scope, supporting setting approaches aimed at reducing health inequalities. A detailed description of the CN has not yet been available in English. The CN comprises a total of 66 institutional cooperation partners. Information concerning the structure and activities can be found on a special website. Coordination Centres (CC) have been established in the 16 federal states, for the coordination of all state-specific activities. Funding for the CN and CC is provided by the BZgA, the German statutory sickness funds and by the state-specific ministries of health. These partners also support the continuous quality improvement, which is based on the good-practice criteria developed by the Advisory Committee of the CN. In 2011, the 'Municipal Partner Process (MPP)' has been launched, specifically supporting local partners and integrated life-course approaches focussing on children. In 2015, the focus has been widened to include all age-groups. In July 2015, a new national health law concerning health promotion and prevention has been ratified by the federal Parliament, with a focus on reducing health inequalities. Currently, the details of its implementation are discussed on a nationwide basis. The CN has long advocated for such a law, and today the CN is a well-accepted partner providing concepts, methods and a strong and long-standing network. The article closes with future challenges faced by the CN.

Near white light emitting ZnAl{sub 2}O{sub 4}:Dy{sup 3+} nanocrystals: Sol–gel synthesis and luminescence studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumar, Mithlesh, E-mail: mithlesh@barc.gov.in; Gupta, Santosh K.; Kadam, R.M.

2016-02-15

Highlights: • ZnAl{sub 2}O{sub 4}:Dy{sup 3+} spinel synthesized using sol–gel method. • Characterized by XRD, SEM and PL spectroscopy. • Investigations of emission, excitation and lifetime properties. • Evaluation of defect centers and trap parameters of the system. • Evaluation of CIE indices of near white light emitting phosphor. - Abstract: ZnAl{sub 2}O{sub 4}:Dy{sup 3+} nanoparticles were synthesized using citrate sol–gel method and characterized systematically using X-ray diffraction, scanning electron microscopy and photoluminescence spectroscopy. Emission spectrum of pure ZnAl{sub 2}O{sub 4} shows intense violet blue emission under ultra violet irradiation. Based on electron paramagnetic resonance (EPR) results; it was attributedmore » to presence of singly ionized oxygen vacancy centres in ZnAl{sub 2}O{sub 4}. On doping Dy{sup 3+} in ZnAl{sub 2}O{sub 4}, complete host–dopant energy transfer does not take place. Local structural investigation and lifetime measurements reveal that dysprosium ion is distributed between both Zn{sup 2+} and Al{sup 3+} sites. Near white light from ZnAl{sub 2}O{sub 4}:Dy{sup 3+} is attributed to combined host and dopant luminescence. The trap parameters such as activation energy (E) and frequency factor (s) for TSL glow peak 165 °C were determined using different heating rate method. Thermally stimulated emission showed the presence of oxygen related defect centre.« less

Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

NASA Astrophysics Data System (ADS)

Ertas, Gokhan; Doran, Simon; Leach, Martin O.

2011-12-01

In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

Providing assistive technology in Italy: the perceived delivery process quality as affecting abandonment.

PubMed

Federici, Stefano; Borsci, Simone

2016-01-01

The study brings together three aspects rarely observed at once in assistive technology (AT) surveys: (i) the assessment of user interaction/satisfaction with AT and service delivery, (ii) the motivational analysis of AT abandonment, and (iii) the management/design evaluation of AT delivery services. 15 health professionals and 4 AT experts were involved in modelling and assessing four AT Local Health Delivery Service (Centres) in Italy through a SWOT analysis and a Cognitive Walkthrough. In addition 558 users of the same Centres were interviewed in a telephone survey to rate their satisfaction and AT use. The overall AT abandonment was equal to 19.09%. Different Centres' management strategies resulted in different percentages of AT disuse, with a range from 12.61% to 24.26%. A significant difference between the declared abandonment and the Centres' management strategies (p = 0.012) was identified. A strong effect on abandonment was also found due to professionals' procedures (p = 0.005) and follow-up systems (p = 0.002). The user experience of an AT is affected not only by the quality of the interaction with the AT, but also by the perceived quality of the Centres in support and follow-up. Implications for Rehabilitation AT abandonment surveys provide useful information for modelling AT assessment and delivery process. SWOT and Cognitive Walkthrough analyses have shown suitable methods for exploring limits and advantages in AT service delivery systems. The study confirms the relevance of person centredness for a successful AT assessment and delivery process.

OA11 Public health and hospices: what is really possible?

PubMed

Hartley, Nigel; Richardson, Heather

2015-04-01

Whilst a growing number of hospices are proactively engaging in the public health agenda, questions remain about whether this is an approach that hospices can adopt successfully. (Sallnow et al . 2014). The experience of St Christopher's in the development of its social hub (The Anniversary Centre) offers insights into the challenges and how these are best addressed. The Anniversary Centre was established to provide a more open and flexible approach to end of life care and to challenge and change public attitudes towards death and dying. It sought, also, to contest an existing culture of care, shifting from professional management of problems to one in which people take a lead in their own care and wellbeing. A review of the progress of the Centre in achieving these aims has been undertaken five years after its establishment. Questions focus on: The degree to which the centre has engaged more of the local communities How much its users are able to determine their own priorities, care and wellbeing through attendance at the centre What evidence of a public health approach exists in the support it provides. The Centre offers a new and alternative way of supporting people living with a life threatening condition. Although successes have been achieved, organisational and historical cultural barriers continue to limit progress. Hospice culture can prohibit public health approaches to palliative care. However, related innovation is possible when clear values and stories are shared, champions are identified and professional assumptions are challenged. Sallnow L, Paul S. Understanding community engagement in end-of-life care: developing conceptual clarity. Crit Public Health 2015;25(2):231-8. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Trauma patient discharge and care transition experiences: Identifying opportunities for quality improvement in trauma centres.

PubMed

Gotlib Conn, Lesley; Zwaiman, Ashley; DasGupta, Tracey; Hales, Brigette; Watamaniuk, Aaron; Nathens, Avery B

2018-01-01

Challenges delivering quality care are especially salient during hospital discharge and care transitions. Severely injured patients discharged from a trauma centre will go either home, to rehabilitation or another acute care hospital with complex management needs. This purpose of this study was to explore the experiences of trauma patients and families treated in a regional academic trauma centre to better understand and improve their discharge and care transition experiences. A qualitative study using inductive thematic analysis was conducted between March and October 2016. Telephone interviews were conducted with trauma patients and/or a family member after discharge from the trauma centre. Data collection and analysis were completed inductively and iteratively consistent with a qualitative approach. Twenty-four interviews included 19 patients and 7 family members. Participants' experiences drew attention to discharge and transfer processes that either (1) Fostered quality discharge or (2) Impeded quality discharge. Fostering quality discharge was ward staff preparation efforts; establishing effective care continuity; and, adequate emotional support. Impeding discharge quality was perceived pressure to leave the hospital; imposed transfer decisions; and, sub-optimal communication and coordination around discharge. Patient-provider communication was viewed to be driven by system, rather than patient need. Inter-facility information gaps raised concern about receiving facilities' ability to care for injured patients. The quality of trauma patient discharge and transition experiences is undermined by system- and ward-level processes that compete, rather than align, in producing high quality patient-centred discharge. Local improvement solutions focused on modifiable factors within the trauma centre include patient-oriented discharge education and patient navigation; however, these approaches alone may be insufficient to enhance patient experiences. Trauma patients encounter complex barriers to quality discharge that likely require a comprehensive, multimodal intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hip joint centre position estimation using a dual unscented Kalman filter for computer-assisted orthopaedic surgery.

PubMed

Beretta, Elisa; De Momi, Elena; Camomilla, Valentina; Cereatti, Andrea; Cappozzo, Aurelio; Ferrigno, Giancarlo

2014-09-01

In computer-assisted knee surgery, the accuracy of the localization of the femur centre of rotation relative to the hip-bone (hip joint centre) is affected by the unavoidable and untracked pelvic movements because only the femoral pose is acquired during passive pivoting manoeuvres. We present a dual unscented Kalman filter algorithm that allows the estimation of the hip joint centre also using as input the position of a pelvic reference point that can be acquired with a skin marker placed on the hip, without increasing the invasiveness of the surgical procedure. A comparative assessment of the algorithm was carried out using data provided by in vitro experiments mimicking in vivo surgical conditions. Soft tissue artefacts were simulated and superimposed onto the position of a pelvic landmark. Femoral pivoting made of a sequence of star-like quasi-planar movements followed by a circumduction was performed. The dual unscented Kalman filter method proved to be less sensitive to pelvic displacements, which were shown to be larger during the manoeuvres in which the femur was more adducted. Comparable accuracy between all the analysed methods resulted for hip joint centre displacements smaller than 1 mm (error: 2.2 ± [0.2; 0.3] mm, median ± [inter-quartile range 25%; inter-quartile range 75%]) and between 1 and 6 mm (error: 4.8 ± [0.5; 0.8] mm) during planar movements. When the hip joint centre displacement exceeded 6 mm, the dual unscented Kalman filter proved to be more accurate than the other methods by 30% during multi-planar movements (error: 5.2 ± [1.2; 1] mm). © IMechE 2014.

Treatment referral system for tuberculosis patients in Dhaka, Bangladesh

PubMed Central

Hirayama, T.; Islam, A.; Ishikawa, N.; Afsana, K.

2015-01-01

Objective: To evaluate the referral system in an urban DOTS-based programme in Dhaka, Bangladesh, including the peri-urban area, and to identify opportunities to strengthen the system. Design: This was a retrospective cohort study in which diagnosed tuberculosis (TB) patients and health providers from DOTS centres were interviewed. Research tools included pre-tested structured questionnaires and the TB patients' referral records. Results: Of 4974 TB patients who were referred to the different treatment centres, only 1756 (35%) of the counterfoils of the referral slips were returned. Of 250 patients randomly selected for interview, 165 reported to a DOTS centre, 69 did not and 16 could not be traced. Variations in educational qualification, residence and the identification of DOTS centres after counselling were statistically significant (P < 0.05). Lower monthly income (RR = 7.84, RR = 5.03), distance from the centre (RR = 36.21) and those receiving treatment from pharmacies (RR = 3) or non-governmental organisations (RR = 28.48) have more risk of irregular treatment. Conclusion: A high proportion of referred patients were registered and initiated treatment, but many did not report to the referral treatment centre. Proper counselling and taking into account the patients' preferences during referral are essential to address access barriers to treatment adherence and improved treatment outcome. PMID:26767176

Making the most of person-centred education by integrating flipped and simulated teaching: An exploratory study.

PubMed

Saunders, Annette; Green, Rosy; Cross, Merylin

2017-11-01

Preparing a person-centred nursing workforce to work in diverse settings is a global health priority. Nursing students' first placement experience is a key transitional moment that shapes professional understanding and motivation to become a nurse. This paper reports the outcomes of combining flipped and simulated learning to enhance nursing students' understanding of person-centred care, the professional nursing role and preparation for placement. The study design was exploratory, the setting, an undergraduate nursing program in an Australian University. Participants included first year nursing students, academic tutors and clinical facilitators. Data collected via survey, semistructured interviews and focus group discussion were analysed descriptively and thematically. Over 90% of students surveyed considered the unit structure, content and resources prepared them well for placement. Pre-class preparation and simulated tutorial activities facilitated student engagement and knowledge translation. Students, tutors and clinical facilitators valued the person-centred approach. Tutors considered the unit materials and focus enhanced students' professional understanding. Clinical facilitators deemed students well-prepared for placement. These results from multiple perspectives, though limited, support combining the flipped classroom and person-centred simulation in nursing education as a strategy to prepare students for clinical placement, translate person-centred values into practice and promote professional understanding and role socialisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Persistence and diversification of the Holarctic shrew, Sorex tundrensis (Family Soricidae), in response to climate change

USGS Publications Warehouse

Hope, Andrew G.; Waltari, Eric; Fedorov, Vadim B.; Goropashnaya, Anna V.; Talbot, Sandra; Cook, Joseph A.

2011-01-01

Environmental processes govern demography, species movements, community turnover and diversification and yet in many respects these dynamics are still poorly understood at high latitudes. We investigate the combined effects of climate change and geography through time for a widespread Holarctic shrew, Sorex tundrensis. We include a comprehensive suite of closely related outgroup taxa and three independent loci to explore phylogeographic structure and historical demography. We then explore the implications of these findings for other members of boreal communities. The tundra shrew and its sister species, the Tien Shan shrew (Sorex asper), exhibit strong geographic population structure across Siberia and into Beringia illustrating local centres of endemism that correspond to Late Pleistocene refugia. Ecological niche predictions for both current and historical distributions indicate a model of persistence through time despite dramatic climate change. Species tree estimation under a coalescent process suggests that isolation between populations has been maintained across timeframes deeper than the periodicity of Pleistocene glacial cycling. That some species such as the tundra shrew have a history of persistence largely independent of changing climate, whereas other boreal species shifted their ranges in response to climate change, highlights the dynamic processes of community assembly at high latitudes.

Atomic-scale sensing of the magnetic dipolar field from single atoms

NASA Astrophysics Data System (ADS)

Choi, Taeyoung; Paul, William; Rolf-Pissarczyk, Steffen; MacDonald, Andrew J.; Natterer, Fabian D.; Yang, Kai; Willke, Philip; Lutz, Christopher P.; Heinrich, Andreas J.

2017-05-01

Spin resonance provides the high-energy resolution needed to determine biological and material structures by sensing weak magnetic interactions. In recent years, there have been notable achievements in detecting and coherently controlling individual atomic-scale spin centres for sensitive local magnetometry. However, positioning the spin sensor and characterizing spin-spin interactions with sub-nanometre precision have remained outstanding challenges. Here, we use individual Fe atoms as an electron spin resonance (ESR) sensor in a scanning tunnelling microscope to measure the magnetic field emanating from nearby spins with atomic-scale precision. On artificially built assemblies of magnetic atoms (Fe and Co) on a magnesium oxide surface, we measure that the interaction energy between the ESR sensor and an adatom shows an inverse-cube distance dependence (r-3.01±0.04). This demonstrates that the atoms are predominantly coupled by the magnetic dipole-dipole interaction, which, according to our observations, dominates for atom separations greater than 1 nm. This dipolar sensor can determine the magnetic moments of individual adatoms with high accuracy. The achieved atomic-scale spatial resolution in remote sensing of spins may ultimately allow the structural imaging of individual magnetic molecules, nanostructures and spin-labelled biomolecules.

Persistence and diversification of the Holarctic shrew, Sorex tundrensis (Family Soricidae), in response to climate change

USGS Publications Warehouse

Hope, Andrew G.; Waltari, Eric; Fedorov, V.B.; Goropashnaya, A.V.; Talbot, Sandra; Cook, Joseph A.

2014-01-01

Environmental processes govern demography, species movements, community turnover and diversification and yet in many respects these dynamics are still poorly understood at high latitudes. We investigate the combined effects of climate change and geography through time for a widespread Holarctic shrew, Sorex tundrensis. We include a comprehensive suite of closely related outgroup taxa and three independent loci to explore phylogeographic structure and historical demography. We then explore the implications of these findings for other members of boreal communities. The tundra shrew and its sister species, the Tien Shan shrew (Sorex asper), exhibit strong geographic population structure across Siberia and into Beringia illustrating local centres of endemism that correspond to Late Pleistocene refugia. Ecological niche predictions for both current and historical distributions indicate a model of persistence through time despite dramatic climate change. Species tree estimation under a coalescent process suggests that isolation between populations has been maintained across timeframes deeper than the periodicity of Pleistocene glacial cycling. That some species such as the tundra shrew have a history of persistence largely independent of changing climate, whereas other boreal species shifted their ranges in response to climate change, highlights the dynamic processes of community assembly at high latitudes.

Aspects of the owning/keeping and disposal of horses, and how these relate to equine health/welfare in Ireland

PubMed Central

2011-01-01

Background Ireland has long been renowned as a major centre for the breeding, rearing and keeping of horses. Since 2007, however, there has been increasing concern for horse health and welfare standards, and links between these concerns and the structures, governance and funding of the Irish equine industries have been reported. This paper addresses two central issues: firstly the local governance of, trade in and disposal of unwanted horses; and secondly mechanisms employed to improve standards of care given to horses owned by certain communities. Method Primary information was gathered through visits to horse pounds run by and on behalf of Local Authorities, to social horse projects, to horse dealer yards, ferry ports, horse slaughter plants and knackeries. Results The approach adopted by members of a given group, e.g. ferry ports, is described and differences are highlighted, for example in how different Local Authorities implement the Control of Horses Act of 1986, and how the choice, for example, of disposal route affects the standard of animal welfare. Conclusions There is a pressing need for a more centrally mandated and uniformly applied system of governance to safeguard the health and promote the keeping of horses to a higher welfare standard in Ireland. Fundamental to an understanding of why there is insufficient oversight of the keeping and proper disposal of horses is the lack of a comprehensive, integrated system for the registration, identification and tracing of equidae in Ireland. PMID:21936948

AIC-based diffraction stacking for local earthquake locations at the Sumatran Fault (Indonesia)

NASA Astrophysics Data System (ADS)

Hendriyana, Andri; Bauer, Klaus; Muksin, Umar; Weber, Michael

2018-05-01

We present a new workflow for the localization of seismic events which is based on a diffraction stacking approach. In order to address the effects from complex source radiation patterns, we suggest to compute diffraction stacking from a characteristic function (CF) instead of stacking the original waveform data. A new CF, which is called in the following mAIC (modified from Akaike Information Criterion) is proposed. We demonstrate that both P- and S-wave onsets can be detected accurately. To avoid cross-talk between P and S waves due to inaccurate velocity models, we separate the P and S waves from the mAIC function by making use of polarization attributes. Then, the final image function is represented by the largest eigenvalue as a result of the covariance analysis between P- and S-image functions. Results from synthetic experiments show that the proposed diffraction stacking provides reliable results. The workflow of the diffraction stacking method was finally applied to local earthquake data from Sumatra, Indonesia. Recordings from a temporary network of 42 stations deployed for nine months around the Tarutung pull-apart basin were analysed. The seismic event locations resulting from the diffraction stacking method align along a segment of the Sumatran Fault. A more complex distribution of seismicity is imaged within and around the Tarutung basin. Two lineaments striking N-S were found in the centre of the Tarutung basin which support independent results from structural geology.

Evaluating opinions, behaviours and motivations of the users of a MSW separate collection centre in the town of Baronissi, Southern Italy.

PubMed

De Feo, Giovanni; Polito, Anna Rita; Ferrara, Carmen; Zamballetti, Ivan

2017-10-01

This paper presents the results of a survey regarding customer satisfaction as well as other aspects relating to the frequency and motivations of citizens going to a separate collection centre (SCC) for recyclables in a Southern Italian town. The study was carried out in 2015 to verify whether there were significant changes in the behaviours and opinions of the SCC's users, who had been interviewed in 2013, in the light of the change of the local administration. The majority of the respondents (60.4%) coupled going to the SCC with other tasks, with 58.6% of them going to a supermarket. Therefore, future SCCs should localized near shopping centres (it would be preferable to have small and numerous SCCs). Chi-square and Fisher's exact tests showed how SCC's users of the town under study behaved as a community. The percentage of respondents that declared to 'agree' or 'strongly agree' with the idea that only putrescibles and residue could be collected at their home, with all the other materials being collected at the SCC, increased from 56.6%, in 2013, up to 59.0%, in 2015. The percentage of respondents that declared going to the SCC due to environmental motivations was unanimous. Moreover, the saving of money for the community became the second preferred option, with a significant improvement (from 65.6%, in 2013, up to 93.2%, in 2015). Therefore, the community's interests over the individual's were privileged. The SCC's users confirmed their attention to environmental issues even though the local administration changed. It is probable that this could be the result of maintaining high standard of service as well as a good job in terms of communication, continuous involvment of citizens and the adoption of good environmental practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Carer and service providers' experiences of individual funding models for children with a disability in rural and remote areas.

PubMed

Dew, Angela; Bulkeley, Kim; Veitch, Craig; Bundy, Anita; Lincoln, Michelle; Brentnall, Jennie; Gallego, Gisselle; Griffiths, Scott

2013-07-01

There is a global movement for people with a disability towards person-centred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding (IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas. © 2013 John Wiley & Sons Ltd.

Respiratory infection rates differ between geographically distant paediatric cystic fibrosis cohorts

PubMed Central

Hart, Emily; Turkovic, Lidija; Padros-Goossens, Marc; Stick, Stephen M.; Ranganathan, Sarath C.

2016-01-01

Respiratory infections are a major cause of pulmonary decline in children with cystic fibrosis (CF). We compared the prevalence of infection in early life at geographically distant CF treatment centres participating in the same surveillance programme in Australia. Lower airway microbiology, inflammation and structural lung disease at annual review were evaluated for 260 children 0–8 years old with CF at 1032 visits to CF treatment centres in Melbourne or Perth. Melbourne patients were more likely to be culture-positive for common respiratory pathogens at all age groups (odds ratio (OR) 1.85, 95% CI 1.33–2.58). Subjects <2 years old in Melbourne were also more likely to have neutrophil elastase present (OR 3.11, 95% CI 1.62–5.95). Bronchiectasis (OR 2.02, 95% CI 1.21–3.38) and air trapping (OR 2.53, 95% CI 1.42–4.51) in subjects 2–5 years old was more common in Melbourne subjects. The severity of structural lung disease was also worse in Melbourne patients >5 years old. Patients at both centres had a similar rate of hospitalisations and prescribed antibiotics. No procedural differences were identified that could explain the disparity between pathogen prevalence. Geographical differences in early acquisition of infection may contribute to variability in outcomes between CF centres. PMID:27957481

A person-centred segmentation study in elderly care: towards efficient demand-driven care.

PubMed

Eissens van der Laan, M R; van Offenbeek, M A G; Broekhuis, H; Slaets, J P J

2014-07-01

Providing patients with more person-centred care without increasing costs is a key challenge in healthcare. A relevant but often ignored hindrance to delivering person-centred care is that the current segmentation of the population and the associated organization of healthcare supply are based on diseases. A person-centred segmentation, i.e., based on persons' own experienced difficulties in fulfilling needs, is an elementary but often overlooked first step in developing efficient demand-driven care. This paper describes a person-centred segmentation study of elderly, a large and increasing target group confronted with heterogeneous and often interrelated difficulties in their functioning. In twenty-five diverse healthcare and welfare organizations as well as elderly associations in the Netherlands, data were collected on the difficulties in biopsychosocial functioning experienced by 2019 older adults. Data were collected between March 2010 and January 2011 and sampling took place based on their (temporarily) living conditions. Factor Mixture Model was conducted to categorize the respondents into segments with relatively similar experienced difficulties concerning their functioning. First, the analyses show that older adults can be empirically categorized into five meaningful segments: feeling vital; difficulties with psychosocial coping; physical and mobility complaints; difficulties experienced in multiple domains; and feeling extremely frail. The categorization seems robust as it was replicated in two population-based samples in the Netherlands. The segmentation's usefulness is discussed and illustrated through an evaluation of the alignment between a segment's unfulfilled biopsychosocial needs and current healthcare utilization. The set of person-centred segmentation variables provides healthcare providers the option to perform a more comprehensive first triage step than only a disease-based one. The outcomes of this first step could guide a focused and, therefore, more efficient second triage step. On a local or regional level, this person-centred segmentation provides input information to policymakers and care providers for the demand-driven allocation of resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Optimizing Data Centre Energy and Environmental Costs

NASA Astrophysics Data System (ADS)

Aikema, David Hendrik

Data centres use an estimated 2% of US electrical power which accounts for much of their total cost of ownership. This consumption continues to grow, further straining power grids attempting to integrate more renewable energy. This dissertation focuses on assessing and reducing data centre environmental and financial costs. Emissions of projects undertaken to lower the data centre environmental footprints can be assessed and the emission reduction projects compared using an ISO-14064-2-compliant greenhouse gas reduction protocol outlined herein. I was closely involved with the development of the protocol. Full lifecycle analysis and verifying that projects exceed business-as-usual expectations are addressed, and a test project is described. Consuming power when it is low cost or when renewable energy is available can be used to reduce the financial and environmental costs of computing. Adaptation based on the power price showed 10--50% potential savings in typical cases, and local renewable energy use could be increased by 10--80%. Allowing a fraction of high-priority tasks to proceed unimpeded still allows significant savings. Power grid operators use mechanisms called ancillary services to address variation and system failures, paying organizations to alter power consumption on request. By bidding to offer these services, data centres may be able to lower their energy costs while reducing their environmental impact. If providing contingency reserves which require only infrequent action, savings of up to 12% were seen in simulations. Greater power cost savings are possible for those ceding more control to the power grid operator. Coordinating multiple data centres adds overhead, and altering at which data centre requests are processed based on changes in the financial or environmental costs of power is likely to increase this overhead. Tests of virtual machine migrations showed that in some cases there was no visible increase in power use while in others power use rose by 20--30W. Estimates of how migration was likely to impact other services used in current cloud environments were derived.

Enhancing person-centred communication in NICU: a comparative thematic analysis.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2015-11-01

Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit. Family-centred care (FCC) is acknowledged as fundamental to supporting parents of premature infants, and communication is central to this practice. Accordingly, nurses need good communication skills. GFCC is an intervention developed to improve nurse-parent communication in the neonatal intensive care unit. This intervention helps nurses to realize person-centred communication as an approach to optimize contemporary practice. Our qualitative study had a descriptive and comparative design using semi-structured interviews to explore the parent's experience of GFCC. We conducted 10 dyad interviews with parents (n = 20) and two individual interviews with mothers of premature infants (n = 2). Parents in the intervention group versus SC group were 13 versus 9. Thematic analysis was applied. GFCC was generally experienced as supportive. Three interrelated themes were identified that illustrated how the intervention helped parents cope as persons, parents and couples: (a) discovering and expressing emotions, (b) reaching a deeper level of communication, and (c) obtaining mutual understanding. In contrast, SC communication was more superficial and less structured. Factors such as inaccessibility of nurses, inability to ask for assistance and parent popularity impaired successful communication. Our study suggested that compared to SC, GFCC provided structured delivery of supportive communication between nurses and parents of premature infants. The intervention promoted the discovery of the parents' individual preferences and concerns, which enabled more focused communication, and set the stage for better nurse-parent and parent-parent understanding. We recommend GFCC as a method to improve communication in the neonatal intensive care unit. © 2013 British Association of Critical Care Nurses.

Geomorphological map as a tool for visualisation of geodiversity - example from Cave Park Grabovaca (Croatia)

NASA Astrophysics Data System (ADS)

Buzjak, Nenad; Bocic, Neven; Pahernik, Mladen

2014-05-01

Cave Park Grabovaca is located near Perusic in Lika region (central Croatia). It was established in 2006 at the area of 5.95 km2 (protection category: significant landscape). The main task is management and protection of Samograd, Medina and Amidzina caves that were declared as geomorphological monuments, and 6 other caves located close to each other. Owing to the central geographic location in Croatian Dinaric karst area, good traffic connections between central Europe and tourist centres of the Adriatic coast, preserved nature and easy accessible karst features typical for the Dinaric Karst, it has good potential to develop as an research, educational and tourist centre. In 2013. Cave Park management and the Department of Geography (University of Zagreb, Faculty of Science) established a core team that started to develop the project of Geoeducational centre (GEC) with following goals: exploration-evaluation-presentation-education. According to the accepted strategy, the first step in the project process is to enlarge the area and change the protection category. During the consultation process team members take into account protection, environmental, local economy, tourism and local population issues and proposed that protected area should be increased to 52,2 km2. This enlargement provides more efficient protection, greater geodiversity and biodiversity by occupying geotope, biotope, and landscape units typical for the whole Lika karst region. The next step was inventorying, evaluation, analysis and visualisation of geological, geomorphological and speleological phenomena. This 2 year task was made in cooperation between Croatian Geomorphological Society, Department of Geography, Speleological Society Karlovac and Caving Club Samobor. The inventory was made using field-work mapping and geotagged photographs, cave mapping and DEM analysis. It resulted in GIS oriented geodatabase consisting of geomorphological forms, processes and cave inventory. From those data geomorphological map 1:25.000, morphometrical maps (hypsometrical, slope, relative relief) and speleological maps were produced. Cartographic model of the geomorphological map is defined by 5 groups: geological structure, morphogenetic, morphographic, morphometric and morpho-chronological data. The geodatabase and maps were used for preparing the study as a part of regulated legal procedure for protected area enlargement. It is also a plan to use it for karst and landscape geodiversity presentation and education. For that purpose general geomorphological map, with professional symbology understandable only to professionals, must be didactically transformed to media that is visually and contextually acceptable to wider non-professional audience.

Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali.

PubMed

Cavalli, Anna; Bamba, Sory I; Traore, Mamadou N; Boelaert, Marleen; Coulibaly, Youssouf; Polman, Katja; Pirard, Marjan; Van Dormael, Monique

2010-08-17

Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc.. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007. Campaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local health systems. The campaign budget barely financed institutional strengthening. Finally, though the initiative rested at least partially on national structures, pressures to absorb donated drugs and reach short-term coverage results contributed to distract energies away from other priorities, including overall health systems strengthening. Our study indicates that positive synergies between disease specific interventions and nontargeted health services are more likely to occur in robust health services and systems. Disease-specific interventions implemented as parallel activities in fragile health services may further weaken their responsiveness to community needs, especially when several GHIs operate simultaneously. Health system strengthening will not result from the sum of selective global interventions but requires a comprehensive approach.

Nickel-centred proton reduction catalysis in a model of [NiFe] hydrogenase

NASA Astrophysics Data System (ADS)

Brazzolotto, Deborah; Gennari, Marcello; Queyriaux, Nicolas; Simmons, Trevor R.; Pécaut, Jacques; Demeshko, Serhiy; Meyer, Franc; Orio, Maylis; Artero, Vincent; Duboc, Carole

2016-11-01

Hydrogen production through water splitting is one of the most promising solutions for the storage of renewable energy. [NiFe] hydrogenases are organometallic enzymes containing nickel and iron centres that catalyse hydrogen evolution with performances that rival those of platinum. These enzymes provide inspiration for the design of new molecular catalysts that do not require precious metals. However, all heterodinuclear NiFe models reported so far do not reproduce the Ni-centred reactivity found at the active site of [NiFe] hydrogenases. Here, we report a structural and functional NiFe mimic that displays reactivity at the Ni site. This is shown by the detection of two catalytic intermediates that reproduce structural and electronic features of the Ni-L and Ni-R states of the enzyme during catalytic turnover. Under electrocatalytic conditions, this mimic displays high rates for H2 evolution (second-order rate constant of 2.5 × 104 M-1 s-1 turnover frequency of 250 s-1 at 10 mM H+ concentration) from mildly acidic solutions.

Dynamics of prolonged salt movement in the Glückstadt Graben (NW Germany) driven by tectonic and sedimentary processes

NASA Astrophysics Data System (ADS)

Warsitzka, Michael; Kley, Jonas; Jähne-Klingberg, Fabian; Kukowski, Nina

2017-01-01

The formation of salt structures exerted a major influence on the evolution of subsidence and sedimentation patterns in the Glückstadt Graben, which is part of the Central European Basin System and comprises a post-Permian sediment thickness of up to 11 km. Driven by regional tectonics and differential loading, large salt diapirs, salt walls and salt pillows developed. The resulting salt flow significantly influenced sediment distribution in the peripheral sinks adjacent to the salt structures and overprinted the regional subsidence patterns. In this study, we investigate the geometric and temporal evolution of salt structures and subsidence patterns in the central Glückstadt Graben. Along a key geological cross section, the post-Permian strata were sequentially decompacted and restored in order to reconstruct the subsidence history of minibasins between the salt structures. The structural restoration reveals that subsidence of peripheral sinks and salt structure growth were initiated in Early to Middle Triassic time. From the Late Triassic to the Middle Jurassic, salt movement and salt structure growth never ceased, but were faster during periods of crustal extension. Following a phase from Late Jurassic to the end of the early Late Cretaceous, in which minor salt flow occurred, salt movement was renewed, particularly in the marginal parts of the Glückstadt Graben. Subsidence rates and tectonic subsidence derived from backstripping of 1D profiles reveal that especially the Early Triassic and Middle Keuper times were periods of regional extension. Three specific types of salt structures and adjacent peripheral sinks could be identified: (1) Graben centre salt walls possessing deep secondary peripheral sinks on the sides facing away from the basin centre, (2) platform salt walls, whose main peripheral sinks switched multiple times from one side of the salt wall to the other, and (3) Graben edge pillows, which show only one peripheral sink facing the basin centre.

Shaping Place Identity through Interaction on the Example of the European Solidarity Centre in Gdansk

NASA Astrophysics Data System (ADS)

Targowski, Wojciech; Piotr, Czyż

2017-10-01

The article presents process of shaping place identity on the example of an important for Pomerania region investment - European Solidarity Centre. The idea of a Solidarity social movement is strongly associated with the formation of post-socialist national identity of Poland as well as local identity of Pomerania, from which movement originates. The realization of the European Solidarity Centre aims to be one of the essential elements of shaping Gdańsk’s identity of space. The article is an attempt to analyse how the presence of realization gradually affects the formation of the place identity of new urban space. Analysis of this realization will allow on the one hand to verify design assumptions made by authors, on the other provides the opportunity to search for best description of still vague notion of local identity. This concept, though intuitively close to everyone still seems to elude conceptual apparatus of theory of architecture. The intention of this article is to explore the notion of identity based on the observations of the newly realized significant cultural space. This analysis approaches the concept of identity from two perspectives. The first approach draws from the concept of identity of Christian Norberg-Schulz. Here, local identity is seen as a unique set of characteristics of space. So seen the concept of place identity is a correlate of concept of personal identity. In this analysis, methods of description of personal identity were transferred to the identity of the place. In the second approach, the identity of place is understood as a unique for that place way of being in space, way to spend time and development of the site-specific urban rituals. Such a concept of identity, draws from the concept of place of Kim Dovey. Both presented approaches seems to complement each other but they also emphasize different qualities. The now-traditional concept of Genius Loci sees architecture as a structural system of meanings. Meaningful elements are seen here primarily from aesthetic perspective. As something we can see. In this perspective, the concept of place identity is seen as a static formation. This perfectly corresponds to design determinants of historical spaces associated with the concept of cultural heritage. In the authors’ opinion identity of the place is also built on the interactions that occur between users in space. The space in this approach becomes a catalyst for social contact. What is important for the user is the formation of identity through customs, rituals and urban traditions - that create new network of social connections. This concept of place recognizes dynamic nature of space identity - as a changeable formation which is continuously co-created. Such recognition can give better understanding of identity for specific design conditions, such as gradual formation of new urban spaces. It is so because this approach places emphasis on the processual nature of space identity - as in the case discussed in the article.

Evidence of a relational spatial strategy in learning the centre of enclosures in human children (Homo sapiens).

PubMed

Tommasi, Luca; Giuliano, Alda

2014-07-01

Three- to five-year-old children were trained to localize a sensor hidden underneath the floor, in the centre of a square-shaped enclosure (1.5m×1.5m). Walking over the sensor caused a pleasant music to be played in the environment, thus engaging children in a playful spatial search. Children easily learned to find the centre of the training environment starting from random positions. After training, children were tested in enclosures of different size and/or shape: a larger square-shaped enclosure (3m×3m), a rectangle-shaped enclosure (1.5m×3m), an equilateral triangle-shaped enclosure (side 3m) and an isosceles triangle-shaped enclosure (base 1.5m; sides 3m). Children searched in the central region of the enclosures, their precision varying as a function of the similarity of the testing enclosure's shape to the shape of the training enclosure. This suggests that a relational spatial strategy was used, and that it depended on the encoding of geometrical shape. This result highlights a distinctive role of the geometric centre of enclosed spaces in place learning in children, as already observed in nonhuman species. Copyright © 2014 Elsevier B.V. All rights reserved.

Evidence for involvement of Wnt signalling in body polarities, cell proliferation, and the neuro-sensory system in an adult ctenophore.

PubMed

Jager, Muriel; Dayraud, Cyrielle; Mialot, Antoine; Quéinnec, Eric; le Guyader, Hervé; Manuel, Michaël

2013-01-01

Signalling through the Wnt family of secreted proteins originated in a common metazoan ancestor and greatly influenced the evolution of animal body plans. In bilaterians, Wnt signalling plays multiple fundamental roles during embryonic development and in adult tissues, notably in axial patterning, neural development and stem cell regulation. Studies in various cnidarian species have particularly highlighted the evolutionarily conserved role of the Wnt/β-catenin pathway in specification and patterning of the primary embryonic axis. However in another key non-bilaterian phylum, Ctenophora, Wnts are not involved in early establishment of the body axis during embryogenesis. We analysed the expression in the adult of the ctenophore Pleurobrachia pileus of 11 orthologues of Wnt signalling genes including all ctenophore Wnt ligands and Fz receptors and several members of the intracellular β-catenin pathway machinery. All genes are strongly expressed around the mouth margin at the oral pole, evoking the Wnt oral centre of cnidarians. This observation is consistent with primary axis polarisation by the Wnts being a universal metazoan feature, secondarily lost in ctenophores during early development but retained in the adult. In addition, local expression of Wnt signalling genes was seen in various anatomical structures of the body including in the locomotory comb rows, where their complex deployment suggests control by the Wnts of local comb polarity. Other important contexts of Wnt involvement which probably evolved before the ctenophore/cnidarian/bilaterian split include proliferating stem cells and progenitors irrespective of cell types, and developing as well as differentiated neuro-sensory structures.

Steel Sheet Piles - Applications and Elementary Design Issues

NASA Astrophysics Data System (ADS)

Sobala, Dariusz; Rybak, Jarosław

2017-10-01

High-intensity housing having been carried out in town’s centres causes that many complex issues related to earthworks and foundations must be resolved. Project owners are required to ensure respective number of parking bays, which in turn demands 2-3 storeys of underground car parks. It is especially difficult to fulfil in dense buildings of old town areas where apart from engineering problems, very stringent requirements of heritage conservator supervision are also raised. The problems with ensuring stability of excavation sidewalls need to be, at the same time, dealt with analysis of foundations of neighbouring structures, and possible strengthening them at the stages of installing the excavation protection walls, progressing the excavations and constructing basement storeys. A separate problem refers to necessity of constructing underground storeys below the level of local groundwater. This requires long-term lowering of water table inside excavation while at possibly limited intervention in hydrological regime beyond the project in progress. In river valleys such “hoarding off” the excavation and cutting off groundwater leads to temporary or permanent disturbances of groundwater run-off and local swellings. Traditional way to protect vertical fault and simultaneously to cut-off groundwater inflow consists in application of steel sheet pilings. They enable to construct monolithic reinforced concrete structures of underground storeys thus ensuring both their tightness and high rigidity of foundation. Depending on situation, steel sheet pilings can be in retrieving or staying-in-place versions. This study deals with some selected aspects of engineering design and fabrication of sheet piling for deep excavations and underground parts of buildings.

Ardnamurchan 3D cone-sheet architecture explained by a single elongate magma chamber

PubMed Central

Burchardt, Steffi; Troll, Valentin R.; Mathieu, Lucie; Emeleus, Henry C.; Donaldson, Colin H.

2013-01-01

The Palaeogene Ardnamurchan central igneous complex, NW Scotland, was a defining place for the development of the classic concepts of cone-sheet and ring-dyke emplacement and has thus fundamentally influenced our thinking on subvolcanic structures. We have used the available structural information on Ardnamurchan to project the underlying three-dimensional (3D) cone-sheet structure. Here we show that a single elongate magma chamber likely acted as the source of the cone-sheet swarm(s) instead of the traditionally accepted model of three successive centres. This proposal is supported by the ridge-like morphology of the Ardnamurchan volcano and is consistent with the depth and elongation of the gravity anomaly underlying the peninsula. Our model challenges the traditional model of cone-sheet emplacement at Ardnamurchan that involves successive but independent centres in favour of a more dynamical one that involves a single, but elongate and progressively evolving magma chamber system. PMID:24100542

Solar Coronal Loop Dynamics Near the Null Point Above Active Region NOAA 2666

NASA Astrophysics Data System (ADS)

Filippov, B.

2018-06-01

We analyse observations of a saddle-like structure in the corona above the western limb of the Sun on 2017 July 18. The structure was clearly outlined by coronal loops with typical coronal temperature no more than 1 MK. The dynamics of loops showed convergence towards the centre of the saddle in the vertical direction and divergence in the horizontal direction. The event is a clear example of smooth coronal magnetic field reconnection. No heating manifestations in the reconnection region or magnetically connected areas were observed. Potential magnetic field calculations, which use as the boundary condition the SDO/HMI magnetogram taken on July 14, showed the presence of a null point at the height of 122 arcsec above the photosphere just at the centre of the saddle structure. The shape of field lines fits the fan-spine magnetic configuration above NOAA 2666.

Ardnamurchan 3D cone-sheet architecture explained by a single elongate magma chamber.

PubMed

Burchardt, Steffi; Troll, Valentin R; Mathieu, Lucie; Emeleus, Henry C; Donaldson, Colin H

2013-10-08

The Palaeogene Ardnamurchan central igneous complex, NW Scotland, was a defining place for the development of the classic concepts of cone-sheet and ring-dyke emplacement and has thus fundamentally influenced our thinking on subvolcanic structures. We have used the available structural information on Ardnamurchan to project the underlying three-dimensional (3D) cone-sheet structure. Here we show that a single elongate magma chamber likely acted as the source of the cone-sheet swarm(s) instead of the traditionally accepted model of three successive centres. This proposal is supported by the ridge-like morphology of the Ardnamurchan volcano and is consistent with the depth and elongation of the gravity anomaly underlying the peninsula. Our model challenges the traditional model of cone-sheet emplacement at Ardnamurchan that involves successive but independent centres in favour of a more dynamical one that involves a single, but elongate and progressively evolving magma chamber system.

Integrating TRENCADIS components in gLite to share DICOM medical images and structured reports.

PubMed

Blanquer, Ignacio; Hernández, Vicente; Salavert, José; Segrelles, Damià

2010-01-01

The problem of sharing medical information among different centres has been tackled by many projects. Several of them target the specific problem of sharing DICOM images and structured reports (DICOM-SR), such as the TRENCADIS project. In this paper we propose sharing and organizing DICOM data and DICOM-SR metadata benefiting from the existent deployed Grid infrastructures compliant with gLite such as EGEE or the Spanish NGI. These infrastructures contribute with a large amount of storage resources for creating knowledge databases and also provide metadata storage resources (such as AMGA) to semantically organize reports in a tree-structure. First, in this paper, we present the extension of TRENCADIS architecture to use gLite components (LFC, AMGA, SE) on the shake of increasing interoperability. Using the metadata from DICOM-SR, and maintaining its tree structure, enables federating different but compatible diagnostic structures and simplifies the definition of complex queries. This article describes how to do this in AMGA and it shows an approach to efficiently code radiology reports to enable the multi-centre federation of data resources.

Broad-scale latitudinal variation in female reproductive success contributes to the maintenance of a geographic range boundary in bagworms (Lepidoptera: Psychidae).

PubMed

Rhainds, Marc; Fagan, William F

2010-11-30

Geographic range limits and the factors structuring them are of great interest to biologists, in part because of concerns about how global change may shift range boundaries. However, scientists lack strong mechanistic understanding of the factors that set geographic range limits in empirical systems, especially in animals. Across dozens of populations spread over six degrees of latitude in the American Midwest, female mating success of the evergreen bagworm Thyridopteryx ephemeraeformis (Lepidoptera: Psychidae) declines from ∼100% to ∼0% near the edge of the species range. When coupled with additional latitudinal declines in fecundity and in egg and pupal survivorship, a spatial gradient of bagworm reproductive success emerges. This gradient is associated with a progressive decline in local abundance and an increased risk of local population extinction, up to a latitudinal threshold where extremely low female fitness meshes spatially with the species' geographic range boundary. The reduction in fitness of female bagworms near the geographic range limit, which concords with the abundant centre hypothesis from biogeography, provides a concrete, empirical example of how an Allee effect (increased pre-reproductive mortality of females in sparsely populated areas) may interact with other demographic factors to induce a geographic range limit.

The Operational Role of the Belgian User Support and Operations Centre for the Atmosphere-Space Interactions Monitor (ASIM) on-board the International Space Station.

NASA Astrophysics Data System (ADS)

Muller, C.; Moreau, D., Sr.; Pandey, P. K.; Crosby, N. B.

2014-12-01

The Belgian User Support and Operations Centre (B.USOC) is an operational centre managing technological and scientific payloads on the International Space Station (ISS). B.USOC is the Facility Responsible Centre (FRC) for the European Space Agency's (ESA) Atmosphere-Space Interactions Monitor (ASIM) payload and also manages the Scientific Mission Centre of the Centre National d'Etudes Spatiales (CNES) PICARD satellite that monitors solar activity, among various other space missions. In this respect, B.USOC is ideally positioned to manage possible synergies between ASIM, the satellite TARANIS (Tool for the Analysis of RAdiation from lightNIng and Sprites), other space missions and ground-based networks. The ASIM mission (Neubert, 2009) consists of a package of two nadir instruments: one for the visible spectrum and another for X-ray and gamma-ray frequencies. In the normal operating mode "trigger mode" both instruments continuously measure, but, do not record data below certain thresholds. Another mode is a "timed mode", where, during a certain time the observations are recorded even in the absence of triggers. The "timed mode" demands a lot of flexibility from both scientific teams and B.USOC, as, ASIM's main targets of investigation (sprites and elves) are related to intense thunderstorms and thus, require reliable meteorological forecasts in the entire range of ISS latitudes. Moreover, ASIM is sensitive to a large number of phenomena of which most have a direct relationship with solar activity and therefore would probably need support from the ESA SSA (Space Situational Awareness) Space Weather Coordination Centre (SSCC) that shares the same campus with B.USOC. Local cooperation between the two centres, together with other space payloads such as TARANIS and ground-based networks will greatly optimize ASIM payload operations as well as scientific return. Neubert, T., and the ASIM Team, ASIM - an Instrument Suite for the International Space Station, Corte Workshop 2008, Coupling of Thunderstorms and Lightning Discharges to Near-Earth, Corsica, 2008, edited by N. B. Crosby et al, American Institute of Physics, 978-0-7354-0657-5/09/, 2009.

Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study.

PubMed

Lee, Kun Yun; Ong, Tiong Kiam; Low, Ee Vien; Liow, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng Bang; Ali, Rosli Mohd; Ismail, Omar; Ahmad, Wan Azman Wan; Said, Mas Ayu; Dahlui, Maznah

2017-05-28

Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations. Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Distance to invasive heart centre, performance of acute coronary angiography, and angioplasty and associated outcome in out-of-hospital cardiac arrest: a nationwide study.

PubMed

Tranberg, Tinne; Lippert, Freddy K; Christensen, Erika F; Stengaard, Carsten; Hjort, Jakob; Lassen, Jens Flensted; Petersen, Frants; Jensen, Jan Skov; Bäck, Caroline; Jensen, Lisette Okkels; Ravkilde, Jan; Bøtker, Hans Erik; Terkelsen, Christian Juhl

2017-06-01

To evaluate whether the distance from the site of event to an invasive heart centre, acute coronary angiography (CAG)/percutaneous coronary intervention (PCI) and hospital-level of care (invasive heart centre vs. local hospital) is associated with survival in out-of-hospital cardiac arrest (OHCA) patients. Nationwide historical follow-up study of 41 186 unselected OHCA patients, in whom resuscitation was attempted between 2001 and 2013, identified through the Danish Cardiac Arrest Registry. We observed an increase in the proportion of patients receiving bystander CPR (18% in 2001, 60% in 2013, P < 0.001), achieving return of spontaneous circulation (ROSC) (10% in 2001, 29% in 2013, P < 0.001) and being admitted directly to an invasive centre (26% in 2001, 45% in 2013, P < 0.001). Simultaneously, 30-day survival rose from 5% in 2001 to 12% in 2013, P < 0.001. Among patients achieving ROSC, a larger proportion underwent acute CAG/PCI (5% in 2001, 27% in 2013, P < 0.001). The proportion of patients undergoing acute CAG/PCI annually in each region was defined as the CAG/PCI index. The following variables were associated with lower mortality in multivariable analyses: direct admission to invasive heart centre (HR 0.91, 95% CI: 0.89-0.93), CAG/PCI index (HR 0.33, 95% CI: 0.25-0.45), population density above 2000 per square kilometre (HR 0.94, 95% CI: 0.89-0.98), bystander CPR (HR 0.97, 95% CI: 0.95-0.99) and witnessed OHCA (HR 0.87, 95% CI: 0.85-0.89), whereas distance to the nearest invasive centre was not associated with survival. Admission to an invasive heart centre and regional performance of acute CAG/PCI were associated with improved survival in OHCA patients, whereas distance to the invasive centre was not. These results support a centralized strategy for immediate post-resuscitation care in OHCA patients. © The Author 2017. Published on behalf of the European Society of Cardiology.

The modernizing bias of human rights: stories of mass killings and genocide in Central America.

PubMed

Ekern, Stener

2010-01-01

This article analyses selected cases of mass killings and genocide during the civil wars in El Salvador and Guatemala in the 1980s and the way in which the truth commissions in both countries reframed locally grounded narratives to fit the state-centred language of human rights. Redefining wrongdoings as human rights violations produces stories that communicate poorly with local worldviews because the 'truths' that human rights language proposes disregard local realities and transform local conflicts into a type of 'modern', nationwide struggles. Thus, while the concept of genocide might capture well the horrendous nature of a mass killing, it will also ethnify the conflict. Comparisons between local readings and human rights-based reinterpretations reveal a 'modernizing' or 'Westernizing' bias of international law; the article argues for more awareness about such effects in analysis as well as in policy-making.

Prospective multi-centre Voxel Based Morphometry study employing scanner specific segmentations: Procedure development using CaliBrain structural MRI data

PubMed Central

2009-01-01

Background Structural Magnetic Resonance Imaging (sMRI) of the brain is employed in the assessment of a wide range of neuropsychiatric disorders. In order to improve statistical power in such studies it is desirable to pool scanning resources from multiple centres. The CaliBrain project was designed to provide for an assessment of scanner differences at three centres in Scotland, and to assess the practicality of pooling scans from multiple-centres. Methods We scanned healthy subjects twice on each of the 3 scanners in the CaliBrain project with T1-weighted sequences. The tissue classifier supplied within the Statistical Parametric Mapping (SPM5) application was used to map the grey and white tissue for each scan. We were thus able to assess within scanner variability and between scanner differences. We have sought to correct for between scanner differences by adjusting the probability mappings of tissue occupancy (tissue priors) used in SPM5 for tissue classification. The adjustment procedure resulted in separate sets of tissue priors being developed for each scanner and we refer to these as scanner specific priors. Results Voxel Based Morphometry (VBM) analyses and metric tests indicated that the use of scanner specific priors reduced tissue classification differences between scanners. However, the metric results also demonstrated that the between scanner differences were not reduced to the level of within scanner variability, the ideal for scanner harmonisation. Conclusion Our results indicate the development of scanner specific priors for SPM can assist in pooling of scan resources from different research centres. This can facilitate improvements in the statistical power of quantitative brain imaging studies. PMID:19445668

Structure of the Ni(II) complex of Escherichia coli peptide deformylase and suggestions on deformylase activities depending on different metal(II) centres.

PubMed

Yen, Ngo Thi Hai; Bogdanović, Xenia; Palm, Gottfried J; Kühl, Olaf; Hinrichs, Winfried

2010-02-01

Crystal structures of polypeptide deformylase (PDF) of Escherichia coli with nickel(II) replacing the native iron(II) have been solved with chloride and formate as metal ligands. The chloro complex is a model for the correct protonation state of the hydrolytic hydroxo ligand and the protonated status of the Glu133 side chain as part of the hydrolytic mechanism. The ambiguity that recently some PDFs have been identified with Zn(2+) ion as the active-site centre whereas others are only active with Fe(2+) (or Co(2+), Ni(2+) is discussed with respect to Lewis acid criteria of the metal ion and substrate activation by the CD loop.

Cold chain status at immunisation centres in Ethiopia.

PubMed

Berhane, Y; Demissie, M

2000-09-01

Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling. To assess the status of the cold chain at peripheral vaccine stores in Ethiopia. Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four. Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms. Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37 (57.8%) of the centres. Thermometer was not available in four (6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain. There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended.

Using multilevel models for assessing the variability of multinational resource use and cost data.

PubMed

Grieve, Richard; Nixon, Richard; Thompson, Simon G; Normand, Charles

2005-02-01

Multinational economic evaluations often calculate a single measure of cost-effectiveness using cost data pooled across several countries. To assess the validity of pooling international cost data the reasons for cost variation across countries need to be assessed. Previously, ordinary least-squares (OLS) regression models have been used to identify factors associated with variability in resource use and total costs. However, multilevel models (MLMs), which accommodate the hierarchical structure of the data, may be more appropriate. This paper compares these different techniques using a multinational dataset comprising case-mix, resource use and cost data on 1300 stroke admissions from 13 centres in 11 European countries. OLS and MLMs were used to estimate the effect of patient and centre-level covariates on the total length of hospital stay (LOS) and total cost. MLMs with normal and gamma distributions for the data within centres were compared. The results from the OLS model showed that both patient and centre-level covariates were associated with LOS and total cost. The estimates from the MLMs showed that none of the centre-level characteristics were associated with LOS, and the level of spending on health was the centre-level variable most highly associated with total cost. We conclude that using OLS models for assessing international variation can lead to incorrect inferences, and that MLMs are more appropriate for assessing why resource use and costs vary across centres. Copyright (c) 2004 John Wiley & Sons, Ltd.

Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study.

PubMed

Bourgouin, S; Goudard, Y; Montcriol, A; Bordes, J; Nau, A; Balandraud, P

2017-10-01

Local anaesthesia (LA) has proven effective for inguinal hernia repair in developed countries. Hernias in low to middle income countries represent a different issue. The aim of this study was to analyse the feasibility of LA for African hernia repairs in a limited resource environment. Data from patients who underwent herniorrhaphy under LA or spinal anaesthesia (SA) by the 6th and 7th Forward Surgical Team were prospectively collected. All of the patients benefited from a transversus abdominis plane (TAP) block for postoperative analgesia. Primary endpoints concerned the pain response and conversion to general anaesthesia. Secondary endpoints concerned the complication and recurrence rates. Predictors of LA failure were then identified. In all, 189 inguinal hernias were operated during the study period, and 119 patients fulfilled the inclusion criteria: 57 LA and 62 SA. Forty-eight percent of patients presented with inguinoscrotal hernias. Local anaesthesia led to more pain during surgery and necessitated more administration of analgesics but resulted in fewer micturition difficulties and better postoperative pain control. Conversion rates were not different. Inguinoscrotal hernia and a time interval <50 min between the TAP block and skin incision were predictors of LA failure. Forty-four patients were followed-up at one month. No recurrence was noted. Local anaesthesia is a safe alternative to SA. Small or medium hernias can easily be performed under LA in rural centres, but inguinoscrotal hernias required an ultrasound-guided TAP block performed 50 min before surgery to achieve optimal analgesia, and should be managed only in centres equipped with ultrasonography.

A systematic review of instruments for assessing parent satisfaction with family-centred care in neonatal intensive care units.

PubMed

Dall'Oglio, Immacolata; Mascolo, Rachele; Gawronski, Orsola; Tiozzo, Emanuela; Portanova, Anna; Ragni, Angela; Alvaro, Rosaria; Rocco, Gennaro; Latour, Jos M

2018-03-01

This systematic review synthesised and described instruments measuring parent satisfaction with the increasing standard practice of family-centred care (FCC) in neonatal intensive care units. We evaluated 11 studies published from January 2006 to March 2016: two studies validated a parent satisfaction questionnaire, and nine developed or modified previous questionnaires to use as outcome measures in their local settings. Most instruments were not tested on reliability and validity. Only two validated instruments included all six of the FCC principles and could assess parent satisfaction with FCC in neonatal intensive care units and be considered as outcome indicators for further research. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Pleural procedures and patient safety: a national BTS audit of practice.

PubMed

Hooper, Clare E; Welham, Sally A; Maskell, Nick A

2015-02-01

The BTS pleural procedures audit collected data over a 2-month period in June and July 2011. In contrast with the 2010 audit, which focussed simply on chest drain insertions, data on all pleural aspirations and local anaesthetic thoracoscopy (LAT) was also collected. Ninety hospitals submitted data, covering a patient population of 33 million. Twenty-one per cent of centres ran a specialist pleural disease clinic, 71% had a nominated chest drain safety lead, and 20% had thoracic surgery on site. Additionally, one-third of centres had a physician-led LAT service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.