Barriers of evidence based policy making in iran's health system

La formation des sociétés fondées sur la connaissance, le progrès de la technologie de communications et un meilleur échange d'informations au niveau mondial permet une meilleure utilisation des connaissances produites lors des décisions prises dans le système de santé. Dans des pays en voie de développement, quelques études sont menées sur des obstacles qui empêchent la prise des décisions fondées sur des preuves (PDFDP) alors que des études similaires dans le monde développé sont vraiment rares. L'Iran est le pays qui a connu la plus forte croissance dans les publications scientifiques au cours de ces dernières années, mais la question qui se pose est la suivante : quels sont les obstacles qui empêchent l'utilisation de ces connaissances de même que celle des données mondiales? Cette étude embrasse trois articles consécutifs. Le but du premier article a été de trouver un modèle pour évaluer l'état de l'utilisation des connaissances dans ces circonstances en Iran à l’aide d'un examen vaste et systématique des sources suivie par une étude qualitative basée sur la méthode de la Grounded Theory. Ensuite au cours du deuxième et troisième article, les obstacles aux décisions fondées sur des preuves en Iran, sont étudiés en interrogeant les directeurs, les décideurs du secteur de la santé et les chercheurs qui travaillent à produire des preuves scientifiques pour la PDFDP en Iran. Après avoir examiné les modèles disponibles existants et la réalisation d'une étude qualitative, le premier article est sorti sous le titre de «Conception d'un modèle d'application des connaissances». Ce premier article sert de cadre pour les deux autres articles qui évaluent les obstacles à «pull» et «push» pour des PDFDP dans le pays. En Iran, en tant que pays en développement, les problèmes se situent dans toutes les étapes du processus de production, de partage et d’utilisation de la preuve dans la prise de décision du système de santé. Les obstacles qui existent à la prise de décision fondée sur des preuves sont divers et cela aux différents niveaux; les solutions multi-dimensionnelles sont nécessaires pour renforcer l'impact de preuves scientifiques sur les prises de décision. Ces solutions devraient entraîner des changements dans la culture et le milieu de la prise de décision afin de valoriser la prise de décisions fondées sur des preuves. Les critères de sélection des gestionnaires et leur nomination inappropriée ainsi que leurs remplaçants rapides et les différences de paiement dans les secteurs public et privé peuvent affaiblir la PDFDP de deux façons : d’une part en influant sur la motivation des décideurs et d'autre part en détruisant la continuité du programme. De même, tandis que la sélection et le remplacement des chercheurs n'est pas comme ceux des gestionnaires, il n'y a aucun critère pour encourager ces deux groupes à soutenir le processus décisionnel fondés sur des preuves dans le secteur de la santé et les changements ultérieurs. La sélection et la promotion des décideurs politiques devraient être basées sur leur performance en matière de la PDFDP et les efforts des universitaires doivent être comptés lors de leurs promotions personnelles et celles du rang de leur institution. Les attitudes et les capacités des décideurs et des chercheurs devraient être encouragés en leur donnant assez de pouvoir et d’habiliter dans les différentes étapes du cycle de décision. Cette étude a révélé que les gestionnaires n'ont pas suffisamment accès à la fois aux preuves nationales et internationales. Réduire l’écart qui sépare les chercheurs des décideurs est une étape cruciale qui doit être réalisée en favorisant la communication réciproque. Cette question est très importante étant donné que l'utilisation des connaissances ne peut être renforcée que par l'étroite collaboration entre les décideurs politiques et le secteur de la recherche. Dans ce but des programmes à long terme doivent être conçus ; la création des réseaux de chercheurs et de décideurs pour le choix du sujet de recherche, le classement des priorités, et le fait de renforcer la confiance réciproque entre les chercheurs et les décideurs politiques semblent être efficace.

Choosing the Lesser of Two Evils: Explaining Multinational Banking Groups’ Push for Supranational Oversight in the EU

European Union Series

Optical and Thermal Properties of Diethyl-(2R, 3R) (1)-tartrate Based Chiral Polyurethanes with Main Chain Amido Chromophores

The toluene diisocyanate based optically active chiral polyurethanes were synthesized according to the symmetry conditions. The noncentrosymmetric (both charge asymmetry and spatial asymmetry) environment were attained by the incorporation of the chiral units (diethyl-(2R,3R)(þ)-tartrate) and donor-acceptor building blocks in the main chain which induce a helical conformation in the macromolecular chain. A series of optically active polyurethanes containing chiral linkages in the polymer back bone have been synthesized by using DBTDL catalyst by incorporating the amido diols which were obtained by the aminolysis of e-caprolactone by using the diamines, diaminoethane, diaminobutane, and diaminohexane respectively. The effect of incorporation of the chiral molecule diethyl-(2R,3R)(þ)-tartrate on the properties of polyurethanes was studied by changing the chromophores and also by varying the chiral-chromophore composition. Various properties of polyurethanes were investigated by UV, Fluorescence, TG/DTA, XRD, polarimetric techniques, Kurtz-Perry powder techniques, etc.

Synthesis and Properties of Polyurethanes of Hexamethylene Di-Isocyanate with Multifunctional Chromophores in the Main Chain

Various polyurethanes containing photoactive bis(azo) and bis(o-nitrobenzyl) groups in the main chain were synthesized by polyaddition reactions of diols such as bis(4-hydroxyphenylazo)-2,20-dinitrodiphenylmethane, 4-hydroxy-3-methylphenylazo- 40-hydroxyphenylazo-2,20-dinitrodiphenylmethane and bis(4-hydroxy-3- methylphenylazo)-2,20-dinitrodiphenylmethane with hexamethylene di-isocyanate (HMDI), in dimethyl acetamide (DMAc) in the presence of di-n-butyltin dilaurate (DBTDL) as catalyst. All of them were characterized by IR, UV-vis, 1H NMR and 13C NMR spectra and also by thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and gel permeation chromatography (GPC).

Push button parliament–why India needs a non-partisan, recorded vote system

Decisions of national importance are made by Parliamentary voting. Yet Indian Members of Parliament (MPs) vote with a remarkable lack of freedom and accountability. The introduction of the Tenth Schedule in the Constitution has crippled free expression, since it provides that MPs voting against ‘any direction’ of their Party are liable to disqualification from the legislature  In addition, except for Constitutional amendments, Indian Parliamentary Procedure Rules do not require votes of MPs to be recorded unless the Speaker’s decision is contested in the House. The result is that voting in the House has become mechanical, controlled by Party politics and devoid of responsibility. This paper comments on a general theory of democratic accountability through the lens of Parliamentary voting. It suggests that the voting system adopted in the Parliament is an effective indicator to measure the level of accountability of its Members. In the context of India, this paper argues that the level of accountability will increase to a desirable extent only when there is adoption of a recorded system for every important House vote. Upon examination of India’s record thus far (through the sample of the 14th Lok Sabha) it becomes evident that the level of divisions (recorded votes) is substantially lower than other countries. This leads the paper to probe, as to why that might be the case. Part II of the paper answers that question by examining the Tenth Schedule of the Constitution. The paper scrutinizes the disproportionate influence of the Party in decision making in the Parliament. Apart from dealing with the inherent problem of the Tenth Schedule, this paper suggests two procedural changes to make parliamentary expression more meaningful. Firstly, the recording of all important votes within the Parliament and secondly, registering Party whips with the Minister of Parliamentary Affairs so that the voter knows the clear stand of every Parliamentary continuum. The focus of the paper is thus to bring back the attention of the legislators to their central function, which is deliberation on and the passage of legislation.

The powerful pull of brain images. 'El enorme poder de atracción de las imágenes cerebrales'.

Resumen basado en el de la publicación

Mixed ligand binuclear copper(I) complexes containing (Cu2N8)-N-I chromophores. Observation of emissions from MLCT excited states involving two different ligands

Using the 1:2 condensate (L) of diethylenetriamine and benzaldehyde as the main ligand, binuclear copper(l) complexes [Cu2L2(4,4'-bipyridine)](CIO4)(2).0.5H(2)O (1a) and [Cu2L2(1,2-bis(4-pyridyl)ethane)](CIO4)(2) (1b) are synthesised. The two metal ions in la are bridged by 4,4'-bipyridine and those in 1b by 1,2-bis(4-pyridyl)ethane, From the X-ray crystal structure of la, each metal ion is found to be bound to three N atoms of L and one of the two N atoms of the bridging ligand in a distorted tetrahedral fashion. The Cu(I)-N bond lengths in la lie in the range of 1.998(5)-2.229(6) Angstrom. Electrochemical studies in dichloromethane (DCM) show that the (Cu2N8)-N-I moieties in la and 1b are composed of two essentially non-interacting (CuN4)-N-I cores with Cu-II/I potential of 0.44 V vs. SCE. While la displays metal induced quenching of the inherent emission of 4,4'-bipyridine in DCM solution, 1b exhibits two weak emission bands in DCM solution at 425 and 477 nm (total quantum yield = 3.59 x 10(-5)) originating from MLCT excited states. With the help of Extended Huckel calculations it is established that the higher energy emission in 1b is from Cu(I) --> bridging-ligand charge transfer excited state and the lower energy one in 1b from Cu(I) --> L charge transfer excited state.

Advances in upper limb stroke rehabilitation: a technology push

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. Visual cues can also be used to control the information sent to the patient about exercise performance and to potentially address psychosomatic variables influencing therapy. This paper overviews the current state-of-the-art on upper limb robot-mediated therapy with a focal point on the technical requirements of robotic therapy devices leading to the development of upper limb rehabilitation techniques that facilitate reach-to-touch, fine motor control, whole-arm movements and promote rehabilitation beyond hospital stay. The reviewed literature suggest that while there is evidence supporting the use of this technology to reduce functional impairment, besides the technological push, the challenge ahead lies on provision of effective assessment of outcome and modalities that have a stronger impact transferring functional gains into functional independence.

Effect of media polarity on the photoisomerisation of substituted stilbene, azobenzene and imine chromophores

The influence of substituents and media polarity on the photoinducedE→Z geometrical isomerisation of the stilbene, azobenzene and N-benzylideneaniline chromophores has been compared and assessed. The efficiency of the process in all three systems is markedly dependent on the presence and characteristics of electron-donor and electron-acceptor substituents at the 4- and 4′-positions. The results are discussed in terms of relaxation of the E-excited singlet state. In the absence of a nitro substituent, relaxation to the S1 orthogonal state competes effectively with non-productive intramolecular electron transfer; in the presence of a nitro substituent, the T1 orthogonal state is formed from inter-system crossing. For systems with a 4-nitro and a 4′-electron-donor substituent, access to the triplet state is inhibited by polar solvents promoting formation of the inactive charge-transfer state from the S1 state, and no isomerisation is observed. Similar effects are observed in both solution and polymer films. Such variations in behaviour have important implications for the utilisation of the chromophores in nonlinear optical phenomena including photorefractivity.

Modeling image motion in airborne Three-Line-Array (TLA) push-broom cameras

This paper presents an image motion model for airborne three-line-array (TLA) push-broom cameras. Both aircraft velocity and attitude instability are taken into account in modeling image motion. Effects of aircraft pitch, roll, and yaw on image motion are analyzed based on geometric relations in designated coordinate systems. The image motion is mathematically modeled by image motion velocity multiplied by exposure time. Quantitative analysis to image motion velocity is then conducted in simulation experiments. The results have shown that image motion caused by aircraft velocity is space invariant while image motion caused by aircraft attitude instability is more complicated. Pitch,roll and yaw all contribute to image motion to different extents. Pitch dominates the along-track image motion and both roll and yaw greatly contribute to the cross-track image motion. These results provide a valuable base for image motion compensation to ensure high accuracy imagery in aerial photogrammetry.

Evaluation of positioning error-induced pixel shifts on satellite linear push-broom imagery

Georeferencing is one of the major tasks of satellite-borne remote sensing. Compared to traditional indirect methods, direct georeferencing through a Global Positioning System/inertial navigation system requires fewer and simpler steps to obtain exterior orientation parameters of remotely sensed images. However, the pixel shift caused by geographic positioning error, which is generally derived from boresight angle as well as terrain topography variation, can have a great impact on the precision of georeferencing. The distribution of pixel shifts introduced by the positioning error on a satellite linear push-broom image is quantitatively analyzed. We use the variation of the object space coordinate to simulate different kinds of positioning errors and terrain topography. Then a total differential method was applied to establish a rigorous sensor model in order to mathematically obtain the relationship between pixel shift and positioning error. Finally, two simulation experiments are conducted using the imaging parameters of Chang’ E-1 satellite to evaluate two different kinds of positioning errors. The experimental results have shown that with the experimental parameters, the maximum pixel shift could reach 1.74 pixels. The proposed approach can be extended to a generic application for imaging error modeling in remote sensing with terrain variation.

Bank regulation and the process of internationalisation: a study of Japanese bank entry into London

The paper provides a theoretical insight into bank regulation and the process of internationalisation by examining the concepts of regulatory push and market pull within the context of Japanese bank entry into London during the 1980s. Rugman and Verbeke's [(1998). Corporate strategy and international environmental policy. Journal of International Business Studies, 29(4), 819–833] Consistency of Home and Host Government Goals model is utilised to structure the discussion, which centres on a situation where there is a conflict of goals between multinational enterprises (MNEs) and the home government but goal alignment between MNEs and the host government. As such the paper examines a relatively under-researched aspect of internationalisation and concludes that in certain circumstances internationalisation can occur despite great ‘psychic distance’. The paper also argues that although bank regulation can lead to a conflict situation it can also be conducive to the development of a strong home base and the development of firm specific advantages.

Effect of light-curing units on push-out fiber post bond strength in root canal dentin

The purpose of this study was to evaluate the effectiveness of different light-curing units on the bond strength (push-out) of glass fiber posts in the different thirds of the root (cervical, middle and apical) with different adhesive luting resin systems (dual-cure total-etch; dual-cured and self-etch bonding system; and dual-cure self-adhesive cements), Disks of the samples (n = 144) were used, with approximately 1 mm of thickness of 48 bovine roots restored with glass fiber posts, that were luted with resin cements photo-activated by halogen LCU (QTH, Optilux 501) and blue LED (Ultraled), with power densities of 600 and 550 mW/cm(2), respectively. A universal testing machine (MTS 810 Material Test System) was used with a 1 mm diameter steel rod at cross-head speed of 0.5 mm/min until post extrusion, with load cell of 50 kg, for evaluation of the push-out strength in the different thirds of each sample. The push-out strength values in kgf were converted to MPa and analyzed through Analysis of Variance and Tukey`s test, at significance level of 5%. The results showed that there were no statistical differences between the QTH and LED LCUs. The self-adhesive resin cement had lower values of retention. The total-etch and self-adhesive system resin cements seem to be a possible alternative for glass fiber posts cementation into the radicular canal and the LED LCU can be applied as an alternative to halogen light on photo-activation of dual-cured resin cements.